Infectious Disease News
Dengue Fever Showing Up In Central Florida
Dengue fever has infected a handful of people in Central Florida, health officials said. “This is not a regular flu virus that you get, you feel a lot worse,” said Dr. Todd Husty. “You get a real great fever, a horrible fever; it's called ‘break bone fever.’ You feel like your bones are breaking, but it's really joint pain,” Husty said. Health officials said more than a dozen people have picked up the virus from Mosquitoes in the Keys.
Two-step vaccine may offer "universal" flu jab
A two-step flu vaccine using DNA to "prime" the immune system and then a traditional seasonal influenza vaccine may be able to protect against all strains of the virus -- providing a long-sought "universal" flu vaccine, U.S. researchers said on Thursday. The team at the National Institute of Allergy and Infectious Diseases is already testing the new vaccine in people and says the results of tests in mice, ferrets and monkeys suggest the industry may finally be able to dump the cumbersome process of making fresh flu vaccines every year.
Antibody finding may help in quest for AIDS vaccine
The bodies of some people make these immune system proteins after they are infected with the AIDS virus, when it is too late for them to do much good. But a properly designed vaccine might help the body make them much sooner, the researchers reported in Friday's issue of the journal Science. Two of the antibodies can attach to and neutralize 90 percent of the various mutations of the human immunodeficiency virus that causes AIDS, Nabel said."This is an antibody that evolved after the fact. That is part of the problem we have in dealing with HIV -- once a person becomes infected, the
Spread of Pneumocystis jirovecii in the Surrounding Air of Patients with Pneumocystis Pneumonia
Airborne transmission of Pneumocystis has been demonstrated in animal models and is highly probable in humans. However, information concerning burdens of Pneumocystis jirovecii (human‐derived Pneumocystis) in exhaled air from infected patients is lacking. This study sought to evaluate P. jirovecii air diffusion in patients with Pneumocystis pneumonia and provides the first quantitative data on the spread of P. jirovecii in exhaled air from infected patients. It sustains the risk of P. jirovecii direct transmission in close contact with patients with Pneumocystis pneumonia and leads the way for initiating a quantitative risk assessment for airborne transmission of P. jirovecii.
Azithromycin Combination Therapy for the Treatment of Uncomplicated Falciparum Malaria
In recent studies, the combination of azithromycin and artesunate has proven to be a promising alternative for the treatment of uncomplicated falciparum malaria. This study conducted a randomized, controlled clinical trial assessing the efficacy of azithromycin‐artesunate combination therapy. The 42‐day cure rate by Kaplan‐Meier analysis was 94.6% in the azithromycin‐artesunate arm and 97.0% in the control arm. Fever clearance times and parasite clearance times did not show any differences between the 2 arms suggesting that azithromycin‐artesunate is an efficacious and well‐tolerated treatment for patients with uncomplicated falciparum malaria.
Rapid Test to Detect Hepatitis C Approved
The OraQuick HCV Rapid Antibody Test to detect antibodies from the hepatitis C virus has been approved by the U.S. Food and Drug Administration. The blood diagnostic is a test strip that does not require an additional device to obtain results in about 20 minutes, the agency said in a news release.
New CDC Guidelines Recommend Use of Blood Tests to Diagnose TB in Certain Populations
The Centers for Disease Control and Prevention (CDC) has issued new guidelines on the detection of Mycobacterium tuberculosis infections.
In these landmark guidelines, the CDC advises that Interferon Gamma Release Assay (IGRA) blood tests are now preferred over the tuberculin skin test (TST) for diagnosing tuberculosis (TB) infection in certain populations, including people who typically do not return for the necessary reading of TST results, and those who have received Bacille Calmette-Guérin (BCG) as a vaccine or for cancer therapy. The CDC report appears in the June 25 issue of the CDC's Morbidity & Mortality Weekly Report (MMWR).
Emergence of New Virulent Neisseria meningitidis Serogroup C Sequence Type 11 Isolates in France
In France, there have been variations in the incidence of invasive meningococcal infection due to serogroup C isolates. Infection peaks were observed in 1992 and 2003 that involved isolates of phenotypes C:2a:P1.5,2 and/or C:2a:P1.5, which belong to the sequence type 11 (ST‐11) clonal complex. We report an emergence of isolates belonging to the ST‐11 clonal complex since 2003. These isolates displayed a new phenotype, C:2a:P1.7,1, caused infections that occurred as clusters, and were associated with increased infection severity and high virulence in mice. These isolates may be responsible for a peak in the incidence of serogroup C meningococcal infection in France, for which there is no routine vaccination to date.
Standard versus Newer Antibacterial Agents in the Treatment of Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Randomized Trial of Trimethoprim‐Sulfamethoxazole versus Ciprofloxacin
Although the use of antibiotics in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) is largely accepted, controversy remains regarding whether the choice of antibiotic has any impact on outcome. Our aim was to compare the effects of the combination of trimethoprim and sulfamethoxazole and ciprofloxacin in patients treated for severe COPD exacerbation requiring mechanical ventilation and it showed that in patients with acute exacerbation of COPD requiring mechanical ventilation, efficacy of trimethoprim‐sulfamethoxazole was not inferior to ciprofloxacin.
Treatment Outcomes among Patients with Extensively Drug‐Resistant Tuberculosis
This meta‐analysis provides evidence that the inclusion of later‐generation fluoroquinolones in the treatment of extensively drug‐resistant tuberculosis significantly improves treatment outcomes, even though drug‐susceptibility testing demonstrates resistance to a representative fluoroquinolone.
Drug cocktails cut couples' HIV transmission risk
In a study that supports the widespread use of drugs to help control the AIDS pandemic, researchers said on Wednesday that HIV patients who took the drugs were far less likely to infect their partners. Using the drug cocktail reduced the likelihood of transmission by 92 percent, the researchers reported in the journal Lancet. They said the findings mean the drug cocktails known as antiretroviral therapy, or ART, might be a useful prevention tool as well as a treatment. "These results are ... the strongest evidence to date that ART might decrease HIV transmission risk," said Dr. Connie Celum, professor of medicine and global health at the University of Washington, who worked on the study.
Epidemiology of Community-Acquired and Health Care-Associated Staphylococcus aureus Pneumonia
Information is limited on the descriptive epidemiology of community-acquired pneumonia (CAP) and health care-associated pneumonia (HCAP) due to Staphylococcus aureus. An article in Infectious Disease in Clinical Practice retrospectively identified all patients admitted to a large urban US hospital between January 2005 and May 2008 with pneumonia and positive blood or respiratory cultures for S. aureus within 48 hours of admission. The results showed that Methicillin-resistant S. aureus is an important pathogen in both HCAP and CAP, and simple clinical criteria do not permit early identification of patients with MRSA versus MSSA pneumonia. Fewer than one half of patients with MRSA CAP receive appropriate initial antibiotic therapy compared to 75 % of HAP.
The Potential for Airborne Dispersal of Clostridium difficile from Symptomatic Patients
The high transmissibility and widespread environmental contamination by Clostridium difficile suggests the possibility of airborne dissemination of spores. We measured airborne and environmental C. difficile adjacent to patients with symptomatic C. difficile infection (CDI). An article in Clinical Infectious Diseases conducted air sampling adjacent to 63 patients with CDI for 180 h in total and for 101 h in control settings. Environmental samples were obtained from surfaces adjacent to the patient and from communal areas of the ward. The results show that aerosolization of C. difficile occurs commonly but sporadically in patients with symptomatic CDI. This may explain the widespread dissemination of epidemic strains. Our results emphasize the importance of single‐room isolation as soon as possible after the onset of diarrhea to limit the dissemination of C. difficile.
Flu Vaccine With Both B Strains May Offer Better Protection
Children would be better protected by seasonal flu vaccines if the vaccines contained both strains of influenza B instead of just one, the results of a new study suggest. "Adding a second influenza B virus strain to the seasonal influenza vaccine would take some of the guesswork out of strain selection and help improve the vaccine's ability to prevent influenza," lead investigator Dr. Robert Belshe, director of the Center for Vaccine Development at Saint Louis University, said in a news release. "Since in five of the last 10 years, the influenza B component in the vaccine has been the incorrect one, this seems like an obvious advance to me."
Compound Effective In Destroying Antibiotic-Resistant Biofilms
Researchers at North Carolina State University have found a chemical compound that, when used in conjunction with conventional antibiotics, is effective in destroying biofilms produced by antibiotic-resistant strains of bacteria such as the Staphylococcus strain MRSA and Acinetobacter. The compound also re-sentsitizes those bacteria to antibiotics.
Sex infection gonorrhea risks becoming "superbug"
Catherine Ison, a specialist on gonorrhea from Britain's Health Protection Agency said a World Health Organization (WHO) meeting in Manila next week would be vital to efforts to try to stop the bug repeatedly adapting to and overcoming drugs.
"This is a very clever bacteria. If this problem isn't addressed, there is a real possibility that gonorrhea will become a very difficult infection to treat," she said in a telephone interview.
Scientists Find New Way To Attack TB
Suspecting that a particular protein in tuberculosis was likely to be vital to the bacteria's survival, Johns Hopkins scientists screened 175,000 small chemical compounds and identified a potent class of compounds that selectively slows down this protein's activity and, in a test tube, blocks TB growth, demonstrating that the protein is indeed a vulnerable target.
Reported Ugandan smallpox is likely chickenpox: WHO
Although declared eradicated in 1979, suspected cases of the previously eradicated disease smallpox in eastern Uganda appear to be chickenpox and not the acute contagious disease, the World Health Organization said on Thursday.
Acne Drug May Help in the Fight Against AIDS
A cheap acne drug that's been used for decades appears to target infected immune-system cells in which HIV lies dormant before coming back to life and spreading infection, researchers have found. The authors of a new study say the antibiotic drug, minocycline, sold under names such as Minocin, could add to the HIV-fighting powers of existing AIDS drug regimens.
Infections associated with indwelling ventriculostomy catheters in a teaching hospital
Ventriculostomy-associated infections are a serious complication of external ventricular drains. A study out of the International Journal of Infectious Disease analyzed the clinical features of and risk factors for such infections.
A total of 197 drains (2910 catheter-days) placed in 155 patients were studied. Infections developed in 28 of the 197 (14.2%) drains. Re-insertion of the catheter, patients with a longer intensive care unit stay and a longer duration of catheterization placement had a higher risk of infection. It also shoudl that Gram-negative bacilli were the leading pathogens (84%) with Pseudomonas aeruginosa being the most common isolate.
Oral Ivermectin versus Malathion Lotion for Difficult-to-Treat Head Lice
A study out of New England Journal of Medicine conducted a multicenter, cluster-randomized, double-blind, double-dummy, controlled trial comparing oral ivermectin (at a dose of 400 µg per kilogram of body weight) with 0.5% malathion lotion, each given on days 1 and 8, for patients with live lice not eradicated by topical insecticide used 2 to 6 weeks before enrollment.
In the intention-to-treat population, 95.2% of patients receiving ivermectin were lice-free on day 15, as compared with 85.0% of those receiving malathion (absolute difference, 10.2 percentage points; 95% confidence interval [CI], 4.6 to 15.7; P<0.001) suggesting for difficult-to-treat head-lice infestation, oral ivermectin, given twice at a 7-day interval, had superior efficacy as compared with topical 0.5% malathion lotion, a finding that suggests that it could be an alternative treatment.
Bacteriophages Can Treat and Prevent Pseudomonas aeruginosa Lung Infections
Antibiotic‐resistant bacteria threaten life worldwide. Although new antibiotics are scarce, the use of bacteriophages, viruses that infect bacteria, is rarely proposed as a means of offsetting this shortage. Doubt also remains widespread about the efficacy of phage therapy despite recent encouraging results. Using a bioluminescent Pseudomonas aeruginosa strain, we monitored and quantified the efficacy of a bacteriophage treatment in mice during acute lung infection. Bacteriophage treatment not only was effective in saving animals from lethal infection, but also was able to prevent lung infection when given 24 h before bacterial infection, thereby extending the potential use of bacteriophages as therapeutic agents to combat bacterial lung infection.
An Algorithm for Tuberculosis Screening and Diagnosis in People with HIV
Tuberculosis screening is recommended for people with human immunodeficiency virus (HIV) infection to facilitate early diagnosis and safe initiation of antiretroviral therapy and isoniazid preventive therapy. No internationally accepted, evidence-based guideline addresses the optimal means of conducting such screening, although screening for chronic cough is common. A study in the New England Journal of Medicine consecutively enrolled people with HIV infection from eight outpatient clinics. The presence of cough of any duration, fever of any duration, or night sweats lasting 3 or more weeks in the preceding 4 weeks was 93% sensitive and 36% specific for tuberculosis.In persons with HIV infection, screening for tuberculosis should include asking questions about a combination of symptoms rather than only about chronic cough. It is likely that antiretroviral therapy and isoniazid preventive therapy can be started safely in people whose screening for all three symptoms is negative, whereas diagnosis in most others will require mycobacterial culture.
Risk Factors for Treatment Failure in Patients Receiving Vancomycin for Hospital-Acquired Methicillin-Resistant Staphylococcus aureus Pneumonia
The rate of vancomycin failure in patients with hospital-acquired pneumonia (HAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) has exceeded 40% in several studies. This observation was attributed initially to the lack of weight-based dosing and targeting of lower trough concentrations. However, a subsequent study demonstrated no additional benefit in patients who achieved trough vancomycin concentrations >15mg/L compared with patients with concentrations between 5 and 15mg/L. A study out of Surgical Infections sought to identify contributors to vancomycin failure in patients with MRSA HAP and found data suggest that patients who have recent exposure to vancomycin are at high risk for vancomycin failure and may benefit from an appropriate alternative when a diagnosis of MRSA HAP is made.
57 Million Americans Sickened by H1N1 Flu: CDC
With the H1N1 swine flu pandemic apparently winding down, federal health officials said Friday that about 57 million Americans have suffered through the illness since last April, and the total could range as high as 84 million. In addition, the U.S. Centers for Disease Control and Prevention (CDC) estimates that as many as 378,000 people were hospitalized due to H1N1 flu and up to 17,160 Americans may have died from the virus.
Oseltamivir Treatment Shortens Duration of Clinical Illness but not Viral Shedding in Household Transmission of Influenza Virus
Large clinical trials have demonstrated the therapeutic efficacy of oseltamivir against influenza. We assessed the indirect effectiveness of oseltamivir in reducing secondary household transmission in an incident cohort of influenza index patients and their household members.Index patients who took oseltamivir within 24 h of symptom onset halved the time to symptom alleviation. Oseltamivir treatment was not associated with statistically significant reduction in the duration of viral shedding. Household contacts of index patients who had taken oseltamivir within 24 h of onset had a nonstatistically significant lower risk of developing laboratory‐confirmed infection.
Vaccine-Autism Study Is Retracted
A major British medical journal on Tuesday retracted a flawed study linking the measles, mumps and rubella vaccine to autism and bowel disease. The retraction by The Lancet comes a day after a competing medical journal, BMJ, issued an embargoed commentary calling for The Lancet to formally retract the study. The commentary was to have been published on Wednesday.
Primary and booster immunization with a diphtheria, tetanus, acellular pertussis, hepatitis B (DTPa–HBV) and Haemophilus influenzae type b (Hib) vaccine administered separately or together is safe and immunogenic
A study out of the International Journal of Infectious Disease was conducted to evaluate the safety and immunogenicity of DTPa–HBV and Hib vaccines given mixed or separately to 360 healthy infants at 2, 4, and 6 months of age. One month after primary vaccination, 98% had seroprotective antibody levels against HBV and 94–97% against Hib (anti-PRP≥0.15μg/ml). One month after primary vaccination, 98% had seroprotective antibody levels against HBV and 94–97% against Hib (anti-PRP≥0.15μg/ml). After DTPa–HBV/Hib booster vaccination, 96–100% of subjects had seroprotective antibody concentrations against Hib, hepatitis B, tetanus, and diphtheria and high vaccine response rates against pertussis toxoid, filamentous hemagglutinin, and pertactin.
Escherichia coli Pyomyositis: An Emerging Infectious Disease among Patients with Hematologic Malignancies
Pyomyositis is typically caused by gram‐positive bacteria, especially Staphylococcus aureus. Few cases of Escherichia coli pyomyositis have been reported, including only 1 involving a patient with a hematologic malignancy.The clinical microbiology database at The M. D. Anderson Cancer Center (Houston, TX) was reviewed for the period January 2003 through December 2007 to identify cases of E. coli pyomyositis.Six cases of E. coli pyomyositis were identified. All patients were receiving chemotherapy for a hematologic malignancy; 5 were severely neutropenic. Three patients became hypotensive, 2 required intensive care, and 2 (33%) died, despite receiving carbapenem therapy.Awareness of this emerging syndrome and the usual causative agent is important to ensure appropriate management when febrile, neutropenic patients with hematologic malignancy exhibit signs of localized muscle infection.
Risk of Myocardial Infarction in Patients with HIV Infection Exposed to Specific Individual Antiretroviral Drugs from the 3 Major Drug Classes
The risk of myocardial infarction (MI) in patients with human immunodeficiency virus (HIV) infection has been assessed in 13 anti‐HIV drugs in the Data Collection on Adverse Events of Anti‐HIV Drugs (D:A:D) study. A meta analysis showed that over 178,835 person‐years, 580 patients developed MI. Recent exposure to abacavir or didanosine was associated with an increased risk of MI. No association was found between MI risk and cumulative exposure to nevirapine, efavirenz, nelfinavir, or saquinavir. Cumulative exposure to indinavir and lopinavir‐ritonavir was associated with an increased risk of MI. Of the drugs considered, only indinavir, lopinavir‐ritonavir, didanosine, and abacavir were associated with a significantly increased risk of MI.
