Infectious Disease
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CDC, ECRI Institute devise culturing protocols for duodenoscopes to prevent CRE infection
Responding to a series of outbreaks of CRE (carbapenem-resistant Enterobacteriaceae) linked to duodenoscopes, the Centers for Disease Control and Prevention has developed an interim protocol for culturing the devices before use to create a greater of margin of safety for patients.
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Hospitals moving on antibiotic stewardship, but outpatient settings have a more difficult task
The analogy between antibiotic resistance and climate change is an apt one in the sense that both require a local and a global response. Flagrant antibiotic prescribing in outpatient settings, for example can certainly undermine a judicious hospital response in the grand scheme of things. Similarly, what good is it if one country fights to save fading antibiotic efficacy but another nation passes out pills like candy. More on that later, but first the outpatient problem.
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Spore wars: C. difficile takes a staggering toll as top HAI
While CRE and other “superbugs” have been much in the headlines of late, Clostridium difficile has quietly become one of the most deadly pathogens in the country. Some 500,000 people are being infected annually in the U.S., with 29,000 patients dying within 30 days of the initial diagnosis of a C. diff infection (CDI). That is three times the number of people that have died of Ebola since the epic outbreak began in December of 2013.
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Reservoir Bugs: CRE in Long-term Acute Care Hospitals Threatens to Spread to Other Facilities
With a combination of severely ill patients, high antibiotic use, and lengths of stay measured in weeks, long-term acute care (LTAC) hospitals have been described as a perfect storm for emergence of multidrug-resistant organisms (MDROs).
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Infectious Disease Alert Updates
Water Birth Death
Out, Damned Spore!
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Preventing Active Tuberculosis in Children
A three-month course of weekly rifapentine and isoniazid is safe and at least as effective as nine months of daily isoniazid in preventing tuberculosis in children aged 2 to 17 years.
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Steroids for Severe Community-Acquired Pneumonia: More Evidence or More Uncertainty?
A multicenter, randomized, double-blind, placebo-controlled trial involving patients with severe community-acquired pneumonia and evidence of high inflammation found less treatment failure in those who received steroids. However, in-hospital mortality did not differ between the groups.
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Acute Leukemia Patients Still Plagued by Vancomycin-Resistant Enterococci
Fifteen (7%) of 214 patients hospitalized with newly diagnosed acute leukemia developed bacteremia due to vancomycin-resistant enterococci; 12 (80%) of the 15 had stool colonization with the organism.
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Fusobacterium as a Cause of Pharyngitis in Young Adults
Three hundred twelve students presenting to a university student health clinic with sore throat and 180 asymptomatic students had throat swabs taken and the samples were tested by PCR for Fusobacterium necrophorum, Mycoplasma pneumonia, group A streptococci, and group C/G streptococci. Fusobacterium necrophorum-positive pharyngitis occurs more frequently than group A streptococcal pharyngitis in this population and clinically resembles streptococcal pharyngitis.
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Seizures, Encephalopathy, and Vaccines — Evidence Fails to Support a Link
A comprehensive, independent review of 10 years of all cases in the United States of seizures and encephalopathy reported as linked to vaccination showed that approximately one-quarter of cases had evidence of a pre-existing neurologic abnormality. Among those who developed chronic epilepsy, many had clinical features suggesting genetically determined epilepsy, especially Dravet syndrome.