1/11. central nervous system candidiasis in preterm infants: limited value of biochemical markers for diagnosis.Two rare cases of isolated central nervous system (CNS) candidiasis in preterm infants have been diagnosed in a tertiary neonatal centre over the past 6 years. Despite the life-threatening nature of the disease, biochemical infection markers were not useful for the early identification of localized fungal infection. Because the infection was likely to have been blood borne, we postulated that the initial fungal load was probably low and that the organisms were rapidly eliminated from the circulation after a few had been deposited in the CNS. Hence, the absence of fungaemia or systemic involvement precluded the activation of cytokines and cellular markers. Clinicians should be aware of the limitation of biochemical infection markers so that diagnosis and treatment of fungal infection will not be delayed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/11. Transmission of Trichosporon asahii oesophagitis by a contaminated endoscope.Two cases of oesophageal trichosporonosis due to a suspected nosocomial infection are reported. Both the patients were immunocompetent and had undergone an endoscopic examination on the same day. Six strains of Trichosporon were isolated: three strains from the oesophageal biopsy of the first patient, one strain from the endoscopic forceps, one from the air in the endoscopy room, and one from the oesophageal biopsy of the second patient. The nosocomial nature of the infection and the role of the endoscopic forceps in transporting the micro-organism was suspected, but the morphology and physiology of the isolated strains did not confirm such hypothesis. To elucidate the nature of the infection and the genetic similarities of the strains isolated, all strains were typed with RFLPs of the rDNA fragment and with RAPD. The results of RAPD using primer (GTG)5 (GACA)4, M13 core sequence, and the 15-mer oligonucleotide GAGGGTGGXGGXTCT indicated the molecular identity of three strains supporting the hypothesis concerning a transport of the aetiological agent from the first patient to the second and that the carrier was the forceps of the endoscopic device.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
3/11. Recurrent sphingomonas paucimobilis -bacteraemia associated with a multi-bacterial water-borne epidemic among neutropenic patients.A cluster of septicaemias due to several water-related species occurred in a haematological unit of a university hospital. In recurrent septicaemias of a leukaemic patient caused by sphingomonas paucimobilis, genotyping of the blood isolates by use of random amplified polymorphic dna-analysis verified the presence of two distinct S. paucimobilis strains during two of the separate episodes. A strain of S. paucimobilis identical to one of the patient's was isolated from tap water collected in the haematological unit. Thus S. paucimobilis present in blood cultures was directly linked to bacterial colonization of the hospital water system. Heterogeneous finger-printing patterns among the clinical and environmental isolates indicated the distribution of a variety of S. paucimobilis clones in the hospital environment. This link also explained the multi-microbial nature of the outbreak.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/11. Immunoparalysis as a cause for invasive aspergillosis?aspergillus infections are among the most feared opportunistic infections in humans. These organisms are ubiquitous in nature; protection against infection is usually provided by anatomical barriers and by the immune system. Tissue invasion by aspergillus is uncommon, occurring primarily in the setting of immunosuppression. The prognosis of invasive aspergillosis is very poor. Although it is widely recognised that critically ill patients in the intensive care Unit (ICU) are at risk for nosocomial infections, it is not generally appreciated that such patients may also be at risk for opportunistic infections usually seen only in immunocompromised patients. This might be explained by a biphasic immunological pattern during sepsis: an early hyperinflammatory phase followed by an anti-inflammatory response, leading to a hypo-inflammatory state, the so-called compensatory anti-inflammatory response syndrome (CARS or immunoparalysis). We describe four patients admitted to our ICU for various reasons, without a history of abnormal immune function, who developed invasive pulmonary aspergillosis. We hypothesise that the occurrence of these opportunistic infections in our patients may have been due to immunoparalysis, and that perhaps all ICU patients with sepsis and multiple organ dysfunction syndrome (MODS) may be at risk for opportunistic infections such as aspergillosis as a result of this syndrome. physicians treating critically ill patients in the ICU should be aware of the CARS/immunoparalysis syndrome and its potential to cause opportunistic infections, even in patients with normal immune function prior to ICU admission.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/11. Nosocomial outbreak of scabies.scabies is a common infestation caused by the human itch mite sarcoptes scabiei. Small outbreaks in communities or hospitals are not uncommon, but are rarely documented. In this paper, we report on a nosocomial outbreak of scabies originating from a patient with Norwegian scabies at the intensive care Unit in taiwan Provincial Tainan Hospital. Twenty-nine individuals including four inpatients and 25 hospital personnel were involved. The diagnosis was based on history, clinical findings or a positive skin scraping. Unfamiliarity with the clinical manifestations delayed the diagnosis and the highly contagious nature of Norwegian scabies precipitated this outbreak. Early initiation of effective control measures with extensive therapeutic and prophylactic treatment of all contacts resulted in successful eradication of the outbreak.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/11. A cluster of cases of aspergillus endocarditis after cardiac surgery.aspergillus endocarditis is an ominous condition whose prevalence is increasing in the hospital population. Despite the life-threatening nature of the disease, detection of the source, establishment of the diagnosis, and treatment remain highly challenging. A cluster of three cases of aspergillus endocarditis recently encountered at the Montreal heart Institute are presented.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/11. Hospital-acquired wound mucormycosis.Cutaneous infections due to fungi of the order mucorales are uncommon and usually present as a fulminant necrotizing cellulitis. We describe a case of a progressive wound infection at a surgical drain site caused by rhizopus rhizopodoformis. The indolent nature of the infection and lack of systemic toxicity were atypical features. mucormycosis should be suspected in cases of slowly progressive cellulitis in the appropriate clinical setting.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/11. corynebacterium JK: a new pathogen in ventriculostomy infections.In the past decade, corynebacterium JK has emerged as a pathogen in several distinct clinical settings, including sepsis in immunocompromised patients and prosthetic valve endocarditis. It is also recognized as a nosocomial pathogen in infections of prosthetic devices. We present a case of a patient with carcinomatous meningitis who developed a corynebacterium JK infection of an internal ventriculostomy which was used for intraventricular chemotherapy. Treatment with systemic and intraventriculostomy vancomycin for three weeks resulted in bacteriologic resolution of the infection. Removal of the prosthetic device was not essential for cure in this patient. The clinical spectrum of infection with this organism and aspects of therapy are reviewed. As a greater awareness of the pathogenic nature of this organism develops, it is likely to be implicated as a causative agent in a variety of infections.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/11. Septicemia and endocarditis caused by group G streptococci in a Norwegian hospital.The clinical and bacteriological features of septicemia caused by group G streptococci were analyzed in nine patients seen during a period of 28 months. Four of these patients had acute endocarditis with a high rate of serious neurological complications. The clinical response to antibiotic treatment was slow in the endocarditis patients despite sensitivity of the organism in vitro. Group G streptococcal septicemia can be a very serious condition associated with endocarditis of a destructive nature. Comparison with previous reports suggests that group G streptococcal infections are of increasing importance. The virulence of group G streptococci may be changing, resulting in more serious infections and complications. This series stresses the importance of prompt recognition of this infection and the need for aggressive management of these patients.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/11. Nosocomial infection with candida albicans in a pancreatic transplant recipient investigated by means of restriction enzyme analysis.Restriction enzyme analysis (REA) of total dna was used in order to investigate the possible transmission of candida albicans from the grafted pancreas in a woman with a kidney-pancreas transplant. A strain of candida albicans was recovered from the pancreas-transplant preservation medium cultured routinely before transplantation. Four infecting isolates and one vulval isolate were recovered from the recipient in the early post-operative stage. In addition, 12 unrelated control strains were studied for comparison. By means of EcoRI and HinfI, restriction patterns of the isolates recovered from the preservation medium and from the patient were found to be identical (100% similitude according to Jaccard's coefficient) apart from that of the strain isolated from the vulva. HinfI gave two characteristic fragments of 5.9 and 4.6 kb. In contrast, the 12 control strains generated 12 different patterns. The percentage of similarity between the patterns of the infecting strains and those of the control and the vulval strains was less than 60%. These findings provide evidence of transmission of the infecting strain via the pancreas transplant and the nosocomial nature of infection.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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