Infectious Disease Alert – November 1, 2012

November 1, 2012

• Fungal meningitis and arthritis from epidural, paraspinal and intra-articular injections with contaminated corticosteroid. Early status.

  An investigation initiated after a clinician reported to the Tennessee Department of Health on September 18, 2012 the case of a patient who developed meningitis due to Aspergillus fumigatus after having received an epidural corticosteroid injection at an ambulatory surgical center quickly identified a number of other suspect cases.

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• Pediatric-Specific Antibiograms Improve Empiric Drug Selection

  At Duke University Health System, a tertiary-care medical center that has traditionally provided aggregated antimicrobial susceptibility data from both adult and pediatric isolates, antibiograms for Escherichia coli isolates from children ¡Ü12 years of age from July 2009 to September 2010 were developed and compared with antibiograms that combined adult and pediatric data. A total of 375 pediatric isolates were obtained from 327 patients.

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• Fidaxomicin after Vancomycin for Patients with Multiple C. difficile Recurrences

  Recurrent C. difficile infection (CDI) is a challenging condition to manage. Current guidelines estimate that 25% of patients treated for CDI experience at least 1 additional episode, with those aged 65 years or greater at highest risk.

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• Etiology of Acute Diarrhea in Children

  From November 2003 to November 2005, 254 cases of childhood diarrhea and 452 age- and geographically-matched (by zip code) controls were enrolled in a case-control study of the etiology of acute diarrhea among children 10-49 months of age presenting to a pediatric emergency department.

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• Dengue in Vietnam Prompts Travel Warning

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• Updates By Carol A. Kemper, MD, FACP

  Sanofi Pasteur announced September 28, 2012 a recall of 6 lots of Typhim Vi polysaccharide vaccine, the injectable "killed" vaccine. A significant portion of the stock has been shown to be insufficiently immunogenic and at risk for "low antigen content."

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• Pharmacology Watch: Do Benzodiazepines Cause Dementia in the Elderly?

  In this issue: Dementia and benzodiazepines; effectiveness of omega-3 fatty acid and Ginkgo biloba supplements; and FDA actions.

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• Clinical Briefs in Primary Care supplement

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