International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
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Int. J. Infect. Dis. · Sep 2008
Validation of the Accutrend lactate meter for hyperlactatemia screening during antiretroviral therapy in a resource-poor setting.
The use of highly active antiretroviral therapy (HAART) results in multiple side effects that may jeopardize the life of the patient being treated with antiretroviral drugs. In resource-poor settings it is difficult to definitively diagnose lactic acidosis by laboratory measurement of lactate. Point-of-care (POC) devices are helpful in the measurement of lactate levels and have been validated in the intensive care unit setting, but not in a busy outpatient clinic. The objective of this study was to assess the sensitivity and specificity of the Accutrend lactate meter in the diagnosis of hyperlactatemia/lactic acidosis in patients on nucleoside reverse transcriptase inhibitor (NRTI)-containing regimens (stavudine). ⋯ The Accutrend lactate meter is an appropriate device for screening patients on HAART with symptoms of hyperlactatemia/lactic acidosis. The use of this device decreases analytic and intervention time, preventing further morbidity and mortality in patients on an NRTI (stavudine)-based regimen.
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Int. J. Infect. Dis. · May 2008
ReviewInfluenza viruses and the evolution of avian influenza virus H5N1.
Although small in size and simple in structure, influenza viruses are sophisticated organisms with highly mutagenic genomes and wide antigenic diversity. They are species-specific organisms. Mutation and reassortment have resulted in newer viruses such as H5N1, with new resistance against anti-viral medications, and this might lead to the emergence of a fully transmissible strain, as occurred in the 1957 and 1968 pandemics. ⋯ S. Food and Drug Administration (FDA) approved the first vaccine against the avian influenza virus H5N1 for humans at high risk. However, more research is needed to develop a more effective and affordable vaccine that can be given at lower doses.
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Int. J. Infect. Dis. · May 2008
Prevalent phenotypes and antibiotic resistance in Escherichia coli and Klebsiella pneumoniae at an Indian tertiary care hospital: plasmid-mediated cefoxitin resistance.
The beta-lactam antibiotics, in combination with aminoglycosides, are among the most widely prescribed antibiotics. However, because of extensive and unnecessary use, resistance to these drugs continues to increase. In recent years, resistance in the Indian bacterial population has increased markedly, the majority showing complex mechanisms. Due to increased transcontinental movement of the human population, it would be wise to know the prevalence and resistance complexity of these strains, well in advance, in order to formulate a policy for empirical therapy. ⋯ The prevalence of multidrug-resistant bacterial isolates is quite high in our bacterial population. On comparative evaluation of DDST and TDT in resistant isolates, TDT was found to be the better method, detecting ESBLs in 80% of isolates compared to 15% with DDST. A 19.9-kb plasmid was consistently present in all the screened isolates of E. coli and K. pneumoniae, and was inferred to encode cefoxitin and tetracycline resistance based on curing and transconjugation experiments.
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Int. J. Infect. Dis. · May 2008
Prospective study on procalcitonin and other systemic infection markers in patients with leukocytosis.
To better assess the diagnosis of an infection in patients presenting at an emergency department with peripheral blood leukocytosis (>10 x 10(9) cells/l) on laboratory testing. ⋯ Only about half of the patients attending the emergency department with leukocytosis were suffering from an infection. Determination of the procalcitonin level may be useful for these patients, particularly in the case of a value higher than 0.5 ng/ml.
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Int. J. Infect. Dis. · Mar 2008
Eight years of hepatitis B vaccination in Colombia with a recombinant vaccine: factors influencing hepatitis B virus infection and effectiveness.
To evaluate the effectiveness of a recombinant hepatitis B vaccine used in endemic areas of Colombia, as well as risk factors associated with hepatitis B virus (HBV) infection and carriage after vaccine introduction. ⋯ The recombinant Cuban hepatitis B vaccine has contributed to the reduction of the infection in this highly endemic area, though further efforts are required to improve timely vaccination for children at high risk.