Infections
Drug-resistant TB risk demands push for new drugs
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Multi-drug resistant strains of tuberculosis (TB) could become dominant forms of the disease in the next few decades, adding heavy financial and medical burdens to already struggling health systems, doctors said on Wednesday.
In a series of studies into TB, scientists said “superbug” strains of the disease were already gaining ground in some countries and called for greater investment into research and development of new drugs and possible vaccines.
Multidrug-resistant tuberculosis, known as MDR-TB, has much lower cure rates, higher death rates, and costs far more to treat than normal TB, they warned.
ICU Infection Rates Not a Good Measure of Mortality Risk
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ICU-acquired infection rates are not an indication of patients’ mortality risk, according to researchers the University of Pennsylvania, undermining a central tenet of many pay-for-performance initiatives.
Public reporting of quality data is increasingly common in health care. These “report cards” are designed to improve the quality of care by helping patients choose the best hospitals. Yet, they only work if they successfully identify high performers, and may be misleading if they steer patients toward poor performers.
The findings will be reported at the ATS*2010 International Conference in New Orleans.
Potentially deadly fungus spreading in US, Canada
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A potentially deadly strain of fungus is spreading among animals and people in the northwestern United States and the Canadian province of British Columbia, researchers reported yesterday.
The airborne fungus, called Cryptococcus gattii, usually only infects immunocompromised patients, but the new strain is genetically different, the researchers said.
“This novel fungus is worrisome because it appears to be a threat to otherwise healthy people,” said Dr. Edmond Byrnes of Duke University in North Carolina, who led the study.
Common Cold Symptoms Not Washed Away by Nose Irrigation
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Washing out your nose with a spray or spout of salt water is safe and might even get you back to work sooner after a cold or acute sinus infection. However, there is not enough evidence to show that it can reduce your symptoms significantly, according to a new research review.
The three studies in the review included small numbers of patients and varied widely in their details, “which means small beneficial effects may be missed,” said lead author David King, M.D., of the University of Queensland, in Australia.
One study found that people were more likely to return to work sooner after using the nose washes, and there was some intriguing evidence that nasal washes might reduce antibiotic prescriptions among those who seek the saltwater treatment.
British TB cases at highest since 1980s
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Cases of tuberculosis (TB) in Britain rose by 5.5 percent in the past year and are at their highest levels since the 1980s, health authorities said on Tuesday.
The Health Protection Agency (HPA) said there were more than 9,150 cases of TB in 2009, most of them among immigrants.
The main burden of infection was in London with 3,476 cases reported in 2009, accounting for 38 percent of the nationwide total. Nearly three-quarters of all cases were in people born outside Britain, the figures showed.
Masks, hand sanitizer help halt flu spread
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Want to be prepared for a flu pandemic? You may want to stock up on face masks and hand sanitizer, according to a new study.
College students living in residency halls who wore the masks for a few hours a day and regularly used alcohol-based hand sanitizer cut their risk of coming down with flu-like illness by up to half, Dr. Allison E. Aiello of the University of Michigan in Ann Arbor and her colleagues found.
“We do think it probably would generalize to other settings in which you have people living in close quarters and eating in shared facilities”—for example military barracks or nursing homes, Aiello told Reuters Health in an interview. “We can probably even bring this to the household setting.”
Quantifying the number of pregnancies at risk of malaria in 2007: A demographic study
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Research published this week in PLoS Medicine concludes that at least 125.2 million women at risk of malaria become pregnant each year.
Most malaria deaths are caused by Plasmodium falciparum, which thrives in tropical and sub-tropical regions. But the most widespread type of malaria is P. vivax malaria, which also occurs in temperate regions. Most malaria deaths are among young children in sub-Saharan Africa but pregnant women and their unborn babies are highly vulnerable to malaria. About 10,000 women and 200,000 babies die annually because of malaria in pregnancy, which can cause miscarriages, preterm births, and low-birth-weight births. Estimates on the burden of malaria were previously only available for Africa.
The researchers estimated the sizes of populations at risk of malaria in 2007 by combining maps of the global limits of P. vivax and P. falciparum transmission with data on population densities. They used data from various sources to calculate the annual number of pregnancies (the sum of live births, induced abortions, miscarriages and still births) in each country.
Deadly Stomach Infection Rising in Community Settings
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Mayo Clinic researchers have found that a sometimes deadly stomach bug, Clostridium difficile, is on the rise in outpatient settings. Clostridium difficile is a serious bacteria that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. These findings were presented today at the 2009 American College of Gastroenterology (ACG) Annual Meeting in San Diego.
VIDEO ALERT: Additional audio and video resources are available on the Mayo Clinic News Blog.
Clostridium difficile, often called C. difficile or “C. diff”, is a bacterium that is resistant to some antibiotics and is most often contracted by the elderly in hospitals and nursing homes.
Bowel disease drugs increase cancer risk: study
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Some treatments for inflammatory bowel disease increase the risk of infection-related cancers, French scientists said on Monday, but the benefits of the drugs still outweigh the risks.
Thiopurine drugs—immunosuppressive medicines that inhibit the body’s immune system—are regularly used to treat inflammatory bowel disease, the researchers said, but can increase the risk of cancers linked to viral infections.
Laurent Beaugerie and colleagues at the Saint-Antoine hospital in Paris looked at more than 19,000 patients with inflammatory bowel disease. Around 30 percent of the patients were taking thiopurines, 14 percent had stopped taking them and 56 percent had never taken them.
Enzyme injections unlock bent fingers
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Injections of an enzyme that breaks up collagen can unlock permanently curled fingers for people with a common disabling condition known as Dupuytren’s contracture, U.S. researchers said on Wednesday.
The Auxilium Pharmaceuticals treatment, which is awaiting approval by the U.S. Food and Drug Administration, avoids the need for hand surgery and the long rehabilitation that follows.
“It’s going to mean they have an option to have this cared for without an operation, and that’s never been available before,” said Dr. Lawrence Hurst of the State University of New York at Stony Brook, whose study appears in the New England Journal of Medicine.
Harvard scientists solve mystery about why HIV patients are more susceptible to TB infection
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A team of Harvard scientists has taken an important first step toward the development of new treatments to help people with HIV battle Mycobacterium tuberculosis (TB) infection. In their report, appearing in the July 2009 print issue of the Journal of Leukocyte Biology (http://www.jleukbio.org) they describe how HIV interferes with the cellular and molecular mechanisms used by the lungs to fight TB infection. This information is crucial for researchers developing treatments to help people with HIV prevent or recover from TB infection.
“HIV/TB co-infection is a critical global health problem, especially in developing countries,” said Naimish Patel, M.D., lead researcher on the study and Instructor of Medicine at Beth Israel Deaconess Medical Center and Harvard Medical School. “We hope that these findings will lead to further studies and possible new therapies for treating or preventing tuberculosis in HIV disease.”
Patel and colleagues made their discovery by extracting immune cells called “alveolar macrophages” from the lungs of otherwise healthy, asymptomatic HIV-positive patients as well as from people who did not have HIV. In people who are HIV-positive, the macrophages have a decreased response to the TB bacterium when compared to people who did not have HIV. To learn why, the scientists examined lung specimens from the HIV-positive patients and found increased levels of a molecule called IL-10, which elevated the amount of a protein called “BCL-3” in alveolar macrophages and that reduced their ability to ward off TB infection.
New Detector Promises Earlier Detection of Viral Infections
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A Vanderbilt chemist and a biomedical engineer have teamed up to develop a respiratory virus detector that is sensitive enough to detect an infection at an early stage, takes only a few minutes to return a result and is simple enough to be performed in a pediatrician’s office.
Writing in The Analyst – a journal published by the Royal Society of Chemistry – the developers report that their technique, which uses DNA hairpins attached to gold filaments, can detect the presence of respiratory syncytial virus (RSV) – a leading cause of respiratory infections in infants and young children – at substantially lower levels than the standard laboratory assay.
“We hope that our research will help us break out of the catch-22 that is holding back major advances in the treatment of respiratory viruses,” says Associate Professor of Chemistry David Wright, who is working with Professor of Biomedical Engineering Frederick “Rick” Haselton on the new detection method.
Scientists Map Genome for Parasite Causing Widespread Infections
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Scientists at the Southwest Foundation for Biomedical Research (SFBR) in San Antonio have for the first time constructed a genetic map of the parasite that causes schistosomiasis, a chronic intestinal infection that can damage internal organs and, in children, impair growth and cognitive development. Schistosome parasites are flatworms that infect more than 200 million people a year worldwide. Infection results in an estimated 200,000 deaths annually in sub-Saharan Africa alone, while 20 million suffer severe disease, according to the World Health Organization.
“A genetic map is the essential tool needed for finding the genes that are responsible for drug resistance and pathogenesis in this parasite. In the case of drug resistance, identification of underlying mutations is critical for management of this disease” said Timothy Anderson, Ph.D., of SFBR’s department of genetics.
“First, identification of mutations allows us to better understand the mechanism of action of the drugs used, and to redesign drugs to restore treatment efficacy. Second, identification of mutations involved allows us to efficiently monitor the spread of resistance in parasite populations using simple molecular methods.”
Predicting Fatal Fungal Infections
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In a study published in The Journal of Infectious Diseases, researchers from Albert Einstein College of Medicine of Yeshiva University have identified cells in blood that predict which HIV-positive individuals are most likely to develop deadly fungal meningitis, a major cause of HIV-related death. This form of meningitis affects more than 900,000 HIV-infected people globally—most of them in sub-Saharan Africa and other areas of the world where antiretroviral therapy for HIV is not available.
A major cause of fungal meningitis is Cryptococcus neoformans, a yeast-like fungus commonly found in soil and in bird droppings. Virtually everyone has been infected with Cryptococcus neoformans, but a healthy immune system keeps the infection from ever causing disease.
The risk of developing fungal meningitis from Cryptococcus neoformans rises dramatically when people have weakened immunity, due to HIV infection or other reasons including the use of immunosuppressive drugs after organ transplantation, or for treating autoimmune diseases or cancer. Knowing which patients are most likely to develop fungal meningitis would allow costly drugs for preventing fungal disease to be targeted to those most in need. (In the U.S., the widespread use of antiretroviral therapy by HIV-infected people, and their preventive use of anti-fungal drugs, has dramatically reduced their rate of fungal meningitis from Cryptococcus neoformans to about 2%.)
H1N1 flu infects 13,000 in 46 countries: WHO
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The World Health Organization said on Tuesday that nearly 13,000 people have been confirmed to have infection of the new H1N1 flu strain but the number of countries affected is stable at 46.
In its latest tally, which tends to lag behind national reports, but is considered more accurate, the United Nations agency said its labs have confirmed 12,954 infections with the newly discovered strain that has killed 92 people.
Mexico has been most heavily affected by the flu outbreak, which has caused 80 deaths there. The other fatalities have been in the United States, where 10 people have died, and Costa Rica and Canada, which have reported one death each.
