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https://www.readbyqxmd.com/read/28936146/adherence-to-clinical-practice-guidelines-for-the-treatment-of-candidemia-at-a-veterans-affairs-medical-center
#1
Chester N Ashong, Andrew S Hunter, M David Mansouri, Richard M Cadle, Richard J Hamill, Daniel M Musher
OBJECTIVES: The primary objective of this study was to examine the appropriateness of candidemia management at a Veterans Affairs Medical Center as recommended by the 2009 Infectious Diseases Society of America (IDSA) guidelines for treatment of Candida infections. METHODS: A retrospective analysis of 94 adult patients with blood cultures positive for Candida spp. was performed. Patients were stratified by severity of disease into two groups: non-neutropenic, mild-moderate disease (Group 1, n = 54, 56%) and non-neutropenic, moderate-severe disease (Group 2, n = 40, 42%)...
July 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28922285/what-where-and-why-exploring-fluorodeoxyglucose-pet-s-ability-to-localise-and-differentiate-infection-from-cancer
#2
Abby Douglas, Eddie Lau, Karin Thursky, Monica Slavin
PURPOSE OF REVIEW: To review the utility of FDG-PET imaging in detecting the cause of fever and infection in patients with cancer. RECENT FINDINGS: FDG-PET has been shown to have high sensitivity and accuracy for causes of neutropenic fever, leading to higher diagnostic certainty in this group. Recent advances in pathogen-specific labelling in PET to identify Aspergillus spp. and Yersinia spp. infections in mice, as well as differentiating between Gram-positive, Gram-negative and mycobacterial infections are promising...
September 15, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28920169/diagnostic-value-of-strem-1-il-8-pct-and-crp-in-febrile-neutropenia-after-autologous-stem-cell-transplantation
#3
C S Michel, D Teschner, E M Wagner, M Theobald, Markus P Radsak
Infections and infectious complications are the major cause of morbidity and mortality in febrile neutropenic patients after autologous stem cell transplantation. Laboratory biomarkers are helpful for early identification of critically ill patients and optimal therapy management. Several studies in adult non-neutropenic patients proposed sTREM-1 as a superior biomarker for identification of septic patients as well as a predictor for survival in these patients compared with procalcitonin (PCT), C-reactive protein (CRP), or interleukin-8 (IL-8)...
September 17, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28916227/granulocyte-transfusions-a-concise-review-for-practitioners
#4
REVIEW
Juan Gea-Banacloche
Granulocyte transfusions (GTXs) have been used to treat and prevent infections in neutropenic patients for more than 40 years, despite persistent controversy regarding their efficacy. This narrative review attempts to complement recent systematic reviews by the Cochrane Collaboration and provide both historical context and critical assessment of the most significant clinical studies published over the years. The data suggest that properly collected and promptly infused granulocytes are active against infections, both bacterial and fungal...
September 12, 2017: Cytotherapy
https://www.readbyqxmd.com/read/28912539/diphenyleneiodonium-chloride-dpic-displays-broad-spectrum-bactericidal-activity
#5
Manitosh Pandey, Alok Kumar Singh, Ritesh Thakare, Sakshi Talwar, Pratiksha Karaulia, Arunava Dasgupta, Sidharth Chopra, Amit Kumar Pandey
Indiscriminate use of antibiotics globally has lead to an increase in emergence of drug-resistant pathogens under both nosocomial, as well as more worryingly, in community setting as well. Further, a decrease in the corporate interest and financial commitment has exerted increasing pressure on a rapidly dwindling antimicrobial drug discovery and developmental program. In this context, we have screened the Library of Pharmacologically Active Compounds (LOPAC, Sigma) against Staphylococcus aureus and Mycobacterium tuberculosis to identify potent novel antimicrobial molecules amongst non-antibiotic molecules...
September 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28887465/host-immune-status-specific-production-of-gliotoxin-and-bis-methyl-gliotoxin-during-invasive-aspergillosis-in-mice
#6
Janyce A Sugui, Stacey R Rose, Glenn Nardone, Muthulekha Swamydas, Chyi-Chia R Lee, Kyung J Kwon-Chung, Michail S Lionakis
Delayed diagnosis in invasive aspergillosis (IA) contributes to its high mortality. Gliotoxin (GT) and bis-methyl-gliotoxin (bmGT) are secondary metabolites produced by Aspergillus during invasive, hyphal growth and may prove diagnostically useful. Because IA pathophysiology and GT's role in virulence vary depending on the underlying host immune status, we hypothesized that GT and bmGT production in vivo may differ in three mouse models of IA that mimic human disease. We defined temporal kinetics of GT and bmGT in serum, bronchoalveolar lavage fluid (BALF) and lungs of A...
September 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28881492/a-novel-elane-mutation-associated-with-inflammatory-arthritis-defective-netosis-and-recurrent-parvoviral-infection
#7
Uma Thanarajasingam, Mark A Jensen, Jessica M Dorschner, Theresa Wampler Muskardin, Yogita Ghodke-Puranik, Monica Purmalek, Elias Eliopoulos, Maria I Zervou, George N Goulielmos, Matthew Howard, Mariana J Kaplan, Timothy B Niewold
OBJECTIVE: We describe a 38-year-old woman presenting with a history of inflammatory arthritis, rash and daily fevers. She was noted to have chronic parvoviral infection with persistently detectable viral titers and a novel mutation in the ELANE gene. ELANE encodes neutrophil elastase, a neutrophil serine protease with important antimicrobial effects and is found as part of neutrophil extracellular trap (NET) complexes. Pathogenic ELANE mutations have been described in forms of hereditary neutropenia...
September 7, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28872724/successful-treatment-of-bilateral-endogenous-fusarium-solani-endophthalmitis-in-a-patient-with-acute-lymphocytic-leukemia
#8
Ilaria Rizzello, Fausto Castagnetti, Pier Giorgio Toschi, Patrizia Bertaccini, Laura Primavera, Michela Paolucci, Luca Faccioli, Luca Spinardi, Russell E Lewis, Michele Cavo, Marta Stanzani
Fusarium spp. are an uncommon cause of fungemia in immunocompromised and neutropenic patients that may hematogenously disseminate to the eyes. Herein, we describe a patient with acute lymphoblastic leukemia and a prior history of extensive corticosteroid exposure who developed disseminated Fusarium solani infection following chemotherapy despite posaconazole prophylaxis. She was successfully treated with combination liposomal amphotericin B and voriconazole, intraocular injections of voriconazole, topical amphotericin B and bilateral vitrectomy...
September 5, 2017: Mycoses
https://www.readbyqxmd.com/read/28856437/diagnosis-and-empirical-treatment-of-fever-of-unknown-origin-fuo-in-adult-neutropenic-patients-guidelines-of-the-infectious-diseases-working-party-agiho-of-the-german-society-of-hematology-and-medical-oncology-dgho
#9
REVIEW
W J Heinz, D Buchheidt, M Christopeit, M von Lilienfeld-Toal, O A Cornely, H Einsele, M Karthaus, H Link, R Mahlberg, S Neumann, H Ostermann, O Penack, M Ruhnke, M Sandherr, X Schiel, J J Vehreschild, F Weissinger, G Maschmeyer
Fever may be the only clinical symptom at the onset of infection in neutropenic cancer patients undergoing myelosuppressive chemotherapy. A prompt and evidence-based diagnostic and therapeutic approach is mandatory. A systematic search of current literature was conducted, including only full papers and excluding allogeneic hematopoietic stem cell transplant recipients. Recommendations for diagnosis and therapy were developed by an expert panel and approved after plenary discussion by the AGIHO. Randomized clinical trials were mainly available for therapeutic decisions, and new diagnostic procedures have been introduced into clinical practice in the past decade...
August 30, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28833874/use-of-granulocyte-transfusions-among-haematology-units-in-england-and-north-wales
#10
S Morton, A Mijovic, D I Marks, J Griffin, E Massey, N Bhatnagar, S J Stanworth
OBJECTIVES: To establish the current use of granulocyte transfusions in haematology patients and explore interest in further research. BACKGROUND: Granulocytes may be used for the treatment of severe infection in neutropenic patients or for primary or secondary prophylaxis. Clinical utility of granulocyte transfusions is unclear, and recent studies have demonstrated equivocal outcomes. Pooled granulocytes are the main granulocyte product used in England and Wales, but there are no data on the patterns of use and little consensus on accepted indications...
August 18, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28830945/pharmacodynamics-of-the-orotomides-against-aspergillus-fumigatus-new-opportunities-for-treatment-of-multidrug-resistant-fungal-disease
#11
William W Hope, Laura McEntee, Joanne Livermore, Sarah Whalley, Adam Johnson, Nicola Farrington, Ruwanthi Kolamunnage-Dona, Julie Schwartz, Anthony Kennedy, Derek Law, Michael Birch, John H Rex
F901318 is an antifungal agent with a novel mechanism of action and potent activity against Aspergillus spp. An understanding of the pharmacodynamics (PD) of F901318 is required for selection of effective regimens for study in phase II and III clinical trials. Neutropenic murine and rabbit models of invasive pulmonary aspergillosis were used. The primary PD endpoint was serum galactomannan. The relationships between drug exposure and the impacts of dose fractionation on galactomannan, survival, and histopathology were determined...
August 22, 2017: MBio
https://www.readbyqxmd.com/read/28808915/cost-effectiveness-of-posaconazole-tablets-for-invasive-fungal-infections-prevention-in-acute-myelogenous-leukemia-or-myelodysplastic-syndrome-patients-in-spain
#12
Rafael Cámara, Irmina Gozalbo, Manuel Jurado, Jaime Sanz, Belén Aragón, Santiago Grau
INTRODUCTION: Posaconazole is superior to fluconazole (FLU) and itraconazole (ITRA) in the prevention of invasive fungal diseases (IFDs) in neutropenic patients with acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS). A new tablet formulation of posaconazole with improved pharmacokinetic and pharmacodynamic properties compared to posaconazole oral solution has recently been approved. The objective of this study is to estimate the cost-effectiveness of the newly developed posaconazole tablets versus FLU oral suspension or ITRA oral solution for preventing IFDs in high-risk neutropenic patients with AML or MDS and from the perspective of the Spanish National Health System (NHS)...
August 14, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28807922/are-standard-doses-of-piperacillin-in-piperacillin-tazobactam-regimens-adequate-for-the-management-of-febrile-neutropenia-answers-from-population-pharmacokinetic-modelling-and-monte-carlo-simulations
#13
Fekade Bruck Sime, Uwe Hahn, Morgyn S Warner, Ing Soo Tiong, Michael S Roberts, Jeffrey Lipman, Sandra L Peake, Jason A Roberts
Changes in the pharmacokinetics of piperacillin in febrile neutropenic patients have been reported to result in sub-optimal exposures. This study aimed to develop a population pharmacokinetic model for piperacillin and perform dosing simulation to describe optimal dosing regimens for haematological malignancy patients with febrile neutropenia. Concentration-time data were obtained from previous prospective observational pharmacokinetic and interventional therapeutic drug monitoring studies. Non-parametric population pharmacokinetic analysis and Monte Carlo dosing simulations were performed with Pmetrics® package for R...
August 14, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28807906/impact-of-type-iii-secretion-effectors-and-of-phenoxyacetamide-inhibitors-of-type-iii-secretion-on-abscess-formation-in-a-mouse-model-of-pseudomonas-aeruginosa-infection
#14
Bryan J Berube, Katherine Murphy, Matthew C Torhan, Nicholas O Bowlin, John D Williams, Terry L Bowlin, Donald T Moir, Alan R Hauser
Pseudomonas aeruginosa is a leading cause of intra-abdominal infections, wound infections, and community-acquired folliculitis, each of which may involve macro- or micro-abscess formation. The rising incidence of multi-drug resistance among P. aeruginosa isolates has increased both the economic burden and the morbidity and mortality associated with P. aeruginosa disease and necessitates a search for novel therapeutics. Previous work from our group detailed novel phenoxyacetamide inhibitors that block type III secretion and injection into host cells in vitro In this study, we used a murine abscess model of P...
August 14, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28797785/granulocyte-transfusions-a-critical-reappraisal
#15
REVIEW
Caterina Giovanna Valentini, Francesca Farina, Livio Pagano, Luciana Teofili
Granulocyte transfusions (GTs) are seldom used as a life-saving therapy for neutropenic patients with severe infections. Despite compelling evidence of GT efficacy in retrospective and prospective case series, no study has been successful in demonstrating a definite advantage for recipients in controlled clinical trials. This review critically revises some aspects emerging from past experience that might have weakened the evidence of GT benefits. Some specific issues relevant to the efficacy of this therapeutic approach, such as primary infection, delivered doses and schedules, and immunologic effects of GTs, are discussed...
August 7, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28782216/temporal-changes-in-neutropenic-blood-culture-isolates-and-disease-associations-a-single-centre-series-of-1139-episodes
#16
Nathanael Lucas, Michael Humble, Dalice Sim, Michelle Balm, John Carter, Robert Weinkove
Neutropenic infections are life-threatening and require empiric antibiotic treatment. We examined 1139 blood culture isolates from our institution over a 36-year period from neutropenic patients to examine temporal trends and disease associations. Positive associations were found between viridans streptococci and acute myeloid leukaemia, coagulase negative staphylococci and acute lymphoblastic leukaemia and Pseudomonas aeruginosa and indolent B-cell malignancies.
August 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28776170/viridans-group-streptococci-bloodstream-infections-in-neutropenic-adult-patients-with-hematologic-malignancy-single-center-experience
#17
J Radocha, P Paterová, A Zavřelová, B Víšek, F Gabalec, H Žemličková, P Žák
Viridans group streptococci bloodstream infections (VGS BSI) remain a significant cause of mortality and morbidity in patients with severe neutropenia. The goal of our study was to evaluate clinical course and microbiological susceptibility of VGS BSI at our center. Retrospective analysis of all microbiologically documented bloodstream infections caused by VGS during the 9-year time period (from January 2006 until December 2014) was carried out. Only patients with severe neutropenia (< 500/μL) were included in the study...
August 3, 2017: Folia Microbiologica
https://www.readbyqxmd.com/read/28775254/adamts-13-regulates-neutrophil-recruitment-in-a-mouse-model-of-invasive-pulmonary-aspergillosis
#18
Astrid Alflen, Steve Prüfer, Katharina Ebner, Sebastian Reuter, Pamela Aranda Lopez, Inge Scharrer, Fumiaki Banno, Michael Stassen, Hansjörg Schild, Kerstin Jurk, Markus Bosmann, Hendrik Beckert, Markus P Radsak
Von Willebrand factor (VWF) is secreted as an acute phase protein during inflammation. ADAMTS-13 regulates the size and prothrombotic activity of VWF by it's specific proteolytic activity. To determine the relevance of this regulatory pathway for the innate inflammatory response by polymorphonuclear neutrophils (PMN), we employed a mouse model of invasive pulmonary aspergillosis (IPA) where PMN functionality is crucial for fungal clearance and survival. IPA was induced by intratracheal application of Aspergillus fumigatus (A...
August 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28774702/candida-and-invasive-mould-diseases-in-non-neutropenic-critically-ill-patients-and-patients-with-haematological-cancer
#19
REVIEW
A L Colombo, J N de Almeida Júnior, Monica A Slavin, Sharon C-A Chen, Tania C Sorrell
Critically ill patients and patients with haematological cancer are HIV-negative populations at high risk of invasive fungal infections. In intensive-care units, candidaemia and intra-abdominal candidiasis predominate, but aspergillosis has emerged as a lethal, under-recognised cause of pneumonia. In patients with haematological malignancies or who have undergone stem-cell transplantations, pulmonary disease due to aspergillus and other mould diseases predominate. In this Series paper, we provide an update on risk assessment, new diagnostic strategies, and therapeutic approaches...
July 31, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28753224/aspergillus%C3%A2-fumigatus-protein-phosphatase-ppza-is-involved-in-iron-assimilation-secondary-metabolite-production-and-virulence
#20
Adriana Oliveira Manfiolli, Patrícia Alves de Castro, Thaila Fernanda Dos Reis, Stephen Dolan, Sean Doyle, Gary Jones, Diego M Riaño Pachón, Mevlüt Ulaş, Luke M Noble, Derek J Mattern, Axel A Brakhage, Vito Valiante, Rafael Silva-Rocha, Ozgur Bayram, Gustavo H Goldman
Metal restriction imposed by mammalian hosts during an infection is a common mechanism of defence to reduce or avoid the pathogen infection. Metals are essential for organism survival due to its involvement in several biological processes. Aspergillus fumigatus causes invasive aspergillosis, a disease that typically manifests in immunocompromised patients. A. fumigatus PpzA, the catalytic subunit of protein phosphatase Z (PPZ), has been recently identified as associated with iron assimilation. A. fumigatus has 2 high-affinity mechanisms of iron acquisition during infection: reductive iron assimilation and siderophore-mediated iron uptake...
July 28, 2017: Cellular Microbiology
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