The Journal of infection
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The Journal of infection · Feb 2011
Impact of discordant empirical therapy on outcome of community-acquired bacteremic acute pyelonephritis.
As ciprofloxacin resistance rate of Escherichia coli causing urinary tract infections has been increasing, concern about inappropriate empirical therapy has been arisen. ⋯ Discordant empirical therapy, mostly with ciprofloxacin, leads to worse early clinical response and longer hospital stay than concordant therapy in community-acquired bacteremic acute pyelonephritis, although it does not affect on overall mortality or clinical cure rate.
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The Journal of infection · Feb 2011
ReviewThe inflammasome regulatory pathway and infections: role in pathophysiology and clinical implications.
The innate immune system serves to generate immediate host defenses against pathogens. Advance in the mechanism of innate immunity has provided new insights into host-pathogen microbial interactions. ⋯ We summarize the current knowledge regarding the regulatory functions of the inflammasome in the pathogenesis of infections by various microbes (e.g., bacteria, fungi, viruses, and protozoa), and discuss its potential application in a clinical setting. Understanding of the unique role of the inflammasome signaling pathway in initiating and regulating inflammation is pivotal for the development of innovative approaches to optimize management of these infections.
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The Journal of infection · Feb 2011
Multicenter StudyEpidemiology, microbiology and outcomes of healthcare-associated and community-acquired bacteremia: a multicenter cohort study.
Classically, infections have been considered either nosocomial or community-acquired. Healthcare-associated infection represents a new classification intended to capture patients who have infection onset outside the hospital, but who, nonetheless, have interactions with the healthcare system. Regarding bloodstream infection (BSI), little data exist differentiating healthcare-associated bacteremia (HCAB) from community-acquired bacteremia (CAB). We studied the epidemiology and outcomes associated with HCAB. ⋯ HCAB accounts for a substantial proportion of all patients with BSIs admitted to the hospital. HCAB is associated with a higher mortality rate than CAB. Physicians should recognize that HCAB is responsible for many BSIs presenting to the hospital and may represent a distinct clinical group from CAB.
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The Journal of infection · Jan 2011
Risk factors and pathogenic significance of severe sepsis and septic shock in 2286 patients with gram-negative bacteremia.
The aim of this study was to identify risk factors for development of severe sepsis or septic shock and to evaluate the clinical impact of severe sepsis on outcome in patients with gram-negative bacteremia (GNB). ⋯ Severe sepsis or septic shock was a common finding in patients with GNB, predicting a higher mortality rate. Renal disease and indwelling urinary catheter were the most important risk factors significantly associated with severe sepsis or septic shock among patients with GNB.
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The Journal of infection · Dec 2010
Aspergillus galactomannan antigen assay in bronchoalveolar lavage fluid for diagnosis of invasive pulmonary aspergillosis.
A recently developed bronchoalveolar lavage (BAL) galactomannan (GM) assay shows promising results. We evaluated the diagnostic performance of this assay and analyzed risk factors for false-positive results. ⋯ The BAL GM assay appears promising for the diagnosis of IPA. However, treatment with certain antibiotics may interfere with the results of the BAL GM assay.