Infectious Disease Alert articles from March 2003

Infectious Disease Alert archives from March 2003

Norovirus infection.(norovirus gastroenteritis treatment options)
March 1, 2003... ABSTRACT & COMMENTARY Synopsis: Noroviruses are a frequent cause of acute gastroenteritis. During the last 2 months of 2002 in a single health district in Washington state, 10 outbreaks of acute gastroenteritis attributable to norovirus...

Vancomycin TDM: therapeutic drug monitoring or just fooling ourselves?
March 1, 2003... ABSTRACT & COMMENTARY Synopsis: Despite many years of practice, a recent questionnaire about therapeutic drug monitoring of vancomycin revealed marked variability and a lack of consensus regarding postdose assay sampling times, target...

Need for susceptibility testing of linezolid.
March 1, 2003... ABSTRACT & COMMENTARY Synopsis: The study established a policy of routine suscetibility testing of linezolid and quinupristin/dalfopristin isolates of VRE from any sterile site. Source: Potoski BA, et al. Clinical failures of linezolid...

Better targeting of antibiotic therapy against the Gram-positive coccal infections of neutropenic patients.
March 1, 2003... ABSTRACT & COMMENTARY Synopsis: Indices have been developed to help assess the risk of neutropenic patients developing Gram-positive infections when they become febrile that might allow strategies to be developed for managing these...

Acyclovir and renal dysfunction. (Updates).(Brief Article)
March 1, 2003... Source: Vomiero G, et al. Pediatr Nephrol. 2002;17:633-637. HISTORICALLY, ACYCLOVIR HAS been reported to precipitate renal impairment in up to 16% of patients, although more recent clinical experience suggests that, with adequate hydration,...

What makes BCG less virulent than MTb? (Updates).(Bacille Calmette-Guerin )(Brief Article)
March 1, 2003... Source: Lewis KN, et al. J Infect Dis. 2003;187:l 17-123. THE GENETIC MUTATIONAL BASIS of TB vaccine Bacille Calmette-Guerin (BCG) has remained a mystery for years. Ever since Calmette described the organism, which is naturally attenuated,...

Broad-range bacterial PCR in meningitis. (Updates).(polymerase chain reaction)(Brief Article)
March 1, 2003... Source: Saravolatz LD, et al. Clin Infect Dis. 2003;36:40-45. DNA AMPLIFICATION TECHNIQUES may significantly enhance our ability to quickly diagnosis bacterial meningitis. Using a broad-range for bacterial 16s RNA, which is highly...

The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. (Clinical Briefs in Primary Care).(Brief Article)
March 1, 2003... Source: Lakka HM, et al. JAMA. 2002;288:2709-2716. THE METABOLIC SYNDROME (MBS) HAS 2 currently popular definitions. According to the National Cholesterol Education Program, MBS exists when a patient has at least 3 of the following...

Amlodipine fosinopril combination on microalbuminuria in hypertensive type 2 diabetic patients. (Clinical Briefs in Primary Care).(Brief Article)
March 1, 2003... Source: Fogari R, et al. Am J Hypertens. 2002;15:1042-1049. NUMEROUS STUDIES HAVE CONfirmed the role of ACE inhibitors in modulation of microalbuminuria. The data on effects of calcium channel blockers (CCB) have been conflicting,...

Relation between alcohol consumption and C-reactive protein levels in the adult United States population. (Clinical Briefs in Primary Care).(Brief Article)
March 1, 2003... Source: Stewart SH, et al. J Am Board Fam Pract. 2002;15:437-442. EPIDEMIOLOGIC DATA CONSISTENTLY indicate that moderate intake of alcohol (ETOH) is associated with reductions in cardiovascular mortality. Though the mechanism by which this...

Prostate cancer screening. (Clinical Briefs in Primary Care).(Brief Article)
March 1, 2003... Source: Ransohoff DF, et al. Am J Med. 2002;113:663-667. IN CONTRAST TO SCEENING FOR breast and colon cancer, both of which have been demonstrated to reduce mortality, prostate cancer screening (PCS) has not yet been proven to favorably...

Can we trust home BP measurement? (Clinical Briefs in Primary Care).(blood pressure)(Brief Article)
March 1, 2003... Source: Bachmann LM, et al. J Clin Hypertens. 2002;4:405-407,412. THE WINDOW OF OBSERVATION OF blood pressure as obtained in the typical office setting has important limitations, with both exaggerations (ie, "white-coat" hypertension), and...

Systolic and diastolic dysfunction. (Clinical Briefs in Primary Care).(congestive heart failure)(Brief Article)
March 1, 2003... Source: Redfield MM, et al. JAMA. 2003;289:194-202. CONGESTIVE HEART FAILURE (CHF) IS typically classified as systolic (ie, reduced ejection fraction), diastolic (normal ejection fraction, with impaired ventricular filling), or both....

Smallpox Vaccination guidelines published by CDC. (Pharmacolocy Watch).("Smallpox Vaccination and Adverse Reactions--Guidance for Clinicians")
March 1, 2003... The CDC published "Smallpox Vaccination and Adverse Reactions--Guidance for Clinicians" in the Jan. 24th edition of Morbidity and Mortality Weekly Report. The guidance is a thorough review of the smallpox vaccine with a well-illustrated...

Tenofovir in HIV/HBV-coinfected patients.
March 15, 2003... ABSTRACTS & COMMENTARY Synopsis: Tenofovir effectively reduces HBV replication over 24 weeks of therapy in HIV-coinfected patients. Sources: Ristig MB, et al. Tenofovir disoproxil fumarate therapy for chronic hepatitis B in human...

Getting the bugs out of bronchoscopes.
March 15, 2003... ABSTRACTS & COMMENTARY Synopsis: Bacterial contamination of bronchoscopes, resulting in both unnecessary antibiotic use and clinical infection, resulted from a change in design of the instruments. Sources: Kirschke DL, et al....

Outpatient antibiotic use--France vs Germany: A cultural lesson.
March 15, 2003... ABSTRACT & COMMENTARY Synopsis: The French use antibiotics quite differently from the Germans, for a variety of reasons, including cultural factors and regulations, in addition to physician habits and patient expectations. Source:...

More on MRSA: long-term risk of infection following acquisition.(methicillin-resistant Staphylococcus aureus)
March 15, 2003... ABSTRACT & COMMENTARY Synopsis: Twenty-nine percent of patients newly identified as carrying MRSA will have subsequent MRSA infection over the following 18 months. Source: Huang SS, Platt R. Risk of methicillin-resistant...

Antibiotic susceptibility of Bacteroides fragilis group organisms.
March 15, 2003... ABSTRACT & COMMENTARY Synopsis: Metronidazole, piperacillin/tazobactam, and the carbapenems remain the most reliably active against B fragilis group organisms. Source: Aldridge KE, et al. Bacteremia due to Bacteroides fragilis group:...

CME questions.(Brief Article)
March 15, 2003... Effective with this testing period, Infectious Disease Alert is changing its testing procedure. You will no longer need to return a Scantron answer sheet to earn credit for the activity Please review the text, answer the following questions,...

KS fails to respond to cidofovir. (Updates).(Kaposi sarcoma)(Brief Article)
March 15, 2003... Source: Little RE, et al. J Infect Dis. 2003;187:149-153. ANECDOTAL REPORTS HAVE SUGgested that Kaposi sarcoma (KS), which is believed to be, in part, due to the presence of human herpes virus 8, may respond to antiherpes drugs. Cidofovir,...

MRSA hits big city gays hard. (Updates).(methicillin-resistant Staphylococcus aureus)(Brief Article)
March 15, 2003... Source: ProMED-mail post. February 27, 2003; promed@promedmail.org. PHYSICIANS AND LOCAL HEALTH authorities in the San Francisco Bay Area, Los Angeles, and Boston are reporting an epidemic of methicillin-resistant Staphylococcus aureus...

CCR5 genotype and HIV risk in women. (Updates).(Brief Article)
March 15, 2003... Source: Philpott S, et al. J Infect Dis. 2003;187:569-575. THE CC CHEMOKINE RECEPTOR 5 (CCR5) acts as a coreceptor for HIV-1 transmission. Earlier studies of predominantly gay men found that homozygous, but not heterozygous, gene deletion...

Off-Road driving and Cocci? (Updates).(Brief Article)
March 15, 2003... Source: ProMED-mail post. February 20, 2003; promed@promedmail.org. ONE ASTUTE READER SUGGESTS that the recent increase in popularity of off-road vehicles (ORVs) may be to blame for the recent increased incidence of coccidioidomycosis,...