Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
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Clin. Microbiol. Infect. · Apr 2010
Genotypic analysis of genes associated with isoniazid and ethionamide resistance in MDR-TB isolates from Thailand.
Nucleotide sequences of genes conferring isoniazid resistance (katG, inhA, oxyR-ahpC and ndh) and ethionamide resistance (ethA) in 160 drug-resistant Mycobacterium tuberculosis clinical isolates from Thailand were analysed. Mutations in the katG gene were found in 129 isolates, predominantly at codon 315, which was mutated in 127 isolates. ⋯ Of 24 ethionamide-resistant isolates, 13 had mutations in the ethA gene. However, these mutations were dispersed along the entire gene, with no codon predominating significantly.
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Clin. Microbiol. Infect. · Mar 2010
Case ReportsA family outbreak due to an emm-type 11 multiresistant strain of Streptococcus pyogenes.
Four cases of Streptococcus pyogenes infection due to an emm-type 11 strain, including one with a fatal outcome, occurred within a seven-member family. All strains shared biotype 5, pyrogenic exotoxin genes speB and speC, and resistance to kanamycin, tetracycline, macrolides and lincosamides. ⋯ This highlights the ability of S. pyogenes to spread rapidly among family members. This first report of a family outbreak due to emm11 S. pyogenes reinforces the importance of surveillance of close family contacts of individuals with invasive streptococcal disease, and provides further support for antibiotic prophylaxis among the elderly.
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Clin. Microbiol. Infect. · Mar 2010
ReviewThe past and present threat of vector-borne diseases in deployed troops.
From time immemorial, vector-borne diseases have severely reduced the fighting capacity of armies and caused suspension or cancellation of military operations. Since World War I, infectious diseases have no longer been the main causes of morbidity and mortality among soldiers. However, most recent conflicts involving Western armies have occurred overseas, increasing the risk of vector-borne disease for the soldiers and for the displaced populations. ⋯ West Nile encephalitis and chikungunya fever). For this reason, vector control and personal protection strategies are always major requirements in ensuring the operational readiness of armed forces. Scientific progress has allowed a reduction in the impact of arthropod-borne diseases on military forces, but the threat is always present, and a failure in the context of vector control or in the application of personal protection measures could allow these diseases to have the same devastating impact on human health and military readiness as they did in the past.
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Clin. Microbiol. Infect. · Dec 2009
ReviewMethods for screening for methicillin-resistant Staphylococcus aureus carriage.
Screening patients for methicillin-resistant Staphylococcus aureus (MRSA) carriage at hospital admission is widely accepted as an essential part of MRSA control programmes. It is assumed, although not proven, that rapid reporting of screening results will improve MRSA control, provided that a clear action plan for positive cases is in place and is being followed. An effective culture screening method is direct inoculation of pooled nose, throat and perineal swabs on a well-performing MRSA-selective chromogenic agar; presumptive MRSA colonies can be confirmed rapidly by latex agglutination with antibodies directed against penicillin-binding protein 2a. ⋯ PCR methods are now available that can produce same-day results, provided that samples reach the laboratory in time for batch processing, but cultures are required for susceptibility testing. In comparison with culture-based methods, PCR tests are costly, and some have relatively high false-positivity rates; definitive evidence of their clinical cost-effectiveness is lacking. New point-of-care PCR tests are being introduced that are potentially even more rapid but are even more expensive; studies on the clinical cost-effectiveness of these very rapid tests are awaited.