Wednesday, September 19, 2012
Vaccines and antibiotic resistance.
Vaccines and antibiotic resistance.
Sept 2012
Source
Novartis Vaccines, Research Center, via Fiorentina 1, 53100, Siena, Italy.
Abstract
Vaccines and antibiotics have significantly contributed to improve health and also to increase the longevity of human beings. The fast-acting effect of antibiotics makes them indispensable to treat infected patients. Likewise, when the causative agent of the infection is unknown and in cases of superinfections with different species of bacteria, antibiotics appear to be the only therapeutic option. On the contrary, vaccines are usually not efficacious in people already infected and their action is generally limited to a much narrowed range of pathogens. However, vaccines have contributed to the eradication of some of the most deadly infectious agents worldwide, can generate immunity to infections lasting for several years or life-long, and are able to induce herd immunity. Nonetheless, infectious diseases are still among the leading causes of morbidity and mortality worldwide. This is mainly owing to the emergence of bacterial resistance to antibiotics and the lack of efficacious medications to treat several other infectious diseases. Development of new vaccines appears to be a promising solution to these issues. Indeed, with the advent of new discovery approaches and adjuvants, today is possible to make vaccines virtually against every pathogen. In addition, while vaccine-resistant bacteria have never been reported, accumulating literature is providing evidence that vaccination can reduce the raise of antibiotic resistant strains by decreasing their use.
Labels: Antibiotic resistance, bacteria, causative agent, immunity, superinfections, vaccine
# posted by Pat O'Connor @ 9:02 AM
The most common isolates from pleural infections.
The most common isolates from pleural infections.
Sept 2012
Source
Immunology and Virology Institute for Pulmonary Diseases of Vojvodina, Center for Microbiology Put doktora Goldmana 4 21204 Sremska Kamenica Serbia.
Abstract
Isolation and identification of the pathogens are important for appropriate treatment of pleural infections. Distribution of the most frequent causative agents varies throughout the world and may change in time.The objective of the study is to analyze the bacteriological isolates of pleural fluids in order to identify the most frequent infectious agents and assess their variability in time.The retrospective study included 272 patients with positive pleural fluid samples analyzed in 5-year period. The samples were examined using the conventional microbiological technique.Of 315 bacterial isolates the most common were streptococcal species, 105 (33%), of which 55 (17.3%) represented the Streptococcus milleri group. Gram-positive anaerobic cocci were detected in 56 (17.6%) isolates. Enterobacteriaceae family included 27 (8.5%) isolates and Pseudomonas aeruginosa was registered in 13 (4.1%). No statistically significant difference was registered in pathogen distribution in the examined period (p = 0.288).The most common agents of community-acquired pleural infections are the Streptococcus milleri group and anaerobic Gram-positive cocci. They differ from the most common pathogens of pneumonia. Among the hospital-acquired pleural infections, Pseudomonas species, Staphylococcus aureus and enterobacteria prevail. The distribution ofbacterial agents isolated in the 5-year period exhibits no significant differences.
Labels: Enterobacteriaceae, Gram-positive cocci, isolates, pathogens, pleural fluid, pleural infections, Pseudomonas, streptococcal species
# posted by Pat O'Connor @ 9:00 AM
Dietzia species pacemaker pocket infection: an unusual organism in human infections.
Dietzia species pacemaker pocket infection: an unusual organism in human infections
Sept 2012
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Source
Cardiology Department, Conquest Hospital, St Leonards-on-Sea, East Sussex, UK.
Abstract
An 87-year-old man presented 10 months following permanent pacemaker insertion with cellulitis-like inflammation around the impulse generator. Symptoms improved with oral flucloxacillin, but only days after stopping, the infection recurred, and he was admitted from clinic for intravenous antibiotics. Suspecting the source was likely Staphylococcal, intravenous flucloxacillin was started, and the patient's inflammatory markers responded adequately. Two samples of fluid were aspirated from the pacemaker site. These showed no bacterial growth using routine microbiological culture techniques. The samples were sent for 16S rDNA PCR and Dietzia species was detected in both samples. Dietzia species is an Actinomyces-like organism, which is not commonly associated with human infection, but is reported to have been isolated from clinical specimens and thus presumptively associated with human disease. The pacemaker was explanted and the pocket debrided with no complications. He made a full recovery after a prolonged course of flucloxacillin.
Labels: Dietzia species, flucloxacillin, human infection, inflammation, intravenous antibiotics, oral flucloxacillin, pacemaker
# posted by Pat O'Connor @ 8:58 AM
Hypothesis: Chlamydia trachomatis infection of the female genital tract is controlled by Type 2 immunity.
Hypothesis: Chlamydia trachomatis infection of the female genital tract is controlled by Type 2 immunity.
Sept 2012
Source
University of Pittsburgh School of Medicine, Department of Pediatrics, Rangos Research Center, 4401 Penn Avenue Pittsburgh, PA 15224, USA.
Abstract
Chlamydia trachomatis is an obligate intracellular bacterium sexually transmitted to more than 90 million individuals each year. As this level of infectivity implies, C. trachomatis is a successful human parasite; a success facilitated by its ability to cause asymptomatic infection. Host defense against C. trachomatis in the female genital tract is not well defined, but current dogma suggests infection is controlled largely by T(H)1 immunity. Conversely, it is well established that T(H)2 immunity controls allergens, helminths, and other extracellular pathogens that cause repetitive or persistent T cell stimulation but do not induce the exuberant inflammation that drives T(H)1 and T(H)17 immunity. As C. trachomatis persists in female genital tract epithelial cells but does not elicit over tissue inflammation, we now posit that defense is maintained by Type 2 immune responses that control bacterial growth but minimize immunopathological damage to vital reproductive tract anatomy.
Evaluation of this hypothesis may uncover novel mechanisms by which Type 2 immunity can control growth of C. trachomatis and other intracellular pathogens, while confirmation that T(H)2 immunity was selected by evolution to control C. trachomatis infection in the female genital tract will transform current research, now focused on developing vaccines that elicit strong, and therefore potentially tissue destructive, Chlamydia-specific T(H)1 immunity.
Labels: chlamydia trachomatis, female genital tract, human parasite, intracellular pathogens, Type 2 immunity
# posted by Pat O'Connor @ 8:54 AM
Factors associated with rifampin resistance in staphylococcal periprosthetic joint infections (PJI): a matched case-control study
Factors associated with rifampin resistance in staphylococcal periprosthetic joint infections (PJI): a matched case-control study.
Sept 2012
Achermann Y, Eigenmann K, Ledergerber B, Derksen L, Rafeiner P, Clauss M, Nüesch R, Zellweger C, Vogt M, Zimmerli W.
Source
University and University Hospital Zurich, Zurich, Switzerland.
Abstract
PURPOSE:
Rifampin combination therapy plays an important role in the management of staphylococcal periprosthetic joint infection (PJI). However, the emergence of rifampin resistance is a feared complication. We retrospectively analysed predetermined potential risk factors in patients with rifampin-resistant staphylococcal PJI in a multicentre case-control study.
METHODS:
Cases (n = 48) were defined as PJI caused by rifampin-resistant staphylococci. Rifampin-susceptible controls (n = 48) were matched for microorganism and type of prosthetic joint. Uni- and multivariable conditional logistic regression analyses were performed to estimate odds ratios (OR) with 95 % confidence intervals (95 % CI).
RESULTS:
Forty-eight cases (31 men; median age 67 years; age range 39-88 years) with hip- (n = 29), knee- (n = 13), elbow- (n = 4), shoulder- (n = 1) or ankle-PJI (n = 1) were enrolled in the study. Staphylococcus aureus and coagulase-negative staphylococci were isolated in ten and 38 episodes, respectively. Most of the cases (n = 44, 92 %) had a previous PJI, and 93 % (n = 41) of these had been treated with rifampin. There was an independent association of emergence of rifampin resistance with male sex (OR 3.6, 95 % CI 1.2-11), ≥3 previous surgical revisions (OR 4.7, 95 % CI 1.6-14.2), PJI treatment with high initial bacterial load (inadequate surgical debridement, 2 weeks of intravenous treatment of the combination medication, and inadequate rifampin therapy
CONCLUSIONS:
Based on our results, extensive surgical debridement and adequate antibiotic therapy are needed to prevent the emergence of rifampin resistance.
Labels: bacterial load, joint infections, prosthetic joint, rifampin, rifampin-resistant staphylococcal PJI
# posted by Pat O'Connor @ 8:49 AM
Saturday, September 01, 2012
Real-life 'Contagion' uses DNA to halt outbreak
Real-life 'Contagion' uses DNA to halt outbreak
August 2012
By Sharon Begley - Reuters
NEW YORK — If Hollywood needs a plot for a medical thriller, scientists at the National Institutes of Health have one: Doctors, using cutting-edge technology called whole-genome sequencing, trace an outbreak of a deadly bacterial infection, identify precisely how it's spreading - and in the final minutes sic poison-spewing robots on the rampaging microbes.
That's essentially what scientists did when Klebsiella pneumoniae, an often-lethal bacterium, spread through NIH's research hospital in Bethesda, Maryland last year, as described in a study published on Wednesday in the journal Science Translational Medicine.
"With whole-genome sequencing," said microbial geneticist Julie Segre of NIH's National Human Genome Research Institute, who led the study, "we were able to understand how the outbreak was moving through the hospital and identify weaknesses" in infection-control practices, finally halting the outbreak.
The unprecedented effort to use genome sequencing to save patients from an infectious outbreak offers hope that the technique could fight other hospital-acquired infections. These infections kill some 99,000 people die from such infections in the United States every year, estimates the U.S. Centers for Disease Control and Prevention. The added health-care costs, according to the CDC: $4.5 billion a year.
Calling it a "compelling story," virologist and microbe hunter Ian Lipkin of Columbia University in New York City said the NIH scientists' feat shows what ultra-fast whole-genome sequencing can accomplish in so-called microbial forensics. In whole-genome sequencing, machines identify the DNA units that make up an organism's entire genome.
Researchers were able "to implicate 'Patient Zero,' track transmission of a drug-resistant bacterium over the course of an important outbreak and provide insights that will inform infection control and patient care," said Lipkin, director of the Center for Infection and Immunity at Columbia's Mailman School of Public Health and a scientific adviser on the 2011 film "Contagion."
The outbreak at NIH's hospital began last summer. In June a 43-year-old patient with antibiotic-resistant K. pneumoniae, which infects the urinary tract and bloodstream and can cause sepsis, a blood infection, was transferred to its intensive-care unit from a New York City hospital. "Patient Zero" was put in an isolation room; staff and visitors had to wear gowns, masks and gloves to enter.
Labels: bacterial infection, bloodstream, DNA, genome sequencing, hospital-acquired infections, K. pneumonia, microbes, sepsis, urinary tract
# posted by Pat O'Connor @ 10:40 AM
Study: Tattoo infections traced to tainted ink
Study: Tattoo infections traced to tainted ink
August 2012
ATLANTA — An outbreak of infected tattoos has led to an unlikely source: the ink.
With the growing popularity of tattoos, health officials say they are seeing more cases of a nasty skin infection caused by a common bacteria traced to the ink. In the largest outbreak, 19 people in Rochester, N.Y., ended up with bubbly rashes on their new tattoos, researchers reported Wednesday.
Infections from tattooing are nothing new. Hepatitis, staph infections and even the superbug known as MRSA have been tied to tattoos. Dirty needles and unsanitary conditions are often to blame.
But all the New York cases were linked to an unidentified artist who wore disposable gloves and sterilized his instruments. The problem, investigators concluded, was in the ink.
"Even if you get a tattoo from a facility that does everything right, it's not risk free," said Dr. Byron Kennedy, deputy director of the health department in New York's Monroe County. He is lead author of a report on last fall's Rochester cases was released by the New England Journal of Medicine on Wednesday.
In the past year, there have been 22 confirmed cases and more than 30 suspected cases of the skin infection in Colorado, Iowa, New York and Washington state, health officials said. The infections were tied to ink or water used to dilute the ink. Tattoo artists and ink makers should use only sterile water to dilute ink, health officials advise.
Scattered reports of the illness in tattoo customers have been reported over the past 10 years. But they may be growing more common as more people get tattoos, experts said. An estimated 1 in 5 U.S. adults have at least one tattoo, an increase from years past, according to polls.
The illnesses were caused by a bacterial cousin of tuberculosis named Mycobacterium chelonae (pronounced chell-OH-nay). The bacteria can cause itchy and painful pus-filled blisters that can take months to clear up, and involve treatment with harsh antibiotics with unpleasant side effects.
The bacteria are common in tap water, and have been seen in the past when tattoo artists used contaminated water to lighten dark ink. The ink used in New York was "gray wash," used for shaded areas of tattoos. The ink was recalled and has not returned to the market.
Companies that make gray wash sometimes use distilled water to lighten the ink, thinking it's clean of infection-causing contaminants. But the bacteria can live in that too, said Tara MacCannell, who led a related investigation by the Centers for Disease Control and Prevention. Her study appears in CDC's Morbidity and Mortality Weekly Report released Wednesday.
Some ink manufacturers add witch hazel or an alcohol preservative to lower risk of certain viruses, but those additives don't kill off the hardy chelonae bacteria, she added.
Investigators found the bacteria in opened and unopened bottles of ink at the New York tattoo parlor. They did not find it in water at the shop, MacCannell said.
Health officials say tattoo customers should ask what kind of ink is being used and what measures are in place to prevent infections.
Labels: antibiotics, contaminants, Hepatitis, Infections, MRSA, Mycobacterium chelonae, skin infection, staph infections, tainted ink, tattoo
# posted by Pat O'Connor @ 9:41 AM
Seven year old boy dies from flesh eating bacterial disease
Seven year old boy dies from flesh eating bacterial disease
Sept 1, 2012
MailOnline
Sept 1, 2012
A seven-year-old boy from Texas who developed a rash under his arm during a July trip to San Diego, California, died after contracting a flesh-eating bacterial infection, the Medical Examiner’s Office announced on Thursday
Tevita Alatini’s official cause of death was listed as bacterial necrotizing myositis, which means that infection spread into muscle tissue.
Officials listed autoimmune hemolytic anemia - a malfunction of the immune system - as a contributing condition.
Alatini passed away on July 10 at Rady Children’s Hospital, three days after arriving in San Diego with his family from Spring, Texas, for a family reunion, the San Diego Union-Tribune reported.
Shortly after the boy’s death, his uncle Sione Niko told the North County Times that the family had traveled to Lake O’Neill Recreational Park on the Camp Pendleton Marine Corps base on July 9 when his nephew fell ill and developed a rash.
Helen Niko, one of Tevita's aunts, told San Diego's 10News.com: 'He was happy and climbing light poles and running around and having a good time just like any other seven-year-old would.
'At first we thought it was nothing to worry about as he was born with a weak immune system but then the rash came.'
Flesh-eating infections are often contracted while swimming in a lake or pond, and the boy's parents told the press in July that their son ventured into the water during the camping trip.
However, Niko insisted that his nephew did not even go near the lake.
'He was sitting down and just hanging out with everybody, just having family time. Then he was complaining about a pain on his side, and it started off just like a little rash, and then it just became bigger,' Niko said.
He was just laying there not feeling well, and he was throwing up again, and he just became real sick. He wasn’t really responding to his mother, so that’s when they decided that he needed to go straight to the ER.'
The autopsy conducted on the seven-year-old’s body did not address how the boy might have developed the rare disease.
Tevita’s parents noticed a large red spot under his left arm after their lake outing and took their son to the base hospital, where doctors recognized the signs of a severe infection and had the child airlifted to Rady Children’s Hospital.
The boy went into medical arrest shortly after arriving at the hospital and was pronounced dead early the next morning.
The day after he died, the family held a memorial for the seven-year-old at the beach at Camp Pendleton.
The bacteria that led to Tevita’s death is known to release toxins which destroy tissue, thus earning it the term ‘flesh-eating.’
According to the National Necrotizing Fasciitis Foundation, it can be caused by various types of germs which usually enter the body through a wound in the skin, sometimes as small as a paper cut. They can also be swallowed or inhaled.
One drop of untreated water can contain millions of bacteria. It is possible to develop skin infections, ear infections, eye infections, diarrhea, and respiratory infections from contaminated lake water.
If caught early, the rapidly progressing disease can be stopped with the use of antibiotics, according to the foundation.
MailOnline
Labels: autoimmune hemolytic anemia, bacterial necrotizing myositis, flesh eating bacteria, immune system, Infection
# posted by Pat O'Connor @ 9:34 AM
CFIA/Health Hazard Alert: Certain Catania Brand Mangoes May Contain Salmonella Braenderup Bacteria
CFIA/Health Hazard Alert: Certain Catania Brand Mangoes May Contain Salmonella Braenderup Bacteria
The Canadian Food Inspection Agency (CFIA) and M.L. Catania Co. Ltd. are warning the public not to consume the Catania brand mangoes described below because they may be contaminated with Salmonella Braenderup bacteria.
The affected product, Daniella brand Mango packed by M. L. Catania Co. Ltd., was sold in a 6-pack plastic clamshell bearing UPC 0 61968 61603 0 and a Pack date. All Pack dates from 12 JL 19 to 12 AU 21 are affected by this alert. This product was repacked using Daniella brand mangoes implicated in other recalls. The original Daniella brand sticker may or may not be present on each individual mango.
This recall is part of an ongoing food safety investigation.
There have been several confirmed illnesses associated with the consumption of Daniella brand mangoes.
The Daniella brand Mango packed with Catania label has been distributed in Newfoundland and Ontario, and may have been distributed in other provinces.
Food contaminated with Salmonella may not look or smell spoiled. Consumption of food contaminated with these bacteria may cause salmonellosis, a foodborne illness. In young children, the elderly and people with weakened immune systems, salmonellosis may cause serious and sometimes deadly infections. In otherwise healthy people, salmonellosis may cause short-term symptoms such as high fever, severe headache, vomiting, nausea, abdominal pain and diarrhoea. Long-term complications may include severe arthritis. If you think you have illness symptoms related to salmonellosis, please contact your family doctor.
Labels: bacteria, Canadian Food Inspection Agency, CFIA, foodborne illness, mangos, Salmonella Braenderup Bacteria
# posted by Pat O'Connor @ 9:23 AM
Influence of material on the development of device-associated infections.
Influence of material on the development of device-associated infections.
July 2012
Source
AO Research Institute Davos, Davos, Switzerland.
Abstract
Clin Microbiol Infect
Keywords:
Bacterial adhesion, biocompatibility, macrophage, preclinical testing, surface chemistry, surface topography
ABSTRACT: The use of implanted devices in modern orthopaedic surgery has greatly improved the quality of life for an increasing number of patients, by facilitating the rapid and effective healing of bone after traumatic fractures, and restoring mobility after joint replacement. However, the presence of an implanted device results in an increased susceptibility to infection for the patient, owing to the creation of an immunologically compromised zone adjacent to the implant. Within this zone, the ability of the host to clear contaminating bacteria may be compromised, and this can lead to biofilm formation on the surface of the biomaterial. Currently, there are only limited data on the mechanisms behind this increased risk of infection and the role of material choice. The impacts of implant material on bacterial adhesion, immune response and infection susceptibility have been investigated individually in numerous preclinical in vitro and in vivo studies. These data provide an indication that material choice does have an impact on infection susceptibility; however, the clinical implications remain to be clearly determined.
Labels: Bacterial adhesion, bacterial infection, biocompatibility, immunologically compromised, implanted devices, macrophage, preclinical testing, surface chemistry, surface topography
# posted by Pat O'Connor @ 9:18 AM
Type I interferon and bacterial infection
Type I interferon and bacterial infection
July 2012
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[Article in Chinese]
Source
Department of Respiratory Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
Abstract
Interferons (IFNs) are cytokines playing an important role in immune responses. Interferons are classified into two distinct types according to specific interferon receptors(IFNR). Type I IFNs include IFN-α and IFN-β, whereas IFN-γ is type II IFN. It is well known that type I IFNs have important roles in the host defense against viruses through activation of interferon receptor A (IFNAR). However, many recent studies have also demonstrated that type I IFNs have effects on immune responses tobacterial infection. This review focuses on the immune regulation of type I IFN-mediated signal pathways in bacterial infections such as listeria monocytogenes, streptococcus, mycobacterium tuberculosis, bacillus anthracis, legionella, pseudomonas aeruginosa and others.
Labels: bacterial infection, cytokines, IFNAR, IFNs, immune regulation, immune responses, interferon receptor A, Interferons
# posted by Pat O'Connor @ 9:12 AM
Antibiogram testing of pediatric skin infections in the era of methicillin-resistant Staphylococci aureus: an Egyptian University Hospital-based study.
Antibiogram testing of pediatric skin infections in the era of methicillin-resistant Staphylococci aureus: an Egyptian University Hospital-based study.
August 2012
Source
Departments of Dermatology and Venereology Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Abstract
Background Community-associated methicillin-resistant Staphylococci aureus (CA-MRSA) pediatric skin infections have been reported worldwide. However, little is known about pathogens' implications in Egyptian children, and beta-lactams are still the empiric antimicrobials prescribed. This warrants Egyptian studies on antibiogram testing of pediatric skin infections.
Objectives To determine antibiotic susceptibility patterns of bacterial isolates from Egyptian pediatric skin infections to find out if we need reconsideration of the empiric beta-lactam antimicrobial therapy.
Materials and methods Throughout an eight-month cross-sectional study, antibiogram testing was conducted on bacterial isolates from pediatric skin infections. Determination of inducible resistance to clindamycin using D-test was performed for isolates susceptible to clindamycin and resistant to erythromycin.
Results One-hundred and 21 children (mean age 6.9 years ± 3 SD) presented with pyogenic skin infections. Methicillin-sensitive Staphylococci aureus (MSSA) were isolated from 114 children, associated with group A Streptococci (GAS) in four of them, while GAS were the only isolates in three patients. A diagnosis of CA-MRSA was fulfilled in four children. Antibiotic susceptibilities differed between isolated organisms but with no statistically significant differences between susceptibility patterns of isolates from primary skin infections and those from secondary infection of skin diseases. Positive D-test was detected in five MSSA isolates.
Conclusions CA-MRSA skin infections are not common among Egyptian children and, therefore, beta-lactams are still effective empiric antimicrobial therapy for most infections. Antibiogram testing from suppurative skin lesions are, however, better to be recommended to guide individual therapy. Clindamycin should not be considered for susceptible isolates unless they are erythromycin susceptible or D-test negative.
Labels: Antibiogram, antibiotic susceptibility, CA-MRSA, clindamycin, group A Streptococci, methicillin-resistant Staphylococci aureus, skin infections, skin lesions
# posted by Pat O'Connor @ 9:08 AM
Diagnostic methods in sepsis: the need of speed.
Diagnostic methods in sepsis: the need of speed.
August 2012
Source
Laboratory Specialist, Instituto de Química, Universidade de São Paulo, São Paulo, SP, Brazil.
Abstract
Keywords: Sepsis, methods, cytokines.
OBJECTIVE:
Sepsis is a common condition encountered in hospital environments. There is no effective treatment for sepsis, and it remains an important cause of death at intensive care units. This study aimed to discuss some methods that are available in clinics, and tests that have been recently developed for the diagnosis of sepsis.
METHODS:
A systematic review was performed through the analysis of the following descriptors: sepsis, diagnostic methods, biological markers, and cytokines.
RESULTS:
The deleterious effects of sepsis are caused by an imbalance between the invasiveness of the pathogen and the ability of the host to mount an effective immune response. Consequently, the host's immune surveillance fails to eliminate the pathogen, allowing it to spread. Moreover, there is a pro-inflammatory mediator release, inappropriate activation of the coagulation and complement cascades, leading to dysfunction of multiple organs and systems. The difficulty achieve total recovery of the patient is explainable. There is an increased incidence of sepsis worldwide due to factors such as aging population, larger number of surgeries, and number of microorganisms resistant to existing antibiotics.
CONCLUSION: The search for new diagnostic markers associated with increased risk of sepsis development and molecules that can be correlated to certain steps of sepsis is becoming necessary. This would allow for earlier diagnosis, facilitate patient prognosis characterization, and prediction of possible evolution of each case. All other markers are regrettably constrained to research units.
Labels: cytokines, diagnostic methods, immune surveillance, methods, sepsis, treatment
# posted by Pat O'Connor @ 8:57 AM
