124 research outputs found
Emerg Infect Dis
No full textSalmonella Typhi infection in a patient in Pakistan initially responded to standard treatment but failed to respond to subsequent treatment. The first strain was susceptible to carbapenems and azithromycin; subsequent strains harbored the NDM-5 gene. Treatment with a combination of intravenous meropenem and colistin was successful. Carbapenem-resistant Salmonella Typhi emergence will hinder treatment
Respiratory tract infections in the immunocompromised.
No full textPURPOSE OF REVIEW: Pulmonary infections are particularly common in the immunosuppressed host. This review discusses emerging threats, newer modalities of diagnostic tests and emerging treatment options, and also highlights the increasing problem of antimicrobial resistance. RECENT FINDINGS: Nosocomial pneumonia is increasingly due to multidrug-resistant Gram-negative organisms in immunosuppressed patients. Viral pneumonias remain a very significant threat, present atypically and carry a high mortality. Aspergillosis remains the most common fungal infection, and infections due to Mucorales are increasing. Multidrug-resistant tuberculosis is on the increase throughout the world. Mixed infections are common and early bronchoscopy with appropriate microbiological tests, including molecular diagnostics, optimise management and reduce mortality. CONCLUSION: Pulmonary infection remains the most frequent infectious complication in the immunocompromised host. These complex infections are often mixed, have atypical presentations and can be due to multidrug-resistant organisms. Multidisciplinary involvement in specialist centres with appropriate diagnostics, treatment and infection control improves outcome. There is a desperate need for new antimicrobial agents active against Gram-negative pathogens
Infectious complications in pediatric acute liver failure.
No full textOBJECTIVES: Acute liver failure (ALF) is rare in children but carries high mortality. Infectious complications (IC) in adults are an important cause of mortality; however, there are few data in the pediatric population. The aim of the study was to determine the incidence of IC and their effects on the outcome in children with ALF. MATERIALS AND METHODS: The present study is a retrospective review of the case records of children presenting with ALF to our center. All patients with ALF received antibiotics and antifungal as prophylaxis from day 1 and high-dose acyclovir was given to neonates only (stopped when herpes simplex was ruled out). Biochemical parameters, duration of ventilation and intensive care, overall hospital stay, and patient outcome were compared between patients with IC and non-IC. RESULTS: A total of 145 children (78 boys), median (range) age 4.22 (1 day-16 years) years, were studied. Thirty-seven of 145 (25%) patients had proven IC. The predominant infections included 14 episodes of bacteremia in 13 patients and lower respiratory tract infection and urinary tract infection in 10 and 8 patients, respectively. IC occurred in patients after a median (range) duration of 16 (0-54) days of admission. Median (range) duration of hospital stay in patients with IC was 38 (1-201) days and was significantly higher than in those without IC (10 [1-74] days), P < 0.0001. Overall mortality was 21% (31), of which 7% (11) was from the IC group and 14% (20) from the non-IC group; the difference was not statistically significant. CONCLUSIONS: Infections were more frequent after 2 weeks of admission. Patients with sepsis had longer hospital stays and prolonged ventilation. Invasive fungal infections were rare in pediatric ALF with adequate doses of antifungal prophylaxis
Review: Diagnosis of Helicobacter pylori infection
No full textInternational audienceNew imaging techniques are still the topic of many evaluations for both the diagnosis of Helicobacter pylori gastritis and the detection of early gastric cancer. Concerning invasive tests, there were studies on the reuse of the rapid urease test material for other tests, and a novel fluorescent method to be used for histology but with limited sensitivity. Progress occurred essentially in the molecular methods area, especially next‐generation sequencing which is applied to detect both H pylori and the mutations associated with antibiotic resistance. For non‐invasive tests, a few studies have been published on the validity of breath collection bags, the shortening of the testing time, the performance of different analysers or the added value of citric acid in the protocol. The accuracy of serological immunochromatographic tests is also improving. Multiplex serology detecting antibodies to certain proteins allows confirmation of a current infection. Dried blood spots can be used to collect and store blood without a loss of accuracy. Finally, the serum antibody titer can be useful in predicting the risk of gastric cancer. Several stool antigen tests were evaluated with good results, and a novel test using immunomagnetic beads coated with monoclonal antibodies is potentially interesting. PCR detection in stools can also be effective but needs an efficient DNA extraction method. The use of easyMAG® (bioMérieux) combined with Amplidiag® H pylori + ClariR (Mobidiag) appears to be powerful
No scalpel vasectomy: a cross-sectional study of knowledge, attitude and practice of gynaecologists
No full textBackground: In spite of no scalpel vasectomy (NSV) being cheaper and safer, female sterilisations account for the majority of sterilisations performed worldwide. Research has focussed more on the “demand” and less on the “provider” side. Gynaecologists can be front-runners for the cause of population control in India. Hence, authors decided to estimate the knowledge of gynaecologists, their attitude and prevalent practice of NSV.Methods: Cross-sectional study. Interviewer-administered questionnaire used for face-to-face data collection from gynecologists registered with the Pune Obstetric and Gynecological Society.Results: Out of 447 gynecologists, 158 (35.3%) were males and 289 (64.7%) females. Mean age was 46.3 years ± 12.1 years, (range 24-80 years). Only 14 (3.1%) were trained in performing NSV. Only a minority knew about type of anaesthesia used (1.8%) and number of accesses needed (48.1%) for NSV. Only 40.7% and 18.1% knew about time to resume sexual activity and number of ejaculations to be covered by additional contraceptives after NSV respectively. More than half [258 (57.7%)] were willing to undergo training in NSV. Among those unwilling for training, female and older gynecologists (≥40 years) significantly outnumbered male and younger gynecologists (76.5% Vs. 23.5%; p=0.000 and 78.8% Vs. 21.2% respectively; p=0.000). Majority (79.9%) referred a couple willing for NSV to surgeons or urologists or advised female sterilization (17%).Conclusions: Knowledge of gynecologists about NSV was inadequate. Minority were trained in performing NSV. Male and younger gynecologists were willing to undergo training in NSV. Most preferred practices were referring couples elsewhere or advising female sterilization
E-Waste Management
No full textElectronic Waste (e-Waste) is a major concern given the negative effects it creates on our environment. Huge quantities of e-Waste are generated every year and the rate is expected to rise in our digital economy. There are regulations and laws around e-Waste; however for its effective enforcement, all the relevant stakeholders need to come together to enforce the laws and regulations. In this chapter, the author describe the e-Waste problem, the challenges and issues involved and finally, present the life-cycle approach (cradle-to-grave) and finally, the author present a policy framework for effective e-Waste management.</jats:p
E-Waste Management
No full textElectronic Waste (e-Waste) is a major concern given the negative effects it creates on our environment. Huge quantities of e-Waste are generated every year and the rate is expected to rise in our digital economy. There are regulations and laws around e-Waste; however for its effective enforcement, all the relevant stakeholders need to come together to enforce the laws and regulations. In this chapter, the author describe the e-Waste problem, the challenges and issues involved and finally, present the life-cycle approach (cradle-to-grave) and finally, the author present a policy framework for effective e-Waste management.</jats:p
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