Archive for December 7, 2014

Hepatitis C Virus Maintains Infectivity for Weeks After Drying on Inanimate Surfaces at Room Temperature: Implications for Risks of Transmission

Journal of Infectious Diseases April 15, 2014 V.209 N.8 P.1205-1211

Elijah Paintsil1, Mawuena Binka2, Amisha Patel2, Brett D. Lindenbach3 and Robert Heimer2

1Departments of Pediatrics and Pharmacology, Yale School of Medicine

2Department of the Epidemiology of Microbial Diseases, Yale School of Public Health

3Microbial Pathogenesis, Yale School of Medicine, New Haven, Connecticut

Correspondence: Elijah Paintsil, MD, Departments of Pediatrics and Pharmacology, Yale School of Medicine, 464 Congress Avenue, New Haven, Connecticut 06520, USA (elijah.paintsil@yale.edu).

Abstract

Background

Healthcare workers may come into contact with fomites that contain infectious hepatitis C virus (HCV) during preparation of plasma or following placement or removal of venous lines. Similarly, injection drugs users may come into contact with fomites. Hypothesizing that prolonged viability of HCV in fomites may contribute significantly to incidence, we determined the longevity of virus infectivity and the effectiveness of antiseptics.

Methods

We determined the volume of drops misplaced during transfer of serum or plasma. Aliquots equivalent to the maximum drop volume of plasma spiked with the 2a HCV reporter virus were loaded into 24-well plates. Plates were stored uncovered at 3 temperatures: 4°C, 22°C, and 37°C for up to 6 weeks before viral infectivity was determined in a microculture assay.

Results

The mean volume of an accidental drop was 29 µL (min–max of 20–33 µL). At storage temperatures 4°C and 22°C, we recovered viable HCV from the low-titer spots for up to 6 weeks of storage. The rank order of HCV virucidal activity of commonly used antiseptics was bleach (1:10) > cavicide (1:10) > ethanol (70%).

Conclusions

The hypothesis of potential transmission from fomites was supported by the experimental results. The anti-HCV activity of commercial antiseptics varied.

PDF

http://jid.oxfordjournals.org/content/209/8/1205.full.pdf+html

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December 7, 2014 at 7:02 pm

Bad Bugs Need Old Drugs: A Stewardship Program’s Evaluation of Minocycline for Multidrug-Resistant Acinetobacter baumannii Infections

Clinical Infectious Diseases November 15, 2014 V.59 N.10 S381-S387

Debra A. Goff1, Karri A. Bauer1, and Julie E. Mangino2,3

1Department of Pharmacy

2Division of Infectious Diseases, Department of Internal Medicine

3Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center

Correspondence: Debra A. Goff, PharmD, FCCP, Specialty Practice Pharmacist Infectious Diseases, The Ohio State University Wexner Medical Center, Department of Pharmacy, 410 West 10th Ave, Rm 368 Doan Hall, Columbus, OH 43210 (debbie.goff@osumc.edu).

Background.

Minocycline is an “old-drug” with Food and Drug Administration approval for the treatment of infection due to Acinetobacter species. The purpose of this study is to describe an Antimicrobial Stewardship Program’s evaluation of minocycline for the treatment of patients with multidrug resistant A. baumannii (MDR-AB) infections.

Methods.

This study evaluated hospitalized adult patients (September 2010 through March 2013) who received minocycline intravenously (IV) for a MDR-AB infection. Clinical and microbiological outcomes were analyzed. Secondary outcomes included infection-related mortality, length of hospital stay (LOS), infection-related LOS, intensive care unit (ICU) LOS, mechanical ventilation days, and 30-day readmission.

Results.

A total of 55 patients received minocycline. Median age was 56 (23–85) years, 65% were male with an APACHE II score of 21 (4–41). Clinical success was achieved in 40/55 (73%) patients treated with minocycline monotherapy (n = 3) or in combination with a second active agent (n = 52). Overall 43 (78%) patients demonstrated documented or presumed microbiologic eradication. Infection-related mortality was 25%. Hospital LOS was 31 (5–132) and infection-related LOS was 16 (2–43) days. Forty-seven (85%) patients were admitted to the ICU for a LOS of 18 (2–78) days. Thirty-nine (71%) patients required mechanical ventilation for 6 (2–29) days. One patient had a 30-day readmission.

Conclusions.

The response rate to minocycline monotherapy or in combination for the treatment of MDR-AB infections is encouraging as therapeutic options are limited. Prospective studies in patients with MDR-AB infections will help establish the role of minocycline alone or in combination with other antimicrobials.

PDF

http://cid.oxfordjournals.org/content/59/suppl_6/S381.full.pdf+html

 

December 7, 2014 at 6:59 pm

A Review of Intravenous Minocycline for Treatment of Multidrug-Resistant Acinetobacter Infections

Clinical Infectious Diseases December 1, 2014 V.59 suppl 6  S374-S380

David J. Ritchie1,2 and Alexandria Garavaglia-Wilson2,3

1Department of Pharmacy, Barnes-Jewish Hospital

2Pharmacy Practice Department, St Louis College of Pharmacy

3Infectious Diseases Clinic, Washington University School of Medicine, St Louis, Missouri

Correspondence: David J. Ritchie, PharmD, FCCP, BCPS, Barnes-Jewish Hospital and St. Louis College of Pharmacy, Mailstop 90-52-411, 216 S Kingshighway Blvd, St Louis, MO 63110 (dritchie@stlcop.edu).

Options for treatment of multidrug-resistant (MDR) Acinetobacter baumannii infections are extremely limited.

Minocycline intravenous is active against many MDR strains of Acinetobacter, and Clinical and Laboratory Standards Institute breakpoints exist to guide interpretation of minocycline susceptibility results with Acinetobacter.

In addition, minocycline intravenous holds a US Food and Drug Administration indication for treatment of infections caused by Acinetobacter.

There is an accumulating amount of literature reporting successful use of minocycline intravenous for treatment of serious MDR Acinetobacter infections, particularly for nosocomial pneumonia.

These results, coupled with the generally favorable tolerability of minocycline intravenous, support its use as a viable therapeutic option for treatment of MDR Acinetobacter infections.

PDF

http://cid.oxfordjournals.org/content/59/suppl_6/S374.full.pdf+html

December 7, 2014 at 6:57 pm


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