Archive for January 28, 2016

CMV in the gut: a critical review of CMV detection in the immunocompetent host with colitis

European J of Clinical Microb & Infec Dis January 2015 V.34 N.1 P.13-18

  1. L. Goodman , C. D. Murray, J. Watkins, P. D. Griffiths, D. P. Webster
  2. Department of Infection and Immunity, University College London, Cruciform Building, Gower Street, London, WC1E 6BT, UK
  3. Department of Gastroenterology, Royal Free London NHS Foundation Trust, London, NW3 2QG, UK
  4. Department of Cellular Pathology, Royal Free London NHS Foundation Trust, London, NW3 2QG, UK
  5. Centre for Virology, University College London Medical School, Rowland Hill Street, London, NW3 2PF, UK

Abstract

As scientific techniques for the detection of cytomegalovirus (CMV) improve, we are able to detect small amounts of CMV in the mucosal wall. As clinicians, we are unsure how to interpret the results of this novel test. There is controversy in the literature as to the significance of the detection of CMV in the gut. Whilst the importance of CMV and reactivation of the virus is clear in those patients such as allograft recipients with established immune compromise, the role is less clear in patients with less damaged immune systems. We explore whether the detection of CMV in such cases influences outcome and how it should be optimally managed. We discuss the optimal management of such cases, according to current guidelines, with a review of the literature.

abstract

http://link.springer.com/article/10.1007/s10096-014-2212-x

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January 28, 2016 at 2:33 pm

Epidemiology, clinical history and microbiology of peritonsillar abscess

European J of Clinical Microb & Infec Dis March 2015 V.34 N.3 P.549-554

Mazur , E. CzerwińskaAffiliated, I. Korona-Głowniak, A. Grochowalska, M. Kozioł-Montewka

Medical Microbiology Department, Medical University of Lublin, ul. Chodźki 1, 20-093, Lublin, Poland

Department of Otolaryngology, Regional Specialist Hospital in Radom, ul. Aleksandrowicza 5, 26-617, Radom, Poland

Department of Pharmaceutical Microbiology, Medical University of Lublin, ul. Chodźki 1, 20-093, Lublin, Poland

Microbiological Laboratory, Regional Specialist Hospital in Radom, ul. Aleksandrowicza 5, 26-617, Radom, Poland

Abstract

The purpose of this investigation was to explore the epidemiology, clinical history and microbiology of peritonsillar abscess (PTA). A retrospective review of PTA cases treated at the Department of Otolaryngology, Regional Specialist Hospital in Radom, Poland between 1st October 2003 and 30th September 2013 was undertaken. A total of 111 PTA patients were admitted. The study population consisted of 57.7 % males and 42.3 % females, with an average age of 31.0 (range 5–78) years. Smokers comprised 22.0 % of the study group. The seasonal variation of PTA was statistically insignificant (p = 0.45). Recurrent tonsillitis occurred in 35.5 % of patients. In comparison with the rest of the study population, patients with a history of recurrent pharyngotonsillitis had higher incidence of previous PTA episodes [odds ratio (OR) 17.8, 95 % confidence interval (CI) 2.1–148.7, p = 0.001]. Also, they were more frequently treated with antibiotics prior to hospitalisation (OR 4.6, 95 % CI 2.0–10.9, p = 0.0005) and had significantly longer hospital stay (p = 0.03). Bacterial cultures of abscess aspirates were performed in 40.5 % of patients. Monomicrobial growth was detected in 77.8 % of aerobic cultures. Streptococcus pyogenes, growing most frequently in monoculture, was found in 28.9 % of aerobic cultures. PTA patients with and without recurrent pharyngotonsillitis differed with regard to clinical history and course of disease. The percentage of smokers among PTA patients was lower than that described in the literature. Monomicrobial growth predominated in PTA aspirate cultures. S. pyogenes proved to be the most frequent pathogen.

abstract

http://link.springer.com/article/10.1007/s10096-014-2260-2

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January 28, 2016 at 2:32 pm

Empirical antibiotic therapy for pneumonia in intensive care units: a multicentre, retrospective analysis of potentially pathogenic microorganisms identified by endotracheal aspirates cultures

Europ J of Clinical Microb & Infec Dis Nov 2015 V.34 N.11 P.2295-2305

B. J. Scholte , H. L. Duong, C. Linssen, H. Van Dessel, D. Bergmans, R. van der Horst, P. Savelkoul

Department of Medical Microbiology, Maastricht University Medical Centre+

Zentrum für Intensivmedizin, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland

Department of Intensive Care Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands

Department of Medical Microbiology, Zuyderland Medical Centre, Heerlen, The Netherlands

Department of Medical Microbiology, Maastricht University Medical Centre+, Maastricht, The Netherlands

Department of Pulmonary Medicine and Intensive Care Medicine, Zuyderland Medical Centre, Heerlen, The Netherlands

Abstract

The purpose of this investigation was to explore the presumed relationship between the days of hospitalisation and microorganisms identified by endotracheal aspirate cultures in relation to adequate empirical treatment strategies of pneumonia in the intensive care unit (ICU). All potentially pathogenic microorganisms identified by (surveillance) cultures of endotracheal aspirates obtained in the ICUs of two Dutch teaching hospitals in 2007 and 2012 were retrospectively collected and analysed. Antibiotic susceptibilities to 11 antibiotics were calculated for several time points (days or weeks) after hospital admission and expressed per patient-day. In total, 4184 potentially pathogenic microorganisms identified in 782 patients were analysed. Prevalence of the classic early-onset pneumonia-causing microorganisms decreased from 55 % on the first four days to 34 % on days 4–6 after hospital admission (p < 0.0001). Susceptibility to amoxicillin/clavulanic acid was below 70 % on all days. Except for days 0 and 12, susceptibility to ceftriaxone was below 80 %. The overall susceptibility to piperacillin/tazobactam was 1518/1973 (77 %) in 2007 vs. 727/1008 (67 %) in 2012 (p < 0.0001). After day 8 of hospital admission, susceptibility to piperacillin/tazobactam therapy was below 80 % in 2012. After one week of hospital admission, susceptibilities to antibiotics were lower in the hospital that included that antibiotic in the local empirical treatment protocols as compared to the hospitals in which that antibiotic was not or infrequently included: 90/434 (21 %) vs. 117/398 (29 %); p = 0.004 for amoxicillin/clavulanic acid and 203/433 (47 %) vs. 253/398 (64 %); p < 0.001 for ceftriaxone. No cut-off in the number of days after hospital admission could be identified to distinguish early-onset from late-onset pneumonia. Consequently, the choice of empirical antibiotics should probably not be based on the time of onset.

abstract

http://link.springer.com/article/10.1007/s10096-015-2482-y

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January 28, 2016 at 2:30 pm


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