Author Interviews, Infections, NIH, Rheumatology / 31.03.2014

MedicalResearch.com Interview with: Eleftherios Mylonakis, M.D., Ph.D., FIDSA Dean's Professor of Medical Science Chief, Infectious Diseases Division Alpert Medical School and Brown University and Dr. Irene Kourbeti MD Research Associate Infectious Disease Division Rhode Island Hospital, Providence, RI MedicalResearch.com: What are the main findings of the study? Answer : There was high quality of evidence that biologic agents are associated with increased risk of all opportunistic infections, but there was no difference in mortality attributed to the opportunistic infections. Patients receiving biologics were twice more likely to develop opportunistic infections (OIs) compared to controls (OR 1.79; 95% CI, 1.17-2.74) with a number needed to harm (NNH) of 582 patients. That means that 1 opportunistic infection  would occur in every 582 patients receiving biologics. The opportunistic infections usually occurred at the commencement of the use of the biological agent and they were not statistically more in patients with a previous exposure to anti-TNF agents as compared to the patients that had never received an anti-TNF agent.. (more…)
Author Interviews, CDC, Hand Washing, Hospital Acquired, Infections, NEJM / 26.03.2014

MedicalResearch.com Interview with: Shelley S. Magill, M.D., Ph.D. From the Centers for Disease Control and Prevention Emory University School of Medicine Atlanta, Georgia MedicalResearch.com: What are the main findings of the study? Dr. Magill: The results of this survey show that healthcare-associated infections continue to be a threat to patient safety in U.S. acute care hospitals. Among the more than 11,000 patients included in the survey, approximately 4% (or 1 in 25) had at least one healthcare-associated infection at the time of the survey. We used these results to develop national estimates of healthcare-associated infections. We estimated that in 2011, there were approximately 721,800 healthcare-associated infections in U.S. acute care hospitals. The most common types of infections were surgical site infections (SSIs), pneumonias, and gastrointestinal infections. (more…)
Author Interviews, Infections, JAMA, OBGYNE / 19.03.2014

Shamez Ladhani, MRCPCH PhD Health Protection Services, Immunisation, Hepatitis, and Blood Safety Department, Public Health England, LondonMedicalResearch.com Interview with: Shamez Ladhani, MRCPCH PhD Health Protection Services, Immunisation, Hepatitis, and Blood Safety Department, Public Health England, London   MedicalResearch.com: What are the main findings of the study? Dr. Ladhani: Pregnancy was associated with an increased of serious infection by a bacterium called Haemophilus influenzae which is usually associated with respiratory tract infections. Nearly all the H. influenzae were unencapsulated; that is, they did not have an outer sugar capsule which is often required to make the bacterium more virulent. The encapsulated H. influenzae type b (Hib), for example, was the most common cause of bacterial meningitis in your children prior to routine immunisation. We also found that infection with unencapsulated H. influenzae was associated with poor pregnancy outcomes, including miscarriages, stillbirth and premature birth. (more…)
Author Interviews, Hospital Acquired, Infections, NIH, Surgical Research, University of Pennsylvania, Wake Forest / 09.03.2014

William G Ward, Sr. MD Chair of Orthopaedic Surgery, Chief of Musculoskeletal Service Line - Guthrie Clinic One Guthrie Square Sayre, Pennsylvania 18840 (Professor Emeritus - Wake Forest University Dept of Orthopaedic Surgery)MedicalResearch.com Interview with: William G Ward, Sr. MD Chair of Orthopaedic Surgery, Chief of Musculoskeletal Service Line - Guthrie Clinic Sayre, Pennsylvania 18840 (Professor Emeritus - Wake Forest University Dept of Orthopaedic Surgery) MedicalResearch.com: What are the main findings of this study? Dr. Ward: The main findings of the study include:
  1. The use of disposable spun-lace “paper” gowns was associated with a dramatic decrease in the likelihood of culture-detected bacterial contamination on the surgeon’s gloved hand and gown sleeve.
  2. For a double-gloved surgeon, changing the outer glove just prior to implant handling should decrease bacterial contamination from the surgeon by about 50%.
  3. Bacteria suspended in saline solution transgressed the material of standard reusable scrub attire in 96% (26/27) of tested gowns and in 0% (0/27) of spun-lace disposable “paper” gowns. (more…)
Annals Thoracic Surgery, Author Interviews, Dental Research, Heart Disease, Infections, Mayo Clinic / 01.03.2014

Dr. Kendra J. Grim Department of Anesthesiology Mayo Clinic, Rochester, MN 55905MedicalResearch.com Interview with: Dr. Kendra J. Grim Department of Anesthesiology Mayo Clinic, Rochester, MN 55905 MedicalResearch.com: What are the main findings of the study? Dr. Grim: “The current guidelines say that if possible, treating the dental problems that patients have before heart surgery is best, to try to prevent both early and late heart infections. But the data is very unclear, because it’s very difficult to study. We found in our study that their risk of serious complications after having teeth removed may be higher than we thought. We were primarily looking at stroke, heart attack, renal failure and death. We found that actually the incidence of having one of those major morbidities was 8 percent.  Of that 8 percent, we had six patients, or 3 percent, of the total group who died between their dental surgery and scheduled heart surgery, so these patients never made it to their heart surgery. An additional 3 percent of patients died after heart surgery. “ (more…)
Annals Internal Medicine, Author Interviews, Infections, Transplantation / 01.03.2014

MedicalResearch.com Interview with: Dr. Susan N. Hocevar MD Centers for Disease Control and Prevention Atlanta, GA 30333; MedicalResearch.com:  What are the main findings of the study? Dr. Hocevar: This public health investigation uncovered microsporidiosis transmitted to 3 organ recipients who received organs from a common donor. This illness cluster was the first recognized occurrence of donor-derived microsporidiosis. (more…)
Author Interviews, Infections, Outcomes & Safety, Pharmacology, Urinary Tract Infections / 28.02.2014

Dr. Jerome A. Leis, MD, MSc Sunnybrook Health Sciences Centre Toronto, ON, M4N 3M5, CanadaMedicalResearch.com Interview with: Dr. Jerome A. Leis, MD, MSc Sunnybrook Health Sciences Centre Toronto, ON, M4N 3M5, Canada MedicalResearch.com: What are the main findings of the study? Dr. Leis: We know that positive urine cultures from patients who lack signs and symptoms of urinary tract infection are a trigger FOR unnecessary antibiotic prescriptions in hospitals. This problem has not improved despite many educational initiatives.  We identified a subset of patients in our hospital where only 2% of all urine specimens sent to the laboratory were associated with symptomatic infection and decided to no longer routinely report positive results from these specimens on the electronic medical record, unless a special telephone request was made.  We found that with this simple change, unnecessary antibiotic prescriptions declined markedly and this did not require any education of care providers. Most importantly, based on our safety audits, patients who had a urinary tract infection all received appropriate treatment. (more…)
Author Interviews, Dengue, Infections, NEJM, Respiratory / 27.02.2014

Valérie D'Acremont, MD, PhD Group leader Swiss Tropical and Public Health Institute | Basel | Switzerland Médecin-adjointe, PD-MER Travel clinic | Department of Ambulatory Care and Community Medicine | University hospital of Lausanne | SwitzerlandMedicalResearch.com Interview with: Valérie D'Acremont, MD, PhD Group leader Swiss Tropical and Public Health Institute | Basel | Switzerland Médecin-adjointe, PD-MER Travel clinic | Department of Ambulatory Care and Community Medicine | University hospital of Lausanne | Switzerland MedicalResearch.com: What are the main findings of the study? Dr. D'Acremont: We discovered that, in a rural and an urban area of Tanzania, half of the children with fever (temperature >38°C) had an acute respiratory infection, mainly of the upper tract (5% only had radiological pneumonia). These infections were mostly of viral origin, in particular influenza. The other children had systemic viral infections such as HHV6, parvovirus B19, EBV or CMV. Overall viral diseases represented 71% of the cases. Only a minority (22%) had a bacterial infection such as typhoid fever, urinary tract infection or sepsis due to bacteremia. Malaria was found in only 10% of the children, even in the rural setting. (more…)
Author Interviews, Infections, JAMA / 26.02.2014

MedicalResearch.com Interview with: Tobias Skillbäck, MD Clinical Neurochemistry Laboratory Institute of Neuroscience and Physiology Department of Neurochemistry, Sahlgrenska Academy University of Gothenburg Mölndal, Sweden MedicalResearch.com: What are the main findings of the study? Dr. Skillbäck: There were two main findings in this study. First; Levels of t-tau and the T-tau/P-tau ratio in CSF of CJD (Creutzfeldt-Jakob Disease) patients are markedly increased, as compared to patients with Alzheimer's disease and other dementias, and they  are high enough to distinguish CJD against these important differential diagnoses. Secondly, levels of these biomarkers tend to increase rapidly with disease progress in Creutzfeldt-Jakob Disease. This trend could not be observed for Alzheimer's disease and other dementias, and could also be used to clinically distinguish CJD and indicates that repeated CSF measurements might be of value if a clinical suspicion of Creutzfeldt-Jakob Diseaseis present. (more…)
Author Interviews, Infections, JAMA, Vaccine Studies / 25.02.2014

Signe Sørup, PhD Research Center for Vitamins and Vaccines (CVIVA) Bandim Health Project, Statens Serum Institut Artillerivej 5, DK-2300 Copenhagen S, DenmarkMedicalResearch.com Interview with: Signe Sørup, PhD Research Center for Vitamins and Vaccines (CVIVA) Bandim Health Project, Statens Serum Institut Artillerivej 5, DK-2300 Copenhagen S, Denmark MedicalResearch.com: What are the main findings of the study? Dr. Sørup: We found that admissions with any type of infection was reduced with 14 % for Danish children having the live, attenuated vaccine against measles, mumps, and rubella (MMR) as the most recent vaccine compared with children having the inactivated vaccine against Diphtheria, Tetanus, Pertussis, Polio, and Haemophilus Influenzae type b (DTaP-IPV-Hib) as the most recent vaccine. In Denmark herd immunity against measles, mumps, and rubella is high and only 26 of the more 42,000 admissions was related to measles, mumps, and rubella; so this finding cannot be explained by the specific protection against the targeted diseases. In Denmark MMR vaccination is recommended at 15 months of age, but only 50% of the children in the study had received MMR before 16 months of age. We estimated that one hospital admission between 16 and 24 months of age could be avoided for 201 children vaccinated with MMR before 16 months of age rather than later. These results are based on a retrospective cohort study including approximately half a million Danish children. The analyses are adjusted for age and a long range of background factors, including socio-economic factors. (more…)
Infections, NEJM / 23.02.2014

Dr. T. M. A van Dongen, MD Univ Med Ctr Utrecht Julius Ctr Hlth Sci & Primary Care, Dept Epidemiol Utrecht, Netherlands.MedicalResearch.com Interview with: Dr. T. M. A van Dongen, MD Univ Med Ctr Utrecht Julius Ctr Hlth Sci & Primary Care, Dept Epidemiol Utrecht, Netherlands. MedicalResearch.com: What are the main findings of the study? Answer: We performed a pragmatic trial, in which we randomly assigned 230 children who had acute tympanostomy-tube otorrhea to receive antibiotic-glucocorticoid eardrops, oral antibiotics or to undergo initial observation. The primary outcome of our study was the presence of ear discharge, 2 weeks after study-group assignment. We also looked at, among others, the duration of the initial otorrhea episode and the total number of days of otorrhea and the number of otorrhea recurrences during 6 months of follow-up. We found that antibiotic–glucocorticoid eardrops were superior to oral antibiotics and initial observation for all outcomes. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, Outcomes & Safety / 20.01.2014

Allan J. Walkey, M.D., M.Sc Boston University School of Medicine Pulmonary Center Boston, MassachusettsMedicalResearch.com Interview with: Allan J. Walkey, M.D., M.Sc Boston University School of Medicine Pulmonary Center Boston, Massachusetts MedicalResearch.com: What are the main findings of the study? Dr. Walkey: Thank you for the interest in our study.  Current evidence-based treatments for severe sepsis (ie, infection+systemic inflammatory response+ end organ dysfunction) include specific processes of care rather specific therapeutics.  These processes include early administration of antibiotics, early fluid resuscitation, and lung protective ventilation strategies.  We hypothesized that hospitals with more ‘practice’ at treating patients with severe sepsis may have more effective care processes leading to improved patient outcomes.  We examined more than 15,000 severe sepsis admissions from 124 US academic medical centers. Our findings supported our hypothesis. After adjustment for patient severity of illness and hospital characteristics, mortality in the highest quartile severe sepsis case volume hospitals was 22% and  mortality in lowest severe sepsis case volume hospitals was 29%.  The 7% absolute mortality difference would result in an estimated number needed to treat in high severe sepsis volume hospitals to prevent one death in low case volume hospitals of 14 (though we advise caution in interpretation of a number needed to treat in an observational study). Costs and length of stay were not different across levels of severe sepsis case volume.  Results were robust to multiple subgroup and sensitivity analyses. (more…)
Author Interviews, Gastrointestinal Disease, Infections, NEJM, Vaccine Studies / 15.01.2014

MedicalResearch.com Interview with Eric S. Weintraub, M.P.H. Epidemiologist at Centers for Disease Control and Prevention MedicalResearch.com: What are the main findings of the study? Mr. Weintraub: While current rotavirus vaccines were not associated with intussusception in large pre-licensure trials, recent post-licensure data (from international settings) suggest the possibility of a low risk of intussusception occurrence after receipt of monovalent rotavirus vaccination (RV1).  We examined the risk of intussusception following RV1 vaccination in a U.S. population.  In this study of more than 200,000 doses of RV1, a slight increased risk of intussusception was observed after vaccination, which should be considered in light of the benefits of preventing rotavirus associated illness. (more…)
Author Interviews, Education, Exercise - Fitness, Infections / 11.01.2014

MedicalResearch.com Interview with: Anna-Christina Lauer, MD Department of Audiology and Phoniatrics Charité-University Medicine Berlin Berlin, Germany MedicalResearch.com: What are the main findings of the study? Dr. Gross: We could show that the injury rates depend on the undergraduate medical training the students attended. This demonstrates that medical undergraduatue education, especially a hands-on training, is critical in the prevention of needlestick- and sharps injuries. Also the use of safety devices has proven to reduce injury rates significantly. Given the large size of our study we could not only comfirm that needlestick and sharps injuries are still a common problem, looking at an injury rate of about 20% per year, we also learned a lot about the accident circumstances: Most accidents occur at bedside during venepuncture and intravenous cannulation. The second most common setting is the operating room, where suturing and instrument transfers can lead to injuries. Since we analyzed official reports and the anonymous surveys at the same time we could affirm an underreporting rate of more than 50%. (more…)
Author Interviews, Infections / 28.12.2013

Anders P. Hakansson, Ph.D. Assistant Professor of Microbiology Department of Microbiology and Immunology Buffalo, NY 14214MedicalResearch.com Interview with: Anders P. Hakansson, Ph.D. Assistant Professor of Microbiology Department of Microbiology and Immunology Buffalo, NY 14214 MedicalResearch.com: What are the main findings of the study: Dr. Hakansson: During the last couple of years we have shown that Streptococcus pneumoniae, a common colonizer of the nasopharynx in small children and elderly that sometimes cause respiratory infections such as middle ear infections and pneumonia, and Streptococcus pyogenes, a common colonizer of the oropharynx and also the cause of strep throat and skin infections, colonize us humans by forming biofilms; intricate bacterial communities. Biofilms have been studied for a long time but these specific organisms have not been shown to form biofilms during colonization until recently. As biofilms are much more resistant to environmental stresses and antibiotics, we were interested to see whether biofilms formed by these organisms could survive in the environment. The main reason for doing the experiments was that CDC guidelines indicate that spread of these organisms between individuals occur solely by inhalation of bacteria-containing droplets after coughing or sneezing. The risk of spread through surfaces has been estimated to be very low as laboratory experiments over the last 40 years have shown that these bacteria die very rapidly on surfaces. These studies were not, however, done with biofilm bacteria. Laura Marks in the laboratory with help from Ryan Reddinger therefore first tested how long biofilm bacteria could survive on plastic surfaces and found that rather than hours these bacteria were alive even after a month and could be used to successfully colonize animals. This made us interested in understanding if these bacteria survive better on hands, a common way to spread bacteria. And just as on inanimate surfaces, the biofilms survived much better on hands than bacteria grown in laboratory media. Based on these results, we were allowed to sample bacteria from stuffed toys, books, crib linens and others surfaces in a day care center early in the morning before the children arrived, and found both S. pneumoniae and S. pyogenes on these items. The results of the study indicate that these bacteria can survive in the environment longer than we have previously thought and may therefore play a role in spread between individuals. (more…)
Author Interviews, Cost of Health Care, Infections / 05.12.2013

MedicalResearch.com Interview with: Michael D. April, MD, DPhil San Antonio Uniformed Services Health Education Consortium.Department Harvard Medical School The Medical Practice Evaluation Center MedicalResearch.com: What are the main findings of this study? Dr. April: Using a mathematical model, this study quantified the survival benefits associated with antiretroviral therapy to HIV-infected people in South Africa since 2004.  Our results highlight the astounding benefits of treatment.  In short, antiretroviral therapy has saved 2.8 million years of life in South Africa to date and is projected to save an additional 15.1 million years of life by 2030. (more…)
Author Interviews, Herpes Viruses, Infections, Nature, Pulmonary Disease / 21.11.2013

Gerard Nuovo MD Professor College of Medicine, The Ohio State University Satellite Laboratory, Ohio State Univ Comprehensive Cancer Center Phylogeny Inc, Powell, OhioMedicalResearch.com Interview with: Gerard Nuovo MD Professor College of Medicine, The Ohio State University Satellite Laboratory, Ohio State Univ Comprehensive Cancer Center Phylogeny Inc, Powell, Ohio MedicalResearch.com: What are the main findings of the study? Dr. Nuovo: The main finding of the study was that idiopathic pulmonary fibrosis was strongly associated with an infection by a herpesvirus.  The data that supported this main finding included:
  • 1) detection of the viral DNA by in situ hybridization in each case of idiopathic pulmonary fibrosis (IPF) and in none of the controls;
  • 2) the localization of the viral DNA to the nucleus of the cell that orchestrates IPF, the regenerating epithelial cell (herpes viruses localize to the nucleus of the target cell);
  • 3) the demonstration that the viral DNA co-localized with "pirated proteins" that the virus makes during productive infection (these were IL-17. cyclin D, dihydrofolate reductase, and thymidylate synthase); this combination of proteins are rarely if ever co-expressed in lung disease and  their co-expression per se was highly suggestive of a viral infection;
  • 4) the demonstration by RTPCR that the cyclin D RNA in IPF comes from the virus and not the human cells;
  • 5) the recognition that this family of herpesviruses (called gammaherpesvirus) causes IPF in other animals including horses, mice, and donkeys;
  • 6) the cloning of part of the gene of the virus from a clinical IPF sample that showed 100% homology to the published sequence of the likely viral pathogen - herpesvirus saimiri. (more…)
Author Interviews, Infections / 07.10.2013

George Alangaden MD Senior Staff Physician, Transplant Infectious Diseases Medical Director of Infection Prevention Henry Ford Hospital Professor of Medicine, Wayne State University Infectious Diseases, CFP-316 Detroit, MI  48202MedicalResearch.com Interview with: George Alangaden MD Senior Staff Physician, Transplant Infectious Diseases Medical Director of Infection Prevention Henry Ford Hospital Professor of Medicine, Wayne State University Infectious Diseases, CFP-316 Detroit, MI  48202 MedicalResearch.com: What are the main findings of the study? Dr. Alangaden:
  • Infections caused by Mycobacterium marinum infections are rare. A total of 5 patients were identified in our hospital over a 10 year period.
  • In all instances the infection affected the skin and soft tissues of the hand and arm and presented as sores or bumps on the skin that did not improve after usual antibiotic therapy.
  • All patients had an history of some trauma to the hand and subsequent exposure to water  from home aquariums
  • The time to onset of infection after exposure ranged from 11 days to 56 days.
  • The median time from infection to diagnosis and appropriate therapy was 161 days (range 33-379 days).
  • In all cases the diagnosis was made by doing a skin biopsy.
  • All patients were cured after several weeks of treatment with appropriate antibiotics. (more…)
Hospital Acquired, Infections, Outcomes & Safety, Pediatrics / 07.10.2013

MedicalResearch.com Interview with: Elias Iosifidis, MD, PhD Pediatric Infectious Disease Fellow Aristotle University of Thessaloniki Hippokration Hospital Thessaloniki, Greece MedicalResearch.com: What are the main findings of the study? Dr. Iosifidis: A large outbreak of VRE colonization was found in neonates hospitalized in an intensive care unit (Neonatal Intensive Care Unit, NICU) after the implementation of an active surveillance program. Both high incidence of VRE colonization (or “colonization pressure”) and antibiotic use promoted VRE spread according to the results of the case control study. No proven sources of VRE were found (in local hospital or even in local livestock). A multifaceted management was implemented and included enhanced infection control measures, active surveillance cultures, cohorting of colonized patients, daily audits and optimization of antibiotic therapy. Although the outbreak had a biphasic pattern (monoclonal first wave followed by a polyclonal second wave) strict adherence to the aforementioned bundle of actions was proved essential for reducing VRE colonized cases. During the study period no new VRE infection occurred in neonates. (more…)
Author Interviews, Global Health, Infections, Lancet / 01.10.2013

Prof Didier Pittet, MD, MS Director of the Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, SwitzerlandMedicalResearch.com Interview with : Prof Didier Pittet, MD, MS Director of the Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, Switzerland   MedicalResearch.com : What are the main findings of the study? Prof. Pittet: The main finding is that the WHO hand hygiene promotion strategy is feasible and sustainable across healthcare settings worldwide. For the first time, we have evidence of its feasibility and successful effects to improve hand hygiene in a variety of different geographical and income settings, with an even greater impact in low-/middle-income countries than in high-income countries. (more…)
Author Interviews, C. difficile, Infections, NEJM / 26.09.2013

MedicalResearch.com Interview with: David W. Eyre, B.M., B.Ch. Nuffield Department of Clinical Medicine University of Oxford National Institute for Health Research (NIHR) Oxford Biomedical Research Centre John Radcliffe Hospital MedicalResearch.com: What are the main findings of this study? Dr. Eyre: All cases of Clostridium difficile in Oxfordshire were studied over 3 years. Isolates were characterized by whole genome sequencing and the data was linked to hospital databases allowing epidemiological relationships between patients at the level of the hospital ward, hospital specialty, and post code to be identified. For comparison, similar information was also available for all other patients with and without diarrhea.  Preliminary work on the genetic diversity of Clostridium difficile within individuals and between individuals within discrete outbreaks allowed reliable interpretation of transmission events using genomic data. This allowed a complete reconstruction of the pattern of transmission between affected cases in Oxfordshire to be made. The findings were: 1. Unexpectedly few cases (13%) appear to be acquired from direct ward based contact with other symptomatic cases (these have previously been thought to be the main source of infections, and the focus of prevention efforts). Another 6% were associated with other hospital contact and 3% had plausible community contacts. 2. In 13% of cases potential donors were identified gnomically but no contact, within hospitals or the community, were identified. This suggests that the existence of other modes of transmission of Clostridium difficile. 3. The sources of Clostridium difficile infections were highly genetically diverse, with 45% of cases having a genetically distinct origin - suggesting a diverse reservoir of disease, not previously appreciated 4. During the 3 years of the study the rate of Clostridium difficile in Oxfordshire fell.  Any improvement in infection control techniques would be expected to reduce the incidence of cases caused by within hospital transmission. Surprisingly, similar rates of fall occurred in both in secondary cases (considered to be acquired from hospital associated symptomatic cases) and for primary cases (cases not associated with transmission from symptomatic cases). (more…)
Author Interviews, CMAJ, Infections, Outcomes & Safety, Urinary Tract Infections / 18.09.2013

MedicalResearch.com Interview with: Mohamad Fakih, MD, MPH Medical Director, Infection Prevention and Control St John Hospital and Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Fakih: Urinary catheters are commonly used in the hospital.  Although they help in the management of the sickest patients, they also present a risk for infection and other harms to the patient. The Centers for Medicaid and Medicare Services (CMS) have made catheter associated urinary tract infections (CAUTI) publicly reportable, and no longer reimburse hospitals for these infections if they occur in hospital setting. The definition of CAUTI is based on the surveillance definition of the National Healthcare Safety Network (NHSN) by the Centers for Disease Control and Prevention (CDC). We looked at clinician practice, including the Infectious Diseases specialist’s impression and compared them to the NHSN definition. We found a significant difference between what clinicians think is a urinary catheter infection and give antibiotics for it compared to the NHSN definition. The NHSN definition predicted clinical infection by the Infectious Diseases specialist in only about a third of the cases. We also found that Infectious Disease specialists considered patients to have true CAUTI in only half of what clinicians treated as CAUTI. (more…)
Author Interviews, Heart Disease, Infections, JACC, Yale / 31.08.2013

Behnood Bikdeli, MD Yale/YNHH Center for Outcomes Research and Evaluation One Church St, Suite 200 New Haven CT 0651MedicalResearch.com Interview with: Behnood Bikdeli, MD Yale/YNHH Center for Outcomes Research and Evaluation One Church St, Suite 200 New Haven CT 0651 MedicalResearch.com: What are the main findings of the study?
 Dr. Bikdeli: We determined the trends in hospitalizations and mortality from endocarditis among US older adults from 1999 to 2010. Endocarditis is the most serious cardiovascular infection and our study that had a very large sample, signified the high burden of endocarditis in this time period. (more…)
Author Interviews, Gastrointestinal Disease, Infections, Lancet, Probiotics / 15.08.2013

Prof. Steve Allen Professor of Paediatrics and International Health; RCPCH International Officer and David Baum Fellow Room 314, The College of Medicine, Swansea University, Swansea, SA2 8PP, UK.Prof. Steve Allen Professor of Paediatrics and International Health; RCPCH International Officer and David Baum Fellow Room 314, The College of Medicine, Swansea University, Swansea, SA2 8PP, UK. MedicalResearch.com: What are the main findings of the study? Answer: Overall, diarrhoea occurred in just over 10% participants and diarrhoea caused by C. difficile in about 1%. These outcomes were equally common in those taking the microbial preparation and those taking placebo. Other outcomes (e.g. common GI symptoms, length of hospital stay, quality of life) were also much the same in the two groups. So, there was no evidence that the microbial preparation had prevented diarrhoea or had led to any other health benefit. In agreement with previous research, serious adverse events were also similar in the two groups – so we found no evidence that the microbial preparation caused any harm. (more…)
Author Interviews, HIV, Infections, JNCI, Lymphoma / 08.08.2013

MedicalResearch.com Interview with: Satish Gopal, MD, MPH Program in Global Oncology, Lineberger Comprehensive Cancer Center UNC Project-Malawi, Tidziwe Center, Private Bag A-104, Lilongwe, Malawi MedicalResearch.com: What is the primary message our physician readers should take away from the piece?” Answer: Lymphoma is one of the leading causes of HIV-associated death in the modern ART era. In our analyses of a large multicenter US cohort, survival for HIV-associated lymphoma patients receiving routine care has not clearly improved since the modern ART era began, and remains significantly worse than SEER outcomes for the same lymphoma subtypes in the general population. This was somewhat surprising in an era of normalizing life expectancy for HIV-infected patients on ART, and quite different from the outstanding results achieved for this population in recent clinical trials conducted by AMC and NCI. (more…)
Author Interviews, HPV, Infections, Race/Ethnic Diversity / 02.08.2013

MedicalResearch.com interview with: Matthew B. Schabath, Ph.D Assistant Member, Department of Cancer Epidemiology H. Lee Moffitt Cancer Center, 12902 Magnolia Drive MRC-CANCONT, Tampa, Florida MedicalResearch.com: What are the main findings of the study? Dr. Schabath: In this study we found that Asian/Pacific Islander men had the lowest incidence of human papillomavirus (HPV) infection and that they exhibited a lower probability of acquiring new HPV infections.   Furthermore, men of multiple and mixed race had the second lowest incidence of HPV infection and however, while they had a lower probability of acquiring HPV, they also had a lower probability of clearing an HPV infection once acquired. (more…)
CDC, Infections / 01.08.2013

CDC Highlights from 7/31/2013 From http://www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html

Epidemiologic Investigation

  • As of July 30, 2013 (5pm EDT), CDC has been notified of 378 cases of Cyclospora infection from the following 16 health departments: Iowa, Texas, Nebraska, Florida, Wisconsin, Illinois, New York City, Georgia, Missouri, Arkansas, Connecticut, Kansas, Minnesota, New Jersey, New York, and Ohio.
  • Most of the illness onset dates have ranged from mid-June through early July.
  • At least 21 persons reportedly have been hospitalized in three states.
  • Nebraska and Iowa have performed investigations within their states and have shared the results of those investigations with CDC. Based on their analysis, Cyclospora infections in their states are linked to a salad mix. CDC will continue to work with federal, state, and local partners in the investigation to determine whether this conclusion applies to the increase in cases of cyclosporiasis in other states.
  • It is not yet clear whether the cases from all of the states are part of the same outbreak. (more…)
Author Interviews, Diabetes, Infections, JAMA, Respiratory / 15.07.2013

Andreas Beyerlein, PhD  Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes der Technischen Universität München, Munich, GermanyMedicalResearch.com Interview with: Andreas Beyerlein, PhD Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes der Technischen Universität München, Munich, Germany MedicalResearch.com What are the main findings of the study? Dr. Beyerlein: We identified respiratory infections in early childhood, especially in the first year of life, as a risk factor for islet autoimmunity, which is known as a precursor of type 1 diabetes (T1D). We also found some evidence for short term effects of infectious events on development of autoimmunity. (more…)
Author Interviews, Infections, Lyme, NEJM / 02.07.2013

MedicalResearch.com Interview with: Sam R. Telford III, ScD Department of Infectious Disease and Global Health, Tufts University, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA Borrelia miyamotoi Infection Presenting as Human Granulocytic Anaplasmosis: A Case Report MedicalResearch.com: What are the main findings of the study? Answer: The study presents two additional cases of BMD (Borrelia miyamotoi disease) that add to our knowledge of the spectrum of illness of this recently recognized zoonosis.  Our report of the North American index case in NEJM in January 2013 described a case-patient who was elderly and immunocompromised and it was not clear whether that case was just very unusual.  With our Annals report, we describe cases in immune-intact individuals and suggest that cases of BMD may have been under our noses all along, just presumptively diagnosed as HGA and successfully treated with doxycycline with no followup (e.g., lab confirmation of diagnosis of HGA Human Granulocytic Anaplasmosis).  Hence, individuals presenting with fever, headache, myalgia, and show leukopenia and elevated LFTs may have either HGA or BMD and confirmatory testing should be done accordingly.  It should be noted that all tick borne diseases are clinical diagnoses and treatment of an acute case should not depend on "lab tests".  Both these infections are effectively managed by oral doxycycline, hence those with these signs and symptoms might be empirically treated with doxycyline, which would be important in areas where RMSF and tularemia (which also produce leukopenia and elevated LFTs) co-occur with deer tick -transmitted infections such as Lyme disease; waiting for "lab tests" to confirm RMSF or tularemia might lead to a negative outcome.  RMSF and tularemia are the most dangerous of the tick American tick borne diseases, although I would certainly place the very rare deer tick virus and Powassan virus in the same category. (more…)