Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
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Clin. Microbiol. Infect. · Oct 2012
Multicenter StudyMucormycosis after allogeneic haematopoietic stem cell transplantation: a French Multicentre Cohort Study (2003-2008).
We conducted a nationwide retrospective study to evaluate clinical characteristics and outcome of mucormycosis among allogeneic haematopoietic stem cell transplant recipients. Twenty-nine patients were diagnosed between 2003 and 2008. ⋯ Twenty-six patients received an antifungal treatment; surgery was performed in 12. Overall survival was 34% at 3 months and 17% at 1 year.
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Vaccination of immunocompromised patients is challenging both regarding efficacy and safety. True efficacy data are lacking so existing recommendations are based on immune responses and safety data. ⋯ However, vaccination against pneumococci, Haemophilus influenzae and influenza are generally recommended. Live vaccines must be used with care because the risk for vaccine-associated disease exists.
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Clin. Microbiol. Infect. · Oct 2012
ReviewProphylactic human papillomavirus vaccination and primary prevention of cervical cancer: issues and challenges.
Two prophylactic human papillomavirus (HPV) vaccines have been recently approved: one quadrivalent and the other a bivalent vaccine. When administered in a three-dose course to HPV-naive individuals, both vaccines exhibited excellent safety profiles and were highly efficacious against targeted clinical endpoints in large-scale international phase III clinical trials. Where coverage has been high for the appropriate target population, a reduction of HPV-related diseases with the shortest incubation periods has already been seen. ⋯ Increasing coverage and improving completion of the HPV vaccine schedule, particularly of sexually naive females, is now the most important public-health issue in HPV vaccine efforts. A clear strategy for integrating primary (HPV vaccination) and secondary (screening) cervical cancer prevention must be agreed as soon as possible. Several second-generation prophylactic vaccines are being developed with the aim of resolving some of the limitations of the two current HPV prophylactic vaccines.
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Clin. Microbiol. Infect. · Oct 2012
ReviewCompliance with anti-H1N1 vaccine among healthcare workers and general population.
Population protection through vaccination against infectious diseases has been one of the major achievements of public health care. The recent H1N1 influenza virus pandemic reopened the discussion on the strategic arrangements for vaccination in the face of spreading infection. ⋯ Concern about vaccine safety and distrust of health authorities are the commonest reasons given for low compliance with vaccination by healthcare workers. Better communication strategies to improve vaccination acceptance by the general population and by healthcare workers are required.
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Clin. Microbiol. Infect. · Oct 2012
Multicenter StudySeverity assessment tools in ICU patients with 2009 influenza A (H1N1) pneumonia.
The aim of this study was to determine if severity assessment tools (general severity of illness and community-acquired pneumonia specific scores) can be used to guide decisions for patients admitted to the intensive care unit (ICU) due to pandemic influenza A pneumonia. A prospective, observational, multicentre study included 265 patients with a mean age of 42 (±16.1) years and an ICU mortality of 31.7%. On admission to the ICU, the mean pneumonia severity index (PSI) score was 103.2 ± 43.2 points, the CURB-65 score was 1.7 ± 1.1 points and the PIRO-CAP score was 3.2 ± 1.5 points. ⋯ Low risk for mortality was identified in 27.5% of patients using PIRO-CAP, but above 40% when using PSI (I-III) or CURB65 (<2). Observed mortality was 13.7%, 13.5% and 19.4%, respectively. Pneumonia-specific scores undervalued severity and should not be used as instruments to guide decisions in the ICU.