Time of catheter removal in candidemia and mortality

Background

The impact of central venous catheter (CVC) removal on the outcome of patients with candidemia is controversial, with studies reporting discrepant results depending on the time of CVC removal (early or any time during the course of candidemia).

Current Status of Acanthamoeba in Iran: A Narrative Review Article

Background:

Free-living amoebae belonging to the genus Acanthamoeba have an environmental distribution. Amoebic keratitis due to these protozoan parasites continue to rise in Iran and worldwide. In Iran, there are various researches regarding both morphological and molecular identification of Acanthamoeba spp. in environmental and clinical samples. However, there is no thorough review about Acanthamoeba genotypes and their distribution in environmental sources such as water, dust and biofilm in Iran. Besides, according to increasing cases of Amoebic keratitis in the region awareness regarding the pathogenic potential of these sight-threatening amoebae is of utmost importance.

Methods:

We conducted a thorough review based on the database sources such as MEDLINE, PubMed and Google scholar. No restrictions were placed on study date, study design or language of publication. We searched all valuable and relevant information considering the occurrence of the Acanthamoeba in both environmental and clinical samples.

Results:

According to our thorough review Acanthamoeba belonging to T4 genotype is the most prevalent type strain in environmental and clinical samples in several regions in Iran and worldwide, however, there are reports regarding Acanthamoeba belonging to other genotypes such as T2, T3, T5, T6 and T11 and the mentioned point could leads us to more researches with the goal of presenting the real genotype dominance of Acanthamoeba and related disease in the country.

Conclusion:

Overall, the present review will focus on present status of genotypes of Acanthamoeba in Iran during recent years.     

Transdermal Diagnosis of Malaria Using Vapor Nanobubbles

A fast, precise, noninvasive, high-throughput, and simple approach for detecting malaria in humans and mosquitoes is not possible with current techniques that depend on blood sampling, reagents, facilities, tedious procedures, and trained personnel. We designed a device for rapid (20-second) noninvasive diagnosis of Plasmodium falciparum infection in a malaria patient without drawing blood or using any reagent. This method uses transdermal optical excitation and acoustic detection of vapor nanobubbles around intraparasite hemozoin. The same device also identified individual malaria parasite–infected Anopheles mosquitoes in a few seconds and can be realized as a low-cost universal tool for clinical and field diagnoses.     

Evaluating Epidemiology and Improving Surveillance of Infections Associated with Health Care,United States

The Healthcare-Associated Infections Community Interface (HAIC), launched in 2009, is the newest major activity of the Emerging Infections Program. The HAIC activity addresses population- and laboratory-based surveillance for Clostridium difficile infections, candidemia, and multidrug-resistant gram-negative bacilli. Other activities include special projects: the multistate Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey and projects that evaluate new approaches for improving surveillance. The HAIC activity has provided information about the epidemiology and adverse health outcomes of health care–associated infections and antimicrobial drug use in the United States and informs efforts to improve patient safety through prevention of these infections.     

2011—2013年北京某城区感染性腹泻患者致病菌检测分析

目的分析北京某城区2011—2013年感染性腹泻患者致病菌分布及脉冲场凝胶电泳(PFGE)图谱特征,为感染溯源提供依据。方法收集2011年1月—2013年12月该区域肠道门诊感染性腹泻患者粪便标本1 179份,对其培养分离的致病菌进行血清分型及PFGE分析。结果 1 179份标本,共培养肠道病原菌330株,其中检出居前4位的肠道致病菌依次为志贺菌属93株(28.18%)、沙门菌属69株(20.91%)、副溶血性弧菌44株(13.33%)及致泻性大肠埃希菌11株(3.33%)。18株宋内志贺菌PFGE分为8个型别,聚类相似度接近88%;69株沙门菌属细菌分为18个血清型,共41种PFGE型别,其中山夫登堡沙门菌和肠炎沙门菌具有明显的优势带型;23株副溶血性弧菌PFGE型别较为分散。结论 3年间感染性腹泻患者致病菌的血清型和PFGE带型分布较为广泛,应注意沙门菌属和志贺菌属细菌的PFGE优势菌型,警惕其引发的感染性腹泻暴发流行。     

18例早产儿真菌败血症临床特点

目的对某院早产儿真菌败血症的临床特点进行分析,为临床诊治提供参考。方法对该院2011年1月—2013年12月18例早产儿真菌败血症的临床资料进行回顾性分析。结果 18例早产儿胎龄为27~36周,出生体重为1 050~3 100 g,其中极低出生体重儿(VLBWI)8例;均有广谱抗菌药物用药史,感染前均长时间静脉营养,10例机械通气,2例经外周静脉穿刺中心静脉置管(PICC)。临床表现以呼吸暂停、抽搐、喂养困难、反应差等为主;出现症状时间为出生后3 h~52 d。13例(72.22%)早产儿血白细胞(WBC)计数异常,12例(66.67%)血小板(PLT)100×109/L,18例(100.00%)C反应蛋白(CRP)均增高,平均CRP浓度为(41.90±26.77)mg/L。感染病原菌以假丝酵母菌属为主,共17例(94.44%),其中包括近平滑假丝酵母菌7例,白假丝酵母菌5例,白假丝酵母菌生物变种4例,无名假丝酵母菌1例。用氟康唑及两性霉素B治疗,15例治愈(83.33%),2例好转(11.11%),1例死亡(5.56%)。结论早产儿真菌败血症以假丝酵母菌感染为主,临床缺乏特异性表现,应严密观察具有高危因素的早产儿临床症状,定期检测血常规及CRP等指标,及时给予抗真菌药物治疗,有助于取得良好的治疗效果。     

特比萘酚联合氟康唑对念珠菌及新生隐球菌的体外药敏试验

目的研究特比萘酚（FCZ）和氟康唑（TBNF）对念珠菌及新生隐球菌体外联合药敏试验中的相互作用，为临床用药提供实验室依据。方法参照美国国家临床实验室标准化委员会（NCCLS）提出的标准（M27-A方案）采用棋盘微量稀释法对10株念珠菌和18株新生隐球菌进行了特比萘酚和氟康唑的体外联合药敏试验。结果联合用药时FCZ的最低抑菌浓度（MIC）几何均值从单用药时的5.124降至0.672，差异有显著性（t=5.558，P〈0.001）;TBNF从2.26降至0.291，差异有显著性（t=6.552，P〈0.001）。两种药物联用有协同或相加作用，联合抑菌指数（FICI）的平均值为0.629。结论特比萘酚和氟康唑对致病酵母菌主要表现为协同相加作用。     

Do Fish Thrombocytes Play an Immunological Role? Their Cytoenzymatic Profiles and Function During an Accidental Piscine Candidiasis in Aquarium

Fish (F) thrombocytes (THRs) from healthy trouts were studied in terms of cytoenzyme expression. FTHRs were positive to acid periodic of shiff (PAS) and acid phosphatase (ac. phos.) without tartaric acid (? TA) stainings, as well to alkaline phosphatase. However, when compared with autologous macrophages (MØs), they were negative to naphthol cloroacetate esterase (AS-D), α-naphthyl acetate esterase (Anae), peroxidase (perox) and control ac. phos. with tartaric acid (+ TA) stainings, thus indicating a lack of typical lysosomial enzymes. This evidence supports the notion that FTHRs are not true digesting cells. Quite interestingly, trouts and human MØs were positive for PAS, AS-D, Anae, and perox stainings, thus confirming that cellular cytochemistries are maintained across evolution as their phagocytic functions. Additionally, blood films from trouts, accidentally infected with Candida albicans in aquarium, were morphologically analyzed. Actually, FTHRs interact with erythrocytes, potentiating the formation of rosettes around a central MØ. Polymorph nuclear cells and lymphocytes are present in these cellular aggregates, thus suggesting that FTHRs may represent a link between innate and adaptive immunity.