http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Wed, 06 Feb 2013 11:55:15 +0000 http://www.hindawi.com/journals/tswj/2013/252469/ Objective. Vancomycin resistant enterococci (VRE) colonization and the spread decrease with compliance and isolation guidelines. For the isolation methods to succeed, compliance with the isolation guidelines needs to be overseen. In this study, VRE outbreak among the Pediatric Ward patients, the preventative efforts to control this outbreak, and the impact of scoring tables used in controlling this outbreak on the success are explained. Design. Rectal swab cultures were taken from patients who were admitted to the Ward between October and December 2010 due to diagnoses of VRE and urinary tract infection. Results. VRE were isolated in the rectal swab samples of 34 patients. VRE infection findings were clinically detected in two of the cases with VRE isolation. Two isolations of VRE were detected on cultures from patient room door handle surface and the telephone in the room for common use. Close contact isolation was achieved and barrier precautions were taken for all cases, as soon as the detections were made. A scoring system was developed to evaluate the feasibility of and the compliance with the precautions to be taken. Conclusions. With the method presented in this study, the outbreak at our hospital was under control within two months. Vuslat Kecik Bosnak, Mustafa Namiduru, Ilkay Karaoglan, and Ayse Ozlem Mete Copyright © 2013 Vuslat Kecik Bosnak et al. All rights reserved. Tue, 05 Feb 2013 08:13:34 +0000 http://www.hindawi.com/journals/tswj/2013/363652/ To aid the clinical diagnosis of typhoid fever in India, where most hospitals and primary health centres have no facilities for culture, we report on the development of a novel and rapid immunodiagnostic kit for the direct detection of Salmonella Typhi—specific IgG antibodies against S. Typhi flagellar H antigen. The disease often does not show a specific clinical picture, and can be confused with other febrile illness such as malaria, dengue fever and Staphylococcus aureus. To overcome the problem of cross reactivity specific epitope of the flagellar H antigen was immobilised on the testing kit strip eliminating chances of cross reactivity and false positive results thereby increasing the specificity of the test. Since the immunodiagnostic kit, uses the flagellar H antigen from bacteria present in our country, the antibodies present in the serum of patients of our country will have maximum binding affinity, enhancing the sensitivity of our test kit. The immunodiagnostic kit on analysis gave a positive result with clinically diagnosed typhoid positive patient serum and negative results were obtained with the sera of clinically diagnosed malaria, abscess of Staphylococcus aureus and Visceral leishmaniasis (Kala-azar) patients. Rahul Mitra, Surya Bhan, Gopal Nath, Narender Kumar, and Ziledar Ali Copyright © 2013 Rahul Mitra et al. All rights reserved. Sun, 20 Jan 2013 15:21:54 +0000 http://www.hindawi.com/journals/tswj/2013/457435/ When a Staphylococcus-like organism (SLO) is microscopically found in Gram staining of blood culture (BC) specimen, it seems reasonable to administrate a glycopeptide (GP) for empirical therapy. The paper investigates the risk factors for 14-day mortality in patients with methicillin-resistance Staphylococcus aureus bacteremia (MRSAB) and clarifies the impact of the timing for initiating GP therapy. A retrospective study identifies patients with MRSAB (endocarditis was excluded) between 2006 and 2009. Patients were categorized as receiving GP at the interval before a preliminary BC report indicating the growth of SLO and the onward 24 hours or receiving GP 24 h after a preliminary BC report indicating the growth of SLO. Total 339 patients were enrolled. There was no difference on the 14-day overall or infection-related mortality rates at the time to administer GP. Multivariate analysis disclosed pneumonia (OR = 4.47; of 95% CI; of 2.09–9.58; ) and high APACHE II score (OR, 2.81, with 95% CI, 1.19–6.65; ) were independent risk factors for infection-related mortality. The mortality rate did not decrease following administrating GP immediately after a preliminary BC indicating SLO growth. An additional research for the optimal timing for initiating GP treatment is warranted. Chen-Hsiang Lee, Chun-Chih Chien, and Jien-Wei Liu Copyright © 2013 Chen-Hsiang Lee et al. All rights reserved. Tue, 24 Apr 2012 12:47:23 +0000 http://www.hindawi.com/journals/tswj/2012/169028/ Objective. This study aimed to evaluate epidemiological, clinical, laboratory, and neuroimaging features of 160 adult patients with tuberculous meningitis (TBM) according to “Thwaites’ diagnostic index.” Methods. The subjects of this retrospective study are the patients with TBM who were followed up between years 1998 and 2009 in a tertiary referral hospital. Diagnosis of TBM was based on clinical, laboratory, and neuroimaging signs and Thwaites’ diagnostic index. Results. Mycobacterium tuberculosis was isolated from CSF in 59 of 148 patients. Seventeen percent of the patients died, 71% recovered completely, and 13% recovered with neurological sequel at the end of the sixth month. Conclusions. Despite new developments in laboratory or neuroimaging techniques, the diagnosis of TBM is still based on clinical features with the help of laboratory. Early diagnosis by suspecting TBM may prevent therapy delay and may result in decrease in the mortality and morbidity. Filiz Pehlivanoglu, Kadriye Kart Yasar, and Gonul Sengoz Copyright © 2012 Filiz Pehlivanoglu et al. All rights reserved. Sun, 01 Apr 2012 09:12:27 +0000 http://www.hindawi.com/journals/tswj/2012/104239/ Brucellosis is one of the most important reemerging zoonoses in many countries. Brucellosis is caused by Gram-negative coccobacillus belonging to genus Brucella. Human brucellosis often makes the diagnosis difficult. The symptoms and clinical signs most commonly reported are fever, fatigue, malaise, chills, sweats headaches, myalgia, arthralgia, and weight loss. Some cases have been presented with only joint pain, lower backache, and involuntary limb movement, burning feet, or ischemic heart attacks. The focus of this work was to develop a highly sensitive and specific indirect ELISA by using smooth lipopolysaccharide antigen of Brucella abortus 99 to detect anti-Brucella antibodies at Project Directorate on Animal Disease Monitoring and Surveillance. Serum samples collected from 652 individuals in whom fever was not the major symptom but the complaint was of joint pain, headache, lower backache, and so forth, were screened by Rose Bengal plate agglutination test (RBPT) and standard tube agglutination test (STAT). Subsequent testing of sera by indigenous indirect ELISA detected 20 samples positive (3.6% seroprevalence), and indirect ELISA was found to be more sensitive than RBPT and STAT. The seroprevalence in South Karnataka was 2.14%, and in North Karnataka it was 0.92%. Annapurna S. Agasthya, Srikrishna Isloor, and Prabhudas Krishnamsetty Copyright © 2012 Annapurna S. Agasthya et al. All rights reserved. Wed, 01 Feb 2012 13:30:30 +0000 http://www.hindawi.com/journals/tswj/2012/396302/ The authors show the results of an integrated model for risk management of tuberculosis in a sample of sheltered homeless in Rome. Tuberculin skin test (TST) was used for evaluating the prevalence of latent infection (LTBI). In TST positives, expectorate was collected and chest X-ray was achieved. Multiple logistic regression analysis was performed to investigate determinants of infection. Out of 288 recruited subjects, 259 returned for the TST reading; 45.56% were positive and referred to a specialized center; 70 accessed the health facility and completed the clinical pathway. The risk factors associated to LTBI were male gender (OR=3.72), age over 60 years (OR=3.59), immigrant status (OR=3.73), and obesity (OR=2.19). This approach, based on an integrated social network, guarantees high adherence to screening (89.93%), allowing patients testing positive for latent tuberculosis infection to be diagnosed and rapidly referred to a specialized center. Patrizia Laurenti, Stefania Bruno, Gianluigi Quaranta, Giuseppe La Torre, Antonio G. Cairo, Pierangela Nardella, Giovanni Delogu, Giovanni Fadda, Tommaso Pirronti, Salvatore Geraci, Salvatore Pelargonio, Francesco N. Lauria, Delia Goletti, and Gualtiero Ricciardi Copyright © 2012 Patrizia Laurenti et al. All rights reserved. Wed, 04 Jan 2012 10:55:45 +0000 http://www.hindawi.com/journals/tswj/2012/159821/ Neuroysticercosis is the most common helminthic infection of the nervous system, and a leading cause of acquired epilepsy worldwide. The disease occurs when humans become intermediate hosts of Taenia solium by ingesting its eggs from contaminated food or, most often, directly from a taenia carrier by the fecal-to-oral route. Cysticerci may be located in brain parenchyma, subarachnoid space, ventricular system, or spinal cord, causing pathological changes that are responsible for the pleomorphism of neurocysticercosis. Seizures are the most common clinical manifestation, but many patients present with focal deficits, intracranial hypertension, or cognitive decline. Accurate diagnosis of neurocysticercosis is possible after interpretation of clinical data together with findings of neuroimaging studies and results of immunological tests. The introduction of cysticidal drugs have changed the prognosis of most patients with neurocysticercosis. These drugs have shown to reduce the burden of infection in the brain and to improve the clinical course of the disease in most patients. Further efforts should be directed to eradicate the disease through the implementation of control programs against all the interrelated steps in the life cycle of T. solium, including human carriers of the adult tapeworm, infected pigs, and eggs in the environment. Oscar H. Del Brutto Copyright © 2012 Oscar H. Del Brutto. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2008/186498/ Endocarditis due to Abiotrophia spp. occurs in about 5% of endocarditis cases. Most of the cases respond to a combination of penicillin and gentamicin, or vancomycin. We describe a case of Staphylococcus epidermidis (CONS) and Abiotrophia spp. endocarditis that failed vancomycin treatment, but responded to daptomycin and rifampin. E. Bishburg, D. Ghuman, A. Cohen, T. Chan, and S. Nalmas Copyright © 2008 E. Bishburg et al. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2007/251848/abs/ Streptococcus constellatus (S. constellatus) is known to cause abscesses in the oral, genitourinary, and gastrointestinal tracts, frequently in association with anaerobic bacteria. We report a rare case of S. constellatus and Prevotella bivia (P. bivia) causing a penile abscess, which was successfully treated with surgical drainage and antibiotic treatment. Sandhya Nalmas, Eliahu Bishburg, and Trini Chan Copyright © 2007 Sandhya Nalmas et al. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2004/421021/abs/ We report a case of tuberculosis (TB) involving duplex kidney that has not been reported in the literature so far. Conservative surgery was done, which was effective in our case. Tanweer A.N. Bhatty and Ahmed M. Alkhayat Copyright © 2004 Tanweer A.N. Bhatty and Ahmed M. Alkhayat. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2002/289140/abs/ Infectious diseases can be manifested by a spectrum of clinical signs and resultant clinical courses that range from acute to chronic and possible persistence in the victim in a latent form. Until recently, the origins of this kind of biodiversity were poorly understood, but advances in immunology — especially in identifying the constitutional mechanisms of immunity — have contributed to our understanding of the origins of biodiversity in infectious diseases. Infectious diseases affect only focal areas in the affected organisms, and the amounts and distribution of infectious lesions vary from patient to patient. In a population attacked by an infectious agent, individuals can be conveniently divided into three categories: totally resistant organisms which contain no susceptible structures and are not affected; mildly susceptible organisms in which a few foci appear and in which the infection runs a benign course; organisms in which the number of constitutionally susceptible structures is high and the infectious process develops in a severe form. The diversity is determined by the differences in susceptibility of various parts of the organism under consideration. Sergey N. Rumyantsev Copyright © 2002 Sergey N. Rumyantsev. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2007/320147/abs/ The purpose was to evaluate the prevalence of sexual abuse in patients who were referred to a pediatric gynecologist for evaluation based on the clinical findings of anogenital warts. A retrospective analysis was performed on 131 patients between the ages 6 month and 9 years referred to a pediatric gynecologist after the finding of anogenital warts by a clinical provider, parent or caregiver. A complete physical examination under colposcopy by a the same, trained pediatric gynecologist was completed, and a complete medical and family history including maternal and sibling history for evidence of Human Papillomavirus (HPV) and anogenital warts. The legal system completed a full investigation to examine the sexual abuse allegations. In 131 patients with anogenital warts, a maternal history of warts, cervical dysplasia or both was present in 66 (50%). The remaining patients had either a negative maternal history for HPV clinical findings (54 patients or 41.2%), or maternal history was unknown (11 patients, or 8.3%). Of 131 patients, 81 (61%) patients had a sibling. Of those with siblings 40 (49.4%) had warts and 41 (50.6%) did not. Forty-five (34%) of the cases had a positive maternal history for warts, dysplasia or both but also had a sibling. In that cohort, 32 (71%) of the siblings also had anogenital warts. Three of 131 patients were ruled suspicious for sexual abuse by the legal authorities but not confirmed. Of those three patients two were female and one was male. Two had no maternal history for HPV and both of these patients had a sibling without anogenital warts. Most cases of anogenital warts in children are likely to be the result of non-sexual transmission, namely prenatal mode. Thus, these patients should be handled differently by the legal system unless other reasons for suspicion exist. This study also showed the importance of maternal gynecologic history. Valerie Jones, Shawn J. Smith, and Hatim A. Omar Copyright © 2007 Valerie Jones et al. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2006/512923/abs/ The aim of this study was to assess the role of the routine practice of microbial culture and sensitivity at incision and drainage of superficial soft tissue abscesses. The case notes of 162 consecutive patients, selected from the microbiology database over a period of 1 year, were reviewed. All had incision and drainage of superficial soft tissue abscesses and included perianal, pilonidal, axillary, and breast abscesses. Patients with chronic wounds, recurrent abscesses, diabetes, pregnancy, and immunosuppression were excluded. The impact of pus culture and sensitivity (C/S) on management and clinical outcome was documented. Out of 162 patients, 97 were male (59.8%) and 65 were female (40.1%). Only 115 (70.9%) yielded positive cultures and 47 (29.1%) were sterile. The cultured microbial flora was predictable and sensitive to empirical antibiotics. In four patients, the results of microbial culture sensitivity showed microbial resistance to empirical antibiotics; however, it did not affect the management or the outcome for these patients. The routine practice of sending swabs for C/S after incision and drainage of superficial soft tissue abscesses does not contribute significantly towards patient management. Most patients are already on antibiotics prior to the referral and in the remainder, surgeons start antibiotics empirically. These broad-spectrum antibiotics cover the common pathogens involved, and there is no significant change in the antibiotic treatment after reviewing the culture reports following incision and drainage of uncomplicated superficial skin abscesses. Muhammad N. Khan, Raghavan Vidya, and Richard E. Lee Copyright © 2006 Muhammad N. Khan et al. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2001/638969/abs/ Fabiana Horn, Michele Bastiani, and D.S. Santos Copyright © 2001 Fabiana Horn et al. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2009/657359/ P. Velagapudi, Mohit Turagam, C. Are, H. Patel, and L. Yekkirala Copyright © 2009 P. Velagapudi et al. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2007/673857/abs/ Tenofovir is an acyclic nucleotide analogue reverse transcriptase inhibitor that is commonly prescribed as part of a highly active antiretroviral therapy (HAART) regimen in HIV-infected patients. Although it is generally well tolerated, renal insufficiency has been associated with its use. We report a biopsy-proven case of acute renal failure that developed within weeks of initiating a HAART regimen containing tenofovir, and review the literature with specific attention to cases of renal failure occurring within 8 weeks of tenofovir initiation. Our patient developed renal insufficiency within 3 weeks of initiating tenofovir-containing HAART and overt renal failure was noted within 5 weeks. Renal biopsy demonstrated histopathologic changes suggestive of HIV nephropathy, despite normal baseline serum creatinine values. Thirty additional cases of tenofovir-associated renal failure have been reported. In the majority (n = 22, 73%), renal failure occurred months after initiating therapy (range: 5–26 months). However, in a significant subset (n = 8, 27%), renal failure occurred within 8 weeks of treatment initiation. Our data suggest that some patients are at risk for developing renal failure within weeks of tenofovir initiation. Thorough evaluation of renal function should be undertaken before prescription of tenofovir-containing HAART. For those in whom subclinical renal disease is discerned, added vigilance when monitoring renal function may be warranted. Shilpa M. Patel, Teresa R. Zembower, Frank Palella, Yashpal S. Kanwar, and Shubhada N. Ahya Copyright © 2007 Shilpa M. Patel et al. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2005/726174/abs/ Tuberculosis (TB) is becoming an ever more serious worldwide problem. This contagious disease kills four people every minute somewhere in the world and accounts for more than 2 million deaths per year. Due to the rapid spread of TB strains resistant to all the major anti-TB drugs on the market, and the association of TB with human immunodeficiency virus (HIV) infection in AIDS, we urgently need to develop new drugs to fight against TB. In this context, due to the importance of nature in the development of new drugs, the aim of the present review is to highlight a series of new and promising anti-TB agents derived from plants and fungi discovered between 2001 and 2005. Marcus Vinicius Nora De Souza Copyright © 2005 Marcus Vinicius Nora De Souza. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2011/750420/ Today, 30 years after the onset of the HIV pandemic, although treatment strategies have considerably improved, there is still no cure for the disease. Recently, we described a successful hematopoietic stem cell transplantation in an HIV-1–infected patient, transferring donor-derived cells with a natural resistance against HIV infection. These hematopoietic stem cells engrafted, proliferated, and differentiated into mature myeloid and lymphoid cells. To date, the patient has not required any antiretroviral treatment, more than 4 years after allogeneic transplantation. In the analysis of peripheral blood cells and different tissue samples, including gut, liver, and brain, no viral load or proviral DNA could be detected. Our report raises the hope for further targeted treatment strategies against HIV and represents a successful personalized treatment with allogeneic stem cells carrying a beneficial gene. However, this case has ignited a controversy regarding the question of whether this patient has achieved complete eradication of HIV or not. Here we give an update on open questions, unsolved aspects, and clinical consequences concerning this unique case. Gero Hütter and Susanne Ganepola Copyright © 2011 Gero Hütter and Susanne Ganepola. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2006/901865/abs/ Natural products represent an outstanding source of compounds that play an important role in the treatment of human diseases. Due to the importance of nature as a source of new drug candidates, the aim of this review is to highlight the marine natural products, which exhibit antituberculosis activity, discovered between 2000 and 2005. Marcus Vinícius Nora De Souza Copyright © 2006 Marcus Vinícius Nora De Souza. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2010/930717/ Elena Sendagorta, Pedro Herranz, Héctor Guadalajara, Francisco Zamora, and Juan Gonzalez Copyright © 2010 Elena Sendagorta et al. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2004/953563/abs/ Victoria R. Staiman and Franklin C. Lowe Copyright © 2004 Victoria R. Staiman and Franklin C. Lowe. All rights reserved. Mon, 01 Jan 1900 00:00:00 +0000 http://www.hindawi.com/journals/tswj/2011/979785/ Tuberculosis (TB) is a truly global disease, found in every country on earth. One-third of humanity, over 2 billion people, carry the bacillus that causes TB and 2 million people die of the disease each year. Despite that, no new specific drug against Mycobacterium tuberculosis has been developed since the 1960s. There are several candidates for new anti-TB agents, but none proven clinically effective. Stilbenes are compounds found in numerous medicinal plants and food products with some known biological and even antimycobacterial activity. This paper describes the synthesis and the anti–M. tuberculosis activity of eight stilbene analogues. The synthesis and characterization of these compounds are shown, and the results compared with one “first”-line drug used in current therapy. Fernando R. Pavan, Gustavo Senra G. de Carvalho, Adilson D. da Silva, and Clarice Q. F. Leite Copyright © 2011 Fernando R. Pavan et al. All rights reserved.