Current opinion in infectious diseases
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Curr. Opin. Infect. Dis. · Jun 2003
ReviewTreatment of community-acquired methicillin-resistant Staphylococcus aureus in children.
The concept of methicillin-resistant Staphylococcus aureus (MRSA) associated with broad resistance, nosocomial acquisition, and known risk factors has recently been expanded. A new type of MRSA that is resistant to fewer antibiotics has emerged in pediatric practice since the mid-1990s. These isolates are community acquired and have been reported from diverse geographic regions. Awareness of these organisms is important for appropriate treatment of S. aureus infections in children. ⋯ The appearance of CA-MRSA has important implications for therapy of infections caused by S. aureus in children. Three specific issues are the development of resistance during clindamycin therapy, insufficient data on the use of trimethoprim-sulfamethoxazole in serious CA-MRSA infections, and the appropriate role for newer antibiotics such as linezolid.
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Toll-like receptors (TLRs) are a family of pattern recognition receptors that are activated by specific components of microbes and certain host molecules. They constitute the first line of defense against many pathogens and play a crucial role in the function of the innate immune system. Recently, TLRs were observed to influence the development of adaptive immune responses, presumably by activating antigen-presenting cells. This has important implications for our understanding of how the host tailors its immune response as a function of specific pathogen recognition. The present review discusses the recent studies that demonstrate the role of TLRs in the regulation of adaptive T-helper-1 (Th1) and Th2 responses, and the mechanisms by which the effects are carried out. ⋯ A greater understanding of the processes by which TLRs regulate adaptive immunity may yield not only improved ways to treat infectious diseases but also new approaches to the treatment and prevention of allergic and certain autoimmune disorders.
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Curr. Opin. Infect. Dis. · Jun 2003
Descriptive and molecular epidemiology of Gram-negative bacilli infections in the neonatal intensive care unit.
The critically ill neonate is particularly prone to life threatening bacterial infections compared with other patient populations. Current patterns of neonatal sepsis caused by Gram-negative bacilli are reviewed to enable the clinician to better anticipate and effectively respond to neonatal infection by these serious pathogens. ⋯ Gram-negative bacilli are prominent causes of infection in the neonatal intensive care unit. Their incidence, antibiotic susceptibility pattern, and modes of acquisition continue to evolve in the modern intensive care unit setting.