Meningococcal infection

Meningococcal disease is an important medical emergency demanding early diagnosis and prompt treatment. This article provides an overview of meningococcal infection and discusses mode of transmission, risk factors, prevention of spread, vaccination and current recommendations for treatment.     

Bloodstream infection

Bloodstream infection is the most serious disease and the third mortality rate among nosocomial infections. Recently, catheter-related bloodstream infection(CRBSI) is the major cause of the bloodstream infection, related to serious complication, leading to increase in morbidity and mortality. Coagulase-negative staphylococci, Staphylococcus aureus, enterococci and Candida spp. are most commonly causes of CRBSI. A variety of methods such as aseptic insertion techniques and appropriate catheter care have proved effective, which are also preferable to prevent CRBSI. If CRBSI occurs, empirical antimicrobial therapy should be immediately started after appropriate cultures of blood and catheter sample are performed.     

Viral infection

Viral infections, particularly in the fetus or newborn and in immunocompromised individuals, can produce severe, even fatal disease. Indeed Herpesviridae infections are the major cause of morbidity and mortality in them. Antiviral drugs have been used for prophylaxis and treatment for some viral infections. An alternative approach is to boost the host immune defences. Administration of pooled human sera have been used for prophylaxis or alleviation of clinical severity of ongoing infections with measles, CMV, VZV and hepatitis A and B and so on. Human monoclonal antibody preparations, which have now being developed, may overcome the problems inherent in the pooled sera. These include high volume load, difficulty of quality control and adventitious transmission of unknown pathogenic agents.     

Cytomegalovirus infection

Interest has focused on cytomegalovirus (CMV) infections during recent years for two reasons: First, the number of immunocompromised patients with CMV infections has risen continuously and, secondly, recent advances in basic research have clarified some of the mechanisms of persistent and recurrent CMV infection. Three different clinical pictures can arise with CMV infection. In healthy individuals most of the CMV infections are not clinically apparent. In immunocompromised patients CMV causes a wide spectrum of diseases and is one of the predominant causes of death in AIDS patients and bone marrow transplant recipients. The most important problem for public health associated with CMV are connatal and perinatal CMV infections. Progress has been made with treatment of CMV infection in immunocompromised patients with inhibitors of viral replication.     

Gastrointestinal infection

Rotavirus and various types of E coli can cause life-threatening vomiting and diarrhoea in children. Food poisoning and traveller's diarrhoea cause problems for adults.     

HCV-HBV infection

Chronic infection of hepatitis C (HCV) and B virus (HBV) frequently causes viral hepatitis. Patients with chronic viral hepatitis are at risk for liver cirrhosis and even hepatocellular carcinoma. In patients with chronic hepatitis C, the most effective therapy is elimination of HCV with interferon (IFN). The most effective initial IFN therapy is the combination of pegylated IFN alpha-2b plus ribavirin. Forty-eight weeks of this combination therapy produces sustained viral response rates of approximately 50%. Moreover, several reports showed that long-term IFN therapy also reduced the risk of liver carcinogenesis. In patients with chronic hepatitis B, seroconversion from HBeAg to anti-HBe antibodies suppresses viral replication and attenuates the hepatitis. Twenty-four weeks of IFN therapy produces HBeAg seroconversion rates approximately 30%.