6 research outputs found
Possible Clinical Failure of Artemether-Lumefantrine in an Italian Traveler with Uncomplicated Falciparum Malaria.
Artemisinin-combination therapies (ACTs) are recommended for the treatment of uncomplicated malaria in endemic areas with multidrug resistant Plasmodium falciparum. We report a case of possible artemether-lumefantrine clinical failure in an Italian traveler with uncomplicated P. falciparum malaria imported from Democratic Republic of Congo
Tigecycline use in serious nosocomial infections: a drug use evaluation
<p>Abstract</p> <p>Background</p> <p>Tigecycline is a novel antibiotic with activity against multidrug resistant bacteria. The aim of this study was to assess the efficacy of tigecycline use in serious hospital-acquired infections (HAI)</p> <p>Case presentation</p> <p>Prospective observational study of tigecycline use was conducted in a 1500 beds university hospital. From January 1, 2007 and January 31, 2010, 207 pts were treated with tigecycline for the following indications: intra-abdominal, pneumonia, bloodstream and complicated skin and soft tissue infections and febrile neutropenia. The therapy was targeted in 130/207 (63%) and empirical in 77/207 (37%) patients. All bacteria treated were susceptible to tigecycline. Median duration of tigecycline therapy was 13 days (range, 6-28). Clinical success was obtained in 151/207 (73%) cases, with the highest success rate recorded in intra-abdominal infections [81/99 (82%)]. Microbiological success was achieved in 100/129 (78%) treated patients. Adverse clinical events were seen in 16/207 patients (7.7%):</p> <p>Conclusions</p> <p>Considering the lack of data on tigecycline for critically ill patients, we think that the reported data of our clinical experience despite some limitations can be useful for clinicians.</p
Hospital-related outbreaks due to rare fungal pathogens: a review of the literature from 1990 to June 2011
Abstract Fungi can cause severe infections. Two or more
nosocomial unusual fungal infections diagnosed in a short
period should be assumed as an outbreak. The reviewâs aim
was to collect data to improve their management. The free
online worldwide database for nosocomial outbreaks (http://
www.outbreak-database.com) and the PubMed/MEDLINE
database were used to collect the English literature published
from 1990 to June 2011. The more common Candida
spp. and Aspergillus spp. infections were excluded. For each
outbreak, the following data were reviewed: species,
duration, source and site of infection, ward, risk factors,
number of patients infected, treatment, related mortality,
type of epidemiological study and time elapsed between
index cases and second cases. Thirty-six reports were
considered: yeasts caused the majority of the outbreaks
(16 out of 36). The median values for the overall
duration, number of infected people per outbreak and
infection-related mortality were 5 months, 4 and 20 %,
respectively. Eighteen cases were caused by contaminated
substances and 13 cases were hypothesised as
human-transmitted. Nosocomial outbreaks due to rare
fungal pathogens involve few patients but have high
related mortality. These results could be explained by
the diagnostic delay, the inability of recognising the source of
the infections and the challenges of the treatment. More efforts
should be concentrated to implement the application of proper
hygiene practices to avoid humanâhuman transmission