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"BACTERIAL INFECTIONS"
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The good virus : the untold story of phages: the most abundant life forms on Earth and what they can do for us
\"The untold story of the most abundant form of life on Earth, bacteriophages, and how they play a crucial role in our lives, our health and the health of our planet. Not all viruses are out to get us - in fact, the viruses that do us harm are vastly outnumbered by viruses that can actually save lives. At every moment, within your body and all around you, trillions of microscopic combatants are fighting an invisible war. Countless times per second, 'good' viruses known as phages are infecting and destroying bacteria. These phages are the most abundant life form on the planet and have an incredible power to heal rather than harm. So why have most of us never even heard of them? The Good Virus reveals how personalities, power and politics have repeatedly crashed together to hinder our understanding of these weird and wonderful life forms. We explore why Stalin's Soviet Union embraced using phages to fight disease but the rest of the world shunned the idea. We find out why scientists only recently realised phages are central to all ecosystems on Earth. And we meet the often eccentric phage heroes who have shaped the strange history of this field and are unlocking its exciting future. Faced with the threat of antibiotic-resistance, we need phages now more than ever. The Good Virus celebrates what phages could do for us and our planet if they are at last given the attention they deserve.\"--Publisher's description.
Book
Antibacterial Envelope to Prevent Cardiac Implantable Device Infection
Infection is a known complication of the placement of cardiac implantable electronic devices. In this randomized, controlled trial involving 6983 patients undergoing cardiac-device placement, an antibacterial envelope was studied to determine infection prevention. The envelope reduced infection by 40%.
Journal Article
Procalcitonin-Guided Use of Antibiotics for Lower Respiratory Tract Infection
Differentiating acute bacterial infection from other causes of lower respiratory tract illness is challenging. In this trial, procalcitonin was investigated as a point-of-care test to aid in determining whether antibiotics were needed in the treatment of these illnesses.
Journal Article
E. coli
This book traces the history of this mutating menace, reviews efforts to contain outbreaks when they occur, and where medical science is in efforts to find treatments. There is a timeline on the discovery, treatment, and outbreaks of E. coli, and sidebars on a young dancer who was paralyzed by bacteria in her burger, and the dangers of kiddie pools.
Book
Bacteremia in Children Hospitalized with Respiratory Syncytial Virus Infection
The risk of bacteremia is considered low in children with acute bronchiolitis. However the rate of occult bacteremia in infants with RSV infection is not well established. The aim was to determine the actual rate and predictive factors of bacteremia in children admitted to hospital due to confirmed RSV acute respiratory illness (ARI), using both conventional culture and molecular techniques.
A prospective multicenter study (GENDRES-network) was conducted between 2011-2013 in children under the age of two admitted to hospital because of an ARI. Among those RSV-positive, bacterial presence in blood was assessed using PCR for Meningococcus, Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus pyogenes, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus, in addition to conventional cultures.
66 children with positive RSV respiratory illness were included. In 10.6% patients, bacterial presence was detected: H. influenzae (n = 4) and S. pneumoniae (n = 2). In those patients with bacteremia, there was a previous suspicion of bacterial superinfection and had received empirical antibiotic treatment 6 out of 7 (85.7%) patients. There were significant differences in terms of severity between children with positive bacterial PCR and those with negative results: PICU admission (100% vs. 50%, P-value = 0.015); respiratory support necessity (100% vs. 18.6%, P-value < 0.001); Wood-Downes score (mean = 8.7 vs. 4.8 points, P-value < 0.001); GENVIP scale (mean = 17 vs. 10.1, P-value < 0.001); and length of hospitalization (mean = 12.1 vs. 7.5 days, P-value = 0.007).
Bacteremia is not frequent in infants hospitalized with RSV respiratory infection, however, it should be considered in the most severe cases.
Journal Article
Have bacteria won?
Today, we are far less likely to die from infection than at any other time in history, but still we worry about epidemics, the menace of antibiotic resistance and modern \"plagues\" like Ebola. In this timely new book, eminent bacteriologist Hugh Pennington explores why these fears remain and why they are unfounded. He reports on outright victories (such as smallpox), battles where the enemy is on its last stand (polio), surprise attacks from vegetarian bats (Ebola, SARS) and demented cows (BSE). Qualified optimism, he argues, is the message for the future but the battles will go on forever. -- Provided by publisher.
Book
Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship
Background. Organisms resistant to antimicrobials continue to emerge and spread. This study was performed to measure the medical and societal cost attributable to antimicrobial-resistant infection (ARI). Methods. A sample of high-risk hospitalized adult patients was selected. Measurements included ARI, total cost, duration of stay, comorbidities, acute pathophysiology, Acute Physiology and Chronic Health Evaluation III score, intensive care unit stay, surgery, health care-acquired infection, and mortality. Hospital services used and outcomes were abstracted from electronic and written medical records. Medical costs were measured from the hospital perspective. A sensitivity analysis including 3 study designs was conducted. Regression was used to adjust for potential confounding in the random sample and in the sample expanded with additional patients with ARI. Propensity scores were used to select matched control subjects for each patient with ARI for a comparison of mean cost for patients with and without ARI. Results. In a sample of 1391 patients, 188 (13.5%) had ARI. The medical costs attributable to ARI ranged from $18,588 to $29,069 per patient in the sensitivity analysis. Excess duration of hospital stay was 6.4–12.7 days, and attributable mortality was 6.5%. The societal costs were $10.7–$15.0 million. Using the lowest estimates from the sensitivity analysis resulted in a total cost of $13.35 million in 2008 dollars in this patient cohort. Conclusions. The attributable medical and societal costs of ARI are considerable. Data from this analysis could form the basis for a more comprehensive evaluation of the cost of resistance and the potential economic benefits of prevention programs.
Journal Article
Colonization with multidrug resistant organisms determines the clinical course of patients with acute myeloid leukemia undergoing intensive induction chemotherapy
The global spread of multidrug-resistant organisms (MDRO) complicates treatment and isolation measures in hospitals and has shown to increase mortality. Patients with disease- or therapy-related immunodeficiency are especially at risk for fatal infections caused by MDRO. The impact of MDRO colonization on the clinical course of AML patients undergoing intensive induction chemotherapy-a potentially curative but highly toxic treatment option-has not been systematically studied.
312 AML patients undergoing intensive induction chemotherapy between 2007 and 2015 were examined for MDRO colonization. Patients with evidence for MDRO before or during the hospital stay of induction chemotherapy were defined as colonized, patients who never had a positive swab for MDRO were defined as noncolonized.
Of 312 AML patients 90 were colonized and 130 were noncolonized. Colonized patients suffered from significantly more days with fever, spent more days on the intensive care unit and had a higher median C-reactive protein value during the hospital stay. These findings did not result in a prolonged length of hospital stay or an increased mortality rate for colonized patients. However, in a subgroup analysis, patients colonized with carbapenem-resistant enterobacteriaceae (CRE) had a significantly reduced 60- and 90-day, as well as 1- and 2-year survival rates when compared to noncolonized patients.
Our analysis highlights the importance of intensive MDRO screening especially in patients with febrile neutropenia since persisting fever can be a sign of MDRO-colonization. CRE-colonized patients require special surveillance, since they seem to be at risk for death.
Journal Article