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Results in Journal Advances in Infectious Diseases: 255

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Rabab Fouad, Olfat Shaker, Hanan Abdel Hafez, Rabab Salama, Mayssa El Raziky, Samar Marzouk, Wafaa Elakel, Marwa Abdel Ghany, Gamal Esmat
Advances in Infectious Diseases, Volume 3, pp 71-77; doi:10.4236/aid.2013.32011

Abstract:
Background and Aim of the Study: HCV infection is the most common co-infection in HIV patients so we aimed to determine the prevalence of HIV infection in chronic HCV patients and its impact on chronic HCV patients treatment response. Patients and Methods: A retrospective study performed on 1852 chronic HCV patients subjected to anti HCV treatment with alpha 2a, alpha 2b or standard interferon and Ribavirin and tested and confirmed for HIV co infection by ELISA twice. Upon HIV testing, two groups were generated, Group 1: 1840 HCV patients, positive for HCV RNA, and Group 2: 12 HIV positive patients and positive also for HCV. Informed consents were obtained from patients. Proper hematological biochemical investigations and other causes of hepatitis rather than HCV were carried out and excluded. Results: The prevalence of HIV among HCV infected Egyptian patients was 0.64%. We found a male gender predominance; the hematological and biochemical parameters were similar in both groups with mild elevations in liver enzymes in group II. High rates of failure to treatment (77.8%) with lower SVR (22.2%) were in group II compared to group I (59.9%) as SVR was 22.1% in group II vs. 34.1% in group I, however with no statistical significance. Conclusion: Despite the lower prevalence of HIV in Egyptian patients with HCV infection, it still affects their response to treatment .Therefore; we must screen HIV in all HCV patients and recommend its test to routine investigations before starting HCV therapy.
Li Kiang Tan, Sally Lam, Swee Ling Low, Lee Ching Ng, Diana Teo
Advances in Infectious Diseases, Volume 3, pp 1-9; doi:10.4236/aid.2013.31001

Abstract:
The risk of blood-borne transmission of infectious diseases has led to an increasing awareness of the need for a safe and effective pathogen reduction technology. This study evaluated the efficacy of 2 pathogen reduction systems to inactivate dengue virus (DENV-2) and chikungunya virus (CHIKV) spiked into apheresis platelets (APLT) concentrates. Double-dose APLT collections (n = 3) were split evenly into two units and spiked with 107 infectious units of DENV-2 or CHIKV. APLTs samples were assayed for viral infectivity before and after Amotosalen photochemical treatment (PCT) or Riboflavin pathogen reduction treatment (PRT). Viral infectivity was determined by plaque assays. Platelet (PLT) count, pH and residual S-59 were measured during the storage of 5 days. Amotosalen PCT showed robust efficacy and complete inactivation of both viruses in APLTs, with up to 3.01 and 3.75 log reductions of DENV-2 and CHIKV respectively. At similar initial concentrations, Riboflavin PRT showed complete inactivation of CHIKV with up to 3.73 log reduction, much higher efficacy than against DENV-2 where a log reduction of up to 1.58 was observed. All post-treated APLTs maintained acceptable PLT yields and quality parameters. This parallel study of 2 pathogen reduction systems demonstrates their efficacy in inactivating or reducing DENV and CHIKV in APLTs and reaffirms the usefulness of pathogen inactivation systems to ensure the safety in PLTs transfusion.
Nachiket D. Vaze, Christopher L. Emery, Richard J. Hamilton, Ari D. Brooks, Suresh G. Joshi
Advances in Infectious Diseases, Volume 3, pp 10-16; doi:10.4236/aid.2013.31002

Abstract:
A characterization of the clinical demographic features of patients with infection caused Acinetobacter baumannii, and the antibiotyping of the isolates recovered from these patients was undertaken, with a special reference to carbapenem-resistant variants, and their risk factors. This study was conducted retrospectively from January 2010 to March 2011 at a 616-bed tertiary care university hospital. Sixty-four patients were identified. Clinical and microbiological data were analyzed for risk factors and demographic features to derive relative risk and odds ratio. We identified 100 A. baumannii from 64 patients during 15 months period. Significant risk factors were working age (18 - 60 years), male gender, hospital stay (>1 week but
S. H. Abbadi, Hamdy Youssef, Dalal Nemenqani, Ahmed S Abdel-Moneim
Advances in Infectious Diseases, Volume 3, pp 44-49; doi:10.4236/aid.2013.31005

Abstract:
Screening for colonization with methicillin resistant Staphylococcus aureas (MRSA) is a key aspect of infection control to limit the nosocomial spread of this organism. Current methods for the detection of MRSA in clinical microbiology laboratories using conventional methods is time consuming. In this research we are trying to evaluate the use of real time PCR for the detection of MRSA. The PCR assay was evaluated in clinical isolates of MRSA (n = 45) and methicillin susceptible Staphylococcus aureas MSSA (n = 10). The diagnostic values of the assay showed high sensitivity and specificity. This real-time PCR assay proved to be a fast, sensitive and specific tool for MRSA detection in a routine microbiological laboratory. Real-time PCR now is available in all laboratories so its use in identification of MRSA will help in shortening the period for MRSA identification and will help in the success of infection control programs in hospitals.
Anna Nussbaum, Noriel Mariano, Rita Colon-Urban, Rachelle A. Modeste, Sadia Zahid, Wehbeh Wehbeh, Sorana Segal-Maurer, Carl Urban
Advances in Infectious Diseases, Volume 3, pp 50-54; doi:10.4236/aid.2013.31006

Abstract:
The clinical and microbiologic characteristics of 34 patients with extended-spectrum β-lactamase (ESBL) positive E. coli isolated from blood were compared to 66 bacteremic patients with ESBL negative E. coli, from January 2007 through December 2009. Of the 21 ESBL positive isolates available for PCR analysis, 13 were positive for CTX-M, 8 for TEM, 4 for SHV β-lactamases, with 6 possessing multiple enzymes. Twenty of 34 (59%) ESBL-positive and 41 of 66 (62%) ESBL-negative blood isolates were considered community-associated. All but one isolate in both groups had MICs of ≤1.0 μg/ml to meropenem. However, when compared to ESBL-negative isolates, ESBL-positive isolates were more frequently resistant to levofloxacin, trimethoprim/sulfamethoxazole and had higher MICs to gentamicin, tobramycin and piperacillin/tazobactam. The use of intravenous and urinary catheters was strongly associated with the isolation of E. coli bloodstream isolates in both groups of patients. Although hospital stay was similar in both groups, appropriate therapy was given in 87% of patients with ESBL positive vs. 98% of patients with ESBL negative isolates and mortality was greater for patients with ESBL positive isolates (26% vs. 17%). Since a large proportion of E. coli blood isolates were ESBL-positive and community-associated, carbapenems should be considered as initial empiric therapy for such infections in our locale.
Samson B Adebayo, Richard I. Olukolade, Omokhudu Idogho, Jennifer Anyanti, Augustine Ankomah
Advances in Infectious Diseases, Volume 3, pp 210-218; doi:10.4236/aid.2013.33031

Abstract:
Objective: Until recently, HIV prevalence has been based on estimates from antenatal sentinel surveys which have been found to overestimate HIV prevalence among the general population. Multiple studies have shown women to be disproportionately affected by HIV and AIDS epidemic. Design: Data for this study were based on the first Nigerian population household-based HIV biomarker survey of 2007, which used a multi-stage probability sampling technique. Methods: Respondents were selected through probability sampling (male age 15 - 64 years and female 15 - 49 years). This paper, therefore, examined the correlates of marital status and HIV prevalence among women in Nigeria. Results: A descriptive analysis of the data showed that HIV prevalence of women that were formerly married: divorced, separated or widowed were more than double that of those who were currently married/cohabiting with a sexual partner; and more than three times those that were never married. Bivariate and multivariate levels of analysis were explored in this paper. At bivariate level, findings showed a significant difference in HIV prevalence among women according to their marital status (p < 0.0001), educational attainment (p = 0.004) and geo-political zones (p = 0.003). Respondents that were formerly married were 5.6 times as likely to be infected with HIV compared with those who had never married (OR = 5.6, p < 0.0001) while HIV prevalence increased with higher educational attainment. Conclusion: In view of these findings, HIV programmers should design interventions that will improve economic empowerment as well as social security for women that were formerly married. In addition, gender mainstreaming in the ongoing HIV and AIDS preventive efforts should be strengthened and scaled-up.
Hyppolite K. Tchidjou, Nicola Cotugno, Giuseppe Pontrelli, Emma Concetta Manno, Luana Coltella, De Vito Rita, Stefania Baldassari, Vittorio Colizzi, Paolo Rossi, Maria C. Lucchetti, et al.
Advances in Infectious Diseases, Volume 3, pp 157-161; doi:10.4236/aid.2013.33023

Abstract:
Background: The risk of Human Papillomavirus (HPV) infection and cervical cancer has increased in Human Immunodeficiency Virus (HIV) infected women. Several other Genital Infections (GI), have been shown to act as risk factors for the acquisition of HPV infection and for the development of cervical cancer. Methods: In this observational study, we evaluated the prevalence of HPV infection, GI and cervical abnormalities among vertically HIV-infected young women in the early years of sexual activity. HPV viral strains have been classified as high risk and low risk to develop precancerous and cancerous lesions according to the WHO classification. Results: Eighteen vertically HIV-infected young women and eleven healthy age matched controls were studied. HIV-infected young women showed a higher incidence of high risk HPV genotype infection compared to healthy control. HIV-infected women affected by HPV presented lower levels of CD4+ percentages. GI and Pap test did not show any relation with HPV infection and effects were similar in both groups. Conclusion: HIV infection and low CD4+ percentages seem to play a key role as risk factors for HPV-infection among HIV-infected young women. Therefore, future efforts will be needed to improve the adherence of HIV-infected young women in HPV pap test screening considering the lower ability of these patients to clear the HPV infection.
Josefina Marquez, Laura Acosta, Manuel Fernandez
Advances in Infectious Diseases, Volume 2, pp 119-121; doi:10.4236/aid.2012.24020

Maliha Zahid, Ish Singla, Chester B. Good, Roslyn A. Stone, Sunghee Kim, Michael J. Fine, Ali F. Sonel
Advances in Infectious Diseases, Volume 2, pp 122-134; doi:10.4236/aid.2012.24021

Abstract:
Background: Although pneumococcal vaccination prevents the most common pneumonia of bacterial etiology, its associations without comes of Acute Coronary Syndrome (ACS) are unknown. Methods: This is a prospective cohort study of 1436 patients hospitalized with suspected ACS/non-ST elevation MI that were eligible for pneumococcal vaccination. Primary outcomes were death and subsequent Myocardial Infarction (MI) within 6-months of the index hospitalization. We used Cox regression to assess associations between pneumococcal vaccination and outcomes, adjusting for influenza vaccination and relevant clinical covariates. We also utilized propensity scores to adjust for potential confounding. Results: Overall, 937 (65.3%) patients received pneumococcal vaccination either prior to or during the index hospitalization. Unvaccinated patients had higher mortality (26.9% vs. 7.9%; p < 0.001) and non-significantly higher frequency of subsequent MI (7.4% vs. 3.5%; p = 0.06).Compared to patients who did not receive either pneumococcal or influenza vaccination, the unadjusted Hazard Ratio (HR) of death was significantly lower for those who received only pneumococcal vaccination (HR = 0.13; 95% CI 0.07 - 0.23) or both vaccinations (HR = 0.66, 95% CI 0.47 - 0.92), and significantly higher for patients who received only influenza vaccination (HR = 1.88, 95% CI 1.33 - 2.64). The corresponding HRs and 95% CIs for subsequent MI were 0.58 (95% CI 0.32 - 1.03) for pneumococcal vaccination only, 0.41 (95% CI 0.21 - 0.80) for both vaccinations and 0.97 (95% CI 0.48 - 1.95) for influenza vaccination alone. These remained unchanged after covariate or propensity score adjustment. Conclusions: Among patients hospitalized with suspected ACS, pneumococcal vaccination, with or without influenza vaccination, was associated with significantly lower risk of mortality within 6 months.
Foued Bellazreg, Wissem Hachfi, Atef Ben Abdelkader, Zouhour Hattab, Naoufel Kaabia, Fathi Bahri, Amel Letaief
Advances in Infectious Diseases, Volume 2, pp 148-150; doi:10.4236/aid.2012.24024

Abstract:
A 40-year-old man presented recurrent cough and bloody sputum for 4 months. Chest X-ray showed a large mass in the right upper lobe. Histopathologic examination of tissue from percutaneous biopsy of the lesion revealed actinomycotic granules and branching filamentous bacteria, and therefore pulmonary actinomycosis was diagnosed. These findings suggest that pulmonary actinomycosis should be included in the differential diagnosis of a mass on a chest X-ray film.
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