Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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The temporal and spatial distributions of the 2003 severe acute respiratory syndrome (SARS) outbreak in Amoy Gardens of Hong Kong was reexamined using all confirmed cases. The outbreak actually extended to nearby residential complexes. Airborne spread was the most likely explanation, and the SARS coronavirus could have spread over a distance of 200 m.
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Early identification of sepsis is important to be able to initiate timely therapy and optimize survival. Neutrophil CD64 (nCD64) expression has been proposed as a potential marker of sepsis. ⋯ Measurement of nCD64 expression at ICU admission, especially when combined with CRP concentrations, is useful in diagnosing sepsis. Serial determinations of nCD64 could be used for monitoring purposes.
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The 2012 outbreak of fungal meningitis associated with contaminated methylprednisolone produced by a compounding pharmacy has resulted in >750 infections. An important question facing patients and clinicians is the duration of antifungal therapy. We evaluated (1-3)-β-d-glucan (BDG) as a marker for monitoring response to treatment. ⋯ Our data suggest that measuring BDG in CSF is a highly sensitive test for diagnosis of fungal meningitis in this outbreak. Analysis of BDG levels in serially collected CSF demonstrated that BDG may correlate with clinical response. Routine measurement of BDG in CSF may provide useful adjunctive data for the clinical management of patients with outbreak-associated meningitis.
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In Asia, Salmonella Paratyphi A is an emerging infection, and travelers are increasingly at risk. During October 2009-November 2009, an outbreak in S. Paratyphi A infection was noted in Israeli travelers returning from Nepal. ⋯ A point-source, "Paratyphoid Mary"-like outbreak was identified among Israeli travelers to Nepal. Combination Ceftriaxone-Azithromycin therapy may provide a therapeutic advantage over monotherapy, and merits further clinical trials.
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The Centers for Disease Control and Prevention is pursuing 3 distinct, complementary efforts focused on providing data for action, including facility-level use metrics for benchmarking across comparable patient care settings, national estimates of usage patterns using sentinel surveillance sites, and limited assessments using proprietary data.