Posts filed under ‘REVIEWS’

Hantavirus Cardiopulmonary Syndrome Due to Imported Andes Hantavirus Infection in Switzerland: A Multidisciplinary Challenge, Two Cases and a Literature Review.

Clin Infect Dis. November 13, 2018 V.67 N.11 P.1788-1795.

Kuenzli AB1, Marschall J1, Schefold JC1, Schafer M1, Engler OB2, Ackermann-Gäumann R2, Reineke DC1, Suter-Riniker F3, Staehelin C1.

Author information

1 Bern University Hospital and University of Bern, Switzerland.

2 Spiez Laboratory, Federal Office for Civil Protection, Switzerland.

3 Institute for Infectious Diseases, University of Bern, Switzerland.

Abstract

Two travellers returning from South America were diagnosed with Andes hantavirus infection, the only member of the Hantaviridae family known to be transmitted from person to person.

We describe the clinical course and therapeutic and infection control measures.

While both patients showed high viral load (VL) and shedding over several months, 1 patient recovered within 1 week from severe respiratory illness that required noninvasive ventilation, whereas the second patient developed severe hantavirus cardiopulmonary syndrome that required extracorporeal membrane oxygenation for 27 days.

The clinical course in the latter patient was complicated by severe disseminated intravascular coagulopathy with diffuse hemorrhage that necessitated mass transfusions, as well as by multiple organ failure, including the need for renal replacement therapy.

Results of VL in blood, respiratory secretions, and semen for the first 9 months of follow-up are reported. To our knowledge, these are the first cases of Andes hantavirus infection detected in Europe.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233683/pdf/ciy443.pdf

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January 19, 2019 at 11:17 am

First literature review of carbapenem-resistant Providencia.

New Microbes New Infect. 2018 Jun 4;25:16-23.

Abdallah M1, Balshi A2.

Author information

1 Pharmaceutical Care Services, Riyadh, Saudi Arabia.

2 Intensive Care Unit, King Saud Medical City, Riyadh, Saudi Arabia.

Abstract

Providencia species are Gram-negative bacteria that belong to the Enterobacteriaceae family. They have intrinsic resistance to colistin and tigecycline, which makes treatment of the multidrug-resistant strains of Providencia challenging. Carbapenem-resistant Providencia species are increasingly reported. In this review, patients’ characteristics, resistance mechanisms, treatment and infection control measures of carbapenem-resistant Providencia species in the literature are described.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031241/pdf/main.pdf

 

January 18, 2019 at 9:37 am

Mycobacterium tuberculosis prosthetic joint infections: A case series and literature review

Journal of Infection January 2019 V.78 N.1 P.27–34

Fabrice Uhel, Gregory Corvaisier, Yves Poinsignon, Catherine Chirouze, Guillaume Beraud, Olivier Grossi, Nicolas Varache, Cédric Arvieux, Rozenn Le Berre, Pierre Tattevin, for the Groupe d’Epidémiologie et Recherche en Infectiologie Clinique Centre-Ouest (GERICCO)

Objectives

We aimed to characterize diagnosis, management, and outcome of Mycobacterium tuberculosis prosthetic joint infections (PJI).

Methods

Cases of M. tuberculosis PJI documented in 7 referral French centers were retrospectively reviewed. Data were collected from medical files on a standardized questionnaire. We performed a literature review using the keywords ‘prosthetic joint’, and ‘tuberculosis’.

Results

During years 1997–2016, 13 patients (8 males, 5 females, median age 79 years [range, 60–86]) had documented M. tuberculosis PJI, involving hip (n = 6), knee (n = 6), or shoulder (n = 1). Median time from arthroplasty to diagnosis was 9 years [0.4–20]. The diagnosis was obtained on joint aspirates (n = 9), or synovial tissue (n = 4). PCR was positive in all cases tested (5/5). Median duration of antituberculosis treatment was 14 months [6–32]). Nine patients underwent surgery: debridement (n = 4), resection arthroplasty (n = 3), and revision arthroplasty (1-stage exchange, n = 2). PJI was controlled in 12 patients. Seventeen additional cases of documented M. tuberculosis PJI have been reported, with a favorable outcome in 79% (11/14) of patients with no surgery, 85% (11/13) with debridement, 86% (19/22) with revision arthroplasty, and 81% (17/21) with resection (NS).

Conclusions

  1. tuberculosis PJI can be controlled with prolonged antituberculosis treatment in most cases, with or without surgical treatment.

FULL TEXT

https://www.journalofinfection.com/article/S0163-4453(18)30253-6/abstract

PDF

https://www.journalofinfection.com/article/S0163-4453(18)30253-6/pdf

January 12, 2019 at 10:01 am

Diagnostic value of symptoms and signs for identifying urinary tract infection in older adult outpatients: Systematic review and meta-analysis

Journal of Infection November 2018 V.77 N.5 P.379–390

Oghenekome A. Gbinigie, José M. Ordóñez-Mena, Thomas R. Fanshawe, Annette Plüddemann, Carl Heneghan

Highlights

  • Older adults may present atypically with UTI and making a diagnosis can be difficult.
  • There is limited authoritative guidance on how older adult outpatients present with UTI.
  • Symptoms and signs traditionally associated with UTI (e.g. nocturia, urgency and abnormal vital signs) may have limited utility in diagnosing these infections in older adult outpatients.
  • Disability in performing a number of acts of daily living may be better predictors of UTI; high quality studies should be conducted in this area to confirm this

Objectives

To critically appraise and evaluate the diagnostic value of symptoms and signs in identifying UTI in older adult outpatients, using evidence from observational studies.

Methods

We searched Medline and Medline in process, Embase and Web of Science, from inception up to September 2017. We included studies assessing the diagnostic accuracy of symptoms and/or signs in predicting UTI in outpatients aged 65 years and above. Study quality was assessed using the QUADAS-2 tool.

Results

We identified 15 eligible studies of variable quality, with a total of 12,039 participants (range 65–4259), and assessed the diagnostic accuracy of 66 different symptoms and signs in predicting UTI. A number of symptoms and signs typically associated with UTI, such as nocturia, urgency and abnormal vital signs, were of limited use in older adult outpatients. Inability to perform a number of acts of daily living were predictors of UTI: For example, disability in feeding oneself, + ve LR: 11.8 (95% CI 5.51–25.2) and disability in washing one’s hands and face, + ve LR: 6.84 (95% CI 4.08–11.5).

Conclusions

The limited evidence of varying quality shows that a number of symptoms and signs traditionally associated with UTI may have limited diagnostic value in older adult outpatients.

FULL TEXT

https://www.journalofinfection.com/article/S0163-4453(18)30190-7/fulltext

PDF

https://www.journalofinfection.com/article/S0163-4453(18)30190-7/pdf

January 12, 2019 at 9:59 am

Review – Vibrio vulnificus, an important cause of severe sepsis and skin and soft-tissue infection.

International Journal of Infectious Diseases 2011 V.15 e157-e166

Michael A. Horseman a,b,c,*, Salim Surani c,d,e

aDepartment of Pharmacy Practice, College of Pharmacy, Texas A&M Health Sciences Center, Kingsville, Texas, USA

bDepartment of Family Medicine & Community Medicine, School of Medicine, University of Texas Health Sciences Center, San Antonio, Texas, USA

c Christus Spohn Hospital Corpus Christi – Memorial, 2606 Hospital Blvd, Corpus Christi, Texas 78405, USA

dDepartment of Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, Texas, USA

eDepartment of Internal Medicine, Texas A&M Health Science Center – College of Medicine, Scott and White Hospital, Temple, Texas, USA

Vibrio vulnificus is a halophilic Gram-negative bacillus found worldwide in warm coastal waters.

The pathogen has the ability to cause primary sepsis in certain high-risk populations, including patients with chronic liver disease, immunodeficiency, iron storage disorders, end-stage renal disease, and diabetes mellitus.

Most reported cases of primary sepsis in the USA are associated with the ingestion of raw or undercooked oysters harvested from the Gulf Coast.

The mortality rate for patients with severe sepsis is high, exceeding 50% in most reported series.

Other clinical presentations include wound infection and gastroenteritis.

Mild to moderate wound infection and gastroenteritis may occur in patients without obvious risk factors.

Severe wound infection is often characterized by necrotizing skin and soft-tissue infection, including fasciitis and gangrene.

V. vulnificus possesses several virulence factors, including the ability to evade destruction by stomach acid, capsular polysaccharide, lipopolysaccharide, cytotoxins, pili, and flagellum.

The preferred antimicrobial therapy is doxycycline in combination with ceftazidime and surgery for necrotizing soft-tissue infection.

PDF

https://www.ijidonline.com/article/S1201-9712(10)02538-5/pdf

January 10, 2019 at 8:32 am

Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States.   January 4, 2019. 366 pag

Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States.   January 4, 2019.  366 pag

Developed by the HHS Panel on Treatment of Pregnant Women with HIV Infection and Prevention of Perinatal Transmission – A Working Group of the Office of AIDS Research Advisory Council (OARAC)

What’s New in the Guidelines

Text, references, and appendices were updated to include new data and publications where relevant.

The sections that address infant feeding now include links to a new section that was added on March 27, 2018, titled Guidance for Counseling and Managing Women Living with HIV in the United States Who Desire to Breastfeed.

Major content changes are summarized below; all changes are highlighted throughout the guidelines.

PDF

http://aidsinfo.nih.gov/contentfiles/lvguidelines/PerinatalGL.pdf

January 8, 2019 at 8:08 am

Highlights From Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections in Adults and Children

Infectious Diseases in Clinical Practice May 2011 V.19 N.3 P.207-20

Clinical Guidelines

File, Thomas M. Jr

Recently, the Infectious Diseases Society published evidence-based guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections.

The guideline discusses the management of a variety of infections including skin infections, bacteremia and endocarditis, pneumonia, and osteomyelitis and joint infections.

FULL TEXT

https://journals.lww.com/infectdis/Fulltext/2011/05000/Highlights_From_Clinical_Practice_Guidelines_by.13.aspx

PDF (CLIC en PDF)

December 7, 2018 at 9:28 am

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