Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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Tuberculosis contact investigation identifies individuals who may be recently infected with tuberculosis and are thus at increased risk for disease. Contacts with latent tuberculosis infection (LTBI) are offered chemoprophylaxis to prevent active disease; however, the effectiveness of this intervention is unclear as treatment completion is generally low. ⋯ Contact investigation facilitates active case finding and tuberculosis prevention, even when completion rates of chemoprophylaxis are suboptimal.
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The increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) has resulted in a reevaluation of the role of vancomycin for surgical prophylaxis. Two systematic reviews of randomized control studies have concluded that cephalosporins are as effective as vancomycin for the prevention of surgical site infections (SSIs). However, most of these studies were conducted more than 10 years ago and cannot be generalized to the current rates of MRSA. ⋯ Decision analysis models have also been used to estimate thresholds of MRSA prevalence for which vancomycin would minimize the incidence and cost of SSIs. Combination therapy and the emergence of resistant pathogens following vancomycin prophylaxis are reviewed. Vancomycin is not recommended for routine use in surgical prophylaxis but may be considered as a component of a MRSA prevention bundle for SSIs in selective circumstances.
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Pneumonia was a common complication among hospitalized patients with 2009 pandemic influenza A H1N1 [pH1N1] in the United States in 2009. ⋯ Hospitalized patients with pH1N1 and pneumonia were at risk for severe outcomes including ARDS, sepsis, and death; antiviral treatment was often delayed. In the absence of accurate pneumonia diagnostics, patients hospitalized with suspected influenza and lung infiltrates on chest radiography should receive early and aggressive treatment with antibiotics and influenza antiviral agents.
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Comparative Study
Performance of Candida real-time polymerase chain reaction, β-D-glucan assay, and blood cultures in the diagnosis of invasive candidiasis.
The sensitivity of blood cultures for diagnosing invasive candidiasis (IC) is poor. ⋯ Candida PCR and, to a lesser extent, BDG testing significantly enhanced the ability of blood cultures to diagnose IC.