Expert review of anti-infective therapy
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Expert Rev Anti Infect Ther · Aug 2008
Toll-like receptors: their roles in bacterial recognition and respiratory infections.
Although respiratory infections cause significant morbidity and mortality throughout the world, the immunologic factors that mediate host susceptibility to these infections remain poorly understood. The lung contains a vast surface at the host-environment interface and acts as a crucial barrier to invading pathogens. ⋯ In this review, we will summarize current knowledge of TLRs and their bacterial ligands and explore their role in respiratory infections. Moreover, we will highlight recent advances in the role of TLRs in pulmonary infections from a human immunogenetics perspective.
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Expert Rev Anti Infect Ther · Jun 2008
ReviewCurrent concepts in the management of Clostridium tetani infection.
This review summarizes the microbiology, management and prevention of tetanus. Tetanus is an acute toxemic illness caused by Clostridium tetani infection at a laceration or break in the skin. It can also occur as a complication of burns, puerperal infections, umbilical stumps (tetanus neonatorum) and surgical-site infection. ⋯ Treatment goals include interrupting the production of toxin, neutralizating the unbound toxin, controlling muscle spasms, managing dysautonomia and appropriate supportive management. Specific therapy includes intramuscular administration of tetanus immunoglobulin to neutralize circulating toxin before it binds to neuronal cell membranes. The disease can be prevented by immunization with tetanal toxoid and appropriate wound care.
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Expert Rev Anti Infect Ther · Jun 2008
ReviewAcinetobacter baumannii: an emerging multidrug-resistant threat.
Amid the recent attention focused on the growing impact of methicillin-resistant Staphylococcus aureus and multidrug-resistant Pseudomonas aeruginosa infections, the pathogen Acinetobacter baumannii has been stealthily gaining ground as an agent of serious nosocomial and community-acquired infection. Historically, Acinetobacter spp. have been associated with opportunistic infections that were rare and of modest severity; the last two decades have seen an increase in both the incidence and seriousness of A. baumannii infection, with the main targets being patients in intensive-care units. ⋯ The persistence of this organism in healthcare facilities, its inherent hardiness and its resistance to antibiotics results in it being a formidable emerging pathogen. This review aims to put into perspective the threat posed by this organism in hospital and community settings, describes new information that is changing our view of Acinetobacter virulence and resistance, and calls for greater understanding of how this multifaceted organism came to be a major pathogen.
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Expert Rev Anti Infect Ther · Apr 2008
Treatment options for paracoccidioidomycosis and new strategies investigated.
Paracoccidioidomycosis is the most prevalent systemic endemic mycosis in South America with most reported cases in Brazil. It is a major cause of disability and death among young adult rural workers during their most productive years of life. Sequels are frequent and the evolution of the disease and mortality burden are strongly influenced by the socio-economic status of the patients. ⋯ Early diagnosis is hampered by structural factors, ranging from the high costs of reagents, the lack of trained personnel and limited access to the healthcare system by rural workers. A peptide vaccine aimed at immunotherapy of paracoccidioidomycosis, as an adjuvant to chemotherapy, is being studied. The protective effects obtained in mice intratracheally infected with Paracoccidioides brasiliensis, and the promiscuous binding of the peptide P10 to HLA-DR molecules, suggest that it could be used as a vaccine to reduce the duration of chemotherapy and the risk of relapse.