Posts filed under ‘REPORTS’

Recent advances in understanding Epstein-Barr virus.

F1000Res. 2017 Mar 29;6:386.

Stanfield BA1, Luftig MA1.

Author information

1 Department of Molecular Genetics and Microbiology, Duke Center for Virology, Duke University Medical Center, Durham, NC, USA.

Abstract

Epstein-Barr virus (EBV) is a common human herpes virus known to infect the majority of the world population.

Infection with EBV is often asymptomatic but can manifest in a range of pathologies from infectious mononucleosis to severe cancers of epithelial and lymphocytic origin. Indeed, in the past decade, EBV has been linked to nearly 10% of all gastric cancers.

Furthermore, recent advances in high-throughput next-generation sequencing and the development of humanized mice, which effectively model EBV pathogenesis, have led to a wealth of knowledge pertaining to strain variation and host-pathogen interaction.

This review highlights some recent advances in our understanding of EBV biology, focusing on new findings on the early events of infection, the role EBV plays in gastric cancer, new strain variation, and humanized mouse models of EBV infection.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5373418/pdf/f1000research-6-11413.pdf

July 25, 2017 at 7:50 pm

Infectious Mononucleosis.

Curr Top Microbiol Immunol. 2015;390(Pt 1):211-40.

Dunmire SK1, Hogquist KA2, Balfour HH3.

Author information

1 Center for Immunology, University of Minnesota, Minneapolis, MN, 55455, USA. dunmi002@umn.edu.

2 Center for Immunology, University of Minnesota, Minneapolis, MN, 55455, USA. hogqu001@umn.edu.

3 Department of Laboratory Medicine and Pathology, Department of Pediatrics, University of Minnesota, University of Minnesota Medical School, Minneapolis, MN, 55455, USA. balfo001@umn.edu.

Abstract

Infectious mononucleosis is a clinical entity characterized by sore throat, cervical lymph node enlargement, fatigue, and fever most often seen in adolescents and young adults and lasting several weeks.

It can be caused by a number of pathogens, but this chapter only discusses infectious mononucleosis due to primary Epstein-Barr virus (EBV) infection. EBV is a γ-herpesvirus that infects at least 90% of the population worldwide.

The virus is spread by intimate oral contact among teenagers and young adults. How preadolescents acquire the virus is not known.

A typical clinical picture with a positive heterophile test is usually sufficient to make the diagnosis, but heterophile antibodies are not specific and do not develop in some patients. EBV-specific antibody profiles are the best choice for staging EBV infection.

In addition to causing acute illness, there can also be long-term consequences as the result of acquisition of the virus.

Several EBV-related illnesses occur including certain cancers and autoimmune diseases, as well as complications of primary immunodeficiency in persons with the certain genetic mutations.

A major obstacle to understanding these sequelae has been the lack of an efficient animal model for EBV infection, although progress in primate and mouse models has recently been made. Key future challenges are to develop protective vaccines and effective treatment regimens.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4670567/pdf/nihms741628.pdf

July 25, 2017 at 7:48 pm

Timing of preoperative antibiotic prophylaxis in 54,552 patients and the risk of surgical site infection: A systematic review and meta-analysis

Medicine July 2017 V.96 N.29 P.e6903

de Jonge, Stijn Willem MDa; Gans, Sarah L. MD, PhDa; Atema, Jasper J. MD, PhDa; Solomkin, Joseph S. MDb; Dellinger, Patchen E. MDc; Boermeester, Marja A. MD, PhDa,*

Abstract

The aim of the study was to assess the effect of timing of preoperative surgical antibiotic prophylaxis (SAP) on surgical site infection (SSI) and compare the different timing intervals.

The benefit of routine use of SAP prior to surgery has long been recognized. However, the optimal timing has not been defined. For the purpose of developing recommendations for the World Health Organization guideline for SSI prevention, a systematic review and meta-analysis of all relevant evidence was conducted.

Major medical databases were searched from 1990 to 2016. The primary outcome was SSI after preoperative-SAP comparing different timing intervals. Adjusted odds ratios (OR) with 95% confidence intervals (CI) were extracted and pooled for each comparison with a random effects model.

Fourteen papers with 54,552 patients were included in this review. In a quantitative analysis, there was no significant difference when SAP was administered 120–60 minutes prior to incision compared to administration 60–0 minutes prior to incision. Studies investigating different timing intervals within the last 60 minutes time frame reported contradictive results. The risk of SSI almost doubled when SAP was administered after first incision (OR:1.89; 95%CI:[1.05–3.40]) and was 5 times higher when administered more than 120 minutes prior to incision (OR5.26; 95%CI:[3.29–8.39]).

Administration of antibiotic prophylaxis more than 120 minutes before incision or after incision is associated a higher risk of surgical site infections than administration less than 120 minutes before incision. Within this 120-minute time frame prior to incision, no differential effects could be identified. The broadly accepted recommendation to administer prophylaxis within a 60-minute time frame prior to incision could not be substantiated.

FULL TEXT

http://journals.lww.com/md-journal/Fulltext/2017/07210/Timing_of_preoperative_antibiotic_prophylaxis_in.1.aspx

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July 22, 2017 at 10:01 am

The Active Component of Aspirin, Salicylic Acid, Promotes Staphylococcus aureus Biofilm Formation in a PIA-dependent Manner

Front. Microbiol. 23 January 2017   

Cristian Dotto1, Andrea Lombarte Serrat1, Natalia Cattelan2, María S. Barbagelata1†, Osvaldo M. Yantorno2, Daniel O. Sordelli1, Monika Ehling-Schulz3, Tom Grunert3 and Fernanda R. Buzzola1*

1 Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Instituto de Investigaciones en Microbiología y Parasitología Médica, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina

2 Facultad de Ciencias Exactas, Centro de Investigación y Desarrollo de Fermentaciones Industriales (CINDEFI), Centro Científico Technológico Consejo Nacional de Investigaciones Científicas y Tócnicas (CTT CONICET La Plata), Universidad Nacional de La Plata, La Plata, Argentina

3 Functional Microbiology, Institute for Microbiology, University of Veterinary Medicine, Vienna, Austria

Aspirin has provided clear benefits to human health. But salicylic acid (SAL) -the main aspirin biometabolite- exerts several effects on eukaryote and prokaryote cells. SAL can affect, for instance, the expression of Staphylococcus aureus virulence factors.

SAL can also form complexes with iron cations and it has been shown that different iron chelating molecules diminished the formation of S. aureus biofilm. The aim of this study was to elucidate whether the iron content limitation caused by SAL can modify the S. aureus metabolism and/or metabolic regulators thus changing the expression of the main polysaccharides involved in biofilm formation.

The exposure of biofilm to 2 mM SAL induced a 27% reduction in the intracellular free Fe2+ concentration compared with the controls. In addition, SAL depleted 23% of the available free Fe2+ cation in culture media. These moderate iron-limited conditions promoted …

FULL TEXT

https://doi.org/10.3389/fmicb.2017.00004

 

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July 19, 2017 at 6:53 pm

Leptospirosis. Puesta al día

Rev. Chil. infectol. Junio 2007 V.24 N.3 P.220-226

Enna Zunino M. y Rolando Pizarro P.

Hospital Dr. Lucio Córdova Santiago, Chile

Resumen

Se revisan los aspectos clínicos, diagnóstico de laboratorio y alternativas terapéuticas para la leptospirosis.

Destaca en la epidemiología el riesgo ocupacional y laboral y la falta de datos, por no haber constituido en Chile tema de vigilancia epidemiológica hasta el año 2000.

Los datos clínicos evidencian una notable heterogeneidad de manifestaciones, muchas veces inespecíficas. La complejidad del diagnóstico diferencial que plantea hace necesario incluirlo en el análisis causal de múltiples situaciones clínicas.

El diagnóstico de laboratorio es aún complejo y poco accesible. Aunque es todavía controvertido, el análisis de la literatura apoya el beneficio del tratamiento antimicrobiano con varias alternativas de elección.

PDF

http://www.scielo.cl/pdf/rci/v24n3/art08.pdf

July 17, 2017 at 8:30 am

Oseltamivir Use Among Children and Adults Hospitalized With Community-Acquired Pneumonia.

Open Forum Infect Dis. Dec. 27, 2016 V.4 N.1

Oboho IK1,2, Bramley A1, Finelli L1, Fry A1, Ampofo K3, Arnold SR4,5, Self WH6, Williams DJ6, Courtney DM7, Zhu Y6, Anderson EJ8, Grijalva CG6, McCullers JA4,5, Wunderink RG7, Pavia AT3, Edwards KM6, Jain S1.

Author information

1 Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.

2 Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.

3 University of Utah Health Sciences Center, Salt Lake City.

4 Le Bonheur Children’s Hospital, Memphis, Tennessee.

5 University of Tennessee Health Science Center, Memphis.

6 Vanderbilt University School of Medicine, Nashville, Tennessee.

7 Northwestern University Feinberg School of Medicine, Chicago, Illinois.

8 Emory University School of Medicine, Atlanta, Georgia.

Abstract

BACKGROUND:

Data on oseltamivir treatment among hospitalized community-acquired pneumonia (CAP) patients are limited.

METHODS:

Patients hospitalized with CAP at 6 hospitals during the 2010-2012 influenza seasons were included. We assessed factors associated with oseltamivir treatment using logistic regression.

RESULTS:

Oseltamivir treatment was provided to 89 of 1627 (5%) children (<18 years) and 143 of 1051 (14%) adults. Among those with positive clinician-ordered influenza tests, 39 of 61 (64%) children and 37 of 48 (77%) adults received oseltamivir. Among children, oseltamivir treatment was associated with hospital A (adjusted odds ratio [aOR], 2.76; 95% confidence interval [CI], 1.36-4.88), clinician-ordered testing performed (aOR, 2.44; 95% CI, 1.47-5.19), intensive care unit (ICU) admission (aOR, 2.09; 95% CI, 1.27-3.45), and age ≥2 years (aOR, 1.43; 95% CI, 1.16-1.76). Among adults, oseltamivir treatment was associated with clinician-ordered testing performed (aOR, 8.38; 95% CI, 4.64-15.12), hospitals D and E (aOR, 3.46-5.11; 95% CI, 1.75-11.01), Hispanic ethnicity (aOR, 2.06; 95% CI, 1.18-3.59), and ICU admission (aOR, 2.05; 95% CI, 1.34-3.13).

CONCLUSIONS:

Among patients hospitalized with CAP during influenza season, oseltamivir treatment was moderate overall and associated with clinician-ordered testing, severe illness, and specific hospitals. Increased clinician education is needed to include influenza in the differential diagnosis for hospitalized CAP patients and to test and treat patients empirically if influenza is suspected.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413989/pdf/ofw254.pdf

July 16, 2017 at 11:44 am

Practices of Lyme disease diagnosis and treatment by general practitioners in Quebec, 2008-2015.

BMC Fam Pract. 2017 May 22;18(1):65.

Gasmi S1,2, Ogden NH3,4, Leighton PA5, Adam-Poupart A6, Milord F6, Lindsay LR7, Barkati S8, Thivierge K9.

Author information

1 Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, 20045, chemin Sainte-Marie, Sainte-Anne-de-Bellevue, H9X 3R5, Canada.

2 Policy Integration and Zoonoses Division, Centre for Food-borne, Environmental & Zoonotic Infectious Diseases, Public Health Agency of Canada, 3200 Sicotte, Saint-Hyacinthe, J2S 7C6, Canada.

3 Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, 3200 Sicotte, Saint-Hyacinthe, J2S 7C6, Canada.

4 Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique (GREZOSP), 3200 Sicotte, Saint-Hyacinthe, J2S 7C6, Canada.

5 Faculty of Veterinary Medicine, University of Montreal, 3200 Sicotte, Saint-Hyacinthe, J2S 7C6, Canada.

6 Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, 190, boulevard Crémazie Est, Montréal, H2P 1E2, Canada.

7 Zoonotic Diseases & Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, R3E 3R2, Canada.

8 Department of Microbiology and Immunology, Faculty of Medicine, University of Montreal, 2900, boul. Édouard-Montpetit, Montréal, H3T 1J4, Canada.

9 Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, 20045, chemin Sainte-Marie, Sainte-Anne-de-Bellevue, H9X 3R5, Canada. karine.thivierge@inspq.qc.ca

Abstract

BACKGROUND:

Lyme disease (LD), a multisystem infection caused by the spirochete Borrelia burgdorferi sensu stricto (B. burgdorferi), is the most reported vector-borne disease in North America, and by 2020, 80% of the population in central and eastern Canada could live in LD risk areas. Among the key factors for minimising the impact of LD are the accurate diagnosis and appropriate management of patients bitten by ticks. In this study, the practices of Quebec general practitioners (GPs) on LD diagnosis and management of patients bitten by infected ticks are described.

METHODS:

Eight years (2008 to 2015) of retrospective demographic and clinical data on patients bitten by infected Ixodes scapularis (I. scapularis) ticks and on the management of suspected and confirmed LD cases by Quebec GPs were analysed.

RESULTS:

Among 50 patients, all the antimicrobial treatments of LD clinical cases were appropriate according to current guidelines. However, more than half (62.8%) of erythema migrans (EM) were possibly misdiagnosed, 55.6%, (n = 27) of requested serologic tests were possibly unnecessary and the majority (96.5%, n = 57) of prophylactic antimicrobial treatments were not justified according to current guidelines.

CONCLUSIONS:

These observations underline the importance for public health to enhance the knowledge of GPs where LD is emerging, to minimise the impact of the disease on patients and the financial burden on the health system

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441092/pdf/12875_2017_Article_636.pdf

July 15, 2017 at 2:12 pm

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