Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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Influenza A virus subtype H1N1 with the H274Y mutation emerged and spread worldwide. However, the clinical effectiveness of the neuraminidase inhibitors, oseltamivir and zanamivir, has not been adequately reevaluated. ⋯ The effectiveness of oseltamivir, but not that of zanamivir, decreased significantly for H1N1 virus infection during the 2008-2009 season.
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There is a paucity of population-based studies on Staphylococcus aureus bacteremia (SAB) in the United States. We determined the incidence of and trends in SAB in Olmsted County, Minnesota, over an 8-year period. ⋯ The incidence of SAB in adults remained stable in Olmsted County, Minnesota, from 1998 to 2005, but the proportion of episodes due to MRSA significantly increased over the 8-year period.
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Various agents have been applied topically to treat infected wounds for millennia, but their proper role remains unclear. Topical therapy affords many potential advantages but also has disadvantages. Opinions differ on which clinical signs define wound infection and on whether quantitative microbiological studies are useful. ⋯ Meta-analyses and systematic reviews suggest there are few proven indications for topical antimicrobials. Use of a newer, relatively nontoxic antiseptic (eg, cadexomer iodine or silver dressings) is preferable to use of topical antibiotics, especially agents that are available for systemic use. We provide clinically relevant information on currently available topical antimicrobial agents.
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Case Reports
Domestically acquired seoul virus causing hemorrhagic fever with renal syndrome-Maryland, 2008.
Hantaviruses are rodent-borne viruses capable of causing human disease. The Seoul virus is a hantavirus that causes hemorrhagic fever with renal syndrome in East Asia. To our knowledge, we report the first domestically acquired case of hemorrhagic fever with renal syndrome caused by the Seoul virus, confirmed by serology testing, reverse-transcriptase polymerase chain reaction, and nucleotide sequence analysis. The patient presented with myalgias and fever, and developed acute renal failure.
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Verifying immunization status and updating vaccinations are important steps in the evaluation of patients who are solid-organ transplant candidates because the potential benefits of vaccination outweigh the risk of adverse events. Because patients with end-organ disease, such as end-stage renal disease and cirrhosis, have reduced immune responses to many vaccines, vaccination should be performed as early as possible during the course of these diseases. Furthermore, it is particularly important for live vaccines to be updated during the pretransplant assessment because such vaccines are contraindicated once a patient is maintained on immunosuppression. Current information on vaccination for adult solid-organ transplant candidates is reviewed.