Volume 57, Issue 9, 1 November 2013

A clinical intervention on Staphylococcus aureus bacteremia (SAB) based on 6 selected evidence-based quality-of-care indicators was conducted in 12 tertiary hospitals in Spain. The intervention, carried out by microbiologists and infectologists, improved the management and mortality of patients with SAB.

Integrating rapid organism identification with matrix-assisted laser desorption/ionization time-of-flight and real-time review and intervention by an antimicrobial stewardship team was associated with decreased mortality, decreased length of intensive care unit stay, improved time to effective and optimal antibiotic therapy, and decreased recurrent bacteremia.

During region-wide point prevalence surveillance, we detected 9-fold higher rates of colonization with Klebsiella pneumoniae carbapenemase–producing Enterobacteriaceae among patients in long-term acute care hospitals, compared with intensive care unit patients in short-stay acute care hospitals.

Among US veterans in 2011, Escherichia coli ST131, primarily its H30 subclone, accounted for most antimicrobial-resistant E. coli clinical isolates and was the dominant E. coli strain overall. Possible contributors included multidrug resistance, extensive virulence gene content, and ongoing transmission.

Patients with Crimean-Congo hemorrhagic fever were stratified using a novel severity scoring index. Ribavirin was effective in reducing the casefatality rate among moderately ill patients, whereas steroids were beneficial particularly among patient with more-severe disease.

The application of routine polymerase chain reaction testing on respiratory specimens from patients with pneumonia led to a >4-fold increase in case detection for Legionnaires' disease, and clarified the regional epidemiology of this disease.

Using a statewide repository of hospital data that allowed patient tracking between facilities, we found that limiting surgical site infection (SSI) surveillance to the hospital where the operation took place caused varying degrees of SSI underestimation and impacted hospitals' relative rankings.

This study identifies clinical indicators that were associated with STFS fatal outcome. However, it finds no evidence to support effectiveness for use of ribavirin in the treatment of individuals with SFTS.

People who use drugs experience delayed HIV diagnosis, reduced entry into and retention in care, delayed initiation of antiretroviral therapy, and inferior HIV outcomes. Overcoming healthcare disparities requires evidence-based, comprehensive packages of clinical/social services, including treatment for substance use disorders.

Tumor necrosis factor alpha (TNF-α) inhibitors can increase the risk of infections. This systematic literature review describes the epidemiology, microbiology, and types of infections reported in children and adolescents with juvenile idiopathic arthritis and inflammatory bowel disease treated with TNF-α inhibitors.

Herpes simplex virus type 2 (HSV-2) coinfection in HIV-infected individuals may contribute to increased systemic inflammation and immune activation that persist despite suppressive antiretroviral therapy. Valacyclovir did not decrease systemic immune activation in HIV-1/HSV-2–coinfected adults on suppressive antiretroviral therapy.

Accounting for outcomes among those lost to follow-up in a Ugandan HIV treatment program among patients entering care with a CD4 count >350 cells/µL and not immediately eligible for antiretroviral therapy reveals retention to be higher than most prevailing estimates.

This systematic review found that prevalence of cytomegalovirus retinitis in resource-limited settings, notably Asian countries, remains high, indicating that HIV programs need to ensure capacity to manage the needs of patients who present late for care.