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Sample records for sanguinicola infection clinical

  1. Genomic characterization, phylogenetic analysis, and identification of virulence factors in Aerococcus sanguinicola and Aerococcus urinae strains isolated from infection episodes

    DEFF Research Database (Denmark)

    Carkaci, Derya; Højholt, Katrine; Nielsen, Xiaohui Chen

    2017-01-01

    Aerococcus sanguinicola and Aerococcus urinae are emerging pathogens in clinical settings mostly being causative agents of urinary tract infections (UTIs), urogenic sepsis and more seldomly complicated infective endocarditis (IE). Limited knowledge exists concerning the pathogenicity of these two...

  2. Six cases of Aerococcus sanguinicola infection: Clinical relevance and bacterial identification

    DEFF Research Database (Denmark)

    Ibler, K.; Jensen, K.T.; Ostergaard, C.

    2008-01-01

    were associated with infective endocarditis. Most patients were elderly (median age 70 y) and had underlying neurological disorders including dementia, cerebral degeneration, and myelomeningocele. The primary focus of infection was the urinary tract in 3 cases and the gallbladder in 1; no focus...

  3. Aerococcus urinae and Aerococcus sanguinicola

    DEFF Research Database (Denmark)

    Carkaci, Derya; Nielsen, Xiaohui C.; Fuursted, Kurt

    2017-01-01

    Aerococcus urinae and Aerococcus sanguinicola are relatively newcomers and emerging organisms in clinical and microbiological practice. Both species have worldwide been associated with urinary tract infections. More rarely cases of bacteremia/septicemia and infective endocarditis have been reported...

  4. Aerococcus urinae and Aerococcus sanguinicola: Susceptibility Testing of 120 Isolates to Six Antimicrobial Agents Using Disk Diffusion (EUCAST), Etest, and Broth Microdilution Techniques

    DEFF Research Database (Denmark)

    Carkaci, Derya; Nielsen, Xiaohui Chen; Fuursted, Kurt

    2017-01-01

    BACKGROUND: Aerococcus urinae and Aerococcus sanguinicola are relatively newcomers and emerging organisms in clinical and microbiological practice. Both species have worldwide been associated with urinary tract infections. More rarely cases of bacteremia/septicemia and infective endocarditis have...

  5. Sanguinicola platyrhynchi n. sp. (Digenea: Sanguinicolidae parasite of visceral cavity of Hemisorubim platyrhynchos (Valenciennes, 1840 (Pisces: Pimelodidae from the floodplain of the upper Paraná River, Brazil

    Directory of Open Access Journals (Sweden)

    GUIDELLI G. M.

    2002-01-01

    Full Text Available A new species is of the genus Sanguinicola Plehn, 1905 described, Sanguinicola platyrhynchi n. sp., digenetic parasite of visceral cavity of Hemisorubim platyrhynchos (Valenciennes, 1840 from the floodplain of the upper Paraná River, Brazil. The species has been thus included because of the presence of separate dorsal genital pores, while differing from other species of the same genus mainly in digestive apparatus features, genital pore position, and infection site. Emendation of generic diagnosis is included.

  6. Designation of the Provisional New Enterococcus Species CDC PNS-E2 as Enterococcus sanguinicola sp. nov., Isolated from Human Blood, and Identification of a Strain Previously Named Enterococcus CDC PNS-E1 as Enterococcus italicus Fortina, Ricci, Mora, and Manachini 2004▿

    Science.gov (United States)

    Carvalho, Maria da Glória S.; Steigerwalt, Arnold G.; Morey, Roger E.; Shewmaker, Patricia Lynn; Falsen, Enevold; Facklam, Richard R.; Teixeira, Lucia M.

    2008-01-01

    We have previously characterized two new enterococcal species (provisionally designated CDC PNS-E1 and CDC PNS-E2) recovered from clinically significant specimens associated with invasive infections in humans. In the present report we provide additional data and propose formal denominations for isolates of these two species of Enterococcus. Results of 16S rRNA gene sequencing, sodium dodecyl sulfate-polyacrylamide gel electrophoretic analysis of whole-cell protein profiles, and DNA-DNA reassociation experiments indicated that the blood isolate ATCC BAA-780 (SS 1728; CDC PNS-E1) corresponds to Enterococcus italicus, whose species epithet was proposed to designate isolates from artisanal Italian cheese. Strain ATCC BAA-781 (CCUG 47861; SS 1729; CDC PNS-E2), a vancomycin-resistant isolate recovered from the blood of a patient in the United States, was found to be highly related at the species level to another blood isolate (SS 1743; CCUG 47884) from Sweden, and for these we propose the designation Enterococcus sanguinicola sp. nov. PMID:18667594

  7. Trichinella infection and clinical disease

    DEFF Research Database (Denmark)

    Clausen, M R; Meyer, C N; Krantz, T

    1996-01-01

    Trichinellosis is caused by ingestion of insufficiently cooked meat contaminated with infective larvae of Trichinella species. The clinical course is highly variable, ranging from no apparent infection to severe and even fatal disease. We report two illustrative cases of trichinellosis. Returning....... Life-threatening cardiopulmonary, renal and central nervous system complications developed. The patient recovered after several months. Her husband, who also ate the pork, did not have clinical symptoms, but an increased eosinophil count and a single larva in a muscle biopsy confirmed infection...

  8. Periprosthetic Joint Infections: Clinical and Bench Research

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    Laurence Legout

    2013-01-01

    Full Text Available Prosthetic joint infection is a devastating complication with high morbidity and substantial cost. The incidence is low but probably underestimated. Despite a significant basic and clinical research in this field, many questions concerning the definition of prosthetic infection as well the diagnosis and the management of these infections remained unanswered. We review the current literature about the new diagnostic methods, the management and the prevention of prosthetic joint infections.

  9. Periprosthetic Joint Infections: Clinical and Bench Research

    OpenAIRE

    Laurence Legout; Eric Senneville

    2013-01-01

    Prosthetic joint infection is a devastating complication with high morbidity and substantial cost. The incidence is low but probably underestimated. Despite a significant basic and clinical research in this field, many questions concerning the definition of prosthetic infection as well the diagnosis and the management of these infections remained unanswered. We review the current literature about the new diagnostic methods, the management and the prevention of prosthetic joint infections.

  10. Photodynamic therapy for infections: clinical applications.

    Science.gov (United States)

    Kharkwal, Gitika B; Sharma, Sulbha K; Huang, Ying-Ying; Dai, Tianhong; Hamblin, Michael R

    2011-09-01

    Photodynamic therapy (PDT) was discovered over 100 years ago by its ability to kill various microorganisms when the appropriate dye and light were combined in the presence of oxygen. However it is only in relatively recent times that PDT has been studied as a treatment for various types of localized infections. This resurgence of interest has been partly motivated by the alarming increase in drug resistance amongst bacteria and other pathogens. This review will focus on the clinical applications of antimicrobial PDT. The published peer-reviewed literature was reviewed between 1960 and 2011. The basics of antimicrobial PDT are discussed. Clinical applications of antimicrobial PDT to localized viral infections caused by herpes and papilloma viruses, and nonviral dermatological infections such as acne and other yeast, fungal and bacterial skin infections are covered. PDT has been used to treat bacterial infections in brain abscesses and non-healing ulcers. PDT for dental infections including periodontitis and endodontics has been well studied. PDT has also been used for cutaneous Leishmaniasis. Clinical trials of PDT and blue light alone therapy for gastric Helicobacter pylori infection are also covered. As yet clinical PDT for infections has been mainly in the field of dermatology using 5-aminolevulanic acid and in dentistry using phenothiazinium dyes. We expect more to see applications of PDT to more challenging infections using advanced antimicrobial photosensitizers targeted to microbial cells in the years to come. Copyright © 2011 Wiley-Liss, Inc.

  11. Intracranial Infections: Clinical and Imaging Characteristics

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    Foerster, B.R.; Thurnher, M.M.; Malani, P.N.; Petrou, M.; Carets-Zumelzu, F.; Sundgren, P.C. [Dept. of Radiology, and Divisions of Infectious Diseases and G eriatric Medicine, Dept. of Internal Medicine, Univ. of Michigan Medical Center, Ann Arbor, MI (United States)

    2007-10-15

    The radiologist plays a crucial role in identifying and narrowing the differential diagnosis of intracranial infections. A thorough understanding of the intracranial compartment anatomy and characteristic imaging findings of specific pathogens, as well incorporation of the clinical information, is essential to establish correct diagnosis. Specific types of infections have certain propensities for different anatomical regions within the brain. In addition, the imaging findings must be placed in the context of the clinical setting, particularly in immunocompromised and human immunodeficiency virus (HIV)-positive patients. This paper describes and depicts infections within the different compartments of the brain. Pathology-proven infectious cases are presented in both immunocompetent and immunocompromised patients, with a discussion of the characteristic findings of each pathogen. Magnetic resonance spectroscopy (MRS) characteristics for several infections are also discussed.

  12. Clinical effects of rhinovirus infections.

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    Peltola, Ville; Waris, Matti; Osterback, Riikka; Susi, Petri; Hyypiä, Timo; Ruuskanen, Olli

    2008-12-01

    Rhinovirus is the major cause of common cold and frequently associates with acute wheezing, otitis media, sinusitis, and pneumonia. High prevalence of rhinovirus in hospitalized children and adults has been documented recently. We screened children > or =1 month of age, hospitalized for any infection, for the presence of rhinoviruses and recruited 24 families with > or =2 children for a 3-week follow-up study. Rhinovirus was detected in 46 (28%) of 163 hospitalizations by study children. Most rhinovirus-positive children (85%) had respiratory symptoms. During the follow-up, rhinoviruses were detected in virtually all children and in one-half of adults in families with a rhinovirus-positive index child, but commonly also in families with a rhinovirus-negative index child. Melting temperature and sequence analysis revealed the transmission routes of the viruses and showed that several virus types could circulate in the families simultaneously. Our studies corroborate the major contribution of rhinovirus to hospitalization of children, most often because of wheezing. Young children with respiratory symptoms are major spreaders of rhinovirus in family setting.

  13. Clinical and subclinical infections with Giardia and Cryptosporidium in animals

    Science.gov (United States)

    Giardia and Cryptosporidium are frequent parasites of livestock, companion animals, and wildlife, raising questions about the clinical significance of such infections. Infections with both parasites have a wide spectrum of symptoms that can vary between asymptomatic infections to serious infection ...

  14. Clinical Patterns of Candida Infections in Bombay

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    J Pratiba Dalal

    1980-01-01

    Full Text Available One hundred consecutive cases of candidiasis in Bombay were studied. In each case the suspicion was confirmed by isolation typing of the Candida species. The clinical was as follows: vulvo-vaginitis 30%; intertrigo 18%; onychia and paronychia 12%; thrush 16%; generalised cutaneous candidasis 8%, enteritis 3%; bronchitis 12% and urinary tract infection 1%. When compared to a study carried out in Bombay in 1966, there was an increase in the frequency of disseminated cutaneous candidiasis and a reduction in the cases of intertrigo and onychia and paronychia.

  15. Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

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    Davis, Joshua S.; Eichenberger, Emily; Holland, Thomas L.

    2015-01-01

    SUMMARY Staphylococcus aureus is a major human pathogen that causes a wide range of clinical infections. It is a leading cause of bacteremia and infective endocarditis as well as osteoarticular, skin and soft tissue, pleuropulmonary, and device-related infections. This review comprehensively covers the epidemiology, pathophysiology, clinical manifestations, and management of each of these clinical entities. The past 2 decades have witnessed two clear shifts in the epidemiology of S. aureus infections: first, a growing number of health care-associated infections, particularly seen in infective endocarditis and prosthetic device infections, and second, an epidemic of community-associated skin and soft tissue infections driven by strains with certain virulence factors and resistance to β-lactam antibiotics. In reviewing the literature to support management strategies for these clinical manifestations, we also highlight the paucity of high-quality evidence for many key clinical questions. PMID:26016486

  16. HIV INFECTION AND THE KIDNEY CLINICAL

    African Journals Online (AJOL)

    2008-04-04

    Apr 4, 2008 ... An association between HIV and renal disease was first reported in 1984 by ... Parasites: pneumocystis, toxoplasma, microsporidia. ▫ Glomerulopathies .... Direct cytopathogenic effect on glomerular cells with undefined mechanisms .... Human immunodeficiency virus infection and renal failure. Infect.

  17. Clinical studies on hepatitis B, C, and E virus infection

    NARCIS (Netherlands)

    Willemse, S.B.

    2017-01-01

    Chronic viral hepatitis is a major cause of liver-related morbidity and mortality. This thesis describes clinical aspects of hepatitis B, C, and E virus infection. Part I focuses on hepatitis B virus (HBV) infection. This part describes immune responses of patients with acute HBV-infection,

  18. Respiratory viral infections in infants with clinically suspected pertussis

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    Angela E. Ferronato

    2013-11-01

    Conclusion: the results suggest that viral infection can be present in hospitalized infants with clinical suspicion of pertussis, and etiological tests may enable a reduction in the use of macrolides in some cases. However, the etiological diagnosis of respiratory virus infection, by itself, does not exclude the possibility of infection with BP.

  19. Symptomatic HIV infection in infancy - clinical and laboratory ...

    African Journals Online (AJOL)

    Symptomatic HIV infection in infancy - clinical and laboratory markers of infection. M.P. Meyer, Z Latief, C Haworth, S Salie, A van Dyk. Abstract. Objective. To investigate the usefulness of immunological tests in the diagnosis of HIV infection in young symptomatic children < 15 months of age). Design. Tests were evaluated in ...

  20. RATIONAL ANTIVIRAL TREATMENT OF ACUTE RESPIRATORY INFECTIONS IN OUTPATIENT CLINIC

    OpenAIRE

    M.G. Lukashevich

    2008-01-01

    An epidemiology and clinical symptomatology of frequently occurred acute respiratory viral infections (ARVI) and opportunities of treatment of patients with these diseases in outpatient clinics are described. New information about effectiveness and safety of antiviral medications in treatment and prophylaxis of ARVI in children are discussed.Key words: children, acute respiratory viral infections, antiviral medications, interferon, interferon inductors.

  1. RATIONAL ANTIVIRAL TREATMENT OF ACUTE RESPIRATORY INFECTIONS IN OUTPATIENT CLINIC

    Directory of Open Access Journals (Sweden)

    M.G. Lukashevich

    2008-01-01

    Full Text Available An epidemiology and clinical symptomatology of frequently occurred acute respiratory viral infections (ARVI and opportunities of treatment of patients with these diseases in outpatient clinics are described. New information about effectiveness and safety of antiviral medications in treatment and prophylaxis of ARVI in children are discussed.Key words: children, acute respiratory viral infections, antiviral medications, interferon, interferon inductors.

  2. Clinical treatment of postoperative infection following sinus augmentation

    OpenAIRE

    Hong, Seung-Bum; Kim, Jae-Suk; Shin, Seung-Il; Han, Ji-Young; Herr, Yeek; Chung, Jong-Hyuk

    2010-01-01

    Purpose The aim of this case report is to present the successful clinical treatment of two cases of postoperative infection following maxillary sinus augmentation. Methods In the two cases of postoperative infection, immediate total removal of the grafted material from the sinus was conducted to stop the spread of the infection, after which a high dose of antibiotics was administrated. Re-augmentation procedures were then conducted after the infection subsided. Results No further complication...

  3. HIV INFECTION AND THE KIDNEY CLINICAL

    African Journals Online (AJOL)

    2008-04-04

    Apr 4, 2008 ... Numerous electrolyte and acid-base abnormalities have ... Membranous. 3. Various glomerulonephropathies: This is a heterogeneous group with ... Very few data exist on screening asymptomatic HIV- infected patients for ...

  4. Clinical Features of Infection in Older Adults.

    Science.gov (United States)

    Norman, Dean C

    2016-08-01

    The impact of infectious diseases on older adults is far greater than on younger adults because of significantly higher morbidity and mortality caused by infection. The reasons for this greater impact include factors such as lower physiologic reserve due to age and chronic disease, age-related changes in host defenses, loss of mobility, higher risk for polypharmacy and adverse drug reactions, and being on drugs that increase the risk for infection (e.g., anticholinergic and other sedating medications increase the risk for pneumonia). Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Infections in orthopaedic surgery : clinical and experimental studies

    NARCIS (Netherlands)

    Vogely, Henri Charles

    2000-01-01

    The diagnostic difficulties, variability in outcome and the heterogeinity of the problem of orthopaedic infections stimulated the author to a study of the literature, and several clinical and experimental studies. The diagnosis prosthesis-related infection can only be reached with an acceptable

  6. Helicobacter pylori infection: New pathogenetic and clinical aspects

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    Hagymási, Krisztina; Tulassay, Zsolt

    2014-01-01

    Helicobacter pylori (H. pylori) infects more than half of the world’s human population, but only 1% to 3% of infected people consequently develop gastric adenocarcinomas. The clinical outcome of the infection is determined by host genetic predisposition, bacterial virulence factors, and environmental factors. The association between H. pylori infection and chronic active gastritis, peptic ulcer disease, gastric cell carcinoma, and B cell mucosa-associated lymphoid tissue lymphoma has been well established. With the exception of unexplained iron deficiency anemia and idiopathic thrombocytopenic purpura, H. pylori infection has no proven role in extraintestinal diseases. On the other hand, there is data showing that H. pylori infection could be beneficial for some human diseases. The unpredictability of the long-term consequences of H. pylori infection and the economic challenge in eradicating it is why identification of high-risk individuals is crucial. PMID:24914360

  7. Cytomegalovirus infection in liver transplant recipients: Updates on clinical management

    OpenAIRE

    Marcelin, Jasmine Riviere; Beam, Elena; Razonable, Raymund R

    2014-01-01

    Cytomegalovirus (CMV) infection is a common complication after liver transplantation, and it is associated with multiple direct and indirect effects. Management of CMV infection and disease has evolved over the years, and clinical guidelines have been recently updated. Universal antiviral prophylaxis and a pre-emptive treatment strategy are options for prevention. A currently-recruiting randomized clinical trial is comparing the efficacy and safety of the two prevention strategies in the high...

  8. Clinical Features of Adult Patients with Acute Hepatitis B Virus Infection Progressing to Chronic Infection

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    Kojiro Michitaka

    2014-01-01

    Full Text Available Background. Information regarding the progression of acute hepatitis B virus (HBV infection to chronic infection in adults is scarce. Methods. Twenty-five adult patients with acute HBV infection (14 men and 11 women, 18–84 years old, whose clinical features progressed to those of chronic infection (group A or did not (group B, were studied retrospectively. Results. There were 3 and 22 patients in groups A and B, respectively. Two of the 3 patients of group A lacked the typical symptoms of acute hepatitis. No differences were found between groups with respect to age, sex, or HBV genotypes. However, total bilirubin and alanine aminotransaminase levels were significantly lower in group A. Conclusions. Three of the 25 adult patients with acute HBV infection progressed to chronic infection. Hepatitis was mild in these patients. Patients with mild acute hepatitis B or unapparent HBV infection may have a higher risk of progressing to chronic infection.

  9. Exploring the context for effective clinical governance in infection control.

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    Halton, Kate; Hall, Lisa; Gardner, Anne; MacBeth, Deborough; Mitchell, Brett G

    2017-03-01

    Effective clinical governance is necessary to support improvements in infection control. Historically, the focus has been on ensuring that infection control practice and policy is based on evidence, and that there is use of surveillance and auditing for self-regulation and performance feedback. There has been less exploration of how contextual and organizational factors mediate an infection preventionists (IP's) ability to engage with evidence-based practice and enact good clinical governance. A cross sectional Web-based survey of IPs in Australia and New Zealand was undertaken. Questions focused on engagement in evidence-based practice and perceptions about the context, culture, and leadership within the infection control team and organization. Responses were mapped against dimensions of Scally and Donaldson's clinical governance framework. Three hundred surveys were returned. IPs appear well equipped at an individual level to undertake evidence-based practice. The most serious set of perceived challenges to good clinical governance related to a lack of leadership or active resistance to infection control within the organization. Additional challenges included lack of information technology solutions and poor access to specialist expertise and financial resources. Focusing on strengthening contextual factors at the organizational level that otherwise undermine capacity to implement evidence-based practice is key to sustaining current infection control successes and promoting further practice improvements. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  10. Syphilis Infection during Pregnancy: Fetal Risks and Clinical Management

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    De Santis, Marco; De Luca, Carmen; Mappa, Ilenia; Spagnuolo, Terryann; Licameli, Angelo; Straface, Gianluca; Scambia, Giovanni

    2012-01-01

    Congenital syphilis is still a cause of perinatal morbidity and mortality. Untreated maternal infection leads to adverse pregnancy outcomes, including early fetal loss, stillbirth, prematurity, low birth weight, neonatal and infant death, and congenital disease among newborns. Clinical manifestations of congenital syphilis are influenced by gestational age, stage of maternal syphilis, maternal treatment, and immunological response of the fetus. It has been traditionally classified in early congenital syphilis and late congenital syphilis. Diagnosis of maternal infection is based on clinical findings, serological tests, and direct identification of treponemes in clinical specimens. Adequate treatment of maternal infection is effective for preventing maternal transmission to the fetus and for treating fetal infection. Prenatal diagnosis of congenital syphilis includes noninvasive and invasive diagnosis. Serological screening during pregnancy and during preconception period should be performed to reduce the incidence of congenital syphilis. PMID:22829747

  11. Syphilis Infection during Pregnancy: Fetal Risks and Clinical Management

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    Marco De Santis

    2012-01-01

    Full Text Available Congenital syphilis is still a cause of perinatal morbidity and mortality. Untreated maternal infection leads to adverse pregnancy outcomes, including early fetal loss, stillbirth, prematurity, low birth weight, neonatal and infant death, and congenital disease among newborns. Clinical manifestations of congenital syphilis are influenced by gestational age, stage of maternal syphilis, maternal treatment, and immunological response of the fetus. It has been traditionally classified in early congenital syphilis and late congenital syphilis. Diagnosis of maternal infection is based on clinical findings, serological tests, and direct identification of treponemes in clinical specimens. Adequate treatment of maternal infection is effective for preventing maternal transmission to the fetus and for treating fetal infection. Prenatal diagnosis of congenital syphilis includes noninvasive and invasive diagnosis. Serological screening during pregnancy and during preconception period should be performed to reduce the incidence of congenital syphilis.

  12. Syphilis Infection during pregnancy: fetal risks and clinical management.

    Science.gov (United States)

    De Santis, Marco; De Luca, Carmen; Mappa, Ilenia; Spagnuolo, Terryann; Licameli, Angelo; Straface, Gianluca; Scambia, Giovanni

    2012-01-01

    Congenital syphilis is still a cause of perinatal morbidity and mortality. Untreated maternal infection leads to adverse pregnancy outcomes, including early fetal loss, stillbirth, prematurity, low birth weight, neonatal and infant death, and congenital disease among newborns. Clinical manifestations of congenital syphilis are influenced by gestational age, stage of maternal syphilis, maternal treatment, and immunological response of the fetus. It has been traditionally classified in early congenital syphilis and late congenital syphilis. Diagnosis of maternal infection is based on clinical findings, serological tests, and direct identification of treponemes in clinical specimens. Adequate treatment of maternal infection is effective for preventing maternal transmission to the fetus and for treating fetal infection. Prenatal diagnosis of congenital syphilis includes noninvasive and invasive diagnosis. Serological screening during pregnancy and during preconception period should be performed to reduce the incidence of congenital syphilis.

  13. Chalmydia trachomatis infection among asymptomatic males in an infertility clinic

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    Mania - Pramanik J

    2001-09-01

    Full Text Available Chlamydia trachomatis can lead to a variety of complications including tubal infertility. Similarly asymptomatic infection in male partner can also hinder conception. The prevalence of this infection among the infertile female in the Institute′s Infertility Clinic was observed to be 34%. Hence the present study was undertaken to find out these infection among the asymptomatic male partners of these infected women. Fifteen asymptomatic males who were not treated with any antibiotics in recent past were enrolled. First voided urine, semen and blood were collected from each individual for diagnosis of this infection. Chlamydia antigen was detected in 33.3% while Chlamydia antibody was detected in seven (46.7% of these cases. Of these seven, three cases were positive for antigen. This preliminary observation suggests that amongst the infertile couple a sizable percentage (60% of asymptomatic male partners remain infected with Chlamydia trachomatis.

  14. Influence of infection on clinical picture of diabetic foot syndrome.

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    Strbova, L; Krahulec, B; Waczulikova, I; Gaspar, L; Ambrozy, E; Bendzala, M; Dukat, A

    2011-01-01

    The aim of our study was to analyse the foot infections in diabetic patients. We analysed foot ulcerations in 124 diabetics who attended outpatient foot clinic, or were hospitalized in the period from 1996 to 2006. Basic neuropathy screening examination was made with cotton wisp, pin-prick, tuning fork, and monofilament. For evaluation of leg ischemia, besides the evaluation of the presence of pedal pulses, the ankle-brachial pressure index was measured. If the infection of foot ulceration was clinically present, bacteriology examinations was performed. In the case of deep wound infection, x-ray examination was made. If bone destruction was present, osteomyelitis was diagnosed by technecium bone scanning and by technecium-labelled leukocyte scan. Deformation and destruction of the bone without infection was appoited as Charcot neuroarthropathy. Foot ulcer infection was found in 58 % diabetic patients, wounds were more often deep (80 %). Infection was not associated with special location of foot ulcer. Two-third of the total infected wounds were associated with leg ischemia and 30.6 % of infected ulcer ended with leg amputation. More foot ulcer infections were found in the diabetics with HbAlc over 8 %. Infection was coupled with diabetic retinopathy (in 63 % patients) (p=0.023), and also with diabetic nephropathy (in 66 % patients) (p=0.012). Bacteriology examination revealed most often Staphylococci (45.8 %), antibiotic therapy was made most often with chinolones. Osteomyelitis was present in 34.7 % of foot ulcer infections. In 14 diabetics (56 %) after antibiotic therapy it was not necessary to perform a leg amputation. HbAlc seems to be a significant predictor of osteomyelitis (pdiabetic foot infections, especially on ischemic leg, in diabetics with poor metabolic control and chronic diabetic microvascular complications, are associated with a higher risk of leg amputations. Further, it is possible to cure osteomyelitis successfully without surgery in more than

  15. Clinical Manifestations of Campylobacter concisus Infection in Children

    DEFF Research Database (Denmark)

    Nielsen, Hans Linde; Engberg, Jørgen; Ejlertsen, Tove

    2013-01-01

    BACKGROUND:: There is only sparse information about the clinical impact of Campylobacter concisus infections in children. METHODS:: A study was performed during a two-year period to determine the clinical manifestations in C. concisus positive children with gastroenteritis. A case patient...... with Campylobacter jejuni/coli infection. RESULTS:: Two thousand three hundred and seventy-two diarrheic stool samples from 1,867 children were cultured for pathogenic enteric bacteria during the study period, and 85 and 109 children with C. concisus and C. jejuni/coli, respectively, were identified. Comparison...... for more than two weeks and two-thirds of all children with C. concisus reported loose stools after six month follow-up. CONCLUSIONS:: Campylobacter concisus infection in children seems to have a milder course of acute gastroenteritis compared with C. jejuni/coli infection, but is associated with more...

  16. Prevalence and clinical correlates of Schistosoma mansoni co-infection among malaria infected patients, Northwest Ethiopia.

    Science.gov (United States)

    Getie, Sisay; Wondimeneh, Yitayih; Getnet, Gebeyaw; Workineh, Meseret; Worku, Ligabaw; Kassu, Afework; Moges, Beyene

    2015-09-28

    In Ethiopia, where malaria and schistosomiasis are co-endemic, co-infections are expected to be high. However, data about the prevalence of malaria-schistosomiasis co-infection and their clinical correlation is lacking. Therefore, the aim of this study was to assess prevalence of Schistosoma mansoni co-infection and associated clinical correlates in malaria patients. A cross-sectional study was conducted in 2013 at Chwahit Health Center, in northwest Ethiopia. Blood film positive malaria patients (N = 205) were recruited for the study. Clinical, parasitological, hematological, and biochemical parameters were assessed from every study participant. Stool samples were also collected and processed with Kato-Katz technique to diagnose and classify intensity of Schistosoma mansoni. The prevalence of Schistosoma mansoni and malaria co-infection was 19.5%. The age group of 16-20 years old was significantly associated with co-infection. Co-infected patients with a moderate-heavy egg burden of Schistosoma mansoni had significantly high mean Plasmodium parasitemia. On the other hand, age group of 6-10 years old and moderate-heavy Schistosoma mansoni co-infection were significantly associated with severe malaria. Prevalence of malaria and Schistosoma mansoni co-infection in the study area was considerably high. Severity of malaria and parasitemia of Plasmodium were associated with certain age groups and intensity of concurrent Schistosoma mansoni. Further study is needed to explore the underlying mechanisms of interaction between malaria and Schistosoma mansoni.

  17. GB Virus C Infection: Clinical Significance

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    Xiang Wei Meng

    1999-01-01

    Full Text Available GB virus C (GBV-C RNA positivity rates were examined in serum specimens from 231 patients with liver disease (23 patients with hepatitis B, 175 patients with hepatitis C, five patients with hepatitis B virus plus hepatitis C virus coinfection, and 28 patients with non-A, non-B, non-C hepatitis to clarify the clinical significance of this virus. GBV-C RNA was detected in none of 12 patients with fulminant hepatitis, one of two patients with acute hepatitis positive for hepatitis B surface antigen and one of four patients with acute non-A, non-B, non-C hepatitis. Pathogenetic involvement of GBV-C was suspected in some patients in the latter group. Among patients with the non-B, non-C type of chronic disease, one of seven with cirrhosis (14% and none with chronic hepatitis or hepatocellular carcinoma were GBV-C-positive. In chronic hepatitis C patients who had received interferon treatment, no difference was found in clinical findings, alanine aminotransferase (ALT concentrations, histology or response to interferon between 11 patients who were GBV-C RNA-positive and 101 patients who were GBV-C RNA-negative. Moreover, changes in ALT after interferon therapy showed no relation to positivity for GBV-C RNA. On the basis of these findings, GBV-C appears to be an unlikely cause of initiation or progression of chronic hepatic diseases.

  18. Clinical and Laboratory Diagnosis of Dengue Virus Infection.

    Science.gov (United States)

    Muller, David A; Depelsenaire, Alexandra C I; Young, Paul R

    2017-03-01

    Infection with any of the 4 dengue virus serotypes results in a diverse range of symptoms, from mild undifferentiated fever to life-threatening hemorrhagic fever and shock. Given that dengue virus infection elicits such a broad range of clinical symptoms, early and accurate laboratory diagnosis is essential for appropriate patient management. Virus detection and serological conversion have been the main targets of diagnostic assessment for many years, however cross-reactivity of antibody responses among the flaviviruses has been a confounding issue in providing a differential diagnosis. Furthermore, there is no single, definitive diagnostic biomarker that is present across the entire period of patient presentation, particularly in those experiencing a secondary dengue infection. Nevertheless, the development and commercialization of point-of-care combination tests capable of detecting markers of infection present during different stages of infection (viral nonstructural protein 1 and immunoglobulin M) has greatly simplified laboratory-based dengue diagnosis. Despite these advances, significant challenges remain in the clinical management of dengue-infected patients, especially in the absence of reliable biomarkers that provide an effective prognostic indicator of severe disease progression. This review briefly summarizes some of the complexities and issues surrounding clinical dengue diagnosis and the laboratory diagnostic options currently available. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  19. Clinical variations in dermatophytosis in HIV infected patients

    Directory of Open Access Journals (Sweden)

    Kaviarasan P

    2002-01-01

    Full Text Available Dermatophyte infections are common in HIV infected patients and can occur at some point during their illness. They may show clinical variations. The present study was to note the prevalence and clinical variations in dermatophytosis in HIV infected patients. Out of 185 HIV infected patients screened at our hospital, the diagnosis of dermatophytosis was made in 41 cases. The prevalence of dermatophytosis was 22.2% Male to female ratio was 3:1 The mean age of our patients was 30.7 years. The occupations of our patients in decreasing order of frequency were labourers (43.9%, drivers (29.3% and rest were housewives, commercial sex workers etc. Heterosexual route was the most common mode of acquisition of HIV infection. Tinea corporis was the commonest dermatophyte infection and was seen in 22 (53.7% cases, followed by tinea cruris in 18 (49.9%, tinea pedis in 7 (17.1, tinea faciei in 6 (14.7% and one patient had tinea manum infection. Tinea unguium was recorded in 11 cases. Out of the 22 patients with tinea corporis, 19 were in the HIV Group IV. Ten of them presented with multiple, large sharply marginated areas of hyperkeratosis resembling dry scaly skin (anergic form of tinea corporis. Proximal white subungual onychomycosis (PWSO, thought to be pathognomonic of HIV was seen in 3 cases only. This study has brought into focus variations in presentations of dermatophytosis.

  20. Cytomegalovirus infection in liver transplant recipients: updates on clinical management.

    Science.gov (United States)

    Marcelin, Jasmine Riviere; Beam, Elena; Razonable, Raymund R

    2014-08-21

    Cytomegalovirus (CMV) infection is a common complication after liver transplantation, and it is associated with multiple direct and indirect effects. Management of CMV infection and disease has evolved over the years, and clinical guidelines have been recently updated. Universal antiviral prophylaxis and a pre-emptive treatment strategy are options for prevention. A currently-recruiting randomized clinical trial is comparing the efficacy and safety of the two prevention strategies in the highest risk D+R- liver recipients. Drug-resistant CMV infection remains uncommon but is now increasing in incidence. This highlights the currently limited therapeutic options, and the need for novel drug discoveries. Immunotherapy and antiviral drugs with novel mechanisms of action are being investigated, including letermovir (AIC246) and brincidofovir (CMX001). This article reviews the current state of CMV management after liver transplantation, including the updated practice guidelines, and summarizes the data on investigational drugs and vaccines in clinical development.

  1. Clinical manifestations of non-O1 Vibrio cholerae infections.

    Directory of Open Access Journals (Sweden)

    Yen-Ting Chen

    Full Text Available BACKGROUND: Infections caused by non-O1 Vibrio cholera are uncommon. The aim of our study was to investigate the clinical and microbiological characteristics of patients with non-O1 V. cholera infections. METHODS: The clinical charts of all patients with non-O1 V. cholera infections and who were treated in two hospitals in Taiwan were retrospectively reviewed. RESULTS: From July 2009 to June 2014, a total of 83 patients with non-O1 V. cholera infections were identified based on the databank of the bacteriology laboratories of two hospitals. The overall mean age was 53.3 years, and men comprised 53 (63.9% of the patients. Liver cirrhosis and diabetes mellitus were the two most common underlying diseases, followed by malignancy. The most common type of infection was acute gastroenteritis (n = 45, 54.2%, followed by biliary tract infection (n = 12, 14.5% and primary bacteremia (n = 11, 13.3%. Other types of infection, such as peritonitis (n = 5, 6.0%, skin and soft tissue infection (SSTI (n = 5, 6.0%, urinary tract infection (n = 3, 3.6% and pneumonia (2, 2.4%, were rare. July and June were the most common months of occurrence of V. cholera infections. The overall in-hospital mortality of 83 patients with V. cholera infections was 7.2%, but it was significantly higher for patients with primary bacteremia, hemorrhage bullae, acute kidney injury, acute respiratory failure, or admission to an ICU. Furthermore, multivariate analysis showed that in-hospital mortality was significantly associated with acute respiratory failure (odds ratio, 60.47; 95% CI, 4.79-763.90, P = 0.002. CONCLUSIONS: Non-O1 V. cholera infections can cause protean disease, especially in patients with risk factors and during warm-weather months. The overall mortality of 83 patients with non-O1 V. cholera infections was only 7.2%; however, this value varied among different types of infection.

  2. CLINICAL AND LABORATORY FEATURES OF PARVOVIRUS INFECTION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    E. V. Sharipova

    2013-01-01

    Full Text Available The article is devoted to the study of clinical symptoms and laboratory changes at parvovirus B19 infection in children during the rise of the incidence of infectious erythema. 44 children ailing with laboratory confirmed parvovirus B19 infection aging from 2 months to 14 years were complexly examined. It was established that the disease occurs mainly in boys of preschool and early school age, with a seasonal rise in April and May. General infectious syndrome and syndrome of exanthema dominate the clinical picture. Infectious erythema has benign course.

  3. Clinical manifestations of Campylobacter concisus infection in children.

    Science.gov (United States)

    Nielsen, Hans Linde; Engberg, Jørgen; Ejlertsen, Tove; Nielsen, Henrik

    2013-11-01

    There is only sparse information about the clinical impact of Campylobacter concisus infections in children. A study was performed during a 2-year period to determine the clinical manifestations in C. concisus-positive children with gastroenteritis. A case patient was defined as a child or teenager (Campylobacter jejuni/coli infection. Two thousand three hundred seventy-two diarrheic stool samples from 1867 children were cultured for pathogenic enteric bacteria during the study period, and 85 and 109 children with C. concisus and C. jejuni/coli, respectively, were identified. Comparison of the acute clinical manifestations in 44 C. concisus patients with those in 64 C. jejuni/coli patients showed a significantly lower prevalence of fever, chills and blood in stools in the former. However, half of C. concisus patients compared with one-fourth of C. jejuni/coli patients had prolonged diarrhea for more than 2 weeks and two-thirds of all children with C. concisus reported loose stools after 6-month follow-up. C. concisus infection in children seems to have a milder course of acute gastroenteritis compared with C. jejuni/coli infection but is associated with more prolonged diarrhea. Children with C. concisus have the same degree of late gastrointestinal complaints as children diagnosed with C. jejuni/coli infection.

  4. Symptomatic HIV infection in infancy - clinical and laboratory ...

    African Journals Online (AJOL)

    polymerase chain reaction (PCR). viral culture. p24 antigen) the presence of infection can usually be reliably .... used, except where the expected cell values were less than. 5. (Fisher's exact test was used in these cases.) .... Overall, the clinical presentations of the patients who were. HIV seropositive was similar to those who ...

  5. KIR : HLA association with clinical manifestations of HBV infection in ...

    Indian Academy of Sciences (India)

    KIR : HLA association with clinical manifestations of HBV infection in Madurai, south India. Narayanan Kalyanaraman, Lakshmikanthan Thayumanavan and Mariakuttikan Jayalakshmi. J. Genet. 95, 13–19. Table 1. Distribution of KIR genotypes with their relative frequency among the case and control populations. Genotype ...

  6. Clinical correlates of suicidality among individuals with HIV infection ...

    African Journals Online (AJOL)

    This paper describes clinical risk factors for suicidality among individuals with HIV infection and AIDS disease in Mbarara, Uganda. In this study, suicidality includes both suicidal ideation and suicidal attempts. A cross-sectional survey was conducted with 543 HIV-positive individuals aged 15 years and above, recruited from ...

  7. The Clinical Spectrum and Financial Burden of HIV Infected ...

    African Journals Online (AJOL)

    The Clinical Spectrum and Financial Burden of HIV Infected Children in a Regional Hospital in South Africa. ... South African Family Practice ... that the cost of hospitalising HIV-positive children is significantly more than HIV-negative controls, which will increase the financial burden on already restricted health resources.

  8. Clinical ineffectiveness of latamoxef for Stenotrophomonas maltophilia infection

    Directory of Open Access Journals (Sweden)

    Hagiya H

    2015-10-01

    Full Text Available Hideharu Hagiya,1 Ken Tasaka,2 Toshiaki Sendo,2 Fumio Otsuka11Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2Department of Pharmacy, Okayama University Hospital, Okayama, JapanObjectives: Stenotrophomonas maltophilia shows wide-spectrum resistance to antimicrobials and causes various infections in immunocompromised or critically ill patients with high mortality. In this era of antibiotics resistance, a revival of old antibiotics is now featured. We examined the clinical usefulness of latamoxef (LMOX for the treatment of S. maltophilia infection.Patients and methods: The observational study was retrospectively performed at Okayama University Hospital (Okayama, Japan from January 2011 to December 2013. LMOX was administered to 12 patients with S. maltophilia infection, with eleven of those patients being admitted to the intensive care unit.Results: Underlying conditions of the patients included postoperation, hematological transplantation, hepatic transplantation, and burn. Major infectious foci were surgical site infection (six cases, respiratory infection (four cases, blood stream infection (three cases, and burn site infection (one case. The doses of LMOX administered ranged from 1 g/d to 3 g/d for ten adult patients and from 40 mg/kg/d to 80 mg/kg/d for two pediatric patients. Microbiologic failure was seen in five (41.7% of 12 cases, and 30-day and hospital mortality rates were 25% and 50%, respectively. Minimum inhibitory concentrations of LMOX were higher in the deceased group (4–64 µg/mL than in the surviving group (1–4 µg/mL.Conclusion: LMOX treatment is not recommended for the treatment of S. maltophilia infection. Further investigation would be needed before its clinical use.Keywords: latamoxef, Stenotrophomonas maltophilia, intensive care unit, revival

  9. Clinically significant Kluyvera infections: a report of seven cases.

    Science.gov (United States)

    Carter, J Elliot; Evans, Tara N

    2005-03-01

    To determine the clinical significance of Kluyvera isolates at our institution, we retrospectively analyzed clinical microbiology data from January 1999 to September 2003. We identified 11 isolates classified as Kluyvera ascorbata, 7 of which were considered clinically significant pathogens: 3 cases represented urinary tract infections; 2, bacteremia; 1, a soft tissue infection of the finger; and 1, acute appendicitis with a subsequent intra-abdominal abscess. The age distribution of patients was wide, ranging from 2 months to 73 years. Antimicrobial susceptibility studies of the clinically significant and non-clinically significant Kluyvera isolates showed susceptibility patterns similar to those reported in the medical literature, namely trends of resistance to ampicillin and first- and second-generation cephalosporins. Of the 4 non-clinically significant isolates in our study, 1 was resistant to ciprofloxacin, a finding reported in only 1 other isolate of Kluyvera in the medical literature. Patient outcome after treatment with third-generation cephalosporins and aminoglycosides in the 7 clinically significant cases was good, with no long-term sequelae. The potential virulence of K ascorbata highlights the need for heightened scrutiny of its antimicrobial susceptibility patterns for adequate clinical treatment.

  10. Surgical Burn Wound Infections and Their Clinical Implications

    Science.gov (United States)

    Posluszny, Joseph A.; Conrad, Peggie; Halerz, Marcia; Shankar, Ravi; Gamelli, Richard L.

    2011-01-01

    Typically, burn wound infections are classified by the organisms present in the wound within the first several days following injury or later, by routine surveillance cultures. With universal acceptance of early excision and grafting, classification of burn wound colonization in unexcised burn wounds is less relevant shifting clinical significance to open burn-related surgical wound infections (SWI). To better characterize SWIs and their clinical relevance, we identified the pathogens responsible for SWIs, their impact on rates of regrafting, and the relationship between SWI and nosocomial infection (NI) pathogens. Epidemiologic and clinical data for 71 adult patients with ≥20% TBSA burn were collected. Following excision and grafting, if a grafted site had clinical characteristics of infection, a wound culture swab was obtained and organism identified. Surveillance cultures were not obtained. SWI pathogen, anatomic location, post-burn day of occurrence and need for regrafting were compiled. A positive culture obtained from an isolated anatomic location at any time point after excision and grafting of that location was considered a distinct infection. Pathogens responsible for NIs (urinary tract infections, pneumonia, bloodstream and catheter-related bloodstream infections, pseudomembranous colitis and donor site infections) and their post-burn day were identified. The profiles of SWI pathogens and NI pathogens were then compared. Of the 71 patients included, 2 withdrew, 6 had no excision or grafting performed and 1 had incomplete data. Of the 62 remaining, 24 (39%) developed a SWI. In these 24 patients, 70 distinct infections were identified of which 46% required regrafting. Candida species (24%), Pseudomonas aeruginosa (22%), Serratia marcescens (11%) and Staphylococcus aureus (11%) comprised the majority of pathogens. The development of a SWI with the need for regrafting increased overall length of stay, area of autograft, number of operative events and was

  11. A review of the clinical implications of anti-infective biomaterials and infection-resistant surfaces.

    Science.gov (United States)

    Campoccia, Davide; Montanaro, Lucio; Arciola, Carla Renata

    2013-11-01

    Infection is currently regarded as the most severe and devastating complication associated to the use of biomaterials. The important social, clinical and economic impacts of implant-related infections are promoting the efforts to obviate these severe diseases. In this context, the development of anti-infective biomaterials and of infection-resistant surfaces is being regarded as the main strategy to prevent the establishment of implant colonisation and biofilm formation by bacteria. In this review, the attention is focused on the biomaterial-associated infections, from which the need for anti-infective biomaterials originates. Biomaterial-associated infections differ markedly for epidemiology, aetiology and severity, depending mainly on the anatomic site, on the time of biomaterial application, and on the depth of the tissues harbouring the prosthesis. Here, the diversity and complexity of the different scenarios where medical devices are currently utilised are explored, providing an overview of the emblematic applicative fields and of the requirements for anti-infective biomaterials. © 2013 Elsevier Ltd. All rights reserved.

  12. Clinical Relevance of HLA Gene Variants in HBV Infection

    Directory of Open Access Journals (Sweden)

    Li Wang

    2016-01-01

    Full Text Available Host gene variants may influence the natural history of hepatitis B virus (HBV infection. The human leukocyte antigen (HLA system, the major histocompatibility complex (MHC in humans, is one of the most important host factors that are correlated with the clinical course of HBV infection. Genome-wide association studies (GWASs have shown that single nucleotide polymorphisms (SNPs near certain HLA gene loci are strongly associated with not only persistent HBV infection but also spontaneous HBV clearance and seroconversion, disease progression, and the development of liver cirrhosis and HBV-related hepatocellular carcinoma (HCC in chronic hepatitis B (CHB. These variations also influence the efficacy of interferon (IFN and nucleot(side analogue (NA treatment and response to HBV vaccines. Meanwhile, discrepant conclusions were reached with different patient cohorts. It is therefore essential to identify the associations of specific HLA allele variants with disease progression and viral clearance in chronic HBV infection among different ethnic populations. A better understanding of HLA polymorphism relevance in HBV infection outcome would enable us to elucidate the roles of HLA SNPs in the pathogenesis and clearance of HBV in different areas and ethnic groups, to improve strategies for the prevention and treatment of chronic HBV infection.

  13. The Clinical Risks of Infection Associated with Endoscopy

    Directory of Open Access Journals (Sweden)

    Alistair E Cowen

    2001-01-01

    Full Text Available The cleaning of flexible endoscopes is difficult and time consuming. Any method of attempted sterilization or high level disinfection will fail if prior cleaning has been defective. Inadequate reprocessing of endoscopes may result in patient to patient transmission of serious bacterial and viral diseases or infection with endemic hospital pathogens. Antibiotic prophylaxis is required to prevent septicemia and bacterial endocarditis in high risk patients undergoing specific endoscopic procedures. Prevention of serious endoscopy-associated clinical infections requires strict compliance with detailed reprocessing protocols by specially trained nursing staff.

  14. Clinical infectious outcomes associated with biofilm-related bacterial infections: a retrospective chart review

    National Research Council Canada - National Science Library

    Barsoumian, Alice E; Mende, Katrin; Sanchez, Jr, Carlos J; Beckius, Miriam L; Wenke, Joseph C; Murray, Clinton K; Akers, Kevin S

    2015-01-01

    Biofilms are associated with persistent infection. Reports characterizing clinical infectious outcomes and patient risk factors for colonization or infection with biofilm forming isolates are scarce...

  15. [PAPILLOMAVIRUS INFECTION: PRINCIPLE CHARACTERISTICS, CLINICAL MANIFESTATIONS, VACCINE PROPHYLAXIS].

    Science.gov (United States)

    Lopukhov, P D; Briko, N I; Khaldin, A A; Tsapkova, N N; Lupashko, O V

    2016-01-01

    Papillomaviruses are a large and diverse group of viruses. It includes approximately 200 fully described types that have been detected in humans. Human papilloma viruses (HPV) are etiologic agents during various, benign and malignant lesions of mucous membrane and skin epithelium. Very importantly, persistent HPV infection of certain types is a leading cause of carcinoma of uterine cervix, penis, vulva; vagina, anal canal and fauces (including tongue base and tonsils). HPV infection prophylaxis is the best means to control HPV-conditioned diseases, and vaccination, as had been demonstrated, --the most effective method of its prophylaxis. In this paper principle characteristics and clinical manifestations of papillomavirus infection, as well as effectiveness of vaccination against HPV are examined.

  16. Clinical and laboratory diagnosis of influenza virus infections.

    Science.gov (United States)

    Newton, D W; Treanor, J J; Menegus, M A

    2000-03-01

    Influenza epidemics account for more than 20,000 deaths in the United States each year, as well as substantial morbidity, medical costs, and time away from work and school. Since the 1950s, the principal weapon against these seasonal epidemics has been killed virus vaccine formulations. Despite massive efforts to immunize at-risk individuals against influenza, not everyone receives the vaccine. In addition, use of some drugs, such as amantadine and rimantadine, can lead to the development of drug resistant viruses in infected individuals and to transmission of these viruses to susceptible individuals. The many factors that contribute to the high annual incidence of influenza virus infections mandate prompt clinical recognition and appropriate patient management. Rapid diagnostic tests have been developed that may make it possible to avoid the use of antibacterial drugs, quickly decide whether isolation of infected patients is needed, and discharge hospitalized patients sooner.

  17. Images of deep neck space infection and the clinical significance.

    Science.gov (United States)

    Wang, Bing; Gao, Bu-Lang; Xu, Guo-Ping; Xiang, Cheng

    2014-10-01

    Deep neck infection is not difficult to diagnose clinically, but correct localization of the involved space for timely incision and drainage is not easy without assistance of imaging. To investigate the images of deep neck space infection of phlegmon and abscess and the role of imaging examination in correct localization and treatment. Between June 2004 and June 2010, 28 patients were diagnosed with deep neck infection (14 men, 14 women; age range, 17-72 years; mean age, 46 years). Clinical presentations included neck swelling, pain, dysphagia, fever, and elevated white blood cell count. Of the 28 cases, 20 had computed tomography (CT) scans, 18 had magnetic resonance imaging (MRI) examinations, and 10 had both CT and MRI. All 28 patients were confirmed by CT and/or MRI to have deep neck infection, with 11 cases in the retropharyngeal space, five in the parapharyngeal space, four in the masseteric space, and eight in multiple spaces. Thirteen cases had abscesses that were successfully treated with incision and drainage under CT guidance in combination with large doses of antibiotics, and 15 had phlegmon managed with large doses of antibiotics. Followed up for 5-20 months, all patients recovered completely. Two patients were confirmed by imaging examination to have retropharyngeal infection spreading to the superior mediastinum with abscess formation and another two patients had multiple space infection because inappropriate puncture or incision for drainage without imaging guidance in these patients caused the spread of infection. Clinical diagnosis was not accurate with only 12 patients (42.9%) being correctly diagnosed of the exact deep neck space involved before imaging confirmation. CT and/or MRI made the correct diagnosis in all 28 patients. CT and/or MRI also directly changed the treatment plan in seven patients and contributed to the recovery of these patients. CT and MRI play a crucial role in both the diagnosis and correct puncture and incision for

  18. Nontyphoid Salmonella Infection: Microbiology, Clinical Features, and Antimicrobial Therapy

    Directory of Open Access Journals (Sweden)

    Hung-Ming Chen

    2013-06-01

    Full Text Available Nontyphoid Salmonella is the most common bacterial pathogen causing gastrointestinal infection worldwide. Most nontyphoid Salmonella infection is limited to uncomplicated gastroenteritis that seldom requires antimicrobial treatment. Nevertheless, invasive infections, such as bacteremia, osteomyelitis, and meningitis, may occur and require antimicrobial therapy. Continuous genetic and genomic evolution in Salmonella leading to increased virulence and resistance to multiple drugs are of significant public health concern. Two major changes in the epidemiology of nontyphoid salmonellosis in Europe and in the USA occurred in the second half of the 20th century: the emergence of foodborne human infections caused by Salmonella enterica serotype Enteriditis and by multidrug-resistant strains of Salmonella enterica serotype Typhimurium. In the 21st century, a worsening situation is the increasing resistance to fluoroquinolones and third-generation cephalosporins in nontyphoid Salmonella. Clinical isolates showing carbapenem resistance also have been identified. Although antimicrobial therapy is usually not indicated for uncomplicated Salmonella gastroenteritis, recent studies indicated that a short-course ceftriaxone therapy (3–5 days for patients with severe gastroenteritis would lead to a faster clinical recovery. Continuous surveillance of Salmonella in both humans and animals is mandatory. A better understanding of the mechanisms that lead to the emergence of antimicrobial resistance in Salmonella may help in the devising of better interventional strategies to reduce the spread of resistant Salmonella between humans and reservoirs along the food chain.

  19. Clinical significance of occult hepatitis B virus infection.

    Science.gov (United States)

    Romero, Miriam; Madejón, Antonio; Fernández-Rodríguez, Conrado; García-Samaniego, Javier

    2011-03-28

    Occult hepatitis B virus (HBV) infection (OBI) is defined as the presence of HBV DNA in the liver (with or without detectable HBV DNA in serum) for individuals testing HBV surface antigen negative. Until recently, the clinical effect of OBI was unclear on the progression of liver disease; on the development of hepatocellular carcinoma; and on the risk for reactivation or transmission of HBV infection. Several studies suggest a high prevalence of OBI among patients with cryptogenic chronic liver disease, but its role in the progression to cirrhosis remains unclear. Although OBI has been well documented in human immunodeficiency virus (HIV)-positive patients, especially among those coinfected with hepatitis C virus, further studies are needed to determine its current clinical impact in HIV setting.

  20. Development of a clinical data warehouse for hospital infection control.

    Science.gov (United States)

    Wisniewski, Mary F; Kieszkowski, Piotr; Zagorski, Brandon M; Trick, William E; Sommers, Michael; Weinstein, Robert A

    2003-01-01

    Existing data stored in a hospital's transactional servers have enormous potential to improve performance measurement and health care quality. Accessing, organizing, and using these data to support research and quality improvement projects are evolving challenges for hospital systems. The authors report development of a clinical data warehouse that they created by importing data from the information systems of three affiliated public hospitals. They describe their methodology; difficulties encountered; responses from administrators, computer specialists, and clinicians; and the steps taken to capture and store patient-level data. The authors provide examples of their use of the clinical data warehouse to monitor antimicrobial resistance, to measure antimicrobial use, to detect hospital-acquired bloodstream infections, to measure the cost of infections, and to detect antimicrobial prescribing errors. In addition, they estimate the amount of time and money saved and the increased precision achieved through the practical application of the data warehouse.

  1. Development of a Clinical Data Warehouse for Hospital Infection Control

    Science.gov (United States)

    Wisniewski, Mary F.; Kieszkowski, Piotr; Zagorski, Brandon M.; Trick, William E.; Sommers, Michael; Weinstein, Robert A.

    2003-01-01

    Existing data stored in a hospital's transactional servers have enormous potential to improve performance measurement and health care quality. Accessing, organizing, and using these data to support research and quality improvement projects are evolving challenges for hospital systems. The authors report development of a clinical data warehouse that they created by importing data from the information systems of three affiliated public hospitals. They describe their methodology; difficulties encountered; responses from administrators, computer specialists, and clinicians; and the steps taken to capture and store patient-level data. The authors provide examples of their use of the clinical data warehouse to monitor antimicrobial resistance, to measure antimicrobial use, to detect hospital-acquired bloodstream infections, to measure the cost of infections, and to detect antimicrobial prescribing errors. In addition, they estimate the amount of time and money saved and the increased precision achieved through the practical application of the data warehouse. PMID:12807807

  2. Infection Control Measures in Private Dental Clinics in Lebanon

    OpenAIRE

    Jihad Dagher; Charles Sfeir; Ahmad Abdallah; Zeina Majzoub

    2017-01-01

    Purpose. Evaluate infection control knowledge, attitude, and practice in Lebanese private dental clinics. Materials and Methods. A survey including 46 questions related to routine safety procedures was sent to 1150 Lebanese dentists between July 1st and 2nd, 2015. The study sample was selected from the database of registered dentists based on a proportional random sampling ensuring equitable representation of the 5 geographic regions of Lebanon. A subset of 29 questions was used to generate a...

  3. Syphilis Infection during Pregnancy: Fetal Risks and Clinical Management

    OpenAIRE

    De Santis, Marco; De Luca, Carmen; Mappa, Ilenia; Spagnuolo, Terryann; Licameli, Angelo; Straface, Gianluca; Scambia, Giovanni

    2012-01-01

    Congenital syphilis is still a cause of perinatal morbidity and mortality. Untreated maternal infection leads to adverse pregnancy outcomes, including early fetal loss, stillbirth, prematurity, low birth weight, neonatal and infant death, and congenital disease among newborns. Clinical manifestations of congenital syphilis are influenced by gestational age, stage of maternal syphilis, maternal treatment, and immunological response of the fetus. It has been traditionally classified in early co...

  4. [Infection and molecular characteristics of Giardia in clinical diarrheal patients].

    Science.gov (United States)

    Liu, Hua; Shen, Yu-juan; Zhang, Yu-mei; Wang, Bin; Liu, Hui; Cao, Jian-ping

    2015-04-01

    To initially understand the infection status and the molecular characteristics of Giardia in clinical diarrheal patients. A total of 95 stool samples were collected from the clinical diarrheal patients admitted in a hospital in Shanghai from May to July, 2014, and the Giardia cysts in the samples were examined by an optical microscope. Then the tpi gene of Giardia in the positive samples were amplified by using the nested-PCR method, and the PCR products were sequenced and analyzed by using BLAST, ClustalX 1.83, and the phylogenetic tree was drawn by using MEGA6.0 software. Only one patient was infected with Giardia and the positive detection rate was 1.05%. The Giardia cysts in the fecal specimen were seen clearly under the microscope. Through the identification by PCR, the amplified fragment was about 530 bp, and the sequencing analysis indicated it was Giardia and which was further identified as assemblage B by drawing phylogenetic tree based on tpi gene. Meanwhile, the sequence had 100% homology with the reported sequence from huian (KF271445). Giardia infection can occur in the clinical diarrheal patients. The study could provide more data for understanding the genetic characteristics of Giardia and the epidemiological study of giardiasis.

  5. [The Infection RIsk Scan in clinical practice: improving infection prevention and antibiotic use through transparency].

    Science.gov (United States)

    Willemsen, I; Kluytmans, J A J W

    2016-01-01

    The increase in Highly Resistant Micro-Organisms (HRMO) in hospitals and nursing homes requires an intensification of infection prevention measures. This paper describes a new, standardised approach to infection prevention and monitoring of antibiotic use. Cross-sectional, observational study. The Infection RIsk Scan (IRIS) measures a number of objectifiable variables in the field of infection prevention, including the dissemination of HRMO, the use of antibiotics and indwelling medical devices, environmental contamination, hand hygiene and personal hygiene of healthcare workers, and various infection control preconditions. The scan converts the measurements into a risk profile and an improvement chart, a graphic presentation that is easy to understand for care professionals, managers and patients. Based on the results, targeted improvements can be made by a department or institution, and a quality cycle can be started in which the scans are repeated. The IRIS has been successfully applied in 5 hospital departments, a rehabilitation clinic and 19 nursing homes. In the hospital departments, 3 IRIS cycles resulted in a significant improvement in hand hygiene compliance (43% to 66%, pnursing home, the IRIS resulted in a previously undetected outbreak of HRMO being discovered. The IRIS method makes it possible to compare departments and institutions and can therefore provide an impetus for standardization of measurements of risks and results in the field of infection prevention, antibiotic use and resistance.

  6. Clinical indicators for bacterial co-infection in Ghanaian children with P. falciparum infection.

    Directory of Open Access Journals (Sweden)

    Maja Verena Nielsen

    Full Text Available Differentiation of infectious causes in severely ill children is essential but challenging in sub- Saharan Africa. The aim of the study was to determine clinical indicators that are able to identify bacterial co-infections in P. falciparum infected children in rural Ghana. In total, 1,915 severely ill children below the age of 15 years were recruited at Agogo Presbyterian Hospital in Ghana between May 2007 and February 2011. In 771 (40% of the children malaria parasites were detected. This group was analyzed for indicators of bacterial co-infections using bivariate and multivariate regression analyses with 24 socio-economic variables, 16 terms describing medical history and anthropometrical information and 68 variables describing clinical symptoms. The variables were tested for sensitivity, specificity, positive predictive value and negative predictive value. In 46 (6.0% of the children with malaria infection, bacterial co-infection was detected. The most frequent pathogens were non-typhoid salmonellae (45.7%, followed by Streptococcus spp. (13.0%. Coughing, dehydration, splenomegaly, severe anemia and leukocytosis were positively associated with bacteremia. Domestic hygiene and exclusive breastfeeding is negatively associated with bacteremia. In cases of high parasitemia (>10,000/μl, a significant association with bacteremia was found for splenomegaly (OR 8.8; CI 1.6-48.9, dehydration (OR 18.2; CI 2.0-166.0 and coughing (OR 9.0; CI 0.7-118.6. In children with low parasitemia, associations with bacteremia were found for vomiting (OR 4.7; CI 1.4-15.8, severe anemia (OR 3.3; CI 1.0-11.1 and leukocytosis (OR 6.8 CI 1.9-24.2. Clinical signs of impaired microcirculation were negatively associated with bacteremia. Ceftriaxone achieved best coverage of isolated pathogens. The results demonstrate the limitation of clinical symptoms to determine bacterial co-infections in P. falciparum infected children. Best clinical indicators are dependent on the

  7. Clinical experience, infection control practices and diagnostic algorithms for poxvirus infections - an Emerging Infections Network survey

    Directory of Open Access Journals (Sweden)

    Lash R Ryan

    2010-02-01

    Full Text Available Abstract Background In order to determine how best to tailor outreach messages about poxvirus diagnosis and infection control for health practitioners, we surveyed infectious disease physicians in the Infectious Diseases Society of America's Emerging Infections Network. Findings Surveys consisting of two unknown case scenarios designed to raise suspicion for monkeypox and orf were distributed to the 1,080 members of the EIN. The surveys contained questions pertaining to which diagnostic tests, points of contact, and transmission precautions they would likely utilize during patient evaluation. Basic response rates and frequencies of responses were calculated. Comparisons of the survey responses were made using the chi-square test. Of the 212 members who responded (20% response rate, significantly more respondents indicated that they would request diagnostic testing in the context of the monkeypox case scenario as compared to the orf case scenario. A significantly higher number of respondents indicated they would institute droplet or airborne precautions for the monkeypox case as opposed to the orf case scenario. Conclusions This survey provided an opportunity for public health practitioners to gain insight into physician approaches to evaluation, diagnosis and reporting of suspected poxvirus-associated infections. This survey identified key areas in which public health practitioners can better serve physicians by focusing on education. As a result we were able to identify potential knowledge gaps and deficits in the availability of useful resources to facilitate accurate case identification and management.

  8. Clinical aspects of feline immunodeficiency and feline leukemia virus infection.

    Science.gov (United States)

    Hartmann, Katrin

    2011-10-15

    Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) are retroviruses with a global impact on the health of domestic cats. The two viruses differ in their potential to cause disease. FIV can cause an acquired immunodeficiency syndrome that increases the risk of developing opportunistic infections, neurological diseases, and tumors. In most naturally infected cats, however, FIV itself does not cause severe clinical signs, and FIV-infected cats may live many years without any health problems. FeLV is more pathogenic, and was long considered to be responsible for more clinical syndromes than any other agent in cats. FeLV can cause tumors (mainly lymphoma), bone marrow suppression syndromes (mainly anemia) and lead to secondary infectious diseases caused by suppressive effects of the virus on bone marrow and the immune system. Today, FeLV is less important as a deadly infectious agent as in the last 20 years prevalence has been decreasing in most countries. Copyright © 2011 Elsevier B.V. All rights reserved.

  9. Clinical and economic implications of urinary tract infections.

    Science.gov (United States)

    Steiger, Samantha N; Comito, Rachel R; Nicolau, David P

    2017-08-01

    Urinary tract infections represent one of the most frequent reasons for hospitalization. As a result of their prevalence from community-based origins as well as those which develop in hospital setting, this constellation of infections represents a tremendous burden to the global healthcare system. Areas covered: Over the last several decades the management of these infections has become more complicated due to the underlying comorbid conditions of the patients as well as escalating antimicrobial resistance to many of the most frequently used oral and parenteral agents. One such example is the emergence of extend spectrum β-lactamase-producing (ESBL) bacteria that render many of the most frequently utilized oral and parenteral penicillin and cephalosporin based regimens of little clinical utility. As such new treatment strategies are required to effectively manage the growing population of patients with multi-drug resistant bacteria. Expert commentary: Herein, we review some of the current literature which reveals the challenges associated with the contemporary management of UTIs, while presenting strategies such as the implementation of clinical pathways that have the potential to enhance the quality and efficiency of care while reducing the overall cost of care.

  10. Grepafloxacin Clinical Program for Lower Respiratory Tract Infections

    Directory of Open Access Journals (Sweden)

    Arne C Rodloff

    1998-01-01

    Full Text Available The present paper evaluates the clinical trial program in lower respiratory tract infections treated with a new fluoroquinolone antibiotic, grepafloxacin. Unlike older quinolones, grepafloxacin has excellent activity against Gram-positive organisms, which include Streptococcus pneumoniae and “atypical” pathogens Legionella species. Mycoplasma pneumoniae and Chlamydia pneumoniae. Grepafloxacin has a long half-life of 12 to 15 h, which allows once daily dosing. Six studies have been conducted regarding community-acquired lower respiratory tract infections (LRTls, four about community-acquired pneumonia (CAP and two about acute bacterial exacerbations of chronic bronchitis (ABECB . In these studies, grepafloxacin demonstrated clinical equivalence with standard therapies. but, in patients with documented infections. grepafloxacin was statistically superior to amoxycillin in both CAP and ABECB. The new fluoroquinolone has a good safety profile, comparable with that of ciprofloxacin. The most common adverse effects of grepafloxacin were nausea and a metallic taste; however, these effects resulted in only a few discontinuations of therapy. With the increasing prevalence of resistance in pathogens isolated from community-acquired LRTIs, grepafloxacin offers a good alternative for monotherapy in these patients.

  11. Feline cowpoxvirus infections in Germany: clinical and epidemiological aspects.

    Science.gov (United States)

    Appl, Caroline; von Bomhard, Wolf; Hanczaruk, Matthias; Meyer, Hermann; Bettenay, Sonya; Mueller, Ralf

    2013-01-01

    Clinical and epidemiological aspects of cats with cowpox in Germany from the years 2004 to 2010 are described and discussed. Questionnaires were sent to veterinarians and owners of affected cats identified with the help of a number of pathology laboratories. Of 69 mailed questionnaires, 45 veterinary and 26 owner questionnaires were returned and a total of 46 feline poxcases were evaluated. The cases were distributed all over Germany although there was an accumulation of cases in specific geographic areas. The clinical and epidemiological observations match those of other studies. The majority of cats were outdoor cats, came from a rural environment and developed clinical signs in late summer or autumn. All cats showed skin lesions which were predominantly localized on the anterior part of the body, 61% of the cats showed other clinical signs in addition to the skin lesions. Approximately half of the cats lived in a multi-pet household, but in only one case clinical signs typical for cowpox were observed in another cat of the household. In two cases a cat-to-human transmission was assumed. In addition, to evaluate the prevalence of pox virus infections in outdoor cats in areas with previous reports of such infections, 92 apparently unaffected outdoor cats were tested for orthopoxvirus antibodies using an indirect immunofluorescence assay. Sixteen (17%) of the tested serum samples were seropositive against orthopoxvirus (titre between 1:20 and 1:40).This is a higher serum prevalence than in previously published studies from Germany. A possible explanation is selection of a population of outdoor cats from regions with previous known clinical cases.

  12. Epidemiologic and Clinical Impact of Acinetobacter baumannii Colonization and Infection

    Science.gov (United States)

    Villar, Macarena; Cano, María E.; Gato, Eva; Garnacho-Montero, José; Miguel Cisneros, José; Ruíz de Alegría, Carlos; Fernández-Cuenca, Felipe; Martínez-Martínez, Luis; Vila, Jordi; Pascual, Alvaro; Tomás, María; Bou, Germán; Rodríguez-Baño, Jesús

    2014-01-01

    Abstract Acinetobacter baumannii is one of the most important antibiotic-resistant nosocomial bacteria. We investigated changes in the clinical and molecular epidemiology of A. baumannii over a 10-year period. We compared the data from 2 prospective multicenter cohort studies in Spain, one performed in 2000 (183 patients) and one in 2010 (246 patients), which included consecutive patients infected or colonized by A. baumannii. Molecular typing was performed by repetitive extragenic palindromic polymerase chain reaction (REP-PCR), pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST). The incidence density of A. baumannii colonization or infection increased significantly from 0.14 in 2000 to 0.52 in 2010 in medical services (p < 0.001). The number of non-nosocomial health care-associated cases increased from 1.2% to 14.2%, respectively (p < 0.001). Previous exposure to carbapenems increased in 2010 (16.9% in 2000 vs 27.3% in 2010, p = 0.03). The drugs most frequently used for definitive treatment of patients with infections were carbapenems in 2000 (45%) and colistin in 2010 (50.3%). There was molecular-typing evidence of an increase in the frequency of A. baumannii acquisition in non-intensive care unit wards in 2010 (7.6% in 2000 vs 19.2% in 2010, p = 0.01). By MSLT, the ST2 clonal group predominated and increased in 2010. This epidemic clonal group was more frequently resistant to imipenem and was associated with an increased risk of sepsis, although not with severe sepsis or mortality. Some significant changes were noted in the epidemiology of A. baumannii, which is increasingly affecting patients admitted to conventional wards and is also the cause of non-nosocomial health care-associated infections. Epidemic clones seem to combine antimicrobial resistance and the ability to spread, while maintaining their clinical virulence. PMID:25181313

  13. Clinical correlates of tuberculosis co-infection in HIV-infected children hospitalized in Peru.

    Science.gov (United States)

    Ramírez-Cardich, María E; Kawai, Vivian; Oberhelman, Richard A; Bautista, Christian T; Castillo, María E; Gilman, Robert H

    2006-07-01

    In developing countries, tuberculosis (TB) is responsible for almost 250,000 deaths among children yearly. Active TB in children with human immunodeficiency virus (HIV) infection is difficult to diagnose and progresses rapidly to death. The aim of this preliminary study was to investigate the prevalence and clinical correlates of TB-related illness among HIV-infected children admitted to an infectious diseases ward in Peru, a country where TB is highly endemic. Forty-seven HIV-infected children admitted for a suspected infectious process in a Peruvian hospital were investigated for evidence of clinical tuberculosis by auramine stain, culture, and polymerase chain reaction (PCR) of clinical specimens. Eight children (17%) had evidence of tuberculosis, including five with positive cultures and three with positive PCR tests only. Weight loss was the only feature associated with a positive test for tuberculosis. Radiological changes were very common in both TB-positive and TB-negative groups and these changes were not useful to identify TB-positive cases. Weight loss may be used to identify high-risk HIV positive children who require more aggressive evaluation for tuberculosis. Radiological changes were common in both TB-positive and TB-negative groups.

  14. [Viral respiratory co-infections in pediatric patients admitted for acute respiratory infection and their impact on clinical severity].

    Science.gov (United States)

    Martínez, Pamela; Cordero, Jaime; Valverde, Cristián; Unanue, Nancy; Dalmazzo, Roberto; Piemonte, Paula; Vergara, Ivonne; Torres, Juan P

    2012-04-01

    Respiratory viruses are the leading cause of acute respiratory tract infection (ARI) in children. It has been reported that viral respiratory co-infection could be associated with severe clinical course. To describe the frequency of viral co-infection in children admitted for AlRI and evaluate whether this co-infection was associated with more severe clinical course. Prospective, descriptive study in pediatric patients who were hospitalized for ARI, with molecular detection of at least 1 respiratory virus in nasopharyngeal sample studied by PCR-Microarray for 17 respiratory viruses. 110 out of 147 patients with detection of > 1 respiratory virus were included. Viral co-infection was detected in 41/110 (37%). 22/110 children (20%) were classified as moderate to severe clinical course and 88/110 (80%) were classified as mild clinical course. In the group of moderate to severe clinical course, viral respiratory co-infection was detected in 6/22 (27.3%), compared to 35/88 (39.8 %) in the mild clinical course group. No statistically significant difference was found regarding the presence of co-infection between groups (p = 0.33). We detected high rates of viral co-infection in children with ARI. It was not possible to demonstrate that viral co-infections were related with severe clinical course in hospitalized children.

  15. Problem-oriented clinical microbiology and infection. 2nd. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Hilary Humphreys; William, L. Irving [Royal College of Surgeons (Ireland)

    2004-08-01

    This medical textbook is problem-based, in line with current medical teaching, and covers 70 clinical cases. This second edition has been updated to include new material on AIDS/HIV, emerging antibiotic-resistant bacteria and new viral pathogens such as SARS. Sections are headed; Skin and mucous membranes; Respiratory tract; Gastrointestinal system which includes a case study entitled: Bob, a 55-year-old retired coal miner with abdominal pain; Genito-urinary system; Central nervous system; Systemic infections; Pregnancy and the neonate; and Miscellaneous. 29 ills., 125 photos.

  16. Clinical presentation of Mycoplasma genitalium Infection versus Neisseria gonorrhoeae infection among women with pelvic inflammatory disease.

    Science.gov (United States)

    Short, Vanessa L; Totten, Patricia A; Ness, Roberta B; Astete, Sabina G; Kelsey, Sheryl F; Haggerty, Catherine L

    2009-01-01

    Women with pelvic inflammatory disease (PID) often present with a spectrum of symptoms. The characteristics of nongonococcal, nonchlamydial PID have not been well described. Our objective was to examine the characteristics of Mycoplasma genitalium infection among women with clinically suspected PID. We evaluated 722 women who were enrolled in the PID Evaluation and Clinical Health study. Women with M. genitalium monoinfection were compared with women with Neisseria gonorrhoeae monoinfection or Chlamydia trachomatis monoinfection. Compared with women with gonococcal PID, women with M. genitalium infection were less likely to have elevated systemic inflammatory markers, including an erythrocyte sedimentation rate >15 mm/h (5 [22.7%] of 22 patients vs. 45 [60.8%] of 74 patients; P = .002), a white blood cell count >10,000 cells/mL (4 [28.6%] of 14 patients vs. 42 [64.6%] of 65 patients; (P = .018), and an oral temperature > or =38.3 degrees C (0 [0.0%] of 22 patients vs. 10 [13.9%] of 72 patients; (P = .001). In addition, they were less likely to present with mucopurulent cervicitis (9 [47.4%] of 19 patients vs. 60 [83.3%] of 72 patients; P = .001), elevated vaginal pH (P = .018), and high pelvic pain score (P = .014). In contrast, women with chlamydial PID had signs and symptoms that were similar to those in women with M. genitalium infection. Because symptoms might be mild, women with M. genitalium infection might not seek PID treatment. Further studies are needed to assess the potential reproductive tract sequelae of M. genitalium infection of the upper genital tract.

  17. Psychiatric Diagnoses among an HIV-Infected Outpatient Clinic Population.

    Science.gov (United States)

    Shacham, Enbal; Önen, Nur F; Donovan, Michael F; Rosenburg, Neal; Overton, E Turner

    2016-01-01

    As individuals with HIV infection are living longer, the management of psychiatric disorders has increasingly been incorporated into comprehensive care. Individuals were recruited from an outpatient HIV clinic to assess the prevalence and related associations of current psychiatric disorders and biomarkers. Of the 201 participants who completed the interviews, the median age was 43.5 years, and the majority was male and African American. Most were receiving HIV therapy and 78% of those had achieved virologic suppression. Prevalent psychiatric diagnoses included major depressive disorder, generalized anxiety, and agoraphobia. Alcohol and cocaine/crack abuse and dependence were common substance use disorders. Current receipt of HIV therapy was less common among those diagnosed with generalized anxiety disorder. Agoraphobia was the only disorder associated with unsuppressed viral load. Psychiatric and substance use disorders are highly prevalent among an urban HIV clinic population, although we identified few associations between psychiatric diagnoses and HIV diseases status. © The Author(s) 2014.

  18. Clinical Manifestations and Outcomes of West Nile Virus Infection

    Science.gov (United States)

    Sejvar, James J.

    2014-01-01

    Since the emergence of West Nile virus (WNV) in North America in 1999, understanding of the clinical features, spectrum of illness and eventual functional outcomes of human illness has increased tremendously. Most human infections with WNV remain clinically silent. Among those persons developing symptomatic illness, most develop a self-limited febrile illness. More severe illness with WNV (West Nile neuroinvasive disease, WNND) is manifested as meningitis, encephalitis or an acute anterior (polio) myelitis. These manifestations are generally more prevalent in older persons or those with immunosuppression. In the future, a more thorough understanding of the long-term physical, cognitive and functional outcomes of persons recovering from WNV illness will be important in understanding the overall illness burden. PMID:24509812

  19. Clinical Manifestations and Outcomes of West Nile Virus Infection

    Directory of Open Access Journals (Sweden)

    James J. Sejvar

    2014-02-01

    Full Text Available Since the emergence of West Nile virus (WNV in North America in 1999, understanding of the clinical features, spectrum of illness and eventual functional outcomes of human illness has increased tremendously. Most human infections with WNV remain clinically silent. Among those persons developing symptomatic illness, most develop a self-limited febrile illness. More severe illness with WNV (West Nile neuroinvasive disease, WNND is manifested as meningitis, encephalitis or an acute anterior (polio myelitis. These manifestations are generally more prevalent in older persons or those with immunosuppression. In the future, a more thorough understanding of the long-term physical, cognitive and functional outcomes of persons recovering from WNV illness will be important in understanding the overall illness burden.

  20. Clinical and genetic features of human metapneumovirus infection in children.

    Science.gov (United States)

    Park, Ji Young; Yun, Ki Wook; Lim, Jae Woo; Lee, Mi Kyung; Lim, In Seok; Choi, Eung Sang

    2016-01-01

    Human metapneumovirus (hMPV) is one of the main pathogens responsible for respiratory tract infection in children. From 2011 to 2013, nasopharyngeal aspirates were obtained from Korean children and tested for hMPV on reverse transcription-polymerase chain reaction (RT-PCR). The genotype of hMPV in each sample was identified on PCR-restriction length polymorphism analysis of the fusion gene. We divided patients into three groups according to degree of fever. Patients with fever peaking at >39.5°C or lasting >7 days were classified as the high fever (HF) group; those with fevers peaking at features of hMPV infection were compared between the HF and LF groups. We classified 80 subjects into the HF group and 84 subjects into the LF group. Mean absolute neutrophil count (5625 ± 4418 vs 4072 ± 3076/μL, P = 0.010) and C-reactive protein (2.39 ± 3.39 vs 0.96 ± 1.77 mg/dL, P = 0.001) were higher in the HF group. Wheezing (5.0% vs 32.1%, P < 0.001) and dyspnea (2.5% vs 15.5%, P = 0.010) were more frequently seen in the LF group. Genotype distribution was similar in the two groups. Two distinct clinical presentations of hMPV infection were identified in this study. © 2015 Japan Pediatric Society.

  1. A clinical and mycological study of onychomycosis in HIV infection

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    Surjushe Amar

    2007-01-01

    Full Text Available Background: Onychomycosis is one of the early manifestations of HIV infection with a prevalence of 15-40%. Multiple nail involvement, isolation of both common and rare species, and resistance to treatment are the characteristics of onychomycosis in HIV. Aim: To study the epidemiology, clinical manifestations of onychomycosis in HIV-infected individuals and to identify the various causative fungi microbiologically. Methods: A total of 250 HIV infected patients, diagnosed by ELISA, were screened for nail involvement; of which 60 patients i.e., 40 males and 20 females, who had clinically suspected untreated fungal infection were included in this study. Results: Of the 60 respondents, 34 (56.66% were from the 31-40 years age group. Amongst the 40 males, there were 20 manual laborers and 14 farmers; while 18 of 20 females were housewives. Toenail involvement was seen in 38 patients (63.33%, fingernail in 12 patients (20% while 10 (16.66% patients had involvement of both. Twenty eight (46.66% patients gave history of some trauma, 6 (10% had diabetes mellitus, and only 1 patient (1.66% had history of peripheral vascular disease. Nineteen (31.66% patients had associated tinea pedis, 5 (8.33% had tinea manuum, 10 (16.66% had tinea corporis and 7 (11.66% had tinea cruris. Twenty one (35% respondents had distal and lateral superficial onychomycosis (DLSO, 5 (8.33% had proximal subungual onychomycosis (PSO, 1 (1.66% had superficial white onychomycosis (SWO, while 33 (55% had total dystrophic onychomycosis (TDO. Fungal elements were demonstrated by KOH mount in 49 patients (81.66% and growth was seen in 32 (53.33% cultures. Dermatophytes were isolated in 13 (21.66% and nondermatophytic molds (NDM in 19 (31.66%. Out of the 13 positive dermatophyte cultures, Trichophyton rubrum was isolated on 11 and Trichophyton mentagrophytes on 2 cultures. Of the 19 non-dermatophytic cultures, Aspergillus niger was isolated on 3 and Candida spp. on 12 while Cladosporium spp

  2. Infection Control Measures in Private Dental Clinics in Lebanon

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    Jihad Dagher

    2017-01-01

    Full Text Available Purpose. Evaluate infection control knowledge, attitude, and practice in Lebanese private dental clinics. Materials and Methods. A survey including 46 questions related to routine safety procedures was sent to 1150 Lebanese dentists between July 1st and 2nd, 2015. The study sample was selected from the database of registered dentists based on a proportional random sampling ensuring equitable representation of the 5 geographic regions of Lebanon. A subset of 29 questions was used to generate an overall score of compliance (excellent, good, fair, and poor. Comparisons according to gender, type, region, and years of practice were performed. Results. 417 dentists returned the completed questionnaires. 96% expressed concern about infection transmission, 90.6% were vaccinated against Hepatitis B, and 61.8% asked routinely about patients medical history. Only 43% used protective eyewear. Although most dentists (65% used autoclaves, dry heat was still used. Significant correlations were found between gender and use of personal protective equipment. Less compliance was shown by clinicians with fewer years of experience. In the overall compliance questionnaire, the mean percentage of correct answers was roughly 54% with <5% of the practitioners scoring “excellent.” Conclusions. The study found inadequacy of compliance in private Lebanese dental clinics necessitating improved educational training and sustained monitoring by regulatory bodies.

  3. Zika virus infection: epidemiology, clinical manifestations and diagnosis.

    Science.gov (United States)

    Calvet, Guilherme Amaral; Santos, Flavia Barreto Dos; Sequeira, Patricia Carvalho

    2016-10-01

    Zika virus (ZIKV) is an arbovirus previously believed to cause only a mild and self-limiting illness. Recently, it has emerged as a new public health threat that caused a large outbreak in French Polynesia in 2013-2014 and since 2015 an explosive outbreak in Brazil, with an increase in severe congenital malformations (microcephaly) and neurological complications, mainly Guillain-Barré syndrome (GBS). Since then, it has spread through the Americas. On 1 February 2016, the WHO declared the ZIKV epidemic in Brazil a Public Health Emergency of International Concern. We reviewed the epidemiology of ZIKV infection, clinical presentations and diagnosis. We highlighted the clinical features and nonvector borne transmission of the virus. Association between ZIKV infection and severe foetal outcomes, including microcephaly and other birth defects; increased rate of GBS and other neurological complications due to the ongoing ZIKV outbreak; increased evidence to date of ZIKV being the only arbovirus linked to sexual transmission; the challenge of ZIKV diagnosis; and the need for a specific point-of care test in epidemic scenarios. The findings illustrate the emergence of a viral disease with the identification of new associated disorders, new modes of transmission, including maternal-foetal and sexual transmission.

  4. Clinical Features and Outcomes of Pasteurella multocida Infection.

    Science.gov (United States)

    Giordano, Antonio; Dincman, Toros; Clyburn, Benjamin E; Steed, Lisa L; Rockey, Don C

    2015-09-01

    Pasteurella multocida, a zoonotic infectious organism, has most often been described in patients after an animal bite. Here, we characterize the clinical features and outcomes of P multocida infection in a large cohort of patients according to the presence or absence of an animal bite.We retrospectively searched MUSC's laboratory information system for all patients with positive P multocida cultures from 2000 to 2014. Extensive data were abstracted, including clinical and outcome data. The Charlson comorbidity index (CCI) was used to assess comorbidities among patients.We identified 44 patients with P multocida infections, including 25 with an animal bite. The average age was 64 years and the majority of patients were women (N = 30). There was no difference in age and sex distribution among those with and without a bite (P = 0.38 and 0.75, respectively). A CCI ≥1 was significantly associated with the absence of a bite (P = 0.006). Patients presenting without a bite were more frequently bacteremic (37% vs 4%, respectively, P = 0.001), and were hospitalized more often (84% vs 44%, respectively, P = 0.012). Of the 8 patients who required intensive care unit (ICU)-based care, 7 were non-bite-related. There were 4 deaths, all occurring in patients not bitten.P multocida infections not associated with an animal bite were often associated with bacteremia, severe comorbidity(ies), immune-incompetent states, the need for ICU management, and were associated with substantial mortality.

  5. Clinical Evaluation of Superficial Fungal Infections in Children

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    Ragıp Ertaş

    2015-12-01

    Full Text Available Objective: This retrospective study was referred to evaluate 51 cases of superficial mycoses, referred to our Pediatric Dermatology outpatient clinic in one year. Methods: We reviewed following data for all patients: age, gender, accompanied diseases, clinical types, localization and treatment. Superficial mycotic infections were diagnosed on the basis of clinical picture, direct microscopy and some of them were confirmed by fungal cultures. Results: Our patients comprised 33 boys (64.7% and 18 girls (35.3%, with an average age of 6.2 years (range 4 months to 17 years. Eighteen patients (35.3% had dermatophytes on the scalp. Clinical forms, in the order of frequency, were: tinea capitis profunda in 10 patients (19.6%, tinea capitis superficialis in 8 patients (15.8%, tinea unguium in 8 patients (15.8%. Tinea capitis (35.3% was the most frequent form of dermatomycosis. The most common symptom was the pruritus. Thirty (58% patients were treated with local antimycotics and 21 (42% patients were treated with systemic terbinafine or itraconazole. Conclusion: In this study it was found that, tinea capitis was the most frequent form of dermatomycosis and onychomycosis in children are not uncommon as it is mentioned. The data also suggest that topical antifungal agents may be effective and well-tolerated in the treatment of onychomycosis and tinea capitis in children.

  6. Neurosyphilis in a clinical cohort of HIV-1-infected patients

    Science.gov (United States)

    Ghanem, Khalil G.; Moore, Richard D.; Rompalo, Anne M.; Erbelding, Emily J.; Zenilman, Jonathan M.; Gebo, Kelly A.

    2008-01-01

    Objectives To describe the risk factors, clinical presentation, and long-term follow up of patients enrolled in a clinical cohort of HIV-infected patients who were diagnosed and treated for neurosyphilis. Methods Comprehensive demographic, clinical, and therapeutic data were collected prospectively on all patients between 1990 and 2006. Patients were diagnosed with neurosyphilis if they had positive syphilis serologies and any of the following: (a) one or more cerebrospinal fluid abnormalities on lumbar puncture [white blood cells >10/μl; protein >50 mg/dl; reactive venereal diseases research laboratory], (b) an otherwise unexplained neurological finding. Results Of 231 newly diagnosed syphilis cases, 41 neurosyphilis cases met entry criteria (median age 38.6 years, 79.1% male). Risk factors for neurosyphilis included a CD4 cell count of less than 350 cells/ml at the time of syphilis diagnosis (odds ratio: 2.87; 95% confidence interval: 1.18–7.02), a rapid plasma regain titer >1:128 (2.83; 1.11–7.26), and male sex (2.46; 1.06–5.70). Use of any highly active antiretroviral therapy before syphilis infection reduced the odds of neurosyphilis by 65% (0.35; 0.14–0.91). Sixty-three percent of cases presented with early neurosyphilis and the median time to neurosyphilis diagnosis was 9 months. Symptomatic patients had more cerebrospinal fluid abnormalities on initial lumbar puncture than asymptomatic patients (P =0.01). Follow-up lumbar puncture within 12 months revealed that only 38% had resolution of all cerebrospinal fluid abnormalities. At 1 year, 38% had persistence of their major symptom despite adequate treatment for neurosyphilis. Twelve of 41 (29%) patients were retreated for syphilis. Conclusion Early neurosyphilis was common in this cohort. Highly active antiretroviral therapy to reverse immunosuppression may help mitigate neurological complications of syphilis. PMID:18525260

  7. Posaconazole: clinical pharmacology and potential for management of fungal infections.

    Science.gov (United States)

    Groll, Andreas H; Walsh, Thomas J

    2005-08-01

    Posaconazole is a novel lipophilic antifungal triazole that inhibits cytochrome P450-dependent 14-alpha demethylase in the biosynthetic pathway of ergosterol. Inhibition of this enzyme leads to an accumulation of toxic 14-alpha methylsterols and a depletion of ergosterol, resulting in a perturbation of the function of the fungal cell membrane and blockage of cell growth and division. In vitro, posaconazole has potent and broad-spectrum activity against opportunistic, endemic and dermatophytic fungi. This activity extends to organisms that are often refractory to existing triazoles, amphotericin B or echinocandins, such as Candida glabrata, Candida krusei, Aspergillus terreus, Fusarium spp. and the Zygomycetes. A large variety of animal models of invasive fungal infections have provided consistent evidence of efficacy against these organisms in vivo, both in normal and immunocompromised animals. Posaconazole is available as an oral suspension and optimal exposure is achieved when the drug is administered in two to four divided doses along with food or a nutritional supplement. The compound has a large volume of distribution, in the order of 5 l/kg, and a half-life of approximately 20 h. Posaconazole is not metabolized to a significant extent through the cytochrome P450 enzyme system and is primarily excreted in an unchanged form in the feces. Although it is inhibitory, cytochrome P3A4 has no effect on 1A2, 2C8, 2C9, 2D6 and 2E1 isoenzymes, and therefore, a limited spectrum of drug-drug interactions can be expected. Pharmacokinetic studies in special populations revealed no necessity for dosage adjustment based on differences in age, gender, race, renal or hepatic function. Posaconazole has demonstrated strong antifungal efficacy in Phase II and III clinical trials in immunocompromised patients with oropharyngeal and esophageal candidiasis. Posaconazole also showed promising efficacy as salvage therapy in a large Phase II study including 330 patients with invasive

  8. Clinical manifestation and risk factors of tuberculosis infection in Malaysia: case study of a community clinic.

    Science.gov (United States)

    Shanmuganathan, Rohan; Subramaniam, Indra Devi

    2015-01-01

    The main aim of this study was to describe the clinical manifestation of tuberculosis infection cases in Malaysia and to determine the individual risk factors for their occurrence. The study adopted a quantitative research approach with use of descriptive statistical approach. The study setting was a community clinic which treats walk in patients who are mainly living and working in the surrounding areas. The study was conducted for a period of one year. All tuberculosis patients who sought treatment in the clinic during the time were included in this study. The total number of cases was 40. Data was collected from the medical records of the tuberculosis patients. The risk factors selected for investigation were demographic characteristics of age and sex, personal habits such as smoking, drug use and alcohol and presence of diseases such as human immunodeficiency virus positive (HIV+), diabetes mellitus, cancer, cyanotic heart disease, renal failure and steroid use. Patients in the age group ranging from 41 to 50 years had the highest incidence of the infection. Smoking appears to be the most important risk factor for contracting followed by drug abuse, HIV+ infection and diabetes mellitus. People with diseases such as diabetes mellitus and HIV that are high risk factors for TB should be screened for TB so that early detection and intervention is possible. Educational programs should be carried out to create awareness among the at risk groups.

  9. Clinical Manifestation and Risk Factors of Tuberculosis Infection in Malaysia: Case Study of a Community Clinic

    Science.gov (United States)

    Shanmuganathan, Rohan; Shanmuganathan, Indra Devi

    2015-01-01

    Introduction: The main aim of this study was to describe the clinical manifestation of tuberculosis infection cases in Malaysia and to determine the individual risk factors for their occurrence. Methodology: The study adopted a quantitative research approach with use of descriptive statistical approach. The study setting was a community clinic which treats walk in patients who are mainly living and working in the surrounding areas. The study was conducted for a period of one year. All tuberculosis patients who sought treatment in the clinic during the time were included in this study. The total number of cases was 40. Data was collected from the medical records of the tuberculosis patients. The risk factors selected for investigation were demographic characteristics of age and sex, personal habits such as smoking, drug use and alcohol and presence of diseases such as human immunodeficiency virus positive (HIV+), diabetes mellitus, cancer, cyanotic heart disease, renal failure and steroid use. Results: Patients in the age group ranging from 41 to 50 years had the highest incidence of the infection. Smoking appears to be the most important risk factor for contracting followed by drug abuse, HIV+ infection and diabetes mellitus. Conclusions: People with diseases such as diabetes mellitus and HIV that are high risk factors for TB should be screened for TB so that early detection and intervention is possible. Educational programs should be carried out to create awareness among the at risk groups. PMID:25946947

  10. Clinical experience of infective endocarditis complicated by acute cerebrovascular accidents.

    Science.gov (United States)

    Hsu, Chan-Yang; Chi, Nai-Hsin; Wang, Shoei-Shen; Chen, Yih-Sharng; Yu, Hsi-Yu

    2017-04-01

    To evaluate the clinical results of patients with infective endocarditis (IE) complicated by acute cerebrovascular accidents (CVAs). A total of 44 patients with IE complicated by CVA at admission were retrospectively analyzed in a single medical institute from 2005 to 2011. At the time of admission, 18 patients were diagnosed with hemorrhagic stroke, and 26 patients were diagnosed with ischemic stroke. Fifteen patients received surgical intervention during hospitalization. The hospital mortality rate was 38.9% for the hemorrhagic stroke group and 42.3% for the ischemic stroke group (p = 0.821). The mortality rate was 33.3% for the surgical group and 44.8% for the nonsurgical group (p = 0.531). At 30 days of hospitalization, 45.8% of the patients experienced an adverse event (defined as death due to organ failure, restroke, cardiogenic shock, or septic shock during the treatment period), and the attrition rate was 1.5% per day. Surgery performed after the adverse events increased mortality (80.0%) compared with surgery performed on patients with no adverse events (10.0%; p = 0.017). A Cox regression analysis revealed that creatinine > 2 mg/dL, diabetes, and staphylococcal infection were the risk factors of the adverse events. Early surgical intervention for IE with ischemic stroke may prevent adverse events, particularly in patients with impaired renal function, diabetes, or staphylococcal infection. A delay in operation of > 30 days is recommended after hemorrhagic stroke. Copyright © 2017. Published by Elsevier Taiwan.

  11. Respiratory infection by Corynebacterium striatum: epidemiological and clinical determinants

    Directory of Open Access Journals (Sweden)

    F. Renom

    2014-07-01

    Full Text Available The increasing prevalence of advanced chronic respiratory disease, with frequent exposure to broad-spectrum antibiotics for repeated and prolonged hospitalizations, favours the emergence of nosocomial respiratory infection by Gram-positive bacteria, such as outbreaks of Corynebacterium striatum. There is little evidence about patterns of respiratory infection, transmission and adaptive ability of this pathogen. Seventy-two C. striatum isolates from 51 advanced respiratory patients, mainly chronic obstructive pulmonary disease, were studied during 38 months. Patients were 74.8 ± 8.6 years old and 81.9% were men, who had required an average of 2.2 hospitalizations and 63.5 days in the hospital in the previous year. Of 49 isolates from 42 patients we were able to identify 12 clones by multilocus sequence analysis (MLSA, nine phenotypic variants and 22 antibiotic susceptibility patterns, and we determined their clinical and epidemiological determinants. MLSA allows identification of the existence of nosocomial outbreaks by transmission of the same or different clones, the persistence of the same clone in the environment or in patient airways for months. The study showed the high variability and adaptive capacity of the isolates, the antibiotic multidrug-resistance in all of them, and their contribution to a high morbidity and mortality (41% during the study period.

  12. Important clinical advances in the understanding of Clostridium difficile infection.

    Science.gov (United States)

    Pacheco, Susan M; Johnson, Stuart

    2013-01-01

    Clostridium difficile remains an important cause of infectious colitis, particularly in healthcare facilities. This review summarizes recent advances in the epidemiology, diagnosis, and treatment of this endemic pathogen. C. difficile infection (CDI) hospitalizations and mortality rates have increased over the last decade. The BI/NAP1/027 strain has been responsible for epidemics with increased severity and mortality and is now endemic in many settings, particularly North America. Concurrent antibiotics have now been shown to decrease the cure rates for anti-C. difficile therapy and increase the risk of recurrence. Although studies implicate proton pump inhibitors as a risk for CDI, the magnitude of and the biological basis for that risk remain unclear. Molecular diagnostic techniques are rapid and sensitive but highlight the importance of using appropriate clinical testing criteria. Fidaxomicin is a promising new therapy associated with decreased recurrence; infections due to BI strains, however, are associated with inferior outcomes regardless of the treatment agent. Fecal transplantation continues to have impressive success rates for patients with recurrent CDI, and a new colon-sparing surgical procedure presents an intriguing suggested alternative to total colectomy in severe, complicated cases. Elucidating CDI risk factors, identifying rapid, accurate diagnostic tools, and validating new treatment approaches remains an urgent priority.

  13. Clinical Evaluation of Shilajatu Rasayana in patients with HIV Infection.

    Science.gov (United States)

    Gupta, G D; Sujatha, N; Dhanik, Ajay; Rai, N P

    2010-01-01

    AIDS is one of the serious global health concerns caused by Human Immuno Deficiency(HIV) virus and is predominantly a sexually transmitted disease. Currently there is no vaccine or cure for AIDS still Anti Retroviral Therapy (ART) is successful. It reduces both the mortality and the morbidity of HIV infection, but is expensive and inaccessible in many countries. However intense the therapy may be, HIV virus is rarely eliminated, and drug resistance is a major setback during long-term therapy. The development of new drugs and strategies and exploring alternative systems of medicine for antiviral herbs or drugs is the need of the age to improve treatment outcomes. Ayurveda describes many diseases which incorporate HIV like illness e.g. Rajayakshma, Ojo Kshaya, Sannipata jwara etc. HIV infection affects multisystems, chiefly the Immune System which can be correlated to Ojo Kshaya. Rasayana Chikitsa is the frontline therapy employed to treat Ojus disorders. Therefore Shilajatu (Mineral pitch), Centella asiatica (Mandukaparni), Tinospora cordifolia (Guduchi) and Emblica officinalis (Amalaki), well known for their Immuno-modulator and antioxidant properties were selected to evaluate their role on immune system. The study was carried on 20 patients from OPD and IPD of Kayachikitsa, S.S.Hospital, IMS, BHU and was randomly allocated into Treated group (Shilajatu+ART) and Control group (ART). Treated Group responded better to ART both clinically and biochemically. The results show that Shilajatu decreases the recurrent resistance of HIV virus to ART and improves the outcome of the therapy.

  14. Electromagnetic radiation influence on clinical course of experimental wound infection

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    Pronina Е.А.

    2010-09-01

    Full Text Available The article gives close attention to the study of electromagnetic radiation influence (EMR at the frequency of molecular spectrum absorption and radiation (MSAR of nitric oxide (150 GHz and atmospheric oxygen (129 GHz on the clinical course of experimental wound infection caused by antibiotic-sensitive and antibiotic-resistant strains of Pseudomonas aeruginosa. The panoramic spectrometric measuring complex, developed in Saratov Scientific Research Institute of Measuring Equipment was used while carrying out the research. Electromagnetic vibrations of extremely high frequencies were stimulated in this complex imitating the atmospheric oxygen and nitric oxide absorption and radiation molecular spectrum structure. The experiments proved the fact that exposure to radiation at the frequency of molecular spectrum absorption and radiation (MSAR of nitric oxide and atmospheric oxygen had positive impact on the course of traumatic process

  15. Viral and atypical bacterial infections in the outpatient pediatric cystic fibrosis clinic

    DEFF Research Database (Denmark)

    Olesen, Hanne Vebert; Nielsen, Lars P; Schiotz, Peter Oluf

    2006-01-01

    BACKGROUND: Respiratory viral and atypical bacterial infections are associated with pulmonary exacerbations and hospitalisations in cystic fibrosis patients. We wanted to study the impact of such infections on children attending the outpatient clinic. METHODS: Seventy-five children were followed...

  16. [Clinical guidelines for the prevention of infective endocarditis].

    Science.gov (United States)

    Pérez-Lescure Picarzo, J; Crespo Marcos, D; Centeno Malfaz, F

    2014-03-01

    This article sets out the recommendations for the prevention of infective endocarditis (IE), contained in the guidelines developed by the American Heart Association (AHA) and the European Society of Cardiology (ESC), from which the recommendations of the Spanish Society of Paediatric Cardiology and Congenital Heart Disease have been agreed. In recent years, there has been a considerable change in the recommendations for the prevention of IE, mainly due to the lack of evidence on the effectiveness of antibiotic prophylaxis in prevention, and the risk of the development of antibiotic resistance. The main change is a reduction of the indications for antibiotic prophylaxis, both in terms of patients and procedures considered at risk. Clinical practice guidelines and recommendations should assist health professionals in making clinical decisions in their daily practice. However, the ultimate judgment regarding the care of a particular patient must be taken by the physician responsible. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  17. Vaginal infections in pregnant patients of a high complexity clinic from Medellín-Colombia

    OpenAIRE

    Rojas Jimenez, Sara; Universidad Pontificia Bolivariana; Lopera Valle, Johan Sebastián; Rodríguez Padilla, Libia María; Universidad Pontificia Bolivariana; Martínez Sánchez, Lina Maria; Universidad Pontificia Bolivariana

    2016-01-01

    Objective: to describe the characteristics of vaginal infections in pregnant patients. pregnancy is a predisposing factor for vaginal infections, which can lead to deleterious consequences for mother and fetus. Materials and methods: a cross-sectional study. Population consists in pregnant patients diagnosed with vaginal infection in a high complexity clinic, January 2011 to June 2012. Sociodemographic, clinical, microbiological and therapeutic information were collected from the clinical his...

  18. Clinical disease severity of respiratory viral co-infection versus single viral infection: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Sandra A Asner

    Full Text Available Results from cohort studies evaluating the severity of respiratory viral co-infections are conflicting. We conducted a systematic review and meta-analysis to assess the clinical severity of viral co-infections as compared to single viral respiratory infections.We searched electronic databases and other sources for studies published up to January 28, 2013. We included observational studies on inpatients with respiratory illnesses comparing the clinical severity of viral co-infections to single viral infections as detected by molecular assays. The primary outcome reflecting clinical disease severity was length of hospital stay (LOS. A random-effects model was used to conduct the meta-analyses.Twenty-one studies involving 4,280 patients were included. The overall quality of evidence applying the GRADE approach ranged from moderate for oxygen requirements to low for all other outcomes. No significant differences in length of hospital stay (LOS (mean difference (MD -0.20 days, 95% CI -0.94, 0.53, p = 0.59, or mortality (RR 2.44, 95% CI 0.86, 6.91, p = 0.09 were documented in subjects with viral co-infections compared to those with a single viral infection. There was no evidence for differences in effects across age subgroups in post hoc analyses with the exception of the higher mortality in preschool children (RR 9.82, 95% CI 3.09, 31.20, p<0.001 with viral co-infection as compared to other age groups (I2 for subgroup analysis 64%, p = 0.04.No differences in clinical disease severity between viral co-infections and single respiratory infections were documented. The suggested increased risk of mortality observed amongst children with viral co-infections requires further investigation.

  19. Prevalence and clinical features of Dientamoeba fragilis infections in patients suspected to have intestinal parasitic infection.

    Science.gov (United States)

    Rayan, Hanan Z E; Ismail, Ola A; El Gayar, Eman K

    2007-08-01

    The present study was conducted to determine the prevalence and clinical features of dientamoebiasis in patients presumed to be infected with intestinal parasites. A total of 168 patients were examined for D. fragilis using microscopy (after Wheatley's trichrome staining) and culture (using modified Boeck and Drbohlav's medium). D. fragilis trophozoites were detected in 15 samples (8.9%) examined using trichrome staining and in 50 samples (29.8%) by culture method. Other enteric parasites were common in the study population as 48.8% of patients (82/168) were found harboring intestinal parasites. Blastocystis hominis was the most common, identified in 33.3% (56/168) of the samples. Giardia lamblia was detected in 17.9% (30/168) and E. histolytica/E. dispar in 11.9% (20/168). The symptoms most frequently encountered were diarrhea, abdominal pain and weight loss and fatigue. Diarrhea and abdominal pain were significantly more frequent in patients with dientamoebiasis compared to non pathogenic cases (P fragilis compared to 50% of patients infected with G. lamblia, while abdominal pain was encountered with D. fragilis in 41% compared to 33.3% with G. lamblia. These differences were insignificant (P > 0.05).

  20. Clinical correlates of helicobacter pylori infection in children seen at ...

    African Journals Online (AJOL)

    Background: Helicobacter pylori (H pylori) infection is the commonest global chronic human bacterial infection. Data from developed countries show that acquisition occurs in childhood but manifestation of chronic gastroduodenal diseases occur more commonly in adulthood. H. pylori infection has however been associated ...

  1. Severe bacterial infections in patients with non-transfusion-dependent thalassemia: prevalence and clinical risk factors

    Directory of Open Access Journals (Sweden)

    Nattiya Teawtrakul

    2015-10-01

    Conclusion: The prevalence of bacterial infection in patients with NTDT was found to be moderate. Time after splenectomy >10 years, deferoxamine therapy, and iron overload may be clinical risk factors for severe bacterial infection in patients with NTDT. Bacterial infection should be recognized in splenectomized patients with NTDT, particularly those who have an iron overload.

  2. Functional dyspepsia and dyspepsia associated with Helicobacter pylori infection: Do they have different clinical characteristics?

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    J.L. Rodríguez-García

    2016-07-01

    Conclusions: The patients with dyspepsia infected with Helicobacter pylori had similar clinical characteristics to the non-infected patients and could not be differentiated a priori. The prevalence of Helicobacter pylori infection in patients with functional dyspepsia was 58% and increased with age.

  3. Clinical and diagnostic pathways in pediatric fungal infections

    Directory of Open Access Journals (Sweden)

    Elio Castagnola

    2013-07-01

    Full Text Available Generally speaking, in pediatrics the patients mostly affected by fungal infections are hematological patients, followed by those with solid tumors, and transplant recipients. Candida infections generally occur just after birth, whereas Aspergillus infections are age-related, and increase their incidence with age. However, among infections, the incidence of bacteremias are still greater than that of mycoses. In pediatrics, in Italy the immunocompromised patients – thus particularly susceptible to fungal infections – are mainly those with severe combined immunodeficiency, chronic mucocutaneous candidiasis, and chronic granulomatous disease. Particular Aspergillus or Scedosporium infections should be considered in peculiar kinds of patients, such as those affected by cystic fibrosis. Finally, different kinds of fungi should be considered in those who come from or spend a lot time in specific areas, such as South America (e.g. coccidioidomycoses, for which differential diagnosis is with tuberculosis.http://dx.doi.org/10.7175/rhc.v4i1S.859

  4. Puerperal infections of the genital tract: a clinical review.

    Science.gov (United States)

    Karsnitz, Deborah Brandt

    2013-01-01

    Puerperal genital tract infections, although less common in the 21st century, continue to affect maternal mortality and morbidity rates in the United States. Puerperal genital tract infections include endometritis as well as abdominal and perineal wound infections. These infections interrupt postpartum restoration, increase the potential for readmission to a health care facility, and can interfere with maternal-infant bonding. In addition, unrecognized or improperly treated genital tract infection could extend to other sites via venous circulation or the lymphatic system and increase the risk of severe complications or sepsis. Midwives are leaders in education, low rates of intervention, and prompt recognition of deviation from normal. Because puerperal genital tract infection usually begins after discharge, detailed education for women will encourage preventative health care, prompt recognition, and treatment. © 2013 by the American College of Nurse-Midwives.

  5. MYCOPLASMA INFECTION: CLINICAL TYPES, VARIATIONS OF CLINICAL COURSE AND DIAGNOSTIC MISTAKES

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    M.S. Savenkova

    2013-01-01

    Full Text Available Aim: to assess clinical course of various types of mycoplasma infection during the last epidemic (September 2012 – February 2013 according to the positive results of serological analyses. Patients and methods: 3553 laboratory tests were performed, 177 (20% positive results of mycoplasma were detected. During the study clinical types, gender and age of patients were analyzed; special characteristics of clinical course of mycoplasma pneumonia were identified. Results: among 78 patients with pneumonia severe form was detected only in one. Twenty five percent of patients had ENT-diseases. The authors performed comparative analysis of antibacterial treatment (first-line and macrolides. The duration of X-ray changes depended on treatment scheme; the best results were achieved in children who were administered combined treatment with first-line (cephalosporin and macrolide in suspension. Conclusions: during the period of 2012–2013 yy pneumonia has had a moderate clinical course, rarely — with complications. In 25% of children diseases of ENT organs were diagnosed. Mycoplasma was most often associated with chlamydia and types 1 and 2 of herpes simplex viruses, which is necessary to be considered in determination of therapy regimen. In treatment it is preferably to use combination of cephalosporin and macrolide in suspension.

  6. Risk groups for clinical complications of norovirus infections: an outbreak investigation.

    NARCIS (Netherlands)

    Mattner, F; Sohr, D; Heim, A; Gastmeier, P; Vennema, H; Koopmans, M

    2006-01-01

    Norovirus infections have been described as self-limiting diseases of short duration. An investigation of a norovirus outbreak in a university hospital provided evidence for severe clinical features in patients with several underlying diseases. Clinical outcomes of norovirus infection were defined.

  7. Clinical Characteristics of Nocardia Infection in Patients with Rheumatic Diseases

    Science.gov (United States)

    Yamagata, Mieko; Hirose, Koichi; Ikeda, Kei; Nakajima, Hiroshi

    2013-01-01

    Although Nocardiosis has considerable recurrence and mortality rates, characteristics and risk factors of Nocardia infection have not been assessed in patients with rheumatic diseases. Here, we examined the characteristics and risk factors of Nocardia infection in rheumatic disease patients in our hospital. Ten rheumatic disease patients who developed Nocardia infection were identified by retrospectively reviewing the medical records. Possible predisposing factors for Nocardia infection were high-dose glucocorticoid treatment, concomitant use of immunosuppressants, preexisting pulmonary diseases, and diabetes mellitus. All patients had pulmonary Nocardiosis, and six of them had disseminated Nocardiosis when their pulmonary lesions were identified. PMID:24171035

  8. Clinical findings and survival in cats naturally infected with feline immunodeficiency virus.

    Science.gov (United States)

    Liem, B P; Dhand, N K; Pepper, A E; Barrs, V R; Beatty, J A

    2013-01-01

    The clinical course and outcome of natural feline immunodeficiency virus (FIV) infection are variable and incompletely understood. Assigning clinical relevance to FIV infection in individual cats represents a considerable clinical challenge. To compare signalment, hematologic and biochemical data, major clinical problem, and survival among client-owned, FIV-infected, and uninfected domestic cats. Client-owned, domestic cats tested for FIV (n = 520). Retrospective, case control study. Logistic regression analyses were conducted to identify risk factors for FIV infection and to compare hematologic and biochemical data between cases and controls, after adjusting for potential confounders. Survival times were compared using Kaplan-Meier curves. The prevalence of FIV infection was 14.6%. Mixed breed, male sex, and older age were risk factors for FIV infection. Hematologic abnormalities, biochemical abnormalities or both were common in both FIV-infected and uninfected cats. Lymphoid malignancies were slightly more common in FIV-infected than uninfected cats. Survival of FIV-infected cats was not significantly different from that of uninfected cats. Multiple hematologic and biochemical abnormalities are common in old, sick cats regardless of their FIV status. Their presence should not be assumed to indicate clinical progression of FIV infection. A negative effect of FIV on survival was not apparent in this study. Copyright © 2013 by the American College of Veterinary Internal Medicine.

  9. Pattern Of Sexually Transmitted Infections In A Reference Clinic Of ...

    African Journals Online (AJOL)

    Gonorrhea and scabies made up 3 (3.33%) each of the cases while genital herpes including infective Herpes zoster and Molluscum contagiosum associated infections accounted for 2.22% each of the cases. Conclusion: The patients presented with significant range of STIs with some showing similar prevalence rate.

  10. Clinical outcome after treatment of infected primary total knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Jensen, Tim Toftgaard

    2002-01-01

    Twenty-six consecutive cases of infected primary total knee arthroplasties were treated at our institution from 1989 through 2000. Eleven patients had debridement and irrigation performed within 2 months of index arthroplasty or hematogenous spread; only one infection was eradicated. Twenty-five ...

  11. Clinical and molecular epidemiology of Staphylococcus argenteus infections in Thailand.

    Science.gov (United States)

    Thaipadungpanit, Janjira; Amornchai, Premjit; Nickerson, Emma K; Wongsuvan, Gumphol; Wuthiekanun, Vanaporn; Limmathurotsakul, Direk; Peacock, Sharon J

    2015-03-01

    Molecular typing of 246 Staphylococcus aureus isolates from unselected patients in Thailand showed that 10 (4.1%) were actually Staphylococcus argenteus. Contrary to the suggestion that S. argenteus is less virulent than S. aureus, we demonstrated comparable rates of morbidity, death, and health care-associated infection in patients infected with either of these two species. Copyright © 2015, Thaipadungpanit et al.

  12. Clinical and Molecular Epidemiology of Staphylococcus argenteus Infections in Thailand

    OpenAIRE

    Thaipadungpanit, Janjira; Amornchai, Premjit; Nickerson, Emma K.; Wongsuvan, Gumphol; Wuthiekanun, Vanaporn; Limmathurotsakul, Direk; Peacock, Sharon J.

    2015-01-01

    Molecular typing of 246 Staphylococcus aureus isolates from unselected patients in Thailand showed that 10 (4.1%) were actually Staphylococcus argenteus. Contrary to the suggestion that S. argenteus is less virulent than S. aureus, we demonstrated comparable rates of morbidity, death, and health care-associated infection in patients infected with either of these two species.

  13. EPIDEMIOLOGICAL AND CLINICAL FEATURES OF COMBINED RESPIRATORY INFECTIONS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    V. V. Shkarin

    2017-01-01

    Full Text Available Presents a review of publications on the problem of combined respiratory infections among children. Viral-bacterial associations are registered  in a group of often ill children in 51.7%. More than half of the patients have herpesvirus infection in various combinations. The presence of a combined acute respiratory viral infection among children in the group from 2 to 6 years was noted in 44.2% of cases, among which, in addition to influenza viruses, RS-, adeno-, etc., metapneumovirus and bocavirus plays an important role.The increase in severity of acute respiratory viral infection with combined  infection, with chlamydia  and mycoplasma infection is shown. A longer and more severe course of whooping cough was observed when combined with respiratory viruses.The revealed facts of frequency of distribution of combined  respiratory infections in children, the severity and duration of their course with the development of various complications and the formation of chronic pathology dictate the need to improve diagnosis and treatment tactics of these forms of infections.

  14. Age-specificity of clinical dengue during primary and secondary infections.

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    Khoa T D Thai

    2011-06-01

    Full Text Available This study aims to estimate the age-specific risks of clinical dengue attack (i.e., the risk of symptomatic dengue among the total number of dengue virus (DENV infections during primary and secondary infections.We analyzed two pieces of epidemiological information in Binh Thuan province, southern Vietnam, i.e., age-specific seroprevalence and a community-wide longitudinal study of clinical dengue attack. The latter data set stratified febrile patients with DENV infection by age as well as infection parity. A simple modeling approach was employed to estimate the age-specific risks of clinical dengue attack during primary and secondary infections.Using the seroprevalence data, the force of infection was estimated to be 11.7% (95% confidence intervals (CI: 10.8-12.7 per year. Median age (and the 25-75 percentiles of dengue fever patients during primary and secondary infections were 12 (9-20 and 20 (14-31 years, respectively. The estimated age-specific risk of clinical dengue increases as a function of age for both primary and secondary infections; the estimated proportion of symptomatic patients among the total number of infected individuals was estimated to be <7% for those aged <10 years for both primary and secondary infections, but increased as patients become older, reaching to 8-11% by the age of 20 years.For both primary and secondary infections, higher age at DENV infection was shown to result in higher risk of clinical attack. Age as an important modulator of clinical dengue explains recent increase in dengue notifications in ageing countries in Southeast Asia, and moreover, poses a paradoxical problem of an increase in adult patients resulting from a decline in the force of infection, which may be caused by various factors including time-dependent variations in epidemiological, ecological and demographic dynamics.

  15. Review: clinical management of Helicobacter pylori infection in China.

    Science.gov (United States)

    Xie, Chuan; Lu, Nong-Hua

    2015-02-01

    Helicobacter pylori (H. pylori) infection has been associated with gastric disorders. The situation of H. pylori infection in China-where a high prevalence of H. pylori infection, a high incidence of gastric cancer, and widespread resistance to clarithromycin, metronidazole, and levofloxacin exist-is quite different from that in Western countries. In order for Chinese clinicians to better manage H. pylori infection, a Chinese Study Group on H. pylori published four consensus reports regarding the management of H. pylori infection in China between 1999 and 2012. The eradication rate with standard triple therapy was pylori in China in recent years. © 2014 John Wiley & Sons Ltd.

  16. Overview of the Clinical Manifestations of Borrelia burgdorferi Infection

    Directory of Open Access Journals (Sweden)

    Raymond J Dattwyler

    1991-01-01

    Full Text Available Lyme disease, caused by the spirochete Borrelia burgdorferi, has classically been divided into three stages: erythema migrans; neurological or cardiac involvement; and arthritis. Rather than defining a set disease pattern, however, one should, more logically, conceptualize a progressive infection that may be localized or disseminated, acute or chronic. Erythema migrans, the earliest and most easily recognized manifestation of B burgdorferi infection, is an expanding annular erythematous skin lesion with a central clearing that develops soon after the bite of an infected ixodes tick. Musculoskeletal manifestations are common, with approximately one-half of untreated individuals developing arthritis. Of these, only 10% have chronic arthritis. Invasion of the central nervous system occurs as the infection disseminates hematogenously, with encephalitis, myelitis and meningopolyneuritis being the most severe results. Acute cardiac involvement is recognized in up to 8% of adult patients, and less often in children. Early antibiotic treatment of the infection is highly effective.

  17. Clinical manifestations of new versus recrudescent malaria infections following anti-malarial drug treatment.

    Science.gov (United States)

    Shaukat, Ayesha M; Gilliams, Elizabeth A; Kenefic, Leo J; Laurens, Matthew B; Dzinjalamala, Fraction K; Nyirenda, Osward M; Thesing, Phillip C; Jacob, Christopher G; Molyneux, Malcolm E; Taylor, Terrie E; Plowe, Christopher V; Laufer, Miriam K

    2012-06-18

    Distinguishing new from recrudescent infections in post-treatment episodes of malaria is standard in anti-malarial drug efficacy trials. New infections are not considered malaria treatment failures and as a result, the prevention of subsequent episodes of malaria infection is not reported as a study outcome. However, in moderate and high transmission settings, new infections are common and the ability of a short-acting medication to cure an initial infection may be outweighed by its inability to prevent the next imminent infection. The clinical benefit of preventing new infections has never been compared to that of curing the initial infection. Children enrolled in a sulphadoxine-pyrimethamine efficacy study in Blantyre, Malawi from 1998-2004 were prospectively evaluated. Six neutral microsatellites were used to classify new and recrudescent infections in children aged less than 10 years with recurrent malaria infections. Children from the study who did not experience recurrent parasitaemia comprised the baseline group. The odds of fever and anaemia, the rate of haemoglobin recovery and time to recurrence were compared among the groups. Fever and anemia were more common among children with parasitaemia compared to those who remained infection-free throughout the study period. When comparing recrudescent vs. new infections, the incidence of fever was not statistically different. However, children with recrudescent infections had a less robust haematological recovery and also experienced recurrence sooner than those whose infection was classified as new. The results of this study confirm the paramount importance of providing curative treatment for all malaria infections. Although new and recrudescent infections caused febrile illnesses at a similar rate, recurrence due to recrudescent infection did have a worsened haemological outcome than recurrence due to new infections. Local decision-makers should take into account the results of genotyping to distinguish new

  18. Clinical and radiographic predictors of the etiology of pulmonary nodules in HIV-infected patients.

    Science.gov (United States)

    Jasmer, R M; Edinburgh, K J; Thompson, A; Gotway, M B; Creasman, J M; Webb, W R; Huang, L

    2000-04-01

    To determine the etiology and the clinical and radiographic predictors of the etiology of pulmonary nodules in a group of HIV-infected patients. Retrospective analysis. A large urban hospital in San Francisco, CA. HIV-infected patients evaluated at San Francisco General Hospital from June 1, 1993, through December 31, 1997, having one or more pulmonary nodules on chest CT. Three physicians reviewed medical records for clinical data and final diagnoses. Three chest radiologists blinded to clinical data reviewed chest CTs. Univariate and multivariate analyses were performed to determine clinical and radiographic predictors of having an opportunistic infection and the specific diagnoses of bacterial pneumonia and tuberculosis. Eighty seven of 242 patients (36%) had one or more pulmonary nodules on chest CT. Among these 87 patients, opportunistic infections were the underlying etiology in 57 patients; bacterial pneumonia (30 patients) and tuberculosis (14 patients) were the most common infections identified. Multivariate analysis identified fever, cough, and size of nodules < 1 cm on chest CT as independent predictors of having an opportunistic infection. Furthermore, a history of bacterial pneumonia, symptoms for 1 to 7 days, and size of nodules < 1 cm on CT independently predicted a diagnosis of bacterial pneumonia; a history of homelessness, weight loss, and lymphadenopathy on CT independently predicted a diagnosis of tuberculosis. In HIV-infected patients having one or more pulmonary nodules on chest CT scan, opportunistic infections are the most common cause. Specific clinical and radiographic features can suggest particular opportunistic infections.

  19. Clinical features of acute respiratory viral infections in children in conjunction with pathology of pharyngeal tonsil

    OpenAIRE

    Олександр Іванович Сміян; Євгенія Василівна Дмітрова; Олена Геннадіївна Васильєва

    2015-01-01

    Aim: to study clinical features of the clinical course of an acute respiratory viral infection in conjunction with pathology of pharyngeal tonsil in children of preschool age. Methods: generally clinical;Laboratory and instrumental;Statistical.Separation of viral infection was done using the methods of lumicroscopy and polymerase chain reaction from nasopharynx lavage.Statistical processing of received results was carried out with the help of standard statistical computer system «MicrosoftExc...

  20. Incidence and clinical implication of nosocomial infections associated with implantable biomaterials – catheters, ventilator-associated pneumonia, urinary tract infections

    Science.gov (United States)

    Guggenbichler, Josef Peter; Assadian, Ojan; Boeswald, Michael; Kramer, Axel

    2012-01-01

    of suitable antiseptics in combination with medical devices may further support reduction and prevention of such infections. In addition to reducing the adverse clinical outcomes related with these infections, such reduction may substantially decrease the economic burden caused by device-related infection for health care systems. PMID:22242099

  1. Clinical Characteristics of Nosocomial Rotavirus Infection in Children in Taiwan

    Directory of Open Access Journals (Sweden)

    Jian-Te Lee

    2008-10-01

    Conclusion: NRI may cause significant morbidity in hospitalized children, especially young infants and those with underlying diseases. Infection control with hospital surveillance, strict isolation and cohort care should be adopted to prevent the spread of rotavirus among special care units.

  2. ENTEROVIRUS INFECTION: VARIETY OF ETIOLOGICAL FACTORS AND CLINICAL MANIFESTATIONS

    Directory of Open Access Journals (Sweden)

    O. I. Kanaeva

    2014-01-01

    Full Text Available Abstract. Enteroviruses are widely distributed human infectious pathogens. In spite of infection a disease does not manifest in majority number of cases. However, in some infected persons the different kind of symptoms can be observed; from common cold signs up to  aseptic (serous meningitis and myocarditis. Severe enteroviral cases with lethal outcomes are rarely reported. Ability of enteroviruses to cause large outbreaks and even epidemic distribution is very significant for health care systems. Taking in account a high genetic diversity of enteroviruses it is possible appearance of new highly pathogenic strains in the future. In some countries including the Russian Federation the permanent surveillance for enteroviral infections is provided besides of WHO polio elimination program. The laboratory diagnostics of enterovirus infections is complicated by numerous of pathogen serotypes. Thus, classical virological methods should be supported by molecular-biological tools to sequence pathogen genome and to define phylogenetic relations between different enterovirus strains.

  3. Clinical, Pathological and Immunological Aspects of Transplacental PRRS Virus Infection

    DEFF Research Database (Denmark)

    Nielsen, Jens

    2011-01-01

    isolate of PRRS vaccine-derived virus (VDV) could cause disease in swine consistent with PRRS, thus confirming the etiological role of VDV. Since the complex pathology following in utero infection with PRRSV indicates impairment of the immune system of congenitally infected pigs, we studied various aspect......The present paper describes Danish research activities on porcine reproductive and respiratory syndrome (PRRS) with emphasis on experimental infections in pregnant swine. The first case of PRRS was diagnosed in Denmark in 1992 and subsequently the disease spread to most other parts of the country...... PRRSV in the previously unaffected Danish pig population. Acute PRRS like disease was observed in non-vaccinated as well as in vaccinated herds, and it was demonstrated that the vaccine strain had reverted to virulence. By experimental infection of late term pregnant sows, we demonstrated that a field...

  4. The relationships between clinical variables and renal parenchymal disease in pediatric clinically suspected urinary tract infection

    Directory of Open Access Journals (Sweden)

    Jung Lim Byun

    2010-02-01

    Full Text Available Purpose : To evaluate the significance of clinical signs and laboratory findings as predictors of renal parenchymal lesions and vesicoureteral reflux (VUR in childhood urinary tract infection (UTI. Methods : From July 2005 to July 2008, 180 patients admitted with a first febrile UTI at the Pediatric Department of Konkuk University Hospital were included in this study. The following were the clinical variables: leukocytosis, elevated C-reactive protein (CRP, positive urine nitrite, positive urine culture, and fever duration both before and after treatment. We evaluated the relationships between clinical variables and dimercaptosuccinic acid (DMSA scan and voiding cystourethrography (VCUG results. Results : VCUG was performed in 148 patients; of them, 37 (25.0% had VUR: 18 (12.2% had low-grade (I-II VUR, and 19 (10.5% had high-grade (III-V VUR. Of the 95 patients who underwent DMSA scanning, 29 (30.5% had cortical defects, of which 21 (63.6% had VUR: 10 (30.3%, low-grade (I-II VUR; and 11 (33.3%, high-grade VUR. Of the 57 patients who were normal on DMSA scan, 8 (14.0% had low-grade VUR and 6 (10.5% had high-grade VUR. The sensitivity, specificity, and positive and negative predictive values of the DMSA scan in predicting high-grade VUR were 64.7%, 69.9%, 33.3%, and 89.5%, respectively. Leukocytosis, elevated CRP, and prolonged fever (?#243;6 hours after treatment were significantly correlated with the cortical defects on DMSA scans and high-grade VUR. Conclusion : Clinical signs, including prolonged fever after treatment, elevated CRP, and leukocytosis, are positive predictors of acute pyelonephritis and high-grade VUR.

  5. Laboratory and Clinical Aspects of Human Herpesvirus 6 Infections

    Science.gov (United States)

    Bonnafous, Pascale; Gautheret-Dejean, Agnès

    2015-01-01

    SUMMARY Human herpesvirus 6 (HHV-6) is a widespread betaherpesvirus which is genetically related to human cytomegalovirus (HCMV) and now encompasses two different species: HHV-6A and HHV-6B. HHV-6 exhibits a wide cell tropism in vivo and, like other herpesviruses, induces a lifelong latent infection in humans. As a noticeable difference with respect to other human herpesviruses, genomic HHV-6 DNA is covalently integrated into the subtelomeric region of cell chromosomes (ciHHV-6) in about 1% of the general population. Although it is infrequent, this may be a confounding factor for the diagnosis of active viral infection. The diagnosis of HHV-6 infection is performed by both serologic and direct methods. The most prominent technique is the quantification of viral DNA in blood, other body fluids, and organs by means of real-time PCR. Many active HHV-6 infections, corresponding to primary infections, reactivations, or exogenous reinfections, are asymptomatic. However, the virus may be the cause of serious diseases, particularly in immunocompromised individuals. As emblematic examples of HHV-6 pathogenicity, exanthema subitum, a benign disease of infancy, is associated with primary infection, whereas further virus reactivations can induce severe encephalitis cases, particularly in hematopoietic stem cell transplant recipients. Generally speaking, the formal demonstration of the causative role of HHV-6 in many acute and chronic human diseases is difficult due to the ubiquitous nature of the virus, chronicity of infection, existence of two distinct species, and limitations of current investigational tools. The antiviral compounds ganciclovir, foscarnet, and cidofovir are effective against active HHV-6 infections, but the indications for treatment, as well as the conditions of drug administration, are not formally approved to date. There are still numerous pending questions about HHV-6 which should stimulate future research works on the pathophysiology, diagnosis, and

  6. BLOOD-STAGE DYNAMICS AND CLINICAL IMPLICATIONS OF MIXED PLASMODIUM VIVAX–PLASMODIUM FALCIPARUM INFECTIONS

    Science.gov (United States)

    MASON, DANIEL P.; McKENZIE, F. ELLIS

    2008-01-01

    We present a mathematical model of the blood-stage dynamics of mixed Plasmodium vivax–Plasmodium falciparum malaria infections in humans. The model reproduces features of such infections found in nature and suggests several phenomena that may merit clinical attention, including the potential recrudescence of a long-standing, low-level P. falciparum infection following a P. vivax infection or relapse and the capacity of an existing P. vivax infection to reduce the peak parasitemia of a P. falciparum superinfection. We simulate the administration of anti-malarial drugs, and illustrate some potential complications in treating mixed-species malaria infections. Notably, our model indicates that when a mixed-species infection is misdiagnosed as a single-species P. vivax infection, treatment for P. vivax can lead to a surge in P. falciparum parasitemia. PMID:10497972

  7. Clinical and laboratory features of canine Anaplasma platys infection in 32 naturally infected dogs in the Mediterranean basin.

    Science.gov (United States)

    Bouzouraa, Tarek; René-Martellet, Magalie; Chêne, Jeanne; Attipa, Charalampos; Lebert, Isabelle; Chalvet-Monfray, Karine; Cadoré, Jean-Luc; Halos, Lenaig; Chabanne, Luc

    2016-10-01

    Since the first description of Anaplasma platys Infection (ApI), the disease has been sporadically reported worldwide. Whereas it is considered a subclinical disease in the United States or in Australia, severe cases are reported in Europe. Thus far, little information is available regarding the clinical and laboratory findings associated with the disease and the implication of co-infections with other vector-borne pathogens (VBPs) in Southern Europe. The purpose of the study was to describe clinical and laboratory findings in PCR-confirmed naturally infected dogs in the Mediterranean Basin, and to assess the potential impact of co-infections with other VBPs. This is a retrospective analysis of medical records from 32 client-owned dogs diagnosed with ApI using PCR-based assays. Anorexia (62.5%) and weight loss (43.8%) were the major changes, whereas lethargy was less frequent (34.4%). Lymphadenomegaly (43.8%), hyperthermia (40.6%) and hemorrhage (37.5%) were frequent clinical abnormalities, whereas cutaneous signs (31.3%), musculoskeletal disorders (21.9%), splenomegaly (15.6%), dehydration and ocular inflammation (12.5%) were less common. Hematological abnormalities included thrombocytopenia (81.0%), anemia (81.0%), leukocytosis (33.3%) and leucopenia (23.8%). Seven dogs (33.3%) were severely thrombocytopenic. Among the 28 dogs with complete testing, 15 and 13 were mono- and co-infected, respectively. Co-infections included Ehrlichia canis (3 dogs), Leishmania infantum (4), Babesia vogeli (2) and Hepatozoon canis (5). One dog was infected concurrently with Anaplasma platys, Ehrlichia canis and Babesia vogeli. The 1-month mortality rate was 23.9% and only 38.1% improved. In the univariate analysis the 15 mono- and the 13 co-infected dogs did not differ regarding the relative frequencies of clinical and laboratory findings. Sequencing and phylogenetic analyses suggested the existence of 2 different groups of strains: one of them might have higher pathogenicity. In

  8. Role of the clinical microbiology laboratory in infection control - a Danish perspective

    DEFF Research Database (Denmark)

    Kolmos, H J

    2001-01-01

    Clinical microbiology laboratories in Denmark are located in hospitals and staffed by clinical microbiologists who are clinically trained medical doctors. Each county has its own clinical microbiology unit, serving a population of 0.3-0.6 million. The responsibilities of clinical microbiology unit...... for standardization and documentation of quality. Currently a national standard for infection control is being prepared. It consists of a main standard defining requirements for the management system and 12 subsidiary standards defining requirements for specific areas of infection control. Adoption of the standard...

  9. Clinical profile of hospitalized HIV-infected children in Bangladesh, a low-HIV-prevalence country.

    Science.gov (United States)

    Shahrin, Lubaba; Leung, Daniel T; Matin, Nashaba; Kawser, Chowdhury Ali; Pervez, Mohammed Moshtaq; Chisti, Mohammod Jobayer

    2014-05-01

    Bangladesh has a low HIV prevalence and data on the risk factors and clinical presentation of HIV-infected children are lacking. To describe the clinical characteristics of hospitalized HIV-infected children in Bangladesh and determine the factors associated with a low CD4 count. An anonymous, retrospective review was undertaken of the medical records of all patients admitted to the HIV unit of the iccdr,b Dhaka Hospital between February 2009 and July 2012. Demographic, clinical and laboratory data were extracted from the electronic medical record system. HIV-infected children with a low absolute CD4 count (country.

  10. Epidemiological and Clinical profile of HIV-infected patients ...

    African Journals Online (AJOL)

    Background: Treatment and care services for HIV patients in Tanzania began 2004 with free access to anti-retroviral therapy (ART). More than 1000 HIV clinics have been established to-date. Each clinic is obliged to provide statistical and clinical feedback for further improvement. Broad objective: The objective of this study ...

  11. Clinical and laboratory characteristics of viral lower respiratory tract infections in preschool children.

    Science.gov (United States)

    Berce, Vojko; Unuk, Sibila; Duh, Darja; Homšak, Matjaž; Vičič, Maja

    2015-12-01

    Viral lower respiratory tract infections are the leading cause of hospitalizations in preschool children. Clinical pictures of different viral causes are not well characterized. The aim of this study was to establish the differences in clinical and laboratory characteristics between the different viral causes of lower respiratory tract infections in preschool children. We included 278 preschool children hospitalized because of lower respiratory tract infection. White blood cell count and C-reactive protein values were determined and chest X-ray was performed in most patients. Polymerase chain reaction assay was used for the detection of viral pathogens from nasopharyngeal swab. Pneumonia was present in 71.4 % of all coronavirus infections, 35.1 % of all respiratory syncytial virus infections, and 13.0 % of all rhinovirus infections. Coronavirus (p = 0.03) and respiratory syncytial virus (p infections and in only 33.3 % of all adenovirus infections. Rhinovirus (p infections mean C-reactive protein value was 72.4 mg/L and white blood cell count 19.000/µl, both significantly higher than in other viruses (p respiratory tract infections significantly differ. With the advance of viral detection methods and increase of knowledge it becomes possible to characterize different respiratory viral infections and to improve the differential diagnosis.

  12. Clinical significance of different virus load of human bocavirus in patients with lower respiratory tract infection.

    Science.gov (United States)

    Jiang, Wujun; Yin, Fang; Zhou, Weifang; Yan, Yongdong; Ji, Wei

    2016-02-01

    To assess the impact of human bocavirus (HBoV) virus load on epidemiologic and clinical characteristics in children with lower respiratory tract infection (LRTI). Clinical records of a total of 654 patients with HBoV infection during January 2013 and December 2014 were retrospectively reviewed. Patients with high HBoV virus load infection had a similar age distribution with the total HBoV infection, which had a peak age group of 6-24 months. Patients with high virus load are significantly younger (P infection was found significantly more frequently among patients with low virus load than those with high virus load (57.0% vs 38.9%; P infections are found in an important proportion of the hospitalized children with respiratory illnesses (8.85% in our series). A high HBoV virus load could be an etiologic agent for LRTI, which may lead to more severe lower respiratory tract symptom and severe disease.

  13. Pregnancy-Related Group A Streptococcal Infections: Temporal Relationships Between Bacterial Acquisition, Infection Onset, Clinical Findings, and Outcome

    Science.gov (United States)

    Hamilton, Stephanie M.; Stevens, Dennis L.; Bryant, Amy E.

    2013-01-01

    Puerperal sepsis caused by group A Streptococcus (GAS) remains an important cause of maternal and infant mortality worldwide, including countries with modern antibiotic regimens, intensive care measures and infection control practices. To provide insights into the genesis of modern GAS puerperal sepsis, we reviewed the published cases and case series from 1974 to 2009, specifically seeking relationships between the likely source of pathogen acquisition, clinical signs, and symptoms at infection onset and patient outcomes that could provide clues for early diagnosis. Results suggest that the pathogenesis of pregnancy-related GAS infections in modern times is complex and not simply the result of exposure to GAS in the hospital setting. Additional research is needed to further explore the source of GAS, the specific M types involved, and the pathogenesis of these pregnancy-related infections to generate novel preventative and therapeutic strategies. PMID:23645851

  14. Clinical implications of infection with a novel metastrongyloid species in the red panda (Ailurus fulgens).

    Science.gov (United States)

    Willesen, Jakob L; Meyland-Smith, Frederik; Wiinberg, Bo; Monrad, Jesper; Bertelsen, Mads F

    2012-06-01

    In a recent survey, 30% of the European red panda (Ailurus fulgens) population was found to be infected with a newly discovered metastrongyloid nematode. In a following prospective study, four naturally infected captive-bred red pandas infected with this parasite were examined and compared with two uninfected control animals. On clinical examination, no abnormalities were detected with respect to vital parameters and cardiovascular system in all six examined animals. Similarly, few and nonspecific changes were recorded on serum biochemistry. No changes on pulmonary pattern were noted on thoracic radiographs. Vertebral heart scores were between 7.2 to 8.6, and no difference was noted between infected and control animals. Two animals had slightly prolonged clotting time and reaction time on thromboelastography but not likely to be of clinical relevance. In conclusion, infection with the newly identified metastrongyloid nematode in the red pandas seems to have little or no clinical importance.

  15. [Prevalence and clinical characteristics of coronavirus NL63 infection in children hospitalized for acute lower respiratory tract infections in Changsha].

    Science.gov (United States)

    Zhang, Fei; Zhang, Bing; Xie, Zhi-Ping; Gao, Han-Chun; Zhao, Xin; Zhong, Li-Li; Zhou, Qiong-Hua; Hou, Yun-De; Duan, Zhao-Jun

    2012-04-01

    The main objective of this study was to explore the prevalence and clinical characteristics of human coronavirus NL63 infection in hospitalized children with acute lower respiratory tract infection (ALRTI) in Changsha. Nasopharyngeal aspirates (NPA) samples were collected from 1185 hospitalized children with ALRTI at the People's Hospital of Hunan province, between September 2008 and October 2010. Reverse transcriptase polymerase chain reaction (RT-PCR) was employed to screen for coronavirus NL63, which is a 255 bp fragment of a part of N gene. All positive amplification products were confirmed by sequencing and compared with those in GenBank. The overall frequency of coronavirus NL63 infection was 0.8%, 6 (60%) out of the coronavirus NL63 positive patients were detected in summer, 2 in autumn, 1 in spring and winter, respectively. The patients were from 2 months to two and a half years old. The clinical diagnosis was bronchopneumonia (60%), bronchiolitis (30%), and acute laryngotracheal bronchitis (10%). Four of the 10 cases had critical illness, 4 cases had underlying diseases, and 7 cases had mixed infection with other viruses. The homogeneity of coronavirus NL63 with those published in the GenBank at nucleotide levels was 97%-100%. Coronavirus NL63 infection exists in hospitalized children with acute lower respiratory tract infection in Changsha. Coronavirus NL63 infections are common in children under 3 years of age. There is significant difference in the infection rate between the boys and the girls: the boys had higher rate than the girls. The peak of prevalence of the coronavirus NL63 was in summer. A single genetic lineage of coronavirus NL63 was revealed in human subjects in Changsha. Coronavirus NL63 may also be one of the lower respiratory pathogen in China.

  16. Rapid enzyme analysis as a diagnostic tool for wound infection: Comparison between clinical judgment, microbiological analysis, and enzyme analysis

    NARCIS (Netherlands)

    Arkes, Miriam; Haalboom, Marieke; van der Palen, Jacobus Adrianus Maria; Heinzle, Andrea; Sigi, Eva; Guebitz, Georg; Beuk, Roland

    2015-01-01

    In clinical practice, diagnosis of wound infection is based on the classical clinical signs of infection. When infection is suspected, wounds are often swabbed for microbiological culturing. These methods are not accurate (clinical judgment in chronic wounds) or provide results after several days

  17. Clinical appearance of oral candida infection and therapeutic strategies

    Directory of Open Access Journals (Sweden)

    Shankargouda ePatil

    2015-12-01

    Full Text Available Candida species present both as commensals and opportunistic pathogens of the oral cavity. For decades, it has enthralled the clinicians to investigate its pathogenicity and to improvise newer therapeutic regimens based on the updated molecular research. Candida is readily isolated from the oral cavity, but simple carriage does not predictably result in development of an infection. Whether it remains as a commensal, or transmutes into a pathogen, is usually determined by pre-existing or associated variations in the host immune system. The candida infections may range from non-life threatening superficial mucocutaneous disorders to invasive disseminated disease involving multiple organs. In fact, with the increase in number of AIDS cases, there is a resurgence of less common forms of oral candida infections. The treatment after confirmation of the diagnosis should include recognizing and eliminating the underlying causes such as ill-fitting oral appliances, history of medications (antibiotics, corticosteroids, etc., immunological and endocrine disorders, nutritional deficiency states and prolonged hospitalization. Treatment with appropriate topical antifungal agents such as amphotericin, nystatin or miconazole usually resolves the symptoms of superficial infection. Occasionally, administration of systemic antifungal agents may be necessary in immunocompromised patients, the selection of which should be based upon history of recent azole exposure, a history of intolerance to an antifungal agent, the dominant Candida species and current susceptibility data.

  18. Independent and interactive effects of HIV infection, clinical stage ...

    African Journals Online (AJOL)

    Background. There is still limited to no evidence on the independent and interactive effects of HIV infection, disease stage, baseline disease severity and other important comorbidities on mortality risk among young children treated for severe acute malnutrition (SAM) in South Africa (SA, using the World Health Organization ...

  19. Chronic Hepatitis C Infection: Clinical and Societal Evaluations

    NARCIS (Netherlands)

    D.M. Hotho (Daphne)

    2013-01-01

    textabstractChronic hepatitis C virus infection (HCV) affects 180 million people worldwide. Chronic HCV can cause hepatic decompensation, hepatocellular carcinoma (HCC), and portal hypertension1. Nowadays, chronic HCV is the leading indication for liver transplantation in developed countries. HCV is

  20. KIR : HLA association with clinical manifestations of HBV infection in ...

    Indian Academy of Sciences (India)

    In a HIV study by Martin et al. (2002), KIR3DS1 : HLA. Bw4Iso80 genotype has been implicated in slower progres- sion to AIDS with low viral load and protection against other opportunistic infections (Qi et al. 2006). This geno- type has also been reported to confer protection against development of the liver cancer among ...

  1. A behavioral and cognitive profile of clinically stable HIV-infected children

    NARCIS (Netherlands)

    Nozyce, ML; Lee, SS; Wiznia, A; Nachman, S; Mofenson, LM; Smith, ME; Yogev, R; McIntosh, K; Stanley, K; Pelton, S

    OBJECTIVE. The purpose of this research was to characterize behavioral and cognitive profiles of clinically and immunologically stable antiretroviral-experienced HIV-infected children. METHODS. Two hundred seventy-four previously treated HIV-infected children aged 2 to 17 years were assessed for

  2. Age-specificity of clinical dengue during primary and secondary infections

    NARCIS (Netherlands)

    Thai, Khoa T. D.; Nishiura, Hiroshi; Hoang, Phuong Lan; Tran, Nga Thanh Thi; Phan, Giao Trong; Le, Hung Quoc; Tran, Binh Quang; Nguyen, Nam Van; de Vries, Peter J.

    2011-01-01

    This study aims to estimate the age-specific risks of clinical dengue attack (i.e., the risk of symptomatic dengue among the total number of dengue virus (DENV) infections) during primary and secondary infections. We analyzed two pieces of epidemiological information in Binh Thuan province, southern

  3. Clinical Staging of HIV Infection as a Surrogate for CD4 Count in HIV ...

    African Journals Online (AJOL)

    BACKGROUND: Human immunodeficiency virus (HIV) infection is a major cause of infant and childhood mortality and morbidity; without treatment about 50% of them will succumb to HIV/AIDS before the age of two years. OBJECTIVE: To evaluate the usefulness of clinical manifestations of HIV infection as a surrogate for ...

  4. The impact of HIV infection on the clinical presentation of severe ...

    African Journals Online (AJOL)

    A study was undertaken in a central nutritional rehabilitation unit (NRU) in southern Malawi to assess the impact of HIV infection on clinical presentation and case fatality rate. The HIV seroprevalence for 250 severely malnourished children over 1 year of age was 34.4% and the overall mortality was 28%. HIV infection was ...

  5. Clinical Forms of Chronic Epstein — Barr Virus Infection: Questions of Modern Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    O.K. Duda

    2015-02-01

    Full Text Available The article discussed in detail the questions of clinical picture, diagnosis and treatment of Epstein — Barr virus infection. The basic methods of modern laboratory diagnosis of this disease are given, and the list of examinations which must be indicated to a patient with suspected Epstein — Barr virus infection is provided.

  6. Herpes Simplex Virus Infection in a University Health Population: Clinical Manifestations, Epidemiology, and Implications

    Science.gov (United States)

    Horowitz, Robert; Aierstuck, Sara; Williams, Elizabeth A.; Melby, Bernette

    2010-01-01

    Objective: The authors described clinical presentations of oral and genital herpes simplex virus (HSV) infections in a university health population and implications of these findings. Participants and Methods: Using a standardized data collection tool, 215 records of patients with symptomatic culture-positive HSV infections were reviewed. Results:…

  7. Evaluation of the clinical management of HIV-infected patients by ...

    African Journals Online (AJOL)

    2009-11-25

    Nov 25, 2009 ... as weight loss and the presence of opportunistic infections to change therapy. Thirty-three doctors (19.3%) tested for resistance before they changed therapy. Two-thirds of these doctors also used CD4 count and VL to change therapy. Frequency of clinical and laboratory monitoring of HIV- infected patients.

  8. Pulmonary infection in patients with cyclosporine, azathioprine, and corticosteroids after cardiac transplantation; Clinical and radiographic assessment

    Energy Technology Data Exchange (ETDEWEB)

    Murayama, Sadayuki; Ikezoe, Junpei; Godwin, J.D.; Marglin, S.I.; Allen, M.D. (University of Washington Medical Center, Seattle, WA (United States))

    1991-07-01

    Between November 1985 and November 1989, 54 patients have undergone 55 cardiac transplants, 5 of whom died during operation or one week after transplantation. The remaining 49 patients with a minimum follow-up of 5 months were studied to examine pulmonary infection clinically and radiologically while receiving triple drug immunosuppression consisting of cyclosporine, azathioprine, and prednisolone. Pulmonary infection occurred in 14 patients (29%) with a total of 21 occasions. Causative organisms were identified in 9 occasions, with the most common organism being Cytomegalovirus (CMV). One patient died of pulmonary infection with Aspergillus. Causative organisms occurring in the remaining 12 occasions of pulmonary infection were unknown, which did not lead to death. Because pulmonary infection of unknown organisms rapidly responded to convensional antibiotics, it seemed to have been caused by bacteria. Pulmonary infection of unknown organism occurred 13.2{+-}3.2 months after transplantation, as compared with 3.3{+-}1.0 months in pulmonary infection of known organisms. Chest plain radiographic features fell into four types: (1) interstitial shadow seen in pulmonary infection of CMV, Pneumocystis carinii, or Hemophilia influenza, (2) patchy, and basilar and lobular consolidation shadows in bacterial pneumonia, (3) localized nodular shadow in aspergillosis, and (4) multiple patchy and confluent opacity patterns occurring in herpes simplex viral infection. Pulmonary infection of influenza bacteria for one patient and pulmonary infection of unknown organisms for 4 patients were difficult to identify from pulmonary infection of CMV. (N.K.).

  9. Parasitic Infections Based on 320 Clinical Samples Submitted to Hanyang University, Korea (2004-2011)

    Science.gov (United States)

    Choi, Sung-Chul; Lee, Soo-Young; Song, Hyun-Ouk; Ryu, Jae-Sook

    2014-01-01

    We analyzed 320 clinical samples of parasitic infections submitted to the Department of Environmental Biology and Medical Parasitology, Hanyang University from January 2004 to June 2011. They consisted of 211 nematode infections, 64 trematode or cestode infections, 32 protozoan infections, and 13 infections with arthropods. The nematode infections included 67 cases of trichuriasis, 62 of anisakiasis (Anisakis sp. and Pseudoterranova decipiens), 40 of enterobiasis, and 24 of ascariasis, as well as other infections including strongyloidiasis, thelaziasis, loiasis, and hookworm infecions. Among the cestode or trematode infections, we observed 27 cases of diphyllobothriasis, 14 of sparganosis, 9 of clonorchiasis, and 5 of paragonimiasis together with a few cases of taeniasis saginata, cysticercosis cellulosae, hymenolepiasis, and echinostomiasis. The protozoan infections included 14 cases of malaria, 4 of cryptosporidiosis, and 3 of trichomoniasis, in addition to infections with Entamoeba histolytica, Entamoeba dispar, Entamoeba coli, Endolimax nana, Giardia lamblia, and Toxoplasma gondii. Among the arthropods, we detected 6 cases of Ixodes sp., 5 of Phthirus pubis, 1 of Sarcoptes scabiei, and 1 of fly larva. The results revealed that trichuriasis, anisakiasis, enterobiasis, and diphyllobothriasis were the most frequently found parasitosis among the clinical samples. PMID:24850969

  10. Pulmonary Mycobacterium kansasii infection: comparison of the clinical features, treatment and outcome with pulmonary tuberculosis.

    OpenAIRE

    Evans, S. A.; Colville, A.; Evans, A J; Crisp, A. J.; Johnston, I. D.

    1996-01-01

    BACKGROUND: In the United Kingdom Mycobacterium kansasii is the most common pulmonary non-tuberculous mycobacteria to cause disease in the non-HIV positive population. METHODS: The clinical features, treatment, and outcome of 47 patients (13 women) of mean (SD) age 58 (17) years with culture positive pulmonary M kansasii infection were compared with those of 87 patients (23 women) of mean (SD) age 57 (16) years with culture positive pulmonary M tuberculosis infection by review of their clinic...

  11. Clinical chorioamnionitis at term III: how well do clinical criteria perform in the identification of proven intra-amniotic infection?

    Science.gov (United States)

    Romero, Roberto; Chaemsaithong, Piya; Korzeniewski, Steven J; Kusanovic, Juan P; Docheva, Nikolina; Martinez-Varea, Alicia; Ahmed, Ahmed I; Yoon, Bo Hyun; Hassan, Sonia S; Chaiworapongsa, Tinnakorn; Yeo, Lami

    2016-01-01

    The diagnosis of clinical chorioamnionitis is based on a combination of signs [fever, maternal or fetal tachycardia, foul-smelling amniotic fluid (AF), uterine tenderness and maternal leukocytosis]. Bacterial infections within the amniotic cavity are considered the most frequent cause of clinical chorioamnionitis and an indication for antibiotic administration to reduce maternal and neonatal morbidity. Recent studies show that only 54% of patients with the diagnosis of clinical chorioamnionitis at term have bacteria in the AF and evidence of intra-amniotic inflammation. The objective of this study was to examine the performance of the clinical criteria for the diagnosis of chorioamnionitis to identify patients with microbial-associated intra-amniotic inflammation (also termed intra-amniotic infection). This retrospective cross-sectional study included 45 patients with the diagnosis of clinical chorioamnionitis at term, whose AF underwent analysis for: 1) the presence of microorganisms using both cultivation and molecular biologic techniques [polymerase chain reaction (PCR) with broad primers], and 2) interleukin (IL)-6 concentrations by enzyme-linked immunosorbent assay. The diagnostic performance (sensitivity, specificity, accuracy, and likelihood ratios) of each clinical sign and their combination to identify clinical chorioamnionitis were determined using microbial-associated intra-amniotic inflammation [presence of microorganisms in the AF using cultivation or molecular techniques and elevated AF IL-6 concentrations (≥2.6 ng/mL)] as the gold standard. The accuracy of each clinical sign for the identification of microbial-associated intra-amniotic inflammation (intra-amniotic infection) ranged between 46.7% and 57.8%. The combination of fever with three or more clinical criteria did not substantially improve diagnostic accuracy. In the presence of a fever during labor at term, signs used to diagnose clinical chorioamnionitis do not accurately identify the

  12. Clinical, Laboratory Diagnosis and Treatment of Ehrlichial Infections ...

    African Journals Online (AJOL)

    Clinically the disease can take the acute or chronic form with a wide range of clinical presentations that include fever, depression, lethargy, dyspnea, anorexia, weight loss, lymphadenopathy, hemorrhage, epistaxis, increased hair loss, vomiting, blindness, edema, ataxia and polyarthritis. Superinfection with other organisms ...

  13. Experimental human challenge infections can accelerate clinical malaria vaccine development

    NARCIS (Netherlands)

    Sauerwein, R.W.; Roestenberg, M.; Moorthy, V.S.

    2011-01-01

    Malaria is one of the most frequently occurring infectious diseases worldwide, with almost 1 million deaths and an estimated 243 million clinical cases annually. Several candidate malaria vaccines have reached Phase IIb clinical trials, but results have often been disappointing. As an alternative to

  14. Evaluation of Clinical and Laboratory Data in Patients with Recurrent Infections and Suspected Immunodeficiency

    Directory of Open Access Journals (Sweden)

    Hamid Ahanchian

    2014-09-01

    Full Text Available Background: Frequent infections is among the most frequent clinical dilemmas for primary care physicians. Immunodeficiency disorders are a heterogeneous group of illnesses that predispose patients to the recurrent infections, autoimmunity and malignancies. The aim of this study was to evaluate the clinical and laboratory data collected for the final diagnosis of patients referred with recurrent infections and suspected immunodeficiency to a local immunodeficiency clinic.   Methods: This epidemiological study was carried out between April 2010 and September 2012 at the Immunodeficiency Clinic of Mashhad. All patients with clinical manifestations of immunodeficiency who were referred to our clinic during this period of time were included in this study. 41 patients aged from 10 months to 51 years, were evaluated. Results: Forty one patients, aged between 10 months and 51 years were evaluated. Eleven patients had a primary immunodeficiency, four cases had a secondary immunodeficiency, in three patients an underlying structural disease were found, eight patients were predisposed to recurrent infections as a result of allergies and finally, fifteen cases were found to be normal individuals.   Discussion: Most patients with recurrent infection have a normal immune system. Allergic disorders are the most common predisposing factor to recurrent infection. However, as immunodeficiency disorders are potentially serious, early diagnosis can improve the quality of life and outcome and prevent severe sequels in future.

  15. Clinical features of acute respiratory viral infections in children in conjunction with pathology of pharyngeal tonsil

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    Олександр Іванович Сміян

    2015-09-01

    Full Text Available Aim: to study clinical features of the clinical course of an acute respiratory viral infection in conjunction with pathology of pharyngeal tonsil in children of preschool age. Methods: generally clinical;Laboratory and instrumental;Statistical.Separation of viral infection was done using the methods of lumicroscopy and polymerase chain reaction from nasopharynx lavage.Statistical processing of received results was carried out with the help of standard statistical computer system «MicrosoftExcel» (2007 adapted for medical and biological studies. Result:In the clinical presentation of respiratory viral infection prevailed rhinorrhea, short cough, subfibrilitet with usual duration near 3 days. On the contrary in children with acute respiratory viral infections with pathology of the pharyngeal tonsil prevailed stuffiness in nose, productive cough, snore and decrease of hearing, ear ache, polyadenopathy. Fever had fibril and hectic character with duration more than 3 days. . Dyspeptic syndrome was demonstrated more intensively in children with acute respiratory viral infections with pathology of the pharyngeal tonsil and characterized with thickening on tongue, periodic ache in stomach, meteorism, constipation, stool instability. Conclusions: The main syndromes in the clinical presentation of an acute respiratory viral infection were: intoxicational, catarrhal and dyspeptic. In children with pathology of the pharyngeal tonsil the clinical course of ARVI was more evident with long course and increase of the frequency of complications of ARVI

  16. Clinical and epidemiological features of patients with chronic hepatitis C co-infected with HIV

    Directory of Open Access Journals (Sweden)

    Braga Eduardo Lorens

    Full Text Available Co-infection with hepatitis C virus (HCV and human immunodeficiency virus (HIV is increasingly common and affects the clinical course of chronic hepatitis C. Highly active antiretroviral therapy has improved the life expectancy of HIV infected patients, but, by extending survival, it permits the development of HCV cirrhosis. This study tried to evaluate clinical and epidemiological features of patients with chronic hepatitis C co-infected with HIV. We evaluated 134 HCV-infected patients: i group A - 65 co-infected HCV/HIV patients, ii group B - 69 mono-infected HCV patients. The impact of HIV infection on HCV liver disease was analyzed using Child's score, ultrasound findings and liver histology. Patients were subjected to HCV genotyping and anti-HBs dosage. Patients mean age was 42.4 years (±9.1 and 97 (72.4% were males. Injected drug use and homo/bisexual practice were more frequently encountered in the co-infected group: 68.3% and 78.0%, respectively. Antibodies against hepatitis B virus (anti-HBs were found in only 38.1% of the patients (66.7% group A x 33.3% group B. Ten out of 14 individuals (71.4% who had liver disease (Child B or C and 25 out of 34 (73.5% who showed ultrasound evidence of chronic liver disease were in the co-infection group. HCV genotype-2/3 was more frequently encountered in co-infected patients (36.9% group A vs. 21.8% group B. Conclusions: a HIV infection seems to adversely affect the clinical course of chronic hepatitis C, b injected drug use, bi/homosexual practice and genotype-2/3 were more frequently encountered in co-infected patients, c immunization against HBV should be encouraged in these patients.

  17. The current epidemiology and clinical decisions surrounding acute respiratory infections.

    Science.gov (United States)

    Zaas, Aimee K; Garner, Bronwen H; Tsalik, Ephraim L; Burke, Thomas; Woods, Christopher W; Ginsburg, Geoffrey S

    2014-10-01

    Acute respiratory infection (ARI) is a common diagnosis in outpatient and emergent care settings. Currently available diagnostics are limited, creating uncertainty in the use of antibacterial, antiviral, or supportive care. Up to 72% of ambulatory care patients with ARI are treated with an antibacterial, despite only a small fraction actually needing one. Antibiotic overuse is not restricted to ambulatory care: ARI accounts for approximately 5 million emergency department (ED) visits annually in the USA, where 52-61% of such patients receive antibiotics. Thus, an accurate test for the presence or absence of viral or bacterial infection is needed. In this review, we focus on recent research showing that the host-response (genomic, proteomic, or miRNA) can accomplish this task. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Respiratory Tract Infection Clinical Trials from 2007 to 2012. A Systematic Review of ClinicalTrials.gov.

    Science.gov (United States)

    Ruopp, Marcus; Chiswell, Karen; Thaden, Joshua T; Merchant, Kunal; Tsalik, Ephraim L

    2015-12-01

    Respiratory tract infections are highly prevalent and variable, and confer considerable morbidity and mortality. There is a growing need for new treatments for such infections, particularly in the setting of worsening antibacterial resistance. We analyzed data from ClinicalTrials.gov to summarize activity in respiratory infection trials, identify gaps in research activity, and inform efforts to address disparities between antimicrobial resistance and development of new antibacterial drugs. We examined 69,779 interventional trials registered with ClinicalTrials.gov from 2007 to 2012, focusing on study conditions and interventions to identify respiratory infection-related trials. Programmatic identification with manual confirmation yielded 6,253 infectious disease trials, 1,377 respiratory infection trials, and 270 lower respiratory tract infection trials for analysis. The 1,377 respiratory infection trials accounted for 2% of all trials and 22% of infectious diseases trials. Such trials (54.8%) were more likely than either nonrespiratory infectious diseases trials (48.1%) or noninfectious disease trials (42.8%) to receive industry funding. Stratification of respiratory infection trials by registration year demonstrated declining industry funding: 181 (64.9%) in 2007-2008 to 110 (46.0%) in 2011-2012. Respiratory infection trials more frequently evaluated vaccines (52.7 vs. 15.5% of nonrespiratory tract infection trials). Lower respiratory tract infection trials (excluding tuberculosis) focused primarily on bacterial pathogens (78.5%) followed by viral (12.6%), fungal (5.6%), and nontuberculous mycobacterial (3.0%) pathogens. Approximately 40% of 120 lower respiratory tract infection trials that were completed or terminated published results in the literature. On multivariable logistic regression analysis, a treatment focus was associated with decreased odds of publishing results (odds ratio, 0.28; 95% confidence interval, 0.10-0.82; P = 0.02). There were also

  19. Clinical Appearance of Oral Candida Infection and Therapeutic Strategies

    OpenAIRE

    Patil, Shankargouda; Rao, Roopa S.; Majumdar, Barnali; Anil, Sukumaran

    2015-01-01

    Candida species present both as commensals and opportunistic pathogens of the oral cavity. For decades, it has enthralled the clinicians to investigate its pathogenicity and to improvise newer therapeutic regimens based on the updated molecular research. Candida is readily isolated from the oral cavity, but simple carriage does not predictably result in development of an infection. Whether it remains as a commensal, or transmutes into a pathogen, is usually determined by pre-existing or assoc...

  20. Clinical aspects of Campylobacter jejuni infections in adults.

    OpenAIRE

    Peterson, M C

    1994-01-01

    Campylobacter jejuni is an almost ubiquitous, microaerophilic, gram-negative rod. Outbreaks have been associated with drinking raw milk or contaminated water and eating poultry. Campylobacter jejuni accounts for 3.2% to 6.1% of cases of diarrheal illness in the general population of the United States, and infected patients frequently present with abdominal pain and fever. Less frequently, C jejuni is responsible for bacteremia, septic arthritis, septic abortion, and other extraintestinal infe...

  1. Clinical relevance of rhinovirus infections among adult hospitalized patients.

    Science.gov (United States)

    Fica, Alberto; Dabanch, Jeannette; Andrade, Winston; Bustos, Patricia; Carvajal, Ita; Ceroni, Carolina; Triantafilo, Vjera; Castro, Marcelo; Fasce, Rodrigo

    2015-01-01

    Human rhinovirus (HRV) is an emerging viral pathogen. To characterize a group of patients admitted due to infection by this agent in a general hospital in Chile. Cases were identified by RT-PCR for 1 year through active surveillance of patients admitted with severe respiratory illness. Diagnosis was not available during hospitalization. Thirty-two cases were identified, 90% were ≥60 years old or had co-morbid conditions. Human rhinovirus-related admissions represented 23.7% of hospitalization due to severe acute respiratory infections among adults and ranked second to influenza (37.8%). Patients presented with pneumonia (68.8%), decompensated chronic lung conditions (21.9%), heart failure or influenza-like illness (6.3% each). Admission to intensive or intermediate care units was required by 31.2% and in-hospital mortality reached 12.5%. A CURB-65 score ≥3 was significantly associated to in-hospital mortality (prhinovirus infections in elderly patients with co-morbid conditions are associated with hospitalizations, requiring critical or semi-critical antibiotics use. A high CURB-65 score was associated to in-hospital mortality. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  2. Sexual behaviour and sexually transmitted infections in sexually transmitted infection clinic attendees in the Netherlands, 2007-2011.

    Science.gov (United States)

    de Coul, E L M Op; Warning, T D; Koedijk, F D H

    2014-01-01

    High annual figures of sexually transmitted infections (STIs) are diagnosed in the Netherlands despite significant efforts to control them. Herein, we analyse trends and determinants of STI diagnoses, co-infections, and sexual risks among visitors of 26 STI clinics between 2007 and 2011. We recorded increased positivity rates of STIs (chlamydia, syphilis, gonorrhoea, and/or HIV) in women and heterosexual men up to 12.6% and 13.4%, respectively, in 2011, while rates in men having sex with men (MSM) were stable but high (18.8%) through the documented years. Younger age, origin from Surinam/Antilles, history of previous STI, multiple partners, or a previous notification are the identified risk factors for an STI in this population. Known HIV-infected men (MSM and heterosexuals) were at highest risk for co-infections (relative rate heterosexual men: 15.6; MSM: 11.6). STI positivity rates remained high (MSM) or increased over time (women and heterosexual men), a fact that highlights the importance of continuing STI prevention. Most importantly, the very high STI co-infection rates among HIV-positive men requires intensified STI reduction strategies to put an end to the vicious circle of re-infection and spread of HIV and other STIs.

  3. Co-Infections and Sero-Prevalence of HIV, Syphilis, Hepatitis B and C Infections in Sexually Transmitted Infections Clinic Attendees of Tertiary Care Hospital in North India.

    Science.gov (United States)

    Bhattar, Sonali; Aggarwal, Prabhav; Sahani, Satyendra Kumar; Bhalla, Preena

    2016-01-01

    HIV, syphilis, hepatitis B and C (HBV & HCV) infections modify the epidemiology and presentation of each other. This study aimed to estimate the seroprevalence of these infections and their co-infections in sexually transmitted infections (STI) clinic attendees in New Delhi, India. A retrospective study including 220 patients was conducted during May 2014 through December 2014. Serodiagnosis of HIV was performed as per Strategy III of NACO guidelines; syphilis by VDRL followed by TPHA; HBV and HCV by rapid immuno-chromatographic test followed by ELISA. Male subjects were slightly more in number as compared to females (56.36% vs. 43.63%). Twelve (5.45%), 14 (6.36%), three (1.36 %) and one (0.45%) were reactive for HIV, VDRL, HBV and HCV, respectively. Three were both HIV and syphilis positive and one was both HIV and HBV positive; no co-infections of HBV/HCV, HIV/HBV/HCV and HIV/HBV/HCV/syphilis coexisted. High prevalence of HIV, HBV, HCV and syphilis in STI clinic attendees mandate routine screening to detect co-infections and follow prompt therapy in order to minimize their sequelae.

  4. High prevalence of occult hepatitis B virus genotype H infection among children with clinical hepatitis in west Mexico

    OpenAIRE

    Escobedo-Melendez, Griselda; Panduro, Arturo; Fierro, Nora A; Roman, Sonia

    2014-01-01

    Studies on the prevalence of infection with hepatitis B virus (HBV) among children are scarce in Latin American countries, especially in Mexico. This study was aimed to investigate the prevalence of HBV infection, occult hepatitis B infection (OBI) and HBV genotypes among children with clinical hepatitis. In total, 215 children with clinical hepatitis were evaluated for HBV infection. HBV serological markers and HBV DNA were analysed. OBI diagnosis and HBV genotyping was performed. HBV infect...

  5. Features of a current meningoencefalitis at child with the mixed bacterial infection (clinical cases

    Directory of Open Access Journals (Sweden)

    N. V. Skripchenko

    2013-01-01

    Full Text Available In the past decade the proportion of mixed infections has increased. The clinical aspects of mixed infections can be atypical, and the course of the disease depends on the type of pathogen-associants, their biological properties, relationships with each other and with the host. A clinical case, showing the possibility of mixed associations of Yersinia ana Listeria infections, caused the meningoencephalitis, is given. It is described the experience of the authors on neuroinfection diseases, according to which, a parallel study of blood and cerebrospinal fluid in molecular-genetic, serological as well as immunohistochemical diagnostic methods is required for the detection of mixed infection or co-infection in order to clarify the etiology of the disease.

  6. [Clinical importance of CMV-infection in German-speaking burn centers].

    Science.gov (United States)

    Pfau, M; Hamprecht, K; Schaller, H-E; Rennekampff, H-O

    2004-12-01

    Due to immunosuppression, burn patients are at risk for CMV-infection. By means of a retrospective questionnaire we evaluated the clinical rating and management of CMV-infection in German-speaking burn centers. 41 % of the participating burn centers considered the role of CMV-infection of overall minor importance, 41 % of importance only in intensive care burn patients, 18 % of overall great importance. 70 % of the participating burn centers do not perform CMV-screening at admission. More than 50 % of the participating burn centers consider application of CMV-negative human blood-derived products in CMV-seronegative individuals as essential. At present clinical importance of CMV-infection in burn patients can not be clearly determined. But further prospective studies utilizing recently developed diagnostics seem warranted to the potential influence of CMV-infection on morbidity and mortality in burn patients.

  7. Intestinal Helminth Infections in Pregnant Women Attending Antenatal Clinic at Kitale District Hospital, Kenya

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    A. W. Wekesa

    2014-01-01

    Full Text Available Intestinal helminth infections during pregnancy are associated with adverse outcomes including low birth weight and prenatal mortality. The infections are a major public health problem in developing countries. A hospital based survey was undertaken for six months to determine the infection prevalence, intensity, and risk factors. The study involved expectant women attending antenatal clinic. Stool samples were screened microscopically for helminth ova using Kato Katz technique. Information on risk factors was collected using semistructured questionnaire and analyzed using SPSS. Epidemiological data was analysed using descriptive statistics and multivariate analysis. The overall prevalence of infection was 21 (13.8%. Ascariasis was the most prevalent 10 (6.5%, hookworm infection was 6 (3.9%, and trichuriasis was 2 (1.3%. Pregnant women aged below 29 years (OR = 3.63, CI = 0.87–11.75 and those with primary level of education (OR = 3.21, CI = 0.88–11.75 were at a higher risk of infection compared to those aged ≥ 29 years with secondary level of education. Hand washing was significantly associated with reduced likelihood of infection (OR = 0.18, 95% CI = 0.06–0.57. It was concluded that intestinal helminth infections were prevalent among pregnant women. We recommended that all expectant women visiting antenatal clinics be screened for intestinal helminth infections and positive cases be advised to seek treatment.

  8. [Nosocomial infections in the intensive care unit of a gynecology clinic].

    Science.gov (United States)

    Arsenijević, Ljubica; Popović, Nada; Gojnić, Miroslava

    2006-01-01

    Nosocomial infections are caused by microorganisms, and they develop 48 hours or more after admission to a hospital. It is considered that these infections are neither manifested nor present during the incubation period at the time of admission. The objective of our study was to identify the most frequent microorganisms causing nosocomial infections in the Intensive Care Unit of the Institute of Gynecology and Obstetrics. The study included 33 patients, mean age 43.5 +/- 5 years, who were critical cases treated in Intensive Care Unit of the Institute of Gynecology and Obstetrics, Clinical Center of Serbia, in the period 2001 - 2003. All patients were surgically treated, intubated and assisted by mechanical ventilation. The most common causative agents isolated from the endotracheal tube were Staphylococcus aureus, Staphylococcus coagulasa negative and Pseudomonas spp., whereas Escherichia colli and Enterococcus were isolated from the wounds. These are highly resistant strains to antimicrobial agents. Two big groups of microorganisms were isolated as causative organisms of nosocomial infections. The first group causes blood stream infections, such as Staphilococcus aureus and coagulasa negative, and the second group causes respiratory infections like Pseudomonas aeruginosa, Klebsiella Enterobacter and Acinetobacter. The mortality and morbidity are very high, up to 40 - 80%. We can conclude that invasive diagnostic procedures are causing a high percentage of nosocomial infections. It is of utmost importance to prevent these infections by early use of antibiotics and infection control which depends on the hospital or clinic.

  9. ENTEROVIRUS INFECTION IN CHILDREN: CLINICAL AND EPIDEMIOLOGICAL FEATURES AT THE CURRENT STAGE

    Directory of Open Access Journals (Sweden)

    G. P. Martynova

    2016-01-01

    Full Text Available The article presents the current clinical and epidemiological features of enterovirus infection in children of Krasnoyarsk Territory. A retrospective analysis of the incidence of enterovirus infection and enterovirus meningitis in the period 2014—2015 according to the forms of state statistical reporting №2 «Information on infectious and parasitic diseases». Clinical and epidemiological analysis of enterovirus infection in 454 children who were treated at MBUZ «City Children's Infectious Hospital №1» in the period of seasonal rise of morbidity in 2014 revealed a prevalence of etiological structure of enteroviruses Coxsackie B, Coxsackie B5, Coxsackie B3, Coxsackie B4. The region recorded the different clinical forms of enterovirus infection (rash, myalgia, diarrhea, gerpangina, the structure of which is still, aseptic meningitis prevails.

  10. Vitamin D and clinical disease progression in HIV infection

    DEFF Research Database (Denmark)

    Viard, Jean-Paul; Souberbielle, Jean-Claude; Kirk, Ole

    2011-01-01

    BACKGROUND:: We examined the association between vitamin D [25(OH)D] level and disease progression in HIV infection. METHODS:: Within the EuroSIDA study, 2000 persons were randomly selected for 25(OH)D measurement in stored plasma samples closest to study entry. 25(OH)D results were stratified...... into tertiles. Factors associated with 25(OH)D levels and associations of 25(OH) levels with subsequent risk of all-cause mortality, AIDS and non-AIDS events were analyzed. RESULTS:: Of 1985 persons with 25(OH)D levels available, 23.7% had 25(OH)D 30 ng/ml. At the time of 25(OH)D measurement, older persons......, persons of black ethnic origin, living outside Southern Europe/Argentina, sampled during winter, and infected with HIV through non-homosexual exposure were at higher odds of having low 25(OH)D levels, while persons receiving protease inhibitors were at lower odds. Compared to those in the lowest 25(OH)D...

  11. Epidemiological and clinical correlates of malaria-helminth co-infections in Southern Ethiopia.

    Science.gov (United States)

    Mulu, Andargachew; Legesse, Mengistu; Erko, Berhanu; Belyhun, Yeshambel; Nugussie, Demise; Shimelis, Techalew; Kassu, Afework; Elias, Daniel; Moges, Beyene

    2013-07-03

    In many areas of the world, including Ethiopia, malaria and helminths are co-endemic, therefore, co-infections are common. However, little is known how concurrent infections affect the epidemiology and/or pathogenesis of each other. Therefore, this study was conducted to assess the effects of intestinal helminth infections on the epidemiology and clinical patterns of malaria in southern Ethiopia where both infections are prevalent. A cross-sectional study was conducted in 2006 at Wondo Genet Health Center and Bussa Clinic, southern Ethiopia. Consecutive blood film positive malaria patients (N=230) and malaria negative asymptomatic individuals (N=233) were recruited. Malaria parasite detection and quantification was diagnosed using Giemsa-stained thick and thin blood films, respectively. Helminths were detected using direct microscopy and formol-ether concentration techniques. Coarse quantification of helminths ova was made using Kato Katz method. The over all magnitude of intestinal parasitic infection was high irrespective of malaria infection (67% among malaria positive patients versus 53.1% among malaria non-infected asymptomatic individuals). Trichuris trichiura infection was associated with increased malaria prevalence while increased worm burden of helminths as expressed by egg intensity was associated with increased malaria parasitaemia which could be a potential factor for development of severe malarial infection with the course of the disease. Majority (77%) of the subjects had multiple helminths infection. T. trichiura, Ascaris lumbricoides, Schistosoma mansoni, and hookworm infestation accounted for 64.5, 57.7 %, 28.4%, and 12.2% of the infections, respectively. Populations in malaria-endemic areas of southern Ethiopia are multi-parasitized with up to four helminths. Mass deworming may be a simple practical approach in endemic areas in reducing the risk of severe malarial attack particularly for those at high risk of both infections.

  12. Staphylococcus aureus ocular infection: methicillin-resistance, clinical features, and antibiotic susceptibilities.

    Directory of Open Access Journals (Sweden)

    Chih-Chun Chuang

    Full Text Available BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA infection is an important public health issue. The study aimed to determine the prevalence of ocular infections caused by MRSA and to identify the clinical characteristics and antibiotic susceptibility of ocular MRSA infections by comparing those of ocular methicillin-sensitive S. aureus (MSSA infections. METHODOLOGY/PRINCIPAL FINDINGS: The medical records of the patients (n = 519 with culture-proven S. aureus ocular infections seen between January 1, 1999 and December 31, 2008 in Chang Gung Memorial Hospital were retrospectively reviewed. Two hundred and seventy-four patients with MRSA and 245 with MSSA ocular infections were identified. The average rate of MRSA in S. aureus infections was 52.8% and the trend was stable over the ten years (P value for trend  = 0.228. MRSA ocular infections were significantly more common among the patients with healthcare exposure (P = 0.024, but 66.1% (181/274 patients with MRSA ocular infections had no healthcare exposure. The most common clinical presentation for both MRSA and MSSA ocular infections was keratitis; MRSA and MSSA caused a similar disease spectrum except for lid infections. MRSA was significantly more resistant than MSSA to clindamycin, erythromycin and sulfamethoxazole/trimethoprim (all P<0.001. CONCLUSIONS/SIGNIFICANCE: We demonstrated a paralleled trend of ocular MRSA infection in a highly prevalent MRSA country by hospital-based survey. Except for lid disorder, MRSA shared similar spectrum of ocular pathology with MSSA. Since S. aureus is a common ocular pathogen, our results raise clinician's attention to the existence of highly prevalent MRSA.

  13. Staphylococcus aureus Ocular Infection: Methicillin-Resistance, Clinical Features, and Antibiotic Susceptibilities

    Science.gov (United States)

    Tan, Hsin-Yuan; Ma, David Hui-Kang; Lin, Ken-Kuo; Chang, Chee-Jen; Huang, Yhu-Chering

    2012-01-01

    Background Methicillin-resistant Staphylococcus aureus (MRSA) infection is an important public health issue. The study aimed to determine the prevalence of ocular infections caused by MRSA and to identify the clinical characteristics and antibiotic susceptibility of ocular MRSA infections by comparing those of ocular methicillin-sensitive S. aureus (MSSA) infections. Methodology/Principal Findings The medical records of the patients (n = 519) with culture-proven S. aureus ocular infections seen between January 1, 1999 and December 31, 2008 in Chang Gung Memorial Hospital were retrospectively reviewed. Two hundred and seventy-four patients with MRSA and 245 with MSSA ocular infections were identified. The average rate of MRSA in S. aureus infections was 52.8% and the trend was stable over the ten years (P value for trend  = 0.228). MRSA ocular infections were significantly more common among the patients with healthcare exposure (P = 0.024), but 66.1% (181/274) patients with MRSA ocular infections had no healthcare exposure. The most common clinical presentation for both MRSA and MSSA ocular infections was keratitis; MRSA and MSSA caused a similar disease spectrum except for lid infections. MRSA was significantly more resistant than MSSA to clindamycin, erythromycin and sulfamethoxazole/trimethoprim (all PMRSA infection in a highly prevalent MRSA country by hospital-based survey. Except for lid disorder, MRSA shared similar spectrum of ocular pathology with MSSA. Since S. aureus is a common ocular pathogen, our results raise clinician’s attention to the existence of highly prevalent MRSA. PMID:22880135

  14. Prevalence and risk factors for hepatitis B virus infections among visitors to an STD clinic

    NARCIS (Netherlands)

    Y.T.H.P. van Duynhoven; M.J.W. van de Laar; W.A. Schop; Ph.H. Rothbarth (Philip); W.I. van der Meijden (Willem); A.M. van Loon (Anton); M.J.W. Sprenger (Marc)

    1997-01-01

    textabstractObjective: To determine the prevalence and risk factors for hepatitis B virus (HBV) infections among individuals attending an STD clinic in a low endemic region. Study design: A total of 1228 women and 1648 men attending the STD clinic at the University Hospital Rotterdam, Netherlands,

  15. Risk factors for clinical Salmonella enterica subsp. enterica serovar Typhimurium infection on Dutch dairy farms

    NARCIS (Netherlands)

    Veling, J.; Wilpshaar, H.; Frankena, K.; Bartels, C.; Barkema, H.W.

    2002-01-01

    Risk factors for outbreaks in 1999 of clinical Salmonella enterica subsp. enterica serovar Typhimurium infection on dairy farms were studied in a matched case–control study with 47 case farms and 47 control farms. All 47 case farms experienced a clinical outbreak of salmonellosis which was confirmed

  16. CLINICAL AND VIROLOGIC FOUNDATION FOR PATHOGENETIC THERAPY OF HUMAN HERPES VIRUS TYPE 6 INFECTION IN CHILDREN

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    N.A. Myukke

    2006-01-01

    Full Text Available Information about an infection caused by human herpes virus type 6, its' epidemiology, pathogenesis and clinical variants, is reviewed. Clinical cases, diagnosed at a time of study, are briefly reviewed.Key words: human herpes virus type 6, exanthema subitum (roseola infantum, fever of unknown origin, mononucleosis like syndrome, meningoencephalitis, children.

  17. Quantitation of respiratory viruses in relation to clinical course in children with acute respiratory tract infections

    NARCIS (Netherlands)

    Jansen, Rogier R.; Schinkel, Janke; dek, Irene; Koekkoek, Sylvie M.; Visser, Caroline E.; de Jong, Menno D.; Molenkamp, Richard; Pajkrt, Dasja

    2010-01-01

    Quantitation of respiratory viruses by PCR could potentially aid in clinical interpretation of PCR results. We conducted a study in children admitted with acute respiratory tract infections to study correlations between the clinical course of illness and semiquantitative detection of 14 respiratory

  18. Cervicitis as a Clinical Indicator of Gonococcal and Chlamydial Infections in Pregnancy

    Directory of Open Access Journals (Sweden)

    Susan L. Jackson

    1995-01-01

    Full Text Available Objective: We undertook the present study to attempt to apply clinical indicators predictive of cervical infection in nongravid populations with either Neisseria gonorrhoeae or Chlamydia trachomatis to our pregnant population and to determine the significance of the clinical diagnosis of “cervicitis.”

  19. Repeat infection with Chlamydia trachomatis: a prospective cohort study from an STI-clinic in Stockholm

    Directory of Open Access Journals (Sweden)

    Qvarnström Ivar

    2009-06-01

    Full Text Available Abstract Background Infection with genital Chlamydia trachomatis (Ct is the most common notifiable sexually transmitted infection (STI in Sweden. A mutated Chlamydia, nvCT, has contributed to the increase. The occurrence of repeat infections is not investigated in Sweden. The current paper presents the study protocol for the first Swedish clinical investigation of repeat Chlamydial infection. The concern of the study is whether a Chlamydia infection at inclusion indicates an increased risk for Chlamydia at follow-up after 6–8 months, gender-specific risk factors for and clinical presentation of repeat infections. Methods and design Sesam City is a drop-in clinic in the city centre of Stockholm. Patients 20 years and older are admitted. During 2007, the clinic had 15 000 visits, 60% made by men. In December 2007, a cohort study began, and data collection was finished in April 2009. A total of 2813 study participants aged 20–39 years were recruited. Data collection included an anonymous self-administered paper-and-pen questionnaire on sexual behaviour, reproductive health and history of Chlamydia, and condom use. Chlamydia tests were performed by self-sampled specimens, analyzed by the ProbeTec (Becton Dickinson method, Ct-positive specimens also analyzed with a nvCT-specific method. Data from medical records were summarized in clinical report forms. Patients positive for Chlamydia were retested 4 weeks after treatment. Contact tracing covered sexual contacts during the last 12 months. At follow-up 6–8 months after inclusion, Chlamydia tests were performed, and a new questionnaire and CRF completed. Discussion A STI-clinic-based prospective cohort study allowed us to survey 2813 adult patients. The collected data will provide gender-specific information on the occurrence of and risk for repeat Chlamydia infection, the occurrence of nvCT, and clinical data and information on sexual behaviour and reproductive health, risk-taking and condom use.

  20. Dengue infection in children in Ratchaburi, Thailand: a cohort study. II. Clinical manifestations.

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    Chukiat Sirivichayakul

    Full Text Available Dengue infection is one of the most important mosquito-borne diseases. More data regarding the disease burden and the prevalence of each clinical spectrum among symptomatic infections and the clinical manifestations are needed. This study aims to describe the incidence and clinical manifestations of symptomatic dengue infection in Thai children during 2006 through 2008.This study is a school-based prospective open cohort study with a 9,448 person-year follow-up in children aged 3-14 years. Active surveillance for febrile illnesses was done in the studied subjects. Subjects who had febrile illness were asked to visit the study hospital for clinical and laboratory evaluation, treatment, and serological tests for dengue infection. The clinical data from medical records, diary cards, and data collection forms were collected and analyzed.Dengue infections were the causes of 12.1% of febrile illnesses attending the hospital, including undifferentiated fever (UF (49.8%, dengue fever (DF (39.3% and dengue hemorrhagic fever (DHF (10.9%. Headache, anorexia, nausea/vomiting and myalgia were common symptoms occurring in more than half of the patients. The more severe dengue spectrum (i.e., DHF had higher temperature, higher prevalence of nausea/vomiting, abdominal pain, rash, diarrhea, petechiae, hepatomegaly and lower platelet count. DHF cases also had significantly higher prevalence of anorexia, nausea/vomiting and abdominal pain during day 3-6 and diarrhea during day 4-6 of illness. The absence of nausea/vomiting, abdominal pain, diarrhea, petechiae, hepatomegaly and positive tourniquet test may predict non-DHF.Among symptomatic dengue infection, UF is most common followed by DF and DHF. Some clinical manifestations may be useful to predict the more severe disease (i.e., DHF. This study presents additional information in the clinical spectra of symptomatic dengue infection.

  1. Clinical profile of HIV infected patients attending a HIV referral clinic in Pune, India

    Directory of Open Access Journals (Sweden)

    Megha Antwal

    2014-01-01

    Interpretation & conclusions: Signs and symptoms associated with HIV positivity observed in this study can be used by health care providers to detect HIV infection early. Moreover, similar to HIV testing in patients with tuberculosis, strategies can be developed for considering Herpes zoster as a predictor of HIV infection.

  2. Advances In Infection Surveillance and Clinical Decision Support With Fuzzy Sets and Fuzzy Logic.

    Science.gov (United States)

    Koller, Walter; de Bruin, Jeroen S; Rappelsberger, Andrea; Adlassnig, Klaus-Peter

    2015-01-01

    By the use of extended intelligent information technology tools for fully automated healthcare-associated infection (HAI) surveillance, clinicians can be informed and alerted about the emergence of infection-related conditions in their patients. Moni--a system for monitoring nosocomial infections in intensive care units for adult and neonatal patients--employs knowledge bases that were written with extensive use of fuzzy sets and fuzzy logic, allowing the inherent un-sharpness of clinical terms and the inherent uncertainty of clinical conclusions to be a part of Moni's output. Thus, linguistic as well as propositional uncertainty became a part of Moni, which can now report retrospectively on HAIs according to traditional crisp HAI surveillance definitions, as well as support clinical bedside work by more complex crisp and fuzzy alerts and reminders. This improved approach can bridge the gap between classical retrospective surveillance of HAIs and ongoing prospective clinical-decision-oriented HAI support.

  3. Clinical consequences of PCR based diagnosis of intestinal parasitic infections

    NARCIS (Netherlands)

    Rijsman, Lucas H; Monkelbaan, Jan F|info:eu-repo/dai/nl/344499383; Kusters, Johannes G|info:eu-repo/dai/nl/074307428

    2016-01-01

    The implementation of Polymerase Chain Reaction (PCR) based diagnostics of intestinal protozoa have led to higher sensitivity and (subtype) specificity, more convenient sampling and the possibility for high-throughput screening. An increasing number of clinical laboratories use PCR for routine

  4. Infections Disease in the Dental Clinical Nigerian Dentists ...

    African Journals Online (AJOL)

    The dental clinic is a potential source of transmission of infectious disease due to the invasive nature of many dental procedures. Infectious disease therefore constitutes serious occupational hazards to all oral health care workers. This descriptive study aims to assess the knowledge of dentists on common transmissible ...

  5. Clinical Characterization of Aerosolized Francisella tularensis Infection in Cynomolgus macaques

    Science.gov (United States)

    2016-11-21

    Microbiology, Center for Veterinary Medicine , Food and Drug Administration & Veterinary Pathology Services, Joint Pathology Center, Silver Spring, MD... Veterinary Medicine Division for the care and handling of the animals and the Clinical Lab personnel for performing hematology and chemistry tests in...was conducted (USAMRIID) is fully accredited by the Association for the Assessment and Accreditation of Laboratory Animal Care International

  6. Functional dyspepsia and dyspepsia associated with Helicobacter pylori infection: Do they have different clinical characteristics?

    Science.gov (United States)

    Rodríguez-García, J L; Carmona-Sánchez, R

    2016-01-01

    Helicobacter pylori causes motor, secretory, and inflammatory gastrointestinal disorders and therefore the term "functional" has been questioned when referring to dyspepsia associated with this bacterium. Patients with dyspepsia and Helicobacter pylori infection could have clinical characteristics that differentiate them a priori from those with true functional dyspepsia. To determine whether there are clinical differences between patients with functional dyspepsia and Helicobacter pylori-associated dyspepsia that enable their a priori identification and to know the prevalence of Helicobacter pylori infection in patients with functional dyspepsia. A total of 578 patients with dyspepsia with no significant lesions detectable through endoscopy were divided into 2 groups according to the presence of Helicobacter pylori. The clinical characteristics, medical history, comorbidities, and use of health resources were compared between the two groups. A sub-analysis pairing the groups by age and sex in a 1:1 ratio was carried out to reduce bias. A total of 336 patients infected with Helicobacter pylori were compared with 242 non-infected patients. The prevalence of infection in the patients with dyspeptic symptoms and no endoscopically detectable lesions was 58%. The initial analysis showed that the cases with dyspepsia and Helicobacter pylori infection were more frequently associated with overweight, obesity, high blood pressure, diabetes mellitus, and metabolic syndrome, but the paired analysis nullified all these differences. The patients with dyspepsia infected with Helicobacter pylori had similar clinical characteristics to the non-infected patients and could not be differentiated a priori. The prevalence of Helicobacter pylori infection in patients with functional dyspepsia was 58% and increased with age. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  7. [Clinical aspects, diagnosis and therapy of Yersinia enterocolitica infections].

    Science.gov (United States)

    Hoogkamp-Korstanje, J A; de Koning, J

    1990-12-01

    The predominant form (65% of all patients) of yersiniosis is mesenteric adenitis, resulting in enteritis, pseudo-appendicular syndromes, ileitis or colitis. The severity of this form depends to some degree on the age. Extra-mesenteric forms (in 20-25%), focal infections by dissemination, the septic form and the lymphadenopathy syndrome may occur after or without previous enteritis. Persistence of Y. enterocolitica in lymphnodes and the GALT is responsible for chronic and recurrent forms. Secondary immunological complications (25%) are arthritis and Erythema nodosum. Diagnosis is made by culture, serology, of which demonstration of specific antibodies against released proteins is more reliable than demonstration of agglutinins and antigen detection by indirect immunofluorescence in biopsies. Antibiotic treatment of mild enteric forms is questionable, extra-mesenteric forms should be treated. Appropriate antibiotics are trimethoprim, chloramphenicol, tetracycline and the new fluoroquinolones. Studies are in progress (Leeuwarden and Hanover, MHH) to elucidate the indication of antibiotic treatment of Yersinia-arthritis patients.

  8. The clinical management of lower respiratory tract infections.

    Science.gov (United States)

    Liapikou, Adamantia; Torres, Antoni

    2016-03-16

    The 2010 Global Burden of Disease Study reported that lower respiratory tract infections, including pneumonia, are the fourth most common cause of death globally. The etiology of acute bronchitis and asthma exacerbations is mostly viral and the therapy is symptomatic. Management decisions in community acquired pneumonia regarding site of care, extent of assessment, and level of treatment are based primarily on disease severity (outpatient, inpatient, ICU admission). Antibiotics are the main choice of treatment for patients with pneumonia, acute exacerbations (AE) of COPD (including increased sputum purulence and worsening shortness of breath) and AE of non-CF bronchiectasis. Inhaled antibiotics may represent a more optimal approach for the treatment and prevention of AE of non-CF bronchiectasis. Approved strategies for the prevention of exacerbations include smoking cessation and rehabilitation programs, drug therapy and vaccination.

  9. Oral administration of Lactobacillus brevis KB290 to mice alleviates clinical symptoms following influenza virus infection.

    Science.gov (United States)

    Waki, N; Yajima, N; Suganuma, H; Buddle, B M; Luo, D; Heiser, A; Zheng, T

    2014-01-01

    Lactobacillus brevis KB290 (KB290), isolated from a traditional Japanese pickle 'Suguki', has been reported to have immunomodulatory effects. We investigated whether oral administration of KB290 has protective effects against influenza virus (IFV) infection in mice. After 14 days of administration of lyophilized KB290 suspended in phosphate-buffered saline by oral gavage, BALB/c mice were intranasally infected with 2 × MLD50 (50% mouse lethal dose) of IFV A/PR/8/34 (H1N1). Prophylactically administered KB290 significantly alleviated the loss of body weight and the deterioration in observational physical conditions induced by the infection. In addition, 7 days after infection, the levels of IFV-specific immunoglobulin (Ig)A in bronchoalveolar lavage fluid were significantly increased in mice fed KB290 compared with controls. Moreover, there was a significant elevation of serum interferon (IFN)-α in KB290 group mice, even at three and 7 days after infection, despite the administration of KB290 being stopped before IFV infection. Our results demonstrated that oral administration of KB290 before infection could alleviate IFV-induced clinical symptoms. Alleviation of clinical symptoms by KB290 consumption may have been induced by long-lasting enhancement of IFN-α production and the augmentation of IFV-specific IgA production. This study demonstrated that oral administration of Lactobacillus brevis KB290 (KB290), a probiotic strain derived from a Japanese traditional pickle, could protect against influenza virus (IFV) infection in mice. Our results demonstrated that continual intake of KB290 for 14 days prior to IFV infection alleviated clinical symptoms such as loss of body weight and deterioration in observational physical conditions induced by the infection. The beneficial effects of KB290 consumption may have been elicited by the long-lasting enhancement of interferon-α production and the augmentation of IFV-specific immunoglobulin A production. © 2013 The

  10. Vancomycin-resistant enterococcal infections: epidemiology, clinical manifestations, and optimal management.

    Science.gov (United States)

    O'Driscoll, Tristan; Crank, Christopher W

    2015-01-01

    Since its discovery in England and France in 1986, vancomycin-resistant Enterococcus has increasingly become a major nosocomial pathogen worldwide. Enterococci are prolific colonizers, with tremendous genome plasticity and a propensity for persistence in hospital environments, allowing for increased transmission and the dissemination of resistance elements. Infections typically present in immunosuppressed patients who have received multiple courses of antibiotics in the past. Virulence is variable, and typical clinical manifestations include bacteremia, endocarditis, intra-abdominal and pelvic infections, urinary tract infections, skin and skin structure infections, and, rarely, central nervous system infections. As enterococci are common colonizers, careful consideration is needed before initiating targeted therapy, and source control is first priority. Current treatment options including linezolid, daptomycin, quinupristin/dalfopristin, and tigecycline have shown favorable activity against various vancomycin-resistant Enterococcus infections, but there is a lack of randomized controlled trials assessing their efficacy. Clearer distinctions in preferred therapies can be made based on adverse effects, drug interactions, and pharmacokinetic profiles. Although combination therapies and newer agents such as tedizolid, telavancin, dalbavancin, and oritavancin hold promise for the future treatment of vancomycin-resistant Enterococcus infections, further studies are needed to assess their possible clinical impact, especially in the treatment of serious infections.

  11. Vancomycin-resistant enterococcal infections: epidemiology, clinical manifestations, and optimal management

    Directory of Open Access Journals (Sweden)

    O’Driscoll T

    2015-07-01

    Full Text Available Tristan O’Driscoll,1 Christopher W Crank2 1Department of Pharmacy Practice, Chicago College of Pharmacy, Downers Grove, IL, USA; 2Pharmacy Services, Rush-Copley Medical Center, Aurora, IL, USA Abstract: Since its discovery in England and France in 1986, vancomycin-resistant Enterococcus has increasingly become a major nosocomial pathogen worldwide. Enterococci are prolific colonizers, with tremendous genome plasticity and a propensity for persistence in hospital environments, allowing for increased transmission and the dissemination of resistance elements. Infections typically present in immunosuppressed patients who have received multiple courses of antibiotics in the past. Virulence is variable, and typical clinical manifestations include bacteremia, endocarditis, intra-abdominal and pelvic infections, urinary tract infections, skin and skin structure infections, and, rarely, central nervous system infections. As enterococci are common colonizers, careful consideration is needed before initiating targeted therapy, and source control is first priority. Current treatment options including linezolid, daptomycin, quinupristin/dalfopristin, and tigecycline have shown favorable activity against various vancomycin-resistant Enterococcus infections, but there is a lack of randomized controlled trials assessing their efficacy. Clearer distinctions in preferred therapies can be made based on adverse effects, drug interactions, and pharmacokinetic profiles. Although combination therapies and newer agents such as tedizolid, telavancin, dalbavancin, and oritavancin hold promise for the future treatment of vancomycin-resistant Enterococcus infections, further studies are needed to assess their possible clinical impact, especially in the treatment of serious infections. Keywords: Gram-positive, Enterococcus faecalis, Enterococcus faecium, VRE, antibiotic resistance, multidrug resistance

  12. Clinical profile of orofacial infections: An experience from two primary care dental practices

    Science.gov (United States)

    Hollinshead, Frank

    2012-01-01

    Objectives: Orofacial infections are common reasons for dental consultations worldwide. However, there is scarcity of data on clinico-epidemiological profiles reported from primary care dental practices. To address this issue, a study was done to characterize the clinical pattern, age groups affected and sex predilection of orofacial infections in the primary care dental practice. Study design: Clinical data was evaluated from random electronic files of patients for whom antimicrobials were prescribed at two Dental Practices in UK between January 2009 and December 2010. Results: 200 case records were studied. 104 (52%) cases were females. Mean age was 37.2 (+/-15.1) years. 107 (53.5%) cases belonged to age group 21-40 years. Posterior teeth were involved in 112 (56%) cases. Types of disease were as follows: dentoalveolar abscess 63(31.5%), pulpitis 27(13.5%), apical periodontitis 21(10.5%), pericoronitis 21(10.5%), dry socket 13(6.5%), periodontitis 9(4.5%) infected root stump 5(2.5%), facial swelling 5(2.5%) and infections unspecified 36(18%) cases. Conclusions: Orofacial infections affect both sexes equally. 21-40 years is the commonest age-group affected. Dentoalveolar abscess is the commonest infection followed by unspecified infections and pulpitis. Key words:Orofacial infections, primary care dental practice, dentoalveolar abscess and pulpitis. PMID:22322492

  13. Prevention and Treatment of Postoperative Infections after Sinus Elevation Surgery: Clinical Consensus and Recommendations

    Directory of Open Access Journals (Sweden)

    Tiziano Testori

    2012-01-01

    Full Text Available Introduction. Maxillary sinus surgery is a reliable and predictable treatment option for the prosthetic rehabilitation of the atrophic maxilla. Nevertheless, these interventions are not riskless of postoperative complications with respect to implant positioning in pristine bone. Aim. The aim of this paper is to report the results of a clinical consensus of experts (periodontists, implantologists, maxillofacial surgeons, ENT, and microbiology specialists on several clinical questions and to give clinical recommendations on how to prevent, diagnose, and treat postoperative infections. Materials and Methods. A panel of experts in different fields of dentistry and medicine, after having reviewed the available literature on the topic and taking into account their long-standing clinical experience, gave their response to a series of clinical questions and reached a consensus. Results and Conclusion. The incidence of postop infections is relatively low (2%–5.6%. A multidisciplinary approach is advisable. A list of clinical recommendation are given.

  14. Characterization of bacteriophages infecting clinical isolates of Pseudomonas aeruginosa stored in a culture collection

    Directory of Open Access Journals (Sweden)

    C.C.S. Zanetti

    2013-08-01

    Full Text Available Some clinical isolates of Pseudomonas aeruginosa stored in our culture collection did not grow or grew poorly and showed lysis on the culture plates when removed from the collection and inoculated on MacConkey agar. One hypothesis was that bacteriophages had infected and killed those clinical isolates. To check the best storage conditions to maintain viable P. aeruginosa for a longer time, clinical isolates were stored at various temperatures and were grown monthly. We investigated the presence of phage in 10 clinical isolates of P. aeruginosa stored in our culture collection. Four strains of P. aeruginosa were infected by phages that were characterized by electron microscopy and isolated to assess their ability to infect. The best condition to maintain the viability of the strains during storage was in water at room temperature. Three Siphoviridae and two Myoviridae phages were visualized and characterized by morphology. We confirmed the presence of bacteriophages infecting clinical isolates, and their ability to infect and lyse alternative hosts. Strain PAO1, however, did not show lysis to any phage. Mucoid and multidrug resistant strains of P. aeruginosa showed lysis to 50% of the phages tested.

  15. Characterization of bacteriophages infecting clinical isolates of Pseudomonas aeruginosa stored in a culture collection.

    Science.gov (United States)

    Zanetti, C C S; Mingrone, R C C; Kisielius, J J; Ueda-Ito, M; Pignatari, A C C

    2013-08-01

    Some clinical isolates of Pseudomonas aeruginosa stored in our culture collection did not grow or grew poorly and showed lysis on the culture plates when removed from the collection and inoculated on MacConkey agar. One hypothesis was that bacteriophages had infected and killed those clinical isolates. To check the best storage conditions to maintain viable P. aeruginosa for a longer time, clinical isolates were stored at various temperatures and were grown monthly. We investigated the presence of phage in 10 clinical isolates of P. aeruginosa stored in our culture collection. Four strains of P. aeruginosa were infected by phages that were characterized by electron microscopy and isolated to assess their ability to infect. The best condition to maintain the viability of the strains during storage was in water at room temperature. Three Siphoviridae and two Myoviridae phages were visualized and characterized by morphology. We confirmed the presence of bacteriophages infecting clinical isolates, and their ability to infect and lyse alternative hosts. Strain PAO1, however, did not show lysis to any phage. Mucoid and multidrug resistant strains of P. aeruginosa showed lysis to 50% of the phages tested.

  16. Clinical, serological, and parasitological analysis of snakes naturally infected with Cryptosporidium serpentis.

    Science.gov (United States)

    Paiva, Philipp Ricardo S O; Grego, Kathleen F; Lima, Valéria M F; Nakamura, Alex A; da Silva, Deuvânia C; Meireles, Marcelo V

    2013-11-15

    Infection by Cryptosporidium serpentis is one of the most important diseases in reptiles and is characterized by chronic clinical or subclinical infection and the presence of hypertrophic gastritis, food regurgitation, progressive weight loss, mortality, and intermittent or continuous shedding of oocysts in the feces. The objectives of this study were to standardize an indirect enzyme-linked immunosorbent assay (ELISA) to detect antibodies against C. serpentis and to evaluate the clinical, parasitological, and humoral immune response in snakes naturally infected with C. serpentis. Twenty-one snakes naturally infected with C. serpentis and housed at the Butantan Institute, São Paulo, Brazil, underwent clinical and parasitological analyses for C. serpentis infection through daily records of clinical signs and a monthly survey of fecal shedding of oocysts using the Kinyoun's acid-fast staining. The serological evaluation was performed monthly by indirect ELISA using crude total antigen from oocysts of C. serpentis to detect anti-C. serpentis antibodies. Clinical symptoms consisted of food regurgitation, inappetence, and progressive weight loss. The parasitological analysis revealed intermittent fecal shedding of a variable number of oocysts in all snakes, with positivity in 85.32% (157/184) of the samples. The indirect ELISA was positive in 68.25% (86/126) of the samples. A humoral immune response was observed in most animals; however, fluctuating antibodies levels, leading to alternating positive and negative results, were observed in most snakes. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. Clinical versus computed tomography evaluation in the diagnosis and management of deep neck infection

    Directory of Open Access Journals (Sweden)

    Agricio Nubiato Crespo

    Full Text Available CONTEXT: Deep neck infections have high potential for severe complications and even death, if not properly managed. The difference between clinical and computed tomography findings may demonstrate that clinical evaluation alone underestimates disease extent, which may lead to conservative treatment with worse prognosis. OBJECTIVE: To compare clinical and computed tomography findings from neck spaces affected by deep neck infections and to determine the main clinical and radiological features associated with these. TYPE OF STUDY: Non-randomized retrospective study. SETTING: Department of Otolaryngology and Head and Neck, Universidade Estadual de Campinas. METHODS: Medical charts of 65 patients with deep neck infections were evaluated. Age, gender, clinical complaints, physical findings, computed tomography scan and x-ray imaging, microbiology, treatment and outcome were analyzed. All clinical signs and symptoms were evaluated and stratified in order of frequency. The frequency of neck space involvement in such infections was also assessed from the clinical and tomographic evaluation. All clinical and computed tomography findings were compared with surgical observation. RESULTS: The most frequent clinical findings were neck swelling, local pain, erythema and locally increased temperature. Physical evaluation showed that the most affected site was the submandibular triangle (49.2% of cases. However, computed tomography showed this to be the lateropharyngeal space (65% of cases and that more than one deep cervical space was compromised in 90% of cases, as demonstrated by the extent of swelling and increased contrast signs in soft tissue. DISCUSSION: The most frequent clinical symptoms of deep cervical infections were cervical pain, increased cervical volume and fever. The important signs seen via computed tomography were increased contrast in soft neck tissues and swelling. Such examination is the most important method for correct evaluation of

  18. Clinical and virologic manifestations of primary Epstein-Barr virus (EBV) infection in Kenyan infants born to HIV-infected women.

    Science.gov (United States)

    Slyker, Jennifer A; Casper, Corey; Tapia, Kenneth; Richardson, Barbra; Bunts, Lisa; Huang, Meei-Li; Maleche-Obimbo, Elizabeth; Nduati, Ruth; John-Stewart, Grace

    2013-06-15

    Human immunodeficiency virus (HIV) infection is a risk factor for Epstein-Barr virus (EBV)-associated lymphomas. Characterizing primary infection may elucidate risk factors for malignancy. To describe clinical and virologic manifestations of primary EBV infection among infants born to HIV-infected women, specimens were utilized from a cohort study conducted in Nairobi, Kenya. HIV and EBV viral loads were measured serially in plasma. EBV serology was performed on EBV DNA-negative infants. Monthly clinical examinations were performed by pediatricians. The probability of EBV infection by 1 year of age was .78 (95% CI, .67-.88) in HIV-infected and .49 (95% CI, .35-.65) in HIV-uninfected infants (P EBV infection was .96 (95% CI, .89-.99) in HIV-infected infants. Peak EBV loads were higher in HIV-infected versus HIV-uninfected infants (median 2.6 vs 2.1 log10 copies/mL; P EBV DNA for >3 months (79%). Primary EBV infection was associated with cough, fever, otitis media, pneumonia, hepatomegaly, splenomegaly, and hospitalization in HIV-infected infants; conjunctivitis and rhinorrhea in HIV-uninfected infants. EBV infection occurs early in infants born to HIV-infected women. HIV infection was associated with more frequent and higher quantity EBV DNA detection.

  19. A hospital-based study of epidemiological and clinical data on Blastocystis hominis infection.

    Science.gov (United States)

    Laodim, Pongsakorn; Intapan, Pewpan M; Sawanyawisuth, Kittisak; Laummaunwai, Porntip; Maleewong, Wanchai

    2012-12-01

    Blastocystis hominis is a foodborne protozoan found in the human feces worldwide. One hundred and ninety-nine individuals with stool samples positive for B. hominis were identified from a pool of 14,325 patient stools collected between 2003 and 2010 from Srinagarind hospital in Thailand. The medical records of patients were reviewed for demographic and clinical data. Of the 85 patients (42.7%) who had B. hominis infection with no co-infections, 42.5% experienced gastrointestinal symptoms. Abdominal pain is the most frequently observed symptom followed by diarrhea. Strongyloides stercolaris and Opisthorchis viverrini were the predominant parasitic co-infections in blastocystosis patients. The infection rates of B. hominis were high during the rainy season. Most B. hominis-infected patients (94%) had underlying diseases; malignancy and chronic diseases were equally top ranked (35.3%) which indicated that B. hominis is an opportunistic protozoan.

  20. Clinical presentation of soft-tissue infections and its management: A study of 100 cases

    Directory of Open Access Journals (Sweden)

    Baldev Singh

    2017-01-01

    Full Text Available Background: Soft-tissue infections vary widely in their nature and severity. A clear approach to the management must allow their rapid identification and treatment as they can be life-threatening. Objective: Clinical presentation of soft-tissue infections and its management. Materials and Methods: A prospective study based on 100 patients presenting with soft-tissue infections was done. All the cases of soft-tissue infections were considered irrespective of age, sex, etiological factors, or systemic disorders. The findings were evaluated regarding the pattern of soft-tissue infections in relation to age and sex, clinical presentation, complications, duration of hospital stay, management, and mortality. Results: The most commonly involved age group was in the range of 41–60 years with male predominance. Abscess formation (45% was the most common clinical presentation. Type 2 diabetes mellitus was the most common associated comorbid condition. Staphylococcus aureus was the most common culture isolate obtained. The most common complication seen was renal failure. Patients with surgical site infections had maximum duration of stay in the hospital. About 94% of the cases of soft-tissue infections were managed surgically. Mortality was mostly encountered in the cases of complications of cellulitis. Conclusion: Skin and soft-tissue infections are among the most common infections encountered by the emergency physicians. Ignorance, reluctance to treatment, economic constraints, and illiteracy delay the early detection and the initiation of proper treatment. Adequate and timely surgical intervention in most of the cases is of utmost importance to prevent the complications and reduce the mortality.

  1. Clinical and Pathologic Evaluation of Chronic Bartonella henselae or Bartonella clarridgeiae Infection in Cats

    OpenAIRE

    Kordick, Dorsey L.; Brown, Talmage T; Shin, KwangOk; Breitschwerdt, Edward B.

    1999-01-01

    Human Bartonella infections result in diverse medical presentations, whereas many cats appear to tolerate chronic bacteremia without obvious clinical abnormalities. Eighteen specific-pathogen-free cats were inoculated with Bartonella henselae- and/or Bartonella clarridgeiae-infected cat blood and monitored for 454 days. Relapsing bacteremia did not correlate with changes in protein profiles or differences in antigenic protein recognition. Intradermal skin testing did not induce a delayed type...

  2. Clinical correlate of tuberculosis in HIV co-infected children at the ...

    African Journals Online (AJOL)

    Co-infection was significantly higher in older children (>5 years) than in younger children <5 years (32 vs 9, P < 0.05). Severe weight loss was the only clinical feature found to have a fairly good sensitivity (88.9%) and specificity (88.6%) for TB in co-infected children, with a positive predictive value of 23.0%. While immune ...

  3. Clinical characteristics, diagnostic evaluation, and antibiotic prescribing patterns for skin infections in nursing homes

    Directory of Open Access Journals (Sweden)

    Norihiro Yogo

    2016-07-01

    Full Text Available Background: The epidemiology and management of skin infections in nursing homes has not been adequately described. We reviewed the characteristics, diagnosis and treatment of skin infections among residents of nursing homes to identify opportunities to improve antibiotic use. Methods: A retrospective study involving 12 nursing homes in the Denver metropolitan area. For residents at participating nursing homes diagnosed with a skin infection between July 1, 2013 and June 30, 2014, clinical and demographic information was collected through manual chart review.Results: Of 100 cases included in the study, the most common infections were non-purulent cellulitis (n=55, wound infection (n=27, infected ulcer (n=8, and cutaneous abscess (n=7. In 26 cases, previously published minimum clinical criteria for initiating antibiotics (Loeb criteria were not met. Most antibiotics (n=52 were initiated as a telephone order following a call from a nurse, and 41 patients were not evaluated by a provider within 48 hours after initiation of antibiotics. Nearly all patients (n=95 were treated with oral antibiotics alone. The median treatment duration was 7 days (interquartile range [IQR] 7-10; 43 patients received treatment courses of ≥ 10 days.Conclusions: Most newly diagnosed skin infections in nursing homes were non-purulent infections treated with oral antibiotics. Antibiotics were initiated by telephone in over half of cases, and lack of a clinical evaluation within 48 hours after starting antibiotics was common. Improved diagnosis through more timely clinical evaluations and decreasing length of therapy are important opportunities for antibiotic stewardship in nursing homes.

  4. Early Clinical Signs and Symptoms of HIV Infection: Delaying progression to AIDS

    OpenAIRE

    Miedzinski, Lil J.

    1992-01-01

    Early clinical signs and symptoms of human immunodeficiency virus infection are protean and can reflect the effects of the virus or represent early manifestations of an illness associated with the acquired immunodeficiency syndrome. Knowledge of a patient's potential risk for HIV infection and of the natural history of the illness allow early signs and symptoms to be recognized. Early intervention can delay progression to AIDS.

  5. Long-term clinical, microbiological, and immunological observations of a volunteer repeatedly infected with Chlamydia trachomatis.

    OpenAIRE

    Hanna, L; Jawetz, E.; Dawson, C. R.; Thygeson, P

    1982-01-01

    A blind volunteer was inoculated in one eye with an isolate of Chlamydia trachomatis in 1961 and followed for 20 years. During this time, many observations were made of his clinical responses to the first inoculation and several subsequent inoculations with the same and other strains, chlamydial shedding, and antibody and cell-mediated immune responses. Evidence is presented that partial resistance to chlamydial eye infection developed during repeated infections and that antibodies, cell-medi...

  6. INCIDENCE AND CLINICAL FEATURES OF TUBERCULOSIS IN HIV-INFECTED CHILDREN IN THE SVERDLOVSK REGION

    Directory of Open Access Journals (Sweden)

    N. V. Eismont

    2014-01-01

    Full Text Available The paper analyzes the structure of HIV-infected children who was ill with tuberculosis in the Sverdlovsk Region in 2004-2012. The incidence of tuberculosis in children aged 0 to 14 years in the Sverdlovsk Region showed a 79.4% increase in the above period due to the introduction of Russian innovative technologies for the diagnosis of this disease in children. At the same time there was a rise in both the number of HIV-infected children aged 0 to 14 years and the proportion of same-age children with late-stage HIV infection. Simultaneously, the incidence of tuberculosis in the non-HIV-infected children aged 0 to 14 years was 55.2-193.2 times lower than that in the HIV-infected children. In 2004-2014, the Sverdlovsk Region notified fewer new cases of tuberculosis among the children without HIV infection than among those with its late stages. Non-HIV-infected children of both sexes were also ill with tuberculosis less frequently than HIV-infected boys and girls. HIV-infected children 1-3 and 7-14 years of age proved to be most vulnerable to tuberculosis. Among those who fell ill with tuberculosis, there was a preponderance of patients with late-stage HIV infection; moreover, the majority (79.6% received highly active antiretroviral therapy. 63.3% of the cases were in contact with a tuberculosis patient, only every five patients had chemoprophylaxis for this disease. High-quality vaccination against tuberculosis prevented complications and bacterial excretion in children with comorbidity. Out of the clinical forms of tuberculosis in children with HIV infection, there was a predominance of primary tuberculous complex and intrathoracic lymph node tuberculosis. The latter was less common in children without HIV infection than in those with this disease; the same was true of bacterial excretion in respiratory tuberculosis.

  7. Clinical pathology of experimental Schistosoma curassoni infections in sheep and goats.

    Science.gov (United States)

    Vercruysse, J; Fransen, J; Southgate, V R; Rollinson, D; Majeleine, W

    1988-05-01

    The clinical pathology of Schistosoma curassoni infection in sheep and goats was studied for 22 weeks following experimental infection with 7000 and 4000 cercariae, respectively. Excretion of eggs began at week 7 after infection: in goats the numbers increased to 30 to 50 eggs per gram faeces (epg) at weeks 8 to 18, followed by a reduction. In a pregnant goat, epg values increased markedly before and after parturition. The mean faecal egg counts in sheep were lower than in goats, increasing to a maximum level of 30 epg at weeks 16 and 17 after infection. Infected sheep maintained growth rates roughly comparable with controls, whereas infected goats failed to gain as much weight as the controls. Infected goats and sheep produced eosinophil counts of about 3 x 10(3) mm-3, five and eight weeks after infection, respectively. Sheep developed a progressive anaemia from week 11 after infection, in goats blood values remained within normal limits. Differences in serum protein concentration were observed between infected and uninfected goats about nine weeks after infection, but not in sheep. Increased total protein values, hyperglobulinaemia and lowered albumin to globulin ratios were features of infected goats. Serum glutamate oxaloacetate transaminase, glutamate pyruvate transaminase, gamma-glutamyl transferase, total lactate dehydrogenase and bilirubin were not significantly changed. The mean recovery in sheep was 608 worms, in goats 428 worms, but the total tissue egg counts were higher in the latter. Of the total eggs deposited in the goats 92 per cent were found in the liver with 51.5 per cent in the ovine liver. The histopathological changes were studied.

  8. Simple Clinical and Laboratory Predictors of Chikungunya versus Dengue Infections in Adults

    Science.gov (United States)

    Lee, Vernon J.; Chow, Angela; Zheng, Xiaohui; Carrasco, Luis R.; Cook, Alex R.; Lye, David C.; Ng, Lee-Ching; Leo, Yee-Sin

    2012-01-01

    Background Dengue and chikungunya are co-circulating vector-borne diseases with substantial overlap in clinical presentations. It is important to differentiate between them during first presentation as their management, especially for dengue hemorrhagic fever (DHF), is different. This study compares their clinical presentation in Singapore adults to derive predictors to assist doctors in diagnostic decision-making. Methods We compared 117 patients with chikungunya infection diagnosed with reverse transcription-polymerase chain reaction (RT-PCR) with 917 dengue RT-PCR-positive adult patients (including 55 with DHF). We compared dengue fever (DF), DHF, and chikungunya infections by evaluating clinical characteristics of dengue and chikungunya; developing classification tools via multivariate logistic regression models and classification trees of disease etiology using clinical and laboratory factors; and assessing the time course of several clinical variables. Findings At first presentation to hospital, significantly more chikungunya patients had myalgia or arthralgia, and fewer had a sore throat, cough (for DF), nausea, vomiting, diarrhea, abdominal pain, anorexia or tachycardia than DF or DHF patients. From the decision trees, platelets chikungunya with an overall correct classification of 89%. For DHF versus chikungunya using platelets chikungunya infections, but simple clinical and laboratory variables can predict these infections at presentation for appropriate management. PMID:23029573

  9. [Cytomegalovirus: congenital infection and clinical presentation in infants with respiratory distress syndrome].

    Science.gov (United States)

    Martínez-Contreras, Angélica; Lira, Rosalía; Soria-Rodríguez, Carmen; Hori-Oshima, Sawako; Maldonado-Rodríguez, Angélica; Rojas-Montes, Othón; Ayala-Figueroa, Rafael; Estrada-Guzmán, Julia; Álvarez-Muñoz, Ma Teresa

    2015-01-01

    Respiratory distress syndrome (RDS) is a multifactorial and common disease that varies from 15 to 50 % in the newborn, causing 50 % of mortality. The RDS may be associated with bacterial and viral infections, and one of the most common viral agents is the cytomegalovirus (CMV). In the neonatal period the virus incidence goes from 0.4 to 2.5 % with a seroprevalence of 50 to 75 %; the incidence of infection in newborn with RDS is unknown. The objective was to determine the frequency of CMV infection in neonates with RDS and identify the risk factors associated with infection. The CMV-DNA was identified in plasma by quantitative PCR; maternal and neonatal variables that defined the clinical findings were analyzed by logistic regression.The CMV-DNA was identified in plasma by quantitative PCR; maternal and neonatal variables that defined the clinical findings were analyzed by logistic regression. The frequency of CMV infection in 197 infants with RDS was 8.6 % (95 % CI, 4.7-12.5). The significant variables in newborn were: neutropenia (p = 0.012), thrombocytopenia (p = 0.021), mottled skin (p = 0.03), and the maternal significant variable was cervicovaginitis (p = 0.05). We reported for the first time the highest frecuency of CMV infection in newborns with RDS and the association of various risk factors with CMV infection.

  10. Clinical infectious outcomes associated with biofilm-related bacterial infections: a retrospective chart review.

    Science.gov (United States)

    Barsoumian, Alice E; Mende, Katrin; Sanchez, Carlos J; Beckius, Miriam L; Wenke, Joseph C; Murray, Clinton K; Akers, Kevin S

    2015-06-07

    Biofilms are associated with persistent infection. Reports characterizing clinical infectious outcomes and patient risk factors for colonization or infection with biofilm forming isolates are scarce. Our institution recently published a study examining the biofilm forming ability of 205 randomly selected clinical isolates. This present study aims to identify potential risk factors associated with these isolates and assess clinical infectious outcomes. 221 clinical isolates collected from 2005 to 2012 and previously characterized for biofilm formation were studied. Clinical information from the associated patients, including demographics, comorbidities, antibiotic usage, laboratory values, and clinical infectious outcomes, was determined retrospectively through chart review. Duplicate isolates and non-clinical isolates were excluded from analysis. Associations with biofilm forming isolates were determined by univariate analysis and multivariate analysis. 187 isolates in 144 patients were identified for analysis; 113 were biofilm producers and 74 were not biofilm producers. Patients were primarily male (78 %) military members (61 %) with combat trauma (52 %). On multivariate analysis, the presence of methicillin-resistant Staphylococcus aureus (p biofilm producing isolate group. Infectious outcomes of patients with non-biofilm forming isolates, including cure, relapse/reinfection, and chronic infection, were similar to infectious outcomes of patients with biofilm-forming isolates. Mortality with initial infection was higher in the biofilm producing isolate group (16 % vs 5 %, p = 0.01) but attributable mortality was low (1 of 14). No characteristics examined in this study were found to be associated with relapse/reinfection or chronic infection on multivariate analysis. Bacteria species, but not clinical characteristics, were associated with biofilm formation on multivariate analysis. Biofilm forming isolates and non-biofilm forming isolates had similar infectious

  11. Chlorhexidine Bathing and Healthcare-Associated Infections: A Randomized Clinical Trial

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    Noto, Michael J.; Domenico, Henry J.; Byrne, Daniel W.; Talbot, Tom; Rice, Todd W.; Bernard, Gordon R.; Wheeler, Arthur P.

    2015-01-01

    Importance Daily bathing of critically ill patients with the broad spectrum, topical antimicrobial agent chlorhexidine is widely performed and may reduce healthcare-associated infections. Objective To determine if daily bathing of critically ill patients with chlorhexidine decreases the incidence of healthcare-associated infections. Design, setting, and participants A pragmatic cluster-randomized, cross-over study of 9,340 patients admitted to five adult intensive care units of a tertiary medical center in Nashville, Tennessee Intervention Units performed once-daily bathing of all patients with disposable cloths impregnated with 2% chlorhexidine or non-antimicrobial cloths as a control. Bathing treatments were performed for a 10-week period followed by a two-week washout period during which patients were bathed with non-antimicrobial disposable cloths, before crossover to the alternate bathing treatment for 10 weeks. Each unit crossed over between bathing assignments three times during the study Main Outcome and Measures The primary prespecified outcome was a composite of central line-associated blood stream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP), and Clostridium difficile infections. Secondary outcomes included rates of clinical cultures positive for multi-drug resistant organisms, blood culture contamination, healthcare-associated bloodstream infections, and rates of the primary outcome by ICU. Results A total of 55 and 60 infections occurred during chlorhexidine and control bathing periods, respectively (4 and 4 CLABSI, 21 and 32 CAUTI, 17 and 8 VAP, 13 and 16 C. difficile infections, respectively, between chlorhexidine and control bathing periods). The primary outcome rate was 2.86 per 1000 patient-days and 2.90 per 1000 patient-days during chlorhexidine and control bathing periods, respectively (rate difference, −0.04; 95% CI, −1.09 to 1.01; P=0.95). After adjusting for baseline

  12. Vitamin D in the prevention of acute respiratory infection: systematic review of clinical studies.

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    Jolliffe, David A; Griffiths, Christopher J; Martineau, Adrian R

    2013-07-01

    Vitamin D metabolites enhance immunity to a wide range of respiratory pathogens in vitro. Numerous observational studies have investigated whether vitamin D deficiency is a risk factor for acute respiratory infection, and a number of clinical trials of vitamin D supplementation for the prevention of acute respiratory infection have recently been conducted. Syntheses of this literature are lacking. We therefore conducted a systematic review of clinical studies investigating the association between vitamin D deficiency and susceptibility to acute respiratory infection in humans. A total of 39 studies (4 cross-sectional studies, 8 case-control studies, 13 cohort studies and 14 clinical trials) satisfying review eligibility criteria were identified. Observational studies predominantly reported statistically significant associations between low vitamin D status and increased risk of both upper and lower respiratory tract infections. Results from randomised controlled trials were conflicting however, reflecting heterogeneity in dosing regimens and baseline vitamin D status in study populations. Further trials of vitamin D supplementation for the prevention of acute respiratory infection should be conducted in populations with a high prevalence of vitamin D deficiency at baseline, using doses sufficient to induce sustained elevation of serum 25-hydroxyvitamin D concentrations, and powered to detect clinically important sub-group effects. This article is part of a Special Issue entitled 'Vitamin D Workshop'. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Dengue infection in children and adolescents: Clinical profile in a reference hospital in northeast Brazil

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    Roberto da Justa Pires Neto

    2013-12-01

    Full Text Available Introduction This study aimed to describe the clinical spectrum of dengue in children and adolescents from a hyperendemic region who were admitted for hospitalization. Methods A retrospective study was conducted on patients diagnosed with dengue infection upon admission to a reference center in Fortaleza, Brazil. Results Of the 84 patients included, 42 underwent confirmatory testing. The main symptoms were fever, abdominal pain and vomiting. The median level of serum aspartate aminotransferase was 143.5±128mg/dL. Conclusions A peculiar clinical profile was evident among children and adolescents with dengue infection in a reference center in northeast Brazil, including gastrointestinal symptoms and liver involvement.

  14. Clinical and Morphological Studies on Spontaneous Cases of Pseudomonas aeruginosa Infections in Birds

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    I Dinev1, S Denev2* and G Beev2

    2013-07-01

    Full Text Available Clinical, pathoanatomical, histological, and bacteriological studies were performed on broiler chickens, growing broiler parents, and growing egg layers, in three different poultry farms, after an outbreak of Pseudomonas aeruginosa infections. The method of contamination of the birds was established. Several local and systemic clinico-morphological forms of spontaneous P. aeruginosa infections in various categories of stock birds were described: cases of P. aeruginosa infection resulting from injection of contaminated vaccines; case of P. aeruginosa infections through contaminated aerosol vaccine and cases of pododermatitis, periarthritis and arthritis in broiler chickens associated with P. aeruginosa infection. In different cases mortality range between 0.5 and 50%. The results showed that apart from embryonic mortality in hatcheries, and septicemic infections in newly hatched chickens, the pathogenicity of P. aeruginosa was associated with localized and systemic lesions in this category, as well as in young and growing birds. On one hand, these results have a theoretical significance, contributing for the confirmation and expansion of the wide array of clinico-morphological forms of P. aeruginosa infections in birds. On the other hand, the knowledge on these forms has a purely practical significance in the diagnostics of P. aeruginosa infections by poultry pathologists and veterinary practitioners.

  15. Diverse effects of Galleria mellonella infection with entomopathogenic and clinical strains of Pseudomonas aeruginosa.

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    Andrejko, Mariola; Zdybicka-Barabas, Agnieszka; Cytryńska, Małgorzata

    2014-01-01

    In numerous studies, the greater wax moth Galleria mellonella has been exploited as an alternative model host for investigating virulence factors of different pathogenic bacteria. In the present paper, we provide evidence that G. mellonella constitutes a useful and convenient model for analysis of the pathogenicity of Pseudomonas aeruginosa clinical strains. In this in vivo study on the G. mellonella–P. aeruginosa interaction, a bidirectional analysis comprising evaluation of humoral immune response of the bacteria-infected larvae and determination of P. aeruginosa proteinases synthesized during the infection was performed. The effects of G. mellonella infection by two clinical strains (PA C124/9 and PA 02/18) and one entomopathogenic strain (ATCC 27853) cultured in a rich LB and minimal M9 medium, known to induce synthesis of different sets of extracellular proteinases, were evaluated. Both clinical isolates were able to establish infection in G. mellonella caterpillars after intrahemocelic injection. However, although the final effect of the larvae infection by each P. aeruginosa strain was their death within ca. 48 h, considerable strain and medium-dependent differences in the immune response of the insects were detected. The results indicated that G. mellonella larvae distinguished between the three P. aeruginosa strains, which was well reflected by the diverse humoral immune response. The significant differences concerned, among others, the level of phenoloxidase, lysozyme, and antibacterial activity in the hemolymph of the infected insects. An analysis of proteinases performed using specific activity tests, zymography and immunoblotting, revealed that elastase B and alkaline protease were synthesized by each P. aeruginosa strain during the infection. In contrast, a high level of elastase A activity was detected only in the larvae infected by the P. aeruginosa ATCC 27853 strain. It can be postulated that the three P. aeruginosa strains exploit different

  16. [Clinical analysis of 192 pregnant women infected by syphilis].

    Science.gov (United States)

    Zhang, Xiao-min; Zhang, Rong-na; Lin, Shu-qin; Chen, Shui-xian; Zheng, Li-ying

    2004-10-01

    To investigate the clinical characteristics of pregnant women with syphilis, their pregnant outcomes, perinatal and neonatal prognosis and the incidence of congenital syphilis. One hundred and ninety-two pregnant women with syphilis by serological assays were divided into two groups, group A (n = 93): treated with a full course anti-syphilis therapy and group B (n = 99): untreated group. Meanwhile, they were divided into groups C and D according to maternal serum rapid plasma reagin (RPR) test: RPR titer or = 1:16 (group D). The pregnant outcomes and congenital syphilis were compared between two groups. (1) Perinatal outcomes: Term delivery reached 93.6% (87/93) in group A and only 28.3% (28/99) in group B; the rate of premature birth and fetal intrauterine death were 5.4% (5/93) and 1.1% (1/93) in group A, obviously lower than 28.3% (28/99) and 32.3% (32/99) in group B (P syphilis and neonatal death in group A were significantly lower than those in group B (P syphilis, perinatal death and neonatal death in group C were lower than those in group D (P Gestational week and drug treatment: The earlier the treatment started during pregnancy, the lower the rate of congenital syphilis was (P syphilis were similar between penicillin and dibenzyl penicillin groups (P syphilis therapy is the key to improving the outcomes of pregnancy with syphilis, prognosis of neonates and reducing incidence of congenital syphilis. (2) Maternal serum RPR titer, the starting time of anti-syphilis treatment as well as the choice of therapeutical drugs are important influence factors on the outcomes of pregnancy with syphilis.

  17. Correlation of serotype-specific dengue virus infection with clinical manifestations.

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    Eric S Halsey

    Full Text Available Disease caused by the dengue virus (DENV is a significant cause of morbidity throughout the world. Although prior research has focused on the association of specific DENV serotypes (DENV-1, DENV-2, DENV-3, and DENV-4 with the development of severe outcomes such as dengue hemorrhagic fever and dengue shock syndrome, relatively little work has correlated other clinical manifestations with a particular DENV serotype. The goal of this study was to estimate and compare the prevalence of non-hemorrhagic clinical manifestations of DENV infection by serotype.Between the years 2005-2010, individuals with febrile disease from Peru, Bolivia, Ecuador, and Paraguay were enrolled in an outpatient passive surveillance study. Detailed information regarding clinical signs and symptoms, as well as demographic information, was collected. DENV infection was confirmed in patient sera with polyclonal antibodies in a culture-based immunofluorescence assay, and the infecting serotype was determined by serotype-specific monoclonal antibodies. Differences in the prevalence of individual and organ-system manifestations were compared across DENV serotypes. One thousand seven hundred and sixteen individuals were identified as being infected with DENV-1 (39.8%, DENV-2 (4.3%, DENV-3 (41.5%, or DENV-4 (14.4%. When all four DENV serotypes were compared with each other, individuals infected with DENV-3 had a higher prevalence of musculoskeletal and gastrointestinal manifestations, and individuals infected with DENV-4 had a higher prevalence of respiratory and cutaneous manifestations.Specific clinical manifestations, as well as groups of clinical manifestations, are often overrepresented by an individual DENV serotype.

  18. Correlation of serotype-specific dengue virus infection with clinical manifestations.

    Science.gov (United States)

    Halsey, Eric S; Marks, Morgan A; Gotuzzo, Eduardo; Fiestas, Victor; Suarez, Luis; Vargas, Jorge; Aguayo, Nicolas; Madrid, Cesar; Vimos, Carlos; Kochel, Tadeusz J; Laguna-Torres, V Alberto

    2012-01-01

    Disease caused by the dengue virus (DENV) is a significant cause of morbidity throughout the world. Although prior research has focused on the association of specific DENV serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) with the development of severe outcomes such as dengue hemorrhagic fever and dengue shock syndrome, relatively little work has correlated other clinical manifestations with a particular DENV serotype. The goal of this study was to estimate and compare the prevalence of non-hemorrhagic clinical manifestations of DENV infection by serotype. Between the years 2005-2010, individuals with febrile disease from Peru, Bolivia, Ecuador, and Paraguay were enrolled in an outpatient passive surveillance study. Detailed information regarding clinical signs and symptoms, as well as demographic information, was collected. DENV infection was confirmed in patient sera with polyclonal antibodies in a culture-based immunofluorescence assay, and the infecting serotype was determined by serotype-specific monoclonal antibodies. Differences in the prevalence of individual and organ-system manifestations were compared across DENV serotypes. One thousand seven hundred and sixteen individuals were identified as being infected with DENV-1 (39.8%), DENV-2 (4.3%), DENV-3 (41.5%), or DENV-4 (14.4%). When all four DENV serotypes were compared with each other, individuals infected with DENV-3 had a higher prevalence of musculoskeletal and gastrointestinal manifestations, and individuals infected with DENV-4 had a higher prevalence of respiratory and cutaneous manifestations. Specific clinical manifestations, as well as groups of clinical manifestations, are often overrepresented by an individual DENV serotype.

  19. Correlation of Serotype-Specific Dengue Virus Infection with Clinical Manifestations

    Science.gov (United States)

    Halsey, Eric S.; Marks, Morgan A.; Gotuzzo, Eduardo; Fiestas, Victor; Suarez, Luis; Vargas, Jorge; Aguayo, Nicolas; Madrid, Cesar; Vimos, Carlos; Kochel, Tadeusz J.; Laguna-Torres, V. Alberto

    2012-01-01

    Background Disease caused by the dengue virus (DENV) is a significant cause of morbidity throughout the world. Although prior research has focused on the association of specific DENV serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) with the development of severe outcomes such as dengue hemorrhagic fever and dengue shock syndrome, relatively little work has correlated other clinical manifestations with a particular DENV serotype. The goal of this study was to estimate and compare the prevalence of non-hemorrhagic clinical manifestations of DENV infection by serotype. Methodology and Principal Findings Between the years 2005–2010, individuals with febrile disease from Peru, Bolivia, Ecuador, and Paraguay were enrolled in an outpatient passive surveillance study. Detailed information regarding clinical signs and symptoms, as well as demographic information, was collected. DENV infection was confirmed in patient sera with polyclonal antibodies in a culture-based immunofluorescence assay, and the infecting serotype was determined by serotype-specific monoclonal antibodies. Differences in the prevalence of individual and organ-system manifestations were compared across DENV serotypes. One thousand seven hundred and sixteen individuals were identified as being infected with DENV-1 (39.8%), DENV-2 (4.3%), DENV-3 (41.5%), or DENV-4 (14.4%). When all four DENV serotypes were compared with each other, individuals infected with DENV-3 had a higher prevalence of musculoskeletal and gastrointestinal manifestations, and individuals infected with DENV-4 had a higher prevalence of respiratory and cutaneous manifestations. Conclusions/Significance Specific clinical manifestations, as well as groups of clinical manifestations, are often overrepresented by an individual DENV serotype. PMID:22563516

  20. [Clinical relevance of the Streptococcus milleri group in head and neck infections].

    Science.gov (United States)

    Fujiyoshi, Tatsuya; Yoshida, Masafumi; Udaka, Tsuyoshi; Tanabe, Tadao; Makishima, Kazumi

    2002-01-01

    Streptococcus constellatus, S. intermedius, and S. anginosus, the 3 species of the S. milleri group, form part of the normal flora commonly found in the mouth, throat, and gastrointestinal and genital tracts. This group has become known as an important pathogen in infections and abscesses, but data on the anatomical distribution of these species is lacking in relation to clinical significance. We obtained 275 strains of the S. milleri group from different departments at our hospital over the last 3 years, including 54 strains from dental surgery, 47 from internal medicine, 44 from otolaryngology (head and neck), 43 from surgery, 32 from gynecology, 17 from urology, 16 from dermatology, 11 from brain surgery, 6 from pediatrics, 3 from orthopedics, and 2 from opthalmology. The 44 strains from head and neck were found in 42 patients,--23 with primary infection and 19 with secondary infection induced by cancer treatments. The primary infection group included 4 deep neck abscesses, 1 peritonsillar abscess, 5 tonsillitis, 4 paranasal sinusitis, 3 congenital aural fistula infections, 2 dental infections, 2 paranasal sinus cysts, 1 supprative parotitis, and 1 postoperative wound infection. The secondary infection group included 7 postoperative wound infections, 3 postoperative pulmonary infections, 3 laryngitis and pharyngitis, 3 terminal pneumonias, and 3 infections of the local recurrence site. The S. milleri group was the only isolated organism in 13 cases (56.5%) of primary infection and in 5 (26.3%) of secondary infection. Among other organisms from the primary infection group, no so-called major pathogens were found. Antimicrobial susceptibility tests of the S. milleri group showed that 50% were resistant to CCL and 33% to CTM. ABPC, CPDX, and CFDN were also found to be less sensitive, although no resistant strains were detected. To adequately culture the S. milleri group, incubation in air containing carbon dioxide or in an anaerobic atmosphere is required, and

  1. Does this adult patient have early HIV infection?: The Rational Clinical Examination systematic review.

    Science.gov (United States)

    Wood, Evan; Kerr, Thomas; Rowell, Greg; Montaner, Julio S G; Phillips, Peter; Korthuis, P Todd; Simel, David L

    2014-07-16

    Timely identification of human immunodeficiency virus (HIV) infection in adults can contribute to reduced mortality and likelihood of further HIV transmission. During the first 6 months after infection, known as early HIV infection, patients often report a well-described constellation of symptoms and signs. However, the literature examining utility of the clinical examination in identifying early infection has not been systematically assessed. To assess the accuracy of symptoms and signs in identifying early HIV infection among adults. We searched MEDLINE and EMBASE (1981-May, 2014) for articles investigating symptoms and signs of early HIV infection in adults and searched reference lists of retrieved articles. We retained original studies that compared symptoms and signs among patients with early HIV infection in comparison to HIV-negative individuals. Data were extracted and used to calculate sensitivity, specificity, and likelihood ratios (LRs), and meta-analysis was used to calculate summary LRs. Of 1356 studies, 16 studies included data that were eligible for meta-analysis and included a total of 24,745 patients and 1253 cases of early HIV infection. Symptoms that increased the likelihood of early HIV infection the most included genital ulcers (LR, 5.4; 95% CI, 2.5-12), weight loss (LR, 4.7; 95% CI, 2.1-7.2), vomiting (LR, 4.6; 95% CI, 2.5-8.0), and swollen lymph nodes (LR, 4.6; 95% CI, 1.3-8.0). No symptoms had an LR that was 0.5 or lower, but the absence of recent fever (LR, 0.74; 95% CI, 0.64-0.84) slightly decreased the likelihood of early HIV infection. The presence of lymphadenopathy on physical examination was the most useful sign (LR, 3.1; 95% CI, 1.0-5.2). No sign had an LR of 0.5 or less, but the absence of lymphadenopathy slightly decreased the likelihood of early HIV infection (LR, 0.70, 95% CI, 0.49-0.92). Using data from studies that considered combinations of findings (range of possible findings, 4-17), the summary LR for individuals with 0

  2. Contrasting clinical outcomes in two cohorts of cats naturally infected with feline immunodeficiency virus (FIV)

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    Bęczkowski, Paweł M.; Litster, Annette; Lin, Tsang Long; Mellor, Dominic J.; Willett, Brian J.; Hosie, Margaret J.

    2015-01-01

    Despite over 25 years of feline immunodeficiency virus (FIV) research, relatively little is known about the longitudinal course of FIV infection following natural infection. In contrast to published reports of experimental infections using lethal strains of the virus, clinical signs of naturally acquired FIV infection can be mild or inapparent, rather than life-threatening. In this prospective, longitudinal controlled study, based in Chicago, IL (n = 17) and Memphis, TN (n = 27), we investigated two cohorts of privately owned, naturally infected cats kept under different housing conditions. Cats in the Chicago cohort (Group 1) were kept in households of ≤2 cats, while the Memphis cohort (Group 2) comprised part of a large multi-cat household of over 60 cats kept indoors only, with unrestricted access to one another. The majority of cats from Group 1 did not display clinical signs consistent with immunodeficiency during the 22-month observation period. In contrast, the outcome of infection in Group 2 was dramatically different; 17/27 (63%) of cats lost a median of 51.3% of their bodyweight (P cats classified as ‘healthy’ and ‘not healthy’ at either cohort. FIV load at enrolment was significantly lower in Group 1 than in Group 2 (P cats at either group. In conclusion, the results of this study suggest that management and housing conditions impact on disease progression and survival times of FIV-positive cats. PMID:25595267

  3. BK nephropathy in the native kidneys of patients with organ transplants: Clinical spectrum of BK infection

    Science.gov (United States)

    Vigil, Darlene; Konstantinov, Nikifor K; Barry, Marc; Harford, Antonia M; Servilla, Karen S; Kim, Young Ho; Sun, Yijuan; Ganta, Kavitha; Tzamaloukas, Antonios H

    2016-01-01

    Nephropathy secondary to BK virus, a member of the Papoviridae family of viruses, has been recognized for some time as an important cause of allograft dysfunction in renal transplant recipients. In recent times, BK nephropathy (BKN) of the native kidneys has being increasingly recognized as a cause of chronic kidney disease in patients with solid organ transplants, bone marrow transplants and in patients with other clinical entities associated with immunosuppression. In such patients renal dysfunction is often attributed to other factors including nephrotoxicity of medications used to prevent rejection of the transplanted organs. Renal biopsy is required for the diagnosis of BKN. Quantitation of the BK viral load in blood and urine are surrogate diagnostic methods. The treatment of BKN is based on reduction of the immunosuppressive medications. Several compounds have shown antiviral activity, but have not consistently shown to have beneficial effects in BKN. In addition to BKN, BK viral infection can cause severe urinary bladder cystitis, ureteritis and urinary tract obstruction as well as manifestations in other organ systems including the central nervous system, the respiratory system, the gastrointestinal system and the hematopoietic system. BK viral infection has also been implicated in tumorigenesis. The spectrum of clinical manifestations from BK infection and infection from other members of the Papoviridae family is widening. Prevention and treatment of BK infection and infections from other Papovaviruses are subjects of intense research. PMID:27683628

  4. Epidemiological, clinical, microbiological and therapeutic differences in tuberculosis disease in patients with and without HIV infection.

    Science.gov (United States)

    Martínez-Sanz, Javier; Lago-Gómez, María Rosa; Rodríguez-Zurita, María Elena; Martín-Echevarría, Esteban; Torralba, Miguel

    2017-11-22

    Our objective is to analyze the incidence of tuberculosis (TB) in our population and to compare the characteristics of patients with and without HIV infection. Clinical-epidemiological retrospective cohort study that included patients diagnosed with TB with and without HIV infection between 2005-2016 in the province of Guadalajara (Spain). Epidemiological, clinical, microbiological and therapeutic variables were assessed, including microbiological resistances. TB was diagnosed in 261 patients. There were 25 patients (9.6%) who had HIV infection. Patients with HIV infection were predominantly males, had higher incidence of hepatitis C virus, a higher percentage of extrapulmonary TB, a higher prevalence of resistance to isoniazid and rifampicin, a greater paradoxical response and a longer average hospital stay. On the other hand, they had a lower percentage of positive tuberculin skin test and positive sputum smear (microscopy). A significant percentage of TB patients had no serology for HIV. Patients with HIV infection show remarkable differences in epidemiological, clinical and resistance variables to antituberculosis drugs. A high percentage of patients with TB were not tested for HIV. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  5. A CLINICAL STUDY ON POSTOPERATIVE WOUND INFECTIONS IN RIMS, KADAPA- 3 YEARS EXPERIENCE

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    J. Ramanaiah

    2017-02-01

    Full Text Available BACKGROUND Surgical wound infections continue to consume a considerable portion of healthcare finance. Even though, the complete elimination of wound infections is not possible, a reduction of the observed wound infection rate to a minimum level could have marked benefits in terms of both patient comfort and resources used. 1 MATERIALS AND METHODS The clinical study of postoperative wound infection conducted at RIMS General Hospital, Kadapa, during the period of 2013 to 2016. RESULTS In this clinical study, 150 patients were clinically diagnosed of having SSIs out of 925 patients who underwent major surgeries in Department of General Surgery, an incidence of 16.2%. Dirty type of surgeries have high incidence of SSI at 63.6%. SSI occurred more in patients who didn’t receive preoperative antibiotic within 2 hrs. prior to surgery, i.e. 32.1%. Most of the patients presented with discharge through the wound (81.3%. The most common type of discharge was purulent (52.5%. CONCLUSION Preoperative preparation <24 hrs., preoperative bathing and preoperative antibiotic within 2 hrs. before surgery help in reducing surgical site infections. Early diagnosis of SSI and prompt management by isolation of organism causing SSI using sensitive antibiotics and regular dressing help in reducing morbidity for the patients.

  6. Detection of Theileria lestoquardi cross infection in cattle with clinical theileriosis in Iran.

    Science.gov (United States)

    Jalali, Seyedeh Missagh; Jolodar, Abbas; Rasooli, Aria; Darabifard, Ameneh

    2016-12-01

    Theileriosis caused by Theileria lestoquardi (malignant ovine theileriosis) in sheep and Theileria annulata (tropical theileriosis) in cattle is an important hemoprotozoal tick-borne disease in Iran. Due to major biologic and phylogenic similarities of these two species, this study was carried out to investigate the occurrence of natural infections with T.lestoquardi and T.annulata in cattle with clinical theileriosis in Ahvaz, southwest Iran. Fifty one cattle were selected based on clinical signs of theileriosis and confirmation by microscopic examination of blood smears. Blood samples were collected from each animal and hematologic and microscopic examinations were performed. Theileria piroplasmic forms were detected in all affected cattle. Pale mucous membranes (43.14%), icterus (11.76%) and fever (70.6%) were also observed. PCR-RFLP analysis revealed T. annulata infection in all tested cattle while coinfections with T. lestoquardi were found in two samples (3.92%). All sampled cattle including the two with mixed species Theileria infection were anemic. This is the first report of Theileria species cross infections in cattle with clinical theileriosis in Iran. It can be concluded that cattle can be infected with both pathogenic Theileria species, T. lestoquardi and T. annulata which can be an important issue in the epidemiology and spread of ovine malignant theileriosis.

  7. Prevalence and clinical relevance of helminth co-infections among tuberculosis patients in urban Tanzania.

    Directory of Open Access Journals (Sweden)

    Francis Mhimbira

    2017-02-01

    Full Text Available Helminth infections can negatively affect the immunologic host control, which may increase the risk of progression from latent Mycobacterium tuberculosis infection to tuberculosis (TB disease and alter the clinical presentation of TB. We assessed the prevalence and determined the clinical relevance of helminth co-infection among TB patients and household contact controls in urban Tanzania.Between November 2013 and October 2015, we enrolled adult (≥18 years sputum smear-positive TB patients and household contact controls without TB during an ongoing TB cohort study in Dar es Salaam, Tanzania. We used Baermann, FLOTAC, Kato-Katz, point-of-care circulating cathodic antigen, and urine filtration to diagnose helminth infections. Multivariable logistic regression models with and without random effects for households were used to assess for associations between helminth infection and TB.A total of 597 TB patients and 375 household contact controls were included. The median age was 33 years and 60.2% (585/972 were men. The prevalence of any helminth infection among TB patients was 31.8% (190/597 and 25.9% (97/375 among controls. Strongyloides stercoralis was the predominant helminth species (16.6%, 161, followed by hookworm (9.0%, 87 and Schistosoma mansoni (5.7%, 55. An infection with any helminth was not associated with TB (adjusted odds ratio (aOR 1.26, 95% confidence interval (CI: 0.88-1.80, p = 0.22, but S. mansoni infection was (aOR 2.15, 95% CI: 1.03-4.45, p = 0.040. Moreover, S. mansoni infection was associated with lower sputum bacterial load (aOR 2.63, 95% CI: 1.38-5.26, p = 0.004 and tended to have fewer lung cavitations (aOR 0.41, 95% CI: 0.12-1.16, p = 0.088.S. mansoni infection was an independent risk factor for active TB and altered the clinical presentation in TB patients. These findings suggest a role for schistosomiasis in modulating the pathogenesis of human TB. Treatment of helminths should be considered in clinical management of

  8. Prevalence of sexually transmitted infections among women attending antenatal clinics in Tanga, north eastern Tanzania

    DEFF Research Database (Denmark)

    Chiduo, M; Theilgaard, Z P; Bakari, V

    2012-01-01

    This study aimed to determine the prevalence of sexually transmitted infections (STIs) among HIV-infected and uninfected pregnant women in Tanga, Tanzania. Retrospective data on syphilis and HIV status during 2008-2010 were collected from antenatal clinic (ANC) records. Prospective data were...... collected from HIV-infected (n = 105) and HIV-uninfected pregnant women (n = 100) attending ANCs between April 2009 and August 2010. Syphilis prevalence showed a declining trend (3.1%, 1.4% and 1.3%), while HIV prevalence was stable (6.1%, 6.4% and 5.4%) during 2008-2010. HIV-infected women had...... significantly higher prevalence of trichomoniasis (18.8% versus 5.0%; P women. There were no statistically significant...

  9. [Clinical analysis of nosocomial infection and risk factors of extremely premature infants].

    Science.gov (United States)

    Jiang, Na; Wang, Ying; Wang, Qi; Li, Haijing; Mai, Jingyun; Lin, Zhenlang

    2014-02-01

    To investigate the incidence of nosocomial infections of extremely premature infants and to explore the risk factors and strategies for infection control. There were 118 extremely premature infants who were confirmed to have nosocomial infection in neonatal intensive care unit of the authors' hospital from January 2008 to December 2012. Their data of the infection rate, risk factors and clinical characteristics were retrospectively analyzed. During the study, nosocomial infection occurred in 78 extremely premature infants 129 times. The nosocomial infection rate was 66.10%. The rate of ventilator-associated pneumonia (VAP) was 1.43% (35/2 452). The catheter related blood stream infection (CRBSI) rate was 0.35% (16/4 613). There were 74 (57.36%) cases of pneumonia, which was the most common nosocomial infection of extremely premature infants. There were 35 cases of VAP, which accounted for 47.30% of pneumonia. The next was sepsis, 48 cases. Seventy-four (74/90, 82.22%) strains of isolates were Gram-negative bacteria, which accounted for the highest proportion, followed by Gram-positive (12 strains), fungus (4 strains); Klebsiella pneumonia is the most common pathogens of nosocomial infection in extremely premature infants. The isolation rates of Klebsiella pneumonia with positive extended-spectrum beta-lactamases (ESBL) were 90.91% (20/22) , universally resistant to cephalosporins. Single-factor analysis showed that the body weight, mechanical ventilation, umbilical vein catheterization, central venous catheter, parenteral nutrition and hospitalization time were risk factors for nosocomial infections in extremely preterm infants. Logistic regression analysis showed that length of hospitalization (OR = 1.024, P = 0.043) and central venous catheterization (OR = 6.170, P = 0.041) were independent risk factors of nosocomial infection. Extremely preterm infants were at higher risk of nosocomial infection. It is important to identify the high risk factors for nosocomial

  10. STD Clinic Patients' Awareness of Non-AIDS Complications of HIV Infection.

    Science.gov (United States)

    Castro, José Guillermo; Granovsky, Inna; Jones, Deborah; Weiss, Stephen M

    2015-01-01

    Participants were recruited from a sexually transmitted disease (STD) clinic in Florida and were assessed regarding the knowledge and awareness of non-AIDS conditions associated with HIV infection. Questionnaires were administered before and after a brief information session on non-AIDS conditions associated with HIV infection. Participants included men (n = 46) and women (n = 51). Prior to the information session, at baseline, only 34% of the participants were worried about HIV infection. Most participants (82%) agreed that HIV could be treated with antiretroviral therapy (ART), while only 38% were aware that HIV-associated conditions cannot be easily treated with ART. After the information session, almost all participants reported they were concerned regarding the risk of HIV infection. High-risk patients may have limited knowledge about the consequences of HIV infection beyond the traditional AIDS-associated conditions. Increased awareness of these less known consequences of HIV infection may decrease the potential for complacency regarding acquiring HIV infection. © The Author(s) 2014.

  11. Respiratory viruses in transplant recipients: more than just a cold. Clinical syndromes and infection prevention principles

    Directory of Open Access Journals (Sweden)

    Salma Abbas

    2017-09-01

    Conclusions: RVIs are associated with high morbidity and mortality among SOT and HSCT recipients. Management options are currently limited or lack strong clinical evidence. As community and nosocomial spread has been reported for all reviewed RVIs, strict adherence to infection control measures is key to preventing outbreaks.

  12. A Randomized Clinical Trial of Alternative Stress Management Interventions in Persons with HIV Infection

    Science.gov (United States)

    McCain, Nancy L.; Gray, D. Patricia; Elswick, R. K., Jr.; Robins, Jolynne W.; Tuck, Inez; Walter, Jeanne M.; Rausch, Sarah M.; Ketchum, Jessica McKinney

    2008-01-01

    Research in psychoneuroimmunology suggests that immunosuppression associated with perceived stress may contribute to disease progression in persons with HIV infection. While stress management interventions may enhance immune function, few alternative approaches have yet been tested. This randomized clinical trial was conducted to test effects of…

  13. Cyanoacrylate Skin Microsealant for Preventing Surgical Site Infection after Vascular Surgery : A Discontinued Randomized Clinical Trial

    NARCIS (Netherlands)

    Vierhout, Bastiaan P.; Ott, Alewijn; Reijnen, Michel M. P. J.; Oskam, Jacques; Ott, Alewijn; van den Dungen, Jan J. A. M.; Zeebregts, Clark J.

    Background: Surgical site infections (SSI) after vascular surgery are related to substantial morbidity. Restriction of bacterial access to the site of surgery with a cyanoacrylate sealant is a new concept. We performed a randomized clinical trial to assess the effect of the sealing of skin with a

  14. Acute Appendicitis as the Initial Clinical Presentation of Primary HIV-1 Infection

    DEFF Research Database (Denmark)

    Schleimann, Mariane H; Leth, Steffen; Krarup, Astrid R

    2018-01-01

    We report a case of an adolescent who presented at our emergency department with acute abdominal pain. While the initial diagnosis was acute appendicitis, a secondary and coincidental diagnosis of primary HIV-1 infection was made. Concurrent and subsequent clinical and molecular biology findings...

  15. Bacterial etiology of sexually transmitted infections at a STI clinic in ...

    African Journals Online (AJOL)

    Bacterial etiology of sexually transmitted infections at a STI clinic in Ghana; use of multiplex real time PCR. Augustina A Sylverken, Ellis Owusu-Dabo, Denis D Yar, Samson P Salifu, Nana Yaa Awua-Boateng, John H Amuasi, Portia B Okyere, Thomas Agyarko-Poku ...

  16. Dengue virus infection in travellers returning to Berlin, Germany: clinical, laboratory, and diagnostic aspects

    NARCIS (Netherlands)

    Teichmann, Dieter; Göbels, Klaus; Niedrig, Matthias; Grobusch, Martin P.

    2004-01-01

    BACKGROUND: Dengue is a mosquito-borne viral infection endemic throughout the tropics and subtropics. The global prevalence of dengue has grown dramatically in recent years and it has been recognized as a potential hazard to tourists. OBJECTIVE: In this study, we analyzed the epidemiology, clinical

  17. Virus and host factors affecting the clinical outcome of Bluetongue Virus infection

    NARCIS (Netherlands)

    Caporale, M.; Gialleonorado, L.; Janowicz, A.; Wilkie, G.; Shaw, A.; Savini, G.; Rijn, van P.A.; Mertens, P.; Ventura, M.; Palmarini, M.

    2014-01-01

    Bluetongue is a major infectious disease of ruminants caused by bluetongue virus (BTV), an arbovirus transmitted by Culicoides. Here, we assessed virus and host factors influencing the clinical outcome of BTV infection using a single experimental framework. We investigated how mammalian host

  18. Risk factors and clinical outcomes for carbapenem-resistant Enterobacteriaceae nosocomial infections.

    Science.gov (United States)

    Wang, Q; Zhang, Y; Yao, X; Xian, H; Liu, Y; Li, H; Chen, H; Wang, X; Wang, R; Zhao, C; Cao, B; Wang, H

    2016-10-01

    This study was aimed to determine the risk factors of Carbapenem-resistant Enterobacteriaceae (CRE) nosocomial infections and assess the clinical outcomes. A case-case-control design was used to compare two groups of case patients with control patients from March 2010 to November 2014 in China. Risk factors for the acquisition of CRE infections and clinical outcomes were analyzed by univariable and multivariable analysis. A total of 94 patients with CRE infections, 93 patients with Carbapenem-susceptible Enterobacteriaceae (CSE) infections, and 93 patients with organisms other than Enterobacteriaceae infections were enrolled in this study. Fifty-five isolates were detected as the carbapenemase gene. KPC-2 was the most common carbapenemase (65.5 %, 36/55), followed by NDM-1 (16.4 %, 9/55), IMP-4 (14.5 %, 8/55), NDM-5 (1.8 %, 1/55), and NDM-7 (1.8 %, 1/55). Multivariable analysis implicated previous use of third or fourth generation cephalosporins (odds ratio [OR], 4.557; 95 % confidence interval [CI], 1.971-10.539; P infection. The in-hospital mortality of the CRE group was 57.4 %. In the population of CRE infection, presence of central venous catheters (OR, 4.464; 95 % CI, 1.332-14.925; P = 0.015) and receipt of immunosuppressors (OR, 7.246; 95 % CI, 1.217-43.478; P = 0.030) were independent risk factors for mortality. Appropriate definitive treatment (OR, 0.339; 95 % CI, 0.120-0.954; P = 0.040) was a protective factor for in-hospital death of CRE infection. Kaplan-Meier curves of the CRE group had the shortest survival time compared with the other two groups. Survival time of patients infected with Enterobacteriaceae with a high meropenem MIC (≥8 mg/L) was shorter than that of patients with a low meropenem MIC (2,4, and ≤ 1 mg/L). In conclusion, CRE nosocomial infections are associated with prior exposure to third or fourth generation cephalosporins and carbapenems. Patients infected with CRE had poor outcome and high mortality

  19. [Clinical and Epidemiological Study of Complicated Infection by Varicella-Zoster Virus in the Pediatric Age].

    Science.gov (United States)

    Maia, Catarina; Fonseca, Jacinta; Carvalho, Isabel; Santos, Helena; Moreira, Diana

    2015-01-01

    In Portugal, the incidence of complicated infection by varicella-zoster virus is unknown. The purpose of this study was to describe the epidemiological and clinical features of complicated infection by varicella-zoster virus in children. Retrospective review of the clinical files of patients admitted between January 1999 and July 2013, with a diagnosis of complicated varicella-zoster virus infection. Ninety-four patients were hospitalized with complicated varicella-zoster virus infection, two of them by reactivation of latent infection. The median age was 38 (IQR 18 - 65) months. The most frequent types of complications were bacterial overinfection of the skin and subcutaneous cellular tissue (37.2%) and respiratory complications (24.5%). Other complications were neurologic complications (19.1%), gastrointestinal (9.6%), hematologic (5.3%) and osteoarticular (4.3%). In 38 patients invasive bacterial infections were diagnosed, with bacteremia in 6 patients. The median age was highest in the immunological complications compared with infectious complications. Neurological complications occurred mainly in healthy children, while infectious complications, including the invasive bacterial infections were more frequent in patients treated with ibuprofen and/or corticosteroids. The evolution was favorable in most cases. The complications of varicella-zoster virus infection occurred mainly in pre-school age and in healthy children. Infectious complications, particularly respiratory complications and bacterial overinfection of the skin and subcutaneous cellular tissue, were the most frequent. There was association between infectious complications and previous therapy with ibuprofen and / or corticosteroids. Multicenter studies should be planned in order to optimize and adjust the vaccine strategies to our reality.

  20. Clinical features of bacterial vaginosis in a murine model of vaginal infection with Gardnerella vaginalis.

    Science.gov (United States)

    Gilbert, Nicole M; Lewis, Warren G; Lewis, Amanda L

    2013-01-01

    Bacterial vaginosis (BV) is a dysbiosis of the vaginal flora characterized by a shift from a Lactobacillus-dominant environment to a polymicrobial mixture including Actinobacteria and gram-negative bacilli. BV is a common vaginal condition in women and is associated with increased risk of sexually transmitted infection and adverse pregnancy outcomes such as preterm birth. Gardnerella vaginalis is one of the most frequently isolated bacterial species in BV. However, there has been much debate in the literature concerning the contribution of G. vaginalis to the etiology of BV, since it is also present in a significant proportion of healthy women. Here we present a new murine vaginal infection model with a clinical isolate of G. vaginalis. Our data demonstrate that this model displays key features used clinically to diagnose BV, including the presence of sialidase activity and exfoliated epithelial cells with adherent bacteria (reminiscent of clue cells). G. vaginalis was capable of ascending uterine infection, which correlated with the degree of vaginal infection and level of vaginal sialidase activity. The host response to G. vaginalis infection was characterized by robust vaginal epithelial cell exfoliation in the absence of histological inflammation. Our analyses of clinical specimens from women with BV revealed a measureable epithelial exfoliation response compared to women with normal flora, a phenotype that, to our knowledge, is measured here for the first time. The results of this study demonstrate that G. vaginalis is sufficient to cause BV phenotypes and suggest that this organism may contribute to BV etiology and associated complications. This is the first time vaginal infection by a BV associated bacterium in an animal has been shown to parallel the human disease with regard to clinical diagnostic features. Future studies with this model should facilitate investigation of important questions regarding BV etiology, pathogenesis and associated complications.

  1. Clinical features of bacterial vaginosis in a murine model of vaginal infection with Gardnerella vaginalis.

    Directory of Open Access Journals (Sweden)

    Nicole M Gilbert

    Full Text Available Bacterial vaginosis (BV is a dysbiosis of the vaginal flora characterized by a shift from a Lactobacillus-dominant environment to a polymicrobial mixture including Actinobacteria and gram-negative bacilli. BV is a common vaginal condition in women and is associated with increased risk of sexually transmitted infection and adverse pregnancy outcomes such as preterm birth. Gardnerella vaginalis is one of the most frequently isolated bacterial species in BV. However, there has been much debate in the literature concerning the contribution of G. vaginalis to the etiology of BV, since it is also present in a significant proportion of healthy women. Here we present a new murine vaginal infection model with a clinical isolate of G. vaginalis. Our data demonstrate that this model displays key features used clinically to diagnose BV, including the presence of sialidase activity and exfoliated epithelial cells with adherent bacteria (reminiscent of clue cells. G. vaginalis was capable of ascending uterine infection, which correlated with the degree of vaginal infection and level of vaginal sialidase activity. The host response to G. vaginalis infection was characterized by robust vaginal epithelial cell exfoliation in the absence of histological inflammation. Our analyses of clinical specimens from women with BV revealed a measureable epithelial exfoliation response compared to women with normal flora, a phenotype that, to our knowledge, is measured here for the first time. The results of this study demonstrate that G. vaginalis is sufficient to cause BV phenotypes and suggest that this organism may contribute to BV etiology and associated complications. This is the first time vaginal infection by a BV associated bacterium in an animal has been shown to parallel the human disease with regard to clinical diagnostic features. Future studies with this model should facilitate investigation of important questions regarding BV etiology, pathogenesis and

  2. Benefit of adjunct universal rectal screening for Chlamydia genital infections in women attending Canadian sexually transmitted infection clinics.

    Science.gov (United States)

    Thanh, Nguyen X; Akpinar, Ilke; Gratrix, Jennifer; Plitt, Sabrina; Smyczek, Petra; Read, Ron; Jacobs, Philip; Wong, Tom; Singh, Ameeta E

    2017-11-01

    Adding universal rectal screening to urogenital screening should positively impact rectal Chlamydia trachomatis (CT) incidence in affected populations. A dynamic Markov model was used to evaluate costs and outcomes of three rectal CT screening strategies among women attending sexually transmitted infection clinics in Alberta, Canada: universal urogenital-only screening (UG-only), additional selected (exposure-based) rectal screening (UG+SR), and additional universal rectal screening (UG+UR). The model included two mutually exclusive health states: infected and susceptible. Additionally, the model included two rounds of transmission: male sex partners of women infected with rectal-only CT and female sex partners of those men. CT complications impacting patients' quality of life (QALY) were considered. Alberta and Canadian data were used to estimate model inputs. We used a health care perspective, a time period of 10 years, and a discount rate of 3% for analyses. Compared to UG-only screening, the incremental cost effectiveness ratios (ICERs) were CA$34,000 and CA$49,000 per QALY gained for UG+SR and UG+UR screening strategies, respectively. Compared to UG+SR, the ICER was CA$62,000 per QALY gained for the UG+UR strategy. Both adjunct selected and universal rectal screening strategies are cost effective compared to UG-only screening, and UG+UR screening is cost effective when compared to UG+SR screening.

  3. Simple clinical and laboratory predictors of Chikungunya versus dengue infections in adults.

    Directory of Open Access Journals (Sweden)

    Vernon J Lee

    Full Text Available BACKGROUND: Dengue and chikungunya are co-circulating vector-borne diseases with substantial overlap in clinical presentations. It is important to differentiate between them during first presentation as their management, especially for dengue hemorrhagic fever (DHF, is different. This study compares their clinical presentation in Singapore adults to derive predictors to assist doctors in diagnostic decision-making. METHODS: We compared 117 patients with chikungunya infection diagnosed with reverse transcription-polymerase chain reaction (RT-PCR with 917 dengue RT-PCR-positive adult patients (including 55 with DHF. We compared dengue fever (DF, DHF, and chikungunya infections by evaluating clinical characteristics of dengue and chikungunya; developing classification tools via multivariate logistic regression models and classification trees of disease etiology using clinical and laboratory factors; and assessing the time course of several clinical variables. FINDINGS: At first presentation to hospital, significantly more chikungunya patients had myalgia or arthralgia, and fewer had a sore throat, cough (for DF, nausea, vomiting, diarrhea, abdominal pain, anorexia or tachycardia than DF or DHF patients. From the decision trees, platelets <118 × 10(9/L was the only distinguishing feature for DF versus chikungunya with an overall correct classification of 89%. For DHF versus chikungunya using platelets <100 × 10(9/L and the presence of bleeding, the overall correct classification was 98%. The time course analysis supported platelet count as the key distinguishing variable. INTERPRETATION: There is substantial overlap in clinical presentation between dengue and chikungunya infections, but simple clinical and laboratory variables can predict these infections at presentation for appropriate management.

  4. [Infective endocarditis in intensive cardiac care unit - clinical and biochemical differences of blood-culture negative infective endocarditis].

    Science.gov (United States)

    Kaziród-Wolski, Karol; Sielski, Janusz; Ciuraszkiewicz, Katarzyna

    2017-01-23

    Diagnosis and treatment of infective endocarditis (IE) is still a challenge for physicians. Group of patients with the worst prognosis is treated in Intensive Cardiac Care Unit (ICCU). Etiologic agent can not be identified in a substantial number of patients. The aim of study is to find differences between patients with blood culture negative infective endocarditis (BCNIE) and blood culture positive infective endocarditis (BCPIE) treated in ICCU by comparing their clinical course and laboratory parameters. Retrospective analysis of 30 patients with IE hospitalized in ICCU Swietokrzyskie Cardiac Centre between 2010 and 2016. This group consist of 26 men (86,67%) and 4 women (13,3%). Mean age was 58 years ±13. Most of the cases were new disease, recurrence of the disease was observed in 2 cases (6,7%). 8 patients (26,7%) required artificial ventilation, 11 (36,7%) received inotropes and 6 (20%) vasopresors. In 14 (46,7%) cases blood cultures was negative (BCNIE), the rest of patients (16, 53,3%) was blood cultures - positive infective endocarditis (BCIE). Both of the groups were clinically similar. There were no statistically significant differences in incidence of cardiac implants, localization of bacterial vegetations, administered catecholamines, antibiotic therapy, artificial ventilation, surgical treatment, complication and in-hospital mortality. Incidence of cardiac complications in all of BCNIE cases and in 81,3% cases of BCPIE draws attention, but it is not statistically significant difference (p=0,08). There was statistically significant difference in mean BNP blood concentration (3005,17 ng/ml ±2045,2 vs 1013,42 ng/ml ±1087,6; p=0,01), but there were no statistically significant differences in rest of laboratory parameters. BCNIE group has got higher mean BNP blood concentration than BCPIE group. There were no statistically significant differences between these groups in others laboratory parameters, clinical course and administered antibiotic therapy

  5. [Clinical significance of infection pathogen resistance in a urological clinic for selection of antibacterial therapy regimes for the treatment of complicated urinary infections].

    Science.gov (United States)

    Lopatkin, N A; Derevianko, I I; Nefedova, L A; Lavrinova, L N; Prudnikova, S A

    2001-01-01

    Data on changes of etiological structure of the complicated urinary tract infections treated at the Research Institute of Urology and Hospital No. 47 at the 5-year period (1996-2000) are given. It was shown that the most important microorganisms were the following: Enterobacter spp., E. coli, Proteus spp., Staphylococcus spp., Enterococcus faecalis. The correlation between frequency of the microorganisms isolation and their susceptibility to antimicrobial agents at different periods was analysed. The results of analysis allowed to elaborate algorithm of etiotropic therapy. Choice of the drug depends on pathogen susceptibility to antibiotics, bacteriuria level and clinical symptoms severity.

  6. Chlamydia trachomatis infection among HIV-infected women attending an AIDS clinic in the city of Manaus, Brazil.

    Science.gov (United States)

    Silva, Leila Cristina Ferreira; Miranda, Angélica Espinosa; Batalha, Rosieny Santos; Sabino, Carolina Cristina Dantas; Dib, Elizabeth; Costa, Carolina Marinho da; Ramasawmy, Rajendranath; Talhari, Sinésio

    2012-01-01

    This was a cross-sectional study aimed to determine the prevalence of and to identify risk factors for Chlamydia trachomatis (CT) among human immunodeficiency virus (HIV)-infected women attending the acquired immunodeficiency syndrome (AIDS) clinic in the city of Manaus, Brazil, in 2009-2010. Participants answered a questionnaire containing demographic, epidemiological, and clinical data. A genital specimen was collected during examination to detect CT-DNA by hybrid capture, and blood samples were taken to determine CD4(+)T and HIV viral load. There were 329 women included in the study. Median age was 32 years (IQR=27-38) and median schooling was nine years (IQR=4-11). The prevalence of CT was 4.3% (95%CI: 2.1-6.5). Logistic regression analysis showed that age between 18-29 years [OR=4.1(95%CI: 1.2-13.4)] and complaint of pelvic pain [OR=3.7 (95%CI: 1.2-12.8)] were independently associated with CT. The use of condom was inversely associated with CT [OR=0.39 (95%CI: 0.1-0.9)]. The results showed that younger women who did not use condoms are at a higher risk for CT. Screening for sexually transmitted infections must be done routinely and safe sexual practices should be promoted among this population. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

  7. Chlamydia trachomatis infection among HIV-infected women attending an AIDS clinic in the city of Manaus, Brazil

    Directory of Open Access Journals (Sweden)

    Leila Cristina Ferreira Silva

    Full Text Available This was a cross-sectional study aimed to determine the prevalence of and to identify risk factors for Chlamydia trachomatis (CT among human immunodeficiency virus (HIV-infected women attending the acquired immunodeficiency syndrome (AIDS clinic in the city of Manaus, Brazil, in 2009-2010. Participants answered a questionnaire containing demographic, epidemiological, and clinical data. A genital specimen was collected during examination to detect CT-DNA by hybrid capture, and blood samples were taken to determine CD4+T and HIV viral load. There were 329 women included in the study. Median age was 32 years (IQR = 27-38 and median schooling was nine years (IQR = 4-11. The prevalence of CT was 4.3% (95%CI: 2.1-6.5. Logistic regression analysis showed that age between 18-29 years [OR = 4.1(95%CI: 1.2-13.4] and complaint of pelvic pain [OR = 3.7 (95%CI: 1.2-12.8] were independently associated with CT. The use of condom was inversely associated with CT [OR = 0.39 (95%CI: 0.1-0.9]. The results showed that younger women who did not use condoms are at a higher risk for CT. Screening for sexually transmitted infections must be done routinely and safe sexual practices should be promoted among this population.

  8. Leishmania-HIV co-infection: clinical presentation and outcomes in an urban area in Brazil.

    Science.gov (United States)

    Cota, Gláucia F; de Sousa, Marcos R; de Mendonça, Andrea Laender Pessoa; Patrocinio, Allan; Assunção, Luiza Siqueira; de Faria, Sidnei Rodrigues; Rabello, Ana

    2014-04-01

    Visceral leishmaniasis (VL) is an emerging condition affecting HIV-infected patients living in Latin America, particularly in Brazil. Leishmania-HIV coinfection represents a challenging diagnosis because the clinical picture of VL is similar to that of other disseminated opportunistic diseases. Additionally, coinfection is related to treatment failure, relapse and high mortality. To assess the clinical-laboratory profile and outcomes of VL-HIV-coinfected patients using a group of non HIV-infected patients diagnosed with VL during the same period as a comparator. The study was conducted at a reference center for infectious diseases in Brazil. All patients with suspected VL were evaluated in an ongoing cohort study. Confirmed cases were divided into two groups: with and without HIV coinfection. Patients were treated according to the current guidelines of the Ministry of Health of Brazil, which considers antimony as the first-choice therapy for non HIV-infected patients and recommends amphotericin B for HIV-infected patients. After treatment, all patients with CD4 counts below 350 cells/mm3 received secondary prophylaxis with amphotericin B. Between 2011 and 2013, 168 patients with suspected VL were evaluated, of whom 90 were confirmed to have VL. In total, 51% were HIV coinfected patients (46 patients). HIV-infected patients had a lower rate of fever and splenomegaly compared with immunocompetent patients. The VL relapse rate in 6 months was 37% among HIV-infected patients, despite receiving secondary prophylaxis. The overall case-fatality rate was 6.6% (4 deaths in the HIV-infected group versus 2 deaths in the non HIV-infected group). The main risk factors for a poor outcome at 6 months after the end of treatment were HIV infection, bleeding and a previous VL episode. Although VL mortality rates among HIV-infected individuals are close to those observed among immunocompetent patients treated with amphotericin B, HIV coinfection is related to a low clinical response

  9. Leishmania-HIV co-infection: clinical presentation and outcomes in an urban area in Brazil.

    Directory of Open Access Journals (Sweden)

    Gláucia F Cota

    2014-04-01

    Full Text Available BACKGROUND: Visceral leishmaniasis (VL is an emerging condition affecting HIV-infected patients living in Latin America, particularly in Brazil. Leishmania-HIV coinfection represents a challenging diagnosis because the clinical picture of VL is similar to that of other disseminated opportunistic diseases. Additionally, coinfection is related to treatment failure, relapse and high mortality. OBJECTIVE: To assess the clinical-laboratory profile and outcomes of VL-HIV-coinfected patients using a group of non HIV-infected patients diagnosed with VL during the same period as a comparator. METHODS: The study was conducted at a reference center for infectious diseases in Brazil. All patients with suspected VL were evaluated in an ongoing cohort study. Confirmed cases were divided into two groups: with and without HIV coinfection. Patients were treated according to the current guidelines of the Ministry of Health of Brazil, which considers antimony as the first-choice therapy for non HIV-infected patients and recommends amphotericin B for HIV-infected patients. After treatment, all patients with CD4 counts below 350 cells/mm3 received secondary prophylaxis with amphotericin B. RESULTS: Between 2011 and 2013, 168 patients with suspected VL were evaluated, of whom 90 were confirmed to have VL. In total, 51% were HIV coinfected patients (46 patients. HIV-infected patients had a lower rate of fever and splenomegaly compared with immunocompetent patients. The VL relapse rate in 6 months was 37% among HIV-infected patients, despite receiving secondary prophylaxis. The overall case-fatality rate was 6.6% (4 deaths in the HIV-infected group versus 2 deaths in the non HIV-infected group. The main risk factors for a poor outcome at 6 months after the end of treatment were HIV infection, bleeding and a previous VL episode. CONCLUSION: Although VL mortality rates among HIV-infected individuals are close to those observed among immunocompetent patients treated with

  10. Triclosan-coated sutures reduce wound infections after spinal surgery: a retrospective, nonrandomized, clinical study.

    Science.gov (United States)

    Ueno, Masaki; Saito, Wataru; Yamagata, Megumu; Imura, Takayuki; Inoue, Gen; Nakazawa, Toshiyuki; Takahira, Naonobu; Uchida, Kentaro; Fukahori, Nobuko; Shimomura, Kiyomi; Takaso, Masashi

    2015-05-01

    Surgical site infection (SSI) is a serious postoperative complication. The incidence of SSIs is lower in clean orthopedic surgery than in other fields, but it is higher after spinal surgery, reaching 4.15% in high-risk patients. Several studies reported that triclosan-coated polyglactin 910 sutures (Vicryl Plus; Ethicon, Inc., Somerville, NJ, USA) significantly reduced the infection rate in the general surgical, neurosurgical, and thoracic surgical fields. However, there have been no studies on the effects of such coated sutures on the incidence of SSIs in orthopedics. To compare the incidence of wound infections after spinal surgery using triclosan-coated suture materials with that of noncoated ones. A retrospective, nonrandomized, and clinical study. From May 2010 to April 2012, 405 patients underwent a spinal surgical procedure in the Department of Orthopedic Surgery of two university hospitals. The primary outcome was the number of wound infections and dehiscences. Two hundred five patients had a conventional wound closure with polyglactin 910 suture (Vicryl) between May 2010 and April 2011 (Time Period 1 [TP1]), and 200 patients underwent wound closure with triclosan-coated polyglactin 910 suture (Vicryl Plus) between May 2011 and April 2012 (TP2). Statistical comparisons of wound infections, dehiscence, and risk factors for poor wound healing or infection were performed. None of the authors has any conflict of interest associated with this study. There were two cases of wound dehiscence in TP1 and one in TP2 (p=.509). Using noncoated sutures in TP1, eight patients (3.90%) had wound infections, whereas one patient (0.50%) had wound infections in TP2 (using triclosan-coated sutures); the difference was significant (p=.020). The use of triclosan-coated polyglactin 910 sutures instead of polyglactin 910 sutures may reduce the number of wound infections after spinal surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Evaluation of Nucleic Acid Isothermal Amplification Methods for Human Clinical Microbial Infection Detection.

    Science.gov (United States)

    Etchebarne, Brett E; Li, Zenggang; Stedtfeld, Robert D; Nicholas, Michael C; Williams, Maggie R; Johnson, Timothy A; Stedtfeld, Tiffany M; Kostic, Tanja; Khalife, Walid T; Tiedje, James M; Hashsham, Syed A; Hughes, Mary J

    2017-01-01

    Battling infection is a major healthcare objective. Untreated infections can rapidly evolve toward the condition of sepsis in which the body begins to fail and resuscitation becomes critical and tenuous. Identification of infection followed by rapid antimicrobial treatment are primary goals of medical care, but precise identification of offending organisms by current methods is slow and broad spectrum empirical therapy is employed to cover most potential pathogens. Current methods for identification of bacterial pathogens in a clinical setting typically require days of time, or a 4- to 8-h growth phase followed by DNA extraction, purification and PCR-based amplification. We demonstrate rapid (70-120 min) genetic diagnostics methods utilizing loop-mediated isothermal amplification (LAMP) to test for 15 common infection pathogen targets, called the Infection Diagnosis Panel (In-Dx). The method utilizes filtration to rapidly concentrate bacteria in sample matrices with lower bacterial loads and direct LAMP amplification without DNA purification from clinical blood, urine, wound, sputum and stool samples. The In-Dx panel was tested using two methods of detection: (1) real-time thermocycler fluorescent detection of LAMP amplification and (2) visual discrimination of color change in the presence of Eriochrome Black T (EBT) dye following amplification. In total, 239 duplicate samples were collected (31 blood, 122 urine, 73 mucocutaneous wound/swab, 11 sputum and two stool) from 229 prospectively enrolled hospital patients with suspected clinical infection and analyzed both at the hospital and by In-Dx. Sensitivity (Se) of the In-Dx panel targets pathogens from urine samples by In-Dx was 91.1% and specificity (Sp) was 97.3%, with a positive predictive value (PPV) of 53.7% and a negative predictive value (NPV) of 99.7% as compared to clinical microbial detection methods. Sensitivity of detection of the In-Dx panel from mucocutaneous swab samples was 65.5% with a Sp of 99

  12. Evaluation of Nucleic Acid Isothermal Amplification Methods for Human Clinical Microbial Infection Detection

    Directory of Open Access Journals (Sweden)

    Brett E. Etchebarne

    2017-12-01

    Full Text Available Battling infection is a major healthcare objective. Untreated infections can rapidly evolve toward the condition of sepsis in which the body begins to fail and resuscitation becomes critical and tenuous. Identification of infection followed by rapid antimicrobial treatment are primary goals of medical care, but precise identification of offending organisms by current methods is slow and broad spectrum empirical therapy is employed to cover most potential pathogens. Current methods for identification of bacterial pathogens in a clinical setting typically require days of time, or a 4- to 8-h growth phase followed by DNA extraction, purification and PCR-based amplification. We demonstrate rapid (70–120 min genetic diagnostics methods utilizing loop-mediated isothermal amplification (LAMP to test for 15 common infection pathogen targets, called the Infection Diagnosis Panel (In-Dx. The method utilizes filtration to rapidly concentrate bacteria in sample matrices with lower bacterial loads and direct LAMP amplification without DNA purification from clinical blood, urine, wound, sputum and stool samples. The In-Dx panel was tested using two methods of detection: (1 real-time thermocycler fluorescent detection of LAMP amplification and (2 visual discrimination of color change in the presence of Eriochrome Black T (EBT dye following amplification. In total, 239 duplicate samples were collected (31 blood, 122 urine, 73 mucocutaneous wound/swab, 11 sputum and two stool from 229 prospectively enrolled hospital patients with suspected clinical infection and analyzed both at the hospital and by In-Dx. Sensitivity (Se of the In-Dx panel targets pathogens from urine samples by In-Dx was 91.1% and specificity (Sp was 97.3%, with a positive predictive value (PPV of 53.7% and a negative predictive value (NPV of 99.7% as compared to clinical microbial detection methods. Sensitivity of detection of the In-Dx panel from mucocutaneous swab samples was 65.5% with a

  13. Clinical assessment of infection in nonhealing ulcers analyzed by latent class analysis.

    Science.gov (United States)

    Lorentzen, Henrik F; Gottrup, Finn

    2006-01-01

    The distinction between bacterial colonization and infection relies on clinical judgement. Determining sensitivity and specificity of this judgement are problematic as no gold standard exists. Six specialists in wound management independently assessed 120 nonhealing chronic wounds. Sixty-five (54.2%) patients had venous ulcer, 18 (15%) arterial ulcers, 15 (12.5%) ulcerative pyoderma gangraenosum, 12 (10%) neuropathic or pressure ulcers, six (5%) vasculitis ulcers, and four patients had ulcers caused by a primary or metastatic cancer disease. Unrestricted latent class analysis was used for determining sensitivity and specificity in the observer's assessment of hypergranulation, redness, and overall impression of infection. Interrater agreement among observers was determined by restricted latent class analysis. The observers used the diagnoses (redness, hypergranulation, and overall impression of infection with different frequencies (phypergranulation ranged from 3 to 82%, for redness from 34 to 91% and for overall impression of infection from 37 to 90%. None of the observers were interchangeable. These results indicate that clinical assessment of chronic wounds for the presence of infection are difficult tasks accompanied by great variability and low reliability.

  14. [Clinical study of non-alcoholic fatty liver disease and its combined the chronic HBV infection].

    Science.gov (United States)

    He, J; Zeng, Y L; Li, W; Guo, E E; Li, J L; Kang, Y; Shang, J

    2017-08-20

    Objective: to compared with clinical data between nonalcoholic fatty liver disease (NAFLD) and Chronic HBV infection with NAFLD, and to explore the relationship between HBV infection and hepatic steatosis. Methods: A total of 81 patients with clinical data in the Department of Infectious Diseases in Henan Provincial People's Hospital from June 2013 to June 2016 were enrolled and divided into NAFLD group and HBV combined NAFLD group.Comparison of The levels of liver function (ALT, AST, ALP, GGT), blood lipid (TC, TG, HDL, LDL), blood glucose (GLU), uric acid (UA), hepatic fibrosis (S) and inflammation (G) And hepatic steatosis (F), and to explore the relationship between HBV infection and hepatic steatosis. The independent samples t-test or Wilcoxon two -sample test was used for comparison of continuous data,and the chi-square test was used for comparison of categorical data. Multinomial Logistic regression was used to analyze The risk factors of hepatic steatosis, P HBV with NAFLD group. Baseline level comparison: ALT (t = -4.379, P HBV infection-related indicators, it is difficult to distinguish between NAFLD and NAFLD combined with HBV differences; HBV infection and hepatic steatosis have a certain relationship.

  15. Antimicrobial susceptibilities and clinical characterization of Pseudomonas aeruginosa isolates from urinary tract infections.

    Science.gov (United States)

    Zhang, Xiaobing; Niu, Siqiang; Zhang, Liping

    2014-01-01

    Pseudomonas aeruginosa is a uropathogen that is mainly involved in nosocomial infection. The aim of this study was to analyze the antimicrobial susceptibilities and clinical characterization of P. aeruginosa isolates from urinary tract infections (UTIs). The study collected all P. aeruginosa UTI strains from a hospital in Chongqing, China, from January 1st, 2010 to December 31st, 2011. The antibiotic susceptibilities of the P. aeruginosa isolates were analyzed using the agar dilution method and the genotypes were assessed using random amplification of polymorphic DNA-PCR (RAPD-PCR). The clinical characteristics of the patients with UTIs were collected from the hospital information systems, and significance was analyzed using the proportion test. A total of 2,778 episodes of culture-proven UTIs were used in the study. There were 198 infections (7.1%) caused by P. aeruginosa. P. aeruginosa strains were highly resistant to most drugs tested. The RAPD-PCR data revealed that the 198 P. aeruginosa infections had 82 different genotypes. Antibacterial use, previous UTI, urinary tract catheter and urinary tract operation were found to be risk factors for the development of UTIs. P. aeruginosa is the second most common UTI pathogen in our hospital. We should closely monitor patients with risk factors for P. aeruginosa infection.

  16. Severe clinical course of de novo hepatitis B infection after liver transplantation.

    Science.gov (United States)

    Crespo, J; Fábrega, E; Casafont, F; Rivero, M; Heras, G; de la Peña, J; de la Cruz, F; Pons-Romero, F

    1999-05-01

    The aim of this study is to determine the origin, clinical outcome, allograft histological characteristics, and virological outcome of de novo hepatitis B virus (HBV) infection after orthotopic liver transplantation (OLT). We studied 136 hepatitis B surface antigen (HBsAg)-negative liver transplant recipients. HBV DNA was detected by dot-blot hybridization and polymerase chain reaction (PCR). The S gene was sequenced. Hepatitis C virus (HCV) RNA was assessed by PCR. The long-term clinical and histological outcome was determined. Six of 136 HBsAg-negative patients (4.4%) became HBsAg positive after transplantation. The source of HBV infection was reactivation of latent HBV infection in 2 patients and was not identified in 4 patients. Two donors had isolated core antibody. Two of these 6 patients developed acute liver failure related to hepatitis B. The 4 other patients had severe chronic hepatitis related to hepatitis B. All patients had high-level HBV replication. No significant mutations in the S gene were found. These data suggest that de novo hepatitis B infection is not a mild disease and might represent a significant cause of graft dysfunction. This is the first report of fulminant hepatitis caused by de novo hepatitis B infection after OLT.

  17. Epidemiological and clinical features of human coronavirus infections among different subsets of patients.

    Science.gov (United States)

    Cabeça, Tatiane K; Granato, Celso; Bellei, Nancy

    2013-11-01

    Epidemiological and clinical data of human coronaviruses (HCoVs) infections are restricted to span 1-3 years at most. We conducted a comprehensive 9-year study on HCoVs by analyzing 1137 respiratory samples from four subsets of patients (asymptomatic, general community, with comorbidities, and hospitalized) in São Paulo, Brazil. A pan-coronavirus RT-PCR screening assay was performed, followed by species-specific real-time RT-PCR monoplex assays. Human coronaviruses were detected in 88 of 1137 (7.7%) of the samples. The most frequently detected HCoV species were NL63 (50.0%) and OC43 (27.3%). Patients with comorbidities presented the highest risk of acquiring coronavirus infection (odds ratio=4.17; 95% confidence interval=1.9-9.3), and children with heart diseases revealed a significant HCoV infection presence. Dyspnea was more associated with HCoV-229E infections (66.6%), and cyanosis was reported only in HCoV-OC43 infections. There were interseasonal differences in the detection frequencies, with HCoV-229E being predominant in the year 2004 (61.5%) and HCoV-NL63 (70.8%) in 2008. Our data provide a novel insight into the epidemiology and clinical knowledge of HCoVs among different subsets of patients, revealing that these viruses may cause more than mild respiratory tract disease. © 2013 John Wiley & Sons Ltd.

  18. Parainfluenza virus infections in a tropical city: clinical and epidemiological aspects

    Directory of Open Access Journals (Sweden)

    Mariana Mota Moura Fé

    Full Text Available Little information on the epidemiology and clinical characteristics of human parainfluenza virus (HPIV infections, especially in children from tropical countries, has been published. The aim of this study was to determine the frequency of HPIV infections in children attended at a large hospital in Fortaleza in Northeast Brazil, and describe seasonal patterns, clinical and epidemiological characteristics of these infections. From January 2001 to December 2006, a total of 3070 nasopharyngeal aspirates collected from children were screened by indirect immunofluorescence for human parainfluenza viruses 1, 2, and 3 (HPIV-1, 2 and 3 and other respiratory viruses. Viral antigens were identified in 933 samples and HPIV in 117. The frequency of HPIV-3, HPIV-1 and HPIV-2 was of 83.76%, 11.96% and 4.27%, respectively. Only HPIV-3 showed a seasonal occurrence, with most cases observed from September to November, and with an inverse relationship to the rainy season. Most HPIV-3 infections seen in outpatients were diagnosed as upper respiratory tract infections.

  19. Co-infection by Cryptococcus neoformans and Mycobacterium avium intracellulare in AIDS. Clinical and epidemiological aspects.

    Science.gov (United States)

    Arastéh, K; Cordes, C; Futh, U; Grosse, G; Dietz, E; Staib, F

    In the observation of various opportunistic pathogens in HIV-positive persons, co-infection by Cryptococcus neoformans together with Mycobacterium avium intracellulare was found if there was a CD4 lymphocyte count as low as 3-20/microliters. In 1540 HIV-positive patients under treatment at a Berlin hospital (Auguste-Viktoria-Krankenhaus) during 1985-1994, all AIDS-relevant diseases were examined in a multivariate analysis as variables of influence on the manifestation of a systemic Mycobacterium avium complex (MAC) infection. The analysis involved data on 36 cases of cryptococcosis and 202 cases with a typical clinical course in whom MAC had been detected at sterile body sites. As significant and independent factors of influence, the following were identified: C. neoformans infection, wasting syndrome, lower age, low CD4 lymphocyte count and preceding Pneumocystis carinii pneumonia (PcP) prophylaxis. Cryptococcosis ranged first with an ods ratio of 2.75. The concomitant manifestation of cryptococcosis and systemic MAC infection in six patients is shown. Because both opportunists, C. neoformans and avian mycobacteria, may have their common habitat in droppings of defined species of pet birds, a common source of infection deserves further clinical and epidemiological attention.

  20. Outbreak of Pantoea agglomerans Bloodstream Infections at an Oncology Clinic-Illinois, 2012-2013.

    Science.gov (United States)

    Yablon, Brian R; Dantes, Raymund; Tsai, Victoria; Lim, Rachel; Moulton-Meissner, Heather; Arduino, Matthew; Jensen, Bette; Patel, Megan Toth; Vernon, Michael O; Grant-Greene, Yoran; Christiansen, Demian; Conover, Craig; Kallen, Alexander; Guh, Alice Y

    2017-03-01

    OBJECTIVE To determine the source of a healthcare-associated outbreak of Pantoea agglomerans bloodstream infections. DESIGN Epidemiologic investigation of the outbreak. SETTING Oncology clinic (clinic A). METHODS Cases were defined as Pantoea isolation from blood or catheter tip cultures of clinic A patients during July 2012-May 2013. Clinic A medical charts and laboratory records were reviewed; infection prevention practices and the facility's water system were evaluated. Environmental samples were collected for culture. Clinical and environmental P. agglomerans isolates were compared using pulsed-field gel electrophoresis. RESULTS Twelve cases were identified; median (range) age was 65 (41-78) years. All patients had malignant tumors and had received infusions at clinic A. Deficiencies in parenteral medication preparation and handling were identified (eg, placing infusates near sinks with potential for splash-back contamination). Facility inspection revealed substantial dead-end water piping and inadequate chlorine residual in tap water from multiple sinks, including the pharmacy clean room sink. P. agglomerans was isolated from composite surface swabs of 7 sinks and an ice machine; the pharmacy clean room sink isolate was indistinguishable by pulsed-field gel electrophoresis from 7 of 9 available patient isolates. CONCLUSIONS Exposure of locally prepared infusates to a contaminated pharmacy sink caused the outbreak. Improvements in parenteral medication preparation, including moving chemotherapy preparation offsite, along with terminal sink cleaning and water system remediation ended the outbreak. Greater awareness of recommended medication preparation and handling practices as well as further efforts to better define the contribution of contaminated sinks and plumbing deficiencies to healthcare-associated infections are needed. Infect Control Hosp Epidemiol 2017;38:314-319.

  1. Clinical and laboratory evidence of Trichomonas vaginalis infection among women of reproductive age in rural area.

    Science.gov (United States)

    Fule, S R; Fule, R P; Tankhiwale, N S

    2012-01-01

    Vaginitis is a commonly encountered complaint and one of the most frequent reasons for patient visit to obstetrician-gynaecologists. Three vaginal infections are frequent causes of a vaginal discharge: (1) bacterial vaginosis, (2) vulvovaginal candidiasis and (3) trichomonas vaginitis. Differences in the clinical presentation are helpful in diagnosis. Characteristic signs and symptoms for these three vaginal infections are distinct, but on many occasions, they are overlapping. The aim of the present study was to find the prevalence and correlation between the clinical spectrum and laboratory evidence of Trichomonas vaginalis infection by simple, reliable, confirmatory and specific method, i.e. microscopic examination of wet mount preparation and acridine stain of vaginal fluid. Irrespective of HIV status, a total of 156 women with vaginal discharge were studied for establishing diagnosis of genital tract infection. The cases of bacterial vaginosis and vulvovaginal candidiasis were excluded from the study. Vaginal speculum assisted high vaginal swabs were collected from women with discharge, during collection vagina was inspected for obvious signs. Of the 156 women with vaginal discharge, 19 (12.06 %) showed T. vaginalis infection. All the women belonged to active reproductive age group, i.e. 20-40 years. Itching dysuria, and offensive, malodorous, thin, yellowish vaginal discharge were the main and consistent complaints. Only in 2 (1.52%) cases, vaginal speculum examination revealed erythema and punctuate haemorrhage, the so-called "strawberry' vagina. The pH was recorded to be >4.5. Clinical differentiation of various forms of infectious vaginitis is unreliable. The prevalence of T. vaginalis infection at 12.06% was found among rural young women of reproductive age using simple and reliable screening wet mount microscopy.

  2. Clinical Spectrum of Oral Secondary Syphilis in HIV-Infected Patients

    Directory of Open Access Journals (Sweden)

    Velia Ramírez-Amador

    2013-01-01

    Full Text Available Background. Oral lesions may constitute the first clinical manifestation in secondary syphilis, but detailed descriptions in HIV-infected individuals are scarce. Objective. To describe the clinical characteristics of oral secondary syphilis in HIV-infected patients and its relevance in the early diagnosis of syphilis. Methods. Twenty HIV/AIDS adult subjects with oral secondary syphilis lesions presenting at two HIV/AIDS referral centers in Mexico City (2003–2011 are described. An oral examination was performed by specialists in oral pathology and medicine; when possible, a punch biopsy was done, and Warthin-Starry stain and immunohistochemistry were completed. Intraoral herpes virus infection and erythematous candidosis were ruled out by cytological analysis. Diagnosis of oral syphilis was confirmed with positive nontreponemal test (VDRL, and, if possible, fluorescent treponemal antibody test. Results. Twenty male patients (median age 31.5, 21–59 years with oral secondary syphilis lesions were included. Oral lesions were the first clinical sign of syphilis in 16 (80% cases. Mucous patch was the most common oral manifestation (17, 85.5%, followed by shallow ulcers (2, 10% and macular lesions (1, 5%. Conclusions. Due to the recent rise in HIV-syphilis coinfection, dental and medical practitioners should consider secondary syphilis in the differential diagnosis of oral lesions, particularly in HIV-infected patients.

  3. Competition between Plasmodium falciparum strains in clinical infections during in vitro culture adaptation.

    Science.gov (United States)

    Chen, Kexuan; Sun, Ling; Lin, Yingxue; Fan, Qi; Zhao, Zhenjun; Hao, Mingming; Feng, Guohua; Wu, Yanrui; Cui, Liwang; Yang, Zhaoqing

    2014-06-01

    We evaluated the dynamics of parasite populations during in vitro culture adaptation in 15 mixed Plasmodium falciparum infections, which were collected from a hypoendemic area near the China-Myanmar border. Allele types at the msp1 block 2 in the initial clinical samples and during subsequent culture were quantified weekly using a quantitative PCR method. All mixed infections carried two allele types based on the msp1 genotyping result. We also genotyped several polymorphic sites in the dhfr, dhps and mdr1 genes on day 0 and day 28, which showed that most of the common sites analyzed were monomorphic. Two of the three clinical samples mixed at dhps 581 remained stable while one changed to wild-type during the culture. During in vitro culture, we observed a gradual loss of parasite populations with 10 of the 15 mixed infections becoming monoclonal by day 28 based on the msp1 allele type. In most cases, the more abundant msp1 allele types in the clinical blood samples at the beginning of culture became the sole or predominant allele types on day 28. These results suggest that some parasites may have growth advantages and the loss of parasite populations during culture adaptation of mixed infections may lead to biased results when comparing the phenotypes such as drug sensitivity of the culture-adapted parasites. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Human rhinovirus infections in hospitalized children: clinical, epidemiological and virological features.

    Science.gov (United States)

    Tran, D N; Trinh, Q D; Pham, N T K; Pham, T M H; Ha, M T; Nguyen, T Q N; Okitsu, S; Shimizu, H; Hayakawa, S; Mizuguchi, M; Ushijima, H

    2016-01-01

    Molecular epidemiology and clinical impact of human rhinovirus (HRV) are not well documented in tropical regions. This study compared the clinical characteristics of HRV to other common viral infections and investigated the molecular epidemiology of HRV in hospitalized children with acute respiratory infections (ARIs) in Vietnam. From April 2010 to May 2011, 1082 nasopharyngeal swabs were screened for respiratory viruses by PCR. VP4/VP2 sequences of HRV were further characterized. HRV was the most commonly detected virus (30%), in which 70% were diagnosed as either pneumonia or bronchiolitis. Children with single HRV infections presented with significantly higher rate of hypoxia than those infected with respiratory syncytial virus or parainfluenza virus (PIV)-3 (12·4% vs. 3·8% and 0%, respectively, P < 0·05), higher rate of chest retraction than PIV-1 (57·3% vs. 34·5%, P = 0·028), higher rate of wheezing than influenza A (63·2% vs. 42·3%, P = 0·038). HRV-C did not differ to HRV-A clinically. The genetic diversity and changes of types over time were observed and may explain the year-round circulation of HRV. One novel HRV-A type was discovered which circulated locally for several years. In conclusion, HRV showed high genetic diversity and was associated with significant morbidity and severe ARIs in hospitalized children.

  5. [Cowpox virus infection in an alpaca (Vicugna pacos) - clinical symptoms, laboratory diagnostic findings and pathological changes].

    Science.gov (United States)

    Goerigk, D; Theuß, T; Pfeffer, M; Konrath, A; Kalthoff, D; Woll, D; Vahlenkamp, T W; Beer, M; Starke, A

    2014-01-01

    Orthopoxvirus infections appear to be rare in South American Camelids, because only a few cases have been reported in the literature. Based on a generalized infection with cowpox virus in an alpaca, the clinical symptoms, laboratory diagnostic findings and the pathological changes are described. The case history showed a long treatment because of chronic skin lesions. The main clinical symptom was miliary papules over the entire skin. Furthermore, a bilateral mucopurulent conjunctivitis occurred as well as excessive salivation due to a severe erosive-ulcerative stomatitis. Although the animal received intensive treatment, it died 8 days after admission to the clinic. During necropsy, an erosive-ulcerative laryngitis as well as a necrotising pneumonia and lymphadenitis were observed. Histopathological examination of representative organ samples led to the diagnosis of a suspected orthopoxvirus infection. Electron microscopy and quantitative polymerase chain reaction (qPCR) of tissue samples confirmed this diagnosis. The virus could be isolated in tissue culture and a PCR with subsequent nucleotide sequencing identified cowpox virus as the causative agent for this generalised infection.

  6. Clinical study of the disease of calves associated with Mycoplasma bovis infection.

    Science.gov (United States)

    Stipkovits, L; Ripley, P; Varga, J; Pálfi, V

    2000-01-01

    Clinical, bacteriological and serological examination of 35 calves from the age of 5 to 26 days was performed in a Holstein-Friesian dairy herd endemically infected with Mycoplasma bovis. M. bovis was isolated from 48.6% of nasal swabs taken from the calves at the age of 5 days, and from 91.4% of the same calves at the age of 26 days, indicating the gradual spread of infection. The isolation rate of Pasteurella multocida did not change much, and varied from 28.6 to 25.7%. No P. haemolytica could be detected. In addition to M. bovis and P. multocida, the herd was also infected with different viruses (including bovine viral diarrhoea virus, infectious bovine rhinotracheitis virus, bovine adenoviruses, parainfluenza-3 virus, and bovine respiratory syncytial virus) as a large proportion of the sera of newborn calves contained colostral antibodies against these viruses. In most of the newborn calves severe clinical signs (fever, depression, inappetence, hyperventilation, dyspnoea, nasal discharge and coughing) due to M. bovis infection developed. The clinical signs appeared already on the fifth day of life, and their incidence was the highest at the age of 10 to 15 days. Three calves (8.6%) died as a result of severe serofibrinous pneumonia. The surviving calves showed very poor weight gain (ranging from 1.5 to 3.5 kg) during the first two weeks of life.

  7. Clinical management of rapidly growing mycobacterial cutaneous infections in patients after mesotherapy.

    Science.gov (United States)

    Regnier, Stéphanie; Cambau, Emmanuelle; Meningaud, Jean-Paul; Guihot, Amelie; Deforges, Lionel; Carbonne, Anne; Bricaire, François; Caumes, Eric

    2009-11-01

    Increasing numbers of patients are expressing an interest in mesotherapy as a method of reducing body fat. Cutaneous infections due to rapidly growing mycobacteria are a common complication of such procedures. We followed up patients who had developed cutaneous infections after undergoing mesotherapy during the period October 2006-January 2007. Sixteen patients were infected after mesotherapy injections performed by the same physician. All patients presented with painful, erythematous, draining subcutaneous nodules at the injection sites. All patients were treated with surgical drainage. Microbiological examination was performed on specimens that were obtained before and during the surgical procedure. Direct examination of skin smears demonstrated acid-fast bacilli in 25% of the specimens that were obtained before the procedure and 37% of the specimens obtained during the procedure; culture results were positive in 75% of the patients. Mycobacterium chelonae was identified in 11 patients, and Mycobacterium frederiksbergense was identified in 2 patients. Fourteen patients were treated with antibiotics, 6 received triple therapy as first-line treatment (tigecycline, tobramycin, and clarithromycin), and 8 received dual therapy (clarithromycin and ciprofloxacin). The mean duration of treatment was 14 weeks (range, 1-24 weeks). All of the patients except 1 were fully recovered 2 years after the onset of infection, with the mean time to healing estimated at 6.2 months (range, 1-15 months). This series of rapidly growing mycobacterial cutaneous infections highlights the difficulties in treating such infections and suggests that in vitro susceptibility to antibiotics does not accurately predict their clinical efficacy.

  8. Epidemiological and biological determinants of Staphylococcus aureus clinical infection in New York State maximum security prisons.

    Science.gov (United States)

    Miko, Benjamin A; Befus, Montina; Herzig, Carolyn T A; Mukherjee, Dhritiman V; Apa, Zoltan L; Bai, Ruo Yu; Tanner, Joshua P; Gage, Dana; Genovese, Maryann; Koenigsmann, Carl J; Larson, Elaine L; Lowy, Franklin D

    2015-07-15

    Large outbreaks of Staphylococcus aureus (SA) infections have occurred in correctional facilities across the country. We aimed to define the epidemiological and microbiological determinants of SA infection in prisons to facilitate development of prevention strategies for this underserved population. We conducted a case-control study of SA infection at 2 New York State maximum security prisons. SA-infected inmates were matched with 3 uninfected controls. Subjects had cultures taken from sites of infection and colonization (nose and throat) and were interviewed via structured questionnaire. SA isolates were characterized by spa typing. Bivariate and multivariable analyses were conducted using conditional logistic regression. Between March 2011 and January 2013, 82 cases were enrolled and matched with 246 controls. On bivariate analysis, the use of oral and topical antibiotics over the preceding 6 months was strongly associated with clinical infection (OR, 2.52; P prison setting. Although many of these factors were likely present prior to incarceration, they may help medical staff identify prisoners for targeted prevention strategies. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  9. Correlation of serum HIV antigen and antibody with clinical status in HIV-infected patients.

    Science.gov (United States)

    Paul, D A; Falk, L A; Kessler, H A; Chase, R M; Blaauw, B; Chudwin, D S; Landay, A L

    1987-08-01

    An enzyme immunoassay (EIA) has been developed which detects antigen(s) (Ag) of the human immunodeficiency virus (HIV) in the serum of patients with the acquired immunodeficiency syndrome (AIDS), AIDS-related complex (ARC), and patients at high risk for HIV infection. The test has a sensitivity of approximately 50 pg/ml of HIV protein. The specificity of the assay was determined with various virus infected cell lines, normal human sera/plasma, and serum from patients not known to be at risk for HIV infection. No false-positive HIV-Ag results were seen. Sera from 69% of patients with AIDS were positive for HIV-Ag as were 46% of patients with ARC and 19% of asymptomatic, HIV-antibody-positive individuals. There were significant associations between the stage of HIV infection--ie, AIDS vs ARC vs asymptomatic--and the detection of HIV-Ag in serum (p less than 0.0001) and the lack of detection of antibody to HIV core Ag (p less than 0.0001). HIV-Ag was also found in the serum of two asymptomatic antibody-negative individuals who were at high risk for AIDS and who later developed HIV antibody. The presence of HIV-Ag in sera was confirmed by an inhibition procedure. Thus, HIV-Ag can be detected in the serum of infected individuals prior to antibody production and correlates with the clinical stage of HIV infection.

  10. [The occurrence of "Candidatus Mycoplasma haemolamae" infections in clinically asymptomatic South American Camelids in Austria].

    Science.gov (United States)

    Franz, Sonja; Spergser, Joachim; Schwendenwein, Ilse; Stanitznig, Anna; Lambacher, Bianca; Tichy, Alexander; Wittek, Thomas

    2016-01-01

    Reports of CMhl infections in South American Camelids in Europe are only available from the United Kingdom and Switzerland. Knowing that CMhl infections can lead to severe disease resulting in death if combined with other diseases or stress, it was the aim of this study to assess prevalence data from camelids in Austria. In comparison to the previous studies a representative number of camelids was investigated nationwide. Data were assessed due to differences in geographical region, age, sex, species, and origin. A relatively high prevalence of 25.8% was recorded. CMhl was detected significantly more often in alpacas (Vicunja pacos) than in llamas (Lama glama) and more frequently in animals younger than 2 years. Additionally regional differences have been observed, which might be due to climatic differences and/or variations in insect vectors. In this study apperantly clinical healthy animals were shown to be infected with CMhl. Camelids infected with CMhl are a pathogen reservoir. The results of this study indicate different risk levels of infection between llamas and alpacas and between younger and older animals. The data presented underline the necessity of further studies on CMhlI infections in South American Camelids.

  11. Zika virus and the risk of imported infection in returned travelers: Implications for clinical care.

    Science.gov (United States)

    Goorhuis, Abraham; von Eije, Karin J; Douma, Renée A; Rijnberg, Noor; van Vugt, Michele; Stijnis, Cornelis; Grobusch, Martin P

    2016-01-01

    Since late 2015, an unprecedented outbreak of Zika virus is spreading quickly across Southern America. The large size of the current outbreak in The Americas will also result in an increase in Zika virus infections among travelers returning from endemic areas. We report five cases of imported Zika virus infection to The Netherlands. Although the clinical course is usually mild, establishing the diagnosis is important, mainly because of the association with congenital microcephaly and the possibility of sexual transmission. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Clinical approach to known and emerging tick-borne infections other than Lyme disease.

    Science.gov (United States)

    Shah, Rita G; Sood, Sunil K

    2013-06-01

    We review latest developments in knowledge of established and emerging tick-borne infections in the United States other than Lyme borreliosis, emphasizing a clinical and geographic approach to diagnosis and management. The incidence of tick-borne diseases in the United States has increased. New tick-borne diseases have emerged and will likely continue to be identified. Clinicians should maintain suspicion for tick-borne diseases in children with acute infectious illnesses, and consider treating such patients presumptively to prevent complications. Knowledge of common tick vectors in the United States and the infections they transmit will allow pediatricians to appropriately assess and manage patients with tick-borne diseases.

  13. European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection

    NARCIS (Netherlands)

    Debast, S.B.; Bauer, M.P.; Kuijper, E.J.

    2014-01-01

    In 2009 the first European Society of Clinical Microbiology and Infection (ESCMID) treatment guidance document for Clostridium difficile infection (CDI) was published. The guideline has been applied widely in clinical practice. In this document an update and review on the comparative effectiveness

  14. First clinical case report of Cytauxzoon sp. infection in a domestic cat in France.

    Science.gov (United States)

    Legroux, Jean-Pierre; Halos, Lénaïg; René-Martellet, Magalie; Servonnet, Marielle; Pingret, Jean-Luc; Bourdoiseau, Gilles; Baneth, Gad; Chabanne, Luc

    2017-03-29

    Feline cytauxzoonosis is an emerging infection caused by tick-transmitted apicomplexan parasites of the genus Cytauxzoon. The association of clinical disease with Cytauxzoon infection appears to be limited to C. felis infections in the Americas. Sporadic infections of wild and domestic felids with Cytauxzoon sp. were recently described in European countries but clinical reports of the infection are rare and incomplete. This case report brings new interesting information on cytauxzoonosis expression in Europe. A 9-years-old castrated European shorthair cat living in rural area of north-eastern France (Saint Sauveur, Bourgogne-Franche-Comté region), without any travel history was presented for consultation due to hyperthermia, anorexia, depression and prolonged fever that didn't respond to antibiotic therapy. The cat had outdoor access with a history of vagrancy and was adequately vaccinated (core vaccines and FeLV vaccine). During biological investigations, intraerythrocytic inclusions were observed on blood smear and were further investigated by PCR analysis and sequencing. Molecular analyses confirmed Cytauxzoon sp. infection. The cat was treated with a subcutaneous injection of imidocarb dipropionate (3.5 mg/kg). One week after treatment, the cat improved clinically, although parasitic inclusions within erythrocytes persisted, and only a mild lymphocytosis was found. Two weeks after treatment, the cat appeared in excellent health, appetite was normal and parasitemia was negative. However, one month after treatment the cat relapsed with hyperthermia, anorexia, and depression. Blood smears and PCR were once again positive. Subsequently, the cat received an additional dose of imidocarb dipropionate (3.5 mg/kg SC) and recovered rapidly without other clinical signs. Two weeks after the second imidocarb injection, the cat was hit by a car and died. This case provides the first clinical description of infection by Cytauxzoon sp. in a domestic cat in France. These

  15. Clinical and microbiological characteristics of perianal infections in adult patients with acute leukemia.

    Science.gov (United States)

    Chen, Chien-Yuan; Cheng, Aristine; Huang, Shang-Yi; Sheng, Wang-Huei; Liu, Jia-Hau; Ko, Bo-Sheng; Yao, Ming; Chou, Wen-Chien; Lin, Hui-Chi; Chen, Yee-Chun; Tsay, Woei; Tang, Jih-Luh; Chang, Shan-Chwen; Tien, Hwei-Fang

    2013-01-01

    Perianal infection is a common problem for patients with acute leukemia. However, neutropenia and bleeding tendency are relatively contraindicated to surgical intervention. The epidemiology, microbiology, clinical manifestations and outcomes of perianal infection in leukemic patients are also rarely discussed. The medical records of 1102 adult patients with acute leukemia at a tertiary medical center in Taiwan between 2001 and 2010 were retrospectively reviewed and analyzed. The prevalence of perianal infection was 6.7% (74 of 1102) in adult patients with acute leukemia. Twenty-three (31%) of the 74 patients had recurrent episodes of perianal infections. Patients with acute myeloid leukemia had higher recurrent rates than acute lymphoblastic leukemia patients (p = 0.028). More than half (n = 61, 53%) of the perianal infections were caused by gram-negative bacilli, followed by gram-positive cocci (n = 36, 31%), anaerobes (n = 18, 15%) and Candida (n = 1, 1%) from pus culture. Eighteen patients experienced bacteremia (n = 24) or candidemia (n = 1). Overall 41 (68%) of 60 patients had polymicrobial infection. Escherichia coli (25%) was the most common micro-organism isolated, followed by Enterococcus species (22%), Klebsiella pneumoniae (13%), and Bacteroides species (11%). Twenty-five (34%) of 74 patients received surgical intervention. Acute leukemia patients with surgically managed anal fistulas tended to have fewer recurrences (p = 0.067). Four (5%) patients died within 30 days after diagnosis of perianal infection. Univariate analysis of 30-day survival revealed the elderly (≧ 65 years) (p = 0.015) and patients with shock (pleukemia. Empirical broad-spectrum antibiotics with anaerobic coverage should be considered. Shock independently predicted 30-day crude mortality. Surgical intervention for perianal infection remains challenging in patients with acute leukemia.

  16. Clinical features & risk factors associated with cryptosporidiosis in HIV infected adults in India.

    Science.gov (United States)

    Rao Ajjampur, S S; Asirvatham, J R; Muthusamy, Dheepa; Gladstone, B P; Abraham, O C M; Mathai, Dilip; Ward, Honorine; Wanke, Christine; Kang, Gagandeep

    2007-12-01

    Cryptosporidiosis is a leading cause of protracted, life threatening diarrhoea in HIV infected patients. Although data on prevalence are available for Indian patients, no information on risk factors for transmission exists. We therefore undertook this study to identify risk factors for transmission of cryptosporidiosis in HIV infected adults. Both symptomatic (diarrhoeal) and asymptomatic HIV infected patients were screened for cryptosporidiosis. All Cryptosporidium spp. positive cases were enrolled in the study and interviewed to record socio-demographic information, water supply and animal contact. Data were analysed to study clinical features and potential association with species and genotype. Of the 28 cryptosporidial infections identified on screening 111 HIV positive patients with diarrhoea, 10 (35.7%) had chronic diarrhoea, 14 (50%) had associated fever and 8 (28.6%) had nausea. Symptomatic patients had a significantly higher number of co-infections with other enteric parasites (P=0.04) than 20 asymptomatics of 423 HIV positive individuals screened. Eleven of 17 (64%) patients with potentially zoonotic infections had diarrhoea. Patients with zoonotic species (64%) also tended to have fever more frequently than those infected with C. hominis (58%). Association between area of residence, rural or urban, water source and contact with animals and acquisition of cryptosporidiosis was not statistically significant. Cryptosporidiosis is an important cause of morbidity in HIV infected individuals in India, resulting in chronic diarrhoea. Risk factors for potentially zoonotic transmission of cryptosporidiosis were described in this study, but larger studies need to be done for a clearer understanding of the transmission dynamics of different cryptosporidial species in developing countries.

  17. Herpes simplex and varicella zoster CNS infections: clinical presentations, treatments and outcomes.

    Science.gov (United States)

    Kaewpoowat, Quanhathai; Salazar, Lucrecia; Aguilera, Elizabeth; Wootton, Susan H; Hasbun, Rodrigo

    2016-06-01

    To describe the clinical manifestations, cerebrospinal fluid (CSF) characteristics, imaging studies and prognostic factors of adverse clinical outcomes (ACO) among adults with herpes simplex virus (HSV) or varicella zoster virus (VZV) CNS infections. Retrospective review of adult patients with positive HSV or VZV polymerase chain reaction on CSF from an observational study of meningitis or encephalitis in Houston, TX (2004-2014), and New Orleans, LA (1999-2008). Ninety-eight adults patients were identified; 25 had encephalitis [20 (20.4 %) HSV, 5 (5.1 %) VZV], and 73 had meningitis [60 (61.1 %) HSV and 13 (13.3 %) VZV]. HSV and VZV had similar presentations except for nausea (P 1 and an encephalitis presentation were independently associated with an ACO. The treatment for HSV meningitis was variable, and all patients had a good clinical outcome. Alpha herpes CNS infections due to HSV and VZV infections have similar clinical and laboratory manifestations. ACO was observed more frequently in those patients with comorbidities and an encephalitis presentation.

  18. Classification Models for Neurocognitive Impairment in HIV Infection Based on Demographic and Clinical Variables

    Science.gov (United States)

    Muñoz-Moreno, Jose A.; Pérez-Álvarez, Núria; Muñoz-Murillo, Amalia; Prats, Anna; Garolera, Maite; Jurado, M. Àngels; Fumaz, Carmina R.; Negredo, Eugènia; Ferrer, Maria J.; Clotet, Bonaventura

    2014-01-01

    Objective We used demographic and clinical data to design practical classification models for prediction of neurocognitive impairment (NCI) in people with HIV infection. Methods The study population comprised 331 HIV-infected patients with available demographic, clinical, and neurocognitive data collected using a comprehensive battery of neuropsychological tests. Classification and regression trees (CART) were developed to obtain detailed and reliable models to predict NCI. Following a practical clinical approach, NCI was considered the main variable for study outcomes, and analyses were performed separately in treatment-naïve and treatment-experienced patients. Results The study sample comprised 52 treatment-naïve and 279 experienced patients. In the first group, the variables identified as better predictors of NCI were CD4 cell count and age (correct classification [CC]: 79.6%, 3 final nodes). In treatment-experienced patients, the variables most closely related to NCI were years of education, nadir CD4 cell count, central nervous system penetration-effectiveness score, age, employment status, and confounding comorbidities (CC: 82.1%, 7 final nodes). In patients with an undetectable viral load and no comorbidities, we obtained a fairly accurate model in which the main variables were nadir CD4 cell count, current CD4 cell count, time on current treatment, and past highest viral load (CC: 88%, 6 final nodes). Conclusion Practical classification models to predict NCI in HIV infection can be obtained using demographic and clinical variables. An approach based on CART analyses may facilitate screening for HIV-associated neurocognitive disorders and complement clinical information about risk and protective factors for NCI in HIV-infected patients. PMID:25237895

  19. Complete Genome Sequences of Aerococcus christensenii CCUG 28831T, Aerococcus sanguinicola CCUG 43001T, Aerococcus urinae CCUG 36881T, Aerococcus urinaeequi CCUG 28094T, Aerococcus urinaehominis CCUG 42038 BT, and Aerococcus viridans CCUG 4311T

    DEFF Research Database (Denmark)

    Carkaci, Derya; Dargis, Rimtas; Nielsen, Xiaohui Chen

    2016-01-01

    Strains belonging to the genus Aerococcus are causative agents of human and animal infections, including urogenital infections, bacteremia/septicemia, and infective endocarditis. This study reports the first fully closed and complete genome sequences of six type strains belonging to the genus Aer...

  20. Antimicrobial therapies for odontogenic infections in children and adolescents. Literature review and clinical recomendations.

    Directory of Open Access Journals (Sweden)

    Inés Caviglia

    2014-03-01

    Full Text Available Oral infections are caused by an imbalance in the patient’s indigenous flora which changes from commensal to opportunistic. Odontogenic infections are the most common reason for consultation in children and adolescents. Rational use of antibiotics is the best strategy to avoid microbial resistance. Dental infections should first receive proper local treatment, which can also be complemented with a systemic method. Appropriate drug selection and dosing should be made. Amoxicilin is the first choice for antimicrobial agents in pediatric dentistry. Clindamycin and clarithromycin are the best alternative for patients with penicillin hypersensibility. In this literature review, the authors intended to establish clear clinical management guidelines for emergency treatment and subsequent final resolution.

  1. Helicobacter pylori infection: Clinical, Endoscopic and Pathological findings in Iranian children

    Directory of Open Access Journals (Sweden)

    Farzaneh Motamed

    2014-08-01

    Full Text Available Background: Helicobacter pylori (H.pylori infection has an important role in promoting gastrointestinal disease in human. It may be acquired early in life, particularly in developing countries. The aim of this study is to evaluate the association between H.pylori infection and clinical manifestations in Iranian children.Materials and Methods: In this retrospective, cross-sectional study, H. pylori status was assessed by pathological examination of gastric biopsy in symptomatic children. A total of 266 patients were diagnosed as infected by H. pylori, compared with 268 uninfected patients matched by age and sex. Reported symptoms, endoscopic and pathological findings in the two groups were analyzed using chi square test. The limit of statistical significance was set at P

  2. Clinical characteristics, microbiology, and outcomes of prosthetic joint infection in Taiwan.

    Science.gov (United States)

    Tsai, Jen-Chih; Sheng, Wang-Huei; Lo, Wan-Yu; Jiang, Ching-Chuan; Chang, Shan-Chwen

    2015-04-01

    Prosthetic joint infection (PJI) after total knee or hip replacement is a devastating complication associated with substantial morbidity and economic cost. The incidence of prosthetic joint infection is increasing as the use of mechanical joint replacement increases. The treatment approach to prosthetic joint infection is based on different clinical situations such as a patient's comorbidities, epidemic microbiology data, and surgical procedures. The aim of our study was to understand clinical characteristics of prosthetic joint infection, the microbiology of the prosthetic joint infection, and the outcomes of different treatment strategies during 2006-2011. We retrospectively collected cases of prosthetic joint infection in the National Taiwan University Hospital between January 1, 2006 and December 31, 2011. The patients' characteristics, microbiology, outcomes, and factors associated with treatment success were recorded. One hundred and forty-four patients were identified as having PJI. Of these, 92 patients were entered into per-protocol analysis. Staphylococcus aureus was the most common causative organism (29.9%), followed by coagulase-negative Staphylococci (16.7%), and Enterococci (9.7%). The overall treatment success rate was 50%. Patients who received a two-stage revision had a better outcome, compared to patients who underwent other types of surgeries (70% vs. 32.7%, respectively; p < 0.001). In multivariate analysis, the two-stage revision was significantly associated with treatment success (odds ratio = 3.923, 95% confidence interval = 1.53-10.04). Our study demonstrates that Staphylococcus aureus was the most common causative organisms in PJI. Performing two-stage revisions was significantly associated with a better outcome. Copyright © 2013. Published by Elsevier B.V.

  3. [Analysis on parasitic infection of clinical samples from hospitals in Shanghai during 2011-2013].

    Science.gov (United States)

    Chen, Shao-hong; Zhang, Yong-nian; Li, Hao; Cai, Yu-chun; Chen, Jia-xu

    2014-12-01

    To analyze the results of parasitic pathogen detection on clinical samples from Shanghai hospitals during 2011-2013. Samples of serum, stool, sputum, body fluid and biopsy were collected from hospitals. The etiological, serological and molecular biology methods were used to detect parasitic infection cases. During 2011-2013, a total of 16,151 clinical samples were collected. 855 parasitic infection were found from 5939 samples by pathogen detection, belonging to 32 species, with a detection rate of 14.4%. The positive rate of Blastocystis hominis and Entamoeba histolytica was 8.3% (494/5939) and 3.1% (186/5939), respectively. The rate of intestinal protozoa infection in under 20-year-old age group was higher than other age groups (P0.05). Totally 10,212 serum samples were examined, the total antibody-positive rate was 7.1% (730/10,212). In the 730 positive samples, 173 (23.7%), 143 (19.6%), 139 (19.0%), 132 (18.1%), and 128 (17.5%) showed positive for the antibodies against Cysticercus cellulosae, Schistosoma japonicum, Paragonimus westermani, Toxoplasma gondii and Sparganum mansoni, respectively. The main source regions of protozoal infection were Shanghai (269 cases), Jiangsu (142 cases), Anhui (106 cases) and Zhejiang (82 cases). 89 cases were worm infection, the main source were Zhejiang (24 cases), Shanghai (18 cases), Jiangxi (11 cases). Among the samples from hospitals, the major intestinal protozoans are Blastocystis hominis and Entamoeba histolytica, and the sero-positive cases are mainly Cysticercus cellulosae and Schistosoma japonicum infection.

  4. Eradication of Helicobacter pylori infection with a new bismuth-based quadruple therapy in clinical practice.

    Science.gov (United States)

    Pérez-Arellano, Elena; Rodriguez-Garcia, María Isabel; Galera Rodenas, Ana Belen; de la Morena-Madrigal, Emilio

    2017-10-17

    The eradication of Helicobacter pylori infection represents a clinical challenge. To evaluate the efficacy and safety of quadruple therapy with esomeprazole plus a 3-in-1 capsule containing bismuth subcitrate, metronidazole and tetracycline, plus probiotics in patients diagnosed with H. pylori infection in routine clinical practice. A prospective, interventional, single-centre and open-label study in consecutive patients with a confirmed indication for eradication of H. pylori infection. Patients were treated with three capsules of Pylera(®) four times a day (breakfast, lunch, afternoon snack and dinner), plus 40mg of esomeprazole twice daily for 10 days (30min before breakfast and dinner) and probiotics for 30 days. Eradication of H. pylori infection was confirmed by labelled urea breath test performed at least 28 days after the end of treatment. A total of 100 patients were consecutively enrolled. Twenty-five patients (25.0%) had a prior history of treatment for their H. pylori infection. In the intention-to-treat population, eradication rates were 90.7% (68/75) and 80.0% (20/25) in patients treated with Pylera(®) as the first line or as rescue therapy, respectively. Eighteen patients (18%) had at least one adverse event, most of which (89%) were mild. Ten days of treatment with a quadruple regimen of bismuth, metronidazole and tetracycline plus esomeprazole and probiotics is an effective and safe strategy in patients with H. pylori infection. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  5. High prevalence of rectal gonorrhea and Chlamydia infection in women attending a sexually transmitted disease clinic.

    Science.gov (United States)

    Bazan, Jose A; Carr Reese, Patricia; Esber, Allahna; Lahey, Samantha; Ervin, Melissa; Davis, John A; Fields, Karen; Turner, Abigail Norris

    2015-03-01

    Testing women for urogenital Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) is common in sexually transmitted disease (STD) clinics. However, women may not be routinely tested for rectal GC/CT. This may lead to missed infections in women reporting anal intercourse (AI). This was a retrospective review of all women who underwent rectal GC/CT testing from August 2012 to June 2013 at an STD clinic in Columbus, Ohio. All women who reported AI in the last year had a rectal swab collected for GC/CT nucleic acid amplification testing (n=331). Using log-binomial regression models, we computed unadjusted and adjusted associations for demographic and behavioral factors associated with rectal GC/CT infection. Participants (n=331) were 47% African-American, with median age of 29 years. Prevalence of rectal GC was 6%, rectal CT was 13%, and either rectal infection was 19%. Prevalence of urogenital GC and CT was 7% and 13% respectively. Among women with rectal GC, 14% tested negative for urogenital GC. Similarly, 14% of women with rectal CT tested negative for urogenital CT. In unadjusted analyses, there was increased rectal GC prevalence among women reporting sex in the last year with an injection drug user, with a person exchanging sex for drugs or money, with anonymous partners, and while intoxicated/high on alcohol or illicit drugs. After multivariable adjustment, no significant associations persisted, but a trend of increased rectal GC prevalence was observed for women women who reported AI in the last year had rectal GC or CT infection. Urogenital testing alone would have missed 14% of rectal infections. Standardized guidelines would increase rectal GC/CT testing in women and help detect missed infections.

  6. Clinical manifestations of a cluster of rotavirus infection in young infants hospitalized in neonatal care units.

    Science.gov (United States)

    Tai, I-Chen; Huang, Yhu-Chering; Lien, Rey-In; Huang, Chung-Guei; Tsao, Kuo-Chien; Lin, Tzou-Yien

    2012-02-01

    To define the clinical manifestations of rotavirus (RV) infection in neonates and young infants hospitalized in neonatal care units, which are rarely reported. From October 2008 to September 2010, a total of 153 stool specimens positive for RV were detected from 100 neonates and young infants hospitalized in neonatal care units of our hospital. Four infants had two episodes of RV infection. Demographics and clinical presentations of these infants were collected and analyzed. The infants were further classified as having hospital-acquired (HA) or community-acquired (CA) RV infection. Of the 104 episodes from 100 patients, 76 (73%) were classified as HA. Fifty-six infants were male. The mean age of onset was 2 days. The most common presentations were loose stool passages (52.9%), abdominal distension (51.9%), blood or mucus in stool (42.3%), and unstable vital signs (32.7%). Watery character in stool passage was identified in 13.5% of the infants and vomiting in 21.2%. A picture suggestive of necrotizing enterocolitis (NEC) was identified in 22 episodes (21.1%), and 12 of these were stage II or above. The average number of hospitalization days from the onset of HA-RV infection was 23 days. Compared with those in the CA group, the infants in the HA group had a significantly higher rate of blood or mucus in stools (52.6% vs. 14.3%, p fever (13.8% vs. 42.9%, p fever with watery diarrhea, are commonly seen in neonates and young infants with RV infection. A substantial proportion of these infants may present as NEC. Once introduced, RV appears to become a troublesome problem of HA infections in neonatal care settings. Copyright © 2011. Published by Elsevier B.V.

  7. About features clinical acute Epstein-Barr virus infection in children syndrome undifferentiated Connective tissue dysplasia

    Directory of Open Access Journals (Sweden)

    S. N. Orlova

    2011-01-01

    Full Text Available The aim of the study was to investigate the clinical course of acute Epstein-Barr virus infection in children with the syndrome undifferentiated connective tissue dysplasia. We examined 127 patients aged 6 months to 15 years acute Epstein-Barr virus infection. The study was an open-controlled, parallel-group. Syndrome undifferentiated connective tissue dysplasia verified in 69% of children: mild dysplasia of the connective tissue is installed in 46 patients (36.2%, moderate – in 41 children (32.3%, severe degree is not diagnosed. A total of 40 (31.5% of children surveyed had no phenotypic features of connective tissue dysplasia. The peculiarities of the clinical course of acute Epstein-Barr virus infection in patients with undifferentiated connective tissue dysplasia include an increase severity of infection by increasing the duration of fever, severity and persistence polylimphoadenopathii, frequent development of parenchymal Epstein-Barr virus associated hepatitis. Active proliferation of virus-infected Epstein-Barr virus lymphocytes occurs in all organs, with lymphoid tissue and is accompanied by infiltration and histologic changes in lymph nodes, liver, spleen, etc. In combination with the weakness of connective tissue structures that causes the symptoms of acute polymorphic Epstein-Barr virus infection and nature of the complications. We examined patients revealed changes in the indicators of collagen metabolism, indicating their partial degradation. The severity of these changes varies depending on the severity of the syndrome of connective tissue dysplasia and paired with the severity of virus-infected Epstein-Barr. When verification of the second degree of connective tissue dysplasia in patients with acute Epstein-Barr virus infection with high probability we can predict the development of severe infection that occurs in liver in the form of the Epstein-Barr virusassociated hepatitis. 

  8. Nosocomial infections: knowledge and source of information among clinical health care students in Ghana

    Directory of Open Access Journals (Sweden)

    Bello AI

    2011-08-01

    Full Text Available Ajediran I Bello1, Eunice N Asiedu1, Babatunde OA Adegoke2, Jonathan NA Quartey1, Kwadwo O Appiah-Kubi1, Bertha Owusu-Ansah11Department of Physiotherapy, School of Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana; 2Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, NigeriaBackground: This study determined and compared the knowledge of nosocomial infections among clinical health care students at the College of Health Sciences, University of Ghana.Methods: Two hundred undergraduate health care students from four academic programs participated in the study. The study sample was drawn from each academic program by a simple random sampling technique using the class directory from each course. The Infection Control Standardized Questionnaire (ICSQ was used to assess the knowledge of students about three main domains, ie, hand hygiene, nosocomial infections, and standard precautions. A maximum score of 50 was obtainable, and respondents with scores ≥70% were classified as having a satisfactory knowledge. The response on each item was coded numerically to generate data for statistical analysis. Comparison of knowledge on the domains among categories of students was assessed using the Kruskal–Wallis test, while associations between courses of study and knowledge about nosocomial infections were determined using the Chi-square test. All statistical tests had a significant level of 5% (P < 0.05Results: Overall mean percentage score of the participants on ICSQ was 65.4 ± 2.58, with medical, physiotherapy, radiography, and nursing students recording mean percentage scores of 70.58 ± 0.62, 65.02 ± 2.00, 64.74 ± 1.19, and 61.31 ± 2.35, respectively. The main source of information about the prevention of nosocomial infections as cited by participants was their routine formal training in class. There was no significant association (P > 0.05 between course of study and knowledge of

  9. Amebiasis in HIV-1-infected Japanese men: clinical features and response to therapy.

    Directory of Open Access Journals (Sweden)

    Koji Watanabe

    2011-09-01

    Full Text Available Invasive amebic diseases caused by Entamoeba histolytica are increasing among men who have sex with men and co-infection of ameba and HIV-1 is an emerging problem in developed East Asian countries. To characterize the clinical and epidemiological features of invasive amebiasis in HIV-1 patients, the medical records of 170 co-infected cases were analyzed retrospectively, and E. histolytica genotype was assayed in 14 cases. In this series of HIV-1-infected patients, clinical presentation of invasive amebiasis was similar to that described in the normal host. High fever, leukocytosis and high CRP were associated with extraluminal amebic diseases. Two cases died from amebic colitis (resulting in intestinal perforation in one and gastrointestinal bleeding in one, and three cases died from causes unrelated to amebiasis. Treatment with metronidazole or tinidazole was successful in the other 165 cases. Luminal treatment was provided to 83 patients following metronidazole or tinidazole treatment. However, amebiasis recurred in 6 of these, a frequency similar to that seen in patients who did not receive luminal treatment. Recurrence was more frequent in HCV-antibody positive individuals and those who acquired syphilis during the follow-up period. Various genotypes of E. histolytica were identified in 14 patients but there was no correlation between genotype and clinical features. The outcome of metronidazole and tinidazole treatment of uncomplicated amebiasis was excellent even in HIV-1-infected individuals. Luminal treatment following metronidazole or tinidazole treatment does not reduce recurrence of amebiasis in high risk populations probably due to amebic re-infection.

  10. The quest for anti-inflammatory and anti-infective biomaterials in clinical translation

    Directory of Open Access Journals (Sweden)

    May Griffith

    2016-09-01

    Full Text Available Biomaterials are now being used or evaluated clinically as implants to supplement the severe shortage of available human donor organs. To date however, such implants have mainly been developed as scaffolds to promote the regeneration of failing organs due to old age or congenital malformations. In the real world, however, infection or immunological issues often compromise patients. For example, bacterial and viral infections can result in uncontrolled immunopathological damage and lead to organ failure. Hence, there is a need for biomaterials and implants that not only promote regeneration but also address issues that are specific to compromised patients such as infection and inflammation. Different strategies are needed to address the regeneration of organs that have been damaged by infection or inflammation for successful clinical translation. Therefore, the real quest is for multi-functional biomaterials with combined properties that can combat infections, modulate inflammation and promote regeneration at the same time. These strategies will necessitate the inclusion of methodologies for management of the cellular and signaling components elicited within the local microenvironment. In the development of such biomaterials, strategies range from the inclusion of materials that have intrinsic anti-inflammatory properties, such as the synthetic lipid polymer, 2-methacryloyloxyethyl phosphorylcholine (MPC, to silver nanoparticles that have anti-bacterial properties, to inclusion of nano- and micro-particles in biomaterials composites that deliver active drugs. In this present review, we present examples of both kinds of materials in each group along with their pros and cons. Thus, as a promising next generation strategy to aid or replace tissue/organ transplantation, an integrated smart programmable platform is needed for regenerative medicine applications to create and/or restore normal function at the cell and tissue levels. Therefore, now it is

  11. Mycoplasma genitalium is associated with cervicitis and HIV infection in an urban Australian STI clinic population.

    Science.gov (United States)

    Lusk, M J; Konecny, P; Naing, Z W; Garden, F L; Cumming, R G; Rawlinson, W D

    2011-03-01

    To investigate the prevalence of the genital mollicutes, Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP), and their associations with cervicitis in a sexually transmitted infection (STI) clinic population. Clinical correlates of MG infection were also assessed. 527 women were enrolled in a cross-sectional study at two STI clinics in Sydney between June 2006 and January 2010. Genital mollicutes were detected by multiplex PCR testing of cervical swabs, and associations with cervicitis were analysed. Cervicitis was defined as >30 polymorphonuclear cells per high-power field in at least three non-adjacent fields of cervical mucus on Gram stain. MG was found in 4.0% of women, MH in 17.1%, UU in 14.1%, and UP in 51.8%. MG was the only mollicute associated with cervicitis (unadjusted prevalence ratio (PR) 1.85, 95% CI 1.52 to 2.26, p<0.0001), and this association remained after adjustment for Chlamydia trachomatis (CT) infection (adjusted PR 1.24 (95% CI 1.04 to 1.48), p=0.02). MG was significantly associated with women being HIV positive (p=0.03), but not with age, vaginal discharge, commercial sex work, being of culturally and linguistically diverse background, or concurrent CT infection. Two of the 21 women with MG had ectopic pregnancies. The authors recommend wider application of PCR testing for MG in STI services, particularly in high-risk women and those with cervicitis or HIV infection.

  12. Cultures of diabetic foot ulcers without clinical signs of infection do not predict outcomes.

    Science.gov (United States)

    Gardner, Sue E; Haleem, Ambar; Jao, Ying-Ling; Hillis, Stephen L; Femino, John E; Phisitkul, Phinit; Heilmann, Kristopher P; Lehman, Shannon M; Franciscus, Carrie L

    2014-10-01

    We examined associations between ulcer bioburden and ulcer outcomes in neuropathic diabetic foot ulcers (DFUs) that lacked clinical signs of infection. Three dimensions of bioburden (i.e., microbial load, microbial diversity, and the presence of likely pathogens) were measured at baseline using swab cultures obtained by Levine's technique. Subjects were assessed every 2 weeks for 26 weeks to determine the rate of healing and development of infection-related complications. Foot ulcers were off-loaded using total-contact casts and routinely debrided. To establish associations between bioburden and rate of healing, Cox proportional hazards and least squares regression were used after adjusting for ulcer depth, surface area, and duration. A total of 77 subjects completed the study. Sixty-five (84.4%) had ulcers that healed during follow-up; weeks-to-closure ranged from 2 to 26 (median 4.0). Mean (± SD) percent reduction in surface area/week was 25.0% (± 23.33). Five (6.5%) of the DFUs developed an infection-related complication. None of the bioburden dimensions (i.e., microbial load, microbial diversity, or presence of likely pathogens) was significantly associated with weeks-to-closure or percent reduction in surface area per week. Weeks-to-closure was best predicted by ulcer duration, depth, and surface area (c-statistic = 0.75). Culturing DFUs that showed no clinical signs of infection had no predictive value for outcomes of DFUs managed with total-contact casts and routine debridement. These findings support recommendations of the Infectious Disease Society of America that culturing and antibiotics should be avoided in treating DFUs that show no clinical signs of infection. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  13. Excretion of (3H)prednisolone in clinically normal and experimentally infected bovine udders

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    Geleta, J.N.; Shimoda, W.; Mercer, H.D.

    1984-08-01

    The excretion rate of (3H)prednisolone from clinically normal and experimentally infected udders of 10 lactating cows was studied. Each quarter of 6 cows was injected with a single dose of (3H)prednisolone mixed with non-radioactive prednisolone equivalent to 10 mg in 10 ml of peanut oil base. Each of the remaining 4 cows was given 40 mg of nonradioactive prednisolone and (3H)prednisolone in 60% ethanol IV. Control and postadministration samples of blood, milk, and urine were examined for radioactivity. The effects of (3H)prednisolone were evaluated in the same cows, first in clinically normal udders, then 2 weeks later in udders experimentally infected with Streptococcus agalactiae. Absorption and elimination of prednisolone were the same before and after induced infection. Within 3 hours after intramammary injection, 95% of the labeled prednisolone was absorbed systemically, less than 5% of this dose was recovered in milk, and 29% was excreted in urine. After IV injection of (3H)prednisolone, less than 0.2% of the total radioactivity was recovered in milk and less than 46% was excreted in urine. Clinical mastitis induced by S agalactiae was moderate. Circulating blood leukocytes and somatic cells in the milk of normal cows remained essentially unchanged. The leukocyte response to induced infection was rapid in blood and milk. Large numbers of leukocytes were noticed in the milk and a severe leukopenia occurred. Prednisolone treatment did not alter the number of somatic cells in milk or reduce the inflammatory response of experimentally infected cows.

  14. Excretion of [3H]prednisolone in clinically normal and experimentally infected bovine udders.

    Science.gov (United States)

    Geleta, J N; Shimoda, W; Mercer, H D

    1984-08-01

    The excretion rate of [3H]prednisolone from clinically normal and experimentally infected udders of 10 lactating cows was studied. Each quarter of 6 cows was injected with a single dose of [3H]prednisolone mixed with non-radioactive prednisolone equivalent to 10 mg in 10 ml of peanut oil base. Each of the remaining 4 cows was given 40 mg of nonradioactive prednisolone and [3H]prednisolone in 60% ethanol IV. Control and postadministration samples of blood, milk, and urine were examined for radioactivity. The effects of [3H]prednisolone were evaluated in the same cows, first in clinically normal udders, then 2 weeks later in udders experimentally infected with Streptococcus agalactiae. Absorption and elimination of prednisolone were the same before and after induced infection. Within 3 hours after intramammary injection, 95% of the labeled prednisolone was absorbed systemically, less than 5% of this dose was recovered in milk, and 29% was excreted in urine. After IV injection of [3H]prednisolone, less than 0.2% of the total radioactivity was recovered in milk and less than 46% was excreted in urine. Clinical mastitis induced by S agalactiae was moderate. Circulating blood leukocytes and somatic cells in the milk of normal cows remained essentially unchanged. The leukocyte response to induced infection was rapid in blood and milk. Large numbers of leukocytes were noticed in the milk and a severe leukopenia occurred. Prednisolone treatment did not alter the number of somatic cells in milk or reduce the inflammatory response of experimentally infected cows.

  15. Clinical analysis of bloodstream infections caused by Escherichia coli in elderly patients with hepatobiliary disease

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    WANG Qian

    2015-05-01

    Full Text Available ObjectiveTo investigate the clinical characteristics and drug resistance in elderly patients with hepatobiliary disease and bloodstream infections caused by Escherichia coli, and to provide a basis for clinical therapy. MethodsA retrospective analysis was performed on the clinical characteristics and drug susceptibility of 57 elderly inpatients with hepatobiliary disease and bloodstream infections caused by Escherichia coli in our hospital from 2009 to 2012. Comparison of continuous data between the two groups was made by t test, and comparison of categorical data was made by chi-square test. ResultsThe majority of patients had liver cirrhosis, and spontaneous bacterial peritonitis was the major infection source. A total of 57 strains of Escherichia coli were isolated from elderly patients with hepatobiliary disease, and 24 (421% out of them were positive for extended-spectrum β-lactamase (ESBL. ESBL-positive strains had a significantly higher level of drug resistance than ESBL-negative strains (P<0.05, except for imipenem/cilastatin, meropenem, cefoperazone/sulbactum, ticarcillin/clavulanate, and minocycline. However, there were no significant differences in age, gender, basic disease, infection source, peak body temperature, white blood cell count, and the percentage of neutrophils between the ESBL-positive group and the ESBL-negative group (P>0.05. The case-fatality rate in patients with septic shock, hepatic encephalopathy, or acute kidney injury was significantly higher than that in patients with no complications (χ2=9541,7622,9733,respectively, P<0.05. ConclusionElderly patients with hepatobiliary disease and bloodstream infections caused by ESBL-positive Escherichia coli had a high level of drug resistance and a poor prognosis for severe complications. Antibiotic therapy combined with prevention and control of severe complications should be taken as early as possible to reduce the case-fatality rate.

  16. Are there clinical variables determining antibiotic prophylaxis-susceptible versus resistant infection in open fractures?

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    Gonzalez, Amanda; Suvà, Domizio; Dunkel, Nathalie; Nicodème, Jean-Damien; Lomessy, Antoine; Lauper, Nicolas; Rohner, Peter; Hoffmeyer, Pierre; Uçkay, Ilker

    2014-11-01

    In Gustilo grade III open fractures, it remains unknown which demographic or clinical features may be associated with an infection resistant to the administered prophylactic agent, compared to one that is susceptible. This was a retrospective case-control study on patients hospitalized from 2004 to 2009. We identified 310 patients with Gustilo-III open fractures, 36 (12%) of which became infected after a median of ten days. In 26 (72%) of the episodes the pathogen was susceptible to the prophylactic antibiotic agent prescribed upon admission, while in the other ten it was resistant. All antibiotic prophylaxis was intravenous; the median duration of treatment was three days and the median delay between trauma and surgery was one day. In multivariate analysis adjusting for case-mix, only Gustilo-grade-IIIc fractures (vascular lesions) showed tendency to be infected with resistant pathogens (odds ratio 10; 95% confidence interval 1.0-10; p = 0.058). There were no significant differences between cases caused by antibiotic resistant and susceptible pathogen cases in patient's sex, presence of immune suppression, duration and choice of antibiotic prophylaxis, choice of surgical technique or materials, time delay until surgery, use of bone reaming, fracture localization, or presence of compartment syndrome. We were unable to identify any specific clinical parameters associated with infection with antibiotic resistant pathogens in Gustilo-grade III open fractures, other than the severity of the fracture itself. More research is needed to identify patients who might benefit from a broader-spectrum antibiotic prophylaxis.

  17. Respiratory viruses in transplant recipients: more than just a cold. Clinical syndromes and infection prevention principles.

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    Abbas, Salma; Raybould, Jillian E; Sastry, Sangeeta; de la Cruz, Oveimar

    2017-09-01

    The aim of this review is to provide updated information on the clinical spectrum, treatment options, and infection prevention strategies for respiratory viral infections (RVIs) in both solid organ (SOT) and hematopoietic stem cell transplant (HSCT) patients. The MEDLINE and PubMed databases were searched for literature regarding the aforementioned aspects of RVIs, with focus on respiratory syncytial virus, adenovirus, influenza virus, parainfluenza virus, human metapneumovirus, and rhinovirus. Compared to immunocompetent hosts, SOT and HSCT patients are much more likely to experience a prolonged duration of illness, prolonged shedding, and progression of upper respiratory tract disease to pneumonia when infected with respiratory viruses. Adenovirus and respiratory syncytial virus tend to have the highest mortality and risk for disseminated disease, but all the RVIs are associated with higher morbidity and mortality in these patients than in the general population. These viruses are spread via direct contact and aerosolized droplets, and nosocomial spread has been reported. RVIs are associated with high morbidity and mortality among SOT and HSCT recipients. Management options are currently limited or lack strong clinical evidence. As community and nosocomial spread has been reported for all reviewed RVIs, strict adherence to infection control measures is key to preventing outbreaks. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  18. Clinical and Pathophysiological Overview of Acinetobacter Infections: a Century of Challenges.

    Science.gov (United States)

    Wong, Darren; Nielsen, Travis B; Bonomo, Robert A; Pantapalangkoor, Paul; Luna, Brian; Spellberg, Brad

    2017-01-01

    SUMMARYAcinetobacter is a complex genus, and historically, there has been confusion about the existence of multiple species. The species commonly cause nosocomial infections, predominantly aspiration pneumonia and catheter-associated bacteremia, but can also cause soft tissue and urinary tract infections. Community-acquired infections by Acinetobacter spp. are increasingly reported. Transmission of Acinetobacter and subsequent disease is facilitated by the organism's environmental tenacity, resistance to desiccation, and evasion of host immunity. The virulence properties demonstrated by Acinetobacter spp. primarily stem from evasion of rapid clearance by the innate immune system, effectively enabling high bacterial density that triggers lipopolysaccharide (LPS)-Toll-like receptor 4 (TLR4)-mediated sepsis. Capsular polysaccharide is a critical virulence factor that enables immune evasion, while LPS triggers septic shock. However, the primary driver of clinical outcome is antibiotic resistance. Administration of initially effective therapy is key to improving survival, reducing 30-day mortality threefold. Regrettably, due to the high frequency of this organism having an extreme drug resistance (XDR) phenotype, early initiation of effective therapy is a major clinical challenge. Given its high rate of antibiotic resistance and abysmal outcomes (up to 70% mortality rate from infections caused by XDR strains in some case series), new preventative and therapeutic options for Acinetobacter spp. are desperately needed. Copyright © 2016 American Society for Microbiology.

  19. [Subtype analysis and clinical significance of HPV infection in laryngeal squamous cell carcinoma and precancerous lesions].

    Science.gov (United States)

    Guan, Linlin; Sun, Na; Sun, Guangbin; Fang, Qin; Meng, Yang; Zhao, Xiaoyan; Meng, Lingchao

    2015-09-01

    To investigate the correlation of laryngeal squamous cell carcinoma (LSCC) and precancerous lesion with HPV infection subtypes and possible clinical relationship. Eighty-three cases in paraffin embedded tissues were detected with thirty seven HPV subtypes by flow-through hybridization and gene chip (HybriMax), including 31 cases of laryngeal squamous cell carcinoma, 52 cases of precancerous lesions (29 cases of vocal cord leukoplakia and 23 cases of laryngeal papilloma), and 36 cases of vocal cord polyp as normal vocal mucosa were used as control. The total positive rate of HPV was 19.4% in the group of laryngeal squamous cell carcinoma (6/31), 0 in vocal cord leukoplakia, 65.2% in laryngeal papilloma (15/23), and the control group were all negative, HPV virus subtype of HPV-positive laryngeal squamous cell carcinoma were all high-risk HPV16; and there were 6 HPV virus subtypes in laryngeal papilloma (8: HPV6,4: HPV52, 1: HPV11, 1: HPV18, 2: HPV45, 3: HPV16), individual mixing two or more subtypes infection. HPV infection of laryngeal squamous cell carcinoma and precancerous lesions has no statistically significant difference according to gender, high low-risk subtypes. HPV infection related to laryngeal squamous cell carcinoma and precancerous lesions, but no significant correlation with the subtype distribution of high and low risk; HPV detection is making positive sense to clinical diagnosis of laryngeal carcinoma and precancerous lesions as well as the development of specific HPV subtype vaccine.

  20. The challenge of Clostridium difficile infection: Overview of clinical manifestations, diagnostic tools and therapeutic options.

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    Postma, Nynke; Kiers, Dorien; Pickkers, Peter

    2015-12-01

    The most important infectious cause of antibiotic-associated diarrhoea and colitis is Clostridium difficile, which is a Gram-positive, anaerobic, spore-forming, toxin-producing bacillus. In this overview we will discuss the diagnostic and therapeutic management of patients presenting with suspected or proven C. difficile infection (CDI). The clinical spectrum varies from asymptomatic C. difficile carriers to fulminant colitis with multi-organ failure. The onset of symptoms is usually within 2 weeks after initiation of antibiotic treatment. Diagnosis is based on the combination of clinical symptoms and either a positive stool test for C. difficile toxins or endoscopic or histological findings of pseudomembranous colitis. There is no indication for treatment of asymptomatic carriers, but patients with proven CDI should be treated. Treatment consists of cessation of the provoking antibiotic treatment, secondary prevention by infection control strategies, and treatment with metronidazole or vancomycin. Treatment of recurring CDI, severe infection, the need for surgery, and novel alternative potential treatment strategies will be discussed. The concurrent increase in multiresistant colonisation and increasing numbers of asymptomatic carriers of C. difficile will lead to an increase of the situation in which patients with severe infections, treated with broad-spectrum antibiotics, will develop concurrent severe CDI. We will discuss possible therapy strategies for these patients. Copyright © 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  1. Severe acute disseminated encephalomyelitis with clinical findings of transverse myelitis after herpes simplex virus infection.

    Science.gov (United States)

    Sarioglu, Berrak; Kose, Seda Sirin; Saritas, Serdar; Kose, Engin; Kanik, Ali; Helvaci, Mehmet

    2014-11-01

    ADEM is a central nervous disease that leads to myelin damage as a result of autoimmune response that develops after infections or vaccination. Herpes Simplex Virus (HSV) infection rarely leads to ADEM. 25-month-old male due to urinary retention, paradoxical respiration and muscle weakness after herpetic gingivostomatitis diagnosed as transverse myelitis. In follow-up with cranial and spinal magnetic resonance imaging multiple lesions were demonstrated. Electroneuromyography findings were compatible with acute sensorimotor neuropathy, serum anti-GM2 antibodies and Herpes Simplex Virus (HSV) Type 1/2 IgM / IgG detected negative and positivite, respectively. With these findings he was diagnosed acute disseminated encephalomyelitis (ADEM) following HSV infection. Although acyclovir, intravenous immunoglobulin, methylprednisolone and plasmapheresis therapies, he is still in intensive physical therapy program with heavy sequel. In our case, ADEM demonstrated transverse myelitis clinic after HSV infection which is rarely seen in literature. As well as clinic and spinal imaging findings, cranial imaging findings helped establishment of ADEM diagnosis. To our best knowledge, HSV is a rare etiological and probably the poor prognostic factor of ADEM. © The Author(s) 2014.

  2. Primary vs. Secondary Antibody Deficiency: Clinical Features and Infection Outcomes of Immunoglobulin Replacement

    Science.gov (United States)

    Duraisingham, Sai S.; Buckland, Matthew; Dempster, John; Lorenzo, Lorena; Grigoriadou, Sofia; Longhurst, Hilary J.

    2014-01-01

    Secondary antibody deficiency can occur as a result of haematological malignancies or certain medications, but not much is known about the clinical and immunological features of this group of patients as a whole. Here we describe a cohort of 167 patients with primary or secondary antibody deficiencies on immunoglobulin (Ig)-replacement treatment. The demographics, causes of immunodeficiency, diagnostic delay, clinical and laboratory features, and infection frequency were analysed retrospectively. Chemotherapy for B cell lymphoma and the use of Rituximab, corticosteroids or immunosuppressive medications were the most common causes of secondary antibody deficiency in this cohort. There was no difference in diagnostic delay or bronchiectasis between primary and secondary antibody deficiency patients, and both groups experienced disorders associated with immune dysregulation. Secondary antibody deficiency patients had similar baseline levels of serum IgG, but higher IgM and IgA, and a higher frequency of switched memory B cells than primary antibody deficiency patients. Serious and non-serious infections before and after Ig-replacement were also compared in both groups. Although secondary antibody deficiency patients had more serious infections before initiation of Ig-replacement, treatment resulted in a significant reduction of serious and non-serious infections in both primary and secondary antibody deficiency patients. Patients with secondary antibody deficiency experience similar delays in diagnosis as primary antibody deficiency patients and can also benefit from immunoglobulin-replacement treatment. PMID:24971644

  3. Erythema elevatum diutinum as a first clinical manifestation for diagnosing HIV infection: case history

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    Patrícia Accioni Rover

    Full Text Available CONTEXT: Erythema elevatum diutinum is a chronic and rare dermatosis that is considered to be a variant of leukocytoclastic vasculitis. It is probably mediated by immune complexes. It is generally associated with autoimmune, neoplastic and infectious processes. Recently, it has been added to the group of specific dermatoses that are associated with HIV. CASE REPORT: We report on the case of a patient who had erythema elevatum diutinum as the first clinical evidence for diagnosing HIV infection. Dapsone was used in the treatment of this patient, and partial regression of the lesions was achieved within 15 days, even before antiretroviral therapy was prescribed. CONCLUSION: When there is a diagnosis of erythema elevatum diutinum, HIV infection should be investigated, especially in atypical and exacerbated clinical manifestations.

  4. Infection of mice, ferrets, and rhesus macaques with a clinical mumps virus isolate.

    Science.gov (United States)

    Xu, Pei; Huang, Zhixiang; Gao, Xiudan; Michel, Frank J; Hirsch, Gwen; Hogan, Robert J; Sakamoto, Kaori; Ho, Wenzhe; Wu, Jianguo; He, Biao

    2013-07-01

    In recent years, many mumps outbreaks have occurred in vaccinated populations worldwide. The reasons for these outbreaks are not clear. Animal models are needed to investigate the causes of outbreaks and to understand the pathogenesis of mumps virus (MuV). In this study, we have examined the infection of three animal models with an isolate of mumps virus from a recent outbreak (MuV-IA). We have found that while both ferrets and mice generated humoral and cellular immune responses to MuV-IA infection, no obvious signs of illness were observed in these animals; rhesus macaques were the most susceptible to MuV-IA infection. Infection of rhesus macaques via both intranasal and intratracheal routes with MuV-IA led to the typical clinical signs of mumps 2 weeks to 4 weeks postinfection. However, none of the infected macaques showed any fever or neurologic signs during the experimental period. Mumps viral antigen was detected in parotid glands by immunohistochemistry (IHC). Rhesus macaques represent the best animal model for the study of mumps virus pathogenesis.

  5. Clinical and pathological findings of concurrent poxvirus lesions and aspergillosis infection in canaries.

    Science.gov (United States)

    Reza, Kheirandish; Nasrin, Askari; Mahmoud, Salehi

    2013-03-01

    To investigate clinical, pathological and mycological findings in canaries, in which pox lesions and Aspergillus fumigatus (A. fumigatus) infection were observed simultaneously. This study was performed on a breeding colony (about 100 canaries) affected by fatal wasting disease. Necropsy was undertaken on 10 severely affected canaries, and gross lesions were recorded. Samples from internal organs displaying lesions were obtained for histopathological evaluation. Tracheal swap samples of internal organs of the all infected animals with lesions at necropsy were cultured in Sabouraud Dextrose Agar for mycological examination. At necropsy, caseous foci were determined in the lungs, on the air sacs, liver, spleen, heart. Swelling of the eyelids, diffuse hemorrhages in the subcutaneous tissue with small papular lesions of the skin were other typical necropsy findings. Histopathologically, pathognomonic eosinophilic intracytoplasmic inclusion bodies, which called Bollinger bodies, in both skin cells and vacuolated air way epithelial cells confirmed canary pox infection. Moreover, histopathological examination of the white-yellowish caseous foci revealed necrotic granulomatous reaction consisting of macrophages, heterophil leukocytes and giant cells encapsulated with a fibrous tissue. After the culture of the tissue samples, the formation of bluish green colonies confirmed A. fumigatus infection. Canary pox has been known as the disease that can result in high losses in a short time, as a re-emerging disease that has not been present during recent years in canary flocks in Iran. So, the current paper provides useful information to prevent misdiagnosed of canary pox disease which can cause secondary mycotic infection.

  6. Clinical significance of infection with cag A and vac A positive helicobacter pylori strains

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    Sokić-Milutinović Aleksandra

    2004-01-01

    Full Text Available Clinical relevance of infection with different Helicobacter pylori strains was reviewed in this paper. Helicobacter pylori (H. pylori infection plays a role in pathogenesis of chronic gastritis, peptic ulcer disease, gastric adenocarcinoma and MALT lymphoma. Extragastric manifestations of H. pylori infection most probably include acne rosacea and chronic urticaria, while the importance of H. pylori infection for pathogenesis of growth retardation in children, iron deficiency anemia, coronary heart disease, stroke and idiopathic thrombocytopenic purpura remains vague. The expression of two H. pylori proteins, cytotoxin associated protein (cag A and vacuolization cytotoxin (vac A is considered to be related with pathogenicity of the bacterium. It is clear that presence of cag A+ strains is important for development of peptic ulcer; nevertheless, it is also protective against esophageal reflux disease. On the other hand, cag A+ strains are common in gastric adenocarcinoma and MALT lymphoma patients, but it seems that certain subtypes of vac A cytotoxin are more important risk factors. Infection with cag A+ strains is more common in patients with acne rosacea, stroke and coronary heart disease.

  7. Usefulness of clinical data and rapid diagnostic tests to identify bacterial etiology in adult respiratory infections

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    Pilar Toledano-Sierra

    2015-01-01

    Full Text Available Respiratory tract infections are a common complaint and most of them, such as common cold and laryngitis, are viral in origin, so antibiotic use should be exceptional. However, there are other respiratory tract infections (sinusitis, pharyngitis, lower respiratory tract infections, and exacerbations of chronic obstructive pulmonary disease where a bacterial etiology is responsible for a non-negligible percentage, and antibiotics are often empirically indicated. The aim of the study is to identify the strength of the data obtained from the symptoms, physical examination and rapid diagnostic methods in respiratory infections in which antibiotic use is frequently proposed in order to improve diagnosis and influence the decision to prescribe these drugs. The review concludes that history, physical examination and rapid tests are useful to guide the need for antibiotic treatment in diseases such as acute sinusitis, acute pharyngitis, exacerbation of lower respiratory tract infection and chronic obstructive pulmonary disease. However, no isolated data is accurate enough by itself to confirm or rule out the need for antibiotics. Therefore, clinical prediction rules bring together history and physical examination, thereby improving the accuracy of the decision to indicate or not antibiotics.

  8. Does virus-bacteria coinfection increase the clinical severity of acute respiratory infection?

    Science.gov (United States)

    Damasio, Guilherme A C; Pereira, Luciane A; Moreira, Suzana D R; Duarte dos Santos, Claudia N; Dalla-Costa, Libera M; Raboni, Sonia M

    2015-09-01

    This retrospective cohort study investigated the presence of bacteria in respiratory secretions of patients hospitalized with acute respiratory infections and analyzed the impact of viral and bacterial coinfection on severity and the mortality rate. A total of 169 patients with acute respiratory infections were included, viruses and bacteria in respiratory samples were detected using molecular methods. Among all samples, 73.3% and 59.7% were positive for viruses and bacteria, respectively; 45% contained both virus and bacteria. Bacterial coinfection was more frequent in patients infected by community respiratory viruses than influenza A H1N1pdm (83.3% vs. 40.6%). The most frequently bacteria detected were Streptococcus pneumoniae and Haemophilus influenzae. Both species were co-detected in 54 patients and identified alone in 22 and 21 patients, respectively. Overall, there were no significant differences in the period of hospitalization, severity, or mortality rate between patients infected with respiratory viruses alone and those coinfected by viruses and bacteria. The detection of mixed respiratory pathogens is frequent in hospitalized patients with acute respiratory infections, but its impact on the clinical outcome does not appear substantial. However, it should be noted that most of the patients received broad-spectrum antibiotic therapy, which may have contributed to this favorable outcome. © 2015 Wiley Periodicals, Inc.

  9. Clinical characteristics of HIV-infected patients with adjudicated heart failure.

    Science.gov (United States)

    Steverson, Alexandra B; Pawlowski, Anna E; Schneider, Daniel; Nannapaneni, Prasanth; Sanders, Jes M; Achenbach, Chad J; Shah, Sanjiv J; Lloyd-Jones, Donald M; Feinstein, Matthew J

    2017-11-01

    Aims HIV-infected persons may have elevated risks for heart failure, but factors associated with heart failure in the modern era of HIV therapy are insufficiently understood. Despite substantial disagreement between physician-adjudicated heart failure and heart failure diagnosis codes, few studies of HIV cohorts have evaluated adjudicated heart failure. We evaluated associations of HIV viremia, immunosuppression, and cardiovascular risk factors with physician-adjudicated heart failure. Methods and results We analyzed clinical characteristics associated with heart failure in a cohort of 5041 HIV-infected patients receiving care at an urban hospital system between 2000 and 2016. We also evaluated characteristics of HIV-infected patients who screened negative for heart failure, screened positive for possible heart failure but did not have heart failure after adjudication, and had adjudicated heart failure. HIV-infected patients with heart failure ( N = 216) were older and more likely to be black, hypertensive, and have diabetes than HIV-infected patients without heart failure; heart failure with reduced ejection fraction was more common than heart failure with preserved ejection fraction. In our primary analyses restricted to HIV-infected patients whose heart failure diagnoses did not precede their HIV diagnoses ( N = 149), peak HIV viral load ≥100,000 copies/mL (odds ratio (OR) 2.12, 1.28-3.52) and nadir CD4 T-cell count failure. Overall, 30.6% of patients with any diagnosis code of heart failure had adjudicated heart failure. Conclusion Higher peak HIV viremia and lower CD4 cell nadir are associated with significantly elevated odds of heart failure for HIV-infected persons. Physician adjudication of heart failure may be helpful in HIV cohorts.

  10. Epidemiological and clinical profile of adult patients with Blastocystis sp. infection in Barcelona, Spain.

    Science.gov (United States)

    Salvador, Fernando; Sulleiro, Elena; Sánchez-Montalvá, Adrián; Alonso, Carmen; Santos, Javier; Fuentes, Isabel; Molina, Israel

    2016-10-14

    Blastocystis spp. are among the most frequently observed intestinal parasites in humans. Despite the discovery of Blastocystis approximately 100 years ago, limited information is available regarding its pathogenesis, genetic diversity, and available treatment options. The aim of this study was to describe the epidemiological and clinical characteristics of patients with Blastocystis sp. infections diagnosed at Vall d'Hebron University Hospital (Barcelona, Spain). A retrospective observational study was performed which included all adult patients who attended Vall d'Hebron University Hospital from February 2009 to March 2014 that had Blastocystis sp. detected in their stool. Four hundred eighteen patients were included, the median age was 36 (18-86) years and 236 (56.5 %) were men. Regarding patient symptoms, 234 (56 %) patients were completely asymptomatic, 92 (22 %) patients had symptoms, and 92 (22 %) patients had symptoms that could be attributed to other causes. Of the 92 patients with symptoms not attributable to other etiologies except for Blastocystis infection, the most frequent symptoms were diarrhea (61 patients, 66.3 %) and abdominal pain (34 patients, 37 %). Additionally, nine (9.8 %) patients had cutaneous manifestations. Thirty-one (7.4 %) patients received specific treatment for Blastocystis infection. The clinical response of treated patients was varied. Five patients experienced complete resolution of symptoms, 12 patients reported improvement of clinical symptoms, eight patients described no clinical improvement, and information was unavailable for six patients. Blastocystis infection was detected in 418 patients, most of them foreign-born. Although the vast majority of patients were asymptomatic, 22 % of patients had gastrointestinal symptoms or cutaneous manifestations in the absence of other causes. Despite the scarce information available, given the safety of antiparasitic treatment, and the percentage of patients who experienced

  11. Clinical Outcomes of In Vitro Fertilization among Chinese Infertile Couples Treated for Syphilis Infection.

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    Jing Wang

    Full Text Available To compare the clinical outcomes of infertile patients with and without syphilis after in vitro fertilization and embryo transfer (IVF-ET, in this case-control study, 320 infertile couples were enrolled and divided into syphilis (n = 160 and control groups (n = 160. The primary IVF outcomes were the clinical pregnancy rate and the birth of a healthy baby. All syphilis patients received the standard anti-syphilis treatment before undergoing IVF/ICSI. Our results showed that the endometrial thickness of the syphilis group was greater than that of the control group following hCG injection (16.9±5.4 vs. 13.0±4.7 mm, P<0.001. The numbers of normally fertilized eggs and normally cleaved fertilized eggs and the implantation rate were 6.8±4.8, 6.3±4.7 and 24.2%, respectively, for the syphilis group and 8.3±4.6, 8.1±4.6 and 34.4%, respectively, for the control group, and these values were significantly different between the groups. The clinical pregnancy rate was lower in the syphilis group compared with that in the control group (43.8% vs. 55.6%, P = 0.03. Lower offspring birth weight was observed in the infected male group compared with those in the infected female (2.7±0.4 vs. 3.0±0.4 kg, P = 0.01 and infected couple groups (2.7±0.4 vs. 3.1±0.5 kg, P = 0.007. Therefore, syphilis infection reduces the clinical pregnancy rate after IVF/ICSI.

  12. Caprine herpesvirus 1 (CpHV-1) vaginal infection of goats: clinical efficacy of fig latex.

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    Camero, Michele; Marinaro, Mariarosaria; Losurdo, Michele; Larocca, Vittorio; Bodnar, Livia; Patruno, Giovanni; Buonavoglia, Canio; Tempesta, Maria

    2016-01-01

    The latex of Ficus carica Linn. (Moraceae) has been shown to interfere with the replication of caprine herpesvirus (CpHV)-1 in vitro. The present study was undertaken to determine the efficacy of vaginal administration of fig latex in goats experimentally infected with CpHV-1. The fig latex reduced the clinical signs of the herpetic disease although it slightly influenced the titres of CpHV-1 shed. Thus, the fig latex maintained a partial efficacy in vivo.

  13. Clinical presentation of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections in research and community settings.

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    Swedo, Susan E; Seidlitz, Jakob; Kovacevic, Miro; Latimer, M Elizabeth; Hommer, Rebecca; Lougee, Lorraine; Grant, Paul

    2015-02-01

    The first cases of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) were described >15 years ago. Since that time, the literature has been divided between studies that successfully demonstrate an etiologic relationship between Group A streptococcal (GAS) infections and childhood-onset obsessive-compulsive disorder (OCD), and those that fail to find an association. One possible explanation for the conflicting reports is that the diagnostic criteria proposed for PANDAS are not specific enough to describe a unique and homogeneous cohort of patients. To evaluate the validity of the PANDAS criteria, we compared clinical characteristics of PANDAS patients identified in two community practices with a sample of children meeting full research criteria for PANDAS. A systematic review of clinical records was used to identify the presence or absence of selected symptoms in children evaluated for PANDAS by physicians in Hinsdale, Illinois (n=52) and Bethesda, Maryland (n=40). RESULTS were compared against data from participants in National Institute of Mental Health (NIMH) research investigations of PANDAS (n=48). As described in the original PANDAS cohort, males outnumbered females (95:45) by ∼ 2:1, and symptoms began in early childhood (7.3±2.7 years). Clinical presentations were remarkably similar across sites, with all children reporting acute onset of OCD symptoms and multiple comorbidities, including separation anxiety (86-92%), school issues (75-81%), sleep disruptions (71%), tics (60-65%), urinary symptoms (42-81%), and others. Twenty of the community cases (22%) failed to meet PANDAS criteria because of an absence of documentation of GAS infections. The diagnostic criteria for PANDAS can be used by clinicians to accurately identify patients with common clinical features and shared etiology of symptoms. Although difficulties in documenting an association between GAS infection and symptom onset/exacerbations may

  14. Clinical and subclinical bovine leukemia virus infection in a dairy cattle herd in Zambia.

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    Pandey, Girja S; Simulundu, Edgar; Mwiinga, Danstan; Samui, Kenny L; Mweene, Aaron S; Kajihara, Masahiro; Mangani, Alfred; Mwenda, Racheal; Ndebe, Joseph; Konnai, Satoru; Takada, Ayato

    2017-04-01

    Bovine leukemia virus (BLV) causes enzootic bovine leucosis (EBL) and is responsible for substantial economic losses in cattle globally. However, information in Africa on the disease is limited. Here, based on clinical, hematological, pathological and molecular analyses, two clinical cases of EBL were confirmed in a dairy cattle herd in Zambia. In contrast, proviral DNA was detected by PCR in five apparently healthy cows from the same herd, suggesting subclinical BLV infection. Phylogenetic analysis of the env gene showed that the identified BLV clustered with Eurasian genotype 4 strains. This is the first report of confirmed EBL in Zambia.

  15. Fungal Infections of the Central Nervous System in Small Animals: Clinical Features, Diagnosis, and Management.

    Science.gov (United States)

    Bentley, R Timothy; Taylor, Amanda R; Thomovsky, Stephanie A

    2018-01-01

    Small animal mycoses vary geographically. Different clinical presentations are seen in animals with infection of the central nervous system (CNS), including multifocal meningoencephalomyelitis, intracranial lesions that accompany sinonasal lesions, rapidly progressive ventriculitis, or solitary granuloma of the brain or spinal cord. Systemic, nasal, or extraneural clinical signs are common but, especially in granuloma cases, do not always occur. Surgery may have a diagnostic and therapeutic role in CNS granuloma. There have been recent advancements in serology. Fluconazole, voriconazole, and posaconazole cross the blood-brain barrier, but voriconazole is neurotoxic to cats. Liposomal and lipid-encapsulated formulations of amphotericin B are preferred. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. A Pre-clinical Animal Model of Trypanosoma brucei Infection Demonstrating Cardiac Dysfunction.

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    Charlotte S McCarroll

    2015-05-01

    Full Text Available African trypanosomiasis (AT, caused by Trypanosoma brucei species, results in both neurological and cardiac dysfunction and can be fatal if untreated. Research on the pathogenesis and treatment of the disease has centred to date on the characteristic neurological symptoms, whereas cardiac dysfunction (e.g. ventricular arrhythmias in AT remains largely unstudied. Animal models of AT demonstrating cardiac dysfunction similar to that described in field cases of AT are critically required to transform our understanding of AT-induced cardiac pathophysiology and identify future treatment strategies. We have previously shown that T. brucei can interact with heart muscle cells (cardiomyocytes to induce ventricular arrhythmias in ex vivo adult rat hearts. However, it is unknown whether the arrhythmias observed ex vivo are also present during in vivo infection in experimental animal models. Here we show for the first time the characterisation of ventricular arrhythmias in vivo in two animal models of AT infection using electrocardiographic (ECG monitoring. The first model utilised a commonly used monomorphic laboratory strain, Trypanosoma brucei brucei Lister 427, whilst the second model used a pleomorphic laboratory strain, T. b. brucei TREU 927, which demonstrates a similar chronic infection profile to clinical cases. The frequency of ventricular arrhythmias and heart rate (HR was significantly increased at the endpoint of infection in the TREU 927 infection model, but not in the Lister 427 infection model. At the end of infection, hearts from both models were isolated and Langendorff perfused ex vivo with increasing concentrations of the β-adrenergic agonist isoproterenol (ISO. Interestingly, the increased frequency of arrhythmias observed in vivo in the TREU 927 infection model was lost upon isolation of the heart ex vivo, but re-emerged with the addition of ISO. Our results demonstrate that TREU 927 infection modifies the substrate of the myocardium

  17. A retrospective study of viral central nervous system infections: relationship amongst aetiology, clinical course and outcome.

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    Calleri, Guido; Libanore, Valentina; Corcione, Silvia; De Rosa, Francesco G; Caramello, Pietro

    2017-04-01

    To describe the clinical pattern of viral central nervous system (CNS) infections and compare meningitis and encephalitis. This is a retrospective study reporting the clinical characteristics and outcome of 138 cases of viral meningitis and meningoencephalitis in a real life experience at a referral centre in Turin, Northern Italy. Enteroviruses were predominant in younger patients who were mainly presenting with signs of meningitis, had shorter hospital admission and absence of complications, whereas herpesviruses had more often signs of encephalitis, were more frequent in elderly patients, had longer hospital admission and frequent complications and sequelae. Two main clinical entities with different epidemiology, clinical aspects and prognosis may be identified within the group of viral CNS inefctions.

  18. Surgical site infections in women and their association with clinical conditions

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    Maria Zélia de Araújo Madeira

    2014-07-01

    Full Text Available Introduction Surgical site infections (SSIs can affect body tissues, cavities, or organs manipulated in surgery and constitute 14% to 16% of all infections. This study aimed to determine the incidence of SSIs in women following their discharge from a gynecology outpatient clinic, to survey different types of SSIs among women, and to verify the association of SSIs with comorbidities and clinical conditions. Methods Data were collected via analytical observation with a cross-sectional design, and the study was conducted in 1,026 women who underwent gynecological surgery in a teaching hospital in the municipality of Teresina, in the northeast Brazilian State of Piauí, from June 2011 to March 2013. Results The incidence of SSIs after discharge was 5.8% among the women in the outpatient clinic. The most prevalent surgery among the patients was hysterectomy, while the most prevalent type of SSI was superficial incisional. Comorbidities in women with SSIs included cancer, diabetes mellitus, and hypertension. Conclusions Surveillance of SSIs during the post-discharge period is critical for infection prevention and control. It is worth reflecting on the planning of surgical procedures for patients who have risk factors for the development of SSIs.

  19. Norovirus infections in young children in Lusaka Province, Zambia: clinical characteristics and molecular epidemiology.

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    Howard, Leigh M; Mwape, Innocent; Siwingwa, Mpanji; Simuyandi, Michelo; Guffey, M Brad; Stringer, Jeffrey S A; Chi, Benjamin H; Edwards, Kathryn M; Chilengi, Roma

    2017-01-23

    The burden, clinical features, and molecular epidemiology of norovirus infection in young children in southern Africa are not well defined. Using data from a health facility-based surveillance study of children norovirus infection. A convenience sample of 454 stool specimens was tested for norovirus using reverse-transcriptase polymerase chain reaction (RT-PCR). RT-PCR positive samples underwent additional nucleotide sequencing for genogroup and genotype identification. Clinical features and severity of diarrheal illnesses were compared between norovirus-positive and -negative subjects using Chi-squared and t-tests. Norovirus was detected in 52/454 (11.5%) specimens tested. Abdominal pain, fever, and vomiting were the most common presenting features in norovirus-associated illnesses. However, there were no significant differences in the clinical features of norovirus-positive compared to norovirus-negative illnesses. Of 43 isolates that were available for sequencing, 31 (72.1%) were genogroup II (GII) and 12 (27.9%) were genogroup I (GI). The distribution of genotypes was diverse. Noroviruses were detected in approximately 10% of young children with diarrhea in the Lusaka Province of Zambia, with GII representing the majority of infections. These findings support the role of norovirus in symptomatic diarrhea disease in Africa. Further studies are needed to confirm these observations and to evaluate prevention strategies.

  20. Borrelia persica infection in dogs and cats: clinical manifestations, clinicopathological findings and genetic characterization.

    Science.gov (United States)

    Baneth, Gad; Nachum-Biala, Yaarit; Halperin, Tamar; Hershko, Yizhak; Kleinerman, Gabriela; Anug, Yigal; Abdeen, Ziad; Lavy, Eran; Aroch, Itamar; Straubinger, Reinhard K

    2016-05-10

    Relapsing fever (RF) is an acute infectious disease caused by arthropod-borne spirochetes of the genus Borrelia. The disease is characterized by recurrent episodes of fever that concur with spirochetemia. The RF borrelioses include louse-borne RF caused by Borrelia recurrentis and tick-borne endemic RF transmitted by argasid soft ticks and caused by several Borrelia spp. such as B. crocidurae, B. coriaceae, B. duttoni, B. hermsii, B. hispanica and B. persica. Human infection with B. persica is transmitted by the soft tick Ornithodoros tholozani and has been reported from Iran, Israel, Egypt, India, and Central Asia. During 2003-2015, five cats and five dogs from northern, central and southern Israel were presented for veterinary care and detected with borrelia spirochetemia by blood smear microscopy. The causative infective agent in these animals was identified and characterized by PCR from blood and sequencing of parts of the flagellin (flab), 16S rRNA and glycerophosphodiester phosphodiestrase (GlpQ) genes. All animals were infected with B. persica genetically identical to the causative agent of human RF. Phylogenetic analysis indicated that DNA sequences from these pet carnivores clustered together with B. persica genotypes I and II from humans and O. tholozani ticks and distinctly from other RF Borrelia spp. The main clinical findings in cats included lethargy, anorexia, anemia in 5/5 cats and thrombocytopenia in 4/5. All dogs were lethargic and anorectic, 4/5 were febrile and anemic and 3/5 were thrombocytopenic. Three dogs were co-infected with Babesia spp. The animals were all treated with antibiotics and the survival rate of both dogs and cats was 80 %. The cat and dog that succumbed to disease died one day after the initiation of antibiotic treatment, while survival in the others was followed by the rapid disappearance of spirochetemia. This is the first report of disease due to B. persica infection in cats and the first case series in dogs. Infection was

  1. Clinical presentation and prognostic factors of Streptococcus pneumoniae meningitis according to the focus of infection

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    Samuelsson Susanne

    2005-10-01

    Full Text Available Abstract Background We conducted a nationwide study in Denmark to identify clinical features and prognostic factors in patients with Streptococcus pneumoniae according to the focus of infection. Methods Based on a nationwide registration, clinical information's was prospectively collected from all reported cases of pneumococcal meningitis during a 2-year period (1999–2000. Clinical and laboratory findings at admission, clinical course and outcome of the disease including follow-up audiological examinations were collected retrospectively. The focus of infection was determined according to the clinical diagnosis made by the physicians and after review of the medical records. Results 187 consecutive cases with S. pneumoniae meningitis were included in the study. The most common focus was ear (30%, followed by lung (18%, sinus (8%, and other (2%. In 42% of cases a primary infection focus could not be determined. On admission, fever and an altered mental status were the most frequent findings (in 93% and 94% of cases, respectively, whereas back rigidity, headache and convulsion were found in 57%, 41% and 11% of cases, respectively. 21% of patients died during hospitalisation (adults: 27% vs. children: 2%, Fisher Exact Test, P P = 0.0005. Prognostic factors associated with fatal outcome in univariate logistic regression analysis were advanced age, presence of an underlying disease, history of headache, presence of a lung focus, absence of an otogenic focus, having a CT-scan prior to lumbar puncture, convulsions, requirement of assisted ventilation, and alterations in various CSF parameters (WBC P P = 0.005. Conclusion These results emphasize the prognostic importance of an early recognition of a predisposing focus to pneumococcal meningitis.

  2. CLINICAL PROFILE OF ACUTE LOWER RESPIRATORY TRACT INFECTIONS IN CHILDREN BETWEEN 2MONTHS TO 5 YEARS

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    Amitoj Singh Chhina

    2015-08-01

    Full Text Available BACKGROUND : Acute respiratory infections are a leading cause of morbidity and mortality in under - five children in developing countries. Hence, the present study was undertaken to study the various risk factors, clinical profile and outcome of acute lower respiratory tract infections (ALRI in children aged 2 month to 5 years. OBJECTIVE : clinical features, laborato ry assessment and morbidity and mortality pattern associated with acute lower respiratory tract infections in children aged 2 months to 5 years. METHODS: 100 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 2 month to 5 years were evaluated for clinical profile as per a predesigned proforma in a rural medical college. RESULTS : Of cases 61% were infants and remaining 39%12 - 60 months age group, males outnumbered females with sex ratio of 1.3;1. Elevated total leukocyte counts for age were observed in only 22% of cases, of these 3% were having pneumonia, 9% severe pneumonia and 10% very severe pneumonia. Significant association was found between leukocytosis and ALRI severity (p= 0.0001 Positive blood culture was obtained in 8% of cases and was significantly associated with ALRI severity (p=. 0.027. Among the ALRI cases, 84% required oxygen supplementation at any time during the hospital stay and 8% required mechanical ventilation. The mortality rate was 1%; with 99% of cases recovering and getting discharged uneventfully. CONCLUSION : Among the clinical variables, the signs and symptoms of ALRI as per the WHO ARI Control Programme were found in almost all cases. Regarding the laboratory profile, leukocytosis and blood culture positivity w ere observed in a small percentage, but significant association with ALRI severity was observed for both. Thus, clinical signs, and not invasive blood tests are a better diagnostic tools, though the latter may provide additional therapeutic and prognostic information in severe disease

  3. Clinical features of cerebral palsy in children with symptomatic congenital cytomegalovirus infection.

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    Dakovic, Ivana; da Graça Andrada, Maria; Folha, Teresa; Neubauer, David; Hollody, Katalin; Honold, Michaela; Horber, Veronka; Duranovic, Vlasta; Bosnjak, Vlatka Mejaski

    2014-09-01

    Human cytomegalovirus is the most common cause of vertically transmitted viral infection, affecting around 1% of liveborns. Infection is symptomatic in nearly 10% of infected children who are at higher risk of development of severe neurological disorders, including cerebral palsy. To study the clinical profile of children with cerebral palsy caused by symptomatic congenital cytomegalovirus infection in a multicenter study involving six countries from the Surveillance of Cerebral Palsy in Europe (SCPE) Network. Data on 35 children (13 males, 22 females; mean age at last assessment 12y 6mo, age range 14y 6mo, min 4y, max 18y 6mo) on pre/peri/neonatal history and last clinical assessment were collected. Classification of cerebral palsy and associated impairments was performed according to SCPE criteria. The majority of children had bilateral spastic cerebral palsy, 85.7%, with a confidence interval (CI) [69.7-95.2], and 71.4% [CI 53.7-85.4] were unable to walk (GMFCS levels IV-V) while fine motor function was severely affected in 62.8% [CI 44.9-78.5] (BFMF levels IV and V). Most of the children with severe CP had severe associated impairments. 11.4% of children had severe visual and 42.8% severe hearing impairment, 77.1% [CI 59.9-89.6] suffered from epilepsy, also 77.1% had severe intellectual impairment, and speech was undeveloped in 71.4%. Female:male ratio was 1.69:1 and 80% of children were term born. Cerebral palsy following symptomatic congenital cytomegalovirus infection seems to be in most cases a severe condition and associated impairments are overrepresented. Copyright © 2014 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  4. The unique clinical features and outcome of infectious endocarditis and vertebral osteomyelitis co-infection.

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    Koslow, Matthew; Kuperstein, Rafael; Eshed, Iris; Perelman, Marina; Maor, Elad; Sidi, Yechezkel

    2014-07-01

    The clinical significance of vertebral osteomyelitis and infectious endocarditis co-infection is unclear. This study investigates the rate, clinical features, and outcome of vertebral osteomyelitis with and without concomitant infectious endocarditis. A retrospective study of all cases of osteomyelitis with spinal imaging (n = 176), from January 2007 to April 2013, that were diagnosed as vertebral osteomyelitis. Sixty-two patients with spontaneous vertebral osteomyelitis were identified after excluding postsurgical, decubitus ulcers and spinal metastases. Seventeen (27%) were identified with concomitant infectious endocarditis. All patients presented with back pain and 59% were diagnosed with infectious endocarditis subsequent to vertebral osteomyelitis. Distinguishing features among the co-infection group include the increased use of transesophageal echocardiography (94% vs 58%, P = .004), predisposing cardiac conditions (59% vs 16%, P = .001), and Gram-positive bacteremia, of which Streptococcus sp. and Enterococcus sp. were more common (35% vs 11%, P = .026). Adverse neurologic events were increased significantly in the co-infection group (59% vs 22%, P = .006). On transesophageal echocardiography, 88% of co-infection patients had highly mobile vegetations, 9 of which measured 10 mm or more. The overall mortality was 41% and 29% in the co-infection and lone vertebral osteomyelitis groups, respectively (P = .356). One-year mortality was identical for both groups at 24% (P = .999), and higher than previously reported (11.3% for lone vertebral osteomyelitis). Patients with vertebral osteomyelitis, in whom infectious endocarditis is not excluded, are at increased risk for adverse neurologic events and mortality. The prompt diagnosis of infectious endocarditis, and associated high-risk features that may benefit from surgical intervention, require early evaluation by transesophageal echocardiography. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Clinical and molecular epidemiology of human rhinovirus infections in patients with hematologic malignancy.

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    Jacobs, Samantha E; Lamson, Daryl M; Soave, Rosemary; Guzman, Brigitte Huertas; Shore, Tsiporah B; Ritchie, Ellen K; Zappetti, Dana; Satlin, Michael J; Leonard, John P; van Besien, Koen; Schuetz, Audrey N; Jenkins, Stephen G; George, Kirsten St; Walsh, Thomas J

    2015-10-01

    Human rhinoviruses (HRVs) are common causes of upper respiratory tract infection (URTI) in hematologic malignancy (HM) patients. Predictors of lower respiratory tract infection (LRTI) including the impact of HRV species and types are poorly understood. This study aims to describe the clinical and molecular epidemiology of HRV infections among HM patients. From April 2012-March 2013, HRV-positive respiratory specimens from symptomatic HM patients were molecularly characterized by analysis of partial viral protein 1 (VP1) or VP4 gene sequence. HRV LRTI risk-factors and outcomes were analyzed using multivariable logistic regression. One hundred and ten HM patients presented with HRV URTI (n=78) and HRV LRTI (n=32). Hypoalbuminemia (OR 3.0; 95% CI, 1.0-9.2; p=0.05) was independently associated with LRTI, but other clinical and laboratory markers of host immunity did not differ between patients with URTI versus LRTI. Detection of bacterial co-pathogens was common in LRTI cases (25%). Among 92 typeable respiratory specimens, there were 58 (64%) HRV-As, 12 (13%) HRV-Bs, and 21 (23%) HRV-Cs, and one Enterovirus 68. LRTI rates among HRV-A (29%), HRV-B (17%), and HRV-C (29%) were similar. HRV-A infections occurred year-round while HRV-B and HRV-C infections clustered in the late fall and winter. HRVs are associated with LRTI in HM patients. Illness severity is not attributable to specific HRV species or types. The frequent detection of bacterial co-pathogens in HRV LRTIs further substantiates the hypothesis that HRVs predispose to bacterial superinfection of the lower airways, similar to that of other community-acquired respiratory viruses. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Nosocomial infections with metallo-beta-lactamase-producing Pseudomonas aeruginosa: molecular epidemiology, risk factors, clinical features and outcomes.

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    Lucena, A; Dalla Costa, L M; Nogueira, K S; Matos, A P; Gales, A C; Paganini, M C; Castro, M E S; Raboni, S M

    2014-08-01

    Metallo-β-lactamases (MBLs) have emerged as one of the most important bacterial resistance mechanisms because of their ability to hydrolyse virtually all β-lactam agents. MBL-producing Pseudomonas aeruginosa (MBL-PA) are an important cause of nosocomial infections, particularly in intensive care units (ICUs), where they are associated with serious infections and present a significant clinical risk. To assess the molecular epidemiology, risk factors and outcomes of nosocomial infections caused by MBL-PA in a teaching hospital in Southern Brazil. From January 2001 to December 2008, 142 carbapenem-resistant P. aeruginosa strains were isolated from distinct clinical samples from hospitalized patients. These isolates were screened for MBLs, and underwent polymerase chain reaction, sequencing and pulsed-field gel electrophoresis (PFGE). Patients infected with carbapenem-resistant MBL-PA were considered as cases, and patients infected with non-MBL-PA were considered as controls. Eighty-four of 142 patients with positive carbapenem-resistant P. aeruginosa cultures met the criteria of the Centers for Disease Control and Prevention for infection. Fifty-eight patients were infected with MBL-PA (69%) and 26 patients were infected with non-MBL-PA (31%). Multi-variate analysis revealed that ICU stay [P = 0.003, odds ratio (OR) 4.01, 95% confidence interval (CI) 1.15-14.01] and urinary tract infection (P = 0.001, OR 9.67, 95% CI 1.72-54.48) were important risk factors for MBL-PA infection. Patients infected with MBL-PA showed faster onset of infection (P = 0.002) and faster progression to death (P = 0.04). These results showed the severity of MBL-PA infections, and demonstrated the urgent need for strategies to improve infection control measures to prevent an increase in these nosocomial infections. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  7. Whole Blood Gene Expression Profiling in Preclinical and Clinical Cattle Infected with Atypical Bovine Spongiform Encephalopathy.

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    Elena Xerxa

    Full Text Available Prion diseases, such as bovine spongiform encephalopathies (BSE, are transmissible neurodegenerative disorders affecting humans and a wide variety of mammals. Variant Creutzfeldt-Jakob disease (vCJD, a prion disease in humans, has been linked to exposure to BSE prions. This classical BSE (cBSE is now rapidly disappearing as a result of appropriate measures to control animal feeding. Besides cBSE, two atypical forms (named H- and L-type BSE have recently been described in Europe, Japan, and North America. Here we describe the first wide-spectrum microarray analysis in whole blood of atypical BSE-infected cattle. Transcriptome changes in infected animals were analyzed prior to and after the onset of clinical signs. The microarray analysis revealed gene expression changes in blood prior to the appearance of the clinical signs and during the progression of the disease. A set of 32 differentially expressed genes was found to be in common between clinical and preclinical stages and showed a very similar expression pattern in the two phases. A 22-gene signature showed an oscillating pattern of expression, being differentially expressed in the preclinical stage and then going back to control levels in the symptomatic phase. One gene, SEL1L3, was downregulated during the progression of the disease. Most of the studies performed up to date utilized various tissues, which are not suitable for a rapid analysis of infected animals and patients. Our findings suggest the intriguing possibility to take advantage of whole blood RNA transcriptional profiling for the preclinical identification of prion infection. Further, this study highlighted several pathways, such as immune response and metabolism that may play an important role in peripheral prion pathogenesis. Finally, the gene expression changes identified in the present study may be further investigated as a fingerprint for monitoring the progression of disease and for developing targeted therapeutic

  8. Risk of occupational exposure to the HBV infection in non-clinical healthcare personnel

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    Weronika Rymer

    2016-06-01

    Full Text Available Background: Occupational risk of blood-borne infections is investigated mostly among nurses and doctors, studies concerning non-clinical health personnel (nCHP being rare. The analysis of the occupational exposure to the hepatitis B virus (HBV infection and the history of vaccination against the HBV in the nCHP group has been the aim of the study. Material and Methods: A retrospective analysis of 458 cases of the occupational exposure to biological agents was conducted: group I – doctors (N = 121, 28%, group II – nursing staff (N = 251, 55%, group III – nCHP (N = 86, 19%. Results: In the group III the source was usually unknown (group: I – 0.83%, II – 11.16%, III – 86.05%, p < 0.001, and the proportion of individuals vaccinated against hepatitis B before the exposure was the lowest (group: I – 98.35%, II – 97.19%, III – 77.91%, p < 0.001. In this group most exposures resulted from injuries caused by needles/sharps deposited in waste sacks (60% or anywhere outside of the medical waste container (5%. The possibility of the HBV infection risk during the exposure was found in 25 cases and was significantly more frequent in the group III. The qualification for the HBV post-exposure prophylaxis was also significantly more frequent in the group III. Conclusions: The exposure to the occupational risk of the HBV infection also concerns the non-clinical healthcare personnel. The non-clinical healthcare personnel comprises one of the main groups of the HBV post-exposure recipients. It is essential to determine the causes of the low hepatitis B vaccination coverage in the nCHP and consider introduction of mandatory vaccination in this group in Poland. Med Pr 2016;67(3:301–310

  9. Unique intrahepatic transcriptomics profiles discriminate the clinical phases of a chronic HBV infection.

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    Jun Hou

    Full Text Available Chronic hepatitis B is a highly heterogeneous liver disease characterized by phases with fluctuations in viral replication and progressive liver damage in some, but not all infected individuals. Despite four decades of research, insight into host determinants underlying these distinct clinical phases-immunotolerant, immune active, inactive carrier, and HBeAg-negative hepatitis-remains elusive. We performed an in-depth transcriptome analysis of archived FFPE liver biopsies of each clinical phase to address host determinants associated with the natural history. Therefore, we determined, for the first time, intrahepatic global expression profiles of well-characterized chronic HBV patients at different clinical phases. Our data, obtained by microarray, demonstrate that B cells and NK/cytotoxic-related genes in the liver, including CD19, TNFRSF13C, GZMH, and KIR2DS3, were differentially expressed across the clinical HBV phases, which was confirmed by modular analysis and also Nanostring arrays in an independent cohort. Compared to the immunotolerant phase, 92 genes were differentially expressed in the liver during the immune active phase, 46 in the inactive carrier phase, and 71 in the HBeAg-negative phase. Furthermore, our study also revealed distinctive transcription of genes associated with cell cycle activity, NF-κB signaling, cytotoxic function and mitochondrial respiration between clinical phases. Our data define for the first time using microarray unique transcriptomes in the HBV-infected liver during consecutive clinical phases. We demonstrate that fluctuations of viral loads and liver damage coincide with fluctuations in the liver transcriptome and point to functional- immune and non-immune- components contributing to the clinical phenotype in patients.

  10. Clinical predictors of dengue fever co-infected with leptospirosis among patients admitted for dengue fever - a pilot study.

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    Suppiah, Jeyanthi; Chan, Shie-Yien; Ng, Min-Wern; Khaw, Yam-Sim; Ching, Siew-Mooi; Mat-Nor, Lailatul Akmar; Ahmad-Najimudin, Naematul Ain; Chee, Hui-Yee

    2017-06-28

    Dengue and leptospirosis infections are currently two major endemics in Malaysia. Owing to the overlapping clinical symptoms between both the diseases, frequent misdiagnosis and confusion of treatment occurs. As a solution, the present work initiated a pilot study to investigate the incidence related to co-infection of leptospirosis among dengue patients. This enables the identification of more parameters to predict the occurrence of co-infection. Two hundred sixty eight serum specimens collected from patients that were diagnosed for dengue fever were confirmed for dengue virus serotyping by real-time polymerase chain reaction. Clinical, laboratory and demographic data were extracted from the hospital database to identify patients with confirmed leptospirosis infection among the dengue patients. Thus, frequency of co-infection was calculated and association of the dataset with dengue-leptospirosis co-infection was statistically determined. The frequency of dengue co-infection with leptospirosis was 4.1%. Male has higher preponderance of developing the co-infection and end result of shock as clinical symptom is more likely present among co-infected cases. It is also noteworthy that, DENV 1 is the common dengue serotype among all cases identified as dengue-leptospirosis co-infection in this study. The increasing incidence of leptospirosis among dengue infected patients has posed the need to precisely identify the presence of co-infection for the betterment of treatment without mistakenly ruling out either one of them. Thus, anticipating the possible clinical symptoms and laboratory results of dengue-leptospirosis co-infection is essential.

  11. Occurrence, clinical involvement and zoonotic potential of endoparasites infecting Swiss pigs.

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    Schubnell, Fabienne; von Ah, Sereina; Graage, Robert; Sydler, Titus; Sidler, Xaver; Hadorn, Daniela; Basso, Walter

    2016-12-01

    In order to estimate the diversity, clinical involvement and zoonotic potential of parasites in pigs submitted for diagnosis to the PathoPig project of the Swiss Federal Food Safety and Veterinary Office, faeces (n=125) from suckling piglets (n=39), weaners (n=60) and piglets beginning fattening (n=26) from 74 Swiss farms were examined by 3 coproscopical methods (i.e. sedimentation/zinc chloride-flotation; SAFC and Ziehl-Neelsen staining). Samples microscopically positive for Cryptosporidium were further tested by PCR/sequencing for species assessment. The most frequently detected parasite was Balantidium coli, a facultative pathogenic ciliate with zoonotic potential, in 5.1, 36.7 and 50.0% of suckling, weaners and fatteners and 43.2% of farms; however, no association with disease was observed. Isospora (syn. Cystoisospora) suis infections were detected in 13.3 and 11.1% of suckling piglets with and without diarrhoea, and in 10.0 and 13.3% of weaners and fatteners with diarrhoea, respectively, and were significant associated with emaciation. Cryptosporidium infections were detected in 10.3, 15.0 and 19.2% of sucklings, weaners and fatteners, respectively, and in 18.9% of the farms. Interestingly, two age-related species were identified: C. suis in younger piglets (2 to 6weeks) and C. scrofarum in older ones (6 to 17weeks). None of the pigs infected with C. scrofarum (n=8), but 3 of 4 piglets infected with C. suis (co-infection with I. suis in 2 cases) had diarrhoea. The zoonotic species C. parvum was not detected, nevertheless, sporadic cases of human infection with the porcine-adapted species have been reported. Ascaris suum, Trichuris suis and Strongylida were rarely detected (<4%) in all age categories. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. [Clinical and laboratory characteristics of chronic active Epstein-Barr virus infection in children].

    Science.gov (United States)

    Mao, Jun-Qing; Yang, Shi-Long; Song, Hua; Zhao, Fen-Ying; Xu, Xiao-Jun; Gu, Min-Er; Tang, Yong-Min

    2014-11-01

    To study the clinical and laboratory characteristics of chronic active Epstein-Barr virus (EBV) infection (CAEBV) in children and to provide a basis for the diagnosis and treatment of CAEBV. The clinical data of 13 children with CAEBV, as well as 15 cases of acute EBV infection (AEBV) as controls, were analyzed, including clinical manifestations, EBV antibodies, EBV DNA, and peripheral blood lymphocyte subsets. Both groups of patients had infectious mononucleosis-like symptoms such as fever, hepatomegaly, splenomegaly, and lymphadenectasis, but CAEBV patients had a longer course of disease and continuous and recurrent symptoms. Compared with the AEBV group, the CAEBV group had a significantly higher EBV DNA load in peripheral blood (PCAEBV patients followed up, 8 cases died, 2 cases showed an improvement, 2 cases had a recurrence, and 1 case was lost to follow-up after being transferred to another hospital. All the AEBV patients were cured and had no recurrence during the one-year follow-up. The clinical manifestations of CAEBV vary in children. It is difficult to distinguish CAEBV from AEBV early. More attention should be paid to CAEBV because of its severe complications, poor prognosis, and high mortality. Measurement of EBV DNA load, VCA-IgG titer, and lymphocyte subsets in peripheral blood may be helpful in the diagnosis and differential diagnosis of CAEBV.

  13. Norovirus infection: features of epidemiology and clinical and laboratory manifestations at the present stage

    Directory of Open Access Journals (Sweden)

    N.V. Pronko

    2017-02-01

    Full Text Available Background. Among most significant for practical medicine infections, acute intestinal infections of viral etiology are becoming increasingly topical [2, 4]. According to domestic and foreign literature, up to 70 % of gastroenteritis occur during cold seasons of the year and are induced by viruses [3, 5]. The range of the factors producing viral diarrheas is rather wide. One of the comparatively new acute intestinal infections (AII producing factors is noroviruses [5, 6]. The prevalence of noroviruses has been little studied, and the clinical picture has been characterized insufficiently. This can be explained by insufficient diagnostics and registration of this infection [3, 6, 7]. Aim of the work: analysis of the morbidity and determination of clinical laboratory features of noroviral infection (NVI in children according to the data of the Regional Clinical Infectious Di­seases Hospital in Grodno. Materials and methods. A comprehensive clinical laboratory analysis of 1,105 case histories of children aged 1 month to 14 years with verified viral intestinal infection, who were admitted to Grodno Regional Clinical Infectious Diseases Hospital from January 2013 to December 2016, was carried out. The patients were divided according to the final clinical diagnosis in the following way: rotaviral infection (RVI was found in 676 (61.2 % individuals, adenoviral intestinal infection (AVI — in 212 (19.2 %, NVI was detected in 156 (14.1 % and enteroviral infection — in 61 (5.5 % persons. The examination was carried out according to the protocols approved by the Ministry of Health of the Republic of Belarus. Results. As our study showed, at the period analyzed the viral intestinal diseases amounted to 70.4 % of all the cases of diseases in the structure of AII in children. Patients hospitalized with viral diarrhea showed prevalence of RVI (61.2 %. NVI was the third by the incidence among viral diarrheas, and it was registered in 14.1 % of the cases

  14. Prevalence and clinical role of GBV-C infection after cardiac surgery in childhood: a study on 414 patients.

    Science.gov (United States)

    Vogt, Manfred; Klostermann, Barbara; Braun, Siegmund; Busch, Raymonde; Hess, John; Frösner, Gert; Lang, Thomas

    2006-07-01

    GB-virus C (GBV-C) and hepatitis C virus (HCV) share similar modes of transmission. We, therefore, examined the prevalence and clinical role of GBV-C and HCV in patients after cardiac surgery in childhood. We analysed blood samples of 414 patients and compared them to 487 controls. Evidence of liver disease and risk factors for infection was analysed. Overall prevalence of GBV-C infection was 22.5% in the patients, compared to 6.2% in the controls (HCV infection 11.3 vs. 0.7%). GBV-C RNA was detected in 8.2% of the patients vs. 3.7% in the controls (HCV RNA in 6 and 0%, respectively). Eleven patients had detectable RNA of GBV-C and HCV. 63.4% of patients infected with GBV-C and 46.8% of patients infected with HCV cleared the virus from circulation. GBV-C infection was not associated with hepatitis. Liver disease was not more frequent in patients co-infected with HCV and GBV-C. before 1991 have a substantial risk for HCV and GBV-C infection. However, GBV-C infection seems not to be associated with a liver disease. Co-infection with GBV-C and HCV has no influence on long-term clinical outcome or viral clearance of HCV infection.

  15. [Clinical features of invasive candidiasis and risk factors for Candida bloodstream infection in children: a multicenter study in Urumqi, China].

    Science.gov (United States)

    Ai Er Ken, Ai Bi Bai; Ma, Zhi-Hua; Xiong, Dai-Qin; Xu, Pei-Ru

    2017-04-01

    To investigate the clinical features of invasive candidiasis in children and the risk factors for Candida bloodstream infection. A retrospective study was performed on 134 children with invasive candidiasis and hospitalized in 5 tertiary hospitals in Urumqi, China, between January 2010 and December 2015. The Candida species distribution was investigated. The clinical data were compared between the patients with and without Candida bloodstream infection. The risk factors for Candida bloodstream infection were investigated using multivariate logistic regression analysis. A total of 134 Candida strains were isolated from 134 children with invasive candidiasis, and non-albicans Candida (NAC) accounted for 53.0%. The incidence of invasive candidiasis in the PICU and other pediatric wards were 41.8% and 48.5% respectively. Sixty-eight patients (50.7%) had Candida bloodstream infection, and 45 patients (33.6%) had Candida urinary tract infection. There were significant differences in age, rate of use of broad-spectrum antibiotics, and incidence rates of chronic renal insufficiency, heart failure, urinary catheterization, and NAC infection between the patients with and without Candida bloodstream infection (Pcandidiasis is similar between the PICU and other pediatric wards. NAC is the most common species of invasive candidiasis. Candida bloodstream infection is the most common invasive infection. Younger age (1-24 months) and NAC infection are the risk factors for Candida bloodstream infection.

  16. Acute HIV infection (AHI) in a specialized clinical setting: case-finding, description of virological, epidemiological and clinical characteristics.

    Science.gov (United States)

    Ammassari, Adriana; Abbate, Isabella; Orchi, Nicoletta; Pinnetti, Carmela; Rozera, Gabriella; Libertone, Raffaella; Pierro, Paola; Martini, Federico; Puro, Vincenzo; Girardi, Enrico; Antinori, Andrea; Capobianchi, Maria Rosaria

    2014-01-01

    Diagnosis of HIV infection during early stages is mandatory to catch up with the challenge of limiting HIV viral replication and reservoirs formation, as well as decreasing HIV transmissions by immediate cART initiation. Aims were to describe (a) virological characteristics of AHI identified, (b) epidemiological and clinical factors associated with being diagnosed with AHI. Cross-sectional, retrospective study. All individuals diagnosed with AHI according to Fiebig's staging between Jan 2013 and Mar 2014 at the INMI "L. Spallanzani" were included. Serum samples reactive to a fourth generation HIV-1/2 assay (Architect HIV Ag/Ab Combo, Abbott) were retested with another fourth generation assay (VIDAS DUO HIV Ultra, Biomérieux) and underwent confirmation with HIV-1 WB (New Lav I Bio-Rad) and/or with Geenius confirmatory assay (Bio-Rad). WHO criteria (two env products reactivity) were used to establish positivity of confirmatory assays. In case of clinically suspected AHI, HIV-1 RNA (Real time, Abbott) and p24 assay (VIDAS HIV P24 Bio-Rad) were also performed. Avidity test was carried out, on confirmed positive samples lacking p31 reactivity, to discriminate between recent (true Fiebig V phase) and late infections; to avoid possible misclassifications, clinical data were also used. Demographic, epidemiological, clinical and laboratory data are routinely, and anonymously recorded in the SENDIH and SIREA studies. During the study period, we observed 483 newly HIV diagnosed individuals, of whom 40 were identified as AHI (8.3%). Fiebig classification showed: 7 stage II/III, 13 stage IV, 20 stage V. Demographic, epidemiological, and clinical characteristics of patients are shown in the Table. Overall, the study population had a median S/Co ratio at fourth generation EIA (Architect) of 49.50 (IQR, 23.54-98.05): values were significantly lower in Fiebig II-IV than in Fiebig V (38.68 [IQR, 20.08-54.84] vs 75.72 [IQR, 42.66-249.80], p=0.01). Overall, median HIV-1 RNA was 5

  17. Clinical and epidemiological aspects of parvovirus B19 infections in Ireland, January 1996-June 2008.

    LENUS (Irish Health Repository)

    Nicolay, N

    2009-01-01

    Parvovirus B19 infection may be mistakenly reported as measles or rubella if laboratory testing is not performed. As Europe is seeking to eliminate measles, an accurate diagnosis of fever\\/rash illnesses is needed. The main purpose of this study was to describe the epidemiological pattern of parvovirus B19, a common cause of rash, in Ireland between January 1996 and June 2008, using times series analysis of laboratory diagnostic data from the National Virus Reference Laboratory. Most diagnostic tests for presumptive parvovirus B19 infection were done in children under the age of five years and in women of child-bearing age (between 20-39 years-old). As a consequence, most of the acute diagnoses of B19 infection were made in these populations. The most commonly reported reasons for testing were: clinical presentation with rash, acute arthritis, influenza-like symptoms or pregnancy. The time series analysis identified seasonal trends in parvovirus B19 infection, with annual cycles peaking in late winter\\/spring and a six-year cycle for parvovirus B19 outbreaks in Ireland.

  18. Experimental basis for the clinical epidemiology of fungal infections. A review.

    Science.gov (United States)

    Schaffner, A

    1989-10-01

    Based on the concept that the agents of deep fungal infections can be divided into primary pathogens and opportunists the experimental basis for the clinical epidemiology of mycoses is outlined. Kinetics of experimental infections with opportunists and primary pathogens discriminate between the two fungal categories. Natural resistance eliminates opportunists and prevents the establishment of progressive infection in the normal host. Primary pathogens call upon mechanisms of adoptive cell mediated immunity for their control. Therefore athymic mice which are not more susceptible to opportunists than control mice, cannot control infection with primary pathogens. In order to induce comparable overwhelming opportunistic mycoses with reasonable challenge doses, non-specific phagocytic resistance has to be eliminated. In agreement with in vivo studies, in vitro studies of the susceptibility of fungi to killing by phagocytes point out, that the susceptibility of the tissue phase of fungi to killing by "immunologically unarmed" phagocytes discriminates between opportunists and primary pathogens. In order to restrain primary pathogenic fungi, phagocytes have also in vitro to call upon adoptive, T cell-dependent immune mechanisms, which appear superfluous for control of opportunists. This difference explains the discrepant opportunistic proclivities of the two fungal categories. Patients with defective phagocytic defenses are prone to opportunistic mycoses, while deficient cell mediated immunity results in a greater vulnerability to primary pathogens.

  19. Impact of Mucorales and Other Invasive Molds on Clinical Outcomes of Polymicrobial Traumatic Wound Infections.

    Science.gov (United States)

    Warkentien, Tyler E; Shaikh, Faraz; Weintrob, Amy C; Rodriguez, Carlos J; Murray, Clinton K; Lloyd, Bradley A; Ganesan, Anuradha; Aggarwal, Deepak; Carson, M Leigh; Tribble, David R

    2015-07-01

    Combat trauma wounds with invasive fungal infections (IFIs) are often polymicrobial with fungal and bacterial growth, but the impact of the wound microbiology on clinical outcomes is uncertain. Our objectives were to compare the microbiological features between IFI and non-IFI wounds and evaluate whether clinical outcomes differed among IFI wounds based upon mold type. Data from U.S. military personnel injured in Afghanistan with IFI wounds were examined. Controls were matched by the pattern/severity of injury, including blood transfusion requirements. Wound closure timing was compared between IFI and non-IFI control wounds (with/without bacterial infections). IFI wound closure was also assessed according to mold species isolation. Eighty-two IFI wounds and 136 non-IFI wounds (63 with skin and soft tissue infections [SSTIs] and 73 without) were examined. The time to wound closure was longer for the IFI wounds (median, 16 days) than for the non-IFI controls with/without SSTIs (medians, 12 and 9 days, respectively; P molds (predominant types: order Mucorales, Aspergillus spp., and Fusarium spp.) significantly prolonged the time to wound closure. Overall, the times to wound closure were longest for the IFI wounds with Mucorales growth. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  20. Infection control in clinical placements: experiences of nursing and midwifery students.

    Science.gov (United States)

    Ward, Deborah J

    2010-07-01

    This paper is a report of a study of the experiences of nursing and midwifery students in relation to infection control in their clinical placements and how these affect their learning. Compliance with infection control precautions has been found to be low in many areas. Reasons for non-compliance include factors relevant to nursing and midwifery students, such as lack of knowledge and lack of a positive role model. However, there is little in the literature about how students experience infection control in placements and how this affects their own practice. Semi-structured interviews were undertaken in 2009 with 40 nursing and midwifery students. Analysis of transcripts was by Framework analysis. Students identified practices that they had observed and benchmarked these against what they had been taught at university and what was demonstrated by staff perceived as positive role models. Observing inappropriate practice affected student practice both positively and negatively. Students were reluctant to report poor practice due to fear of failing placements and not wanting to be identified negatively by staff. Students believed that practice supported by theory was important to provide them with a rationale for their activities and to support any complaints that they had. Poor practice in clinical placements can have a negative impact on student learning and practice and may therefore have implications for the practice of future nurses and midwives. In order to maintain patient safety, there needs to be more support for students who wish to identify poor practice.

  1. Clinical features and epidemiology of Acinetobacter baumannii colonization and infection in Spanish hospitals.

    Science.gov (United States)

    Rodríguez-Baño, Jesús; Cisneros, Jose M; Fernández-Cuenca, Felipe; Ribera, Anna; Vila, Jordi; Pascual, Alvaro; Martínez-Martínez, Luis; Bou, German; Pachón, Jerónimo

    2004-10-01

    To investigate the clinical features and the epidemiology of Acinetobacter baumannii in Spanish hospitals. Prospective multicenter cohort study. Twenty-seven general hospitals and one paraplegic center in Spain. All cases of A. baumannii colonization or infection detected by clinical samples during November 2000 were included. Isolates were identified using phenotypic and genotypic methods. The molecular relatedness of the isolates was assessed by pulsed-field gel electrophoresis. Twenty-five (89%) of the hospitals had 221 cases (pooled rate in general hospitals, 0.39 case per 1,000 patient-days; range, 0 to 1.17). The rate was highest in intensive care units (ICUs). Only 3 cases were pediatric. The mean age of the patients in the general hospitals was 63 years; 69% had a chronic underlying disease and 80% had previously received antimicrobial treatment. Fifty-three percent of the patients had an infection (respiratory tract, 51%; surgical site, 16%; and urinary tract, 11%). Crude mortality was higher in infected than in colonized patients (27% vs 10%; relative risk, 1.56; 95% confidence interval, 1.2 to 2.0; P = .003). Molecular analysis disclosed 79 different clones. In most hospitals, a predominant epidemic clone coexisted with other sporadic clones. Imipenem resistance was present in 39% of the hospitals. A. baumannii was present in most participating Spanish hospitals (particularly in ICUs) with different rates among them. The organisms mainly affected predisposed patients; half of them were only colonized. Epidemic and sporadic clones coexisted in many centers.

  2. Virus and host factors affecting the clinical outcome of bluetongue virus infection.

    Science.gov (United States)

    Caporale, Marco; Di Gialleonorado, Luigina; Janowicz, Anna; Wilkie, Gavin; Shaw, Andrew; Savini, Giovanni; Van Rijn, Piet A; Mertens, Peter; Di Ventura, Mauro; Palmarini, Massimo

    2014-09-01

    Bluetongue is a major infectious disease of ruminants caused by bluetongue virus (BTV), an arbovirus transmitted by Culicoides. Here, we assessed virus and host factors influencing the clinical outcome of BTV infection using a single experimental framework. We investigated how mammalian host species, breed, age, BTV serotypes, and strains within a serotype affect the clinical course of bluetongue. Results obtained indicate that in small ruminants, there is a marked difference in the susceptibility to clinical disease induced by BTV at the host species level but less so at the breed level. No major differences in virulence were found between divergent serotypes (BTV-8 and BTV-2). However, we observed striking differences in virulence between closely related strains of the same serotype collected toward the beginning and the end of the European BTV-8 outbreak. As observed previously, differences in disease severity were also observed when animals were infected with either blood from a BTV-infected animal or from the same virus isolated in cell culture. Interestingly, with the exception of two silent mutations, full viral genome sequencing showed identical consensus sequences of the virus before and after cell culture isolation. However, deep sequencing analysis revealed a marked decrease in the genetic diversity of the viral population after passaging in mammalian cells. In contrast, passaging in Culicoides cells increased the overall number of low-frequency variants compared to virus never passaged in cell culture. Thus, Culicoides might be a source of new viral variants, and viral population diversity can be another factor influencing BTV virulence. Bluetongue is one of the major infectious diseases of ruminants. It is caused by an arbovirus known as bluetongue virus (BTV). The clinical outcome of BTV infection is extremely variable. We show that there are clear links between the severity of bluetongue and the mammalian host species infected, while at the breed

  3. Apoptosis and clinical severity in patients with psoriasis and HCV infection

    Directory of Open Access Journals (Sweden)

    Sami A Gabr

    2014-01-01

    Full Text Available Background: It has been proposed that hepatitis C virus (HCV antigens are involved in the pathogenesis of psoriasis and may contribute to severity of the disease. Increased expression of the apoptosis-regulating proteins p53 and tTG and decreased levels of bcl-2 in the keratinocytes of the skin of psoriatic patients have been reported. Aim: This study aims to identify the serum levels of apoptosis-regulating proteins in patients with psoriasis and without HCV infection and to study the relation between clinical severity of psoriasis and the presence of HCV infection. Materials and Methods: Disease severity was assessed by psoriasis area severity index score (PASI of 90 patients with psoriasis grouped as mild (n = 30, moderate (n = 30 and severe (n = 30; 20 healthy individuals were used as controls. All groups were subjected for complete history taking, clinical examination, and tests for liver function and HCV infection. The serum levels of apoptosis related proteins: p53, tTG and bcl-2 were estimated by enzyme linked immune sorbent assay (ELISA. Results: There was a statistically significant (P < 0.001 correlation between clinical severity of psoriasis and presence of HCV antibodies and HCV-mRNA. In addition, significantly (P < 0.001 raised serum p53 and tTG, and reduced bcl-2 were observed among HCV-positive patients as compared to HCV-negative patients and control patients. Conclusion: These results conclude that clinical severity of psoriasis is affected by the presence of HCV antibodies and overexpression of apoptotic related proteins. In addition, altered serum levels of apoptosis-regulating proteins could be useful prognostic markers and therapeutic targets of psoriatic disease.

  4. Clinical efficacy of florfenicol in the treatment of calf respiratory tract infections.

    Science.gov (United States)

    Aslan, V; Maden, M; Erganis, O; Birdane, F M; Corlu, M

    2002-02-01

    This paper reports on a study of the aetiology of calf pneumonia and the clinical efficacy of florfenicol, a new antibiotic in Turkey. Twenty-seven weaned and unweaned calves (13 males and 14 females) between 1 and 16 months of age brought to the clinics of Selçuk University, Faculty of Veterinary Science. Broncho-alveolar lavage (BAL) fluid samples were taken from the animals diagnosed to have upper respiratory tract infection associated with bronchitis (N=2), bronchitis (N=5), bronchopneumonia (N=4), pneumonia (N=3), pleuropneumonia (N=11), bronchopneumonia plus pulmonary oedema (N=2) based on the results of the clinical and laboratory examinations. Then microbiological isolation and antibiotic culturing were performed. The animals were treated with 1 ml/15 kg (20 mg/kg) florfenicol (Nuflor, DIF) twice within 48 hours via intramuscular injection. At the end of the treatment, 23 of the weaned and unweaned calves were completely healed, 1 calf had died and 3 calves showed no healing. The results of BAL samples and microbiological examinations of the 3 calves that did not respond to the treatment indicated that these cases were affected by mixed infections of yeasts, fungi, and bacteria. Widespread pleuropneumonia was observed. According to the results of the microbiological examination of the BAL samples, Mannheimia (Pasteurella) haemolytica had the highest isolation rate (25%) compared with the other isolated bacteria, namely, Klebsiella pneumonia (20%), Actinomyces pyogenes (15%), beta-hemolytic streptococci. (10%), Staphylococcus spp. (5%), and E. coli (5%). The study also revealed fungi [Penicillum spp. (5%) and Aspergillus spp. (5%)] and two calves (10%) had a yeast infection.. We conclude that florfenicol has a high bacteriological and clinical efficacy (100% and 96% respectively) in the treatment of calf respiratory tract diseases.

  5. Real-time polymerase chain reaction correlates well with clinical diagnosis of Clostridium difficile infection.

    Science.gov (United States)

    Berry, N; Sewell, B; Jafri, S; Puli, C; Vagia, S; Lewis, A M; Davies, D; Rees, E; Ch'ng, C L

    2014-06-01

    To determine the clinical utility of a rapid molecular assay for Clostridium difficile infection (CDI) in an acute hospital setting. From March to September 2011, stool specimens from inpatients in two acute hospitals with suspected CDI were tested prospectively by routine cell culture cytotoxin neutralization assay (CCNA), real-time polymerase chain reaction (PCR) using the GeneXpert (Cepheid Inc., Sunnyvale, CA, USA), and a dual testing algorithm [glutamate dehydrogenase (GDH)/toxin enzyme immuno-assay, Premier, Launch Diagnostics, Longfield, UK]. All patients with positive PCR, CCNA or discrepant results were reviewed by a multi-disciplinary team (treating clinician, gastroenterologist, microbiologist and infection control nurse). C. difficile detection rates were 11.7% (PCR), 6% (CCNA) and 13.8% (GDH). Out of 1034 stool specimens included in the study, 974 (94.1%) had concordant CCNA and PCR results. Eighty-nine percent (886/985) had concordant CCNA, PCR and GDH results, and 94.4% (930/985) had concordant GDH and PCR results. Using clinical diagnosis as the reference, PCR had sensitivity of 99.1%, specificity of 98.9%, positive predictive value (PPV) of 91.9% and negative predictive value (NPV) of 99.9%. CCNA on a single sample had sensitivity of 51%, specificity of 99.4%, PPV of 91.9% and NPV of 94.3%. GDH had sensitivity of 83.8%, specificity of 94.5%, PPV of 64.7% and NPV of 97.9%. Almost twice as many patients were positive by PCR compared with CCNA (121 vs 62); 54/59 of those with discrepant results were clinically confirmed as CDI. Rapid diagnosis of CDI using PCR was timely, accurate and correlated well with clinical diagnosis. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  6. The porcine acute phase protein response to acute clinical and subclinical experimental infection with Streptococcus suis

    DEFF Research Database (Denmark)

    Sørensen, Nanna Skall; Tegtmeier, C.; Andresen, Lars Ole

    2006-01-01

    .i.), until the pigs were killed and autopsied on day 14 p.i. Clinical signs (fever and lameness) were observed in four of the five inoculated pigs from day 2 p.i., and these pigs also had arthritic lesions at autopsy. CRP and SAA showed fast increases in serum concentrations, CRP being elevated from days 1...... signs and no arthritic lesions showed an APP response comparable to that of the other, clinically affected pigs. Thus, both acute clinical and subclinical S. suis infection could be revealed by the measurement of one or more of the APPs CRP, SAA, Hp, pig-MAP and Apo A-I. The combined measurement of two...

  7. Surgical-site infections and postoperative complications: agreement between the Danish Gynecological Cancer Database and a randomized clinical trial

    DEFF Research Database (Denmark)

    Antonsen, Sofie L; Meyhoff, Christian Sylvest; Lundvall, Lene

    2011-01-01

    -operation, urinary tract infection, pneumonia and sepsis. RESULTS: Surgical-site infection was found in 21 of 222 patients (9.5%) in the PROXI trial versus 6 of 222 patients (2.7%) in the DGCD (p infections were...... registered in the PROXI trial, but not in the DGCD. Agreements between secondary outcomes were very varying (kappa-value 0.77 for re-operation, 0.37 for urinary tract infections, 0.19 for sepsis and 0.18 for pneumonia). CONCLUSIONS: The randomized trial reported significantly more surgical-site infections......OBJECTIVE: Surgical-site infections are serious complications and thorough follow-up is important for accurate surveillance. We aimed to compare the frequency of complications recorded in a clinical quality database with those noted in a randomized clinical trial with follow-up visits. DESIGN...

  8. Clinical features, outcomes, and cerebrospinal fluid findings in adult patients with central nervous system (CNS) infections caused by varicella-zoster virus: comparison with enterovirus CNS infections.

    Science.gov (United States)

    Hong, Hyo-Lim; Lee, Eun Mi; Sung, Heungsup; Kang, Joong Koo; Lee, Sang-Ahm; Choi, Sang-Ho

    2014-12-01

    Varicella-zoster virus (VZV) is known to be associated with central nervous system (CNS) infections in adults. However, the clinical characteristics of VZV CNS infections are not well characterized. The aim of this study was to compare the clinical manifestations, outcomes, and cerebrospinal fluid (CSF) findings in patients with VZV CNS infections with those in patients with enterovirus (EV) CNS infections. This retrospective cohort study was performed at a 2,700-bed tertiary care hospital. Using a clinical microbiology computerized database, all adults with CSF PCR results positive for VZV or EV that were treated between January 1999 and February 2013 were identified. Thirty-eight patients with VZV CNS infection and 68 patients with EV CNS infection were included in the study. Compared with the EV group, the median age in the VZV group was higher (VZV, 35 years vs. EV, 31 years; P = 0.02), and showed a bimodal age distribution with peaks in the third and seventh decade. Encephalitis was more commonly encountered in the VZV group (VZV, 23.7% vs. EV, 4.4%; P = 0.01). The median lymphocyte percentage in the CSF (VZV, 81% vs. EV, 36%; P < 0.001) and the CSF protein level (VZV, 100 mg/dl vs. EV, 46 mg/dl; P < 0.001) were higher in the VZV group. Compared with patients with EV CNS infection, patients with VZV CNS infection developed encephalitis more often and exhibited more intense inflammatory reaction. Nevertheless, both VZV and EV CNS infections were associated with excellent long-term prognosis. © 2014 Wiley Periodicals, Inc.

  9. Microbiological and clinical aspects of respiratory infections associated with Bordetella bronchiseptica.

    Science.gov (United States)

    García-de-la-Fuente, Celia; Guzmán, Laura; Cano, María Eliecer; Agüero, Jesús; Sanjuán, Carmen; Rodríguez, Cristina; Aguirre, Amaia; Martínez-Martínez, Luis

    2015-05-01

    Bordetella bronchiseptica is a well-known veterinary pathogen, but its implication in human disease is probably not fully recognized. The purpose of this study was to determine the clinical significance of 36 B. bronchiseptica isolates from respiratory samples of 22 patients. Therefore, we describe microbiological characteristics, including phenotypic and genotypic identification as well as antimicrobial susceptibilities of the isolates. Clonal relatedness was evaluated using pulsed-field gel electrophoresis (PFGE). Most of the patients had some underlying immunosuppressive condition. Eighteen out of 22 (82%) patients had respiratory symptoms, and the death of 2 patients was associated with respiratory infection.All strains were correctly identified at species level by the simultaneous use of phenotypic methods and were confirmed by specific amplification of the upstream region of the fla gene. Tigecycline, minocycline, doxycycline, colistin, and meropenem were the most active agents tested. PFGE analysis revealed that repeated infections involving each patient had been caused by the same strain. Published by Elsevier Inc.

  10. HIV infection and its association with an excess risk of clinical fractures: A nationwide case-control study

    NARCIS (Netherlands)

    Prieto-Alhambra, Daniel; Güerri-Fernández, Robert; De Vries, Frank|info:eu-repo/dai/nl/303546670; Lalmohamed, Arief|info:eu-repo/dai/nl/357580680; Bazelier, Marloes|info:eu-repo/dai/nl/341589802; Starup-Linde, Jakob; Diez-Perez, Adolfo; Cooper, Cyrus; Vestergaard, Peter

    2014-01-01

    BACKGROUND: Different studies have reported an association between HIV infection, antiretroviral therapies, and impaired bone metabolism, but data on their impact on fracture risk are scarce. We studied the association between a clinical diagnosis of HIV infection and fracture risk. METHODS: We

  11. Clinical Trial and In Vitro Study for the Role of Cartilage and Synovia in Acute Articular Infection

    DEFF Research Database (Denmark)

    Langenmair, E. R.; Kubosch, E. J.; Salzmann, G. M.

    2015-01-01

    Objective. Osteoarthritis is a long-term complication of acute articular infections. However, the roles of cartilage and synovia in this process are not yet fully understood. Methods. Patients with acute joint infections were enrolled in a prospective clinical trial and the cytokine composition o...

  12. The pH of wound fluid in diabetic foot ulcers -- the way forward in detecting clinical infection?

    Science.gov (United States)

    McArdle, Carla; Lagan, Katie M; McDowell, David A

    2014-05-01

    Infections within diabetic foot ulcers are often hard to detect and extremely difficult to treat. The normal signs and symptoms of infection including purulence, erythema, pain, tenderness, warmth and induration are frequently absent in such wounds necessitating exploration of other ways of rapidly and accurately detecting infection. This study considers diabetic wound fluid pH as a possible alternative means of monitoring infection status. CINAHL, Ovid SP and MEDLINE were searched for papers in English published between January 2004 to May 2014. Key search terms included wound fluid, exudate, wound, ulcer, diabetes, pH, healing, infection, bacteria. This paper considers the potential benefits of augmenting and supporting current clinical practice in the early determination of wound healing trajectory and infection status, by monitoring wound fluid pH. The evidence collected highlights the need for further research and suggests the potential of wound fluid analysis as a possible surrogate marker for detecting infection in diabetic foot ulcers.

  13. Epidemiologic and clinical impact of Acinetobacter baumannii colonization and infection: a reappraisal.

    Science.gov (United States)

    Villar, Macarena; Cano, María E; Gato, Eva; Garnacho-Montero, José; Miguel Cisneros, José; Ruíz de Alegría, Carlos; Fernández-Cuenca, Felipe; Martínez-Martínez, Luis; Vila, Jordi; Pascual, Alvaro; Tomás, María; Bou, Germán; Rodríguez-Baño, Jesús

    2014-07-01

    Acinetobacter baumannii is one of the most important antibiotic-resistant nosocomial bacteria. We investigated changes in the clinical and molecular epidemiology of A. baumannii over a 10-year period. We compared the data from 2 prospective multicenter cohort studies in Spain, one performed in 2000 (183 patients) and one in 2010 (246 patients), which included consecutive patients infected or colonized by A. baumannii. Molecular typing was performed by repetitive extragenic palindromic polymerase chain reaction (REP-PCR), pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST). The incidence density of A. baumannii colonization or infection increased significantly from 0.14 in 2000 to 0.52 in 2010 in medical services (p < 0.001). The number of non-nosocomial health care-associated cases increased from 1.2% to 14.2%, respectively (p < 0.001). Previous exposure to carbapenems increased in 2010 (16.9% in 2000 vs 27.3% in 2010, p = 0.03). The drugs most frequently used for definitive treatment of patients with infections were carbapenems in 2000 (45%) and colistin in 2010 (50.3%). There was molecular-typing evidence of an increase in the frequency of A. baumannii acquisition in non-intensive care unit wards in 2010 (7.6% in 2000 vs 19.2% in 2010, p = 0.01). By MSLT, the ST2 clonal group predominated and increased in 2010. This epidemic clonal group was more frequently resistant to imipenem and was associated with an increased risk of sepsis, although not with severe sepsis or mortality. Some significant changes were noted in the epidemiology of A. baumannii, which is increasingly affecting patients admitted to conventional wards and is also the cause of non-nosocomial health care-associated infections. Epidemic clones seem to combine antimicrobial resistance and the ability to spread, while maintaining their clinical virulence.

  14. Clinical definition of respiratory viral infections in young children and potential bronchiolitis misclassification.

    Science.gov (United States)

    Megalaa, Rosemary; Perez, Geovanny F; Kilaikode-Cheruveettara, Sasikumar; Kotwal, Nidhi; Rodriguez-Martinez, Carlos E; Nino, Gustavo

    2017-09-24

    Viral respiratory infections are often grouped as a single respiratory syndrome named 'viral bronchiolitis', independently of the viral etiology or individual risk factors. Clinical trials and guidelines have used a more stringent definition of viral bronchiolitis, including only the first episode of wheezing in children less than 12 months of age without concomitant respiratory comorbidities. There is increasing evidence suggesting that this definition is not being followed by pediatric care providers, but it is unclear to what extent viral respiratory infections are currently misclassified as viral bronchiolitis using standard definitions. We conducted a retrospective analysis of hospitalized young children (≤3 years) due to viral respiratory infections. Bronchiolitis was defined as the first wheezing episode less than 12 months of age. Demographic variables and comorbidities were obtained by electronic medical record review. The study comprised a total of 513 hospitalizations (n=453). Viral bronchiolitis was diagnosed in 144 admissions (28.1%). Notably, we identified that the majority of children diagnosed with bronchiolitis (63%) were misclassified as they had prior episodes of wheezing. Many children with bronchiolitis misclassification had significant comorbidities, including prematurity (51%), neuromuscular conditions (9.8%), and congenital heart disease (9.8%). Misclassification of bronchiolitis is a common problem that may lead to inappropriate management of viral respiratory infections in young children. A comprehensive approach that takes into consideration viral etiology and individual risk factors may lead to a more accurate clinical assessment of this condition and would potentially prevent bronchiolitis misclassification. © American Federation for Medical Research (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. T-cell exhaustion, co-stimulation and clinical outcome in autoimmunity and infection.

    Science.gov (United States)

    McKinney, Eoin F; Lee, James C; Jayne, David R W; Lyons, Paul A; Smith, Kenneth G C

    2015-07-30

    The clinical course of autoimmune and infectious disease varies greatly, even between individuals with the same condition. An understanding of the molecular basis for this heterogeneity could lead to significant improvements in both monitoring and treatment. During chronic infection the process of T-cell exhaustion inhibits the immune response, facilitating viral persistence. Here we show that a transcriptional signature reflecting CD8 T-cell exhaustion is associated with poor clearance of chronic viral infection, but conversely predicts better prognosis in multiple autoimmune diseases. The development of CD8 T-cell exhaustion during chronic infection is driven both by persistence of antigen and by a lack of accessory 'help' signals. In autoimmunity, we find that where evidence of CD4 T-cell co-stimulation is pronounced, that of CD8 T-cell exhaustion is reduced. We can reproduce the exhaustion signature by modifying the balance of persistent stimulation of T-cell antigen receptors and specific CD2-induced co-stimulation provided to human CD8 T cells in vitro, suggesting that each process plays a role in dictating outcome in autoimmune disease. The 'non-exhausted' T-cell state driven by CD2-induced co-stimulation is reduced by signals through the exhaustion-associated inhibitory receptor PD-1, suggesting that induction of exhaustion may be a therapeutic strategy in autoimmune and inflammatory disease. Using expression of optimal surrogate markers of co-stimulation/exhaustion signatures in independent data sets, we confirm an association with good clinical outcome or response to therapy in infection (hepatitis C virus) and vaccination (yellow fever, malaria, influenza), but poor outcome in autoimmune and inflammatory disease (type 1 diabetes, anti-neutrophil cytoplasmic antibody-associated vasculitis, systemic lupus erythematosus, idiopathic pulmonary fibrosis and dengue haemorrhagic fever). Thus, T-cell exhaustion plays a central role in determining outcome in

  16. Frequency and Spectrum of Unexpected Clinical Manifestations of Primary HIV-1 Infection.

    Science.gov (United States)

    Braun, Dominique L; Kouyos, Roger D; Balmer, Belinda; Grube, Christina; Weber, Rainer; Günthard, Huldrych F

    2015-09-15

    Prospectively and systematically collected data on frequency and spectrum of unexpected clinical manifestations during primary human immunodeficiency virus (HIV) infection (PHI) have not been published. We prospectively enrolled 290 patients with documented PHI in the Zurich Primary HIV Infection Study. Typical acute retroviral syndrome (ARS) was defined as fever plus at least 1 symptom or sign typically considered to be associated with ARS; in absence of fever, presence of 2 or more ARS symptoms or signs. Atypical ARS was defined as lack of symptoms or signs, a single symptom or sign only and absence of fever, presence of symptoms or signs that are not considered typically associated with ARS, or occurrence of an opportunistic disease. Time to diagnosis was calculated based on estimated date of infection and first positive HIV test. We analyzed 290 patients (271 males). PHI manifested with typical ARS in 202 (70%) and with atypical ARS in 88 (30%) patients. Patients with atypical ARS were hospitalized 4 times more often compared with typical ARS (43% vs 11%; P HIV infection suspected during the first medical attendance. Patients with typical ARS were diagnosed slightly earlier compared with atypical ARS, but this difference was not significant (P = .3). Unexpected clinical presentations occurred in a large fraction of patients with PHI and were associated with substantial morbidity. Universal HIV testing may be mandatory in high-risk groups. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  17. Clinical features and seasonality of parechovirus infection in an Asian subtropical city, Hong Kong.

    Directory of Open Access Journals (Sweden)

    Grace P K Chiang

    Full Text Available The epidemiology of human parechovirus (HPeV in Asia remains obscure. We elucidated the prevalence, seasonality, type distribution and clinical presentation of HPeV among children in Hong Kong.A 24-month prospective study to detect HPeV in children ≤36 months hospitalized for acute viral illnesses.2.3% of the 3911 children examined had HPeV infection, with most (87.5% concentrated in September-January (autumn-winter. 81.3% were HPeV1 and 12.5% were HPeV4, while HPeV3 was rare (2.5%. HPeV was a probable cause of the disease in 47.7% (42/88, mostly self-limiting including acute gastroenteritis, upper respiratory tract infection and maculopapular rash. A neonate developed severe sepsis-like illness with HPeV3 as the only pathogen detected. A high proportion (60.0% of children coinfected with HPeV and other respiratory virus(es had acute bronchiolitis or pneumonia. Six children with HPeV coinfections developed convulsion / pallid attack. Most rash illnesses exhibited a generalized maculopapular pattern involving the trunk and limbs, and were more likely associated with HPeV4 compared to other syndrome groups (36.4% vs. 3.1%, p = 0.011.In Hong Kong, HPeV exhibits a clear seasonality (autumn-winter and was found in a small proportion (2.3% of young children (≤36 months admitted with features of acute viral illnesses. The clinical presentation ranged from mild gastroenteritis, upper respiratory tract infection and febrile rash to convulsion and severe sepsis-like illness. HPeV3, which is reported to associate with more severe disease in neonates, is rare in Hong Kong. HPeV coinfection might associate with convulsion and aggravate other respiratory tract infections.

  18. Clinical and Pathologic Responses of American Crows (Corvus brachyrhynchos) and Fish Crows (C ossifragus) to Experimental West Nile Virus Infection

    National Research Council Canada - National Science Library

    Nemeth, N. M; Thomsen, B. V; Spraker, T. R; Benson, J. M; Bosco-Lauth, A. M; Oesterle, P. T; Bright, J. M; Muth, J. P; Campbell, T. W; Gidlewski, T. L; Bowen, R. A

    2011-01-01

    .... Unlike fish crows, which remained clinically normal throughout the study, American crows succumbed to WNV infection subsequent to dehydration, electrolyte and pH imbalances, and delayed or depressed...

  19. Clinical condition and comorbidity as determinants for blood culture positivity in patients with skin and soft-tissue infections

    NARCIS (Netherlands)

    van Daalen, F. V.; Kallen, M. C.; van den Bosch, C. M. A.; Hulscher, M. E. J. L.; Geerlings, S. E.; Prins, J. M.

    2017-01-01

    The utility of performing blood cultures in patients with a suspected skin infection is debated. We investigated the association between blood culture positivity rates and patients' clinical condition, including acute disease severity and comorbidity. We performed a retrospective study, including

  20. Clinical features of acute respiratory infections associated with the Streptococcus milleri group in the elderly.

    Science.gov (United States)

    Sugihara, Eiichiro; Kido, Yasuko; Okamoto, Masaki; Koyanagi, Takeshi; Niizeki, Takashi; Hirota, Naotoshi; Minami, Shuwa; Kinoshita, Takashi; Uehara, Yasuko; Koga, Hideyuki; Ono, Noriyuki; Rikimaru, Toru; Aizawa, Hisamichi

    2004-01-01

    The Streptococcus milleri group are becoming increasingly recognized as important pulmonary pathogens which may lead to the development of empyema or lung abscesses. Although several small series have been reported, the clinical and laboratory features of Streptococcus milleri infection have yet to be fully characterized in the elderly. We retrospectively examined the clinical features of 19 patients with Streptococcus milleri pulmonary disease who were admitted to our hospital between 2000 and 2002, based on their clinical records and laboratory data. The microbiological diagnosis was based on the results of quantitative sputum culture and other invasive procedures, including transthoracic needle aspiration or bronchoscopic examinations. There were thirteen cases of pneumonia, two of contaminant pneumonia and pleuritis, one of bronchitis, two of pulmonary abscess, and one of empyema. The patients ranged in age from 65 to 91. The most common symptoms at presentation were shortness of breath, coughing, sputum, and weight loss. An underlying disease existed in 14 of the 19 cases. We conclude that the Streptococcus milleri group is a more important cause of pulmonary infections than has been previously recognized.

  1. Antimicrobial susceptibility of Acinetobacter clinical isolates and emerging antibiogram trends for nosocomial infection management.

    Science.gov (United States)

    Sohail, Muhammad; Rashid, Abid; Aslam, Bilal; Waseem, Muhammad; Shahid, Muhammad; Akram, Muhammad; Khurshid, Mohsin; Rasool, Muhammad Hidayat

    2016-01-01

    The drug resistant Acinetobacter strains are important causes of nosocomial infections that are difficult to control and treat. This study aimed to determine the antimicrobial susceptibility patterns of Acinetobacter strains isolated from different clinical specimens obtained from patients belonging to different age groups. In total, 716 non-duplicate Acinetobacter isolates were collected from the infected patients admitted to tertiary-care hospitals at Lahore, Pakistan, over a period of 28 months. The Acinetobacter isolates were identified using API 20E, and antimicrobial susceptibility testing was performed and interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. The isolation rate of Acinetobacter was high from the respiratory specimens, followed by wound samples. Antibiotic susceptibility analyses of the isolates revealed that the resistance to cefotaxime and ceftazidime was the most common, in 710 (99.2%) specimens each, followed by the resistance to gentamicin in 670 (93.6%) isolates, and to imipenem in 651 (90.9%) isolates. However, almost all isolates were susceptible to tigecycline, colistin, and polymyxin B. The present study showed the alarming trends of resistance of Acinetobacter strains isolated from clinical specimens to the various classes of antimicrobials. The improvement of microbiological techniques for earlier and more accurate identification of bacteria is necessary for the selection of appropriate treatments.

  2. Antimicrobial susceptibility of Acinetobacter clinical isolates and emerging antibiogram trends for nosocomial infection management

    Directory of Open Access Journals (Sweden)

    Muhammad Sohail

    2016-06-01

    Full Text Available Abstract: Introduction: The drug resistant Acinetobacter strains are important causes of nosocomial infections that are difficult to control and treat. This study aimed to determine the antimicrobial susceptibility patterns of Acinetobacter strains isolated from different clinical specimens obtained from patients belonging to different age groups. METHODS: In total, 716 non-duplicate Acinetobacter isolates were collected from the infected patients admitted to tertiary-care hospitals at Lahore, Pakistan, over a period of 28 months. The Acinetobacter isolates were identified using API 20E, and antimicrobial susceptibility testing was performed and interpreted according to Clinical and Laboratory Standards Institute (CLSI guidelines. RESULTS: The isolation rate of Acinetobacter was high from the respiratory specimens, followed by wound samples. Antibiotic susceptibility analyses of the isolates revealed that the resistance to cefotaxime and ceftazidime was the most common, in 710 (99.2% specimens each, followed by the resistance to gentamicin in 670 (93.6% isolates, and to imipenem in 651 (90.9% isolates. However, almost all isolates were susceptible to tigecycline, colistin, and polymyxin B. CONCLUSIONS: The present study showed the alarming trends of resistance of Acinetobacter strains isolated from clinical specimens to the various classes of antimicrobials. The improvement of microbiological techniques for earlier and more accurate identification of bacteria is necessary for the selection of appropriate treatments.

  3. Gastrointestinal trichostrongylosis can predispose ewes to clinical mastitis after experimental mammary infection.

    Science.gov (United States)

    Mavrogianni, V S; Papadopoulos, E; Gougoulis, D A; Gallidis, E; Ptochos, S; Fragkou, I A; Orfanou, D C; Fthenakis, G C

    2017-10-15

    Objective was to study, in an experimental model, the possible role of gastrointestinal nematode infection in predisposing ewes to mastitis during the lactation period. Twenty-four ewes (A or B [n=12]), free from nematode and trematode helminths, were used. Group A animals received 5000 third-stage larvae of a trichostrongylid helminth cocktail and group B ewes were unparasitised controls. Animals in group A developed gastrointestinal trichostrongylosis confirmed by >500epg in faecal samples; mean epg of group B ewes were mastitis; no ewe in group B developed clinical mastitis, but only subclinical (12 ewes) (P=0.002). M. haemolytica was isolated from 132/132 and 121/132 udder samples from group A or B, respectively (Pmastitis than in others which did not (0.709 and 0.162 versus 0.662 and 0.136, respectively; Pmastitis (in group A or B), inducible-lymphoid-follicles were observed in the teat, which were not observed in ewes with clinical disease. Total pathology scores summed over all days were 127 and 73 for group A or B ewes, respectively (maximum possible 192; Pmastitis. It is concluded that, in view of bacterial challenge, gastrointestinal trichostrongylosis and particularly Teladorsagia infection, might lead to clinical mastitis, through various pathogenetic pathways. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Clinical Manifestations and Outcomes of Rickettsia australis Infection: A 15-Year Retrospective Study of Hospitalized Patients

    Directory of Open Access Journals (Sweden)

    Adam Stewart

    2017-06-01

    Full Text Available Queensland tick typhus (QTT; Rickettsia australis is an important cause of community-acquired acute febrile illness in eastern Australia. Cases of QTT were identified retrospectively from 2000 to 2015 at five sites in Northern Brisbane through a pathology database. Those included had a fourfold rise in spotted fever group (SFG-specific serology, a single SFG-specific serology ≥ 256 or SFG-specific serology ≥ 128 with a clinically consistent illness. Cases were excluded on the basis of clinical unlikelihood of QTT infection. Thirty-six cases were included. Fever was found in 34/36 (94% patients. Rash occurred in 83% of patients with maculopapular being the dominant morphology (70%. Thrombocytopenia, lymphopenia, and raised transaminases were common and occurred in 58%, 69%, and 89% of patients, respectively. Thirty-one of 36 (86% patients received antibiotic therapy (usually doxycycline and the time to correct antibiotic (from admission ranged from 3 to 120 h (mean 45.5 h. Four of 36 (11% required intensive care unit (ICU admission for severe sepsis and end-organ support. There were no deaths. QTT has a wide range of clinical and laboratory features. Early and appropriate antimicrobial therapy is important and may prevent severe disease. Further prospective studies are required to identify factors associated with severe infection and sepsis.

  5. High prevalence of occult hepatitis B virus genotype H infection among children with clinical hepatitis in west Mexico

    Directory of Open Access Journals (Sweden)

    Griselda Escobedo-Melendez

    2014-09-01

    Full Text Available Studies on the prevalence of infection with hepatitis B virus (HBV among children are scarce in Latin American countries, especially in Mexico. This study was aimed to investigate the prevalence of HBV infection, occult hepatitis B infection (OBI and HBV genotypes among children with clinical hepatitis. In total, 215 children with clinical hepatitis were evaluated for HBV infection. HBV serological markers and HBV DNA were analysed. OBI diagnosis and HBV genotyping was performed. HBV infection was found in 11.2% of children with clinical hepatitis. Among these HBV DNA positive-infected children, OBI was identified in 87.5% (n = 21/24 of the cases and 12.5% (n = 3/24 were positive for both HBV DNA and hepatitis B surface antigen. OBI was more frequent among children who had not been vaccinated against hepatitis B (p < 0.05 than in those who had been vaccinated. HBV genotype H was prevalent in 71% of the children followed by genotype G (8% and genotype A (4%. In conclusion, OBI is common among Mexican children with clinical hepatitis and is associated with HBV genotype H. The results show the importance of the molecular diagnosis of HBV infection in Mexican paediatric patients with clinical hepatitis and emphasise the necessity of reinforcing hepatitis B vaccination in children.

  6. Azithromycin in Labor Lowers Clinical Infections in Mothers and Newborns: A Double-Blind Trial.

    Science.gov (United States)

    Oluwalana, Claire; Camara, Bully; Bottomley, Christian; Goodier, Sean; Bojang, Abdoulie; Kampmann, Beate; Ceesay, Samba; D'Alessandro, Umberto; Roca, Anna

    2017-02-01

    We have recently completed a proof-of-concept trial showing that bacterial colonization decreased in women and newborns after the administration of azithromycin during labor. Here, we aim to assess the effect of the intervention on maternal and neonatal clinical infections. This was a double-blind, placebo-controlled randomized trial. Gambian women in labor were given either an oral dose of azithromycin (2 g) or placebo. Follow-up was conducted for 8 weeks after delivery. From April 2013 to April 2014, we recruited 829 mothers and their 830 newborns. Sixteen infants died during the follow-up period (8 per arm). No maternal deaths or serious adverse events related to the intervention were reported. Maternal infections were lower in the azithromycin group (3.6% vs 9.2%; relative risk [RR], 0.40; 95% confidence interval [CI], 0.22-0.71; P = .002), as was the prevalence of mastitis (1.4% vs 5.1%; RR, 0.29; 95% CI, 0.12-0.70; P = .005) and fever (1.9% vs 5.8%; RR, 0.33; 95% CI, 0.15-0.74; P = .006). Among newborns, the overall prevalence of infections was also lower in the azithromycin group (18.1% vs 23.8%; RR, 0.76; 95% CI, 0.58-0.99; P = .052) and there was a marked difference in prevalence of skin infections (3.1% vs 6.4%; RR, 0.49; 95% CI, 0.25-0.93; P = .034). Azithromycin given to women in labor decreases infections in both women and newborns during the puerperal period. Larger studies designed to evaluate the effect of the intervention on severe morbidity and mortality are warranted. Copyright © 2017 by the American Academy of Pediatrics.

  7. GBV-C viremia and clinical events in advanced HIV infection.

    Science.gov (United States)

    Sahni, Harleen; Kirkwood, Katherine; Kyriakides, Tassos C; Stapleton, Jack; Brown, Sheldon T; Holodniy, Mark

    2014-03-01

    GB Virus C (GBV-C) is a non-pathogenic flavivirus, commonly found in HIV infected patients. Studies suggest a survival benefit of GBV-C viremia in HIV infection. Impact of GBV-C viremia was evaluated on clinical outcome in multidrug-resistant HIV. The OPTIMA study enrolled advanced multidrug-resistant HIV patients with a CD4 count ≤300 cells/mm(3). This study included a subset of OPTIMA patients. Primary endpoints included AIDS events or death. GBV-C status was assessed at baseline and last time point on study by real-time PCR. Cox proportional hazards models were used to determine if CD4 count (100/mm(3)), treatment assignment, presence or disappearance of GBV-C viremia, GBV-C viral load level and Hepatitis C virus antibody status were associated with outcome. Of 288 patients (98% male, baseline mean age 48 years, HIV viral load 4.67 log10/ml, and CD4 127 cells/mm(3)), 62 (21.5%) had detectable GBV-C viremia. The mortality rate for GBV-C infected subjects was lower, 19/62 (30.7%) versus 87/226 (38.5%), and time to death shorter (HR 0.67, 95% CI 0.41-1.11), but the results were not significantly different. The time to development of AIDS events was not different (HR 0.90, 95% CI 0.52-1.53). Among covariates, only CD4 count (HR 0.28, CI 0.19-0.42) had a significant survival effect. A trend in decreased mortality was seen in GBV-C+ patients with CD4 GBV-C co-infection in multidrug-resistant HIV infected patients was associated with a trend in improved survival but not decreased AIDS events. Analysis was limited by cohort size. © 2013 Wiley Periodicals, Inc.

  8. Syphilis and HIV infections among pregnant women attending antenatal clinics in Republic of Congo.

    Science.gov (United States)

    Niama, Roch Fabien; Loukabou Bongolo, Nadia Claricelle; Bayonne Kombo, Edith Sophie; Yengo, Ruth; Mayengue, Pembe Issamou; Mandingha Kosso, Etoka-Beka; Louzolo, Igor; Macosso, Lucette; Dzeret, Ghislain; Dzabatou Babeaux, Angélie Serge Patrick; Puruehnce, Marie-Francke; Parra, Henri Joseph

    2017-01-01

    HIV and syphilis during pregnancy remain a public health concern especially in developing countries. Pregnant women attending antenatal clinics sites for the first time between September and December 2011 and who accepted to participate in the study were enrolled. The objective was to estimate the syphilis and HIV infection rate in this population. A study was conducted in 44 selected ANCs from 12 departments (5 urban and 7 rural). Pregnant women who accepted to participate in the study, attending selected sentinel ANCs sites for the first time between September and December 2011 were enrolled. To detect HIV antibodies, two consecutive ELISA assays were used (Genscreen Ultra HIV Ag/Ac, (BioRad, France) and Enzygnostic Intergral II (Siemens, GMBH, Marbug-Germany). In case of discordant results, the Western blot test II, HIV1 and 2 (Bio-Rad, Marne la Coquette, France) was used as the reference method. The RPR (Bio-Scan, Karnataka, India) test was performed to detect syphilis infection. The RPR positive results were confirmed using the TPHA test (Biotech, Cambridge, UK). Data were analyzed using SPSS 17.0 software. A total of 2979 pregnant women attending ANCs were enrolled. The global HIV infection rate was estimated to be 3.6% (CI: 95%; 3.0-4.4). As expected, HIV prevalence was significantly higher in women aged above 25 years (4.4% (3.4-5.6), p = 0.026) and those attending urban ANCs (5.04%, p syphilis occurrence was significantly higher among the single women compared to the married ones (4.4% VS 2.7%; p syphilis coinfection occurred in 22 cases (0.73%). The prevalence's of syphilis and HIV were relatively low. Marital status and sentinel site location were a risk factor associated with HIV and syphilis infections respectively. Therefore, substantial effort is needed to reinforce prevention strategies in this population to prevent mother-to-child and further horizontal transmissions of these infections.

  9. Chronic hepatitis virus infection in patients with multiple myeloma: clinical characteristics and outcomes

    Directory of Open Access Journals (Sweden)

    Chung-Jen Teng

    2011-01-01

    Full Text Available OBJECTIVES: Cytotoxic agents and steroids are used to treat lymphoid malignancies, but these compounds may exacerbate chronic viral hepatitis. For patients with multiple myeloma, the impact of preexisting hepatitis virus infection is unclear. The aim of this study is to explore the characteristics and outcomes of myeloma patients with chronic hepatitis virus infection. METHODS: From 2003 to 2008, 155 myeloma patients were examined to determine their chronic hepatitis virus infection statuses using serologic tests for the hepatitis B (HBV and C viruses (HCV. Clinical parameters and outcome variables were retrieved via a medical chart review. RESULTS: The estimated prevalences of chronic HBV and HCV infections were 11.0% (n = 17 and 9.0% (n = 14, respectively. The characteristics of patients who were hepatitis virus carriers and those who were not were similar. However, carrier patients had a higher prevalence of conventional cytogenetic abnormalities (64.3% vs. 25.0%. The cumulative incidences of grade 3-4 elevation of the level of alanine transaminase, 30.0% vs. 12.0%, and hyperbilirubinemia, 20.0% vs. 1.6%, were higher in carriers as well. In a Kaplan-Meier analysis, carrier patients had worse overall survival (median: 16.0 vs. 42.4 months. The prognostic value of carrier status was not statistically significant in the multivariate analysis, but an age of more than 65 years old, the presence of cytogenetic abnormalities, a beta-2-microglobulin level of more than 3.5 mg/L, and a serum creatinine level of more than 2 mg/ dL were independent factors associated with poor prognosis. CONCLUSION: Myeloma patients with chronic hepatitis virus infections might be a distinct subgroup, and close monitoring of hepatic adverse events should be mandatory.

  10. Three clinically distinct chronic pediatric airway infections share a common core microbiota.

    Science.gov (United States)

    van der Gast, Christopher J; Cuthbertson, Leah; Rogers, Geraint B; Pope, Christopher; Marsh, Robyn L; Redding, Gregory J; Bruce, Kenneth D; Chang, Anne B; Hoffman, Lucas R

    2014-09-01

    DNA-based microbiological studies are moving beyond studying healthy human microbiota to investigate diverse infectious diseases, including chronic respiratory infections, such as those in the airways of people with cystic fibrosis (CF) and non-CF bronchiectasis. The species identified in the respiratory secretion microbiota from such patients can be classified into those that are common and abundant among similar subjects (core) versus those that are infrequent and rare (satellite). This categorization provides a vital foundation for investigating disease pathogenesis and improving therapy. However, whether the core microbiota of people with different respiratory diseases, which are traditionally associated with specific culturable pathogens, are unique or shared with other chronic infections of the lower airways is not well studied. Little is also known about how these chronic infection microbiota change from childhood to adulthood. We sought to compare the core microbiota in respiratory specimens from children and adults with different chronic lung infections. We used bacterial 16S rRNA gene pyrosequencing, phylogenetic analysis, and ecological statistical tools to compare the core microbiota in respiratory samples from three cohorts of symptomatic children with clinically distinct airway diseases (protracted bacterial bronchitis, bronchiectasis, CF), and from four healthy children. We then compared the core pediatric respiratory microbiota with those in samples from adults with bronchiectasis and CF. All three pediatric disease cohorts shared strikingly similar core respiratory microbiota that differed from adult CF and bronchiectasis microbiota. The most common species in pediatric disease cohort samples were also detected in those from healthy children. The adult CF and bronchiectasis microbiota also differed from each other, suggesting common early infection airway microbiota that diverge by adulthood. The shared core pediatric microbiota included both

  11. Clinical course and short-term mortality of cirrhotic patients with infections other than spontaneous bacterial peritonitis.

    Science.gov (United States)

    Fernández, Javier; Acevedo, Juan; Prado, Verónica; Mercado, Mario; Castro, Miriam; Pavesi, Marco; Arteaga, Mireya; Sastre, Lydia; Juanola, Adria; Ginès, Pere; Arroyo, Vicente

    2017-03-01

    Clinical course and risk factors of death in non-spontaneous bacterial peritonitis (SBP) infections are poorly known. We assessed the prevalence of acute kidney injury (AKI) and type-1 hepatorenal syndrome (HRS), hospital, 30-day and 90-day mortality and risk factors of death in 441 decompensated patients. Analysis of 615 non-SBP infections (161 urinary infections (UTI), 95 cellulitis, 92 suspected infections, 92 bacteraemias, 84 pneumonias, 21 bronchitis, 18 cholangitis, 15 spontaneous empyema, 13 secondary peritonitis, 24 other). Ninety-six percent of infections solved. AKI and type-1 HRS were developed in 37% and 9% of infections respectively. Overall hospital, 30-day and 90-day mortality rates were 11%, 12% and 18% respectively. Clinical course and mortality differed markedly across infections. Endocarditis, osteoarticular infections, pneumonia, spontaneous bacteraemia, cholangitis, secondary peritonitis and UTI showed higher rates of AKI. Prevalence of type-1 HRS was not significantly different among infections. Endocarditis, secondary peritonitis, pneumonia and bacteraemia showed lower rates of renal impairment resolution and higher hospital mortality associated with AKI (42% vs 12%, Pperitonitis, pneumonia and bacteraemia show worse prognosis. The combination of data of liver and renal dysfunction and of the type of infection allows the identification of patients with poor prognosis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Differences in Clinical Manifestations of Acute and Early HIV-1 Infection between HIV-1 Subtypes in African Women

    OpenAIRE

    Lemonovich, Tracy L.; Watkins, Richard R.; Morrison, Charles S.; Kwok, Cynthia; Chipato, Tsungai; Musoke, Robert; Arts, Eric J.; Nankya, Immaculate; Salata, Robert A.

    2015-01-01

    Little is known about the differences in clinical manifestations between women with various HIV-1 subtypes during acute (AI) and early (EI) HIV infection. In a longitudinal cohort study, clinical signs and symptoms among Uganda and Zimbabwe women with AI and EI were compared with HIV-negative controls; symptoms were assessed quarterly for 15 to 24 months. Early HIV infection was defined as the first visit during which a woman tested HIV antibody positive. Women who were HIV negative serologic...

  13. Prevalence and microbiological characteristics of clinically infected foot-ulcers in patients with rheumatoid arthritis: a retrospective exploratory study.

    Science.gov (United States)

    Fitzgerald, Pauline; Siddle, Heidi J; Backhouse, Michael R; Nelson, E Andrea

    2015-01-01

    The prevalence of foot ulcers in patients with rheumatoid arthritis (RA) has been reported at almost 10 %. These foot ulcers often occur at multiple sites and are reoccurring, with the potential risk of infection increased due to RA diagnosis and disease modifying medications. The objective of this study was to estimate the prevalence of clinical infection in foot-ulcers of patients with RA; describe the microbiological characteristics and investigate risk factors. Retrospective clinical data was collected for all patients attending a rheumatology foot ulcer clinic between 1st May 2012 and 1st May 2013: wound swab data was collected from those with clinical infection. Twenty-eight patients with RA and foot-ulcers were identified; eight of these patients had clinical infection and wound swabs taken (29 %). Of these eight patients there were equal men and women, with median age 74 years, and average disease duration 22 years. Cardiovascular disease/peripheral-vascular disease (CVD/PVD) were reported in six patients, diabetes in two patients. Six patients were treated with disease-modifying anti-rheumatic drugs (DMARDs); three were on biologic medications and two on steroids. Five wound swabs cultured skin flora, one staphylococcus aureus, one had no growth after culture; and one was rejected due to labelling error. Almost a third of people with RA and foot ulcers attending clinic over one year had clinical infection, however microbiological analysis failed to isolate pathogens in six of seven wound swabs. This may be due to inaccurate diagnosis of ulcer infection or to issues with sampling, collection, transport, analysis or reporting. There was insufficient data to relate risk of clinical infection with risk factors. Further research is required to identify the most appropriate techniques for infection diagnosis, wound sampling and processing. Ethical approval was obtained from University of Leeds, Faculty of Medicine and Health (Reference number: SHREC/RP/349).

  14. Clinical Utility of Viral Load in Management of Cytomegalovirus Infection after Solid Organ Transplantation

    Science.gov (United States)

    2013-01-01

    SUMMARY The negative impact of cytomegalovirus (CMV) infection on transplant outcomes warrants efforts toward improving its prevention, diagnosis, and treatment. During the last 2 decades, significant breakthroughs in diagnostic virology have facilitated remarkable improvements in CMV disease management. During this period, CMV nucleic acid amplification testing (NAT) evolved to become one of the most commonly performed tests in clinical virology laboratories. NAT provides a means for rapid and sensitive diagnosis of CMV infection in transplant recipients. Viral quantification also introduced several principles of CMV disease management. Specifically, viral load has been utilized (i) for prognostication of CMV disease, (ii) to guide preemptive therapy, (iii) to assess the efficacy of antiviral treatment, (iv) to guide the duration of treatment, and (v) to indicate the risk of clinical relapse or antiviral drug resistance. However, there remain important limitations that require further optimization, including the interassay variability in viral load reporting, which has limited the generation of standardized viral load thresholds for various clinical indications. The recent introduction of an international reference standard should advance the major goal of uniform viral load reporting and interpretation. However, it has also become apparent that other aspects of NAT should be standardized, including sample selection, nucleic acid extraction, amplification, detection, and calibration, among others. This review article synthesizes the vast amount of information on CMV NAT and provides a timely review of the clinical utility of viral load testing in the management of CMV in solid organ transplant recipients. Current limitations are highlighted, and avenues for further research are suggested to optimize the clinical application of NAT in the management of CMV after transplantation. PMID:24092851

  15. Clinical features and complications of viridans streptococci bloodstream infection in pediatric hemato-oncology patients.

    Science.gov (United States)

    Huang, Wan-Ting; Chang, Luan-Yin; Hsueh, Po-Ren; Lu, Chun-Yi; Shao, Pei-Lan; Huang, Fu-Yuan; Lee, Ping-Ing; Chen, Chun-Ming; Lee, Chin-Yun; Huang, Li-Min

    2007-08-01

    Viridans streptococci (VS) are part of the normal flora of humans, but are fast emerging as pathogens causing bacteremia in neutropenic patients. The clinical features, outcomes, and antibiotic susceptibilities of VS bloodstream infections in children with hemato-oncological diseases are reported in this study. A retrospective chart review of pediatric patients (pediatric patients, the incidence rate of VS bacteremia was found to be significantly higher in pediatric patients with acute myeloid leukemia compared with other hemato-oncological conditions. Most of the patients had profound neutropenia related to chemotherapy for a median of 5 days on the day of positive blood culture. Eight of the 25 patients had undergone stem cell transplantations. Streptococcus mitis was the most common bloodstream isolate and only 12 (44%) of the 27 isolated strains of VS were penicillin-susceptible. Empirical antibiotic treatments were not effective in half of the episodes, but did not affect overall mortality. Isolated bacteremia (63%) and pneumonia (22%) were the two leading clinical presentations. Complications were recognized more frequently in patients with pneumonia. Hypotension and mechanical ventilation each developed in 8 patients (31%). The overall mortality rate was 23%. Penicillin non-susceptible VS infection has emerged as a threat in children with hemato-oncological diseases, especially those with acute myeloid leukemia. S. mitis is the most common spp. of VS causing bacteremia in children and is associated with serious complications. The development of pneumonia resulted in clinical complications and higher mortality. Empirical antibiotic treatments with activity against the infecting strains did not reduce the overall mortality rate in this study.

  16. Clinical manifestations of human T lymphotropic virus type I-infected patients with systemic lupus erythematosus.

    Science.gov (United States)

    Akimoto, Masaki; Matsushita, Kakushi; Suruga, Yukio; Aoki, Noriko; Ozaki, Atsuo; Uozumi, Kimiharu; Tei, Chuwa; Arima, Naomichi

    2007-09-01

    Human T lymphotropic virus type I (HTLV-I) may be associated with some connective tissue autoimmune diseases, including systemic lupus erythematosus (SLE). To determine the relationship between HTLV-I infection and SLE, we examined the clinical manifestations of SLE patients with HTLV-I infection. Eighty-nine patients with SLE were screened for antibodies to HTLV-I by electrochemiluminescence immunoassay. The presence of HTLV-I proviral sequences in peripheral blood mononuclear cells (PBMC) was determined by real-time polymerase chain reaction (PCR) quantification and Southern blotting analysis. The differences in clinical manifestations between HTLV-I-seropositive and seronegative patients with SLE were analyzed statistically. Fourteen of 89 (15.7%) patients were HTLV-I seropositive. All PBMC samples from 11 patients tested by PCR and 3 samples from 10 patients tested by Southern blotting analysis were positive for HTLV-I-related sequences. The age of HTLV-I-seropositive patients with SLE was significantly higher than that of seronegative patients (median 60 vs 42 yrs; p seronegative patients (median 45.5 vs 30 yrs; p seronegative patients (median 1740 vs 1066/microl; p = 0.027). The maintenance dose of prednisolone in HTLV-I-seropositive patients with SLE was significantly lower than that in seronegative patients (median 5 vs 9 mg/day; p = 0.012). This is the first report of the differences in clinical manifestations between SLE patients with and without HTLV-I infection. Our results suggest some involvement of HTLV-I in the pathogenesis of SLE.

  17. Clinical efficacy of Saccharomyces boulardii or metronidazole in symptomatic children with Blastocystis hominis infection.

    Science.gov (United States)

    Dinleyici, Ener Cagri; Eren, Makbule; Dogan, Nihal; Reyhanioglu, Serap; Yargic, Zeynel Abidin; Vandenplas, Yvan

    2011-03-01

    Although many Blastocystis infections remain asymptomatic, recent data suggest it also causes frequent symptoms. Therapy should be limited to patients with persistent symptoms and a complete workup for alternative etiologies. The goal of this study was to compare the natural evolution (no treatment) to the efficacy of Saccharomyces boulardii (S. boulardii) or metronidazole for the duration of diarrhea and the duration of colonization in children with gastrointestinal symptoms and positive stool examination for Blastocystis hominis. This randomized single-blinded clinical trial included children presenting with gastrointestinal symptoms (abdominal pain, diarrhea, nausea-vomiting, flatulence) more than 2 weeks and confirmed B. hominis by stool examination (B. hominis cysts in the stool with microscopic examination of the fresh stool). The primary end points were clinical evaluation and result of microscopic stool examination at day 15. Secondary end points were the same end points at day 30. Randomization was performed by alternating inclusion: group A, S. boulardii (250 mg twice a day, Reflor®) during 10 days; group B, metronidazole (30 mg/kg twice daily) for 10 days; group C, no treatment. At day 15 and 30 after inclusion, the patients were re-evaluated, and stool samples were examined microscopically. On day 15, children that were still symptomatic and/or were still B. hominis-infected in group C were treated with metronidazole for 10 days. There was no statistically significant difference between the three study groups for age, gender, and the presence of diarrhea and abdominal pain. On day 15, clinical cure was observed in 77.7% in group A (n, 18); in 66.6% in group B (n, 15); and 40% in group C (n:15) (p hominis was very comparable between both groups (94.4% vs. 93.3%, p = 0.43). Metronidazole or S. boulardii has potential beneficial effects in B. hominis infection (symptoms, presence of parasites). These findings challenge the actual guidelines.

  18. Familial aggregation and clinical prognosis of hepatitis B virus infection in Guangzhou, China

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    YE Junzhao

    2016-06-01

    Full Text Available Objective To investigate the characteristics of familial aggregation and prognosis of chronic hepatitis B (CHB in Guangzhou, China, where there is a high prevalence of hepatitis B virus (HBV infection. MethodsThe CHB patients who were treated in Outpatient Department of Hepatitis in the First Affiliated Hospital of Sun Yat-sen University from January 2009 to April 2016 were enrolled. The basic demographic features, relatives′ HBV markers, patients′ HBV indices, liver biochemical parameters, and findings on liver color Doppler ultrasound, computed tomography (CT, and magnetic resonance imaging (MRI were analyzed. Familial aggregation was defined as at least two relatives diagnosed with chronic HBV infection, and the clinical features were compared between the groups with and without familial aggregation. The t-test was used for comparison of normally distributed continuous data between groups, and the Wilcoxon rank sum test was used for non-normally distributed continuous data between groups. The chi-square test or Fisher′s exact test was used for comparison of categorical data between groups. The univariate logistic regression was used to analyze familial aggregation and the risk factors for HBV infection, liver cirrhosis, and liver cancer in offspring. ResultsA total of 1096 CHB patients with a clear family history were enrolled; among these patients, 569 had a positive family history, resulting in a rate of familial aggregation of 51.9%. According to their age, the patients were stratified into groups of 16-30 years, 31-45 years, and >46 years. The proportions of patients diagnosed with liver cirrhosis across the three age stratifications in the groups with and without familial aggregation were 2.1%/11.5%/35.6% and 2.7%/5.7%/38.5%, respectively. The group with familial aggregation had a significantly higher proportion of patients aged 31-45 years who were diagnosed with liver cirrhosis than the group without familial aggregation (χ2

  19. Pathology, clinical signs, and tissue distribution of Toxoplasma gondii in experimentally infected reindeer (Rangifer tarandus

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    Émilie Bouchard

    2017-12-01

    Full Text Available Toxoplasma gondii is a zoonotic parasite found in vertebrates worldwide for which felids serve as definitive hosts. Despite low densities of felids in northern Canada, Inuit people in some regions show unexpectedly high levels of exposure, possibly through handling and consumption of Arctic wildlife. Free-ranging caribou (Rangifer tarandus are widely harvested for food across the Canadian North, show evidence of seroexposure to T. gondii, and are currently declining in numbers throughout the Arctic. We experimentally infected three captive reindeer (conspecific with caribou with 1000, 5000 or 10,000 oocysts of T. gondii via stomach intubation to assess clinical signs of infection, pathology, and tissue distribution. An unexposed reindeer served as a negative control. Signs of stress, aggression, and depression were noted for the first two weeks following infection. By 4 weeks post infection, all infected reindeer were positive on a modified agglutination test at the highest titer tested (1:200 for antibodies to T. gondii. At 20 weeks post infection, no gross abnormalities were observed on necropsy. Following histopathology and immunohistochemistry, tissue cysts were visualized in the reindeer given the highest and lowest dose of oocysts. Focal pleuritis and alveolitis were associated with respiratory problems in reindeer given the middle dose. DNA of T. gondii was detected following traditional DNA extraction and conventional PCR on 25 mg samples from 17/33 muscles and organs, and by magnetic capture DNA extraction from 100 g samples from all 26 tissues examined. This research demonstrated that reindeer/caribou can serve as intermediate hosts for T. gondii, and that the parasite may be associated with health effects in wildlife. The presence of T. gondii in all tissues tested, many of which are commonly consumed raw, smoked, or dried in northern communities, suggests that caribou may serve as a source of human exposure to T

  20. Excess Clinical Comorbidity Among HIV-Infected Patients Accessing Primary Care in US Community Health Centers.

    Science.gov (United States)

    Mayer, Kenneth H; Loo, Stephanie; Crawford, Phillip M; Crane, Heidi M; Leo, Michael; DenOuden, Paul; Houlberg, Magda; Schmidt, Mark; Quach, Thu; Ruhs, Sebastian; Vandermeer, Meredith; Grasso, Chris; McBurnie, Mary Ann

    2017-01-01

    As the life expectancy of people infected with human immunodeficiency virus (HIV) infection has increased, the spectrum of illness has evolved. We evaluated whether people living with HIV accessing primary care in US community health centers had higher morbidity compared with HIV-uninfected patients receiving care at the same sites. We compared data from electronic health records for 12 837 HIV-infected and 227 012 HIV-uninfected patients to evaluate the relative prevalence of diabetes mellitus, hypertension, chronic kidney disease, dyslipidemia, and malignancies by HIV serostatus. We used multivariable logistic regression to evaluate differences. Participants were patients aged ≥18 who were followed for ≥3 years (from January 2006 to December 2016) in 1 of 17 community health centers belonging to the Community Health Applied Research Network. Nearly two-thirds of HIV-infected and HIV-uninfected patients lived in poverty. Compared with HIV-uninfected patients, HIV-infected patients were significantly more likely to be diagnosed and/or treated for diabetes (odds ratio [OR] = 1.18; 95% confidence interval [CI], 1.22-1.41), hypertension (OR = 1.38; 95% CI, 1.31-1.46), dyslipidemia (OR = 2.30; 95% CI, 2.17-2.43), chronic kidney disease (OR = 4.75; 95% CI, 4.23-5.34), lymphomas (OR = 4.02; 95% CI, 2.86-5.67), cancers related to human papillomavirus (OR = 5.05; 95% CI, 3.77-6.78), or other cancers (OR = 1.25; 95% CI, 1.10-1.42). The prevalence of stroke was higher among HIV-infected patients (OR = 1.32; 95% CI, 1.06-1.63) than among HIV-uninfected patients, but the prevalence of myocardial infarction or coronary artery disease did not differ between the 2 groups. As HIV-infected patients live longer, the increasing burden of noncommunicable diseases may complicate their clinical management, requiring primary care providers to be trained in chronic disease management for this population.

  1. An intrepreneurial innovative role: integration of the clinical nurse specialist and infection prevention professional.

    Science.gov (United States)

    Pintar, Paula A

    2013-01-01

    Hospital quality and financial sustainability rely on reducing healthcare-associated events/infections, length of stay, and readmissions. This project focused on designing an integrated role for the clinical nurse specialist (CNS) and the infection prevention professional (IPP) to proactively manage the delivery of evidence-based practice to high-risk surgical patients. The healthcare industry is in the midst of a paradigm shift driven by changing health policy focusing on quality indicators, patient satisfaction, and lowering costs. Coupled with these indicators is the expectation and responsibility to provide evidence-based practice at all levels of the healthcare continuum. This paradigm shift places healthcare facilities in a very competitive atmosphere as they rally for the revenue of a fixed payer mix. A literature search using CINHAL, PubMed, and the CNS national listserve databases was completed to identify if there was any previously written information available on an integrated role of the CNS/IPP. An online business plan template was used to communicate the significance, implications, and return on organizational investment to practice with establishing this role. Chronic health conditions such as diabetes, hypertension, congestive heart failure, and colonization with multidrug-resistant organisms can place patients at an increased risk for developing a surgical site infection or complications. The CNS/IPP will proactively manage these risk factors, including the patient and family in a preventive care model to manage the acute inpatient high-risk surgical patient. Care management will include coordinated, collaborative, and consultative follow-up by the CNS/IPP in the acute care, long-term care facilities, and home settings. The infection prevention skill set brings a level of clinical expertise that makes a unique CNS. The IPP is immersed in using epidemiological principles that examine the impact of comorbidities and the added risk that can

  2. Clinical and molecular epidemiology of Acinetobacter baumannii bloodstream infections in an endemic setting.

    Science.gov (United States)

    Marchaim, Dror; Levit, Dana; Zigron, Roy; Gordon, Michal; Lazarovitch, Tsillia; Carrico, Joao A; Chalifa-Caspi, Vered; Moran-Gilad, Jacob

    2017-03-01

    The transmission dynamics of Acinetobacter baumannii in endemic settings, and the relation between microbial properties and patients' clinical outcomes, are yet obscure and hampered by insufficient metadata. Of 20 consecutive patients with A. baumannii bloodstream infection that were thoroughly analyzed at a single center, at least one transmission opportunity was evident for 85% of patients. This implies that patient-to-patient transmission is the major mode of A. baumannii acquisitions in health facilities. Moreover, all patients who died immediately (baumannii ST457 lineage compared with other strains.

  3. Microbiological and clinical features of four cases of catheter-related infection by Methylobacterium radiotolerans.

    Science.gov (United States)

    Li, Li; Tarrand, Jeffrey J; Han, Xiang Y

    2015-04-01

    Four cases of central venous catheter-related Methylobacterium radiotolerans infection are presented here. The patients were all long-term catheter carriers with an underlying diagnosis of leukemia, and they mostly manifested fevers. The isolated bacterial strains all showed far better growth on buffered charcoal yeast extract agar during the initial isolation and/or subcultures than they did on sheep blood or chocolate agar. This microbiological feature may improve the culture recovery of this fastidious pink Gram-negative bacillus that has rarely been isolated in clinical microbiology laboratories. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  4. Clinically-Endoscopic Manifestations of Peptic Ulcer disease in Children Depending on Helicobacter pylori Infection

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    Т.V. Sorokman

    2014-04-01

    Full Text Available We analyzed the clinical and endoscopic features of H.pylori-associated peptic ulcer disease in children. Prevalence of H.pylori-positive cases of peptic ulcer disease, regardless of the localization of ulcers, was determined. Toxigenic strains of H.pylori cause severe course of ulcer disease with prolonged and frequent relapses. Most of H.pylori-positive lesions are associated with Cag+-VacA+ serotype of microorganism. In individuals infected with serotype CagA-VacA+, ulcers of large sizes are more common.

  5. [Clinical and therapy features of ocular toxoplasmosis in patients with HIV-AIDS infection].

    Science.gov (United States)

    Anghel, Gheorghe

    2002-01-01

    The paper presents clinical and therapy features of the ocular Toxoplasmosis in patients with HIV-AIDS infection. Four cases of AIDS have been observed in witch has been recognized the ocular toxoplasmosis (two at children and two at adults). It was watched the evolution under treatment of the lesions caused by the parasite and it was appreciated the efficiency of the therapy. The antitoxoplasmosis therapy is made in the same way as at the immunocompetents patients, but it must be followed by a maintenance treatment all the patience's life.

  6. Treatment of pregnant women infected with syphilis with intravenous penicillin g: pharmacokinetical and clinical study

    OpenAIRE

    Mavrov, G.; Goubenko, T.

    2001-01-01

    Treatment of pregnant women infected with syphilis with intravenous infusions of penicillin G (2 million units every 12 hours) favors higher concentration of penicillin in blood serum (31 vs. 6-11 mkg/ml) and lower frequency and intensity of adverse effects (2.5 vs. 5.6%) in comparison with intramuscularly injections of benzyl penicillin (0.5–1.0 million units every 3 hours). Penicillin G favored a faster regress of clinical manifestations of syphilis (4-12 vs. 7-17 days) earlier obtaining ne...

  7. Rapid enzyme analysis as a diagnostic tool for wound infection: Comparison between clinical judgment, microbiological analysis, and enzyme analysis.

    Science.gov (United States)

    Blokhuis-Arkes, Miriam H E; Haalboom, Marieke; van der Palen, Job; Heinzle, Andrea; Sigl, Eva; Guebitz, Georg; Beuk, Roland

    2015-01-01

    In clinical practice, diagnosis of wound infection is based on the classical clinical signs of infection. When infection is suspected, wounds are often swabbed for microbiological culturing. These methods are not accurate (clinical judgment in chronic wounds) or provide results after several days (wound swab). Therefore, there is an urgent need for an easy-to-use diagnostic tool for fast detection of wound infection, especially in chronic wounds. This study determined the diagnostic properties of the enzymes myeloperoxidase, human neutrophil elastase (HNE), lysozyme and cathepsin-G in detecting wound infection when compared to wound swabs. Both chronic and acute wounds of 81 patients were assessed through clinical judgment, enzyme analysis and wound swab. Three promising enzyme models for detecting wound infection were identified. A positive test was defined as: at least one enzyme positive after 30 minutes (model 1), lysozyme and HNE positive after 30 minutes (model 2), myeloperoxidase positive after 5 minutes, and HNE or lysozyme positive after 30 minutes (model 3). All models were significant (p≤0.001). There was no correlation between clinical judgment and wound swab, indicating the need for novel diagnostic systems. Enzyme analysis is fast, easy to use and superior to clinical judgment when compared to wound swabs. © 2015 by the Wound Healing Society.

  8. Infection

    Science.gov (United States)

    2010-09-01

    whether BMPs maintain their osteoinductive capability in infected human wounds. The authors are aware of only one series describing the use of BMP in an...et al. Osteogenic protein-1 induces bone formation in the presence of bacterial infection in a rat intramuscular osteoinduction model. J Orthop Trauma

  9. Clinical features and prognosis of patients with primary biliary cholangitis complicated by hepatitis virus infection

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    ZHAO Dantong

    2017-08-01

    Full Text Available ObjectiveTo investigate the clinical features and prognosis of patients with primary biliary cholangitis(PBC complicated by hepatitis virus infection. MethodsA total of 16 patients who were admitted to Beijing YouAn Hospital from October 2004 to October 2012 and diagnosed with PBC complicated by hepatitis virus infection were enrolled, among whom 7 had chronic hepatitis B virus infection, 3 had hepatitis C, 4 had hepatitis E, 1 had hepatitis B and hepatitis C, and 1 had hepatitis A. A total of 76 hospitalized patients with PBC alone were enrolled as controls. The two groups were compared in terms of clinical features, laboratory markers, and autoantibodies, and follow-up visits were performed to investigate prognostic features. The independent samples t-test was used for comparison of normally distributed continuous data, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data; the chi-square test or Fisher′s exact test was used for comparison of categorical data. The Kaplan-Meier method was used to calculate survival rates and the log-rank test was used to compare survival rates between groups. ResultsCompared with the control group, the PBC-hepatitis virus infection group had significantly lower proportion of female patients (χ2=12.22, P=0.002, alkaline phosphatase (U=225.00, P<0.001, CHO (U=363.50, P=0.036, and IgG level (t=2.79, P=0.007, and no patients in the PBC-hepatitis virus infection group experienced abdominal wall varices, upper gastrointestinal bleeding, or hepatic encephalopathy. The PBC-hepatitis virus infection group had various autoantibodies including anti-nuclear antibody, smooth muscle antibody, anti-parietal cell antibody (APCA, anti-liver specific protein antibody, and anti-myocardial antibody, as well as a significantly higher APCA positive rate than the control group (25% vs 3.9%, χ2=5.608, P=0.016. The median follow-up time was 49.5 months (2-312 months. The PBC

  10. Genetic diversity and clinical impact of human rhinoviruses in hospitalized and outpatient children with acute respiratory infection, Argentina.

    Science.gov (United States)

    Marcone, Débora Natalia; Culasso, Andrés; Carballal, Guadalupe; Campos, Rodolfo; Echavarría, Marcela

    2014-12-01

    Human rhinoviruses (HRV) are recognized as a cause of upper and lower acute respiratory infections (ARI). The circulating species and their clinical impact were not described in Argentina. To describe the molecular epidemiology of HRV in children and to determine the association of HRV species with outcome and severity. Hospitalized and outpatients children infections. This study highlights the clinical impact of HRV in children without comorbidities as a cause of lower ARI and hospitalization. The high frequency of HRV infections may be associated with the simultaneous circulation of genotypes and their high turnover rate. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. [Cefuroxime axetil, a new oral cephalosporin for treating infections of the ORL field: clinical synthesis].

    Science.gov (United States)

    Westphal, J F

    1990-01-01

    Cefuroxime axetil (C.A.E.) is a broad spectrum cephalosporin, suitable for oral route. Its antibacterial activity includes all the pathogens usually responsible for E.N.T. infection, with low M.I.C.'s: H. influenzae, S. pneumoniae, S. aureus, S. pyogene. The stability of the drug against betalactamases, especially those produced by H. influenzae, associated with good bio availability (50%) and tissue penetration (30%) account for the potent in vivo bactericidal activity and clinical efficacy of cefuroxime axetil. More than 1,000 patients had been enrolled in controlled clinical trials: the success rates yielded by C.A.E. were 98%, 96% and 91%, respectively for pharingitis/tonsilitis, otitis media and acute sinusitis. C.A.E. is at least as effective as amoxycillin/clavulanic acid and safety appears to be better.

  12. Clinico-Mycological Study Of Superficial Fungal Infection In Children In An Urban Clinic In Kolkata

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    Barbhuiya Joyashree Nath

    2002-01-01

    Full Text Available Seventy children up to the age of 12 years who were suffering from dermatophytosis, candidiasis or pityriasis versicolor were studied clinically and mycologically. Dermatophytosis was the major group, which constituted 52.86% of children. It was followed by candidiasis that constituted 40% of children and pityriasis versicolor was the least, being 7.14% of children. Amongst the clinical types of dermatophytosis, tinea capitis was the commonest (32.43% followed by tinea corporis (27.03%. Candidial intertrigo was the commonest (42.86% from of candidiasis, followed by diaper dermatitis (32.14%. Most susceptible age group was school going children. Peak incidence of infection was during the months of June to September. T rubrum was the commonest dermatophyte isolated in culture. C. albicans was the most common species of candida isolated in culture.

  13. CLINICAL IMMUNOLOGIC GROUNDS FOR LOCAL INTERFERON USE IN ACUTE VIRAL INFECTION TREATMENT

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    I.N. Zakharova

    2011-01-01

    Full Text Available Broad spectrum of antiviral activity of interferons lays grounds to its use in complex therapy of acute viral infections. It has been shown that antiviral and antibacterial interferon activity reveals itself while used both systematically and locally. Clinical efficacy of locally applied viferon is accompanied by nasal mucosa cytokine status changes, as has been shown in nasal swabs. There has been shown dependency of local immune response on the age, severity of the disease, clinical forms of respiratory syndrome, bacterial complications, if present, intensity and characteristics of viral contamination against the background of viferon treatment. Key words: acute respiratory viral disease, interferon, cell immunity, humoral immunity, interferon status, cytokine status, recombinant α-interferon, immunocorrection. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (5: 117–123.

  14. Is radiological appearance of lower respiratory tract infection due to respiratory syncytial virus a predictor of clinical outcome?

    Science.gov (United States)

    Alkan Ozdemir, Senem; Ozer, Esra Arun; Pekcevik, Yeliz; Ilhan, Ozkan; Sutcuoglu, Sumer

    2015-01-01

    Respiratory syncytial virus (RSV) lower respiratory tract infection is the most common viral infection in childhood. RSV-infected infants demonstrate various radiographic findings. The aim of the study is to evaluate whether assessment of radiological characteristics of lower tract infection due to RSV may be a predictor of clinical outcome in newborns. The study included 36 newborn infants hospitalized for lower tract infection. In order to detect RSV, RSV Respi-Strip (Coris Bioconcept Organization) test kits were used on admission. Chest X-rays and clinical characteristics of the study group were reviewed. Of 36 patients hospitalized for lower tract infection from October 2012 to April 2013, 18 (50%) newborns were infected with RSV. The study included 36 neonates. Patients with RSV-positive infants at admission had greater need for respiratory support, supplemental oxygen and prolonged stay in the NICU. Newborns with an atelectasis pattern on admission chest radiograph had greater at RSV-positive infants. Chest radiological patterns with lower respiratory tract infection in newborn infants due to RSV are a predictor of clinical outcome.

  15. Clinical features of adult-onset chronic active Epstein-Barr virus infection: a retrospective analysis.

    Science.gov (United States)

    Arai, Ayako; Imadome, Ken-Ichi; Watanabe, Yuko; Yoshimori, Mayumi; Koyama, Takatoshi; Kawaguchi, Takeharu; Nakaseko, Chiaki; Fujiwara, Shigeyoshi; Miura, Osamu

    2011-05-01

    We performed a retrospective analysis of patients with adult-onset chronic active Epstein-Barr virus infection (CAEBV). First, we analyzed five patients (aged 28-72) diagnosed at our hospitals with EBV-infected clonally proliferating T cells. Four patients were administered cyclophosphamide/doxorubicin/vincristine/prednisone (CHOP) chemotherapy, but no remarkable decrease of viral load was observed in three of the patients. The other patient died 19 days after initiation of CHOP treatment due to disease progression. Addition of high-dose cytarabine to the regimens of two of the patients was discontinued shortly after administration, due to the development of grade 4 pericardial effusion. Together, these regimens may be insufficient for treating adult-onset CAEBV. We next reviewed 23 adult-onset CAEBV patients, adding 18 previously reported patients to the five patients described in the present study. T cells were frequently infected (87%), whereas NK- and T-cell types are known to be almost equally prevalent in childhood-onset cases. The time duration from the onset of disease to initiation of treatment averaged 20 months. Reports showed that 12 patients died; seven patients died at an average of 8 months after initiation of treatment. Patients' disease courses seemed to be rapidly progressive and more aggressive than those of childhood-onset cases. More cases must be studied to clarify clinical features and establish an optimal treatment strategy.

  16. Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections

    Science.gov (United States)

    Sjölund-Karlsson, Maria; Gordon, Melita A.; Parry, Christopher M.

    2015-01-01

    SUMMARY Salmonella enterica infections are common causes of bloodstream infection in low-resource areas, where they may be difficult to distinguish from other febrile illnesses and may be associated with a high case fatality ratio. Microbiologic culture of blood or bone marrow remains the mainstay of laboratory diagnosis. Antimicrobial resistance has emerged in Salmonella enterica, initially to the traditional first-line drugs chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole. Decreased fluoroquinolone susceptibility and then fluoroquinolone resistance have developed in association with chromosomal mutations in the quinolone resistance-determining region of genes encoding DNA gyrase and topoisomerase IV and also by plasmid-mediated resistance mechanisms. Resistance to extended-spectrum cephalosporins has occurred more often in nontyphoidal than in typhoidal Salmonella strains. Azithromycin is effective for the management of uncomplicated typhoid fever and may serve as an alternative oral drug in areas where fluoroquinolone resistance is common. In 2013, CLSI lowered the ciprofloxacin susceptibility breakpoints to account for accumulating clinical, microbiologic, and pharmacokinetic-pharmacodynamic data suggesting that revision was needed for contemporary invasive Salmonella infections. Newly established CLSI guidelines for azithromycin and Salmonella enterica serovar Typhi were published in CLSI document M100 in 2015. PMID:26180063

  17. Pharmacodynamic studies of voriconazole: informing the clinical management of invasive fungal infections.

    Science.gov (United States)

    Job, Kathleen M; Olson, Jared; Stockmann, Chris; Constance, Jonathan E; Enioutina, Elena Y; Rower, Joseph E; Linakis, Matthew W; Balch, Alfred H; Yu, Tian; Liu, Xiaoxi; Thorell, Emily A; Sherwin, Catherine M T

    2016-08-01

    Voriconazole is a broad-spectrum antifungal agent commonly used to treat invasive fungal infections (IFI), including aspergillosis, candidiasis, Scedosporium infection, and Fusarium infection. IFI often occur in immunocompromised patients, leading to increased morbidity and mortality. The objective of this review is to summarize the pharmacodynamic properties of voriconazole and to provide considerations for potential optimal dosing strategies. Studies have demonstrated superior clinical response when an AUC/MIC >25 or Cmin/MIC >1 is attained in adult patients, correlating to a trough concentration range as narrow as 2-4.5 mg/L; however, these targets are poorly established in the pediatric population. Topics in this discussion include voriconazole use in multiple age groups, predisposing patient factors for IFI, and considerations for clinicians managing IFI. Expert commentary: The relationship between voriconazole dosing and exposure is not well defined due to the large inter- and intra-subject variability. Development of comprehensive decision support tools for individualizing dosing, particularly in children who require higher dosing, will help to increase the probability of achieving therapeutic efficacy and decrease sub-therapeutic dosing and adverse events.

  18. Microbiological and Clinical Characteristics of Hypermucoviscous Klebsiella pneumoniae Isolates Associated with Invasive Infections in China.

    Science.gov (United States)

    Guo, Yinjuan; Wang, Shanshan; Zhan, Lingling; Jin, Ye; Duan, Jingjing; Hao, Zhihao; Lv, Jingnan; Qi, Xiuqin; Chen, Liang; Kreiswirth, Barry N; Wang, Liangxing; Yu, Fangyou

    2017-01-01

    A distinctive syndrome caused by hypermucoviscous Klebsiella pneumoniae (HMKP) including pyogenic liver abscess (PLA) is now becoming a globally emerging disease. In the present study, 22.8% (84/369) of K. pneumoniae clinical isolates associated with various types of invasive infections were identified as HMKP, with 45.2% associated with PLA. Multivariate regression analysis showed that male patients with 41-50 years, PLA, diabetes mellitus, and hypertension were independent risk factors for HMKP infections. K2 (42.9%, 36/84) was the most common capsular serotype among HMKP isolates, followed by K1 (23.8%, 20/84). Seventy-five percentage of K1 HMKP isolates were associated with PLA, while K2 HMKP isolates accounted for more types of invasive infections. The positive rates of iutA, mrkD, aerobactin, iroN, and rmpA among HMKP isolates were significantly higher than those among non-HMKP isolates (p pneumoniae K2 isolates was more diverse than K1 isolates. K1 and K2 HMKP isolates had respective specific profiles of virulence-associated genes.

  19. Diagnosis of genital herpes simplex virus infection in the clinical laboratory

    Science.gov (United States)

    2014-01-01

    Since the type of herpes simplex virus (HSV) infection affects prognosis and subsequent counseling, type-specific testing to distinguish HSV-1 from HSV-2 is always recommended. Although PCR has been the diagnostic standard method for HSV infections of the central nervous system, until now viral culture has been the test of choice for HSV genital infection. However, HSV PCR, with its consistently and substantially higher rate of HSV detection, could replace viral culture as the gold standard for the diagnosis of genital herpes in people with active mucocutaneous lesions, regardless of anatomic location or viral type. Alternatively, antigen detection—an immunofluorescence test or enzyme immunoassay from samples from symptomatic patients--could be employed, but HSV type determination is of importance. Type-specific serology based on glycoprotein G should be used for detecting asymptomatic individuals but widespread screening for HSV antibodies is not recommended. In conclusion, rapid and accurate laboratory diagnosis of HSV is now become a necessity, given the difficulty in making the clinical diagnosis of HSV, the growing worldwide prevalence of genital herpes and the availability of effective antiviral therapy. PMID:24885431

  20. Circulating Antigens Levels in Different Clinical Forms of the Schistosoma mansoni Infection

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    Yerkes Pereira e Silva

    1999-01-01

    Full Text Available With the aim to evaluate the circulating cathodic antigen (CCA levels in relation to the different clinical phases of Schistosoma sp. infection a sandwich ELISA using monoclonal antibody 5H11 was performed. The sera of three groups of 25 Brazilian patients with acute, intestinal and hepatosplenic forms of S. mansoni infection were tested and compared to a non-infected control group. Patients and control groups were matched for age and sex and the number of eggs per gram of feces was equally distributed among the three patient groups. Sensitivity of 100%, 72%, 52% of the assay was observed for the intestinal, hepatosplenic and acute toxemic groups respectively. The specificity was 100%. Intestinal and hepatosplenic groups presented CCA levels significantly higher in comparison to those observed for acute patients (F-ratio = 2,524; p = 0.000 and F-ratio = 6,314; p = 0.015 respectively. There was no significant difference of CCA serum levels between hepatosplenic and intestinal groups (F-ratio = 1,026; p = 0.316.

  1. High prevalence of occult hepatitis B virus genotype H infection among children with clinical hepatitis in west Mexico.

    Science.gov (United States)

    Escobedo-Melendez, Griselda; Panduro, Arturo; Fierro, Nora A; Roman, Sonia

    2014-09-01

    Studies on the prevalence of infection with hepatitis B virus (HBV) among children are scarce in Latin American countries, especially in Mexico. This study was aimed to investigate the prevalence of HBV infection, occult hepatitis B infection (OBI) and HBV genotypes among children with clinical hepatitis. In total, 215 children with clinical hepatitis were evaluated for HBV infection. HBV serological markers and HBV DNA were analysed. OBI diagnosis and HBV genotyping was performed. HBV infection was found in 11.2% of children with clinical hepatitis. Among these HBV DNA positive-infected children, OBI was identified in 87.5% (n = 21/24) of the cases and 12.5% (n = 3/24) were positive for both HBV DNA and hepatitis B surface antigen. OBI was more frequent among children who had not been vaccinated against hepatitis B (p hepatitis and is associated with HBV genotype H. The results show the importance of the molecular diagnosis of HBV infection in Mexican paediatric patients with clinical hepatitis and emphasise the necessity of reinforcing hepatitis B vaccination in children.

  2. Clinical effect of discordance in empirical treatment of cases with urinary tract infection accompanied by bacteremia.

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    Dökmetaş, İlyas; Hamidi, Aziz Ahmad; Bulut, Mehmet Emin; Çetin, Sinan; Öncül, Ahsen; Uzun, Nuray

    2017-12-01

    It has been shown in previous studies that inadequate empirical treatment is associated with mortality in a variety of infections caused by Gram-negative bacteria. In this study, the clinical effect of discordance in empirical treatment was investigated in patients with urinary tract infection (UTI) accompanied by bacteremia. We retrospectively reviewed the files of adult (>18 years old) patients who were diagnosed with UTI in our clinic between January 2014 and December 2015. Cases in which the same causative microorganism grew in both blood and urine cultures were included in the study. Patients using ceftriaxone and carbapenem as empirical antibiotic therapy (EAT) were compared as two different groups. In cases that the ethiologic agents were extended- spectrum beta lactamase (ESBL)-producing Klebsiella pneumoniae and Escherichia coli isolates, if the microorganism was resistant to initial antibiotic treatment the situation was defined as EAT discordance, and if it was sensitive it was defined as EAT concordance. After the exclusion criteria were applied, 65 of the 266 cases examined were taken into the study. Clinical and laboratory features of cases of ceftriaxone and carbapenem groups were similar. There was no statistically significant difference between the two groups in terms of hospital stay and survival (p>0.05). Of 28 cases of ESBL-producing E. coli and K. pneumoniae, 18 were EAT discordant and 10 were EAT concordant. Clinical and laboratory features of EAT concordant and EAT discordant groups were similar. No statistically significant difference was found between the two groups in terms of hospital stay and survival (p>0.05). It was considered that ceftriaxone can still be a viable option in the EAT of UTI, which is accompanied by bacteremia without severe sepsis and septic shock findings. It was concluded that EAT discordance may not have a negative effect on the duration of hospital stay and survival rates in neither total cases nor ESBL positive

  3. Streptococcus milleri group pleuropulmonary infection in children: computed tomographic findings and clinical features.

    Science.gov (United States)

    Lee, Edward Y; Khatwa, Umakanth; McAdam, Alexander J; Bastos, Maria d'Almeida; Mahmood, Soran A; Ervoes, John P; Boiselle, Phillip M

    2010-01-01

    Streptococcus milleri group streptococci have recently been increasingly recognized as important pulmonary pathogens, but their imaging features have not been well documented in children. We have recently observed a number of cases of this infection among pediatric patients at our tertiary care, children's hospital. Our purpose was to investigate the computed tomographic (CT) findings and clinical features of S. milleri group pleuropulmonary infection in children. We used our hospital information system to identify all consecutive pediatric patients (milleri group infection and a chest CT scan between December 1996 and May 2009. Each scan was systemically reviewed by 2 pediatric radiologists for pleural and lung parenchymal abnormalities. Pleural effusions were classified as either simple or complex and correlated with results of pleural fluid analysis. Computed tomographic findings were compared with chest radiographic findings in the subset of patients who underwent radiography within 24 hours of CT. Microbiological data, risk factors, immune status, patient management, and clinical outcome were systematically reviewed. The final study cohort consisted of 15 children (6 boys and 9 girls), ranging in age from 4.2 years to 17.7 years (mean, 10.8 years). All patients were immunocompetent without recognized risk factors for this infection. Thirteen pleural effusions were identified in 10 (67%) of the 15 patients, including 10 complex and 3 simple pleural effusions. All complex effusions at CT were consistent with empyemas by pleural fluid analysis. Lung parenchymal abnormalities were identified in 7 (47%) of the 15 patients, including lung abscess in 4 patients, consolidation in 2, and multiple bilateral pulmonary nodules and lung abscesses in 1. In the subset of 7 patients with comparison radiographs, radiographic and CT findings were concordant for the detection of lung abnormalities, except one case in which consolidation was diagnosed on chest radiography

  4. High Prevalence of Hypervirulent Klebsiella pneumoniae Infection in China: Geographic Distribution, Clinical Characteristics, and Antimicrobial Resistance.

    Science.gov (United States)

    Zhang, Yawei; Zhao, Chunjiang; Wang, Qi; Wang, Xiaojuan; Chen, Hongbin; Li, Henan; Zhang, Feifei; Li, Shuguang; Wang, Ruobing; Wang, Hui

    2016-10-01

    Hypervirulent Klebsiella pneumoniae (hvKP) is traditionally defined by hypermucoviscosity, but data based on genetic background are limited. Antimicrobial-resistant hvKP has been increasingly reported but has not yet been systematically studied. K. pneumoniae isolates from bloodstream infections, hospital-acquired pneumonia, and intra-abdominal infections were collected from 10 cities in China during February to July 2013. Clinical data were collected from medical records. All K. pneumoniae isolates were investigated by antimicrobial susceptibility testing, string test, extended-spectrum β-lactamase (ESBL) gene detection, capsular serotypes, virulence gene profiles, and multilocus sequence typing. hvKP was defined by aerobactin detection. Of 230 K. pneumoniae isolates, 37.8% were hvKP. The prevalence of hvKP varied among different cities, with the highest rate in Wuhan (73.9%) and the lowest in Zhejiang (8.3%). Hypermucoviscosity and the presence of K1, K2, K20, and rmpA genes were strongly associated with hvKP (P < 0.001). A significantly higher incidence of liver abscess (P = 0.026), sepsis (P = 0.038), and invasive infections (P = 0.043) was caused by hvKP. Cancer (odds ratio [OR], 2.285) and diabetes mellitus (OR, 2.256) appeared to be independent variables associated with hvKP infections by multivariate analysis. Importantly, 12.6% of hvKP isolates produced ESBLs, and most of them carried blaCTX-M genes. Patients with neutropenia (37.5% versus 5.6%; P = 0.020), history of systemic steroid therapy (37.5% versus 5.6%; P = 0.020), and combination therapy (62.5% versus 16.7%; P = 0.009) were more likely to be infected with ESBL-producing hvKP. The prevalence of hvKP is high in China and has a varied geographic distribution. ESBL-producing hvKP is emerging, suggesting an urgent need to enhance clinical awareness, especially for immunocompromised patients receiving combination therapy. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  5. Clinical and laboratory alterations in dogs naturally infected by Leishmania chagasi

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    José Cláudio Carneiro de Freitas

    2012-02-01

    Full Text Available INTRODUCTION: Canine visceral leishmaniasis (CVL is a zoonotic disease with different clinical manifestations. Parasitism often occurs in bone marrow, but changes have been observed in peripheral blood and serum biochemical parameters. The aim of this study was to evaluate the hematological and biochemical parameters in dogs naturally infected by Leishmania chagasi. METHODS: Eighty-five adult dogs of both sexes and various weights and ages from the Zoonosis Control Center of Fortaleza (CCZ were used, selected by immunofluorescence assay (IFA and considered positive with IFA titers greater than 1:40 and by visualizing amastigotes of Leishmania chagasi in smears obtained by bone marrow aspiration. The dogs (n = 85 were grouped according to clinical signs: negative (CN = 7, subclinical (CS = 10, and clinical (CC = 68. Blood samples were collected for determination of hematological and biochemical serum values. The experimental protocol was approved by the CEUA/UECE. RESULTS: The most frequent clinical signs were cachexia (77.9%, keratitis (61.8%, and lymphadenopathy (55.9%, and 86.8% of the animals showed more than one clinical sign characteristic of CVL. In CC were observed reductions in red blood cells (63%, hematocrit (72%, and hemoglobin (62%, as well as leukocytosis (33%, neutropenia (28%, thrombocytopenia (50%, uremia (45%, hyperproteinemia (53%, p<0.05, hypergammaglobulinemia (62%, p<0.01, and hypoalbuminemia (58%. CONCLUSIONS: Animals with the clinical form of the disease demonstrate hematological and biochemical changes consistent with anemia, uremia, hyperproteinemia, and hyperglobulinemia, which present themselves as strong clinical markers of visceral leishmaniasis associated with the signs previously reported.

  6. Evaluation of Clinical and Immunopathological Features of Different Infective Doses of Trypanosoma cruzi in Dogs during the Acute Phase

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    Israel A. Quijano-Hernández

    2012-01-01

    Full Text Available Infection with Trypanosoma cruzi is a major risk in Latin America, and dogs are believed to be good models for evaluating Chagas disease. Here, we evaluated the clinical and immunopathological alterations developed by mongrel dogs experimentally infected with different infective doses (2,000, 20,000, and 200,000 metacyclic trypomastigotes of Sylvio X10/4 strain kg−1 via intraperitoneal. Clinical and electrocardiographic parameters, as well as antibody production and pathologic lesions were evaluated. All three doses of this strain of T. cruzi induced a similar pattern of infection characterized by cardiac arrhythmias and severe and diffuse myocarditis. Specific anti-T. cruzi IgG indicated seroconversion by day 14 after infection, and IgG levels increased during the period of evaluation. Mortality was observed only in dogs infected with the medium or high parasite doses, but not in the group infected with a low dose of 2,000 parasites kg-1. Infection with a low dose of parasites provides an excellent nonlethal model to evaluate the immunopathology of the acute disease in dogs infected with the Sylvio X10/4 strain of T. cruzi.

  7. Clinical characteristics of respiratory syncytial virus infection in neonates and young infants

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    Savić Nataša

    2011-01-01

    Full Text Available Introduction/Aim. Infection with respiratory syncytial virus (RSV occurs during the first year of life in 50% of children and 20%-40% of them have signs of lower respiratory tract infection (bronchiolitis or pneumonia. There is an increased risk for complicated course and death from RSV infection in premature infants, especially those with bronchopulmonary dysplasia (BPD or congenital heart disease. The aim of our study was to analyze clinical characteristics of laboratory confirmed RSV infection in order to evaluate the need for preventive measures in neonates and young infants. Methods. The prospective study included children under age of 12 months admitted to our hospital in the period November 2008-March 2009 who were positive for RSV by enzyme immunoassay membrane test. The course of disease was assessed by clinical score and radiographic findings. Results. Infection with RSV was confirmed in 91 patients: 21 (23.0% were under the age of 30 days, 37 (40.7% were between 31-60 days, and 33 patients (36.3% were older than 60 days (p > 0.05. The highest hospitalization rate was in January - 33 patients (36.3%; p < 0.01. Disease severity score in these age groups (AG were: 8.4 ± 0.4 (AG 0-30 days; 9.0 ± 0.3 (AG 31-60 days and 8.3 ± 0.3 (AG > 60 days, without statistically significant difference among the groups (p > 0.05. Clinical scores in patients with and without risk factors were 10.5 ± 0.5 and 8.3 ± 0.2, respectively (p < 0.01. Pathological radiographic findings were observed in 72 (79.1% and complications (apnea, significant atelectasis, encephalopathy occured in 15 (16.5% patients. The average length of hospital stay in complicated and uncomplicated course of the disease was 9 days and 6 days, respectively (p < 0.01. Therapy in 85 (93.4% patients included bronchodilators, while systemic glucocorticoids and oxygen therapy were used in 51 (56.0% and 44 (48.4% patients, respectively. Death occured in 2 (2.2% patients, both from a high

  8. [Reactive arthritis: current characteristics and the role of Chlamydia infections in development of a clinical picture].

    Science.gov (United States)

    Doroshenko, Iu A; Nikonova, E N

    2001-01-01

    To examine present-day peculiarities of reactive arthritis (ReA) and effects of chlamydial infection on ReA clinical manifestations. 120 ReA patients entered the trial. Urogenital variant was in 85%, enterocolitic in 15% of the patients. Etiology of ReA was defined with special methods diagnosing chlamydial and ureaplasma infection in scrapes from urethral or cervical epithelium (a cytological test, an enzyme immunoassay, polymerase chain reaction, cultural technique of ureaplasma detection). Antichlamydial antibodies were identified with enzyme immunoassay and reaction of indirect immunofluorescence. Factor analysis and indirect consecutive image recognition were applied. In all the cases, enterocolitic ReA was preceded by acute intestinal infection. In urogenic ReA the disease started with urethritis (62.7%), conjunctivitis (2.0%), arthritis (31.4%) or talalgia (3.9%). Initially, the occurrence of a full Reiter's triad was 15%, incomplete (two signs of the three)--46.7%. The debute was characterized by predominant oligoarticular lesion (65%), in the advanced stage polyarthritis was frequently diagnosed (49.6%). Pain most frequently located in the low spine (60.5%). X-ray evidence on degenerative-dystrophic alterations of the peripheral joints and spine was obtained in 54.2% ReA cases. 60 patients were examined for chlamydial and ureaplasma infection. The etiology of ReA was chlamydial, ureaplasmic and chlamydo-ureaplasma in 43.3, and 35%, respectively. The etiology was not identified in 16.7% cases. Such extraarticular symptoms as urogenital, ocular, skin and mucosal, cardiovascular, lymph nodes were observed in 61.7, 22.5, 13.3, 76.7 and 13.3%, respectively. At present, ReA is characterized by the following most typical features: polymorphism of clinical symptoms at the disease onset, predominance of polyarticular variant of articular involvement at the advanced stage of ReA, high incidence of extraarticular manifestations. The factor analysis shows that

  9. Infectious pancreatic necrosis virus causing clinical and subclinical infections in Atlantic salmon have different genetic fingerprints

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    Stephen Mutoloki

    2016-08-01

    Full Text Available Infectious pancreatic necrosis virus (IPNV is the causative agent of IPN, an important disease of salmonids. IPNV infections result in either sub-clinical or overt disease and the basis of this difference is not well understood. The objective of the present study was to determine the VP2 gene of the virus associated with the different forms of clinical manifestation. Groups of Atlantic salmon (Salmo salar L. reared in farms located in different IPN disease pressures were monitored from brood stock until grow-out over a 3 year period. Hatcheries A1 and B1 as well as cooperating seawater farms were located in a low disease risk area while hatcheries A2 and B2 as well as their cooperating seawater farms were in high IPN risk areas. Samples including eggs, milt, whole fry, kidney depending on the stage of production were collected during outbreaks or in apparently healthy populations where no outbreaks occurred. The virus was re-isolated in CHSE cells and the VP2 gene amplified by RT-PCR followed by sequencing. During the freshwater stage, there were no disease outbreaks at hatcheries A1, A2 and B1 (except in one fish group that originated from hatchery B2, although IPNV was isolated from some of the fish groups at all 3 hatcheries. By contrast, all fish groups at hatchery B2 suffered IPN outbreaks. In seawater, only groups of fish originating from hatchery A1 had no IPN outbreaks albeit virus being isolated from the fish. On the other hand, fish originating from hatcheries A2, B1 and B2 experienced outbreaks in seawater. The VP2 amino acid fingerprint of the virus associated with subclinical infections from A1 and co-operating seawater sites was V64A137P217T221A247N252S281D282E319. By contrast, all virus isolates associated with clinical infections had the motif I64T137T217A221T247V252T281N282A319, where underlined amino acids represent the avirulent and highly virulent motif, respectively. Phylogenetic analysis of amino acid sequences showed 2

  10. Identifying HIV infection in diagnostic histopathology tissue samples--the role of HIV-1 p24 immunohistochemistry in identifying clinically unsuspected HIV infection: a 3-year analysis.

    Science.gov (United States)

    Moonim, Mufaddal T; Alarcon, Lida; Freeman, Janet; Mahadeva, Ula; van der Walt, Jon D; Lucas, Sebastian B

    2010-03-01

    Because of the clinical difficulty in identifying the early stages of human immunodeficiency virus (HIV) infection, the histopathologist often has to consider the diagnosis of HIV in tissue samples from patients with no previous suspicion of HIV infection. The aim was to investigate the practicality and utility of routine HIV-1 p24 immunohistochemistry on tissue samples received at a London histopathology laboratory. Over a 3-year period, HIV-1 p24 was evaluated immunohistochemically on 123 cases. Of these, 37 (30%) showed positive expression of p24 in lesional follicular dendritic cells (FDCs). Of these 37 cases, 11 were not clinically suspected to be HIV+ and had no prior serological evidence of HIV infection. These cases represented lymph node biopsies, tonsillar and nasopharyngeal biopsies and a parotid excision. In addition to expression on FDCs, in 22 cases (60%), p24 also highlighted mononuclear cells and macrophages. p24 was also useful in confirming the presence of HIV in lymphoid tissue in non-lymphoid organs such as the lung, anus, salivary gland and brain. Immunonegativity occurred in occasional known HIV+ cases, probably related to treatment or tissue processing. This study confirms the usefulness of this technique in detecting unsuspected HIV infection in lymphoid and non-lymphoid organs on histopathological material and should be part of routine evaluation of lymph nodes and lymphoid tissue in other organs if morphological or clinical features suggest HIV infection.

  11. Could Urinary Tract Infection Cause Female Stress Urinary Incontinence? A Clinical Study.

    Science.gov (United States)

    Heydari, Fatemeh; Motaghed, Zahra; Abbaszadeh, Fatemeh

    2016-01-01

    Stress urinary incontinence (SUI), the most common type of urinary incontinence (UI), is usually defined as leakage of urine during movement or activity which puts pressure on the bladder, such as coughing, sneezing, running or heavy lifting. It is reported in most countries that 15% to 40% of women struggle with SUI and its severe implications for daily life, including social interactions, sexuality, and psychological wellbeing. The aim of our study was to assess the relationship between urinary tract infection and the severity of stress urinary incontinence (SUI). This research was a cross-sectional study conducted in a public urology clinic in Tehran. The study population was all females with complaints of SUI who visited the clinic during 2014. We compared Valsalva leak point pressure (VLPP) in two groups of patients, with and without history of urinary tract infection (UTI). According to the findings of our study, the mean VLPP was 83.10 cm H2O in the group with UTI history, and 81.29 cm H2O in those without history of UTI. The difference in VLPP between the two groups was not significant (P < 0.05), even after controlling for confounding variables including age, body mass index, history of hysterectomy and number of deliveries. Our study did not confirm a significant relationship between UTI and severity of SUI as measured by VLPP. A decisive opinion would require extensive future studies by prospective methods.

  12. T-cell exhaustion in chronic hepatitis B infection: current knowledge and clinical significance

    Science.gov (United States)

    Ye, B; Liu, X; Li, X; Kong, H; Tian, L; Chen, Y

    2015-01-01

    Hepatitis B virus (HBV) infection is the major cause of inflammatory liver disease, of which the clinical recovery and effective anti-viral therapy is associated with the sustained viral control of effector T cells. In humans, chronic HBV infection often shows weak or absent virus-specific T-cell reactivity, which is described as the ‘exhaustion' state characterized by poor effector cytotoxic activity, impaired cytokine production and sustained expression of multiple inhibitory receptors, such as programmed cell death-1 (PD-1), lymphocyte activation gene-3, cytotoxic T lymphocyte-associated antigen-4 and CD244. As both CD4+ and CD8+ T cells participate in the immune responses against chronic hepatitis virus through distinct manners, compelling evidences have been proposed, which restore the anti-viral function of these exhausted T cells by blocking those inhibitory receptors with its ligand and will pave the way for the development of more effective immunotherapeutic and prophylactic strategies for the treatment of chronic infectious diseases. A large number of studies have stated the essentiality of T-cell exhaustion in virus-infected diseases, such as LCMV, hepatitis C virus (HCV), human immunodeficiency virus infections and cancers. Besides, the functional restoration of HCV- and HIV-specific CD8+ T cells by PD-1 blockade has already been repeatedly verified, and also for the immunological control of tumors in humans, blocking the PD-1 pathway could be a major immunotherapeutic strategy. Although the specific molecular pathways of T-cell exhaustion remain ambiguous, several transcriptional pathways have been implicated in T-cell exhaustion recently; among them Blimp-1, T-bet and NFAT2 were able to regulate exhausted T cells during chronic viral infection, suggesting a distinct lineage fate for this sub-population of T cells. This paper summarizes the current literature relevant to T-cell exhaustion in patients with HBV-related chronic hepatitis, the options

  13. Induction Immunosuppression and Clinical Outcomes in HIV-Infected Kidney Transplant Recipients

    Science.gov (United States)

    Kucirka, Lauren M; Durand, Christine M; Bae, Sunjae; Avery, Robin K; Locke, Jayme E; Orandi, Babak J; McAdams-DeMarco, Mara; Grams, Morgan E; Segev, Dorry L

    2016-01-01

    There is an increased risk of acute rejection (AR) in HIV+ kidney transplant (KT) recipients. Induction immunosuppression is standard-of-care for those at high risk of AR; however, use in HIV+ patients is controversial given fears of increased infection rates. We sought to compare clinical outcomes between HIV+ KT recipients who were treated with 1) anti-thymocyte globulin (ATG), 2) interleukin-2 receptor antagonist (anti-IL2R) and 3) no induction. We studied 830 HIV+ KT recipients between 2000-2014 as captured in SRTR and compared rates of delayed graft function (DGF), AR, graft loss and death. Infections and hospitalizations were ascertained via ICD-9 codes in a subset of 308 with Medicare. Compared to no induction, neither induction agent was associated with an increased risk of infection (wHR=0.80, 95%CI: 0.55-1.18). HIV+ recipients who received induction spent fewer days in the hospital (wRR=0.70, 95%CI:0.52-0.95), had lower rates of DGF (wRR=0.66, 95%CI: 0.51-0.84), less graft loss (wHR=0.47, 95%CI:0.24-0.89), and a trend towards lower mortality (wHR=0.60, 95%CI: 0.24-1.28). Those who received induction with ATG had lower rates of acute rejection (wRR=0.59, 95%CI: 0.35-0.99). Induction in HIV+ KT recipients was not associated with increased infections; in fact, those receiving ATG, the most potent agent, had the lowest rates. In light of the high risk of acute rejection in this population, induction therapy should be strongly considered. PMID:27111897

  14. Clinical, microbiological and pathological findings of Mycobacterium ulcerans infection in three Australian Possum species.

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    Carolyn R O'Brien

    Full Text Available BACKGROUND: Buruli ulcer (BU is a skin disease caused by Mycobacterium ulcerans, with endemicity predominantly in sub-Saharan Africa and south-eastern Australia. The mode of transmission and the environmental reservoir(s of the bacterium and remain elusive. Real-time PCR investigations have detected M. ulcerans DNA in a variety of Australian environmental samples, including the faeces of native possums with and without clinical evidence of infection. This report seeks to expand on previously published findings by the authors' investigative group with regards to clinical and subclinical disease in selected wild possum species in BU-endemic areas of Victoria, Australia. METHODOLOGY/PRINCIPAL FINDINGS: Twenty-seven clinical cases of M. ulcerans infection in free-ranging possums from southeastern Australia were identified retrospectively and prospectively between 1998-2011. Common ringtail possums (Pseudocheirus peregrinus, a common brushtail possum (Trichosurus vulpecula and a mountain brushtail possum (Trichosurus cunninghami were included in the clinically affected cohort. Most clinically apparent cases were adults with solitary or multiple ulcerative cutaneous lesions, generally confined to the face, limbs and/or tail. The disease was minor and self-limiting in the case of both Trichosurus spp. possums. In contrast, many of the common ringtail possums had cutaneous disease involving disparate anatomical sites, and in four cases there was evidence of systemic disease at post mortem examination. Where tested using real-time PCR targeted at IS2404, animals typically had significant levels of M. ulcerans DNA throughout the gut and/or faeces. A further 12 possums without cutaneous lesions were found to have PCR-positive gut contents and/or faeces (subclinical cases, and in one of these the organism was cultured from liver tissue. Comparisons were made between clinically and subclinically affected possums, and 61 PCR-negative, non-affected individuals

  15. Clinical profile of hepatitis C virus infection in a developing country- India.

    Science.gov (United States)

    Mahajan, Ramit; Midha, Vandana; Goyal, Omesh; Mehta, Varun; Narang, Vikram; Kaur, Kirandeep; Singh, Arshdeep; Singh, Dharmatma; Bhanot, Rishu; Sood, Ajit

    2017-09-18

    The epidemiology and clinical profile of hepatitis C virus (HCV) varies worldwide and data from developing countries is sparse. To study the clinical profile of HCV infection in a developing country in South East Asia (India). This observational study assessed patient demographics, viral characteristics, risk factors for virus acquisition and disease characteristics in HCV patients diagnosed between January 2004 and December 2015. Of 8,035 patients were diagnosed with HCV infection, a majority were males (68.3%), middle aged (52.2%), from low (34%) and middle (46%) socioeconomic status and rural population (69.8%). Eighty two percent had identifiable risk factors, commonest being history of dental treatment (52%) and therapeutic injections with reusable syringes/needles (45%). Household contacts of index patients had high prevalence of HCV (15.3%). Common genotypes were genotype 3 (70.4%) and genotype 1 (19.3%). Though a majority of patients were either asymptomatic (54.8%) or had non-specific symptoms (6.7%) at presentation, a significant proportion (9.3%) had advanced liver disease. Presentation with cirrhosis (38.8%) was associated with male gender, higher age at time of virus detection, rural residence, alcohol or opium intake and coinfections with hepatitis B virus (HBV) or human immunodeficiency virus (HIV). HCV infection in northern India is seen more commonly in males, middle aged, rural background from low-middle socioeconomic status. The common possible risk factors are dental treatment and exposure to reused syringes and needles. Though the commonest presentation is incidental detection, a large number of patients present with advanced liver disease. This article is protected by copyright. All rights reserved.

  16. [Skin and soft-tissue infections in hospitalized patients: epidemiology, microbiological, clinical and prognostic factors].

    Science.gov (United States)

    Raya-Cruz, Manuel; Ferullo, Ignacio; Arrizabalaga-Asenjo, María; Nadal-Nadal, Antonio; Díaz-Antolín, María Paz; Garau-Colom, Margarita; Payeras-Cifre, Antonio

    2014-03-01

    Skin and soft-tissue infections (SSTIs) are a frequent cause of consultation in emergence services, and complicated cases require hospitalization. However there are few data in our setting about the clinical characteristics of these infections. A retrospective review of hospital admitted patients with a diagnosis of folliculitis, cellulitis, erysipelas, abscesses, hidradenitis, furuncle, impetigo, fasciitis and Fournier's gangrene. Cases were extracted from the data base of diagnostic codes of the Archive and Clinical Documentation Department of Son Llàtzer Hospital from January 2002 to November 2011. We studied 996 episodes in 841 hospitalized patients with any diagnosis of SSTIs. Cellulitis/erysipelas (66.7%) was the most frequently diagnosed condition, with 77% of all SSTIs being community acquired, and the majority of patients had comorbidities, mainly diabetes (33%) and heart failure (17.7%). The most frequent isolated microorganism was S.aureus (35.1%), in 19 (12.9%) cases with methicillin-resistance (MRSA), 84.2% of them were nosocomial or health care acquired. Monotherapy with aminopenicillin with clavulanic acid was the empiric treatment most frequently used (35.5%). New antibiotics for Gram-positive cocci (linezolid, daptomycin, and tigecycline) were used in patients with comorbidities that presented more complications (P<.001) and more risk of mortality (P=.001). During admission 10.9% of patients died, but only in 2.7% of them mortality was related to the SSTIs. SSTIs attended most frequently in hospitalized patients are mainly cellulitis/erysipela, the majority community acquired. MRSA infections are mainly health care related. Use of new antibiotic for Gram-positive cocci was limited. Copyright © 2012 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  17. Regulatory T cell induction during Plasmodium chabaudi infection modifies the clinical course of experimental autoimmune encephalomyelitis.

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    Alessandro S Farias

    Full Text Available BACKGROUND: Experimental autoimmune encephalomyelitis (EAE is used as an animal model for human multiple sclerosis (MS, which is an inflammatory demyelinating autoimmune disease of the central nervous system characterized by activation of Th1 and/or Th17 cells. Human autoimmune diseases can be either exacerbated or suppressed by infectious agents. Recent studies have shown that regulatory T cells play a crucial role in the escape mechanism of Plasmodium spp. both in humans and in experimental models. These cells suppress the Th1 response against the parasite and prevent its elimination. Regulatory T cells have been largely associated with protection or amelioration in several autoimmune diseases, mainly by their capacity to suppress proinflammatory response. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we verified that CD4(+CD25(+ regulatory T cells (T regs generated during malaria infection (6 days after EAE induction interfere with the evolution of EAE. We observed a positive correlation between the reduction of EAE clinical symptoms and an increase of parasitemia levels. Suppression of the disease was also accompanied by a decrease in the expression of IL-17 and IFN-γ and increases in the expression of IL-10 and TGF-β1 relative to EAE control mice. The adoptive transfer of CD4(+CD25(+ cells from P. chabaudi-infected mice reduced the clinical evolution of EAE, confirming the role of these T regs. CONCLUSIONS/SIGNIFICANCE: These data corroborate previous findings showing that infections interfere with the prevalence and evolution of autoimmune diseases by inducing regulatory T cells, which regulate EAE in an apparently non-specific manner.

  18. Hematological and serum biochemical findings in clinical cases of cattle naturally infected with lumpy skin disease.

    Science.gov (United States)

    Abutarbush, Sameeh M

    2015-03-15

    Lumpy skin disease (LSD) is an acute viral disease of cattle that is currently emerging in the Middle East region and poses a serious threat to Europe and the rest of the world. The objective of this study was to describe hematological and serum biochemical findings associated with natural clinical infection of LSD in cattle. A total of 129 animals clinically infected with LSD were enrolled in the study. Venous blood sample were collected from study animals, and hematological and serum biochemical parameters were measured. Leukocytopenia was found in 8.7%, while leucocytosis was found in 18.2% of affected cattle. Decreased hematocrit concentration was seen in 18.3%. Most affected cattle had reduced mean corpuscular volume (43.7%), mean corpuscular hemoglobin (14.3%), and mean corpuscular hemoglobin concentration (11.5%). All cattle with abnormal platelets count had thrombocytopenia. Hyperfibrinogenemia, hyperproteinemia, and hyperalbuminemia were found in 69%, 59.6%, and 37.2% of affected cattle, respectively. Decreased creatinine concentration was seen in 65.8%. Hyperkalemia and hyperchloremia was found in 9.6% and 10.4% of the affected cattle, respectively. LSD appears to be associated with inflammatory leukogram, anemia, thrombocytopenia, hyperfibrinogenemia, hyperproteinemia, decreased creatinine concentration, hyperchloramia, and hyperkalemia. These are likely due to the associated severe inflammatory process and disease complications such as anorexia and reduced muscle mass. This is the first study that documents hematological and serum biochemical findings associated with LSD infection. Understanding the blood profile picture may give further insight to the pathogenesis of the disease and help in treatment of individual cattle.

  19. Noninvasive mechanical ventilation in high-risk pulmonary infections: a clinical review

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    Antonio M. Esquinas

    2014-12-01

    Full Text Available The aim of this article was to review the role of noninvasive ventilation (NIV in acute pulmonary infectious diseases, such as severe acute respiratory syndrome (SARS, H1N1 and tuberculosis, and to assess the risk of disease transmission with the use of NIV from patients to healthcare workers. We performed a clinical review by searching Medline and EMBASE. These databases were searched for articles on ‘‘clinical trials’’ and ‘‘randomised controlled trials’’. The keywords selected were non-invasive ventilation pulmonary infections, influenza-A (H1N1, SARS and tuberculosis. These terms were cross-referenced with the following keywords: health care workers, airborne infections, complications, intensive care unit and pandemic. The members of the International NIV Network examined the major results regarding NIV applications and SARS, H1N1 and tuberculosis. Cross-referencing mechanical ventilation with SARS yielded 76 studies, of which 10 studies involved the use of NIV and five were ultimately selected for inclusion in this review. Cross-referencing with H1N1 yielded 275 studies, of which 27 involved NIV. Of these, 22 were selected for review. Cross-referencing with tuberculosis yielded 285 studies, of which 15 involved NIV and from these seven were selected. In total 34 studies were selected for this review. NIV, when applied early in selected patients with SARS, H1N1 and acute pulmonary tuberculosis infections, can reverse respiratory failure. There are only a few reports of infectious disease transmission among healthcare workers.

  20. Does chronic hepatitis B infection affect the clinical course of acute hepatitis A?

    Science.gov (United States)

    Shin, Su Rin; Moh, In Ho; Jung, Sung Won; Kim, Jin Bae; Park, Sang Hoon; Kim, Hyoung Su; Jang, Myung Kuk; Lee, Myung Seok

    2013-01-01

    The impact of chronic hepatitis B on the clinical outcome of acute hepatitis A remains controversial. The aim of present study was to evaluate the clinical characteristics of acute hepatitis A in cases with underlying chronic hepatitis B compared to cases of acute hepatitis A alone. Data on 758 patients with acute hepatitis A admitted at two university-affiliated hospitals were reviewed. Patients were classified into three groups: group A, patients with both acute hepatitis A and underlying chronic hepatitis B (n = 27); group B, patients infected by acute hepatitis A alone whose sexes and ages were matched with patients in group A (n  = 54); and group C, patients with acute hepatitis A alone (n = 731). None of the demographic features of group A were significantly different from those of group B or C, except for the proportion of males and body weight, which differed from group C. When comparing to group B, clinical symptoms were more frequent, and higher total bilirubin and lower albumin levels were observed in group A. When comparing to group C, the albumin levels were lower in group A. There were no differences in the duration of hospital stay, occurrence of acute kidney injury, acute liver failure, prolonged cholestasis, or relapsing hepatitis. This study revealed that clinical symptoms and laboratory findings were less favorable for patients with acute hepatitis A and chronic hepatitis B compared to those with acute hepatitis A alone. However, there were no differences in fatal outcomes or serious complications. Copyright © 2012 Wiley Periodicals, Inc.

  1. Clinical outcomes of osteomyelitis patients infected with methicillin-resistant Staphylococcus aureus USA-300 strains.

    Science.gov (United States)

    Peyrani, P; Allen, M; Seligson, D; Roberts, C; Chen, A; Haque, N; Zervos, M; Wiemken, T; Harting, J; Christensen, D; Ramirez, R

    2012-03-01

    Methicillin-resistant Staphylococcus aureus (MRSA) USA-300 strains have emerged as an important cause of community-acquired infections. These strains have been recognized as an etiology of osteomyelitis but data on their incidence and outcomes are limited. We retrospectively studied the incidence and clinical outcomes of MRSA USA-300 osteomyelitis in patients at the University of Louisville Hospital and the Henry Ford Health System between January 2007 and March 2008. Pulsed-field gel electrophoresis was used to determine USA type. Clinical outcomes were defined as management success versus failure at 12 months. Chi-square tests, Fisher exact tests, and Mann-Whitney tests were used to compare patient characteristics on the basis of clinical outcomes and USA type. Of the 50 patients with MRSA osteomyelitis, 27 (54%) had the USA-300 strain. Clinical failure was identified in 22% (6/27) of the patients with MRSA USA-300 and in 30% (7/23) of the patients with MRSA non-USA-300 osteomyelitis (P = .509). Our results showed that MRSA USA-300 is a significant etiology of MRSA osteomyelitis. With current surgical and medical management, outcomes of patients with MRSA USA-300 osteomyelitis are similar to those of patients with MRSA non-USA-300 osteomyelitis.

  2. Divergent cellular responses during asymptomatic subclinical and clinical states of disease in cows naturally infected with Mycobacterium avium subsp. paratuberculosis

    Science.gov (United States)

    Infection of the host with Mycobacterium avium subsp. paratuberculosis (MAP) results in a chronic and progressive enteritis that traverses both subclinical and clinical stages. The mechanism(s) for the shift from asymptomatic subclinical disease state to advanced clinical disease are not fully under...

  3. A Multi-Center Prospective Derivation and Validation of a Clinical Prediction Tool for Severe Clostridium difficile Infection.

    LENUS (Irish Health Repository)

    Na, Xi

    2015-04-23

    Prediction of severe clinical outcomes in Clostridium difficile infection (CDI) is important to inform management decisions for optimum patient care. Currently, treatment recommendations for CDI vary based on disease severity but validated methods to predict severe disease are lacking. The aim of the study was to derive and validate a clinical prediction tool for severe outcomes in CDI.

  4. Prevalence and incidence of Trichomonas vaginalis infections in women participating in a clinical trial in Durban, South Africa.

    Science.gov (United States)

    Naidoo, Sarita; Wand, Handan

    2013-09-01

    Trichomonas vaginalis is known to be the most common, curable, sexually transmitted infection among sexually active women and may be associated with the acquisition and transmission of HIV. The purpose of this analysis is to determine the prevalence and incidence of T vaginalis and assess risk factors associated with T vaginalis infection in a cohort of women participating in a clinical trial. We analysed data from women participating in a phase III vaginal diaphragm trial conducted in two communities in Durban, South Africa from 2003 to 2006. A total of 3492 women were screened and 1485 women meeting the respective study eligibility criteria were enrolled. T vaginalis infection was determined at the initial screening visit and at quarterly visits among the enrolled women. Sexual behaviour and sociodemographic data were collected as per the study protocol. Combined data were analysed using STATA V.10.0. At baseline, prevalence of infection was 6.5%. The overall incident rate was estimated to be 8.6/100 women-years. Prevalent T vaginalis infection was associated with having a concurrent chlamydial infection and incident infections were associated with increased number of sex partners. T vaginalis infection was found to be relatively high among this cohort of women. Given the association of this infection with HIV, there is an evident need for T vaginalis screening and treatment in populations at risk for both infections.

  5. Toxoplasmosis can be a sexually transmitted infection with serious clinical consequences. Not all routes of infection are created equal.

    Science.gov (United States)

    Flegr, J; Klapilová, K; Kaňková, S

    2014-09-01

    Toxoplasma gondii infects about 30% of the human population. Common sources of infection are oocysts in cat faeces contaminating drinking water or unwashed vegetables, undercooked meat containing tissue cysts, and organ transplants from infected donors containing tissue cysts. However, very often, it is not possible to identify any potential source of infection in mothers of children with congenital toxoplasmosis. Here we present a hypothesis suggesting that toxoplasmosis is transmitted from infected men to noninfected women during unprotected sexual intercourse, which can result in the most serious form of disease, congenital toxoplasmosis. Arguments for the hypothesis: (1) Toxoplasma tachyzoites are present in the seminal fluid and tissue of the testes of various animals including humans. In some species infection of females by artificial insemination with semen from infected males has been observed. (2) Up to two thirds of Toxoplasma infections in pregnant women cannot be explained by the known risk factors. (3) Prevalence of toxoplasmosis in women in child-bearing age covaries with the incidence of sexually transmitted diseases in particular countries. (4) In some countries, an increased incidence of toxoplasmosis has been reported in women (but not men) aged 25-35 years. This second peak of infection could be associated with women having regular unprotected sex after marriage. (5) Toxoplasmosis triggers schizophrenia in predisposed subjects. Onset of schizophrenia is about 2-3 years earlier in men than in women. However, this difference in the onset can be found only between Toxoplasma-infected patients. The increased onset of schizophrenia in infected women could be associated with the already mentioned second peak of toxoplasmosis incidence. (6) The prevalence of toxoplasmosis decreases in developed countries in last 20 years. This trend could be a result of decrease in promiscuity and increase in safe sex practices, both associated with the AIDS pandemics

  6. Determination and clinical correlation of markers of inflammation in unvaccinated patients with varicella-zoster infection.

    Science.gov (United States)

    Karadag Oncel, E; Kara, A; Celik, M; Karahan, S; Cengiz, A B; Ceyhan, M

    2013-01-01

    Chicken pox is commonly known as a benign exenthamatous disease of childhood, occasionally neurologic or hemorrhagic complications, or even death may ensue. Early predictors of severity of disease have yet to be identified. TNF-alpha and IL-6 stimulate virus-specific immunoglobulin production and it has been postulated that determination of levels of these cytokines may be useful as a prognostic factor. Patients who were diagnosed with a varicella-zoster virus (VZV) infection in the Outpatient Clinic of the Department of Pediatric Infectious Diseases were evaluated for eligibility. Laboratory assays included an evaluation of complete blood counts, erythrocyte-sedimentation rate (ESR), c reactive protein (CRP), and the number of tumor necrosis factor-alpha/interleukin-6-(TNF-alpha/IL-6-) producing mononuclear cells as determined by flow cytometry. A total of 339 patients (320 with chickenpox and 19 with shingles) were enrolled. Blood samples could only be obtained from 81 of the 320 patients with chickenpox. Patients were also divided into three groups depending on the number of skin (vesicular) lesions. (group 1, ≤ 50 lesions; group 2, 51-100 lesions; group 3, >100 lesions). Correlation analyses did not reveal the presence of a statistically significant correlation between number of skin lesions with either of white blood cells (WBC) count (p = 0.231), ESR (p = 0.879) or CRP (p = 0.373). The mean percentage of TNF-alpha-producing mononuclear cells was significantly higher in group 2 compared to group 3 (p = 0.003). A similar difference was observed with regard to IL-6-producing mononuclear cells, albeit bordering on statistical significance (p = 0.058). Decreased expression of the cytokines TNF-alpha and IL-6 may be responsible for the development of a more severe clinical picture in patients with VZV infection, and determination of intracellular levels of these cytokines may be of benefit for early identification of patients who may have a more severe clinical

  7. Evaluation of epidemiological, clinical, and microbiological features of definite infective endocarditis

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    Faraji, Reza

    2017-01-01

    Full Text Available Background: Infective endocarditis (IE is a microbial infection of heart valves and its endothelial lining which is considered as a life-threatening disorder. This study evaluated the epidemiological, clinical, and microbiological features of IE at the Cardiovascular Research Center in Yazd, Iran. Methods: The cross-sectional study was conducted on 20 patients diagnosed with definite IE on the basis of Duke’s criteria hospitalized for one year in the Cardiovascular Research Center in Yazd, Iran, from January 2015 to December 2015. Demographic information, clinical, laboratory, and microbiological findings, and also trans-esophageal echocardiography (TEE of each patient were recorded and assessed. The collected data were analyzed using SPSS 16. Results: The mean age of the patients under study was 45±16 years with most of the afflicted patients (60% being male. Most cases (70% of IE were observed in the warm seasons (spring and summer. The most common clinical sign (80% was fever. TEE was positive for all (100% patients, and vegetation was seen in all patients. The nosocomial mortality rate was zero. However, 14 (70% patients underwent surgical treatment. The valves afflicted with IE were: the mitral valve (40%, the aortic valve (35%, and the tricuspid valve (25%, respectively. 4 patients (20% had a positive history of IE. Blood culture test was positive only in 1 case and the isolated microorganism belonged to the viridans group streptococci. Conclusion: Despite the one-year high prevalence of IE in this study, the nosocomial mortality rate was not high and was reported to be nil under surgical and antimicrobial therapy.

  8. SYSTEMIC LUPUS ERYTHEMATOSUS AND INFECTIVE ENDOCARDITIS: CLINICAL AND DIAGNOSTIC PARALLELS AND IMAGINARY MIMICRY

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    S. P. Filonenko

    2016-01-01

    Full Text Available Aim of the study – draw attention to the differential diagnosis of systemic lupus erythematosus (SLE and infective endocarditis.Materials and methods. Patient A., 44 years old, was admitted to the cardiologic department of Ryazan Regional Clinical Cardiology Clinic diagnosed with probable infective subacute endocarditis, glomerulonephritis, with complaints of weakness, fatigue, increase in body temperature up to 37.7 °C preferably in the evening, dry cough, shortness of breath on mild exertion, swelling of legs and feet. In early October 2015, the patient's body temperature increased up to 37.8 °C, there was a dry cough. Patient was treated on an outpatient basis for acute respiratory viral infections with antibiotics, decreased body temperature. Acute deterioration of the condition was observed in mid-October: severe shortness of breath even on mild physical exertion, heart rate increased, as well as lower limb edema, blood pressure (BP increased up to 240/140 mmHg. The patient was hospitalized in the therapeutic department. Against the background of the treatment (antibiotics, antihypertensive agents, diuretics, digoxin patient’s condition was improved: shortness of breath decreased, as well as the heart rate, limb edema, blood pressure down to 180/110–190/120 mmHg. However, there was persistent proteinuria (0.33–1.65–3.3 g/L, low grade fever persisting in the evening. On admission to the cardiological department of Ryazan Regional Clinical Cardiology Clinic patient underwent the following survey: assessment of lab parameters in dynamics, electrocardiography, heart echocardiography, computed tomography (CT of lungs.Results. We revealed left ventricular hypertrophy on heart ultrasonography; an increase in the volume of left atrium, right ventricle, right atrium; mitral, aortic, tricuspid valve insufficiency (grade II regurgitation; pulmonary hypertension; on lung CT – the picture of hydrothorax on the right side, hydropericardium

  9. Immunostimulation using bacterial antigens – mechanism ofaction and clinical practice inviral respiratory tract infections

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    Wojciech Feleszko

    2015-12-01

    Full Text Available Recurrent respiratory tract infections constitute a significant problem in the practice of a general practitioner and paediatrician. Antibiotic resistance of bacterial strains, which has been growing for years, prompts the search for alternative ways of combating pathogens. One of them is the usage of preparations based on cell lysis of various bacterial strains. Bacterial lysates have been available in Europe for many years. In preclinical trials, they are characterised by the capability of reducing infections caused by bacteria and viruses that are not the components of the preparations. A range of clinical trials have demonstrated their usefulness in reducing the frequency of seasonal respiratory tract infections and antibiotic use. Moreover, patients with chronic obstructive pulmonary disease gain an additional advantage in the form of the reduction of the risk of hospitalization due to disease exacerbations and a positive influence on the survival curve. The action of bacterial lysates is based on oral immunostimulation of gut-associated lymphoid tissue, which results in increased antibody production. Moreover, they activate a range of mucosal mechanisms of non-specific immunity, mainly by enhancing the activity of TLR-dependent mechanisms. The efficacy of this group of drugs has been confirmed in a range of clinical trials, systematic reviews and meta-analyses. Recent studies also indicate their immunoregulatory potential, suggesting that they might be used in the future in preventing allergies, asthma and autoimmune diseases. To conclude, physicians (paediatricians, laryngologists, pulmonologists should consider reducing the use of antibiotics in their daily practice. Instead, they should offer preparations that promote the immune system, thus controlling infections in a better way.

  10. Clinical presentation, convalescence, and relapse of rocky mountain spotted fever in dogs experimentally infected via tick bite.

    Science.gov (United States)

    Levin, Michael L; Killmaster, Lindsay F; Zemtsova, Galina E; Ritter, Jana M; Langham, Gregory

    2014-01-01

    Rocky Mountain spotted fever (RMSF) is a tick-borne disease caused by R. rickettsii in North and South America. Domestic dogs are susceptible to infection and canine RMSF can be fatal without appropriate treatment. Although clinical signs of R. rickettsii infection in dogs have been described, published reports usually include descriptions of either advanced clinical cases or experimental infections caused by needle-inoculation of cultured pathogen rather than by tick bite. The natural progression of a tick-borne R. rickettsii infection has not been studied in sufficient detail. Here, we provide a detailed description of clinical, hematological, molecular, and serological dynamics of RMSF in domestic dogs from the day of experimental exposure to infected ticks through recovery. Presented data indicate that neither the height/duration of fever nor detection of rickettsial DNA in dogs' blood by PCR are good indicators for clinical prognosis. Only the apex and subsequent subsidence of neutrophilia seem to mark the beginning of recovery and allow predicting a favorable outcome in Rickettsia-infected dogs, even despite the continuing persistence of mucosal petechiae and skin rash. On the other hand the appropriate (doxycycline) antibiotic therapy of sufficient duration is crucial in prevention of RMSF relapses in dogs.

  11. Vitamin D deficiency in a cohort of HIV-infected patients: clinical analysis

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    B Vandercam

    2012-11-01

    Full Text Available Purpose of the study: Observational studies have noted very high rates of low serum 25-hydroxyvitamin D [25(OHD3] levels in both general and HIV-infected populations. In HIV-infected patients, low 25(OHD3 levels are secondary to a combination of usual risk factors and HIV-specific risk factors, like antiretroviral therapy [1]. The objective of our study is to analyse the magnitude of vitamin D deficiency or insufficiency and the role of various factors such as age, sex, ethnicity, season, and antiretroviral medications in our cohort of HIV-infected patients. Methods: We prospectively collected data on 25-hydroxyvitamin D levels sampled between January 2009 and June 2011 from our cohort of 930 HIV-infected patients. Vitamin D dosage was performed using immunoassay (‘Diasorin’ - Saluggia, Italy. We divided vitamin D levels into 3 categories: 25-hydroxyvitamin D levels <20 mg/nl were considered deficient, insufficient between 20 and 29 ng/ml. Levels ≥30 ng/ml were defined as normal [2]. Data on demographic features (age, ethnicity, season, heterosexuality vs homosexuality, clinical features and laboratory findings (CD4 cell count, viral load, HAART, BMI were collected from patients’ medical records using our institutional database ‘Medical explorer v3r9, 2009’. Summary of results: Overall, 848 patients were included in our study (Table 1. Low levels of serum 25(OHD3 were seen in 89.3% of the study population, from which 69.5% were deficient and 19.8% were insufficient. On univariate analysis, female sex, high BMI, black African, heterosexuality, undetectable viral load and antiretroviral treatment were all predictors of vitamin D deficiency and insufficiency. Treatment with efavirenz and tenofovir were the most associated with low vitamin D levels. On multivariate analysis (multiple linear regression model only female sex (OR=1.14; 95% CI 0.84–0.96; p<0.001, dosage during winter months (OR=1.14; 95% CI 1–1.15; p<0.05 and HAART (OR=1

  12. Evaluation of mupirocin ointment in control of central venous catheter related infections: a randomized clinical trial

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    Rezaei J

    2009-09-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Central venous catheter (CVC related infections are important complications of cathter application. This study assessed the usefulness of mupirocin in prevention and control of these infections."n"nMethods: In this randomized clinical trial, consecutive surgical patients requiring central venous catheter (for more than 2 days in Amir-Alam Hospital from 2006-2008 were enrolled. Patients were divided in two groups; in "case group" patients received topical mupirocin 2% every 48 hours at the time of insertion of catheter and dressing change and for "control group" mupirocin was not used. All of the patients received chlorhexidine and enoxoparin as complementary treatments. Two groups were comparable in regard of age, sex and risk factors."n"nResults: One hundred eighteen patients enrolled in the study (57 in case and 61 in control group completed the study. 84 catheters in case group and 88 catheters in control group were inserted. The catheters in 90% of patients were inserted in jugular vein. At the end of study 29(16.8% patients (16 in control versus 13 in case group had catheter colonization (p=NS. Catheter related bloodstream infection was observed in 16(9.3% patients (6 in

  13. Clinical manifestations and hematological and serological findings in children with dengue infection

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    Mulya Rahma Karyanti

    2011-06-01

    Full Text Available Background Dengue hemorrhagic fever (DHF is endemic to Indonesia and remains a public health problem, with its highest incidence in children. There have been few reports on the clinical, hematological and serological data in children \\\\lith dengue. Objective To assess the clinical and laboratory profiles of children \\\\lith dengue infection in Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Methods Clinical, hematological and serological infonnation from children diagnosed v.ith dengue infection in Cipto Mangunkusumo Hospital were collected from 2007 to 2009. Results Of611 children admitted with dengue, 143 (23.4% had dengue fever (DF, 252 (41.2% had DHF grades I and II; and 216 (35.4% had DHF grades III and IV. Of the 81 cases where dengue serotypes were identified, 12.3% were DENV1, 35.8% were DENV-2, 48.2% were DENV-3 and 3.7% were DENV-4. Mean age of subjects was 8.9 years (SD 4.4, and 48.4% of cases were boys. The mean length of fever before hospital admission was 4.2 days (SD 1.1 and mean length of stay in the hospital was 4 days (SD 2.7. Common symptoms observed were petechiae, hepatomegaly and epistaxis. Complications found mostly in those with dengue shock syndrome (DSS were hematemesis (30 cases, 4.9% of all patients, encephalopathy (19 cases, 3.1 % and melena (17 cases, 2.8%. Conclusion Signs and symptoms of fever, bleeding manifestations and thrombocytopenia were present in children 'With DF and DHF, while signs of increased vascular permeability were found only in those 'With DHF. Encephalopathy and gastrointestinal bleeding were found mostly in DSS cases. At admission, leukopenia was found in more DF patients than in DHF patients. Absence of leukopenia may be a sign of more severe dengue infection.

  14. Epidemiology and clinical features of rotavirus and norovirus infection among children in Ji'nan, China.

    Science.gov (United States)

    Sai, Lintao; Sun, Jintang; Shao, Lihua; Chen, Shuai; Liu, Haihong; Ma, Lixian

    2013-10-08

    Acute gastroenteritis caused by bacteria, virus and parasite is an important cause of childhood morbidity and mortality in developing countries. Rotavirus and norovirus have been recognized as the most common pathogens causing acute gastroenteritis among children. However, there is still no valuable data about infections of rotavirus and norovirus in children in Ji'nan, an eastern city in China. The aims of the present study are to determine the incidence of rotavirus and norovirus associated acute gastroenteritis in Ji'nan among children, to characterize rotavirus and norovirus strains circulating during this period; and to provide useful epidemiological and clinical data. Fecal specimens and clinical data were collected from 767 children (502 outpatients and 265 inpatients) under 5 years of age with acute diarrhea at Shandong University Qilu Hospital and Qilu children's Hospital in Ji'nan, China between February 2011 and January 2012. Virus RNA was extracted, amplified, electrophoresed, sequenced and phylogenetically analyzed to determine the prevalent genotypes. Chi-square and U test were used to compare characteristics of clinical manifestation in each group. Of the 767 specimens 263 (34.3%) were positive for rotavirus and 80 (10.4%) were positive for norovirus. Among 263 rotavirus positive cases, G3 (40.7%) was the most prevalent serotype, P[8] (46.8%) was the dominant genotype and G3P[8] (31.9%) was the most common combination. All of the norovirus strains belonged to GII genogroup including GII.3, GII.4 and GII.6, of which GII.4 (61.2%) was the predominant genotype. Phylogenetic analysis of the GII.4 sequences showed that 18 GII.4 strains belonged to GII.4 2004-2006 cluster and 31 GII.4 strains were divided into GII.4 2006b cluster. A peak number of rotavirus infections was observed during the cold season from November to next January. Higher rates of norovirus infections were detected from September to November. Most patients with rotavirus and norovirus

  15. Epidemiology and clinical features of rotavirus and norovirus infection among children in Ji’nan, China

    Science.gov (United States)

    2013-01-01

    Background Acute gastroenteritis caused by bacteria, virus and parasite is an important cause of childhood morbidity and mortality in developing countries. Rotavirus and norovirus have been recognized as the most common pathogens causing acute gastroenteritis among children. However, there is still no valuable data about infections of rotavirus and norovirus in children in Ji’nan, an eastern city in China. The aims of the present study are to determine the incidence of rotavirus and norovirus associated acute gastroenteritis in Ji’nan among children, to characterize rotavirus and norovirus strains circulating during this period; and to provide useful epidemiological and clinical data. Methods Fecal specimens and clinical data were collected from 767 children (502 outpatients and 265 inpatients) under 5 years of age with acute diarrhea at Shandong University Qilu Hospital and Qilu children’s Hospital in Ji’nan, China between February 2011 and January 2012. Virus RNA was extracted, amplified, electrophoresed, sequenced and phylogenetically analyzed to determine the prevalent genotypes. Chi-square and U test were used to compare characteristics of clinical manifestation in each group. Results Of the 767 specimens 263 (34.3%) were positive for rotavirus and 80 (10.4%) were positive for norovirus. Among 263 rotavirus positive cases, G3 (40.7%) was the most prevalent serotype, P[8] (46.8%) was the dominant genotype and G3P[8] (31.9%) was the most common combination. All of the norovirus strains belonged to GII genogroup including GII.3, GII.4 and GII.6, of which GII.4 (61.2%) was the predominant genotype. Phylogenetic analysis of the GII.4 sequences showed that 18 GII.4 strains belonged to GII.4 2004–2006 cluster and 31 GII.4 strains were divided into GII.4 2006b cluster. A peak number of rotavirus infections was observed during the cold season from November to next January. Higher rates of norovirus infections were detected from September to November. Most

  16. Clinical Practice and Infrastructure Review of Fecal Microbiota Transplantation for Clostridium difficile Infection.

    Science.gov (United States)

    Kelly, Brendan J; Tebas, Pablo

    2018-01-01

    A substantial proportion of Clostridium difficile infection (CDI) cases recur after completion of antibiotic therapy, and antibiotic cure rates diminish with each recurrence of CDI. Fecal microbiota transplantation (FMT) is an effective therapy for recurrent FMT, which otherwise requires prolonged or indefinite antibiotic treatment. FMT is performed by introducing the fecal microbial community obtained from a healthy donor or pool of donors into the stomach, small intestine, or colon of a patient with CDI. Multiple clinical trials support the usefulness of FMT in treating recurrent CDI, and CDI treatment guidelines now include consideration of FMT at the third CDI recurrence. However, there remain challenges to incorporating FMT into clinical practice. First, methods of fecal bacterial community processing vary, as do methods of FMT administration. Second, the optimal dosing strategy and expected benefit of FMT for refractory CDI, particularly for severe and severe complicated cases, are uncertain. Third, the US Food and Drug Administration (FDA) considers FMT an investigational treatment. Fourth, insurance reimbursement for FMT usually falls short of FMT administration costs. In the setting of rising C difficile incidence and growing evidence for FMT efficacy, the demand for FMT has increased. However, uncertainty surrounding optimal FMT preparation and administration methods, FDA oversight, and insurance reimbursement presently limits the clinical practice of FMT. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  17. Trypanosoma cruzi infection in a non-endemic country: epidemiological and clinical profile.

    Science.gov (United States)

    Salvador, F; Treviño, B; Sulleiro, E; Pou, D; Sánchez-Montalvá, A; Cabezos, J; Soriano, A; Serre, N; Gómez I Prat, J; Pahissa, A; Molina, I

    2014-07-01

    Chagas disease has been increasingly diagnosed in non-endemic countries. This is a prospective observational study performed at the Tropical Medicine Units of the International Health Program of the Catalan Health Institute, Barcelona (PROgrama de Salud Internacional del Instituto Catalán de la Salud, PROSICS Barcelona, Spain), that includes all patients with Chagas disease who attended from June 2007 to May 2012. Clinical and epidemiological data were collected. Overall, 1274 patients were included, the mean age of the patients was 37.7 years, 67.5% were women and 97% came from Bolivia. Thirteen patients had immunosuppressive conditions. The prevalence of cardiac involvement was 16.9%, lower than in previous studies performed in endemic areas (20-60%). Cardiac alterations were found in 33.8% of symptomatic and 14.1% of asymptomatic patients. The prevalence of digestive involvement was 14.8%. The rate of digestive involvement is very different among previous studies because of different diagnostic tools and strategies used. Barium enema alterations were found in 21.4% of symptomatic and 10.3% of asymptomatic patients, and oesophageal alterations were found in 3.7% of symptomatic and in 2.3% of asymptomatic patients. As shown in previous studies, Chagas disease in non-endemic countries affects younger patients and has lower morbidity. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  18. Factors in Dry Period Associated with Intramammary Infection and Subsequent Clinical Mastitis in Early Postpartum Cows

    Directory of Open Access Journals (Sweden)

    Kansuda Leelahapongsathon

    2016-04-01

    Full Text Available The objective of this study was to determine cow characteristics and farm management factors during the dry period associated with early postparturient intramammary infection (IMI and subsequent clinical mastitis (CM. Data were collected three times: before drying off (P1, during the dry period (P2, and 5 to 14 days after calving (P3, using questionnaires and farm investigation. Milk samples were aseptically collected for bacterial identification at P1 and P3. Factors associated with IMI and CM were analyzed using multiple logistic regression models. The final model showed that IMI in early postpartum was significantly associated with full insertion of dry cow antibiotic, dry cows in barns with a combination of tie and free stalls, body condition score (BCS in dry period and after calving, and milk yield before drying off. For IMI cows, factors significantly associated with clinical expression of mastitis were having daily barn cleaning, teat disinfected with alcohol before administration of dry cow therapy, BCS before drying off, milk yield before drying off, and days in milk at drying off. In conclusion, both cow and farm management factors are associated with the IMI rate and subsequent expression of clinical signs of mastitis in early postpartum cows.

  19. Route of infection alters virulence of neonatal septicemia Escherichia coli clinical isolates

    Science.gov (United States)

    Cole, Bryan K.; Scott, Edgar; Ilikj, Marko; Bard, David; Akins, Darrin R.; Dyer, David W.

    2017-01-01

    Escherichia coli is the leading cause of Gram-negative neonatal septicemia in the United States. Invasion and passage across the neonatal gut after ingestion of maternal E. coli strains produce bacteremia. In this study, we compared the virulence properties of the neonatal E. coli bacteremia clinical isolate SCB34 with the archetypal neonatal E. coli meningitis strain RS218. Whole-genome sequencing data was used to compare the protein coding sequences among these clinical isolates and 33 other representative E. coli strains. Oral inoculation of newborn animals with either strain produced septicemia, whereas intraperitoneal injection caused septicemia only in pups infected with RS218 but not in those injected with SCB34. In addition to being virulent only through the oral route, SCB34 demonstrated significantly greater invasion and transcytosis of polarized intestinal epithelial cells in vitro as compared to RS218. Protein coding sequences comparisons highlighted the presence of known virulence factors that are shared among several of these isolates, and revealed the existence of proteins exclusively encoded in SCB34, many of which remain uncharacterized. Our study demonstrates that oral acquisition is crucial for the virulence properties of the neonatal bacteremia clinical isolate SCB34. This characteristic, along with its enhanced ability to invade and transcytose intestinal epithelium are likely determined by the specific virulence factors that predominate in this strain. PMID:29236742

  20. Clinical profile of Monomelic Amyotrophy (MMA) and role of persistent viral infection.

    Science.gov (United States)

    Vibha, Deepti; Behari, Madhuri; Goyal, Vinay; Shukla, Garima; Bhatia, Rohit; Srivastava, Achal Kumar; Vivekanandhan, S

    2015-12-15

    The objective of our study was to describe the clinical characteristics, electrophysiology, MRI features and conduct viral assays in patients with Monomelic Amyotrophy (MMA) and follow them up over one year. Consecutive patients with MMA who attended the Neurology services from April 2013 to March 2014 were included. Age and sex matched controls were taken for the purpose of viral assay analysis. The clinical evaluation was repeated at six months and one year. 109 cases and 109 controls were included in the study. The patients were predominantly males (98.2%; n=107/109) and had involvement of upper limbs (83.5%; n=91/109). 26 (23.8%) patients with clinically unilateral involvement had bilateral neurogenic changes in the electromyography. Serological assays of Japanese E, West Nile Virus, and Poliovirus 1, 2 and 3, HIV 1 and 2 were negative in all the cases and controls. Patients with MMA are predominantly young males with upper limb wasting and weakness. MRI of the cervical cord is normal in most of the patients (67.9%). The present study did not find any evidence of the association of viral infection in MMA. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Route of infection alters virulence of neonatal septicemia Escherichia coli clinical isolates.

    Directory of Open Access Journals (Sweden)

    Bryan K Cole

    Full Text Available Escherichia coli is the leading cause of Gram-negative neonatal septicemia in the United States. Invasion and passage across the neonatal gut after ingestion of maternal E. coli strains produce bacteremia. In this study, we compared the virulence properties of the neonatal E. coli bacteremia clinical isolate SCB34 with the archetypal neonatal E. coli meningitis strain RS218. Whole-genome sequencing data was used to compare the protein coding sequences among these clinical isolates and 33 other representative E. coli strains. Oral inoculation of newborn animals with either strain produced septicemia, whereas intraperitoneal injection caused septicemia only in pups infected with RS218 but not in those injected with SCB34. In addition to being virulent only through the oral route, SCB34 demonstrated significantly greater invasion and transcytosis of polarized intestinal epithelial cells in vitro as compared to RS218. Protein coding sequences comparisons highlighted the presence of known virulence factors that are shared among several of these isolates, and revealed the existence of proteins exclusively encoded in SCB34, many of which remain uncharacterized. Our study demonstrates that oral acquisition is crucial for the virulence properties of the neonatal bacteremia clinical isolate SCB34. This characteristic, along with its enhanced ability to invade and transcytose intestinal epithelium are likely determined by the specific virulence factors that predominate in this strain.

  2. Route of infection alters virulence of neonatal septicemia Escherichia coli clinical isolates.

    Science.gov (United States)

    Cole, Bryan K; Scott, Edgar; Ilikj, Marko; Bard, David; Akins, Darrin R; Dyer, David W; Chavez-Bueno, Susana

    2017-01-01

    Escherichia coli is the leading cause of Gram-negative neonatal septicemia in the United States. Invasion and passage across the neonatal gut after ingestion of maternal E. coli strains produce bacteremia. In this study, we compared the virulence properties of the neonatal E. coli bacteremia clinical isolate SCB34 with the archetypal neonatal E. coli meningitis strain RS218. Whole-genome sequencing data was used to compare the protein coding sequences among these clinical isolates and 33 other representative E. coli strains. Oral inoculation of newborn animals with either strain produced septicemia, whereas intraperitoneal injection caused septicemia only in pups infected with RS218 but not in those injected with SCB34. In addition to being virulent only through the oral route, SCB34 demonstrated significantly greater invasion and transcytosis of polarized intestinal epithelial cells in vitro as compared to RS218. Protein coding sequences comparisons highlighted the presence of known virulence factors that are shared among several of these isolates, and revealed the existence of proteins exclusively encoded in SCB34, many of which remain uncharacterized. Our study demonstrates that oral acquisition is crucial for the virulence properties of the neonatal bacteremia clinical isolate SCB34. This characteristic, along with its enhanced ability to invade and transcytose intestinal epithelium are likely determined by the specific virulence factors that predominate in this strain.

  3. Clinical course and core variability in HBV infected patients without detectable anti-HBc antibodies.

    Science.gov (United States)

    Anastasiou, Olympia E; Widera, Marek; Verheyen, Jens; Korth, Johannes; Gerken, Guido; Helfritz, Fabian A; Canbay, Ali; Wedemeyer, Heiner; Ciesek, Sandra

    2017-08-01

    The presence of anti-HBc antibodies indicates direct encounter of the immune system with hepatitis B virus (HBV). Aim of our study was to seek for anti-HBc negative but HBV replicating patients and analyze their clinical course and preconditions. From 1568 HBV-DNA positive patients, 29 patients (1.85%) tested negative for anti-HBc. The absence of anti-HBc could be confirmed in 19 patients using an alternative assay. In 16 of 19 cases, a partial or full HBV genome analysis was performed with NGS sequencing to evaluate if specific mutations were associated with anti-HBc absence. As a control group samples from 32 matched HBV infected patients with detectable anti-HBc were sequenced. Patients with detectable HBV-DNA and sequenced HBV core region in the confirmed absence of anti-HBc were diagnosed with acute HBV infection (n=3), HBV reactivation (n=9) and chronic hepatitis B (n=4). Most patients (12/16) were immunosuppressed: 3/16 patients had an HIV coinfection, 7/16 patients suffered from a malignant disease and 4/16 patients underwent solid organ transplantation (from which 2/4 had a malignant disease). Compared to the control cohort, HBV variants from anti-HBc negative patients showed less variability in the core region. In the absence of anti-HBc, HBV-DNA was most often found in immunocompromised hosts. Distinct mutations or deletions in the core region did not explain anti-HBc negativity. It would be advisable not to rely only on a single result of anti-HBc negativity to exclude HBV infection in immunocompromised hosts, but to measure anti-HBc repeatedly or with different methods. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Enterovirus infection in children attending two outpatient clinics in Zhejiang Province, China.

    Science.gov (United States)

    Cai, Jian; Lv, Huakun; Lin, Junfen; Chen, Zhiping; Fang, Chunfu; Han, Jiankang

    2014-09-01

    Enteroviruses are responsible for hand, foot, and mouth disease, and have caused many deaths in China during recent years. But the natural history of enterovirus infection in children, especially asymptomatic children, is not yet clear. From April 2011 to May 2012, 505 stool and throat swab samples of children attending outpatients clinics in two hospitals were collected weekly to test for Enterovirus 71, Coxsackievirus A16, and other enterovirus nucleic acids by real-time RT-PCR. Two hundred sixty-four patients were enterovirus positive, the positive rate was 52.3%, 27.5% (22/80) in children without a rash and 56.9% (242/425) in children with a rash. Coxsackievirus A16 positive rate of male (24%, 61/254) was higher than that of female (15.2%, 26/171) (χ(2)  = 4.87, P = 0.027). The highest positive rate of enterovirus infection was 63.5% in the 2-year-old age group. Comparing children with and without a rash, within the same age groups, no statistical difference was found (P > 0.05). The seasonal distribution of Enterovirus 71 had only one peak in May, but Coxsackievirus A16 had two peaks in April and October. In patients with a rash, the frequency of Enterovirus 71 was relatively high before July, and then that of Coxsackievirus A16 increased gradually. In the case of Enterovirus 71 and Coxsackievirus A16, stool specimens had a higher positive rate than throat swab specimens' (χ(2)  = 3.88, P = 0.05; χ(2)  = 15.13, P < 0.001). Enterovirus infection was more frequent in males 2-3 year-old children, with the implicated virus varying by season. Targeted prevention and control measures should be carried out. © 2014 Wiley Periodicals, Inc.

  5. [Hepatitis E virus infection in patients with clinical diagnosis of viral hepatitis in Colombia].

    Science.gov (United States)

    Peláez, Dioselina; Hoyos, María Cristina; Rendón, Julio César; Mantilla, Carolina; Ospina, Martha Cecilia; Cortés-Mancera, Fabián; Pérez, Olga Lucía; Contreras, Lady; Estepa, Yaneth; Arbeláez, María Patricia; Navas, María Cristina

    2014-01-01

    Hepatitis E virus (HEV) is an emergent virus of global importance; it is the etiological agent of sporadic cases and outbreaks of hepatitis. The epidemiology of this infection in Colombia is unknown. To determine the seropositivity for hepatitis E virus in Colombia in cases with clinical diagnosis of viral hepatitis. Serum samples from patients that were sent to the Instituto Nacional de Salud during the period 2005-2010 (group 1) and samples sent to the Laboratorio Departamental de Salud Pública de Antioquia during the 2008-2009 period were included in this study (group 2). Serum samples were analyzed by immunoassay with commercial kits. From the 344 analyzed samples, 8.7% were positive for anti-HEV; the frequency of anti-HEV IgM was 1.74% (6/344) and the frequency of anti-HEV IgG was 7.5% (26/344). A difference in frequency of anti-HEV between group 1 (6.3%) and group 2 (1.3%) was observed. The cases were identified in nine departments of Colombia. This is the first study of hepatitis E virus infection in patients with diagnosis of hepatitis in Colombia. The frequency of anti-HEV described in this population of patients in Colombia is similar to that described in other Latin American countries like Brazil, Perú and Uruguay. Considering the results of this study, it could be necessary to include hepatitis E virus infection serological markers in the differential diagnosis of viral hepatitis in Colombia.

  6. The clinical and cellular basis of contact lens-related corneal infections

    Directory of Open Access Journals (Sweden)

    Danielle M Robertson

    2008-08-01

    Full Text Available Danielle M Robertson, H Dwight CavanaghDepartment of Ophthalmology, The University of Texas Southwestern Medical Center, Dallas, TX, USAAbstract: Microbial keratitis (MK is the most visually devastating complication associated with contact lens wear. Pseudomonas aeruginosa (PA is highly invasive in the corneal epithelium and is responsible for more than half of the reported cases of contact lens-related MK. To protect against Pseudomonas-mediated MK, the corneal epithelium has evolved overlapping defense mechanisms that function to protect the ocular surface from microbial invasion. Research has shown that contact lens wear disrupts these protective mechanisms through breakdown of normal homeostatic surface renewal as well as damaging the corneal surface, exposing underlying cell membrane receptors that bind and internalize PA through the formation of lipid rafts. Human clinical trials have shown that initial adherence of PA with resulting increased risk for microbial infection is mediated in part by contact lens oxygen transmissibility. Recently, chemical preserved multipurpose solutions (MPS have been implicated in increasing PA adherence to corneal epithelial cells, in addition to inducing significant levels of toxic staining when used in conjunction with specific silicone hydrogel lenses. This review summarizes what is currently known about the relationship between contact lenses, the corneal epithelium, MPS, and infection.Keywords: cornea, epithelium, contact lens, microbial keratitis

  7. Variation in clinical and parasitological traits in Pietrain and Meishan pigs infected with Sarcocystis miescheriana.

    Science.gov (United States)

    Reiner, G; Eckert, J; Peischl, T; Bochert, S; Jäkel, T; Mackenstedt, U; Joachim, A; Daugschies, A; Geldermann, H

    2002-06-03

    Future prophylaxis needs new concepts, including natural disease resistance of hosts against infectious agents. Genomic approaches to detect and improve disease resistance in farm animals and the molecular mechanisms involved in host-parasite interactions depend to a high degree on the trait differences between founder breeds, i.e. on the animal model. The present study evaluates differences in susceptibility/resistance against Sarcocystis miescheriana in the European Pietrain (PI) and the Chinese Meishan (ME) pig breeds, based on 25 individuals, infected orally with 5x10(4) sporocysts of S. miescheriana. Significant differences appeared in clinical, serological, haematological and parasitological findings. The major discriminating period post infection (p.i.) was between days 42 and 45. Severity of signs was negatively correlated with specific immunoglobulin titres during the first 3 weeks p.i. and positively with the load of bradyzoites in muscle tissues of the pigs. Loads of bradyzoites in muscle tissues were 20 times higher in PI than in ME. Sarcocystis-specific differences between the two breeds were in the range of 1-2 standard deviations. The study lays the foundation for further experiments to analyse chromosomal regions, candidate genes, and thus the molecular basis of Sarcocystis susceptibility/resistance as a model for host-parasite interaction in protozoan infectious disease.

  8. Clinical and laboratory findings of cytomegalovirus infection in 115 hospitalized non-immunocompromised adults.

    Science.gov (United States)

    Bonnet, F; Neau, D; Viallard, J F; Morlat, P; Ragnaud, J M; Dupon, M; Legendre, P; Imbert, Y; Lifermann, F; Le Bras, M; Beylot, J; Longy-Boursier, M

    2001-06-01

    We report a retrospective study of 115 hospitalized non-immunocompromised adults with proved or presumed diagnosis of cytomegalovirus infection. Clinical symptoms were fever (95%), constitutive symptoms (80%), joint and muscle pain (41%), shivering (32%), abdominal pain (26%), non-productive cough (20%), cutaneous eruption (20%), and diarrhea (10%). Examination found hepatomegaly (25%), splenomegaly (23%), cutaneous rash (20%), adenopathy (19%), pharyngitis (9%), jaundice (3%) or signs of meningeal irritation (1%). Seventeen patients had a gastrointestinal form (hepatitis, jaundice, colitis, antral gastritis or cholecystitis), eight had a pattern of hemopathy, two interstitial pneumonitis, two pericarditis, two immune thrombocytopenic purpura, two a polymyalgia rheumatica-like pattern, one thrombotic thrombocytopenic purpura, one cutaneous vasculitis and one meningoencephalitis. Sixty-four percent of the patients had atypical lymphocytosis. Hepatocellular injury occurred in 90% of the patients. Nineteen of the patients had biological immune abnormalities. Cytomegalovirus infection should be mainly suspected in any patient with persistent fever, isolated or associated with signs of poor specificity, or in some patients with visceral manifestations of initially unknown origin.

  9. Clinical pharmacokinetics and pharmacodynamics of ganciclovir and valganciclovir in children with cytomegalovirus infection.

    Science.gov (United States)

    Stockmann, Chris; Roberts, Jessica K; Knackstedt, Elizabeth D; Spigarelli, Michael G; Sherwin, Catherine Mt

    2015-02-01

    Among infants and immunocompromised children cytomegalovirus (CMV) is associated with significant morbidity and mortality. This review describes the clinical pharmacokinetics and pharmacodynamics of ganciclovir and valganciclovir for the treatment and prevention of CMV infection in children. A 24-h ganciclovir area under the concentration versus time curve (AUC₀₋₂₄) of 40 - 60 μg h/ml decreased the risk of CMV infection for adults undergoing CMV prophylaxis. For adults undergoing treatment for active CMV disease, a target AUC₀₋₁₂ of 40 - 60 μg h/ml has been suggested. The applicability of these targets to children remains uncertain; however, with the most sophisticated dosing regimens developed to date only 21% of patients are predicted to reach these targets. Moving forward, identification of optimal pediatric ganciclovir and valganciclovir dosing regimens may involve the use of an externally validated pediatric population pharmacokinetic model for empirical dosing, an optimal sampling strategy for collecting a minimal number of blood samples for each patient and Bayesian updating of the dosing regimen based on an individual patient's pharmacokinetic profile.

  10. An evaluation of the infection control potential of a UV clinical podiatry unit.

    Science.gov (United States)

    Humphreys, Paul N; Davies, Chris S; Rout, Simon

    2014-02-28

    Infection control is a key issue in podiatry as it is in all forms of clinical practice. Airborne contamination may be particularly important in podiatry due to the generation of particulates during treatment. Consequently, technologies that prevent contamination in podiatry settings may have a useful role. The aims of this investigation were twofold, firstly to determine the ability of a UV cabinet to protect instruments from airborne contamination and secondly to determine its ability to remove microbes from contaminated surfaces and instruments. A UV instrument cabinet was installed in a University podiatry suite. Impact samplers and standard microbiological techniques were used to determine the nature and extent of microbial airborne contamination. Sterile filters were used to determine the ability of the UV cabinet to protect exposed surfaces. Artificially contaminated instruments were used to determine the ability of the cabinet to remove microbial contamination. Airborne bacterial contamination was dominated by Gram positive cocci including Staphylococcus aureus. Airborne fungal levels were much lower than those observed for bacteria. The UV cabinet significantly reduced (p podiatry settings due to the presence of S. aureus. The use of a UV instrument cabinet can reduce the risk of contamination by airborne microbes. The UV cabinet tested was unable to decontaminate instruments and as such could pose an infection risk if misused.

  11. Clinical and epidemiological characteristics of acute respiratory virus infections in Vietnamese children.

    Science.gov (United States)

    Tran, D N; Trinh, Q D; Pham, N T K; Vu, M P; Ha, M T; Nguyen, T Q N; Okitsu, S; Hayakawa, S; Mizuguchi, M; Ushijima, H

    2016-02-01

    Information about viral acute respiratory infections (ARIs) is essential for prevention, diagnosis and treatment, but it is limited in tropical developing countries. This study described the clinical and epidemiological characteristics of ARIs in children hospitalized in Vietnam. Nasopharyngeal samples were collected from children with ARIs at Ho Chi Minh City Children's Hospital 2 between April 2010 and May 2011 in order to detect respiratory viruses by polymerase chain reaction. Viruses were found in 64% of 1082 patients, with 12% being co-infections. The leading detected viruses were human rhinovirus (HRV; 30%), respiratory syncytial virus (RSV; 23·8%), and human bocavirus (HBoV; 7·2%). HRV was detected all year round, while RSV epidemics occurred mainly in the rainy season. Influenza A (FluA) was found in both seasons. The other viruses were predominant in the dry season. HRV was identified in children of all age groups. RSV, parainfluenza virus (PIV) 1, PIV3 and HBoV, and FluA were detected predominantly in children aged 24 months, respectively. Significant associations were found between PIV1 with croup (P < 0·005) and RSV with bronchiolitis (P < 0·005). HBoV and HRV were associated with hypoxia (P < 0·05) and RSV with retraction (P < 0·05). HRV, RSV, and HBoV were detected most frequently and they may increase the severity of ARIs in children.

  12. Molecular epidemiology and clinical characterization of group A rotavirus infections in Tunisian children with acute gastroenteritis.

    Science.gov (United States)

    Sdiri-Loulizi, Khira; Ambert-Balay, Katia; Gharbi-Khelifi, Hakima; Hassine, Mouna; Chouchane, Slaheddine; Sakly, Nabil; Neji-Guédiche, Mohamed; Pothier, Pierre; Aouni, Mahjoub

    2011-10-01

    Rotaviruses are the most common cause of severe viral gastroenteritis in early childhood worldwide. Thus, the objectives of our study were to determine the molecular epidemiology and the clinical features of rotavirus gastroenteritis in Tunisia. Between January 2003 and April 2007, a prospective study was conducted on 788 stool samples collected from children under 12 years of age who were suffering from acute gastroenteritis. Rotavirus was detected by multiplex RT-PCR in 27% (n = 213) of samples, among them 79.3% (n = 169) cases were monoinfections. The frequency of rotavirus infections was significantly higher among inpatients (29%) than among outpatients (13%) (P rotavirus diarrhea showed a winter peak, with an unusual peak from June to September. The mean duration of hospitalization was 6.5 ± 8.1 days and the mean age was 15.8 ± 22.8 months for rotavirus monoinfections. Fever, vomiting, abdominal pain, and dehydration were observed in 88, 98, 13, and 80 cases, respectively, in children with rotavirus monoinfections. G3P[8] (45.6%) and G1P[8] (23.9%) were the most common genotypes found in our study. The determination of rotavirus infection prevalence and the characterization of the rotavirus strains circulating will help us to better understand the molecular biology and epidemiology of the disease in our country.

  13. Clinical Outcomes and Hospitalizations among Children Perinatally Infected with HIV-1 in Baja California, Mexico.

    Science.gov (United States)

    Viani, Rolando M; Araneta, Maria Rosario G; Lopez, Graciano; Chacón-Cruz, Enrique; Spector, Stephen A

    2011-01-01

    This study characterizes temporal trends in HIV disease progression among perinatally infected children at a clinic in Baja California, Mexico. A total of 73 children were followed, 52% were categorized under US Centers for Disease Control and Prevention (CDC) classification group C with a mean age of 2.3 years (SD ± 3.16) at HIV diagnosis. For the years 1998 to 2001, 2002 to 2003, 2004 to 2005, and 2006 to 2007, highly active antiretroviral therapy (HAART) use increased to 60%, 75%, 83%, and 94% (P mortality was 31% (23 of 73), with pneumonia being the most common cause of death (43% of all deaths) followed by tuberculosis (22%). Mortality rates declined from 30.4% to 25%, 8.9%, and 9.3% (p = 0.035) for the years 1998 to 2001, 2002 to 2003, 2004 to 2005, and 2006 to 2007, respectively. Kaplan-Meier survival analysis showed that median survival was 11.2 years; 1-, 2-, and 5-year survival was 87%, 83%, and 67%, respectively. These findings document a high but improving trend in morbidity and mortality of children perinatally infected with HIV in Tijuana, Baja California, Mexico.

  14. Clinical Characteristics of Nosocomial Bloodstream Infections in Neonates in Two Hospitals, China.

    Science.gov (United States)

    Wang, Shanmei; Chen, Sheng; Feng, Wei; Sun, Fengjun; Wang, Qian; Zhu, Ke; Song, Jie

    2017-07-21

    The improvement of medical condition requires prolonged hospital stays, which increase the risk of nosocomial bloodstream infections (BSIs). All nosocomial BSI newborns in two hospitals were included, and the demographic and clinical characteristics of bacteremia patients were obtained from the information systems. Isolates were identified by biochemical assays. Antimicrobial susceptibility was determined using disk diffusion method. Except for three same risk factors, intubation with mechanical ventilation was a risk factor in Chongqing, while low birth weight was a risk factor in Henan. Klebsiella pneumoniae was the predominant strain in Chongqing, and Escherichia coli was the most prevalent strain in Henan. The resistance rate of gram-negative bacteria in Henan was higher than that of strains in Chongqing. The risk factors and resistance rate of pathogens were different in different areas. Therefore, treatment protocols should be established based on the trends of drug resistance and bacterial spectrum.

  15. Infection

    African Journals Online (AJOL)

    from the neonatal period to school age.' In Saudi Arabia, the rate of 5.3 per cent was reported' while in Nigeria,. Okafor et a1,7 found the prevalence rate .... the multiplication of the organisms in the urine, resulting in lalse diagnosis of urinary tract infection. This over-diagnosis ofl ITI may account for the high prevalence rate ...

  16. Trypanosoma evansi experimental infection in the South American coati (Nasua nasua): clinical, parasitological and humoral immune response.

    Science.gov (United States)

    Herrera, H M; Aquino, L P; Menezes, R F; Marques, L C; Moraes, M A; Werther, K; Machado, R Z

    2001-12-13

    The course of Trypanosoma evansi infection in coatis (Carnivora, Procionidae) was followed for 262 days. Parasites were detected in all infected animals from day 2 post infection until the end of the study. No correlation between temperature and parasitemia was observed. Animals of the infected group demonstrated depression, weakness, lethargy and pale mucous membranes. Indirect fluorescent antibody tests detected anti-T. evansi antibodies within 7 to 14 days post infection and showed high levels until the end of the experimental period. The persistent parasitemia in coati and their relative tolerance to clinical signs suggested that this species develops a chronic disease and plays an important role in the epidemiology of trypanosomosis due to T. evansi in enzootic regions.

  17. Pentraxin 3 as a clinical marker in children with lower respiratory tract infection.

    Science.gov (United States)

    Kim, Hwan Soo; Won, Sulmui; Lee, Eu Kyoung; Chun, Yoon Hong; Yoon, Jong-Seo; Kim, Hyun Hee; Kim, Jin Tack

    2016-01-01

    Pentraxin 3 (PTX-3) is an acute-phase protein that increases in the plasma during inflammation. We aimed to evaluate the usefulness of PTX-3 as a clinical marker in children with lower respiratory tract infection (LRTI) and examine the correlation of PTX-3 with other biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT). We enrolled 117 consecutive patients admitted to Seoul St. Mary's Hospital with LRTI using the WHO criteria. We recorded data on fever duration and peak temperature before admission, duration of fever after admission, respiratory rate, heart rate, oxygen saturation upon admission, duration of oxygen supplementation, and duration of hospital stay. Upon admission, white blood cell (WBC) count, erythrocyte sedimentation rate, CRP level were measured. Multiplex respiratory virus polymerase chain reaction was performed using nasal swabs. PTX-3, PCT, and various cytokines were measured after the study had been completed. We found that there was no significant difference in the level of PTX-3 according to the type of viral infection. PTX-3 levels showed a significant correlation with PCT levels, but not with levels of CRP. The level of PTX-3 showed a significant correlation with peak temperature and duration of fever before admission as well as interleukin (IL)-6 levels. PCT levels showed a significant correlation with IL-6 and granulocyte-colony stimulating factor levels, peak temperature, and duration of fever before admission, and duration of hospital stay. CRP levels showed a significant correlation with duration of fever before admission, total WBC count, and neutrophil count. PCT levels significantly predicted a hospital stay of 7 days or more. PTX-3, PCT, and CRP levels showed no correlation with any other clinical features. PTX-3 reflected disease severity but failed to predict length of hospital stay. Further studies evaluating the use of PTX-3 as a biomarker in mild LRTI would be useful. © 2015 Wiley Periodicals, Inc.

  18. Molecular viral epidemiology and clinical characterization of acute febrile respiratory infections in hospitalized children in Taiwan.

    Science.gov (United States)

    Lee, Chun-Yi; Chang, Yu-Fen; Lee, Chia-Lin; Wu, Meng-Che; Ho, Chi-Lin; Chang, Yu-Chuan; Chan, Yu-Jiun

    2015-11-01

    Acute respiratory infection (ARI) is a leading cause of morbidity and hospitalization in children. To profile the viruses causing ARI in children admitted to a community-based hospital in central Taiwan, a cross-sectional study was conducted on children under 14 years of age that were hospitalized with febrile ARI. Viral etiology was determined using conventional cell culture and a commercial respiratory virus panel fast assay (xTAG RVP), capable of detecting 19 different respiratory viruses and subtype targets. Demographic, clinical, and laboratory data were recorded and analyzed. The RVP fast assay identified at least one respiratory virus in 130 of the 216 specimens examined (60.2%) and rose to 137 (63.4%) by combining the results of cell culture and RVP fast assay. In order of frequency, the etiological agents identified were, rhinovirus/enterovirus (24.6%), respiratory syncytial virus (13.8%), adenovirus (11.5%), parainfluenza virus (9.2%), influenza B (8.4%), influenza A (5.4%), human metapneumovirus (4.6%), human coronavirus (2%), and human bocavirus (2%). Co-infection did not result in an increase in clinical severity. The RVP assay detected more positive specimens, but failed to detect 6 viruses identified by culture. The viral detection rate for the RVP assay was affected by how many days after admission the samples were taken (P = 0.03). In conclusion, Rhinovirus/enterovirus, respiratory syncytial virus, and adenovirus were prevalent in this study by adopting RVP assay. The viral detection rate is influenced by sampling time, especially if the tests are performed during the first three days of hospitalization. © 2015 Wiley Periodicals, Inc.

  19. Viral etiology and clinical profiles of children with severe acute respiratory infections in China.

    Directory of Open Access Journals (Sweden)

    Chen Zhang

    Full Text Available No comprehensive analysis is available on the viral etiology and clinical characterization among children with severe acute respiratory infection (SARI in China during 2009 H1N1 pandemic and post-pandemic period.Cohort of 370 hospitalized children (1 to 72 months with SARI from May 2008 to March 2010 was enrolled in this study. Nasopharyngeal aspirate (NPA specimens were tested by a commercial assay for 18 respiratory viral targets. The viral distribution and its association with clinical character were statistically analyzed.Viral pathogen was detected in 350 (94.29% of children with SARI. Overall, the most popular viruses were: enterovirus/rhinovirus (EV/RV (54.05%, respiratory syncytial virus (RSV (51.08%, human bocavirus (BoCA (33.78%, human parainfluenzaviruse type 3 (PIV3 (15.41%, and adenovirus (ADV (12.97%. Pandemic H1N1 was the dominant influenza virus (IFV but was only detected in 20 (5.41% of children. Moreover, detection rate of RSV and human metapneumovirus (hMPV among suburb participants were significantly higher than that of urban area (P<0.05. Incidence of VSARI among suburb participants was also significant higher, especially among those of 24 to 59 months group (P<0.05.Piconaviruses (EV/RV and paramyxoviruses are the most popular viral pathogens among children with SARI in this study. RSV and hMPV significantly increase the risk of SARI, especially in children younger than 24 months. Higher incidence of VSARI and more susceptibilities to RSV and hMPV infections were found in suburban patients.

  20. Clinical manifestations and survival of HIV/AIDS-infected patients, southern region of Thailand

    Directory of Open Access Journals (Sweden)

    B Chaimay

    2012-11-01

    Full Text Available Objective: The purpose of this study was to determine magnitude of clinical manifestations on survival of HIV/AIDS patients. Methods: The HIV/AIDS information system, a database containing demographic factors and clinical manifestations was used. A prospective, hospital-based cohort study was conducted in HIV/AIDS patients registered in both provincial and community hospitals from 14 provinces in southern region of Thailand, between January 1993 and April 2010. Totally, 52,459 of HIV/AIDS patients were routinely observed and followed up. One-fifth of the HIV/AIDS patients died (n=11,767, 22.43% during the follow-up period. The outcome was timed from diagnosis of HIV/AIDS infection to death. Cox's proportional hazard model was used to analyze the magnitude of clinical manifestations on survival of HIV/AIDS patients. Results: A statistically significant corresponding risk of clinical manifestation on death was found. HIV/AIDS patients who had clinical manifestations including: invasive cervical cancer (HR=0.14, 95% CI: 0.44 to 0.43, herpes simplex (0.81, 0.66 to 0.98, histoplasmosis (0.67, 0.46 to 0.97, Mycobacterium other species (0.78, 0.64 to 0.97 were more likely to have a longer life. However, patients expressed clinical manifestations including; candidiasis (1.45, 1.34 to 1.56, cryptococcosis (1.77, 1.64 to 1.91, cytomegalovirus retinitis (1.58, 1.26 to 1.98, HIV encephalopathy (2.17, 1.92 to 2.47, Mycobacterium avium complex (1.76, 1.32 to 2.33 Mycobacterium tuberculosis (1.25, 1.21 to 1.30, pneumonia recurrent (1.78, 1.61 to 1.96, Pneumocystis carinii (1.71, 1.63 to 1.78, salmonella septicemia (1.85, 1.43 to 2.39 toxoplasmosis (1.47, 1.30 to 1.66 and wasting syndrome (2.13, 2.04 to 2.21 were more likely to die faster. Conclusion: In conclusion, HIV/AIDS patients expressed clinical manifestations which were a risk of death must be monitored closely and intensively care to extend their life and increase their quality of life.

  1. REVIEW OF CLINICAL CASES OF DRUG ALLERGIC REACTIONS IN PATIENTS WITH ACUTE RESPIRATORY VIRAL INFECTIONS

    Directory of Open Access Journals (Sweden)

    Sydorchuk A.S.

    2015-05-01

    Full Text Available Introduction. Problem of drug-induced allergic reaction is especially actual both in well-developing countries as well as in countries of Eastern European region. By the WHO data, distribution of allergy is up to 30 %, and main reasons for that are increasing of pharmaceuticals consumption by a person, change of nutrition style towards more chemicals synthetic substitutions. Generally, a quantity of Europeans with allergy reach 150 mln. Reactions of hypersensitivity to medications is so serious discussion question among physicians and their patients, since it is the most important reason to stop treatment and for refuse remedies. Authors hope, that presenting here clinical material will bring benefit both clinicians and patients like cases of drug-induced allergic reactions due to self-prescribed treatment (antipyretics, antibiotics. Thus, this research paper aimed to analyze the clinical cases of drug-induced allergy in patients with acute respiratory illnesses, which had admitted to Infectious diseases department of Municipal Clinical Hospital of Chernivtsi city (Ukraine. Materials & Methods. Descriptional clinical study enrolled six clinical cases of drug-induced allergy in male patients admitted in different time to the Infectious Diseases Department of Municipal Clinical Hospital of Chernivtsi city (Ukraine with clinical manifestation and epidemiological data of acute respiratory viral infections. Mostly cases of drug-induced allergy confirmed by the indirect immune-termomistry for determination of role of a drug. Results & discussion. First case in male 52 years old patient with signs of polymorphic exudative erythema induced by pills against common cold named «Coldflu». Patient had manifestation clinical features of acute respiratory viral infection and was hospitalized to the Department of Droplet infections for detoxicative and desensitization treatment. Within few days his infectious problem had solved, nevertheless skin rash still

  2. [Relationship between viral load of human bocavirus and clinical characteristics in children with acute lower respiratory tract infection].

    Science.gov (United States)

    Ding, Xiao-Fang; Zhang, Bing; Zhong, Li-Li; Xie, Le-Yun; Xiao, Ni-Guang

    2017-03-01

    To investigate the prevalence of human bocavirus (HBoV) in children with acute lower respiratory tract infection and to explore the relationship between the viral load of HBoV and the clinical characteristics of acute lower respiratory tract infection in children. A total of 1 554 nasopharyngeal aspirates from children who were hospitalized due to acute lower respiratory tract infection between March 2011 and March 2014 were collected. Quantitative real-time PCR was used to detect 12 RNA and 2 DNA viruses, adenovirus (ADV) and HBoV, and to measure the viral load of HBoV in HBoV-positive children. A comprehensive analysis was performed with reference to clinical symptoms and indicators. In the 1 554 specimens, 1 212 (77.99%) were positive for viruses, and 275 (17.70%) were HBoV-positive. In HBoV-positive cases, 94.9% were aged infection, and 230 (83.64%) had mixed infection. There was no significant difference in viral load between children with single infection and mixed infection (P>0.05). The patients with fever had a significantly higher viral load than those without fever (Pacute lower respiratory tract infection (P>0.05). HBoV is one of the important pathogens of acute lower respiratory tract infection in children. Children with a higher viral load of HBoV are more likely to experience symptoms such as fever and wheezing. However, the severity of disease and mixed infection are not significantly related to viral load.

  3. Role of inflammation and infection in the pathogenesis of human acute liver failure: Clinical implications for monitoring and therapy.

    Science.gov (United States)

    Donnelly, Mhairi C; Hayes, Peter C; Simpson, Kenneth J

    2016-07-14

    Acute liver failure is a rare and devastating clinical condition. At present, emergency liver transplantation is the only life-saving therapy in advanced cases, yet the feasibility of transplantation is affected by the presence of systemic inflammation, infection and resultant multi-organ failure. The importance of immune dysregulation and acquisition of infection in the pathogenesis of acute liver failure and its associated complications is now recognised. In this review we discuss current thinking regarding the role of infection and inflammation in the pathogenesis of and outcome in human acute liver failure, the implications for the management of such patients and suggest directions for future research.

  4. Infection

    Science.gov (United States)

    ... Scope | Glossary | References | Site Map | Credits Hospital eTool Administration Central Supply Clinical Services Dietary Emergency Engineering Healthcare Wide Hazards Heliport Housekeeping ICU Laboratory Laundry ...

  5. Correlations between Clinical Features and Mortality in Patients with Vibrio vulnificus Infection.

    Directory of Open Access Journals (Sweden)

    Hong Zhao

    Full Text Available Vibrio vulnificus is a common gram-negative bacterium, which might cause morbidity and mortality in patients following consumption of seafood or exposure to seawater in Southeast China. We retrospectively analyzed clinical data of patients with laboratory confirmed V. vulnificus infection. Twenty one patients were divided into a survival group and a non-surviving (or death group according to their clinical outcome. Clinical data and measurements were statistically analyzed. Four patients (19.05% died and five patients gave positive cultures from bile fluid, and 16 other patients gave positive culture from blood or blisters. Ten patients (47.62% had an underlying liver disease and marine-related events were found in sixteen patients (76.2%. Patients with heavy drinking habits might be at increased mortality (p = 0.028. Clinical manifestations of cellulitis (47.6%, septic shock (42.9% and multiple organ failure (28.6% were statistically significant when comparing survivors and non-survivors (p = 0.035, p = 0.021 and p = 0.003, respectively. The laboratory results, including hemoglobin < 9.0 g/L (p = 0.012, platelets < 2.0 × 109 /L, prothrombin time activity (PTA <20%, decreased serum creatinine and increased urea nitrogen were statistically significant (p = 0.012, p = 0.003, p = 0.028 and p = 0.028, respectively. Patients may be at a higher risk of mortality under situations where they have a history of habitual heavy alcoholic drink consumption (p = 0.028, OR = 22.5, 95%CI 1.5-335.3, accompanied with cellulitis, shock, multiple organ failure, and laboratory examinations that are complicated by decreased platelets, hemoglobin and significantly prolonged prothrombin time (PT.