International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
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Int. J. Infect. Dis. · Jul 2012
Using a checklist to identify barriers to compliance with evidence-based guidelines for central line management: a mixed methods study in Mongolia.
This study aimed to determine the extent to which a checklist has potential for identifying barriers to compliance with central line management guidelines, to evaluate the potential utility of checklists to improve the management of central lines in Mongolia, and to define the gap between current and best practices. ⋯ The health authorities of Mongolia need to adequately address the prevention and control of CLABSIs in their hospitals. Updating local standards and guidelines and implementing adequate multifaceted interventions with behavioral, educational, and logistical components are required. Use of a checklist as a baseline evaluation tool was feasible. It described current practice, showed areas that need urgent attention, and provided important information needed for future planning of CLABSI interventions.
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Int. J. Infect. Dis. · Jul 2012
Emerging clinico-epidemiological trends in melioidosis: analysis of 95 cases from western coastal India.
To study the clinico-epidemiological trends in melioidosis, an emerging disease in the western coastal region of India. ⋯ Melioidosis is quite prevalent in the western coastal region of India, and is strongly associated with rainfall, age, and diabetes mellitus. Higher proportions of musculoskeletal, dental, and lymph node melioidosis were seen in this region as compared to endemic areas. Bacteremic melioidosis has a poorer prognosis than non-bacteremic melioidosis. The presence of septic shock is a strong predictor of mortality. Percutaneous inoculation may not be the main portal of entry for Burkholderia pseudomallei in this region.
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Int. J. Infect. Dis. · Jul 2012
Case fatality associated with a hypervirulent strain in patients with culture-positive Clostridium difficile infection: a retrospective population-based study.
Clostridium difficile is a major infectious cause of healthcare-associated diarrhea. The epidemiology of C. difficile infection (CDI) is changing, with evidence of increased incidence and severity. The first patient with a hypervirulent strain type in Pirkanmaa Hospital District, Finland was reported in September 2008. ⋯ Infection due to a hypervirulent strain is a factor associated with increased case fatality in CDI. Blood leukocytes are significantly higher in CDI caused by a hypervirulent strain. Leukocyte count and CRP are useful prognostic biomarkers in patients with CDI.
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Int. J. Infect. Dis. · Jul 2012
Circulating nucleosomes as a predictor of sepsis and organ dysfunction in critically ill patients.
Sepsis is a leading cause of death in critically ill patients, and apoptosis plays a major role in the pathophysiology of sepsis. Elevated levels of circulating nucleosomes released by apoptotic cells have been detected in patients with severe sepsis and septic shock. The aim of this study was to evaluate the diagnostic/prognostic value of circulating nucleosomes in sepsis. ⋯ The level of circulating nucleosomes in the serum has a predictive value for sepsis and organ dysfunction and may serve as a candidate biomarker for the diagnosis/prognosis of sepsis. Further studies are warranted to confirm the present findings.
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Int. J. Infect. Dis. · Jul 2012
Case ReportsRepeated dengue shock syndrome and 'dengue myocarditis' responding dramatically to a single dose of methyl prednisolone.
The place of steroids in the management of severe forms of dengue is unclear. A retrospective observational study showed the benefits of a single dose of intravenous methyl prednisolone in a highly selected group of patients who developed severe dengue during the febrile phase of infection. We report the case of a 14-year-old boy with dengue who developed three episodes of severe hemodynamic compromise while having high fever, 'myocarditis', third space fluid accumulation, progressive reduction in urine output, and altered mentation, who made a dramatic recovery following a single dose of intravenous methyl prednisolone. Results justify a well powered randomized controlled trial to evaluate the efficacy of this treatment in severe dengue.