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BMC Infectious Diseases - Latest Articles

Measurement of the plasma levels of antibodies against the polymorphic vaccine candidate apical membrane antigen 1 in a malaria-exposed population
Kwadwo KusiDaniel DodooSamuel BosomprahMarjolein van der EijkBart FaberClemens KockenEdmond Remarque Thu, 02 Feb 2012 00:00:00 -0000
Background: Establishing antibody correlates of protection against malaria in human field studies and clinical trials requires, amongst others, an accurate estimation of antibody levels. For polymorphic antigens such as apical membrane antigen 1 (AMA1), this may be confounded by the occurrence of a large number of allelic variants in nature. Methods: To test this hypothesis, plasma antibody levels in an age-stratified cohort of naturally exposed children from a malaria-endemic area in Southern Ghana were determined by indirect ELISA. Titres against four single PfAMA1 alleles were compared with those against three different allele mixtures presumed to have a wider repertoire of epitope specificities. Associations of antibody levels with the incidence of clinical malaria as well as with previous exposure to parasites were also examined. Results: Antibody titres against PfAMA1 alleles generally increased with age/exposure while antibody specificity for PfAMA1 variants decreased, implying that younger children ([less than or equal to] 5 years) elicit a more strain-specific antibody response compared to older children. Antibody titre measurements against the FVO and 3D7 AMA1 alleles gave the best titre estimates as these varied least in pair-wise comparisons with titres against all PfAMA1 allele mixtures. There was no association between antibody levels against any capture antigen and either clinical malaria incidence or parasite density. Conclusions: The current data shows that levels of naturally acquired antigen-specific antibodies, especially in infants and young children, are dependent on the antigenic allele used for measurement. This may be relevant to the interpretation of antibody titre data from measurements against single PfAMA1 alleles, especially in studies involving infants and young children who have experienced fewer infections.
Inter-rater agreement in the assessment of abnormal chest X-ray findings for tuberculosis between two Asian countries
Shinsaku SakuradaNguyen HangNaoki IshizukaEmiko ToyotaLe HungPham ChucLuu LienPham ThuongPham BichNaoto KeichoNobuyuki Kobayashi Wed, 01 Feb 2012 00:00:00 -0000
Background: Inter-rater agreement in the interpretation of chest X-ray (CXR) films is crucial for clinical and epidemiological studies of tuberculosis. We compared the readings of CXR films used for a survey of tuberculosis between raters from two Asian countries. Methods: Of the 11,624 people enrolled in a prevalence survey in Hanoi, Viet Nam, in 2003, we studied 258 individuals whose CXR films did not exclude the possibility of active tuberculosis. Follow-up films obtained from accessible individuals in 2006 were also analyzed. Two Japanese and two Vietnamese raters read the CXR films based on a coding system proposed by Den Boon et al. and another system newly developed in this study. Inter-rater agreement was evaluated by kappa statistics. Marginal homogeneity was evaluated by the generalized estimating equation (GEE). Results: CXR findings suspected of tuberculosis differed between the four raters. The frequencies of infiltrates and fibrosis/scarring detected on the films significantly differed between the raters from the two countries (P < 0.0001 and P = 0.0082, respectively, by GEE). The definition of findings such as primary cavity, used in the coding systems also affected the degree of agreement. Conclusions: CXR findings were inconsistent between the raters with different backgrounds. High inter-rater agreement is a component necessary for an optimal CXR coding system, particularly in international studies. An analysis of reading results and a thorough discussion to achieve a consensus would be necessary to achieve further consistency and high quality of reading.
Influenza vaccination of healthcare workers in acute-care hospitals: a case-control study of its effect on hospital-acquired influenza among patients
Thomas BenetCorinne RegisNicolas VoirinOlivier RobertBruno LinaSilene CronenbergerBrigitte ComteBrigitte CopperePhilippe Vanhems Wed, 01 Feb 2012 00:00:00 -0000
Background: In acute-care hospitals, no evidence of a protective effect of healthcare worker (HCW) vaccination on hospital-acquired influenza (HAI) in patients has been documented. Our study objective was to ascertain the effectiveness of influenza vaccination of HCW on HAI among patients. Methods: A nested case-control investigation was implemented in a prospective surveillance study of influenza-like illness (ILI) in a tertiary acute-care university hospital. Cases were patients with virologically-confirmed influenza occurring >=72 h after admission, and controls were patients with ILI presenting during hospitalisation with negative influenza results after nasal swab testing. Four controls per case, matched per influenza season (2004-05, 2005-06 and 2006-07), were randomly selected. Univariate and multivariate conditional logistic regression models were fitted to assess factors associated with HAI among patients. Results: In total, among 55 patients analysed, 11 (20%) had laboratory-confirmed HAI. The median HCW vaccination rate in the units was 36%. The median proportion of vaccinated HCW in these units was 11.5% for cases vs. 36.1% for the controls (P = 0.11); 2 (20%) cases and 21 (48%) controls were vaccinated against influenza in the current season (P = 0.16). The proportion of >=35% vaccinated HCW in short-stay units appeared to protect against HAI among patients (odds ratio = 0.07; 95% confidence interval 0.005-0.98), independently of patient age, influenza season and potential influenza source in the units. Conclusions: Our observational study indicates a shielding effect of more than 35% of vaccinated HCW on HAI among patients in acute-care units. Investigations, such as controlled clinical trials, are needed to validate the benefits of HCW vaccination on HAI incidence in patients.
Clinical features and risk factors for severe and critical pregnant women with 2009 pandemic H1N1 influenza infection in China
Peng-jun ZhangXiao-li LiBin CaoShi-gui YangLi-rong LiangLi GuZhen XuKe HuHong-yuan ZhangXi-xin YanWen-bao HuangWei ChenJing-xiao ZhangLan-juan LiChen Wang Wed, 01 Feb 2012 00:00:00 -0000
Background: 2009 pandemic H1N1 (pH1N1) influenza posed an increased risk of severe illness among pregnant women. Data on risk factors associated with death of pregnant women and neonates with pH1N1 infections are limited outside of developed countries. Methods: Retrospective observational study in 394 severe or critical pregnant women admitted to a hospital with pH1N1 influenza from Sep. 1, 2009 to Dec. 31, 2009. rRT-PCR testing was used to confirm infection. In-hospital mortality was the primary endpoint of this study. Univariable logistic analysis and multivariate logistic regression analysis were used to investigate the potential factors on admission that might be associated with the maternal and neonatal mortality. Results: 394 pregnant women were included, 286 were infected with pH1N1 in the third trimester. 351 had pneumonia, and 77 died. A PaO2/FiO2 [less than or equal to] 200 (odds ratio (OR), 27.16; 95% confidence interval (CI), 2.64-279.70) and higher BMI (i.e. [greater than or equal to]30) on admission (OR, 1.26; 95% CI, 1.09 to 1.47) were independent risk factors for maternal death. Of 211 deliveries, 146 neonates survived. Premature delivery (OR, 4.17; 95% CI, 1.19-14.56) was associated neonatal mortality. Among 186 patients who received mechanical ventilation, 83 patients were treated with non-invasive ventilation (NIV) and 38 were successful with NIV. The death rate was lower among patients who initially received NIV than those who were initially intubated (24/83, 28.9% vs 43/87, 49.4%; p = 0.006). Septic shock was an independent risk factor for failure of NIV. Conclusions: Severe hypoxemia and higher BMI on admission were associated with adverse outcomes for pregnant women. Preterm delivery was a risk factor for neonatal death among pregnant women with pH1N1 influenza infection. NIV may be useful in selected pregnant women without septic shock.
Immune reconstitution inflammatory syndrome from Penicillium marneffei in an HIV-infected child: A case report and review of literature
Tavitiya SudjaritrukThira SirisanthanaVirat Sirisanthana Tue, 31 Jan 2012 00:00:00 -0000
BackgroundsDisseminated Penicillium marneffei infection is one of the most common HIV-related opportunistic infections in Southeast Asia. Immune reconstitution inflammatory syndrome (IRIS) is a complication related to antiretroviral therapy (ART)-induced immune restoration. The aim of this report is to present a case of HIV-infected child who developed an unmasking type of IRIS caused by disseminated P. marneffei infection after ART initiation.Case presentationA 14-year-old Thai HIV-infected girl presented with high-grade fever, multiple painful ulcerated oral lesions, generalized non-pruritic erythrematous skin papules and nodules with central umbilication, and multiple swollen, warm, and tender joints 8 weeks after ART initiation. At that time, her CD4+ cell count was 7.2% or 39 cells/mm3. On admission, her repeated CD4+ cell count was 11% or 51 cells/mm3 and her plasma HIV-RNA level was <50 copies/mL. Her skin biopsy showed necrotizing histiocytic granuloma formation with neutrophilic infiltration in the upper and reticular dermis. Tissue sections stained with hematoxylin and eosin (H&E), periodic acid-Schiff (PAS), and Grocott methenamine silver (GMS) stain revealed numerous intracellular and extracellular, round to oval, elongated, thin-walled yeast cells with central septation. The hemoculture, bone marrow culture, and skin culture revealed no growth of fungus or bacteria. Our patient responded well to intravenous amphotericin B followed by oral itraconazole. She fully recovered after 4-month antifungal treatment without evidence of recurrence of disease. Conclusions: IRIS from P. marneffei in HIV-infected people is rare. Appropriate recognition and properly treatment is important for a good prognosis.
Infection control management of patients with suspected highly infectious diseases in emergency departments: data from a survey in 41 facilities in 14 European countries
Francesco FuscoStefan SchillingGiuseppina De IacoHans-Reinhard BrodtPhilippe BrouquiHelena MaltezouBarbara BannisterRene GottschalkGail ThomsonVincenzo PuroGiuseppe IppolitoEuroNHID Working Group Sat, 28 Jan 2012 00:00:00 -0000
Background: In Emergency and Medical Admission Departments (EDs and MADs), prompt recognition and appropriate infection control management of patients with Highly Infectious Diseases (HIDs, e.g. Viral Hemorrhagic Fevers and SARS) are fundamental for avoiding nosocomial outbreaks. Methods: The EuroNHID (European Network for Highly Infectious Diseases) project collected data from 41 EDs and MADs in 14 European countries, located in the same facility as a national/regional referral centre for HIDs, using specifically developed checklists, during on-site visits from February to November 2009. Results: Isolation rooms were available in 34 facilities (82,9%): these rooms had anteroom in 19, dedicated entrance in 15, negative pressure in 17, and HEPA filtration of exhausting air in 12. Only 6 centres (14,6%) had isolation rooms with all characteristics. Personnel trained for the recognition of HIDs was available in 24 facilities; management protocols for HIDs were available in 35. Conclusions: Preparedness level for the safe and appropriate management of HIDs is partially adequate in the surveyed EDs and MADs.

 

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BioMed Central - Offers the current infectious disease reports.

Clinical Infectious Diseases, Electronic Edition - Published by the University of Chicago for the Infectious Diseases Society of America. Features news, articles, and practice guidelines.

Communicable Disease and Immunizations - Communicable disease information for HIV/AIDS, pertussis, influenza, tuberculosis, typhoid fever, chickenpox, and others.
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Communicable Disease and Public Health - A journal published by the Health Protection Agency in association with the Scottish Centre for Infection and Environmental Health. Find back and current issues and info about the CDPH.

Diagnosis and Management of Infectious Diseases - Complete electonic version the book in .pdf format.
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Disease Outbreak News - Information about disease outbreaks anywhere in the world, searchable by time period, with archives by disease; from the Communicable Disease Surveillance and Response (CSR), World Health Organization.

eMedicine Health - Consumer health resource center providing information on the causes, symptoms, and treatment of swollen lymph glands.
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eMedicine Health - Finger Infection - Consumer health resource center providing information on the causes, symptoms, and treatment of injury or infection to a finger.
Meta Description: [ Injury or infection to a finger or fingers is a common problem. Infection can range from mild to potentially serious. Often these infections start out small and are relatively easy ... ]

eMedicine Health - Sepsis - Consumer health resource center providing information on the causes, symptoms, and treatment of blood infection.
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Emerging Infectious Diseases Journal - Extensive e-journal from the CDC.

Health Protection Agency: Infections - CDSC is a division of the Health Protection Agency and is the UK information and response center for surveillance and control of infectious diseases.
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Infections - MCW HealthLink - Information about infectious and communicable diseases from the physicians of the Medical College of Wisconsin.
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Infectious Disease Control Unit - Factsheets and news releases related to diseases and various health topics.
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Infectious Disease News - Online version of the magazine. Includes breaking news, archives, online seminars, and specialty forums.

404 Infectious Diseases - Articles in .pdf format - requiring Adobe Acrobat reader. Plus a link directory.

Infectious Diseases in Children - Online version of the journal. Includes case studies, articles, and monographs.

Infectious Diseases Society of America - Includes information about the IDSA, a career center, newsroom, practice guidelines, and journals and publications.

International Society for Infectious Diseases - ISID consists of individuals interested in infectious diseases, including specialists, microbiologists, immunologists, epidemiologists, public health workers, parasitologists, virologists, mycologists, and molecular biologists. Find publications, resources, memberships and programs.

500 Johns Hopkins Infectious Diseases - Information on infectious diseases including hepatitis, STDs, tuberculosis, and HIV/AIDS treatment, prevention, research, education, and epidemiology.
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Karolinska Institute: Library and Information Center - Compilation of medical microbiology and infectious diseases sites.

Kidshealth: Infections - Directory of factsheets covering common infections affecting children.
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Medical Microbiology - Online textbook with scientific and medical information on many disease causing organisms.

Medical Microbiology - Information on the microorganisms that cause diseases in humans. Lecture notes, laboratory notebook, computerized clinical cases, and most common causes of infectious diseases file.
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Mediscover - Infectious Diseases - Content includes topical news from the world or research, recent releases from the world of clinical practice - antivirals, antibiotics and vaccines, regular feature articles, specialist resources.

Medlineplus - Infectious Diseases - Articles about infectious disease and infectious disease links.
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Medscape Infectious Diseases - Directory of news, articles, research reports, and sites. Free registration required to view most of the material.
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Medscape Infectious Diseases Headlines - Latest medical news and information from Medscape.com.

Microbes: in Sickness and in Health - Publication of the National Institute of Allergy and Infectious Diseases.

Microbial Threats to Health: Emergence, Detection, and Response (2003) - Covers emerging diseases, resurgence of known pathogens, and the human factors that converge to provide an environment where diseases can spread. Complete 350-page report from the Board on Global Health of the National Academy of Science, in Open Book and PDF formats.

National Center for Infectious Diseases - A large, searchable database of articles about diseases; resources for scientists, physicians, travelers; publications; training programs.
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National Foundation for Infectious Diseases - NFID supports research into the causes, cures, and prevention of infectious diseases and sponsors public and professional education programs. Virtual library, factsheets, vaccine research conference information, National Coalition for Adult Immunization.
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National Institute of Allergy and Infectious Diseases (NIAID) - Provides major support for scientists conducting research aimed at developing better ways to diagnose, treat and prevent the many infectious, immunologic and allergic diseases.
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New York State Department of Health: Communicable Diseases - Directory of factsheets on infectious diseases, plus press releases.
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404 OHSU Health: Infectious Diseases - Overview, symptom and treatment information about infectious diseases.
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Pediatric Investigator Collaborative Network on Infections in Canada - PICNIC official web site to learn about new research, technologies, and to connect to each other. Offers information about the organization, publications, links and a member only area.
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Research and Training in Tropical Diseases - Co-sponsored by the United Nations Children's Fund (UNICEF), the United Nations Development Programme (UNDP), the World Bank and the World Health Organization (WHO). It helps co-ordinate global efforts to combat infectious diseases of the poor and disadvantaged.
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Scottish Centre for Infection and Environmental Health - Information on communicable diseases and environmental health hazards, travel and veterinary health risks including statistical data.
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The Bad Bug Book - This handbook provides basic facts regarding foodborne pathogenic microorganisms and natural toxins. Each chapter focuses on either one bacteria, virus, parasite, or natural toxin, providing basic facts.
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The American Medical Association's Resources on Infectious Diseases - Current resources for physicians and the public on important issues in infectious diseases. Features news, forums, articles, and archives.
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500 The Core Center - Comprehensive range of outpatient care to individuals and families affected by HIV/AIDS and other infectious diseases.
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The Global Infectious Disease Threat and Its Implications for the United States - Extensive report from the US Central Intelligence Agency.

404 The Internet Pathology Laboratory for Medical Education: Infection Index - Images of organisms and their effects on organs.

The Lancet: Infectious Diseases - Online version of the journal. Includes full text articles and abstracts. Requires registration to see most of the content. Basic registration is free. Some articles are pay per view.

The Merck Manual - Infectious Diseases - Specific and general clinical information on infectious diseases and their treatment.

The New England Journal of Medicine: Infectious Disease - The Infectious Diseases collection covers topics such as sepsis, meningitis, and pneumonia.
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U.S. Army Medical Research Unit-Kenya - Research and surveillance of tropical diseases, including virology, parasitology, and immunology, to develop and test improved means for predicting, detecting, preventing, and treating infectious disease threats in East Africa.

USAMRIID - The United States Army Medical Research Institute for infectious diseases.

Vads Corner - Emerging viruses, Outbreaks, Haze, Nipah virus, enterovirus 71, Influenza, H5N1 Influenza A, Chikungunya virus, West Nile virus, Dioxin, Arsenic, Medline, Medical Journals.

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