Archive for November 18, 2014

Propionibacterium acnes: an underestimated pathogen in implant-associated infections.

Biomed Res Int. 2013;2013:804391.

Portillo ME1, Corvec S, Borens O, Trampuz A.

Author information

1Microbiology Laboratory, Laboratori de Referencia de Catalunya, Barcelona, Spain.

Abstract

The role of Propionibacterium acnes in acne and in a wide range of inflammatory diseases is well established. However, P. acnes is also responsible for infections involving implants.

Prolonged aerobic and anaerobic agar cultures for 14 days and broth cultures increase the detection rate.

In this paper, we review the pathogenic role of P. acnes in implant-associated infections such as prosthetic joints, cardiac devices, breast implants, intraocular lenses, neurosurgical devices, and spine implants.

The management of severe infections caused by P. acnes involves a combination of antimicrobial and surgical treatment (often removal of the device). Intravenous penicillin G and ceftriaxone are the first choice for serious infections, with vancomycin and daptomycin as alternatives, and amoxicillin, rifampicin, clindamycin, tetracycline, and levofloxacin for oral treatment.

Sonication of explanted prosthetic material improves the diagnosis of implant-associated infections.

Molecular methods may further increase the sensitivity of P. acnes detection.

Coating of implants with antimicrobial substances could avoid or limit colonization of the surface and thereby reduce the risk of biofilm formation during severe infections.

Our understanding of the role of P. acnes in human diseases will likely continue to increase as new associations and pathogenic mechanisms are discovered.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3838805/pdf/BMRI2013-804391.pdf

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November 18, 2014 at 8:17 am

Impact of Repeated Vaccination on Vaccine Effectiveness Against Influenza A(H3N2) and B During 8 Seasons

Clinical Infectious Diseases November 15, 2014 V.59 N.10 P.1375-1385

Huong Q. McLean1, Mark G. Thompson2, Maria E. Sundaram1, Jennifer K. Meece3, David L. McClure1, Thomas C. Friedrich4,5, and Edward A. Belongia1

1Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, Wisconsin

2Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia

3Integrated Research and Development Laboratory, Marshfield Clinic Research Foundation

4Department of Pathobiological Sciences, University of Wisconsin School of Veterinary Medicine,

5Wisconsin National Primate Research Center, Madison

Correspondence: Huong Q. McLean, PhD, MPH, Marshfield Clinic Research Foundation (ML2), 1000 N Oak Ave, Marshfield, WI 54449 (mclean.huong@marshfieldclinic.org).

Background.

Recent studies suggest that influenza vaccination in the previous season may influence the effectiveness of current-season vaccination, but this has not been assessed in a single population over multiple years.

Methods.

Patients presenting with acute respiratory illness were prospectively enrolled during the 2004–2005 through 2012–2013 influenza seasons. Respiratory swabs were tested for influenza and vaccination dates obtained from a validated registry. Vaccination status was determined for the current, previous, and prior 5 seasons. Vaccine effectiveness (VE) was calculated for participants aged ≥9 years using logistic regression models with an interaction term for vaccination history.

Results.

There were 7315 enrollments during 8 seasons; 1056 (14%) and 650 (9%) were positive for influenza A(H3N2) and B, respectively. Vaccination during current only, previous only, or both seasons yielded similar protection against H3N2 (adjusted VE range, 31%–36%) and B (52%–66%). In the analysis using 5 years of historical vaccination data, current season VE against H3N2 was significantly higher among vaccinated individuals with no prior vaccination history (65%; 95% confidence interval [CI], 36%–80%) compared with vaccinated individuals with a frequent vaccination history (24%; 95% CI, 3%–41%; P = .01). VE against B was 75% (95% CI, 50%–87%) and 48% (95% CI, 29%–62%), respectively (P = .05). Similar findings were observed when analysis was restricted to adults 18–49 years.

Conclusions.

Current- and previous-season vaccination generated similar levels of protection, and vaccine-induced protection was greatest for individuals not vaccinated during the prior 5 years. Additional studies are needed to understand the long-term effects of annual vaccination.

PDF

http://cid.oxfordjournals.org/content/59/10/1375.full.pdf+html

November 18, 2014 at 8:11 am


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