Volume 55, Issue 4, 15 August 2012

From 2002–2010, the epidemiology of invasive group A streptococcal disease changed dramatically in Utah. The incidence of invasive disease rose from 3.5 to 9.8 cases/100 000 persons, while the incidence of acute rheumatic fever decreased from 6.1 to 3.7 cases/100 000.

In this case-control study, we found that patients with Streptococcus gallolyticus subsp. gallolyticus bacteremia have a strong association with colorectal neoplasia (CRN) that is significantly higher than that in symptomatic patient controls. It is unknown whether this relationship is a consequence of CRN or could have a causal component in CRN development.

Hyperimmunoglobulin treatment for women with early (before gestational week 17) primary cytomegalovirus (CMV) infection and proven vertical transmission (ie, detection of CMV in amniotic fluid by polymerase chain reaction) improved infant outcomes at 1 year of age.

In a cohort of men who have sex with men, most of whom were infected with human immunodeficiency virus, men chronically infected with hepatitis B were 2-fold more likely to die a liver-related death than those chronically infected with hepatitis C.

Findings confirmed that neurologic manifestations associated with influenza are diverse and included encephalitis/encephalopathy, seizures, meningitis, and Guillain–Barré Syndrome. Pediatric admissions were common, and Asian patients, especially those presenting with seizure or encephalopathy, were overrepresented.

Although (1,3)-β-D-glucan (BG) is a biomarker for invasive candidiasis, the usefulness as a prognostic marker is not well characterized. Our study suggests that baseline and consecutive serum BG measurement may be useful as prognostic markers of treatment outcome in IC patients on echinocandins.

Conventional vancomycin therapy is no longer sufficient for treating serious Staphylococcus aureus infections. In this study, an initial vancomycin dosing protocol was developed and prospectively validated to achieve therapeutic serum concentrations in patients undergoing hemodialysis.

In contrast to observations in broths, macrolides show low minimum inhibitory concentrations against Pseudomonas aeruginosa in eukaryotic cell culture media, bronchoalveolar lavage fluid, and serum. This results from increased permeability of the outer membrane, combined with downregulation of oprM expression.

There is a substantial increase in the frequency of failure of oral miltefosine for treatment of visceral leishmaniasis in India, compared with data that led to registration of the drug a decade ago.

In a meta-analysis examining respiratory specimen Gram stain for diagnosis of ventilator-associated pneumonia, absence of bacteria on Gram stain had a high negative predictive value, but a positive Gram stain correlated poorly with organisms recovered in culture.

Despite the major threat multidrug-resistant gram-negative pathogens pose to patients worldwide, the conventional paradigm for the development of drugs against these pathogens is generally ineffectual, We propose innovative development programs that involve implementation of a graduated approval process.

Based on review of existing in vitro, animal, and human studies in drug-resistant tuberculosis, this article highlights key knowledge gaps and provides prioritized recommendations for new preclinical and clinical trials to inform current treatment and future clinical trials of investigational agents.

Study confirms the activity of a number of approved antistaphylococcal agents against both vancomycin-intermediate and -resistant. Staphylococcus aureus (VRSA). Although infections due to VRSA do not appear to be clonal, continued surveillance for outbreaks of infection is needed.

Antimicrobial stewardship programs that target “low-hanging fruit,” which include intravenous-to-oral switch, batching of intravenous antimicrobials, therapeutic substitution, and formulary restriction, can have early success and achieve significant cost savings. We observed cost savings of $832 590 with a staged and systematic approach.

Antiretroviral therapy medication errors are common among hospitalized patients with human immunodeficiency virus (HIV) infection (29% of admissions on hospital day 1) but are quickly corrected (7% of admissions on hospital day 2). Compared with those admitted to the HIV/AIDS service, patients admitted to surgical services were at increased risk of errors.

In individuals with human immunodeficiency virus (HIV) infection, the risk of myocardial infarction was associated with HIV replication, a low CD4 T-cell nadir, and a high current CD8 T-cell count, independently of cardiovascular risk factors and antiretroviral exposure.

The presence of Aspergillus antigens in blood transfusion components from different manufacturers was analyzed. Galacomannans were found in transfused patient, pooled platelet concentrates, fresh frozen plasma, and packed red cells collected using Fresenius Kabi bags. Galacomannans were also found in blood collection anticoagulant and platelet additive solution from this manufacturer.

Since the approval of rotavirus vaccine in 2006 for routine use in US children, there has been a marked reduction in the number of and direct medical charges for all-cause gastroenteritis hospitalizations and rotavirus-coded hospitalizations.