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Innate immunity to Aspergillus species.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
All humans are continuously exposed to inhaled Aspergillus conidia, yet healthy hosts clear the organism without developing disease and without the development of antibody- or cell-mediated acquired immunity to this organism. This suggests that for most healthy humans, innate immunity is sufficient to clear the organism. A failure of these defenses results in a uniquely diverse set of illnesses caused by Aspergillus species, which includes diseases caused by the colonization of the respiratory tract, invasive infection, and hypersensitivity. A key concept in immune responses to Aspergillus species is that the susceptib...
Source: Clinical Microbiology Reviews - September 30, 2009 Category: Microbiology Authors: Park SJ, Mehrad B Tags: Clin Microbiol Rev Source Type: journals

Modern uses of electron microscopy for detection of viruses.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Electron microscopy, considered by some to be an old technique, is still on the forefront of both clinical viral diagnoses and viral ultrastructure and pathogenesis studies. In the diagnostic setting, it is particularly valuable in the surveillance of emerging diseases and potential bioterrorism viruses. In the research arena, modalities such as immunoelectron microscopy, cryo-electron microscopy, and electron tomography have demonstrated how viral structural components fit together, attach to cells, assimilate during replication, and associate with the cellular machinery during replication and egression. These studies...
Source: Clinical Microbiology Reviews - September 30, 2009 Category: Microbiology Authors: Goldsmith CS, Miller SE Tags: Clin Microbiol Rev Source Type: journals

Dengue virus pathogenesis: an integrated view.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Much remains to be learned about the pathogenesis of the different manifestations of dengue virus (DENV) infections in humans. They may range from subclinical infection to dengue fever, dengue hemorrhagic fever (DHF), and eventually dengue shock syndrome (DSS). As both cell tropism and tissue tropism of DENV are considered major determinants in the pathogenesis of dengue, there is a critical need for adequate tropism assays, animal models, and human autopsy data. More than 50 years of research on dengue has resulted in a host of literature, which strongly suggests that the pathogenesis of DHF and DSS involves viral vir...
Source: Clinical Microbiology Reviews - September 30, 2009 Category: Microbiology Authors: Martina BE, Koraka P, Osterhaus AD Tags: Clin Microbiol Rev Source Type: journals

Antibacterial-resistant Pseudomonas aeruginosa: clinical impact and complex regulation of chromosomally encoded resistance mechanisms.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Treatment of infectious diseases becomes more challenging with each passing year. This is especially true for infections caused by the opportunistic pathogen Pseudomonas aeruginosa, with its ability to rapidly develop resistance to multiple classes of antibiotics. Although the import of resistance mechanisms on mobile genetic elements is always a concern, the most difficult challenge we face with P. aeruginosa is its ability to rapidly develop resistance during the course of treating an infection. The chromosomally encoded AmpC cephalosporinase, the outer membrane porin OprD, and the multidrug efflux pumps are particul...
Source: Clinical Microbiology Reviews - September 30, 2009 Category: Microbiology Authors: Lister PD, Wolter DJ, Hanson ND Tags: Clin Microbiol Rev Source Type: journals

Basic concepts of microarrays and potential applications in clinical microbiology.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The introduction of in vitro nucleic acid amplification techniques, led by real-time PCR, into the clinical microbiology laboratory has transformed the laboratory detection of viruses and select bacterial pathogens. However, the progression of the molecular diagnostic revolution currently relies on the ability to efficiently and accurately offer multiplex detection and characterization for a variety of infectious disease pathogens. Microarray analysis has the capability to offer robust multiplex detection but has just started to enter the diagnostic microbiology laboratory. Multiple microarray platforms exist, includin...
Source: Clinical Microbiology Reviews - September 30, 2009 Category: Microbiology Authors: Miller MB, Tang YW Tags: Clin Microbiol Rev Source Type: journals

Clinical significance of enteric protozoa in the immunosuppressed human population.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Globally, the number of immunosuppressed people increases each year, with the human immunodeficiency virus (HIV) pandemic continuing to spread unabated in many parts of the world. Immunosuppression may also occur in malnourished persons, patients undergoing chemotherapy for malignancy, and those receiving immunosuppressive therapy. Components of the immune system can be functionally or genetically abnormal as a result of acquired (e.g., caused by HIV infection, lymphoma, or high-dose steroids or other immunosuppressive medications) or congenital illnesses, with more than 120 congenital immunodeficiencies described to d...
Source: Clinical Microbiology Reviews - September 30, 2009 Category: Microbiology Authors: Stark D, Barratt JL, van Hal S, Marriott D, Harkness J, Ellis JT Tags: Clin Microbiol Rev Source Type: journals

Immune restoration diseases reflect diverse immunopathological mechanisms.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Up to one in four patients infected with human immunodeficiency virus type 1 and given antiretroviral therapy (ART) experiences inflammatory or cellular proliferative disease associated with a preexisting opportunistic infection, which may be subclinical. These immune restoration diseases (IRD) appear to result from the restoration of immunocompetence. IRD associated with intracellular pathogens are characterized by cellular immune responses and/or granulomatous inflammation. Mycobacterial and cryptococcal IRD are attributed to a pathological overproduction of Th1 cytokines. Clinicopathological characteristics of IRD a...
Source: Clinical Microbiology Reviews - September 30, 2009 Category: Microbiology Authors: Price P, Murdoch DM, Agarwal U, Lewin SR, Elliott JH, French MA Tags: Clin Microbiol Rev Source Type: journals

Plasmid-mediated quinolone resistance: a multifaceted threat.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although plasmid-mediated quinolone resistance (PMQR) was thought not to exist before its discovery in 1998, the past decade has seen an explosion of research characterizing this phenomenon. The best-described form of PMQR is determined by the qnr group of genes. These genes, likely originating in aquatic organisms, code for pentapeptide repeat proteins. These proteins reduce susceptibility to quinolones by protecting the complex of DNA and DNA gyrase or topoisomerase IV enzymes from the inhibitory effect of quinolones. Two additional PMQR mechanisms were recently described. aac(6')-Ib-cr encodes a variant aminoglycosi...
Source: Clinical Microbiology Reviews - September 30, 2009 Category: Microbiology Authors: Strahilevitz J, Jacoby GA, Hooper DC, Robicsek A Tags: Clin Microbiol Rev Source Type: journals

Delusional infestation.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This papers aims at familiarizing psychiatric and nonpsychiatric readers with delusional infestation (DI), also known as delusional parasitosis. It is characterized by the fixed belief of being infested with pathogens against all medical evidence. DI is no single disorder but can occur as a delusional disorder of the somatic type (primary DI) or secondary to numerous other conditions. A set of minimal diagnostic criteria and a classification are provided. Patients with DI pose a truly interdisciplinary problem to the medical system. They avoid psychiatrists and consult dermatologists, microbiologists, or general practi...
Source: Clinical Microbiology Reviews - September 30, 2009 Category: Microbiology Authors: Freudenmann RW, Lepping P Tags: Clin Microbiol Rev Source Type: journals

Antibiotic Treatment of Animals Infected with Borrelia burgdorferi.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: Despite resolution of the objective manifestations of Lyme disease after antibiotic treatment, a minority of patients have fatigue, musculoskeletal pain, and/or difficulties with concentration or short-term memory of uncertain etiology; these are called post-Lyme disease symptoms or, in more severe cases, post-Lyme disease syndrome or "chronic Lyme disease." Several recent studies in which Borrelia burgdorferi-infected animals were treated with antibiotic therapy have demonstrated the presence of PCR positivity for B. burgdorferi DNA in the absence of culture positivity. In mice that were treated with antibiot...
Source: Clinical Microbiology Reviews - June 30, 2009 Category: Microbiology Authors: Wormser GP, Schwartz I Tags: Clin Microbiol Rev Source Type: journals

Pathogenesis, diagnosis, and management of primary antibody deficiencies and infections.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: Primary antibody deficiencies are the most common primary immunodeficiency diseases. They are a heterogeneous group of disorders with various degrees of dysfunctional antibody production resulting from a disruption of B-cell differentiation at different stages. While there has been tremendous recent progress in the understanding of some of these disorders, the etiology remains unknown for the majority of patients. As there is a large spectrum of underlying defects, the age at presentation varies widely, and the clinical manifestations range from an almost complete absence of B cells and serum immunoglobulins t...
Source: Clinical Microbiology Reviews - June 30, 2009 Category: Microbiology Authors: Fried AJ, Bonilla FA Tags: Clin Microbiol Rev Source Type: journals

North American Paragonimiasis (Caused by Paragonimus kellicotti) in the Context of Global Paragonimiasis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: Paragonimus species are highly evolved parasites with a complex life cycle that involves at least three different hosts, i.e., snails, crustaceans, and mammals. The adult forms of Paragonimus species reside and mate in the lungs of a variety of permissive mammalian hosts, including humans. Although human paragonimiasis is uncommonly encountered in North America, both autochthonous and imported disease may be encountered. Paragonimus kellicotti, the species endemic to North America, is a well-known pathogen in wild and domestic animals. Five patients with North American paragonimiasis have been reported in the ...
Source: Clinical Microbiology Reviews - June 30, 2009 Category: Microbiology Authors: Procop GW Tags: Clin Microbiol Rev Source Type: journals

Pathogenesis of Aspergillus fumigatus in Invasive Aspergillosis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: Aspergillus species are globally ubiquitous saprophytes found in a variety of ecological niches. Almost 200 species of aspergilli have been identified, less than 20 of which are known to cause human disease. Among them, Aspergillus fumigatus is the most prevalent and is largely responsible for the increased incidence of invasive aspergillosis (IA) in the immunocompromised patient population. IA is a devastating illness, with mortality rates in some patient groups reaching as high as 90%. Studies identifying and assessing the roles of specific factors of A. fumigatus that contribute to the pathogenesis of IA ha...
Source: Clinical Microbiology Reviews - June 30, 2009 Category: Microbiology Authors: Dagenais TR, Keller NP Tags: Clin Microbiol Rev Source Type: journals

Food-borne trematodiases.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: An estimated 750 million people are at risk of infections with food-borne trematodes, which comprise liver flukes (Clonorchis sinensis, Fasciola gigantica, Fasciola hepatica, Opisthorchis felineus, and Opisthorchis viverrini), lung flukes (Paragonimus spp.), and intestinal flukes (e.g., Echinostoma spp., Fasciolopsis buski, and the heterophyids). Food-borne trematodiases pose a significant public health and economic problem, yet these diseases are often neglected. In this review, we summarize the taxonomy, morphology, and life cycle of food-borne trematodes. Estimates of the at-risk population and number of in...
Source: Clinical Microbiology Reviews - June 30, 2009 Category: Microbiology Authors: Keiser J, Utzinger J Tags: Clin Microbiol Rev Source Type: journals

Gnathostomiasis, another emerging imported disease.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Gnathostomiasis is a food-borne zoonosis caused by the late-third stage larvae of Gnathostoma spp. It is being seen with increasing frequency in countries where it is not endemic and should be regarded as another emerging imported disease. Previously, its foci of endemicity have been confined to Southeast Asia and Central and South America, but its geographical boundaries appear to be increasing, with recent reports of infection in tourists returning from southern Africa. It has a complex life cycle involving at least two intermediate hosts, with humans being accidental hosts in which the larvae cannot reach sexual mat...
Source: Clinical Microbiology Reviews - June 30, 2009 Category: Microbiology Authors: Herman JS, Chiodini PL Tags: Clin Microbiol Rev Source Type: journals

Advances and failures in preventing perinatal human immunodeficiency virus infection.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: An estimated 2.5 million children are currently living with HIV, the vast majority as a result of mother-to-child transmission. Prevention of perinatal HIV infection has been immensely successful in developed countries. A comprehensive package of services, including maternal and infant antiretroviral therapy, elective cesarean section, and avoidance of breast-feeding, has resulted in transmission rates of less than 2%. However, in developing countries, access to such services is often not available, as demonstrated by the fact that the vast majority of children with HIV live in Africa. Over the past few years,...
Source: Clinical Microbiology Reviews - June 30, 2009 Category: Microbiology Authors: Buchanan AM, Cunningham CK Tags: Clin Microbiol Rev Source Type: journals

Resistance to Therapies for Infection by Plasmodium vivax.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The gravity of the threat posed by vivax malaria to public health has been poorly appreciated. The widely held misperception of Plasmodium vivax as being relatively infrequent, benign, and easily treated explains its nearly complete neglect across the range of biological and clinical research. Recent evidence suggests a far higher and more-severe disease burden imposed by increasingly drug-resistant parasites. The two frontline therapies against vivax malaria, chloroquine and primaquine, may be failing. Despite 60 years of nearly continuous use of these drugs, their respective mechanisms of activity, resistance, and to...
Source: Clinical Microbiology Reviews - June 30, 2009 Category: Microbiology Authors: Baird JK Tags: Clin Microbiol Rev Source Type: journals

Emergence of the severe syndrome and mortality associated with dengue and dengue-like illness: historical records (1890 to 1950) and their compatibility with current hypotheses on the shift of disease manifestation.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Outbreaks of the severe dengue syndrome, dengue hemorrhagic fever (DHF), emerged beginning in the 1950s, marking a dramatic change in the dengue syndrome. While intense investigations in multiple directions have been conducted for many years to elucidate the intrinsic mechanisms conducive to the development of DHF, no consensus has yet emerged. Meanwhile, relatively little attention has been paid to the occurrence of severe dengue and death prior to the 1950s. This comprehensive review was designed to evaluate outbreak records in the early dengue history to better understand the epidemiologic background and other facto...
Source: Clinical Microbiology Reviews - April 1, 2009 Category: Microbiology Authors: Kuno G Tags: Clin Microbiol Rev Source Type: journals

Gastric helicobacters in domestic animals and nonhuman primates and their significance for human health.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Helicobacters other than Helicobacter pylori have been associated with gastritis, gastric ulcers, and gastric mucosa-associated lymphoid tissue lymphoma in humans. These very fastidious microorganisms with a typical large spiral-shaped morphology were provisionally designated "H. heilmannii," but in fact they comprise at least five different Helicobacter species, all of which are known to colonize the gastric mucosa of animals. H. suis, which has been isolated from the stomachs of pigs, is the most prevalent gastric non-H. pylori Helicobacter species in humans. Other gastric non-H. pylori helicobacters colonizing the h...
Source: Clinical Microbiology Reviews - April 1, 2009 Category: Microbiology Authors: Haesebrouck F, Pasmans F, Flahou B, Chiers K, Baele M, Meyns T, Decostere A, Ducatelle R Tags: Clin Microbiol Rev Source Type: journals

Matrix metalloproteinases as drug targets in infections caused by gram-negative bacteria and in septic shock.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The mammalian immune system is optimized to cope effectively with the constant threat of pathogens. However, when the immune system overreacts, sepsis, severe sepsis, or septic shock can develop. Despite extensive research, these conditions remain the leading cause of death in intensive care units. The matrix metalloproteinases (MMPs) constitute a family of proteases that are expressed in developmental, physiological, and pathological processes and also in response to infections. Studies using MMP inhibitors and MMP knockout mice indicate that MMPs play essential roles in infection and in the host defense against infec...
Source: Clinical Microbiology Reviews - April 1, 2009 Category: Microbiology Authors: Vanlaere I, Libert C Tags: Clin Microbiol Rev Source Type: journals

Pathogen recognition and inflammatory signaling in innate immune defenses.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The innate immune system constitutes the first line of defense against invading microbial pathogens and relies on a large family of pattern recognition receptors (PRRs), which detect distinct evolutionarily conserved structures on pathogens, termed pathogen-associated molecular patterns (PAMPs). Among the PRRs, the Toll-like receptors have been studied most extensively. Upon PAMP engagement, PRRs trigger intracellular signaling cascades ultimately culminating in the expression of a variety of proinflammatory molecules, which together orchestrate the early host response to infection, and also is a prerequisite for the s...
Source: Clinical Microbiology Reviews - April 1, 2009 Category: Microbiology Authors: Mogensen TH Tags: Clin Microbiol Rev Source Type: journals

Infectious complications associated with monoclonal antibodies and related small molecules.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Biologics are increasingly becoming part of routine disease management. As more agents are developed, the challenge of keeping track of indications and side effects is growing. While biologics represent a milestone in targeted and specific therapy, they are not without drawbacks, and the judicious use of these "magic bullets" is essential if their full potential is to be realized. Infectious complications in particular are not an uncommon side effect of therapy, whether as a direct consequence of the agent or because of the underlying disease process. With this in mind, we have reviewed and summarized the risks of infe...
Source: Clinical Microbiology Reviews - April 1, 2009 Category: Microbiology Authors: Salvana EM, Salata RA Tags: Clin Microbiol Rev Source Type: journals

Efflux-mediated antifungal drug resistance.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Fungi cause serious infections in the immunocompromised and debilitated, and the incidence of invasive mycoses has increased significantly over the last 3 decades. Slow diagnosis and the relatively few classes of antifungal drugs result in high attributable mortality for systemic fungal infections. Azole antifungals are commonly used for fungal infections, but azole resistance can be a problem for some patient groups. High-level, clinically significant azole resistance usually involves overexpression of plasma membrane efflux pumps belonging to the ATP-binding cassette (ABC) or the major facilitator superfamily class o...
Source: Clinical Microbiology Reviews - April 1, 2009 Category: Microbiology Authors: Cannon RD, Lamping E, Holmes AR, Niimi K, Baret PV, Keniya MV, Tanabe K, Niimi M, Goffeau A, Monk BC Tags: Clin Microbiol Rev Source Type: journals

Update on eosinophilic meningoencephalitis and its clinical relevance.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Eosinophilic meningoencephalitis is caused by a variety of helminthic infections. These worm-specific infections are named after the causative worm genera, the most common being angiostrongyliasis, gnathostomiasis, toxocariasis, cysticercosis, schistosomiasis, baylisascariasis, and paragonimiasis. Worm parasites enter an organism through ingestion of contaminated water or an intermediate host and can eventually affect the central nervous system (CNS). These infections are potentially serious events leading to sequelae or death, and diagnosis depends on currently limited molecular methods. Identification of parasites in...
Source: Clinical Microbiology Reviews - April 1, 2009 Category: Microbiology Authors: Graeff-Teixeira C, da Silva AC, Yoshimura K Tags: Clin Microbiol Rev Source Type: journals

Enterotoxigenic Bacteroides fragilis: a rogue among symbiotes.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Enterotoxigenic Bacteroides fragilis (ETBF) strains are strains of B. fragilis that secrete a 20-kDa heat-labile zinc-dependent metalloprotease toxin termed the B. fragilis toxin (BFT). BFT is the only recognized virulence factor specific for ETBF. ETBF strains are associated with inflammatory diarrheal disease in children older than 1 year of age and in adults; limited data suggest an association of ETBF colonization with inflammatory bowel disease flare-ups and colorectal cancer. ETBF secretes one of three highly related BFT isoforms. The relationship between BFT isoform and disease expression is unknown. Although th...
Source: Clinical Microbiology Reviews - April 1, 2009 Category: Microbiology Authors: Sears CL Tags: Clin Microbiol Rev Source Type: journals

HLA and infectious diseases.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Following their discovery in the early 1970s, classical human leukocyte antigen (HLA) loci have been the prototypical candidates for genetic susceptibility to infectious disease. Indeed, the original hypothesis for the extreme variability observed at HLA loci (H-2 in mice) was the major selective pressure from infectious diseases. Now that both the human genome and the molecular basis of innate and acquired immunity are understood in greater detail, do the classical HLA loci still stand out as major genes that determine susceptibility to infectious disease? This review looks afresh at the evidence supporting a role for...
Source: Clinical Microbiology Reviews - April 1, 2009 Category: Microbiology Authors: Blackwell JM, Jamieson SE, Burgner D Tags: Clin Microbiol Rev Source Type: journals

AmpC beta-lactamases.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
SUMMARY: AmpC beta-lactamases are clinically important cephalosporinases encoded on the chromosomes of many of the Enterobacteriaceae and a few other organisms, where they mediate resistance to cephalothin, cefazolin, cefoxitin, most penicillins, and beta-lactamase inhibitor-beta-lactam combinations. In many bacteria, AmpC enzymes are inducible and can be expressed at high levels by mutation. Overexpression confers resistance to broad-spectrum cephalosporins including cefotaxime, ceftazidime, and ceftriaxone and is a problem especially in infections due to Enterobacter aerogenes and Enterobacter cloacae, where an isola...
Source: Clinical Microbiology Reviews - January 1, 2009 Category: Microbiology Authors: Jacoby GA Tags: Clin Microbiol Rev Source Type: journals

Clinical microbiology reviews: 2009 instructions to authors.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Authors: PMID: 19136430 [PubMed - in process] (Source: Clinical Microbiology Reviews)
Source: Clinical Microbiology Reviews - January 1, 2009 Category: Microbiology Tags: Clin Microbiol Rev Source Type: journals

Acquired immunity to malaria.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Naturally acquired immunity to falciparum malaria protects millions of people routinely exposed to Plasmodium falciparum infection from severe disease and death. There is no clear concept about how this protection works. There is no general agreement about the rate of onset of acquired immunity or what constitutes the key determinants of protection; much less is there a consensus regarding the mechanism(s) of protection. This review summarizes what is understood about naturally acquired and experimentally induced immunity against malaria with the help of evolving insights provided by biotechnology and places these insi...
Source: Clinical Microbiology Reviews - January 1, 2009 Category: Microbiology Authors: Doolan DL, Dobaño C, Baird JK Tags: Clin Microbiol Rev Source Type: journals

Current issues and considerations regarding trichomoniasis and human immunodeficiency virus in african-americans.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Trichomonas vaginalis has long been recognized as one of the most prevalent sexually transmitted infections. However, it is only in recent years that it has been appreciated that Trichomonas may play a critical role in amplifying human immunodeficiency virus (HIV) transmission. Given the evidence that T. vaginalis likely promotes HIV infection, the apparent high level of Trichomonas infection in the African-American community is cause for concern. Even if T. vaginalis increases the risk of HIV transmission by a small or modest amount, it translates into a sizable population effect since Trichomonas is so common in this...
Source: Clinical Microbiology Reviews - January 1, 2009 Category: Microbiology Authors: Shafir SC, Sorvillo FJ, Smith L Tags: Clin Microbiol Rev Source Type: journals

Microbiology of Odontogenic Bacteremia: beyond Endocarditis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: The human gingival niche is a unique microbial habitat. In this habitat, biofilm organisms exist in harmony, attached to either enamel or cemental surfaces of the tooth as well as to the crevicular epithelium, subjacent to a rich vascular plexus underneath. Due to this extraordinary anatomical juxtaposition, plaque biofilm bacteria have a ready portal of ingress into the systemic circulation in both health and disease. Yet the frequency, magnitude, and etiology of bacteremias due to oral origin and the consequent end organ infections are not clear and have not recently been evaluated. In this comprehensive rev...
Source: Clinical Microbiology Reviews - January 1, 2009 Category: Microbiology Authors: Parahitiyawa NB, Jin LJ, Leung WK, Yam WC, Samaranayake LP Tags: Clin Microbiol Rev Source Type: journals

Host-microbe interactions and defense mechanisms in the development of amoebic liver abscesses.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: Amoebiasis by Entamoeba histolytica is a major public health problem in developing countries and leads to several thousand deaths per year. The parasite invades the intestine (provoking diarrhea and dysentery) and the liver, where it forms abscesses (amoebic liver abscesses [ALAs]). The liver is the organ responsible for filtering blood coming from the intestinal tract, a task that implies a particular structure and immune features. Amoebae use the portal route and break through the sinusoidal endothelial barrier to reach the hepatic parenchyma. When faced with systemic and cell-mediated defenses, trophozoites...
Source: Clinical Microbiology Reviews - January 1, 2009 Category: Microbiology Authors: Santi-Rocca J, Rigothier MC, Guillén N Tags: Clin Microbiol Rev Source Type: journals

Immunobiology of human cytomegalovirus: from bench to bedside.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: Following primary infection, human cytomegalovirus (HCMV) establishes lifelong latency and periodically reactivates without causing symptoms in healthy individuals. In the absence of an adequate host-derived immune response, this fine balance of permitting viral reactivation without causing pathogenesis is disrupted, and HCMV can subsequently cause invasive disease and an array of damaging indirect immunological effects. Over the last decade, our knowledge of the immune response to HCMV infection in healthy virus carriers and diseased individuals has allowed us to translate these findings to develop better dia...
Source: Clinical Microbiology Reviews - January 1, 2009 Category: Microbiology Authors: Crough T, Khanna R Tags: Clin Microbiol Rev Source Type: journals

Neuropathogenesis of congenital cytomegalovirus infection: disease mechanisms and prospects for intervention.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Congenital cytomegalovirus (CMV) infection is the leading infectious cause of mental retardation and hearing loss in the developed world. In recent years, there has been an improved understanding of the epidemiology, pathogenesis, and long-term disabilities associated with CMV infection. In this review, current concepts regarding the pathogenesis of neurological injury caused by CMV infections acquired by the developing fetus are summarized. The pathogenesis of CMV-induced disabilities is considered in the context of the epidemiology of CMV infection in pregnant women and newborn infants, and the clinical manifestation...
Source: Clinical Microbiology Reviews - January 1, 2009 Category: Microbiology Authors: Cheeran MC, Lokensgard JR, Schleiss MR Tags: Clin Microbiol Rev Source Type: journals

Epidemiology, diagnosis, treatment, and control of trichinellosis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: Throughout much of the world, Trichinella spp. are found to be the causative agents of human trichinellosis, a disease that not only is a public health hazard by affecting human patients but also represents an economic problem in porcine animal production and food safety. Due to the predominantly zoonotic importance of infection, the main efforts in many countries have focused on the control of Trichinella or the elimination of Trichinella from the food chain. The most important source of human infection worldwide is the domestic pig, but, e.g., in Europe, meats of horses and wild boars have played a significa...
Source: Clinical Microbiology Reviews - January 1, 2009 Category: Microbiology Authors: Gottstein B, Pozio E, Nöckler K Tags: Clin Microbiol Rev Source Type: journals

Update on the human broad tapeworm (genus diphyllobothrium), including clinical relevance.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: Tapeworms (Cestoda) continue to be an important cause of morbidity in humans worldwide. Diphyllobothriosis, a human disease caused by tapeworms of the genus Diphyllobothrium, is the most important fish-borne zoonosis caused by a cestode parasite. Up to 20 million humans are estimated to be infected worldwide. Besides humans, definitive hosts of Diphyllobothrium include piscivorous birds and mammals, which represent a significant zoonotic reservoir. The second intermediate hosts include both freshwater and marine fish, especially anadromous species such as salmonids. The zoonosis occurs most commonly in countri...
Source: Clinical Microbiology Reviews - January 1, 2009 Category: Microbiology Authors: Scholz T, Garcia HH, Kuchta R, Wicht B Tags: Clin Microbiol Rev Source Type: journals

AmpC {beta}-Lactamases.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: AmpC beta-lactamases are clinically important cephalosporinases encoded on the chromosomes of many of the Enterobacteriaceae and a few other organisms, where they mediate resistance to cephalothin, cefazolin, cefoxitin, most penicillins, and beta-lactamase inhibitor-beta-lactam combinations. In many bacteria, AmpC enzymes are inducible and can be expressed at high levels by mutation. Overexpression confers resistance to broad-spectrum cephalosporins including cefotaxime, ceftazidime, and ceftriaxone and is a problem especially in infections due to Enterobacter aerogenes and Enterobacter cloacae, where an isola...
Source: Clinical Microbiology Reviews - January 1, 2009 Category: Microbiology Authors: Jacoby GA Tags: Clin Microbiol Rev Source Type: journals

Gene therapy using adeno-associated virus vectors.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: The unique life cycle of adeno-associated virus (AAV) and its ability to infect both nondividing and dividing cells with persistent expression have made it an attractive vector. An additional attractive feature of the wild-type virus is the lack of apparent pathogenicity. Gene transfer studies using AAV have shown significant progress at the level of animal models; clinical trials have been noteworthy with respect to the safety of AAV vectors. No proven efficacy has been observed, although in some instances, there have been promising observations. In this review, topics in AAV biology are supplemented with a s...
Source: Clinical Microbiology Reviews - October 1, 2008 Category: Microbiology Authors: Daya S, Berns KI Tags: Clin Microbiol Rev Source Type: journals

Emergence and Disappearance of a Virulent Clone of Haemophilus influenzae Biogroup aegyptius, Cause of Brazilian Purpuric Fever.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: In 1984, children presented to the emergency department of a hospital in the small town of Promissão, São Paulo State, Brazil, with an acute febrile illness that rapidly progressed to death. Local clinicians and public health officials recognized that these children had an unusual illness, which led to outbreak investigations conducted by Brazilian health officials in collaboration with the U.S. Centers for Disease Control and Prevention. The studies that followed are an excellent example of the coordinated and parallel studies that are used to investigate outbreaks of a new disease, which became kno...
Source: Clinical Microbiology Reviews - October 1, 2008 Category: Microbiology Authors: Harrison LH, Simonsen V, Waldman EA Tags: Clin Microbiol Rev Source Type: journals

Candida parapsilosis, an Emerging Fungal Pathogen.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: Candida parapsilosis is an emerging major human pathogen that has dramatically increased in significance and prevalence over the past 2 decades, such that C. parapsilosis is now one of the leading causes of invasive candidal disease. Individuals at the highest risk for severe infection include neonates and patients in intensive care units. C. parapsilosis infections are especially associated with hyperalimentation solutions, prosthetic devices, and indwelling catheters, as well as the nosocomial spread of disease through the hands of health care workers. Factors involved in disease pathogenesis include the sec...
Source: Clinical Microbiology Reviews - October 1, 2008 Category: Microbiology Authors: Trofa D, Gácser A, Nosanchuk JD Tags: Clin Microbiol Rev Source Type: journals

Current World Status of Balantidium coli.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Balantidium coli is a cosmopolitan parasitic-opportunistic pathogen that can be found throughout the world. Pigs are its reservoir hosts, and humans become infected through direct or indirect contact with pigs. In rural areas and in some developing countries where pig and human fecal matter contaminates the water supply, there is a greater likelihood that balantidiosis may develop in humans. The infection may be subclinical in humans, as it mostly is in pigs, or may develop as a fulminant infection with bloody and mucus-containing diarrhea; this can lead to perforation of the colon. The disease responds to treatment wi...
Source: Clinical Microbiology Reviews - October 1, 2008 Category: Microbiology Authors: Schuster FL, Ramirez-Avila L Tags: Clin Microbiol Rev Source Type: journals

New Insights on Classification, Identification, and Clinical Relevance of Blastocystis spp.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: Blastocystis is an unusual enteric protozoan parasite of humans and many animals. It has a worldwide distribution and is often the most commonly isolated organism in parasitological surveys. The parasite has been described since the early 1900s, but only in the last decade or so have there been significant advances in our understanding of Blastocystis biology. However, the pleomorphic nature of the parasite and the lack of standardization in techniques have led to confusion and, in some cases, misinterpretation of data. This has hindered laboratory diagnosis and efforts to understand its mode of reproduction, ...
Source: Clinical Microbiology Reviews - October 1, 2008 Category: Microbiology Authors: Tan KS Tags: Clin Microbiol Rev Source Type: journals

Animal Models of Streptococcus pneumoniae Disease.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews both historical and innovative laboratory pneumococcal animal models that have vastly added to knowledge of (i) mechanisms of infection, pathogenesis, and immunity; (ii) efficacies of antimicrobials; and (iii) screening of vaccine candidates. A comprehensive description of the techniques applied to induce disease is provided, the advantages and limitations of mouse, rat, and rabbit models used to mimic pneumonia, sepsis, and meningitis are discussed, and a section on otitis media models is also included. The choice of appropriate animal models for in vivo studies is a key element for improved understan...
Source: Clinical Microbiology Reviews - October 1, 2008 Category: Microbiology Authors: Chiavolini D, Pozzi G, Ricci S Tags: Clin Microbiol Rev Source Type: journals

Human genetic factors and respiratory syncytial virus disease severity.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: To explain the wide spectrum of disease severity caused by respiratory syncytial virus (RSV) and because of the limitations of animal models to fully parallel human RSV disease, study of genetic influences on human RSV disease severity has begun. Candidate gene approaches have demonstrated associations of severe RSV in healthy infants with genetic polymorphisms that may alter the innate ability of humans to control RSV (surfactants, Toll-like receptor 4, cell surface adhesion molecules, and others) and those that may control differences in proinflammatory responses or enhanced immunopathology (specific cytokin...
Source: Clinical Microbiology Reviews - October 1, 2008 Category: Microbiology Authors: Miyairi I, Devincenzo JP Tags: Clin Microbiol Rev Source Type: journals

Adenoviruses in immunocompromised hosts.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: The number of patients with acquired immunodeficiency has grown steadily as a result of both a larger number of patients receiving solid organ and hematopoietic stem cell transplants and their longer survival times. The use of newer, more potent immunosuppressive regimens has increased the frequency of severe adenovirus infections. Human adenoviruses are a large group of viruses, represented by at least 52 serotypes with various genotypes divided into genomic clusters, and these may cause a broad variety of clinical manifestations. The development of molecular methods has increased the sensitivity and rapidity...
Source: Clinical Microbiology Reviews - October 1, 2008 Category: Microbiology Authors: Echavarría M Tags: Clin Microbiol Rev Source Type: journals

Detection of respiratory viruses by molecular methods.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: Clinical laboratories historically diagnose seven or eight respiratory virus infections using a combination of techniques including enzyme immunoassay, direct fluorescent antibody staining, cell culture, and nucleic acid amplification tests. With the discovery of six new respiratory viruses since 2000, laboratories are faced with the challenge of detecting up to 19 different viruses that cause acute respiratory disease of both the upper and lower respiratory tracts. The application of nucleic acid amplification technology, particularly multiplex PCR coupled with fluidic or fixed microarrays, provides an import...
Source: Clinical Microbiology Reviews - October 1, 2008 Category: Microbiology Authors: Mahony JB Tags: Clin Microbiol Rev Source Type: journals

Evidence-based biosafety: a review of the principles and effectiveness of microbiological containment measures.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We examined the available evidence on the effectiveness of measures aimed at protecting humans and the environment against the risks of working with genetically modified microorganisms (GMOs) and with non-GMO pathogenic microorganisms. A few principles and methods underlie the current biosafety practice: risk assessment, biological containment, concentration and enclosure, exposure minimization, physical containment, and hazard minimization. Many of the current practices are based on experience and expert judgment. The effectiveness of biosafety measures may be evaluated at the level of single containment equipment items a...
Source: Clinical Microbiology Reviews - July 1, 2008 Category: Microbiology Authors: Kimman TG, Smit E, Klein MR Tags: Clin Microbiol Rev Source Type: journals

Pertussis vaccination for health care workers.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Pertussis, an acute respiratory infection caused by Bordetella pertussis, classically manifests as a protracted cough illness. The incidence of pertussis in the United States has been increasing in recent years. Immunity wanes after childhood vaccination, leaving adolescents and adults susceptible to infection. The transmission of pertussis in health care settings has important medical and economic consequences. Acellular pertussis booster vaccines are now available for use and have been recommended for all adolescents and adults. These vaccines are safe, immunogenic, and effective. Health care workers are a priority g...
Source: Clinical Microbiology Reviews - July 1, 2008 Category: Microbiology Authors: Sandora TJ, Gidengil CA, Lee GM Tags: Clin Microbiol Rev Source Type: journals

Increasing importance of Balamuthia mandrillaris.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Balamuthia mandrillaris is an emerging protozoan parasite, an agent of granulomatous amoebic encephalitis involving the central nervous system, with a case fatality rate of >98%. This review presents our current understanding of Balamuthia infections, their pathogenesis and pathophysiology, and molecular mechanisms associated with the disease, as well as virulence traits of Balamuthia that may be potential targets for therapeutic interventions and/or for the development of preventative measures. PMID: 18625680 [PubMed - indexed for MEDLINE] (Source: Clinical Microbiology Reviews)
Source: Clinical Microbiology Reviews - July 1, 2008 Category: Microbiology Authors: Matin A, Siddiqui R, Jayasekera S, Khan NA Tags: Clin Microbiol Rev Source Type: journals

Polymyxins revisited.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The global emergence of multidrug-resistant gram-negative bacilli has spurred a renewed interest in polymyxins. Once discarded due to concerns regarding nephrotoxicity and neurotoxicity, polymyxins now hold an important role in the antibiotic armamentarium. However, more reliable information is needed to determine the optimal dosing of these agents. Also, unanswered questions regarding in vitro testing remain, including questions regarding the reliability of automated systems and the establishment of appropriate breakpoints for defining susceptibility. Most contemporary clinical studies examining the use of these agent...
Source: Clinical Microbiology Reviews - July 1, 2008 Category: Microbiology Authors: Landman D, Georgescu C, Martin DA, Quale J Tags: Clin Microbiol Rev Source Type: journals