Infectious Disease Alert
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Antibiotics for Intraabdominal Infections: Less Is More
A multi-center, randomized trial comparing patients with complicated intraabdominal infections found no difference in outcomes between those who received 4 days of antibiotic therapy vs. 8 days after adequate source control.
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Duration of Antibiotic Treatment for Vertebral Osteomyelitis
Three hundred fifty-nine patients with pyogenic vertebral osteomyelitis were randomized to 6 weeks vs. 12 weeks of antibiotic treatment in an open-label controlled trial. Six weeks of antibiotics was found to be not inferior to 12 weeks of treatment.
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Early, Goal-directed Therapy of Septic Shock
ABSTRACT & COMMENTARY: Hemodynamic management did not lead to an improvement in outcome.
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Reservoir Bugs: CRE in Long-term Acute Care Hospitals Threatens to Spread to Other Facilities
With a combination of severely ill patients, high antibiotic use, and lengths of stay measured in weeks, long-term acute care (LTAC) hospitals have been described as a perfect storm for emergence of multidrug-resistant organisms (MDROs).
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Infectious Disease Alert Updates
Water Birth Death
Out, Damned Spore!
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Preventing Active Tuberculosis in Children
A three-month course of weekly rifapentine and isoniazid is safe and at least as effective as nine months of daily isoniazid in preventing tuberculosis in children aged 2 to 17 years.
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Steroids for Severe Community-Acquired Pneumonia: More Evidence or More Uncertainty?
A multicenter, randomized, double-blind, placebo-controlled trial involving patients with severe community-acquired pneumonia and evidence of high inflammation found less treatment failure in those who received steroids. However, in-hospital mortality did not differ between the groups.
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Acute Leukemia Patients Still Plagued by Vancomycin-Resistant Enterococci
Fifteen (7%) of 214 patients hospitalized with newly diagnosed acute leukemia developed bacteremia due to vancomycin-resistant enterococci; 12 (80%) of the 15 had stool colonization with the organism.
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Fusobacterium as a Cause of Pharyngitis in Young Adults
Three hundred twelve students presenting to a university student health clinic with sore throat and 180 asymptomatic students had throat swabs taken and the samples were tested by PCR for Fusobacterium necrophorum, Mycoplasma pneumonia, group A streptococci, and group C/G streptococci. Fusobacterium necrophorum-positive pharyngitis occurs more frequently than group A streptococcal pharyngitis in this population and clinically resembles streptococcal pharyngitis.
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Seizures, Encephalopathy, and Vaccines — Evidence Fails to Support a Link
A comprehensive, independent review of 10 years of all cases in the United States of seizures and encephalopathy reported as linked to vaccination showed that approximately one-quarter of cases had evidence of a pre-existing neurologic abnormality. Among those who developed chronic epilepsy, many had clinical features suggesting genetically determined epilepsy, especially Dravet syndrome.