The Journal of infection
-
The Journal of infection · Jul 2009
Matrix metalloproteases in bronchoalveolar lavage fluid of patients with type III Pseudomonas aeruginosa pneumonia.
In patients with ventilator-associated pneumonia (VAP), Pseudomonas aeruginosa type III (TTSS) secreting isolates have been linked to poor clinical outcomes. Differential expression of matrix metalloproteinases (MMPs) induced by type III effector proteins may herald an irreversible lung injury. ⋯ VAP linked to P. aeruginosa Type III phenotype portrays a divergent antibiotic treatment response in regards to the concentrations of metalloproteinases in the alveolar space. The imbalance between MMP-9 and TIMP-1 may determine the intensity of alveolocapillary damage and ultimate outcome of P. aeruginosa VAP.
-
The Journal of infection · Jul 2009
Practice GuidelineFever in returned travellers presenting in the United Kingdom: recommendations for investigation and initial management.
International travel is increasing. Most physicians and general practitioners will encounter returned travellers with fever and the majority of travel-related infection is associated with travel to the tropics. In those returning from the tropics malaria must always be excluded, and HIV considered, from all settings. ⋯ The evidence base for much of the management of tropical infections is limited. These recommendations provide a pragmatic approach to the initial diagnosis and management of fever in returned travellers, based on evidence where it is available and on consensus of expert opinion where it is not. With early diagnosis and treatment the majority of patients with a potentially fatal infection related to travel will make a rapid and full recovery.
-
The Journal of infection · Jul 2009
Influence of preoperative antibiotherapy on valve culture results and outcome of endocarditis requiring surgery.
Although medical-surgical therapy can reduce mortality in patients with infective endocarditis (IE), the optimal timing of surgery remains controversial. We evaluated the influence of preoperative antimicrobial therapy duration on positivity of valve culture and outcome. ⋯ Although the duration of adequate preoperative antimicrobial therapy is associated with the positivity of valve culture, the latter factor does not influence short- or long-term outcome.