Volume 57, Issue 5, 1 September 2013

This study highlights an important education gap among US medical schools, suggesting that more attention should be given to instruction of medical students about the principles of antimicrobial stewardship. Medical schools should be partners in global efforts to reduce antimicrobial resistance.

We investigated a Chlamydia pneumoniae outbreak at a federal correctional facility. Higher risk was observed among white inmates and residents of housing unit Y, suggesting that social interaction contributed to transmission. Chlamydia pneumoniae persisted in the oropharynx after antibiotic therapy.

Foodborne transmission should be considered as a possible cause of clusters of group A Streptococcus (GAS) pharyngitis. When possible, strain typing should be employed in epidemiologic investigations of suspected GAS outbreaks to enhance understanding of the epidemiology of GAS disease.

This report describes the largest known US outbreak of blastomycosis, in which we observed neighborhood and household clustering of cases in north-central Wisconsin in 2010. Persons of Hmong ethnicity were disproportionately affected. A common outdoor source was not identified.

In a large human immunodeficiency virus–hepatitis C virus coinfection cohort, we found no evidence that marijuana smoking accelerated progression to significant liver fibrosis, cirrhosis, or end-stage liver disease. Previous studies reporting an association may have been biased by reverse causation due to self-medication.

This large-scale, prospective, multicenter study showed that high levels of plasma human herpesvirus 6 (HHV-6) DNA are associated with higher risk of HHV-6 encephalitis. Cord blood transplantation is a significant risk factor for high-level HHV-6 reactivation and HHV-6 encephalitis.

Marked increases in the incidence of invasive group B streptococcal infection in England and Wales were identified between 1991 and 2010 with a relative shift toward adult disease. Changes in serotypes were noted with marked increase in erythromycin resistance across all age groups.

Clinical and laboratory features were analyzed in dog- and bat-acquired human rabies cases. Aerophobia, hydrophobia, and encephalopathy were more common in dog-acquired rabies, whereas focal neurological deficit, local sensory symptoms, and myoclonus were more common in bat-acquired rabies.

Antibiotic resistance levels are rising around the world. Because antibiotic usage in people and animals is the major driver for this resistance, the role of the environment in the emergence and spread of antibiotic resistance is often overlooked.

Despite advancements in laboratory methods, an unacceptably high percentage of people infected with human immunodeficiency virus (HIV) remain unaware of their diagnosis. A proposed alternative algorithm for the diagnosis of HIV should lead to improved detection of HIV infections, particularly acute HIV and HIV-2.

Urinary tract infections are often caused by strains of uropathogenic Escherichia coli (UPEC), which are becoming increasingly resistant to antibiotics. This review considers UPEC pathogenic mechanisms along with current management strategies and emerging therapies.

A primer is presented on conducting systematic reviews, highlighting differences between review types, outlining steps in performing a systematic review, and offering resources to help authors perform and report valid reviews.

Among 16- to 23-year-old human immunodeficiency virus–infected young women who were human papillomavirus (HPV) DNA and HPV seronegative at the time of vaccination with the quadrivalent HPV vaccine, immune responses to vaccination were generally robust and the vaccine was well tolerated.

A specific substitution in a 3S-based immunogen might allow the generation of specific anti-gp41 antibodies that are capable of eliciting neutralizing antibodies and countering natural killer cytotoxicity against CD4⁺ T cells.

Kaposi sarcoma and lymphoma rates were highest immediately after antiretroviral therapy (ART) initiation, particularly among patients with low CD4 cell counts, whereas other cancers increased with time on ART. Calendar year of ART initiation was not associated with subsequent cancer incidence.

We report a case of AIDS presenting as varicella-zoster virus (VZV) meningomyeloradiculitis associated with human immunodeficiency virus (HIV) quasispecies compartmentalization within the cerebrospinal fluid (CSF), and a CSF viral load that was 1 log higher than in peripheral blood. Prolonged antiviral therapy for both VZV and HIV type 1 was associated with partial resolution.