MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of Infection' source. Wed, 08 Feb 2012 18:15:44 +0100 http://www.medworm.com/index.php?rid=5598903&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311005809%2Fabstract%3Frss%3Dyes Summary: Immunocompromise is a commonly cited risk factor for Clostridium difficile infection (CDI). We reviewed the experimental and epidemiological literature on CDI in three immunocompromised groups, HIV-seropositive individuals, haematopoietic stem cell or bone marrow transplant recipients and solid organ transplant recipients. All three groups have varying degrees of impairment of humoral immunity, a major factor influencing the outcome of CDI. Soluble HIV proteins such as nef and immunosuppressive agents such as cyclosporin, azathioprine and mycophenalate mofetil modify signalling from the key cellular pathways triggered by C. difficile toxin A, although there is a paucity of data on how these factors may interact with pathways activated by toxin B. Despite this, there has been littl... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5598903 Mon, 12 Dec 2011 05:00:00 +0100 5598903 http://www.medworm.com/index.php?rid=5598914&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100572X%2Fabstract%3Frss%3Dyes Conclusions: The worse outcome among diabetes sufferers could be a consequence of the higher prevalence of comorbid underlying medical conditions but not diabetes itself. Further prospective studies are needed to verify these results. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5598914 Mon, 28 Nov 2011 05:00:00 +0100 5598914 http://www.medworm.com/index.php?rid=5598912&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311005603%2Fabstract%3Frss%3Dyes Conclusions: The hepatic tolerability of EFV was good in HIV/HCV-coinfected patients with advanced liver fibrosis. The frequency of grade 3–4 TE was similar to that observed in patients without advanced fibrosis, there was no death attributable to liver failure caused by drug toxicity and the rate of EFV discontinuations due to liver events was low. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5598912 Mon, 28 Nov 2011 05:00:00 +0100 5598912 http://www.medworm.com/index.php?rid=5442527&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100315X%2Fabstract%3Frss%3Dyes Viral load (VL) measurement is critical for monitoring the effectiveness of highly-active antiretroviral therapy (HAART). HAART aims to achieve and maintain HIV RNA levels at undetectable levels. A VL less than 50 copies/ml was previously considered to be undetectable. Following the introduction of the more sensitive Cobas Ampliprep/ Cobas TaqMan HIV-1 (CAP/CTM1) assay in Newcastle in August 2006 many patients with a previously undetectable VL were found to have low-level viraemia. The purpose of this study was to determine the clinical and virological significance of this very low-level HIV viraemia (VLLV, VL detectable at (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442527 Fri, 25 Nov 2011 11:05:46 +0100 5442527 http://www.medworm.com/index.php?rid=5442526&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003148%2Fabstract%3Frss%3Dyes Staphylococcus aureus (SA) encoding Panton-Valentine Leukocidin (PVL-SA) has emerged worldwide as an important cause of skin and soft tissue infections (SSTIs) and necrotizing pneumonia. In 2008, 1,738 cases of PVL-SA were identified in England and Wales, most were MSSA (58%); 34 patients presented with community acquired pneumonia, 11 (32%) of whom died. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442526 Fri, 25 Nov 2011 11:05:46 +0100 5442526 http://www.medworm.com/index.php?rid=5442525&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003136%2Fabstract%3Frss%3Dyes Escherichia coli is the most common Gram-negative organism that causes bloodstream infection (BSI) but there are few recent publications on the outcome of community-acquired E. coli (CA-E. coli) BSI in an unselected population. St. James's Hospital, Dublin (SJH) is Ireland's largest tertiary referral university-affiliated hospital, with 740 in-patient acute beds, approximately 45,000 emergency department (ED) attendances and 23,000-24,000 admissions per year. The purpose of this study was to describe the 6-year experience of CA-E. coli BSI in SJH. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442525 Fri, 25 Nov 2011 11:05:46 +0100 5442525 http://www.medworm.com/index.php?rid=5442524&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003124%2Fabstract%3Frss%3Dyes Invasive aspergillosis (IA) remains a major concern in the management of patients undergoing haematopoietic stem cell transplantation. Due to the acknowledged risk of IA a number of strategies have been developed for the use of antifungal agents ranging from prophylaxis, via pre-emptive therapy to empiric therapy, however diagnosis of IA remains problematic with clinical symptoms that are often non-specific and some radiological findings, such as the presence of a halo sign or cavitating nodules in the lungs may being strongly suggestive of aspergillosis also associated with other infections. Diagnostic tests such as Galactomannan (GM) enzyme immunoassay and qPCR have been widely employed, but it is not clear how the different antifungal treatment strategies influence these tests. (Source:... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442524 Fri, 25 Nov 2011 11:05:46 +0100 5442524 http://www.medworm.com/index.php?rid=5442523&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003112%2Fabstract%3Frss%3Dyes Anthrax is one of the oldest diseases of grazing animals and had been responsible for the deaths of hundreds and thousands of livestock prior to the 20th Century when effective veterinary and human public health programs brought it under control. Robert Koch first identified the bacteria that causes anthrax in 1875 and his experiments with this microbe helped elucidate the role of microbes in causing illness. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442523 Fri, 25 Nov 2011 11:05:46 +0100 5442523 http://www.medworm.com/index.php?rid=5442522&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003100%2Fabstract%3Frss%3Dyes There has been an outbreak of early syphilis in the UK, US, Australia and Europe since the early 2000s particularly in men who have sex with men (MSM). Diagnosis of syphilis requires a high index of suspicion as its manifestations are protean and are often non-specific, hence the adage "he who knows syphilis knows medicine". (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442522 Fri, 25 Nov 2011 11:05:46 +0100 5442522 http://www.medworm.com/index.php?rid=5442521&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003094%2Fabstract%3Frss%3Dyes Intestinal TB (ITB) and Crohn's disease are both chronic granulomatous diseases, and it is well recognised that clinical, endoscopic and histological differentiation can be difficult. In the absence of caseating granulomas and acid-fast bacilli, which are not always detected in ITB, other distinguishing features are also often absent. In addition, changing trends in the epidemiology of these previously geographically distinct diseases have compounded the challenge in diagnosis. Currently, nearly half of the patients diagnosed with Crohn's in an endemic area for TB receive anti-TB therapy before a diagnosis of Crohn's disease is reached, and the morbidity and mortality resulting from delayed/misdiagnosis of either condition can be substantial. In particular, with the new paradigm of using a... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442521 Fri, 25 Nov 2011 11:05:46 +0100 5442521 http://www.medworm.com/index.php?rid=5442520&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003082%2Fabstract%3Frss%3Dyes Clostridium botulinum produces one of the deadliest naturally occurring toxins known to man. Disease may result from food borne ingestion, inhalation or excessive iatrogenic administration of botulinum toxin, or wound infection or intestinal colonisation with C. botulinum and subsequent in vivo botulinum toxin production. The incidence of wound botulism in injecting drug users has increased significantly in the last decade and has been associated with injection of black-tar heroin. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442520 Fri, 25 Nov 2011 11:05:46 +0100 5442520 http://www.medworm.com/index.php?rid=5442519&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003070%2Fabstract%3Frss%3Dyes A 52 year-old man was referred to our service with Escherichia coli bacteraemia. He had presented 3 months earlier to another hospital with abdominal distension and vomiting and had a background history of intermittent diarrhoea over 15 years and corrective spinal surgery with implanted metalwork. CT scan of the abdomen demonstrated small bowel obstruction with a thickened terminal ileum and ascites. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442519 Fri, 25 Nov 2011 11:05:46 +0100 5442519 http://www.medworm.com/index.php?rid=5442518&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003069%2Fabstract%3Frss%3Dyes We present an unusual case of a young lady with a complex past medical history including congenital deafness, epilepsy and numerous HPV associated tumours (AIN, CIN and VIN). She had a four year history of respiratory illness which had, after several scans and biopsies eventually been diagnosed as Non Specific Interstitial Pneumonitis (NSIP). However, despite treatment with Azathioprine and Prednisolone she became increasingly breathless. Radiologically she had enlarging pulmonary nodules which, given her past history, were thought likely to represent malignancy. Several biopsies failed to show any evidence of neoplasm. Eventually an open lung biopsy was performed and this revealed that an infectious organism was responsible for her illness. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442518 Fri, 25 Nov 2011 11:05:46 +0100 5442518 http://www.medworm.com/index.php?rid=5442517&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003057%2Fabstract%3Frss%3Dyes A 45-year-old Caucasian housewife from the travelling community was admitted to Worcestershire Royal Hospital with a GCS of 4/15 having suffered a seizure whilst showering. She had felt non-specifically unwell for previous two weeks. De-cortical limb movements were noted and atypical seizure-like activity that was refractory to first-line anti-epileptic medication and within hours required sedation and intubation on Intensive Care. The patient died six weeks later. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442517 Fri, 25 Nov 2011 11:05:46 +0100 5442517 http://www.medworm.com/index.php?rid=5442516&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003045%2Fabstract%3Frss%3Dyes Yersinia enterocolitica is a psychrotropic, pleomorphic, Gram-negative bacillus within the family Enterobacteriaceae. Septicaemia due to Y.enterocolitica is uncommon, but can be severe and even fatal. Bacteraemia with Y.enterocolitica have been associated with blood transfusions, but non-transfusion-related cases have been reported in patients who are immunocompromised, elderly and those with iron overload states. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442516 Fri, 25 Nov 2011 11:05:46 +0100 5442516 http://www.medworm.com/index.php?rid=5442515&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003033%2Fabstract%3Frss%3Dyes Antimicrobial multidisciplinary teams (AMDT) are increasingly being used to improve the appropriateness of antimicrobial use. In Portsmouth Hospitals, medical wards were receiving two AMDT rounds each week. In order to clarify the benefits, both in terms of changes made to prescriptions and improvements associated with the educational input, we undertook a service evaluation. This was an eight-month ward cross-over study, from August 2008, in which groups of wards for alternate months, had twice-weekly antimicrobial rounds (active wards) or patient consultations on demand (passive wards). Wards were assessed on the appropriateness of their antimicrobial prescribing at the end of each month. Ward antimicrobial costs were used to provide supporting evidence of changes in therapy. (Source: Jo... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442515 Fri, 25 Nov 2011 11:05:46 +0100 5442515 http://www.medworm.com/index.php?rid=5442514&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003021%2Fabstract%3Frss%3Dyes Non-typhoidal Salmonella (NTS) infections are a common cause of bacterial food poisoning, typically causing gastroenteritis but occasionally secondary bacteraemia. The frequency and importance of bacteraemia is debated. A retrospective cross-sectional survey included all patients admitted to a large general hospital in Liverpool, UK, with faecal culture confirmed NTS gastroenteritis, from 1982 through to 2006. Patients were identified from hospital discharge data and laboratory records. Clinical and laboratory data were extracted from patient records onto a standardised proforma. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442514 Fri, 25 Nov 2011 11:05:46 +0100 5442514 http://www.medworm.com/index.php?rid=5442513&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100301X%2Fabstract%3Frss%3Dyes The objective of this research programme is to identify the differentially synthesised bacterial proteins between resistant and sensitive S. Pneumoniae isolates. In addition, proteins that define bacterial pathogenesis, particularly bacterial invasiveness, will also be located using proteomic and mass spectrometry technology to establish correlations between bacterial invasiveness, antibiotic resistance and the differential protein expression. The data obtained from the study can be used as a valid approach for the potential development of new therapeutic and diagnostic solutions. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442513 Fri, 25 Nov 2011 11:05:46 +0100 5442513 http://www.medworm.com/index.php?rid=5442512&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311003008%2Fabstract%3Frss%3Dyes Malaria remains a serious and potentially fatal infection, with an average of 9 deaths / year in the UK, with delay to diagnosis being a potential reason for morbidity and mortality. The early symptoms of malaria are non specific and can be confused with many infectious diseases, including influenza. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442512 Fri, 25 Nov 2011 11:05:46 +0100 5442512 http://www.medworm.com/index.php?rid=5442511&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002994%2Fabstract%3Frss%3Dyes The objective was to describe a series of patients with VO and to search for a relationship between preceding bacteraemia and subsequent VO with the same pathogen. To achieve this aim, a retrospective study of all treated cases of VO in a tertiary hospital over a ten year period was carried out. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442511 Fri, 25 Nov 2011 11:05:46 +0100 5442511 http://www.medworm.com/index.php?rid=5442510&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002982%2Fabstract%3Frss%3Dyes Tuberculous meningitis remains a rare presentation for TB disease in UK children but has a high associated risk of mortality and serious long term neurological sequelae even when appropriate treatment has been given. Current UK Guidelines recommend 12 months treatment including rifampicin, isoniazid, pyrazinamide and ethambutol in the first 2 months with rifampicin and isonaizid for the residual course unless resistance is suspected .There is evidence that adjunctive steroid treatment may reduce mortality and long term sequelae. Controversy remains about the dose and duration of steroids but current recommendations are to wean after 2-3 weeks. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442510 Fri, 25 Nov 2011 11:05:46 +0100 5442510 http://www.medworm.com/index.php?rid=5442509&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002970%2Fabstract%3Frss%3Dyes The development and progression of intracranial tuberculomas whilst on appropriate antituberculous therapy is well recognised. The reported interval between the start of antituberculous therapy and the neurological manifestations of paradoxical tuberculomas range between 10 days to 27 months. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442509 Fri, 25 Nov 2011 11:05:46 +0100 5442509 http://www.medworm.com/index.php?rid=5442508&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002969%2Fabstract%3Frss%3Dyes The control of healthcare associated infections (HCAI) has become a top priority in the United Kingdom (UK) over the last ten years. This is illustrated by a variety of initiatives launched by the British government at both the local and national level to promote the reduction of these types of infections, particularly methicillin-resistant Staphylococcus aureus bacteraemia and cases of Clostridium difficile. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442508 Fri, 25 Nov 2011 11:05:46 +0100 5442508 http://www.medworm.com/index.php?rid=5442507&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002957%2Fabstract%3Frss%3Dyes Tenofovir is known to cause reversible nephrotoxicity with a predilection for the proximal renal tubule. The prevalence of mild tubular dysfunction and consequent phosphate loss has been reported in up to 20% of patients. The EuroSIDA data has shown a four fold increased risk of reduced glomerular rate in patients on tenofovir. Bone Mineral Density was also shown to decrease in patients on tenofovir in the Gilead 903 study likely as a result of chronic hypophosphataemia. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442507 Fri, 25 Nov 2011 11:05:46 +0100 5442507 http://www.medworm.com/index.php?rid=5442506&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002945%2Fabstract%3Frss%3Dyes The objective of this research programme is to identify the differentially synthesised bacterial proteins between resistant and sensitive S. Pneumoniae isolates. In addition, proteins that define bacterial pathogenesis, particularly bacterial invasiveness, will also be located using proteomic and mass spectrometry technology to establish correlations between bacterial invasiveness, antibiotic resistance and the differential protein expression. The data obtained from the study can be used as a valid approach for the potential development of new therapeutic and diagnostic solutions. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442506 Fri, 25 Nov 2011 11:05:46 +0100 5442506 http://www.medworm.com/index.php?rid=5442505&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002933%2Fabstract%3Frss%3Dyes This study aims to assess whether rapid screening for MRSA using the Xpert MRSA PCR assay could be used in preadmission clinics and on the ward. Patients in an orthopaedic preadmission clinic and on a vascular ward were screened for MRSA using the Xpert MSRA PCR assay. Duplicate swabs were taken for culture. Results for each method were then compared in these two clinical settings. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442505 Fri, 25 Nov 2011 11:05:46 +0100 5442505 http://www.medworm.com/index.php?rid=5442504&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002921%2Fabstract%3Frss%3Dyes Reactivation of latent varicella-zoster virus (VZV) infection most commonly manifests as herpes zoster. A range of other manifestations of reactivation of VZV infection has been described. Reports of acute meningitis due to VZV reactivation have increased in recent years, in the context of the increasing use of polymerase chain reaction (PCR) for detection of VZV in cerebrospinal fluid (CSF). VZV reactivation accounts for approximately 5-11% of cases of acute aseptic meningitis. The natural history of VZV meningitis and the role of antiviral therapy are poorly defined. We sought to contribute to the knowledge of the natural history of VZV meningitis and the role of antiviral therapy by reviewing the clinical course, treatment, and outcomes of a series of consecutive patients with this cond... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442504 Fri, 25 Nov 2011 11:05:46 +0100 5442504 http://www.medworm.com/index.php?rid=5442503&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100291X%2Fabstract%3Frss%3Dyes Exposure to potentially infected body fluids is a significant occupational hazard for health care workers (HCW). While those not involved in health care work encounter this hazard less frequently, they remain at risk to exposures such as injuries from discarded needles and during assaults. Such exposures, particularly to blood, carry the potential for transmission of infection, most notably hepatitis B, C and HIV, although such events are rare. They are also the source of considerable distress and can result in long-term psychological sequelae. Appropriate initial first aid management of the injury is likely to reduce incidence of transmission and specific measures such as hepatitis B immunoglobulin (HBIG) and vaccination and HIV post-exposure prophylaxis (PEP) can prevent transmission of ... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442503 Fri, 25 Nov 2011 11:05:46 +0100 5442503 http://www.medworm.com/index.php?rid=5442502&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002908%2Fabstract%3Frss%3Dyes The human cytomegalovirus (HCMV) gene UL144 encodes a structural homologue of the herpes virus entry mediator (HVEM), a member of the tumor necrosis factor (TNF) receptor superfamily. The UL144 protein does not bind any known TNF ligands. UL144 protein binds to a member of the Ig superfamily, B and T lymphocyte attenuator (BTLA), also a ligand of HVEM. Binding of UL144 to BTLA blocks T cell proliferation, can impair lymphocyte responses to HCMV and may affect humoral response. Humoral immunity does not play any significant role in the control of HCMV infection, while its evaluation is very helpful in diagnostics. In some children, despite on-going virus replication, no specific antibodies of IgM class are found in peripheral blood serum. In the reported study, an analysis was performed of ... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442502 Fri, 25 Nov 2011 11:05:46 +0100 5442502 http://www.medworm.com/index.php?rid=5442501&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002891%2Fabstract%3Frss%3Dyes Hepatitis C infection is the leading cause for liver transplantation in the USA and a growing problem in the UK. Although there is effective anti-viral treatment available major challenges remain in preventing a silent epidemic of liver disease. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442501 Fri, 25 Nov 2011 11:05:46 +0100 5442501 http://www.medworm.com/index.php?rid=5442500&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100288X%2Fabstract%3Frss%3Dyes The incidence of tuberculosis has risen in Lothian over recent years. Genotyping of M. tuberculosis allowed us to select the largest cluster between the beginning of January 2003 and end of January 2010 identified by IS6110 RFLP and/or 15 locus MIRU-VNTR typing. We investigated the epidemiology further and assessed the efficacy of the current control program. Information on patients from this cluster was retrospectively gathered from Enhanced Surveillance of Mycobacterial Infection (ESMI) data in conjunction with patients' case note review, TB nurse interview and contact tracing records. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442500 Fri, 25 Nov 2011 11:05:46 +0100 5442500 http://www.medworm.com/index.php?rid=5442499&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002878%2Fabstract%3Frss%3Dyes The Surviving Sepsis Campaign is an international initiative, which aims to improve the management of sepsis. The guidelines recommend that appropriate antimicrobials are administered to patients with sepsis within 3 hours of arrival to the Emergency Department and within 1 hour for patients with septic shock (Grade 1B) or severe sepsis without shock (Grade 1D). Antimicrobial prescribing in sepsis was audited in our Emergency Department in 2008. 73 patients were found to have positive blood cultures. Of those with sepsis, as defined by two or more systemic inflammatory response syndrome (SIRS) criteria, the mean and median times to administration of antimicrobials failed to meet recommendations. Similarly, those with severe sepsis or septic shock did not receive antimicrobials within guide... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442499 Fri, 25 Nov 2011 11:05:46 +0100 5442499 http://www.medworm.com/index.php?rid=5442498&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002866%2Fabstract%3Frss%3Dyes There has been a dramatic increase in the number of women diagnosed with HIV in UK. In the years up to and including 1993, females accounted for 13% of HIV diagnoses, but in 2008 that figure was 37%. This increase is due predominantly to the rise in the number of women becoming infected through heterosexual contact. We undertook a retrospective study on the female cohort of our patient population in Newcastle, UK. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442498 Fri, 25 Nov 2011 11:05:46 +0100 5442498 http://www.medworm.com/index.php?rid=5442497&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002854%2Fabstract%3Frss%3Dyes We present a case of IA in an atypical patient group - a patient with asthma admitted to our Intensive Care Unit with H1N1 pneumonia.We avoided steroids (this would almost certainly have resulted in her death without voriconazole), but she still got IA. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442497 Fri, 25 Nov 2011 11:05:46 +0100 5442497 http://www.medworm.com/index.php?rid=5442496&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002842%2Fabstract%3Frss%3Dyes Gentamicin is an effective antibiotic with activity against gram negative organsims. There is increasing useage in the battle against C. difficile as a result of an attempt to use fewer cephalosprins, quinolones and co - amoxiclav. Gentamicin is usually given as a once daily dose. Due to its toxicity it is essential to monitor the drug levels in the blood so as to determine the appropriate interval between doses. Guidance is avaialble on the Trust's intranet site in the antimicrobial prescribing guidelines. The Consultant Microbiologists or Antimicrobial Pharmacist can provide further advice. In order to provide advice, a minimum amount of information is required from the requestor in order to use the dosing nomogram. The minumum information includes; the dose of genatmicin administered, w... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442496 Fri, 25 Nov 2011 11:05:46 +0100 5442496 http://www.medworm.com/index.php?rid=5442495&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002830%2Fabstract%3Frss%3Dyes An otherwise well 63 year old woman with a history of insulin dependent type 2 diabetes, hypertension, stage 3 CKD and diverticulosis presented to eye clinic with a 2 day history of acute pain and redness of her right eye. She gave a history of night sweats 2 days previously and was nauseous. On examination, right visual acuity was reduced to hand movements. She was found to have an anterior uveitis and modestly raised intra-ocular pressure. A standard regime of intensive topical steroid and mydriatics was commenced. However, this produced no improvement and the patient became increasingly unwell with eye pain and vomiting leading to admission. General examination was unremarkable and re-examination of the eye demonstrated a hypopyon but excluded posterior and retinal involvement. Systemic... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442495 Fri, 25 Nov 2011 11:05:46 +0100 5442495 http://www.medworm.com/index.php?rid=5442494&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002829%2Fabstract%3Frss%3Dyes Cystic fibrosis (CF) is the most commonly inherited disease in persons originating from a white and European background and has a genetic carriage rate of 1 in 20 persons. The most common complication of CF is the recurrence of chronic chest infections usually caused by bacterial pathogens (e.g. Pseudomonas aeruginosa, Burkholderia cepacia complex and Stenotrophomonas maltophilia). It is therefore imperative that stringent disinfection measures are taken to prevent colonization of the lung with these and other organisms, both by the patient, as well as by the health care professional in conjunction with infection control guidelines. Although combinational antibiotic therapy is the cornerstone of the treatment of such infections, once the CF patienr has acquired them, high levels of resista... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442494 Fri, 25 Nov 2011 11:05:46 +0100 5442494 http://www.medworm.com/index.php?rid=5442493&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002817%2Fabstract%3Frss%3Dyes Early start of enteral feeding is an established treatment strategy in intubated patients in intensive care since it reduces invasive bacterial infections and length of hospital stay. There is equipoise whether early enteral feeding is also beneficial in non-intubated patients with cerebral malaria in resource poor settings. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442493 Fri, 25 Nov 2011 11:05:46 +0100 5442493 http://www.medworm.com/index.php?rid=5442492&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002805%2Fabstract%3Frss%3Dyes This study aimed to assess the cross contamination risk from P. acnes in dental handpieces by studying the ability of each isolate at forming biofilms in an in vitro model and to assess the efficacy of biocides used in the decontamination of handpieces at disrupting these biofilms. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442492 Fri, 25 Nov 2011 11:05:46 +0100 5442492 http://www.medworm.com/index.php?rid=5442491&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002799%2Fabstract%3Frss%3Dyes In 1992 the UK added Haemophilus influenzae serotype b (Hib) vaccine to the infant immunisation schedule (at 2, 3, 4 months), resulting in a dramatic decline in the incidence of invasive Hib disease. From 1999 there was a resurgence of invasive Hib disease in fully vaccinated children, older children and adults, which has been controlled by the introduction in 2006 of a routine booster dose of Hib vaccine at 12 months of age. We have characterised over 700 Hib strains, collected between 1987 and 2010 from UK cases of invasive disease, using multilocus variable-number tandem repeat analysis (MLVA). This enabled us to study changes in the distribution of clonal groups in the bacterial population, and of overall genetic diversity over time and between different patient groups. (Source: Journa... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442491 Fri, 25 Nov 2011 11:05:46 +0100 5442491 http://www.medworm.com/index.php?rid=5442490&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002787%2Fabstract%3Frss%3Dyes Fulvic acid is a heat stable low molecular weight, water soluble, cationic colloidal material with proposed therapeutic properties. These colloidal properties render it susceptible to contamination, so bioreactor production from plant material has enabled a stable carbohydrate from of Fulvic Acid CHD-FA). Previous studies have reported antibacterial activity, but no published studies have yet investigated it is an antifungal agent. The aim of this study was to evaluate the antifungal activity of CHD-FA against a panel of Candida albicans clinical isolates, and to evaluate the toxicological properties of this compound. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442490 Fri, 25 Nov 2011 11:05:46 +0100 5442490 http://www.medworm.com/index.php?rid=5442489&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002775%2Fabstract%3Frss%3Dyes Tumbarello et al (Predictors of Mortality in Patients with Bloodstream Infections Caused by Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae: Importance of Inadequate Initial Antimicrobial Treatment, AAC June 2007) showed higher mortality with ESBL bacteraemia where treatment is initiated with inappropriate antibiotics (60% vs. 20% approximately). Dellinger, Levy and Carlet et al state that severe sepsis causes mortality between 28-50% (Surviving Sepsis Campaign, Crit Care Med 2008). Our bacteraemia surveillance shows that ESBL producers are becoming more prevalent. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442489 Fri, 25 Nov 2011 11:05:46 +0100 5442489 http://www.medworm.com/index.php?rid=5442488&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002763%2Fabstract%3Frss%3Dyes In 2008, this provincial Teaching Hospitals Trust was identified to be poorly performing for both the monitored healthcare acquired infections (HCAI) in the UK: Clostridium difficile infection (CDI) & Meticillin Resistant Staphylococcus aureus (MRSA) bacteraemia. Antimicrobial use in elderly patients (>80 years) already avoided cefuroxime. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442488 Fri, 25 Nov 2011 11:05:46 +0100 5442488 http://www.medworm.com/index.php?rid=5442487&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002751%2Fabstract%3Frss%3Dyes The Trust was the poorest performing Teaching Hospital for two monitored healthcare associated infections (HCAI) in the UK: Clostridium difficile infection (CDI) and meticillin resistant Staphylococcus aureus (MRSA) bacteraemia. This was despite ‘CDI friendly' antimicrobial use in elderly care (>80 years). (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442487 Fri, 25 Nov 2011 11:05:46 +0100 5442487 http://www.medworm.com/index.php?rid=5442486&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100274X%2Fabstract%3Frss%3Dyes Our provincial tertiary teaching hospital trust was identified by the Department of Health as under performing on healthcare associated infections in 2008. Part of the response was to expand the antimicrobial stewardship programme. It's estimated that 50% of antimicrobials prescribed in hospitals are unnecessary. In order to improve this, a comprehensive programme to develop and maintain infection diagnosis and treatment guidelines was produced. In addition, the Trust's Medicines Policy was amended to state that all antimicrobial prescriptions must include duration or review date and the indication in the patient's notes. An update in December 2009 required inclusion of the indication on the prescription as well. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442486 Fri, 25 Nov 2011 11:05:46 +0100 5442486 http://www.medworm.com/index.php?rid=5442485&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002738%2Fabstract%3Frss%3Dyes The diagnosis of CDAD has always been a controversy with no gold standard highly sensitive and specific enough but which is also user friendly. Early diagnosis is prudent for infection control purposes to prevent cross infection and also the management of the patient. False positive and negative tests have further complicated the diagnostic tests. Various types of commercial ELISA kits are available for toxin A/B detection, but these have very varied sensitivity and specificity, the major issues were the high false negative and false positive rates. The HPA has recommended 2- step testing, without defining specific tests. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442485 Fri, 25 Nov 2011 11:05:46 +0100 5442485 http://www.medworm.com/index.php?rid=5442484&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002726%2Fabstract%3Frss%3Dyes Increasing numbers of patients with inflammatory bowel disease (IBD) are being treated with anti-Tumour Necrosis Factor (anti-TNF) agents such as infliximab and adalimumab. These monoclonal antibodies bind to TNFα, inhibiting its activity. As well as being a pro-inflammatory cytokine involved in the pathology of IBD, the primary function of TNFα is in the immune response to many bacteria and viruses. Anti-TNF agents, therefore, increase recipients' susceptibility to infections. In particular, they increase the risk of Mycobacterium tuberculosis infection (TB), by approximately five fold. Potential recipients must, therefore, be screened for both active and latentinactive tuberculosis before starting treatment. Guidelines on risk assessment and treatment of active and latent TB prior to a... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442484 Fri, 25 Nov 2011 11:05:46 +0100 5442484 http://www.medworm.com/index.php?rid=5442483&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002714%2Fabstract%3Frss%3Dyes As part of a multidisciplinary approach to optimise the management of Clostridium difficile associated diarrhoea (CDAD), various measures have been undertaken, including the introduction of an isolation unit, revision of antimicrobial policies, vigilance of the infection and prevention and control team, improved ward hygiene, and a Trust-wide educational programme. In addition to these, nutritional support was felt to be vital in our assessment and management of patients with CDAD. Addressing nutritional status and encouraging the use of prebiotics was thought to be a useful adjuvant therapy in the treatment of CDAD. Therefore a simple algorithm of nutritional management was developed for this purpose; this combined the current evidence and guidelines for nutritional support. (Source: Jour... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442483 Fri, 25 Nov 2011 11:05:46 +0100 5442483 http://www.medworm.com/index.php?rid=5442482&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002702%2Fabstract%3Frss%3Dyes Antibiotic stewardship ward rounds are recommended by the Infectious Diseases Society of America as an effective intervention to encourage prudent prescribing of antibiotics in hospitals. Stewardship ward rounds have been operating in our 1000-bed teaching hospital since the year 2000 and involve a multi-disciplinary team of medical microbiologists and antibiotic pharmacists, a paediatric infectious diseases physician and a specialist nurse for surgical site infection. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442482 Fri, 25 Nov 2011 11:05:46 +0100 5442482 http://www.medworm.com/index.php?rid=5442481&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002696%2Fabstract%3Frss%3Dyes (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442481 Fri, 25 Nov 2011 11:05:46 +0100 5442481 http://www.medworm.com/index.php?rid=5442480&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002684%2Fabstract%3Frss%3Dyes This study was a small-sample pilot looking at baseline knowledge amongst doctors within our teaching hospital with the intention to inform future teaching, particularly to Foundation Years 1 and 2. It is hoped that this approach can be applied more widely in future as part of a feedback mechanism for the education programme. It could also be adapted for similar purposes in other staff groups and may also contribute to ensuring progression through competency-based training or the NHS KSF process. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442480 Fri, 25 Nov 2011 11:05:46 +0100 5442480 http://www.medworm.com/index.php?rid=5442479&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002672%2Fabstract%3Frss%3Dyes We report a rare presentation of miliary tuberculosis (TB) in an HIV-negative pregnant Bangladeshi woman masquerading as acute sepsis with rapid progression to respiratory failure and acute respiratory distress syndrome (ARDS) and subsequent acute renal failure (ARF). The absence of any typical systemic prodromal symptoms, the short duration of illness and initially normal chest x-ray (CXR) with rapidly evolving radiological changes made ascertainment of the diagnosis of TB infection difficult. Aggressive investigation including liver and bone marrow biopsy lead to diagnostic confirmation, appropriate therapy, and, despite foetal loss at 22 weeks gestation, to a successful outcome. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442479 Fri, 25 Nov 2011 11:05:46 +0100 5442479 http://www.medworm.com/index.php?rid=5442478&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002660%2Fabstract%3Frss%3Dyes Introduction Optimal blood culture (BC) collection strategies to reduce contamination rates are a recognised target of all hospitals. In 2007 the Department of Health published a summary of best practice for taking blood cultures. Several authors have reported success in reducing blood culture contamination rates by the introduction of specialist phlebotomy or blood culture teams. Within our Trust, phlebotomists have been trained in blood culture collection, but this service is currently only available during routine twice-daily ward visits on weekdays. This audit is a preliminary analysis of blood cultures submitted by phlebotomy staff to clinically assess the impact of introducing this partial service. Full analysis of contamination rates of BCs taken by phlebotomists against a backgrou... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442478 Fri, 25 Nov 2011 11:05:46 +0100 5442478 http://www.medworm.com/index.php?rid=5442477&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002659%2Fabstract%3Frss%3Dyes A severely immunocompromised Zimbabwean man with advanced HIV disease diagnosed 10 years previously presented with a three week history of sore throat, dysphagia, right ear discharge and fever. He was not on anti-retroviral treatment at the time, having been previously unable to comply with numerous Highly Active Anti-Retroviral Therapy (HAART) regimens, and had a CD4 count of 5 cells/ml and HIV viral load of 946,106 copies/ml. His other active HIV related problems included recurrent peri-anal herpes, HIV dermopathy and recurrent folliculitis, chronic suppurative otitis media, co-infection with Hepatitis B, renal dysfunction, peripheral neuropathy and impotence. His most recent travel had been to Zimbabwe five years earlier. On examination he had a temperature of 38oC, a tender, enlarged r... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442477 Fri, 25 Nov 2011 11:05:46 +0100 5442477 http://www.medworm.com/index.php?rid=5442476&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002647%2Fabstract%3Frss%3Dyes On 11 June 2009 WHO declared a global pandemic of influenza A (H1N1), and designated the virus "pandemic influenza A (H1N1) 2009 virus". Over its course, according to WHO the virus "killed more than 18,000 people around the world and sparked mass vaccination programs". Our aim was to review suspected influenza A (H1N1) admissions to a Regional Infectious Diseases Unit during the pandemic of 2009-10. A retrospective review of case records was conducted of adult patients admitted to the Infection Unit at Aberdeen Royal Infirmary with suspected H1N1 between 01/07/09-20/01/10. Data on demographics, body weight, co-morbidities, H1N1+ve/-ve and outcome was collected over 8 weeks. Notes not available during this time were excluded. Categorical data was analysed using Chi-square analysis. 148 of 2... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442476 Fri, 25 Nov 2011 11:05:46 +0100 5442476 http://www.medworm.com/index.php?rid=5442475&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002635%2Fabstract%3Frss%3Dyes Environmental bacterial contamination is associated with the incidence of local healthcare associated infection rates. Such rates are responsive to environmental decontamination interventions. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442475 Fri, 25 Nov 2011 11:05:46 +0100 5442475 http://www.medworm.com/index.php?rid=5442474&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002623%2Fabstract%3Frss%3Dyes Clostridium difficile infection (CDI) is the leading cause of nosocomial diarrhoea. Although there has been a reduction in the total number of cases reported to the Health protection Agency (HPA) in England and Northern Ireland between 2007/8 and 2009/10, it remains a major cause of mortality and morbidity. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442474 Fri, 25 Nov 2011 11:05:46 +0100 5442474 http://www.medworm.com/index.php?rid=5442473&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002611%2Fabstract%3Frss%3Dyes Prosthetic Joint infection (PJI) complicates around 1% of all joint replacements per year. The most commonly implicated aetiological organisms are Gram positive, with coagulase negative staphylococci predominating. Management usually involves debridement or removal of prosthesis combined with insertion of antimicrobial cement or prolonged systemic antibiotics. Gram negative bacilli are an uncommon cause of prosthetic joint infection and are of particular concern given the increasing prevalence of antimicrobial resistance and the attendant risks of prolonged broad-spectrum antibacterials in an elderly patient group. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442473 Fri, 25 Nov 2011 11:05:46 +0100 5442473 http://www.medworm.com/index.php?rid=5442472&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100260X%2Fabstract%3Frss%3Dyes This report set out perinatal recommendations aimed to improve diagnosis and management of HIV in pregnancy to further reduce mother-to-child transmission rates, and ultimately reduce childhood incidence of HIV infection. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442472 Fri, 25 Nov 2011 11:05:46 +0100 5442472 http://www.medworm.com/index.php?rid=5442471&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002593%2Fabstract%3Frss%3Dyes For many years, antibiotic prophylaxis was given routinely to those with congenital or acquired valvular heart disease undergoing invasive procedures such as endoscopy. The evidence base for such prophylaxis was weak and antibiotic use is associated with increased cost, a risk of adverse drug reactions and may drive the development of antimicrobial resistance. As a result, national guidelines gradually reduced the clinical circumstances in which prophylaxis was recommended. In March 2008, the National Institute for Health and Clinical Excellence (NICE) took this further and published Clinical Guideline 64, recommending against antibiotic prophylaxis for dental work or endoscopic procedures unless the procedure involves an infected site or the patient elects to receive prophylaxis after a f... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442471 Fri, 25 Nov 2011 11:05:46 +0100 5442471 http://www.medworm.com/index.php?rid=5442470&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002581%2Fabstract%3Frss%3Dyes Infection is a common cause of morbidity and mortality in oncology patients. The most important risk factor is neutropenia secondary to cytotoxic chemotherapy, although other treatment associated risk factors such as surgery, radiotherapy and use of invasive devices, as well as tumour associated risk factors are important. This immunocompromised group of patients are predisposed to severe, rapidly progressive infections often without development of concurrent inflammation. This, in conjunction with the constantly changing epidemiology of microorganisms, means it is crucial to ensure that locally appropriate empirical antibiotic therapy guidelines are in place. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442470 Fri, 25 Nov 2011 11:05:46 +0100 5442470 http://www.medworm.com/index.php?rid=5442469&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100257X%2Fabstract%3Frss%3Dyes In one of the tuberculosis clinics within Heart of England foundation trust we see about 600 patients in one year. A large proportion of these patients are born outside of the UK, many in places with significant prevalence of viral hepatitis and HIV. We decided to screen all patients for one year. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442469 Fri, 25 Nov 2011 11:05:46 +0100 5442469 http://www.medworm.com/index.php?rid=5442468&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002568%2Fabstract%3Frss%3Dyes Few data currently exist relating to appropriate assessment and management of skin and soft tissue infection (SSTI). A recent Cochrane review was unable to define best treatment for cellulitis and underlined the need for trials to evaluate efficacy of oral antibiotics against intravenous antibiotics in the community setting. Out-patient Home Antibiotic Therapy (OPHAT) is increasingly used for SSTI with high patient satisfaction scores and can markedly reduce hospital in-patient burden. However, it is unclear as to which patients are most appropriate for in or out patient overall management. Furthermore, in many regions, including ours, poor links exist between community and hospital which could improve assessment, management and follow up. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442468 Fri, 25 Nov 2011 11:05:46 +0100 5442468 http://www.medworm.com/index.php?rid=5442467&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002556%2Fabstract%3Frss%3Dyes Blood cultures represent important laboratory investigations in diagnosing bacteraemia, thus guiding clinicians to appropriate antimicrobial therapy. Contamination through poor technique may lead to incorrect diagnosis, unnecessary and costly treatment, and prolonged hospital admission. This was recognised in Department of Health (DOH) guidelines published in 2007. An audit across our trust between April 2005-2007 showed blood culture contamination rates were 0.08. The aim of this study was to assess whether contamination rates had been reduced following implementation of new trust guidelines in 2007. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442467 Fri, 25 Nov 2011 11:05:46 +0100 5442467 http://www.medworm.com/index.php?rid=5442466&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002544%2Fabstract%3Frss%3Dyes Background: Locally formulated antibiotic guidance, taking into account current resistance profiles of key pathogens, is fundamental to prudent prescribing. However there is uncertainty about how this guidance is best presented and whether this has any impact on uptake by its target audience. A survey was conducted among the microbiologists and antibiotic pharmacists (providers) and junior doctors (users) to assess attitudes about their current local guidance. Providers were asked about main mode of presentation, perceived blocks to its uptake and desirable features of future upgrades. Users were asked how easy it was to access and use the guidance and how often they used it, whether they had received any induction on it and if they felt they had adequate background knowledge of microbiolo... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442466 Fri, 25 Nov 2011 11:05:46 +0100 5442466 http://www.medworm.com/index.php?rid=5442465&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002532%2Fabstract%3Frss%3Dyes Clostridium difficile infection (CDI) can be a severe and debilitating illness. Established risk factors include the use of broad spectrum antibiotics, being elderly, anti-ulcer medication, the presence of a naso-gastric tube and long duration of hospital stay. The trust has in place an algorithm for the treatment of CDI. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442465 Fri, 25 Nov 2011 11:05:46 +0100 5442465 http://www.medworm.com/index.php?rid=5442464&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002520%2Fabstract%3Frss%3Dyes This study aims to assess whether these findings apply to a UK district general hospital. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442464 Fri, 25 Nov 2011 11:05:46 +0100 5442464 http://www.medworm.com/index.php?rid=5442463&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002519%2Fabstract%3Frss%3Dyes This study investigated the management of patients diagnosed with epididymo-orchitis over a five year period in a district general hospital. The results were contrasted with the recently published 2010 British Association for Sexual Health and HIV Guidelines. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442463 Fri, 25 Nov 2011 11:05:46 +0100 5442463 http://www.medworm.com/index.php?rid=5442462&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002507%2Fabstract%3Frss%3Dyes Clostridium difficile infection (CDI) is a severe nosocomial enteric infection which is associated with healthcare provision and exposure to antibiotics. Rates of CDI increased sharply in the UK from 2002 reaching a peak in 2007. Despite the introduction of rigorous infection control procedures, the rates of CDI at County Durham and Darlington Foundation Trust (CDDFT) failed to fall. There is evidence that quinolone and cephalosporin antibiotics have a high association with CDI1,2,3. As part of an antibiotic stewardship programme a strict policy of quinolone and cephalosporin restriction was introduced at CDDFT in 2008/9. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442462 Fri, 25 Nov 2011 11:05:46 +0100 5442462 http://www.medworm.com/index.php?rid=5442461&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002490%2Fabstract%3Frss%3Dyes Clostridium difficile infection (CDI) is the most common infectious cause of nosocomial diarrhoea. The consequences of CDI are of great importance to both the individual and the healthcare institution, with a 10-fold increase in mortality, prolonged length of stay and potential ward closures. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442461 Fri, 25 Nov 2011 11:05:46 +0100 5442461 http://www.medworm.com/index.php?rid=5442460&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002489%2Fabstract%3Frss%3Dyes Clostridium difficile infection (CDI) is a severe nosocomial infection which is associated with healthcare provision and exposure to antibiotics. Rates of CDI increased sharply in the UK from 2002 reaching a peak in 2007. National guidance on managing CDI was first published in 1994 with further updates in 2000 and 2008. Since 2006 health care providers in the United Kingdom have been set targets to reduce CDI rates. Despite rigorous infection control practices, the rates of CDI at County Durham and Darlington Foundation Trust (CDDFT) failed to fall in line with national rates and as a result the Trust was placed in escalation by the Health Care Commission with 6 months to resolve the situation. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442460 Fri, 25 Nov 2011 11:05:46 +0100 5442460 http://www.medworm.com/index.php?rid=5442459&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002477%2Fabstract%3Frss%3Dyes Staphlococcus aureus bloodstream infection (BSI) is associated with complications including endocarditis and metastatic and recurrent infection, and carries a mortality of 20-40%. Risk factors for the development of complicated infections include community-acquisition of infection, skin findings suggestive of acute systemic infection, persistent fever at 72 hours, and a positive repeat blood culture at 48-96 hours. Patients with, or at risk of developing complications should received appropriate intravenous antibiotics for at least 4 weeks. A subset of patients with good prognostic features may be treated with intravenous antibiotics for only 2 weeks with a low risk of complications. In our Trust, treatment with appropriate intravenous therapy is recommended for a minimum of 2-4 weeks. (So... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442459 Fri, 25 Nov 2011 11:05:46 +0100 5442459 http://www.medworm.com/index.php?rid=5442458&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002465%2Fabstract%3Frss%3Dyes This study employed multiple combined strategies and it was not clear which of these were the main contributors to the reductions. A mathematical model was developed and validated against this field data. This model was used to analyse the results of the trial in detail. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442458 Fri, 25 Nov 2011 11:05:46 +0100 5442458 http://www.medworm.com/index.php?rid=5442457&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002453%2Fabstract%3Frss%3Dyes Chronic Granulomatous Disease (CGD) is a rare genetically heterogeneous primary immunodeficiency affecting intracellular killing by phagocytes, leading to recurrent and persistent bacterial and fungal infections with formation of granulomata. A range of defects in the NADPH oxidative enzyme complex have been identified. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442457 Fri, 25 Nov 2011 11:05:46 +0100 5442457 http://www.medworm.com/index.php?rid=5442456&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002441%2Fabstract%3Frss%3Dyes We report three cases in which voriconazole was used as consolidation or maintenance therapy in the setting of an elevated fluconazole MIC. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442456 Fri, 25 Nov 2011 11:05:46 +0100 5442456 http://www.medworm.com/index.php?rid=5442455&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100243X%2Fabstract%3Frss%3Dyes This study sought to determine whether the same principles of process management were useful in environmental air monitoring of high risk healthcare units. Results of air sampling at several sites within the paediatric haematology/oncology/BMT unit (in addition to external sites within the hospital grounds) collected over a 2 year period were used to produce SPC charts. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442455 Fri, 25 Nov 2011 11:05:46 +0100 5442455 http://www.medworm.com/index.php?rid=5442454&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002428%2Fabstract%3Frss%3Dyes The aim of highly-active antiretroviral therapy (HAART) is to suppress HIV-1 viral load (VL) to undetectable levels. All patients on HAART should have a VL measured at regular intervals in order to monitor the success of therapy. In October 2006 the Newcastle Health Protection Agency (HPA) laboratory replaced the Roche COBAS HIV-1 Ampliprep Amplicor Monitor (CAP/CA) assay with the more-sensitive Roche COBAS Ampliprep Taqman HIV-1 (CAP/CTM1) assay. Both locally and internationally the introduction of the CAP/CTM1 assay was associated with a significant unexplained increase in the detection of low level HIV-1 viraemia (VL 50 to 1000 copies/ml). (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442454 Fri, 25 Nov 2011 11:05:46 +0100 5442454 http://www.medworm.com/index.php?rid=5442453&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002416%2Fabstract%3Frss%3Dyes Out-patient parenteral antimicrobial therapy (OPAT) is appealing because it reduces hospitalisation, lowers healthcare costs and limits nosocomial infection. Models of OPAT delivery include hospital clinic-based infusion, self-administration, or home-infusion services. OPAT has been used to manage serious infections such as infective endocarditis (IE) for several years. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442453 Fri, 25 Nov 2011 11:05:46 +0100 5442453 http://www.medworm.com/index.php?rid=5442452&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002404%2Fabstract%3Frss%3Dyes World-wide distribution of chronic viral hepatitis B (HBV) and non-haematobium schistosomiasis overlap, affecting sub-Saharan Africa, South America and South-east Asia disproportionately. These two infections individually can lead to liver fibrosis and cirrhosis. Conflicting evidence exists to suggest that co-infection can increase the rate of progression of liver disease. We had noticed that some young patients with co-infection had presented with severe liver cirrhosis or even hepatocellular carcinoma. A retrospective review of 3 groups of infected patients was carried out obtaining results from case notes, a HBV database and schistosomiasis database. The three groups were: patients with schistosomiasis/HBV co-infection, chronic HBV mono-infection and schistosomiasis mono-infection. We c... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442452 Fri, 25 Nov 2011 11:05:46 +0100 5442452 http://www.medworm.com/index.php?rid=5442451&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002398%2Fabstract%3Frss%3Dyes The recent pandemic of 2009 H1N1 influenza lead to higher rates of severe infection (including hospitalisation and death) in those with chronic illness and immunocompromise including HIV. A strain specific vaccine was introduced in the UK in October 2009. The Department of Health (DoH) issued guidelines to GPs on the correct use of seasonal and pandemic H1N1 vaccine in HIV infected individuals, however uptake was anecdotally poor. We aimed to quantify uptake within our HIV cohort using questionnaires during the pandemic. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442451 Fri, 25 Nov 2011 11:05:46 +0100 5442451 http://www.medworm.com/index.php?rid=5442450&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002386%2Fabstract%3Frss%3Dyes Cryptococcus neoformans is a fungus that can cause invasive disease. The majority of cryptococcal infections in immunocompromised patients present in HIV-positive individuals, often as cryptococcal meningitis. Cases of cryptococcal meningitis in non-HIV infected patients are much rarer and can occur in patients who have had organ transplants, patients who are on immunosuppressive agents, or patients with diabetes, cirrhosis, nephrotic syndrome, malignancies, and autoimmune disease. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442450 Fri, 25 Nov 2011 11:05:46 +0100 5442450 http://www.medworm.com/index.php?rid=5442449&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002374%2Fabstract%3Frss%3Dyes A collaborative community arts project supported by a Wellcome Trust small arts award is reported. In a context of family learning, parents and children were introduced to concepts of microscopy, microbes and normal microbial flora. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442449 Fri, 25 Nov 2011 11:05:46 +0100 5442449 http://www.medworm.com/index.php?rid=5442448&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002362%2Fabstract%3Frss%3Dyes A 60-year-old man presented with a history of tingling, numbness and weakness of left upper and lower limbs for a week's duration. He had been diagnosed with Eosinphilic fasciitis 9 months earlier and was receiving immunosuppressive therapy consisting of Prednisolone, Azathioprine Hydroxychloroquine and Cimetidine. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442448 Fri, 25 Nov 2011 11:05:46 +0100 5442448 http://www.medworm.com/index.php?rid=5442447&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002350%2Fabstract%3Frss%3Dyes In the absence of vaccination, Haemophilus Influenza Type B is the commonest cause of bacterial meningitis in children worldwide. Rates of invasive HiB in the UK have fallen dramatically since the introduction of vaccination programmes. Consequently, it is something that is rarely seen by paediatricians but remains a threat amongst vulnerable populations, as is demonstrated in this case. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442447 Fri, 25 Nov 2011 11:05:46 +0100 5442447 http://www.medworm.com/index.php?rid=5442446&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002349%2Fabstract%3Frss%3Dyes Rapid screening for MRSA colonisation is now common place in many hospitals and has been shown to significantly reduce the incidence of nosocomial MRSA acquisition. Currently The Royal Free Hampstead NHS Trust uses the BD GeneOhm™ assay to screen high risk patient groups (ITU patients, hospital transfers and contacts of known positive patients). This assay, which amplifies a single target region from the SCCmec region, has a positive predictive value of 85.4%1 and the amplification platform (SmartCycler, Cepheid) is limited to testing 16 samples per unit. We currently test approximately 40 samples per day and this is likely to increase in the future. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442446 Fri, 25 Nov 2011 11:05:46 +0100 5442446 http://www.medworm.com/index.php?rid=5442445&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002337%2Fabstract%3Frss%3Dyes Background: Malignant otitis externa is a serious infection affecting the external auditory canal & the temporal bone. It is an uncommon complication of both acute & chronic otitis externa. Ear polyps can be a cause or consequence of malignant otitis externa. Delay in diagnosis can lead to serious complications. Prolonged parenteral antibiotics are required and inadequate treatment courses may result in disease progression. Only minimal published information is available on OPAT (Outpatient Parenteral Antimicrobial Therapy) in the management of malignant otitis externa. Here we present a case series of malignant otitis externa managed in our department. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442445 Fri, 25 Nov 2011 11:05:46 +0100 5442445 http://www.medworm.com/index.php?rid=5442444&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002325%2Fabstract%3Frss%3Dyes Outpatient Parenteral Antibiotic Therapy (OPAT) allows outpatient/community-based administration of intravenous (IV) antibiotics as an alternative to inpatient care. Therapy may be administered by a nurse, or alternatively patients (or a carer) may be trained to self-administer; the latter option allows greater flexibility for patients, and facilitates administration of multiple daily doses. Patient-administered OPAT has been shown to be as safe as nurse-administered therapy in large studies, but to date there has been no formal assessment of individual patient/carer retention of training in antibiotic administration over a prolonged treatment course. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442444 Fri, 25 Nov 2011 11:05:46 +0100 5442444 http://www.medworm.com/index.php?rid=5442443&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002313%2Fabstract%3Frss%3Dyes The risk of invasive aspergillosis (IA) in patients with haematological malignancies and following organ transplantation is well characterised; IA is a recognised complication of prolonged high dose corticosteroid therapy, cytotoxic therapy and severe neutropenia. However, new groups at risk of IA with minimal or no immunosuppression continue to emerge; critically-ill patients and post surgical patients are among this group. The important risk factors in these patients are less well defined. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442443 Fri, 25 Nov 2011 11:05:46 +0100 5442443 http://www.medworm.com/index.php?rid=5442442&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002301%2Fabstract%3Frss%3Dyes The number of solid organ transplants in the UK has increased significantly over the last decade. In 2008-2009 over 1,500 renal transplants were performed. Long term immunosuppression can lead to infection from opportunistic and unusual fungal infections which may be difficult to treat. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442442 Fri, 25 Nov 2011 11:05:46 +0100 5442442 http://www.medworm.com/index.php?rid=5442441&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002295%2Fabstract%3Frss%3Dyes Nocardia is a genus of aerobic actinomycetes found ubiquitously in soil and aquatic habitats. It is a branching filamentous Gram positive bacillus. The taxonomy of Nocardia spp. has been revised using molecular techniques. Notably former members of the "Nocardia asteroides complex" have been determined as separate species. N. asteroides drug pattern type VI is now named as N. cyriacigeorgica, a common pathogen in southern United States, Europe and Asia. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442441 Fri, 25 Nov 2011 11:05:46 +0100 5442441 http://www.medworm.com/index.php?rid=5442440&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002283%2Fabstract%3Frss%3Dyes Hospital clinics for Hepatitis C experience very high non-attendance rates among injecting drug users (IDUs), with figures as high as 70% at North Manchester General Hospital. This carries serious financial and public health implications. The aims of this project were to identify the reasons why IDUs do not attend their first appointments for Hepatitis C and to use this information to implement service changes to improve attendance rates. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442440 Fri, 25 Nov 2011 11:05:46 +0100 5442440 http://www.medworm.com/index.php?rid=5442439&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002271%2Fabstract%3Frss%3Dyes This study investigated the presentation, management and outcome of tuberculosis treated in an Infectious Diseases Unit in a large inner city teaching hospital between 2008-9. The Department of Infection and tropical Medicine in Leicester is situated in the University Hospitals of Leicester NHS Trust, a 2000-bed teaching hospital. The City of Leicester has a population of 295,000, of which approximately 40% are from an ethnic minority group, the largest population (28%) being Gujarati Indians. The Incidence of Mycobacterium tuberculosis (TB) in the UK is reported as 14.9/100,000 with a 5% increase of provisionally reported case between 2008-9. In Leicester city the incidence of tuberculosis is 72/100,000 and 250-300 TB cases are provisionally reported each year in the Leicestershire county... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442439 Fri, 25 Nov 2011 11:05:46 +0100 5442439 http://www.medworm.com/index.php?rid=5442438&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100226X%2Fabstract%3Frss%3Dyes In a busy hospital serving a large Asian population, we studied the causes of cervical lymphadenopathy in different ethnic groups. We used information from the pathology and microbiology laboratory and tuberculosis notifications to establish a list of patients who had presented with a neck lymph node during 2009. Using hospital records, we recorded the ethnic group and the likely diagnosis. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442438 Fri, 25 Nov 2011 11:05:46 +0100 5442438 http://www.medworm.com/index.php?rid=5442437&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002258%2Fabstract%3Frss%3Dyes We present a patient with an atypical presentation of Fusobacterium infection, the genus responsible for Lemierre syndrome. The history, presentation, investigations and management of the patient are described and then contrasted with the existing literature surrounding Lemierre syndrome, once termed the "forgotten disease". (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442437 Fri, 25 Nov 2011 11:05:46 +0100 5442437 http://www.medworm.com/index.php?rid=5442436&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002246%2Fabstract%3Frss%3Dyes Clostridium Difficile is a common bacteria carried by 8% population. In CDAD (Clostridium Difficile Associated Disease) symptoms arise as a result of disruption of the microflora in the bowel. The primary methods for this include use of antibiotics, and faeco-oral contamination. Both these methods serve to favour proliferation of Clostridium Difficile. Symptoms include diarrhoea, circulatory collapse, pseudomembranous colitis and toxic megacolon, all in turn potentially leading to septicaemia and perforation. A review of CDAD mortality in Midstaffordshire NHS Trust in 2008 identified measures for improvement of the management of CDAD. In January 2009 new antimicrobial guidelines and environmental hygiene changes were introduced. In March 2009 a new treatment protocol for managing CDAD wa... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442436 Fri, 25 Nov 2011 11:05:46 +0100 5442436 http://www.medworm.com/index.php?rid=5442435&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002234%2Fabstract%3Frss%3Dyes Evidence is accumulating as to the importance of Clostridium difficile Infection (CDI) as a problem in the community as well as the hospital setting. An investigation of the variation in stool sample submissions by all General Practices within Tayside, Scotland during the course of one calendar year was carried out. This would help to assess how complete a picture of community CDI is provided when relying on laboratory identified cases of CDI. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442435 Fri, 25 Nov 2011 11:05:46 +0100 5442435 http://www.medworm.com/index.php?rid=5442434&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002222%2Fabstract%3Frss%3Dyes One of the most common infections seen in primary care today is a urinary tract infection (UTI) caused by the bacterium Escherichia coli. E. coli-positive UTIs have evolved highly specialised mechanisms of resistance to most of the antibiotics commonly used as treatment. One resistance mechanism causing particular concern is the production of extended-spectrum β-lactamases (ESBLs), enzymes that enable E. coli to become resistant to third-generation cephalosporins. As bacteria continue to evolve specialised resistance adaptations, GPs are slowly being forced to prescribe more powerful antibiotics to treat common UTIs, creating an environment where multi-resistant bacteria can thrive. It seems the longer we continue to misuse and overuse antibiotics, the more likely it is that future genera... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442434 Fri, 25 Nov 2011 11:05:46 +0100 5442434 http://www.medworm.com/index.php?rid=5442433&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002210%2Fabstract%3Frss%3Dyes An estimated 200,000 people are chronically infected with Hepatitis C virus (HCV) in the UK. Therapy with Pegylated Interferon/Ribavarin can result in cure, but University Hospitals Leicester (UHL) has historically treated small numbers. From 2004-2005, only 24 patients were treated. Significant measures have been taken to investigate reasons for this and to improve rates of referral, numbers treated and treatment outcomes, in accordance with NICE and international guidelines. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442433 Fri, 25 Nov 2011 11:05:46 +0100 5442433 http://www.medworm.com/index.php?rid=5442432&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002209%2Fabstract%3Frss%3Dyes Multidisciplinary teams (MDT) bring together health-care professionals to plan the management of complex clinical problems. They now form the cornerstone of cancer services in almost every discipline, with clear survival benefits. However, their use in the management of other conditions is not well reported. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442432 Fri, 25 Nov 2011 11:05:46 +0100 5442432 http://www.medworm.com/index.php?rid=5442431&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002192%2Fabstract%3Frss%3Dyes The epidemiology of Clostridium difficile infection (CDI) in Lanarkshire has changed dramatically in recent years. A rising incidence of CDI during the 1990s and early 21st century has begun to decline. Patient populations, previously considered at less risk of CDI than hospitalized patients, have been noted to have an appreciable incidence of CDI such as the elderly in community settings. We assessed 48 episodes of non outbreak related CDI relating to 45 patients living in Lanarkshire in primary care from July to November 2008. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442431 Fri, 25 Nov 2011 11:05:46 +0100 5442431 http://www.medworm.com/index.php?rid=5442430&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002180%2Fabstract%3Frss%3Dyes Enteric fever is an important cause of morbidity in the returning traveller to the UK, with an incidence of approximately 500 cases per year in England and Wales. Most infections are acquired in the Indian Sub-continent where quinolone resistance is common in both Salmonella typhi (70%) and S. paratyphi (96%). (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442430 Fri, 25 Nov 2011 11:05:46 +0100 5442430 http://www.medworm.com/index.php?rid=5442429&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002179%2Fabstract%3Frss%3Dyes (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442429 Fri, 25 Nov 2011 11:05:46 +0100 5442429 http://www.medworm.com/index.php?rid=5442428&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002167%2Fabstract%3Frss%3Dyes Candida species have emerged as significant pathogens causing blood stream infections over the last 10 years, with a mortality rate of approximately 40%. There is also increasing antifungal resistance in the azole class of antifungals among some species of Candida. The identification and sensitivity testing of yeasts has traditionally been labour intensive and slow to yield results. More rapid testing has been desirable to assist in rationalising empirical prescribing of antifungals and prompt initiation of therapy for proven invasive candidiasis. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442428 Fri, 25 Nov 2011 11:05:46 +0100 5442428 http://www.medworm.com/index.php?rid=5442427&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002155%2Fabstract%3Frss%3Dyes The British HIV Association (BHIVA) Guidelines from 2008 recommends which clinical indicator diseases, and at risk populations, should prompt HIV testing. These include several common reasons for hospital admission such as bacterial pneumonia and aseptic meningitis, along with AIDS-defining illnesses such as Tuberculosis. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442427 Fri, 25 Nov 2011 11:05:46 +0100 5442427 http://www.medworm.com/index.php?rid=5442426&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002143%2Fabstract%3Frss%3Dyes An update to the British Thoracic Society (BTS) national guideline for the management of community-acquired pneumonia (CAP) was published in 2009. The BTS guideline recommends preferred treatment with amoxicillin for low severity CAP, a beta-lactam (amoxicillin or benzylpenicillin) with clarithromycin for moderate severity CAP and co-amoxiclav with clarithromycin for severe CAP. The BTS made a standard data collection template available to UK hospitals to audit adherence to selected elements of the CAP guideline. First-line empirical antibiotic treatment recommendations for CAP in our 1,000-bed university hospital differ from those of the BTS guideline in an effort to mitigate the risk of Clostridium difficile superinfection. This non-randomised prospective observational study was carried ... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442426 Fri, 25 Nov 2011 11:05:46 +0100 5442426 http://www.medworm.com/index.php?rid=5442425&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002131%2Fabstract%3Frss%3Dyes The prevention, diagnosis and management of Clostridium difficile infection (CDI) continues to present a challenge for healthcare organizations across the country. Improvements in infection prevention and control measures and antibiotic stewardship as well as mandatory reporting of the number of Clostridium difficile cases to HPA has led to significant reductions in the number of CDI cases. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442425 Fri, 25 Nov 2011 11:05:46 +0100 5442425 http://www.medworm.com/index.php?rid=5442424&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100212X%2Fabstract%3Frss%3Dyes The Scottish Antimicrobial Prescribing Group (SAPG) is a national multi-disciplinary clinical forum formed by the Scottish Government and hosted by the Scottish Medicines Consortium to implement the recommendations of Scottish Management of Antimicrobial Resistance Action Plan (ScotMARAP). SAPG directs national improvement initiatives via a network of NHS Board Antimicrobial Management Teams (AMTs). (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442424 Fri, 25 Nov 2011 11:05:46 +0100 5442424 http://www.medworm.com/index.php?rid=5442423&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002118%2Fabstract%3Frss%3Dyes Prolonged hospital stay due to health care associated infection (HAI) may further increase hospital associated morbidity, including malnutrition, depression and secondary HAIs as well as increasing health care costs. HAI costs may be substantial, previously estimated at 0.5 million excess bed days and an additional £183 million per year in Scottish hospitals. We previously retrospectively identified 110 adults with MRSA Skin and soft tissue infections (SSTIs) who completed IV therapy (69% Vancomycin) as inpatients (IP) in Glasgow hospitals over 16 months. Mean length of stay was 16 days and earlier hospital discharge (via OPAT or oral switch therapy) was considered possible for the 37 patients who survived, received IV therapy for ≥72 hours and who discontinued therapy within 72 hours p... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442423 Fri, 25 Nov 2011 11:05:46 +0100 5442423 http://www.medworm.com/index.php?rid=5442422&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002106%2Fabstract%3Frss%3Dyes We describe a sixth case of K. shroeteri endocarditis but the first case to be treated successfully with daptomycin. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442422 Fri, 25 Nov 2011 11:05:46 +0100 5442422 http://www.medworm.com/index.php?rid=5442421&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100209X%2Fabstract%3Frss%3Dyes Candidaemia is associated with significant morbidity and mortality. Identification of Candida to species level is useful in predicting antifungal susceptibility patterns. In addition, antifungal MIC determination for individual isolates from blood cultures provides further therapeutic guidance. Continued local surveillance should detect any significant change in the prevalence of candidaemia, species distribution and antifungal susceptibilities. At this institution annual reviews of invasive fungal infection are performed. The following larger scale survey reviewed episodes over a 6 year period to provide comparative annual data and to provide a long-term epidemiological assessment of this infection. Laboratory records were examined for all cases of candidaemia from the beginning of 2004 t... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442421 Fri, 25 Nov 2011 11:05:46 +0100 5442421 http://www.medworm.com/index.php?rid=5442420&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002088%2Fabstract%3Frss%3Dyes Prudent antimicrobial prescribing is fundamental to reducing antimicrobial resistance, preventing the development of hospital acquired infections, preventing adverse effects related to antimicrobials and reducing antimicrobial costs. In May 2009, antimicrobial ward rounds consisting of an infectious disease (ID) consultant and an antimicrobial pharmacist were commenced in 2 hospitals within NHS Greater Glasgow and Clyde: Gartnavel General Hospital and the Western Infirmary. The ward rounds aim to promote prudent antimicrobial prescribing, promote adherence to the Greater Glasgow and Clyde Infection Management Guidelines whilst also providing support and advice to prescribers, nurses and pharmacists. The antimicrobial ward rounds were started in two hospital sites; twice weekly on one site ... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442420 Fri, 25 Nov 2011 11:05:46 +0100 5442420 http://www.medworm.com/index.php?rid=5442419&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002076%2Fabstract%3Frss%3Dyes (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442419 Fri, 25 Nov 2011 11:05:46 +0100 5442419 http://www.medworm.com/index.php?rid=5442418&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002064%2Fabstract%3Frss%3Dyes Background - Staphylococcus aureus (SA) is well known as a leading cause of human disease and nosocomial infections. In the United Kingdom around 12500 SA bacteraemia (SAB) cases occur each year of which approximately 30% die and around 50% suffer complicated infection. The emergence of meticillin-resistant SA (MRSA) still represents a major infection control problem and the appearance of some community-acquired strains (caMRSA) and healthcare associated meticillin sensitive SA (MSSA) are of great concern. In addition approximately two thirds of MSSA bacteraemias are healthcare associated, predominantly relating to central venous catheters or surgical site infection. Thus, understanding the epidemiology of all SA is an invaluable infection control tool. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442418 Fri, 25 Nov 2011 11:05:46 +0100 5442418 http://www.medworm.com/index.php?rid=5442417&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002052%2Fabstract%3Frss%3Dyes Almost a third of the world's population is estimated to have been infected with the hepatitis B virus and 350 million have chronic infection. Chronic HBV is higher in those born in high-endemicity countries, many of whom will have acquired infection at birth or in early childhood. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442417 Fri, 25 Nov 2011 11:05:46 +0100 5442417 http://www.medworm.com/index.php?rid=5442416&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002040%2Fabstract%3Frss%3Dyes We present the data from the first 2.5 years of DAP use for the treatment of osteoarticular infections in the UK since marketing authorisation in January 2006. Data from eight participating UK institutions were collected on patient demographics, antibiotic usage, microbiological and clinical outcomes and adverse events from January 2006 until August 2009. All received at least one dose of DAP. Outcomes were assessed by investigators as cured, improved, failure and non-evaluable. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442416 Fri, 25 Nov 2011 11:05:46 +0100 5442416 http://www.medworm.com/index.php?rid=5442415&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002039%2Fabstract%3Frss%3Dyes We present the data from the first 2.5 years of DAP use for the treatment of cSSTIs in the UK since marketing authorisation in January 2006. These data were taken from 11 UK institutions participating in EU-CORESM. Data were collected on patient demographics, antibiotic usage, microbiological and clinical outcomes and adverse events between January 2006 and August 2009. Patients (pts) were categorised by severity (complicated and uncomplicated) and the anatomical site of the primary infection. All had received at least one dose of DAP. Outcomes were assessed by investigators as cured, improved, failure and non-evaluable. All adverse events were recorded. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442415 Fri, 25 Nov 2011 11:05:46 +0100 5442415 http://www.medworm.com/index.php?rid=5442414&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002027%2Fabstract%3Frss%3Dyes Background: In neonates, early signs and symptoms of sepsis are non specific leading to low threshold for initiating empirical antibiotics. However, antibiotic usage may lead to development of multi-resistant organisms and increased costs. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442414 Fri, 25 Nov 2011 11:05:46 +0100 5442414 http://www.medworm.com/index.php?rid=5442413&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002015%2Fabstract%3Frss%3Dyes (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442413 Fri, 25 Nov 2011 11:05:46 +0100 5442413 http://www.medworm.com/index.php?rid=5442412&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311002003%2Fabstract%3Frss%3Dyes Background: Deficiency of 1,25-Hydroxyvitamin D3 (Vitamin D3) is common in the context of HIV-1 infection but its relationship to CD4 T-cell count has been controversial. A prior prospective local study had identified 29.5% of HIV- seropositive individuals as having Vitamin D3 deficiency (defined as mild-severe deficiency per local guidelines). We assessed the relationship betweenVitamin D3 levels and its relation with CD4 T-cell count in a cohort of HIV-positive individuals. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442412 Fri, 25 Nov 2011 11:05:46 +0100 5442412 http://www.medworm.com/index.php?rid=5442411&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100199X%2Fabstract%3Frss%3Dyes Clostridium difficile is an anaerobic, spore-forming Gram positive bacterium, found in health in the stools of 66% of infants and 2% of adults. It is also an important cause of hospital associated infection, causing a spectrum of disease from mild to severe diarrhoea with complications such as pseudomembranous colitis, toxic megacolon and subsequent perforation which can lead to death. The diagnosis of Clostridium difficile infection (CDI) therefore relies upon clinical features and laboratory testing. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442411 Fri, 25 Nov 2011 11:05:46 +0100 5442411 http://www.medworm.com/index.php?rid=5442410&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001988%2Fabstract%3Frss%3Dyes Background: There is a requirement to screen all elective admissions for MRSA, with the introduction of non-elective screening by 2011. The Royal Free Hospital adopted a policy of screening all admissions from April 2009. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442410 Fri, 25 Nov 2011 11:05:46 +0100 5442410 http://www.medworm.com/index.php?rid=5442409&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001976%2Fabstract%3Frss%3Dyes Neonates admitted to NICU often require insertion of a central venous or arterial line. Central venous lines (umbilical venous lines, PICC lines and broviac lines) allow for administration of high osmolarity fluids, in addition to various drug infusions, parental nutrition and emergency drug administration in neonates. All removed central line tips were sent for culture as part of routine practice to the Royal Victoria Hospital Microbiology Department. We conducted an audit in 2009, looking at whether central line tip cultures influenced the treatment and management of the neonates concerned. We repeated this audit in 2010 following recommendations from the 2009 audit, that central line tips should not be sent for routine culture in well neonates. However the line tip should be cultured in... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442409 Fri, 25 Nov 2011 11:05:46 +0100 5442409 http://www.medworm.com/index.php?rid=5442408&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001964%2Fabstract%3Frss%3Dyes N.Gonorrhoeae is a gram negative intracellular diplococcus. In the GUM department it is detected by microscopy and/or culture after a sexual history and examination with relevant swab taking. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442408 Fri, 25 Nov 2011 11:05:46 +0100 5442408 http://www.medworm.com/index.php?rid=5442407&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001952%2Fabstract%3Frss%3Dyes A proportion of neonates in the neonatal intensive care unit (NICU) are intubated for respiratory support. All neonates extubated from mechanical ventilation had the tip of their endotracheal (ET) tube cultured for bacterial organisms at the Royal Victoria Hospital Microbiology Department. We conducted an audit in 2009 (audit 1), looking at whether ET tip cultures influenced the treatment of the neonate and whether culture results led to further investigations of sepsis. We repeated this audit in 2010 (audit 2) following the recommendation from the 2009 audit that ET tips should not be sent routinely unless sepsis or pneumonia was suspected. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442407 Fri, 25 Nov 2011 11:05:46 +0100 5442407 http://www.medworm.com/index.php?rid=5442406&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001940%2Fabstract%3Frss%3Dyes Transrectal ultrasound guided (TRUS) biopsy of the prostate is used routinely in the diagnosis of cancer of the prostate. Although antimicrobial prophylaxis (ciprofloxacin in this institution) is used routinely there is a recognized risk of blood stream infection (BSI) following biopsy. A number of reports have documented antimicrobial resistant bacteria including extended spectrum beta-lactamase (ESBL) producers in this setting. Recently standard practice has changed from performance of 6 biopsies per patient to 12 biopsies although this number of biopsies may not be taken in all cases. Prompted by the presentation of a number of cases of BSI post TRUS biopsy in the first half of 2010 we performed a retrospective review of cases for the first 8 months of 2010 and developed a process for p... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442406 Fri, 25 Nov 2011 11:05:46 +0100 5442406 http://www.medworm.com/index.php?rid=5442405&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001939%2Fabstract%3Frss%3Dyes On 11th June 2009 the World Health Organisation declared a pandemic of Influenza A(H1N1)v, a unique strain of Influenza A, containing genetic components from swine, avian and human sources. Concerns were expressed that this virus would stretch the National Health Service to breaking point and cause significant fatalities. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442405 Fri, 25 Nov 2011 11:05:46 +0100 5442405 http://www.medworm.com/index.php?rid=5442404&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001927%2Fabstract%3Frss%3Dyes A 29 year old lady with a background of epilepsy and tuberculosis recently returned from Pakistan and presented with a four day history of odynophagia and sore throat. She was febrile, tachycardic and hypotensive and oropharyngeal examination demonstrated the presence of bilateral tonsillar swelling with pseudomembranes. A widespread purpuric rash was noted with facial blisters, and given that sodium valproate had been started within the past 3 weeks, an initial diagnosis of Toxic Epidermal Necrolysis (TEN) was made and the patient commenced on steroids and subsequently immunoglobulins. The patient deteriorated rapidly requiring intubation and cardiovascular support on the intensive care unit.The possibility of diphtheria was raised on the microbiology ward round and it was subsequently co... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442404 Fri, 25 Nov 2011 11:05:46 +0100 5442404 http://www.medworm.com/index.php?rid=5442403&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001915%2Fabstract%3Frss%3Dyes This study investigates how different microbiology and infection prevention departments have introduced the recommended MRSA screening programme and whether a regionally applied screening protocol would be beneficial. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442403 Fri, 25 Nov 2011 11:05:46 +0100 5442403 http://www.medworm.com/index.php?rid=5442402&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001903%2Fabstract%3Frss%3Dyes In 2008 a review carried out from February to July, 57 ESBLs were isolated. We decided to change method which can identify Amp C β -lactamase as well as ESBL producing bacteria. So we adopted the five disc diffusion method on a single plate, in the last quarter of 2008. A review done over a period of one year from 1st July 2009 to 20th June 2010 showed that the number of resistant gram negative isolates increased many fold. Type of specimen, location where samples was collected, type of organisms, age of the patient and clinical outcome was recorded. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442402 Fri, 25 Nov 2011 11:05:46 +0100 5442402 http://www.medworm.com/index.php?rid=5442401&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001897%2Fabstract%3Frss%3Dyes We have gathered data on spending on biomedical research from various sources, including the National Research Register (NRR, a now-archived Department of Health-owned database), the MRC, Wellcome Trust, BBSRC and various charities. We identified the infection-related studies, and categorised them into a number of key areas (e.g. respiratory, sexually-transmitted, healthcare-associated, HIV, primary care, bacteriology, virology etc). Checks were made to ensure consistency in application of studies to categories. Data collected also includes amount of funding awarded, institution of research (subsequently categorised into UK regions) and start year of study. Thus we can examine trends of who funds specific areas of research, time-trends (by start year), and which regions received the money.... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442401 Fri, 25 Nov 2011 11:05:46 +0100 5442401 http://www.medworm.com/index.php?rid=5442400&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001885%2Fabstract%3Frss%3Dyes The prevalence of reduced bone mineral density (BMD) and probably also fracture incidence are increased in HIV-positive individuals compared to HIV-negative controls. There are many potential explanations for this - an increased prevalence of established osteoporotic risk factors in HIV-positive individuals, a likely direct effect of HIV infection itself and a contributory role of antiretroviral therapy. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442400 Fri, 25 Nov 2011 11:05:46 +0100 5442400 http://www.medworm.com/index.php?rid=5442399&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001873%2Fabstract%3Frss%3Dyes Extended Spectrum Beta-Lactamases (ESBL) and AmpC Beta-Lactamase (AmpC) producing coliforms are increasing in number, especially among the urine isolates, reducing the possible oral options available for treatment. Currently all new isolates have a full Vitek2® identification and sensitivity to ascertain their resistance pattern and also a 5 disc diffusion method for identification of their resistance mechanism. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442399 Fri, 25 Nov 2011 11:05:46 +0100 5442399 http://www.medworm.com/index.php?rid=5442398&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001861%2Fabstract%3Frss%3Dyes In this study, we investigated the local epidemiology in the ICU of Aberdeen Royal Infirmary by characterizing 53 MRSA isolates collected from patients between 2003-2007, using MLST, PFGE, spa-typing and antibiotic susceptibility typing. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442398 Fri, 25 Nov 2011 11:05:46 +0100 5442398 http://www.medworm.com/index.php?rid=5442397&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100185X%2Fabstract%3Frss%3Dyes We describe the evaluation of a novel internally controlled real-time PCR, targeting the ß-tubulin gene for the diagnosis of PCP in induced sputum or broncheoalveolar lavage fluid. Also, in response to an outbreak of PCP cases in renal transplant patients at the Royal Liverpool University Hospital, genotypic sequencing (two gene fragments) of real-time PCR positive samples was undertaken. To determine the epidemiology, cases were compared with non-renal transplant controls. Both methods were adapted for testing of environmental (air and hard surface) sampling for P. jirovecii to investigate a common infection source. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442397 Fri, 25 Nov 2011 11:05:46 +0100 5442397 http://www.medworm.com/index.php?rid=5442396&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001848%2Fabstract%3Frss%3Dyes A prospective cohort study was set up to investigate a possible association between antibiotic prescribing and antibiotic resistance of E.coli urinary tract infection in the community. A direct link between prescribing and resistance was analysed by searching the records for previous prescription of antibiotics for patients with a suspected urinary tract infection. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442396 Fri, 25 Nov 2011 11:05:45 +0100 5442396 http://www.medworm.com/index.php?rid=5442395&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001836%2Fabstract%3Frss%3Dyes Plasmids are key elements in the horizontal transfer of genes that code for virulence and antimicrobial resistance. Plasmid profile analysis is also useful for epidemiological investigations. A variety of methods have been described for the isolation of plasmid DNA. One of the most commonly used methods, the alkaline lysis (AL) method was developed by Birnholm and Doly in 1979. AL relies on the manipulation of pH to selectively precipitate chromosomal DNA and other high molecular weight cell components resulting in a suspension of plasmid DNA which can be precipitated by isopropanol. The S1 nuclease pulsed field gel electrophoresis (S1PFGE) method was first described by Barton et al. in 1995. This method is based on the ability of S1 nuclease to convert plasmid DNA to linear forms which ca... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442395 Fri, 25 Nov 2011 11:05:45 +0100 5442395 http://www.medworm.com/index.php?rid=5442394&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001824%2Fabstract%3Frss%3Dyes We present the data from the first 2.5 years of DAP use for the treatment of endocarditis in the UK since marketing authorisation in January 2006. These data were taken from eight UK institutions participating in EU-CORESM. Data were collected on demographics, antibiotic usage, microbiological and clinical outcomes and adverse events from pts treated between January 2006 and August 2009. Patients (pts) were categorised by severity and the anatomical site of the primary infection. All pts included in the registry had received at least one dose of DAP. Outcomes were assessed by investigators as cured, improved, failure and non-evaluable. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442394 Fri, 25 Nov 2011 11:05:45 +0100 5442394 http://www.medworm.com/index.php?rid=5442393&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001812%2Fabstract%3Frss%3Dyes Between December 2009 and May 2010 there was an outbreak of C. difficile on the vascular ward at University Hospital of Coventry & Warwickshire, affecting 11 patients. As part of a multi-disciplinary action plan, it was recognised that the use of antibiotics within this clinical area needed to be investigated. This prompted the production of a new antibiotic guideline2 that should be used to guide the treatment of infections in adult patients at high risk of C.difficile disease within relevant clinical areas. It was recognised that it would be of value to audit compliance with both the updated2 and original1 guidelines in these areas. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442393 Fri, 25 Nov 2011 11:05:45 +0100 5442393 http://www.medworm.com/index.php?rid=5442392&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001800%2Fabstract%3Frss%3Dyes The frequency of methicillin-resistant Staphylococcus aureus (MRSA) infections has been reduced in the UK thanks to the presence of effective screening and control programmes. Screening programmes are becoming more common in hospitals worldwide, and it is now mandatory for all elective patients and accident and emergency admissions in England and Wales to be screened, in order to reduce the likelihood of infection. Screening also helps to prevent the unnecessary or inappropriate use of antibiotics, reducing the spread and emergence of resistant organisms. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442392 Fri, 25 Nov 2011 11:05:45 +0100 5442392 http://www.medworm.com/index.php?rid=5442391&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001794%2Fabstract%3Frss%3Dyes Here we present a case of Staphylococcus aureus bacteraemia in an elderly man with lumbar back pain. The initial working diagnosis was lumbar discitis, but this diagnosis was revised after imaging of the spine revealed no focus of infection. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442391 Fri, 25 Nov 2011 11:05:45 +0100 5442391 http://www.medworm.com/index.php?rid=5442390&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001782%2Fabstract%3Frss%3Dyes Between April 2009 and May 2010 four cases of multi-drug resistant (MDR) Pseudomonas aerosinosa (PA) bacteraemia had been identified within a teaching hospital on the south-east coast of England. All four cases were in patients with underlying haematological malignancies being treated for neutropenic sepsis. With an unexpectedly high incidence and similar patient characteristics we undertook a retrospective causational analysis. A common feature found in all four bacteraemic patients was that they had each spent a significant proportion of their admission prior to bacteraemia in the same side-room on the haematology ward. The room was a single side-room with wet-room style en-suite. With concerns regarding an environmental outbreak source in a ward of immunocompromised patients immediate i... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442390 Fri, 25 Nov 2011 11:05:45 +0100 5442390 http://www.medworm.com/index.php?rid=5442389&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001770%2Fabstract%3Frss%3Dyes The clinical implications of isolation of MRSA from screening specimens, or those taken for diagnosis of infection, are not always clear. In particular, the proportion of patients from which MRSA is isolated who will go on to develop infection, or the proportion who require specific anti-MRSA therapy is unknown. We performed a prospective cohort study of all patients who, on admission, were known to be colonised/infected with MRSA, or those who became colonised/infected during their hospital stay to establish their risks of infection. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442389 Fri, 25 Nov 2011 11:05:45 +0100 5442389 http://www.medworm.com/index.php?rid=5442388&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001769%2Fabstract%3Frss%3Dyes International migrants to the United Kingdom have higher rates of infections such as tuberculosis (TB), HIV and chronic viral hepatitis compared to the indigenous population. In the UK, there is no national screening strategy for infections other than TB. The current process for TB screening occurs either through the Port of Entry or at induction centres. However, many people do not pass through either of these channels, and rapid dispersal of asylum seekers and refugees can prevent appropriate follow up. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442388 Fri, 25 Nov 2011 11:05:45 +0100 5442388 http://www.medworm.com/index.php?rid=5442387&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001757%2Fabstract%3Frss%3Dyes In 2007, as part of a strategy to reduce the risk of Clostridium difficile infection (CDI) within the community and hospital setting, high-risk antibiotics (notably cephalosporins and quinolones) were removed from both primary and secondary care prescribing guidelines for all but a small number of clinical indications. The guidelines were then re-launched, and actively promoted through GP surgery and hospital training sessions, ongoing medical microbiology and infectious disease physician advice, hospital and community pharmaceutical advisors, and laboratory reporting practice. Compliance with prescribing guidance was audited through monitoring the consumption of quinolone and cephalosprin antibiotics, whilst hospital and community infection control teams recorded the incidence of CDI as p... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442387 Fri, 25 Nov 2011 11:05:45 +0100 5442387 http://www.medworm.com/index.php?rid=5442386&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001745%2Fabstract%3Frss%3Dyes As part of the MRSA Screening National Rollout in Scotland, NHS Boards were asked about their procedure for taking nasal MRSA swabs. It was found that some obtained their specimens using dry swabs while others used pre-moistened swabs. At present there is much debate regarding the correct procedure for obtaining a nasal swab, in particular, whether the use of a pre-moistened swab improves pickup efficiency over a dry swab. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442386 Fri, 25 Nov 2011 11:05:45 +0100 5442386 http://www.medworm.com/index.php?rid=5442385&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001733%2Fabstract%3Frss%3Dyes Since the discovery and exploitation of antibiotic agents in the 20th century, the targeted selective toxicity of such agents has ensured their widespread and largely effective use to combat infection, however it has paradoxically resulted in the emergence and dissemination of multi drug resistant pathogens. Antimicrobial resistance in both medicine and agriculture is now recognized by the World Health Organisation (WHO), along with other various national authorities, as a major emerging problem of public health importance. It represents a significant challenge of global dimensions to human and veterinary medicine with the prospect of therapeutic failure for life-saving treatments now a reality. In order to minimise the potential development of further antimicrobial resistance "The Copenha... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442385 Fri, 25 Nov 2011 11:05:45 +0100 5442385 http://www.medworm.com/index.php?rid=5442384&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001721%2Fabstract%3Frss%3Dyes We present the data from the first 2.5 years of daptomycin use for the treatment of bacteraemia in the UK. These data were taken from nine UK institutions participating in EU-CORESM. Data were collected on patient demographics, antibiotic usage, microbiological and clinical outcomes and adverse events from pts treated with DAP between January 2006 and August 2009. All pts included in the registry had received at least one dose of DAP. Outcomes were assessed by investigators as cured, improved, failure and non-evaluable. All adverse events were recorded regardless of study drug relationship. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442384 Fri, 25 Nov 2011 11:05:45 +0100 5442384 http://www.medworm.com/index.php?rid=5442383&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS016344531100171X%2Fabstract%3Frss%3Dyes We present the data from the first 2.5 years of daptomycin use for the treatment of Gram-positive infections in the UK since marketing authorisation in January 2006. These data were taken from all UK institutions (13) participating in the EU-CORESM. Data were collected on patient demographics, antibiotic usage, microbiological and clinical outcomes and adverse events from pts treated with DAP between January 2006 and August 2009. Patients (pts) with single or multiple infections were categorised by type of infection. Pts were grouped as follows: endocarditis, osteomyelitis, bacteraemia, other [foreign body, septic arthritis, pyelonephritis/UTI, necrotising fasciitis], cSSTI, uncomplicated skin and soft tissue infection [uSSTI]). All pts included in the registry had received at least one do... Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442383 Fri, 25 Nov 2011 11:05:45 +0100 5442383 http://www.medworm.com/index.php?rid=5442382&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001708%2Fabstract%3Frss%3Dyes Blood cultures (BCs) are key in directing antibiotic therapy, often affecting the sickest patients in hospital. Staphylococci are the most common organism seen in Gram stain. Data from University Hospital Coventry and Warwick, June-August 2008, showed roughly 80% of these are contaminants. At the time of phoning the clinician to discuss an unwell patient, it can be difficult to differentiate a contaminant, a possible methicillin sensitive Staphylococcus aureus(MSSA) or methicillin resistant Staphylococcus aureus(MRSA). (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442382 Fri, 25 Nov 2011 11:05:45 +0100 5442382 http://www.medworm.com/index.php?rid=5442381&cid=s_38514_20_f&fid=38514&url=http%3A%2F%2Fwww.journalofinfection.com%2Farticle%2FPIIS0163445311001691%2Fabstract%3Frss%3Dyes Candidemia is among the leading causes of nosocomial bloodstream infections and is associated with significant mortality. Candida albicans is the commonest isolate and is uniformly sensitive to Fluconazole which is often the choice for initial empiric therapy. Candida glabrata, though numerically less common, may show reduced susceptibility to azoles including fluconazole. (Source: Journal of Infection) Journal of Infection journals http://www.medworm.com/rss/comments.php?id=5442381 Fri, 25 Nov 2011 11:05:45 +0100 5442381