The Journal of infection
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The Journal of infection · Nov 2014
ReviewHost RNA signatures for diagnostics: an example from paediatric tuberculosis in Africa.
Host gene expression profiling is a widely used research tool for assessing the host response to infection in order to provide insight into the immunopathophysiology of disease, as well as the analysis of disease progression and treatment response. It has recently been applied for the diagnosis of tuberculosis in children in Africa, as a result of the implementation of novel statistical methodology that enabled the reduction of a large number of significantly differentially expressed genes into a minimal set, and the development of a 'disease risk score' that could be used to develop a diagnostic test. Whilst the experimental and statistical methodologies are now in place to generate minimal transcriptional signatures that can distinguish disease states, the challenge is how to take these forward into development of a diagnostic test for use in clinical resource-poor settings.
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The Journal of infection · Sep 2014
Multicenter StudyAspergillus in the lower respiratory tract of immunocompetent critically ill patients.
To shed light on the meaning of Aspergillus-positive lower-respiratory-tract samples in non immunocompromized critically ill patients. ⋯ In critically ill immunocompetent patients, risk factors for presence of Aspergillus in lower respiratory tract specimens are steroid therapy (either chronic or initiated in the ICU), ARDS, and high severity of the acute illness. Prospective studies are warranted to further examine these risk factors and to investigate immune functions as well as the impact of antifungal therapy on patient outcomes.
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The Journal of infection · Sep 2014
Ceftolozane/tazobactam activity tested against aerobic Gram-negative organisms isolated from intra-abdominal and urinary tract infections in European and United States hospitals (2012).
Ceftolozane/tazobactam is under clinical development for treatment of complicated intra-abdominal infections (IAI), complicated urinary tract infections (UTI) and ventilator-associated pneumonia. We evaluated the in vitro activity of ceftolozane/tazobactam and comparator agents tested against Gram-negative aerobic bacteria causing IAI and healthcare-associated UTI (HCA-UTI). The organisms were consecutively collected from January to December 2012 from 59 medical centers located in the United States (USA) and 15 European countries by the Program to Assess Ceftolozane/Tazobactam Susceptibility (PACTS). ⋯ Ceftolozane/tazobactam was the most active agent tested against P. aeruginosa (MIC50/90, 0.5/4 mg/L; 93.4-95.7% inhibited at ≤8 mg/L) and retained potency against many MDR (MIC50/90, 2-4/>32 mg/L), ceftazidime-nonsusceptible (MIC50/90, 2-4/>32 mg/L) and meropenem-nonsusceptible (MIC50/90, 2/>32 mg/L) strains. Ceftolozane/tazobactam was also active against Klebsiella oxytoca (MIC50/90, ≤0.12-0.25/0.5-1 mg/L), Enterobacter spp. (MIC50/90, 0.25-0.5/4-8 mg/L), Citrobacter spp. (MIC50/90, 0.25/2-32 mg/L), Proteus mirabilis (MIC50/90, 0.5/0.5 mg/L), indole-positive Proteae (MIC50/90, 0.25/0.5-1 mg/L), and Serratia spp. (MIC50/90, 0.5/1-2 mg/L). In summary, ceftolozane/tazobactam demonstrated potent in vitro activity when tested against contemporary aerobic Gram-negative pathogens causing IAI and HCA-UTI in USA and European medical centers.