RESUMEN
In a tertiary-care hospital and affiliated long-term care facility, a stewardship intervention focused on patients with Clostridioides difficile infection (CDI) was associated with a significant reduction in unnecessary non-CDI antibiotic therapy. However, there was no significant reduction in total non-CDI therapy or in the frequency of CDI recurrence.
Asunto(s)
Antibacterianos/uso terapéutico , Programas de Optimización del Uso de los Antimicrobianos/normas , Infecciones por Clostridium/tratamiento farmacológico , Prescripción Inadecuada/prevención & control , Programas de Optimización del Uso de los Antimicrobianos/organización & administración , Humanos , Prescripción Inadecuada/estadística & datos numéricos , Recurrencia , Centros de Atención TerciariaAsunto(s)
Infecciones Parasitarias del Ojo , Loiasis , Adulto , Dietilcarbamazina/uso terapéutico , Infecciones Parasitarias del Ojo/diagnóstico , Infecciones Parasitarias del Ojo/tratamiento farmacológico , Filaricidas/uso terapéutico , Humanos , Loiasis/diagnóstico , Loiasis/tratamiento farmacológico , Masculino , Resultado del TratamientoRESUMEN
Carbapenem-resistant Enterobacteriaceae (CRE) usually infect patients with significant comorbidities and health care exposures. We present a case of a pregnant woman who developed community-acquired pyelonephritis caused by KPC-producing Klebsiella pneumoniae. Despite antibiotic treatment, she experienced spontaneous prolonged rupture of membranes, with eventual delivery of a healthy infant. This report demonstrates the challenge that CRE may pose to the effective treatment of common infections in obstetric patients, with potentially harmful consequences to maternal and neonatal health.
Asunto(s)
Proteínas Bacterianas/metabolismo , Infecciones Comunitarias Adquiridas/microbiología , Infecciones por Klebsiella/microbiología , Klebsiella pneumoniae/patogenicidad , Pielonefritis/microbiología , Adulto , Antibacterianos/uso terapéutico , Carbapenémicos/uso terapéutico , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Femenino , Humanos , Lactante , Infecciones por Klebsiella/tratamiento farmacológico , Klebsiella pneumoniae/efectos de los fármacos , Klebsiella pneumoniae/metabolismo , EmbarazoRESUMEN
Trichuris trichiura is an helminthic infection with potentially severe health consequences. The hypothesis that host genetic factors can account for the distribution of Trichuris was tested using familial data on egg counts available for two populations, the Jirels of Nepal and the population of Jishan Island in Jiangxi Province of the People's Republic of China. Whipworm is highly prevalent in the Jishan Island population (86%), but occurs at a low rate in the Jirel population (14%). A quantitative genetic analysis was performed on each data set, using a variance component approach. Approximately 28% of the variation in Trichuris trichiura loads was attributable to genetic factors in both populations. Common household effects accounted for only 4% of the variation in the Jirels and none of the variation in the Jishan Island population. These concordant results from two separate populations provide strong evidence of the important role of genetics in determining differential susceptibility to whipworm infection.
