Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 7 de 7
Filtrar
1.
Clin Transplant ; 27(1): E42-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23278388

RESUMO

BK polyomavirus (BKV) infection continues to be a significant source of allograft dysfunction in kidney transplant recipients. The optimal screening method to detect BKV remains undetermined. In this retrospective analysis of 347 consecutive kidney transplant recipients, we compare the diagnostic and screening performance of urine electron microscopy (EM) with plasma polymerase chain reaction (PCR) in testing for BKV, using biopsy-proved polyomavirus-associated nephropathy (PVAN) as the gold standard. Sixty-nine of 347 recipients had a positive screening test for BKV infection. Twenty-nine patients underwent biopsy, and 11 were diagnosed with PVAN. Sensitivity rates of urine EM and plasma PCR were 88% and 100%, respectively. Specificity rates of urine EM and plasma PCR were 91% and 78%. There was no statistical difference in the operating characteristics of the two tests. The majority of both plasma PCR and urine EM tests were positive in the six months prior to a diagnostic biopsy confirming PVAN. In those patients who had evidence of BKV infection but did not have PVAN, the percentage of positive screening tests decreased with aggressive lowering of immunosuppression. We conclude that urine EM and plasma PCR both function well in screening for BKV infection and in the diagnosis of PVAN. There is an opportunity to detect viral replication, lower immunosuppression, and to prevent PVAN in this population.


Assuntos
Vírus BK/ultraestrutura , DNA Viral/sangue , Transplante de Rim/efeitos adversos , Infecções por Polyomavirus/diagnóstico , Infecções Tumorais por Vírus/diagnóstico , Urina/virologia , Adulto , Vírus BK/genética , Vírus BK/isolamento & purificação , DNA Viral/genética , Feminino , Seguimentos , Humanos , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Infecções por Polyomavirus/sangue , Infecções por Polyomavirus/urina , Infecções por Polyomavirus/virologia , Prognóstico , Estudos Retrospectivos , Infecções Tumorais por Vírus/sangue , Infecções Tumorais por Vírus/urina , Infecções Tumorais por Vírus/virologia , Urina/química , Carga Viral
2.
Open Forum Infect Dis ; 5(8): ofy188, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30151413

RESUMO

Here we summarize an April 2016, 7-patient cluster of human adenovirus (HAdV) infections in a cardiothoracic surgery intensive care unit. We show that the patients were infected with a single HAdV21b type. Rapid HAdV typing diagnostics and effective antiviral interventions are needed for immunocompromised patients suffering from HAdV infections.

3.
Open Forum Infect Dis ; 3(3): ofw144, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27704003

RESUMO

We report the case of a 60-year-old man with septic shock due to Capnocytophaga canimorsus that was diagnosed in 24 hours by a novel whole-genome next-generation sequencing assay. This technology shows great promise in identifying fastidious pathogens, and, if validated, it has profound implications for infectious disease diagnosis.

4.
Clin Chest Med ; 26(4): 675-90, vii, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16263405

RESUMO

Although species of Aspergillus and Candida account for most deeply invasive and life-threatening fungal infections, the past decades have seen a rise in the immunocompromised population. With this increase, additional fungi have emerged as important agents of morbidity and mortality. These opportunistic fungi are characterized by their ubiquitous presence in the environment, their ability to cause disease in immunosuppressed patients, and their diminished susceptibility to the currently available antifungal agents. Pneumonia, one aspect of a myriad of clinical manifestations caused by these fungal pathogens, is discussed in this article.


Assuntos
Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Pneumopatias Fúngicas/etiologia , Transplante de Órgãos/efeitos adversos , Humanos , Pneumopatias Fúngicas/microbiologia
5.
Drug Resist Updat ; 3(6): 384-399, 2000 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11498405

RESUMO

Microsporidia are ubiquitous organisms that are emerging pathogens in humans. These are most likely zoonotic and/or waterborne infections. In the immunosuppressed host, such as those treated with immunosuppressive drugs or infected with human immunodeficiency virus particularly at advanced stages of the disease, microsporidia can produce a wide range of clinical diseases. The most common manifestation is gastrointestinal tract infection; however, encephalitis, ocular infection, sinusitis, myositis and disseminated infection have also been described. In addition, these organisms have been reported in immune competent individuals. Multiple genera are involved in these infections and different organisms can result in distinct clinical pictures. Differences in clinical and parasitologic response to various therapeutic agents have emerged from clinical, as well as in vitro and in vivo studies. Currently there are no precisely defined guidelines for the optimal treatment of microsporidial infections. This article reviews the available data on compounds with in vitro activity and/or in vivo efficacy for microsporidial infections. Copyright 2000 Harcourt Publishers Ltd.

6.
Am J Med ; 123(9): 819-28, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20800151

RESUMO

BACKGROUND: Bloodstream infections are a major cause of morbidity and mortality in adults. Bloodstream infections should be reassessed periodically because of increased antibiotic resistance, more patients receiving immunomodulatory therapy, improved antiretroviral therapy, and acquisition of infection in health care settings other than hospitals. METHODS: We conducted retrospective assessment by infectious disease physicians of hospitalized adults with positive blood cultures at 3 academic medical centers. RESULTS: Two thousand two hundred seventy positive blood culture episodes occurred in 1706 patients. Of 2669 isolates, 51% represented true infection, 41% contamination, and 8% unknown clinical significance. Although coagulase-negative staphylococci were most common, only 10% were clinically significant. Among 1225 true bloodstream infections, the most frequent isolates were Staphylococcus aureus, Escherichia coli, Enterococcus spp., Klebsiella pneumoniae, coagulase-negative staphylococci, Pseudomonas aeruginosa, Candida albicans, Enterobacter cloacae, and Serratia marcescens. Intravenous catheters were the most common primary source of bloodstream infection (23% of episodes). Most (81%) bloodstream infections were acquired in the hospital or other health care settings. Crude and attributable in-hospital case-fatality ratios were 20% and 12%, respectively, lower than in previous studies. Increasing age, hypotension, absence of fever, hospital acquisition, extreme white blood cell count values, and the presence of the acquired immunodeficiency syndrome, malignancy, or renal disease were significantly associated with an increased risk of in-hospital attributable death in multivariable analysis. CONCLUSIONS: The proportion of bloodstream infections due to intravenous catheters is continuing to increase. Most episodes were acquired in the hospital or other health care setting. In-hospital case-fatality ratios have decreased compared with previous studies. Several previously identified factors associated with an increased mortality remain statistically significant.


Assuntos
Bacteriemia/diagnóstico , Bacteriemia/mortalidade , Fungemia/diagnóstico , Fungemia/mortalidade , Adulto , Idoso , Bacteriemia/complicações , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Cateteres de Demora/efeitos adversos , Diagnóstico Precoce , Feminino , Fungemia/complicações , Fungemia/tratamento farmacológico , Fungemia/microbiologia , Mortalidade Hospitalar , Hospitais Universitários/estatística & dados numéricos , Humanos , Infusões Intravenosas/efeitos adversos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Estudos Retrospectivos , Fatores de Risco , Estados Unidos/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA