Archive for January 6, 2014

Clinical aspects and self-reported symptoms of sequelae of Yersinia enterocolitica infections in a population-based study, Germany 2009-2010.

BMC Infect Dis. 2013 May 23;13:236.

Rosner BM, Werber D, Höhle M, Stark K.



Foodborne Yersinia enterocolitica infections continue to be a public health problem in many countries. Consumption of raw or undercooked pork is the main risk factor for yersiniosis in Germany. Small children are most frequently affected by yersiniosis. In older children and young adults, symptoms of disease may resemble those of appendicitis and may lead to hospitalization and potentially unnecessary appendectomies. Y. enterocolitica infections may also cause sequelae such as reactive arthritis (ReA), erythema nodosum (EN), and conjunctivitis.


We studied clinical aspects of yersiniosis, antimicrobial use, and self-reported occurrence of appendectomies, reactive arthritis, erythema nodosum and conjunctivitis. To assess post-infectious sequelae participants of a large population-based case-control study on laboratory-confirmed Y. enterocolitica infections conducted in Germany in 2009-2010 were followed for 4 weeks.


Diarrhea occurred most frequently in children ≤4 years (95%); abdominal pain in the lower right quadrant was most common in children 5-14 years of age (63%). Twenty-seven per cent of patients were hospitalized, 37% were treated with antimicrobials. In 6% of yersiniosis patients ≥5 years of age, appendectomies were performed. Self-reported symptoms consistent with ReA were reported by 12% of yersiniosis patients compared to 5% in a reference group not exposed to yersiniosis. Symptoms consistent with EN were reported by 3% of yersiniosis patients compared to 0.1% in the reference group. Symptoms of conjunctivitis occurred with the same frequency in yersiniosis patients and the reference group.


Acute Y. enterocolitica infections cause considerable burden of illness with symptoms lasting for about 10 days and hospitalizations in more than a quarter of patients. The proportion of yersiniosis patients treated with antimicrobial drugs appears to be relatively high despite guidelines recommending their use only in severe cases. Appendectomies and post-infectious complications (ReA and EN) are more frequently reported in yersiniosis patients than in the reference group suggesting that they can be attributed to infections with Y. enterocolitica. Physicians should keep recent Y. enterocolitica infection in mind in patients with symptoms resembling appendicitis as well as in patients with symptoms of unclear arthritis.


January 6, 2014 at 8:51 am

The growing resistance of Klebsiella pneumoniae; the need to expand our antibiogram: case report and review of the literature.

Afr J Infect Dis. 2013;7(1):8-10.

Garbati MA1, Al Godhair AI2.


Carbapenemases are being increasingly reported in Enterobacteriaceae including Klebsiella pneumoniae causing considerable increases in morbidity and mortality with limited therapeutic options.

Issues related to difficulties associated with pathogen identification and infection control have been identified as major obstacles to the control of these multi-drug resistant organisms. Identification of this enzyme in organisms not previously found to harbor them has added to the already existing challenge in the control of this growing problem.

The case of a 60 year-old Saudi lady with diabetes, hypertension, pituitary adenoma, hypothyroidism, and obstructive sleep apnea who was admitted in our intensive care unit following a cardiac arrest is hereby presented. During the course of her treatment she acquired various infections that led to her exposure to antimicrobials from almost all classes at various times; including bacteremia due to a pan-drug resistant Klebsiella pneumoniae and multi-drug resistant Acinetobacter baumannii. She was successfully treated with a combination of colistin and amikacin.

This case highlights the resurgence of colistin in clinical practice and also calls for the need to expand our antibiogram to include antibiotics not conventionally reported, especially in areas where drug resistance is a growing problem.

Improving susceptibility detection methods for Klebsiella pneumoniae and hand hygiene could prove effective in reducing nosocomial infections. Involvement of clinical pharmacists in antimicrobial stewardship could reduce the development of antimicrobial drug resistance.


January 6, 2014 at 8:48 am

Aedes aegypti from temperate regions of South America are highly competent to transmit dengue virus.

BMC Infect Dis. 2013 Dec 28;13(1):610. [Epub ahead of print]

Lourenço-de-Oliveira R, Rua AV, Vezzani D, Willat G, Vazeille M, Mousson L, Failloux AB.



Aedes aegypti is extensively spread throughout South America where it has been responsible for large dengue epidemics during the last decades. Intriguingly, dengue transmission has not been reported in Uruguay and is essentially prevalent in subtropical northern Argentina which borders Uruguay.


We assessed vector competence for dengue virus (DENV) of Ae. aegypti populations collected in subtropical Argentina (Corrientes) as well as temperate Uruguay (Salto) and Argentina (Buenos Aires) in 2012 using experimental oral infections with DENV-2. Mosquitoes were incubated at 28[degree sign]C and examined at 14 and 21 days p.i. to access viral dissemination and transmission. Batches of the Buenos Aires mosquitoes were also incubated at 15[degree sign]C and 20[degree sign]C.


Although mosquitoes from temperate Uruguay and Argentina were competent to transmit DENV, those from subtropical Argentina were more susceptible, displaying the highest virus titters in the head and presenting the highest dissemination of infection and transmission efficiency rates when incubated at 28[degree sign]C. Interestingly, infectious viral particles could be detected in saliva of mosquitoes from Buenos Aires exposed to 15[degree sign]C and 20[degree sign]C.


There is a potential risk of establishing DENV transmission in Uruguay and for the spread of dengue outbreaks to other parts of subtropical and temperate Argentina, notably during spring and summer periods.


January 6, 2014 at 8:45 am


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