Podcasts about Haemophilus

This week Luis continues going over Haemophilus. This time he goes over biochemicals, testing systems, and susceptibility testing. What is the ALA test? What commercial systems are able to identify Haemophilus? What about for Haemophilus influenzae? What is HTM agar? Are there any vaccines for H. influenzae? Tune in to find out more. More information on  H. influenzae vaccines:  https://www.cdc.gov/hi-disease/vaccines/index.html   Questions? Feedback? Send those to letstalkmicro@outlook.com Want to support the podcast? Here's how: Venmo: https://venmo.com/u/letstalkmicro Buy me a Ko-fi: https://ko-fi.com/letstalkmicro  

In this episode Luis continues going over organisms. This time he goes over the genus Haemophilus. We start with an overview of the different species of Haemophilus. Why can't Haemophilus grow on blood agar? What are the X and V factors? Satellite phenomenon? What is the gram stain? What about media? Tune in for the first part of a series about Haemophilus.   Questions? Feedback? Send those to letstalkmicro@outlook.com Want to support the podcast? Here's how: Venmo: https://venmo.com/u/letstalkmicro Buy me a Ko-fi: https://ko-fi.com/letstalkmicro  

Story at-a-glance Research found that higher levels of harmful bacteria (Prevotella intermedia) in the mouth are linked to cognitive impairment, while beneficial bacteria (Neisseria and Haemophilus) support better brain function Nitric oxide production by beneficial oral bacteria plays a crucial role in maintaining blood flow to the brain. Nitrate-rich vegetables help boost the population of these healthy bacteria People with the APOE4 gene show a distinct oral microbiome composition. Research shows they have lower levels of Neisseria bacteria and higher amounts of Prevotella, which is associated with increased dementia risk Harmful oral bacteria have the ability to enter the bloodstream and cross the blood-brain barrier, leading to brain inflammation that results in cognitive decline Maintaining oral health through proper diet, regular brushing and flossing, nose breathing, avoiding antibacterial mouthwash and practicing oil pulling are effective strategies against cognitive decline

Send us a textJoin Marla Dalton, PE, CAE, and William Schaffner, MD, for an inspiring conversation with Kathryn M. Edwards, MD, a renowned expert in childhood respiratory diseases and vaccine safety. Edwards shares her journey from a budding chemist to a trailblazer in the prevention of pediatric infectious diseases and an advocate for ensuring vaccine safety and efficacy in the US.   Show notesWhile at Vanderbilt University Medical Center, her passion for disease prevention brought her to lead efforts evaluating vaccines against pertussis, Haemophilus influenzae type b (Hib), influenza (flu), pneumococcal disease, smallpox, anthrax, and other infectious diseases. During the COVID-19 pandemic, she served on vaccine safety and monitoring committees and helped address questions about adverse events. In 2018, NFID recognized her extraordinary accomplishments by awarding her the Maxwell Finland Award for Scientific Achievement. A native of Williamsburg, IA, Edwards graduated from the University of Iowa  School of Medicine, and did her residency, fellowship, and postdoctoral training in Chicago, IL. Now (mostly) retired, she enjoys spending time with her family, including her beloved grandchildren. Follow NFID on social media

CardioNerds cofounder Dr. Dan Ambinder joins Dr. Angie Molina, Dr. Cullen Soares, and Dr. Andrew Lutz from the University of Maryland Medical Center for some beers and history by Fort McHenry. They discuss a case of disseminated haemophilus influenzapresumed fulminant bacterial myocarditis with mixed septic/cardiogenic shock. Expert commentary is provided by Dr. Stanley Liu (Assistant Professor, Division of Cardiovascular Medicine, University of Maryland School of Medicine). Episode audio was edited by Dr. Chelsea Amo-Tweneboah. A woman in her twenties with a history of intravenous drug use presented with acute onset fevers and sore throat, subsequently developed respiratory distress and cardiac arrest, and was noted to have epiglottic edema on intubation. She developed shock and multiorgan failure. ECG showed diffuse ST elevations, TTE revealed biventricular dysfunction, and pleural fluid culture grew Haemophilus influenza. Right heart catheterization showed evidence of cardiogenic shock. She improved with supportive care and antibiotics. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Sore Throat, Fever, and Myocarditis - It's not always COVID-19 The post-cardiac arrest ECG provides helpful information for diagnosing the underlying etiology.​ Be aware of diagnostic biases - availability and anchoring biases are particularly common during respiratory viral (such as COVID-19, RSV) surges. Consider a broad differential diagnosis in evaluating myocarditis, including non-viral etiologies. Right heart catheterization provides crucial information for diagnosis and management of undifferentiated shock​. When assessing the need for mechanical circulatory support, consider the current hemodynamics, type of support needed, and risks associated with each type. Show Notes - Sore Throat, Fever, and Myocarditis - It's not always COVID-19 ECG findings consistent with pericarditis include diffuse concave-up ST elevations and downsloping T-P segment (Spodick's sign) as well as PR depression (lead II), and PR elevation (lead aVR). In contrast, regional ST elevations with “reciprocal” ST depressions and/or Q-waves should raise concern for myocardial ischemia as the etiology. Biventricular dysfunction and elevated troponin are commonly seen post-cardiac arrest and may be secondary findings. However, an elevation in troponin that is out of proportion to expected demand ischemia, ECG changes (pericarditis, ischemic ST elevations), and cardiogenic shock suggest a primary cardiac etiology for cardiac arrest. The differential diagnosis of infectious myopericarditis includes, most commonly, viral infection (respiratory viruses) and, more rarely, bacterial, fungal, or parasitic. Noninfectious myopericarditis may be autoimmune (such as lupus, sarcoidosis, checkpoint inhibitors), toxin-induced (alcohol, cocaine), and medication-induced (anthracyclines and others). Right heart catheterization can help diagnose the etiology of undifferentiated shock, including distinguishing between septic and cardiogenic shock, by providing right and left-sided filling pressures, pulmonary and systemic vascular resistance, and cardiac output. Mechanical circulatory support (MCS) is indicated for patients in cardiogenic shock with worsening end-organ perfusion despite inotropic and pressor support. MCS includes intra-aortic balloon pump, percutaneous VAD, TandemHeart, and VA-ECMO. The decision to use specific types of MCS should be individualized to each patient with their comorbidities and hemodynamic profile. Shock teams are vital to guide decision-making. References Witting MD, Hu KM, Westreich AA, Tewelde S, Farzad A,

J. Craig Venter, PhD, ( https://www.jcvi.org/about/j-craig-venter ) is regarded as one of the leading scientists of the 21st century for his numerous invaluable contributions to genomic research. Dr. Venter is founder, chairman, and CEO of the J. Craig Venter Institute (JCVI), a not-for-profit, research organization with approximately 120 scientists and staff dedicated to human, microbial, synthetic, and environmental genomic research, and the exploration of social and ethical issues in genomics. Dr. Venter began his formal education after a tour of duty as a Navy Corpsman in Vietnam from 1967 to 1968. After earning both a Bachelor of Science in biochemistry and a PhD in physiology and pharmacology from the University of California at San Diego, he was appointed professor at the State University of New York at Buffalo and the Roswell Park Cancer Institute. In 1984, he moved to the National Institutes of Health campus where he developed expressed sequence tags or ESTs, a revolutionary new strategy for rapid gene discovery. In 1992, Dr. Venter founded The Institute for Genomic Research (TIGR, now part of JCVI), a not-for-profit research institute, where in 1995 he and his team decoded the genome of the first free-living organism, the bacterium Haemophilus influenzae, using the new whole genome shotgun technique. In 1998, Dr. Venter founded Celera Genomics to sequence the human genome using new tools and techniques he and his team developed. This research culminated with the February 2001 publication of the human genome in the journal, Science. He and his team at Celera also sequenced the fruit fly, mouse, and rat genomes. Dr. Venter and his team at JCVI continue to blaze new trails in genomics. They have sequenced and analyzed hundreds of genomes, and have published numerous important papers covering such areas as environmental genomics, the first complete diploid human genome, and the groundbreaking advance in constructing the first self-replicating bacterial cell using synthetic DNA. Dr. Venter is one of the most frequently cited scientists, and the author of more than 280 research articles. He is also the recipient of numerous honorary degrees, public honors, and scientific awards, including the 2008 United States National Medal of Science, the 2002 Gairdner Foundation International Award, the 2001 Paul Ehrlich and Ludwig Darmstaedter Prize, and the King Faisal International Award for Science. Dr. Venter is a member of numerous prestigious scientific organizations including the National Academy of Sciences, the National Academy of Medicine, the American Academy of Arts and Sciences, and the American Society for Microbiology. Dr. Venter is also a serial entrepreneur who has co-founded several companies including Synthetic Genomics, Inc., now Viridos and Human Longevity, Inc. (HLI). Dr. Venter's newest book "The Voyage of Sorcerer II: The Expedition That Unlocked the Secrets of the Ocean's Microbiome" was recently released on September 12, 2023 - https://www.amazon.com/Voyage-Sorcerer-II-Expedition-Microbiome/dp/0674246470 Support the show

#31 Haemophilus influenzae Typ b — Die nicht typisierbaren auf der Überholspur?! In dieser Episode beschäftigen wir uns mit Haemophilus influenzae Typ b: * Welche Rolle spielt Haemophilus influenzae Typ b in der Gesamtheit der Atemwegserkrankungen? * Was ist Haemophilus influenzae Typ b? * Wer bekommt Haemophilus influenzae Typ b? Inwiefern sind Säuglinge und Kleinkinder von Haemophilus influenzae Typ b bedroht? * Welche Komplikationen treten durch eine Infektion am häufigsten auf? * Gibt es eine wirksame Haemophilus influenzae Typ b-Impfung? Gibt es diese Impfung nur in Kombinationsimpfstoffen? * Was empfiehlt die STIKO? * Welche langfristigen Folgen der Haemophilus influenzae Typ b-Impfung zeichnen sich ab? * Was spricht für eine Impfung? Die Evidence-based-Antworten auf diese Fragen und einige mehr findet Ihr in dieser Episode unseres Podcasts. Wenn Ihr zu diesem Thema weiterführende Informationen sucht, werdet Ihr auf unserer Webseite fündig: https://individuelle-impfentscheidung.de/impfungen.html Hier die E-Mail-Adresse für Fragen, auf die wir noch keine Antwort gegeben haben: podcast@individuelle-impfentscheidung.de Nun wünschen wir interessante Einblicke und gute Unterhaltung. Viel Spaß! Zum Schluss noch eine redaktionelle Anmerkung. Ihr habt uns viele Fragen gestellt und fleißig E-Mails geschrieben – wir freuen uns über den Kontakt zu Euch! Allerdings können wir an dieser Stelle keine Einzelberatung leisten. Zur Beantwortung all Eurer Fragen nehmen wir eine Extra-Folge auf. Darüber hinaus möchten wir anregen, diese Fragen auch mit Eurer Hausärztin / Eurem Hausarzt zu besprechen: Die Informationen auf der ÄFI-Website richten sich auch an sie und können eine wichtige Grundlage für ein Impf-Beratungsgespräch sein.

In this episode, we review the high-yield topic of⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Haemophilus influenzae ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Microbiology section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbull --- Send in a voice message: https://podcasters.spotify.com/pod/show/medbulletsstep1/message

Today's episode promises an insightful exploration into a unique case centered on retropharyngeal abscess in the PICU, offering a comprehensive analysis of its clinical manifestations, pathophysiology, diagnostic strategies, and evidence-based management approaches.Today, we unravel the layers of a compelling case involving a 9-month-old with a retropharyngeal abscess, delving into the intricacies of its diagnosis, management, and the critical role played by PICU specialists. Join us as we navigate through the clinical landscape of RPA, providing not only a detailed analysis of the presented case but also valuable takeaways for professionals in the field and those aspiring to enter the world of pediatric intensive care. Welcome to PICU Doc On Call – where MED-ED meets the real challenges of the PICU.Case PresentationPatient: 9-month-old male with rapid symptom onset, left neck swelling, fever, noisy breathing, and decreased oral intake.Initial presentation: Left neck swelling, limited neck mobility, and deteriorating condition.Imaging: Neck X-ray and CT scan with IV contrast confirmed Retropharyngeal Abscess (RPA).Management: High-flow nasal cannula, intravenous antibiotics, and consultation with ENT. PICU admission for comprehensive care.Key ElementsRapid Symptom OnsetNeck Swelling & DroolingLimited Neck MobilityProblem RepresentationA previously healthy 9-month-old male with a recent upper respiratory infection, presenting with rapid-onset left neck swelling, fever, and respiratory distress. Imaging suggestive of a Retropharyngeal Abscess, requiring urgent PICU management for airway protection and antibiotic therapy.Pathophysiology of RPAAnatomy of retropharyngeal spaceRapid communication of infections via lymph nodesInfection sources: dental issues, trauma, localized infections (e.g., otitis, URI)Dangers of RPAAirway compromise and posterior mediastinitisProgression from cellulitis to abscessMicrobial suspects: Group A Streptococcus, anaerobes, Staphylococcus aureus, Haemophilus influenza, Klebsiella, Mycobacterium avium-intracellulareClinical ManifestationsSeen predominantly in children aged 3-4 yearsNon-specific symptoms in the acute settingPronounced symptoms in PICU: neck pain, stiffness, torticollis, muffled voice, stridor, respiratory distress

In this episode, we review the high-yield topic of Haemophilus ducreyi⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Microbiology section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://podcasters.spotify.com/pod/show/medbulletsstep1/message

Dalağın fonksiyonunun çeşitli durumlar sonucunda tamamen kaybına ya da cerrahi olarak çıkarılmış olmasına aspleni, dalağın normalden az fonksiyon göstermesine hipospleni adı verilmektedir. Dalak, lenfoid sisteme ait önemli bir organ olduğu için aspleni durumu, hastalara yaklaşım açısından önem arz eder. Splenektomi ameliyatları en sık dalak yaralanmaları nedeniyle planlanır. Fonksiyonel aspleni ise en sık orak hücreli anemide görülür, hastaların neredeyse tamamında yaşamın ilerleyen evrelerinde aspleni gelişmektedir. Bu durumlar dışında kronik karaciğer hastalıklarında, hemolitik anemilerde, talasemi, maligniteler, HIV enfeksiyonu, sarkoidoz, amiloidoz, Çölyak hastalığı, Whipple hastalığı, sistemik lupus eritematozus ve romatoid artrit gibi bazı hastalıklarda farklı derecelerde hipospleni veya aspleni söz konusu olabilir. Bu yazıda acil servise başvuran asplenik hastalara yaklaşımda dikkat edilecek noktalara değinmek istedim. ​1​ ​2​ ​3​ ​4​ İyi okumalar! Yapı ve Fonksiyon Dalak lenfatik sistemin en büyük organıdır. Diğer lenfoid organlardan farklı olarak korteks ve medullası yoktur. Beyaz pulpa, kırmızı pulpa, vasküler sistem ve destek dokudan meydana gelir. Bir dakikada toplam kalp debisinin %5'ini alır. Hem humoral hem de hücresel immünitede rol oynar. Antijen sunan hücreler ile immün yanıtı başlatır. Beyaz pulpadaki T ve B lenfositlerinin aktivasyonu ve proliferasyonu ile lökositlerin olgunlaşma ve yapım yeridir. Retiküloendotelyal sistemin bir parçası olarak, yaşlanan kan hücrelerini ve mikroorganizmaları uzaklaştırır. Opsonize edilmemiş bakterilerin ve Streptococcus pneumoniae, Neisseria meningitidis ve Haemophilus influenzae gibi kapsüllü bakterilerin uzaklaştırıldığı tek yerdir. Dalak ayrıca alternatif kompleman yolunda da rol oynar. Dalağın inflamatuar kaskadda ve pıhtılaşmada da önemli rolü vardır. Literatürde asplenik hayvanlarda sepsise gidişin ve sepsis mortalitesinin daha yüksek olduğu gözlenmiştir. Ayrıca dalağın normal fonksiyonunun olmadığı hastalarda sitokin aktivitesinin, trombin seviyelerinin, trombosit sayı ve aktivitesinin arttığı; intravasküler hemolizin ve eritrosit membran anormalliklerinin görüldüğü bilinmektedir. Bu faktörler makrovasküler ve mikrovasküler tromboz riskini artırmaktadır. Aspleni Komplikasyonları Enfeksiyon Aspleni önemli enfeksiyon riskine neden olur, bu hastalarda sepsis ve enfeksiyona bağlı ölüm riski genel popülasyona göre 2-3 kat daha fazladır. Asplenik bir hasta enfeksiyon geliştirirse, sonraki 3 yıl boyunca başka bir enfeksiyon için 6 kat daha yüksek risk altındadır.  Riski azaltmak için yapılacaklar şunlardır: En önemli bileşen hasta eğitimidir. Hastalar enfeksiyon riskleri ve türleri, aşıların önemi ve ne zaman tıbbi yardıma başvurmaları gerektiği konusunda bilgilendirilmelidir.   Aşılanma: Uygulanan aşılar arasında pnömokok, meningokok ve HiB aşısı bulunmaktadır. Splenektomi elektif planlanmışsa aşılamalar genellikle ameliyattan 10-12 hafta önce başlatılır, böylece tüm süreç elektif splenektomiden 2 hafta önce tamamlanır. Acil splenektomi yapılan hastalarda aşılar splenektomiden 14 gün sonra planlanmalıdır. Önerilen diğer aşılar arasında yıllık influenza aşısı da bulunmaktadır. Antibiyotik profilaksisi: Splenektomi sonrası yaklaşık 1 yıl boyunca hastalara antibiyotik profilaksisi verilmektedir. İmmünsüprese hastalara ve ciddi enfeksiyon öyküsüne sahip olanlara yaşam boyu profilaksi uygulanabilir. Profilakside genellikle penisilin V ve amoksisilin tercih edilmektedir. Gerekli durumlarda sefalosporinler, florokinolonlar veya makrolidler de kullanılabilir. Acil antibiyotikler: Ateş veya sistemik enfeksiyonu düşündüren semptomlar varlığında kullanılmak üzere hastanın yanında amoksisilin-klavulanat veya sefdinir içeren bir antibiyotiğin olması sağlanır. Bu gruplara alerjisi veya intoleransı olanlar için levofloksasin veya moksifloksasin önerilir. Hastaların acil antibiyotiğin bir dozunu hemen alıp acil servise başvurması gerekmektedir.

This year for World Meningitis Day, we pulled together a remarkable collection of people from around the world to raise awareness and share their story to help light the road ahead to defeat meningitis. Turning the World Health Organization's (WHO) Global Road Map to Defeat Meningitis by 2030 into reality could save more than 200,000 lives annually and significantly reduce disabilities caused by meningitis. At present, bacterial meningitis kills 1 in 10 people who contract it and causes lifelong disability in 1 in 5 people who survive it. :: For this episode our guests were asked to respond to these questions: How were you affected by meningitis? What do you want people to know about meningitis? What are you doing to spread awareness? :: Our guest are: Bob Werner (Wisconsin, USA) Elena Moya (Madrid, Spain) Rekha Lakshmanan (Texas, USA) Siobhan Carroll (Galway, Ireland) Vinny Smith (Bristol, England) Bruce Langoulant (Perth, Australia) John B Grimes (Texas, USA)   :: PODCAST LINKS ::  SUPPORT THIS PODCAST :: BUY ME A COFFEE!  :: https://ko-fi.com/ambiguouslyblind  GET YOUR OWN DONT WAIT MUG!  :: https://amblind.creator-spring.com/listing/destiny-dont-wait-black?product=1565  For show notes, guest profiles, photos, blog and more information, visit AmbiguouslyBlind.com and connect on:    Instagram | Facebook | Twitter | Linkedin    :: EPISODE NOTES AND LINKS ::  Episode participants: Bob Werner (Wisconsin, USA) Becky Werner Meningitis Foundation  :: https://stampoutmeningitis.com/  Elena Moya (Madrid, Spain) Asociación Española contra la Meningitis  :: https://contralameningitis.org/  Rekha Lakshmanan (Texas, USA) The Immunization Partnership  :: https://immunizeusa.org/  Siobhan Carroll (Galway, Ireland) ACT For Meningitis  :: https://actformeningitis.ie/  Vinny Smith (Bristol, England) Meningitis Research Foundation  :: https://www.meningitis.org/  Bruce Langoulant (Perth, Australia) Meningitis Centre Australia  :: https://meningitis.com.au/  John B Grimes (Texas, USA) Confederation of Meningitis Organizations (CoMO)  :: https://www.comomeningitis.org/  :: What is World Meningitis Day? World Meningitis Day was started in 2009 by a community of people affected by meningitis. Today it has grown to be a global movement that brings together people from all over the world. Together they highlight the need to raise awareness of meningitis, its signs and symptoms, the vaccines that are available, and that it is an infection that needs global attention and effort to be defeated. Every year, there are 2.5 million new cases of meningitis. Despite meningitis affecting so many lives, many people don't know enough about it, or how to protect themselves and their loved ones. A lack of knowledge and limited support means it can also be isolating for people looking to rebuild their lives after meningitis. Seeking community is a very human response and one that offers connection, healing and the opportunity for meaningful change. It is out of this need for community that, in 2004, the first world conference of meningitis organizations was held. It led to the creation of the Confederation of Meningitis Organizations (CoMO), the world's first international network of meningitis organizations, with members ranging from healthcare professionals to meningitis survivors to bereaved family members. The World Health Organisation (WHO) has developed a global plan to dramatically improve meningitis prevention, diagnosis and treatment, disease monitoring, health advocacy, support and aftercare. :: The Global Road Map to Defeat Meningitis by 2030 This is a game changer for people at risk of or affected by meningitis. Turning the WHO's Global Road Map to Defeat Meningitis by 2030 into reality could save more than 200,000 lives annually and significantly reduce disabilities caused by meningitis. At present, bacterial meningitis kills 1 in 10 people who contract it and causes lifelong disability in 1 in 5 people who survive it. The Road Map was presented at the World Health Assembly in November 2020, where countries decided to take it forward. They did this by voting on a 'resolution'. The Global Road Map to Defeat Meningitis by 2030 sets out a detailed plan to tackle the main causes of acute bacterial meningitis (including meningococcus, pneumococcus, Haemophilus influenzae and group B streptococcus). The Road Map was developed by WHO with extensive consultation and input from hundreds of global experts, including people directly affected by meningitis, scientists, country representatives, and civil society organizations like Meningitis Research Foundation and the Confederation of Meningitis Organizations.  For more information: Confederation of Meningitis Organizations :: https://www.comomeningitis.org/  Meningitis Research Foundation :: https://www.meningitis.org/     

Este pódcast está destinado exclusivamente a profesionales de la salud. La neumonía adquirida en la comunidad puede ser causada por diversos patógenos, siendo los más comunes los virus respiratorios (COVID-19, virus de la influenza, virus sincitial respiratorio), bacterias como Streptococcus pneumoniae, Haemophilus influenzae y Staphylococcus aures y bacterias atípicas como Mycoplasma pneumoniae y Chlamydophila pneumoniae. En pacientes inmunocomprometidos también puede haber infecciones por hongos como Aspergillus. ¿Cuánto sabe de su diagnóstico y manejo? ¿Cuál es el papel de los esteroides en su tratamiento? Repase el tema con nuestros anfitriones y el invitado de esta semana: Dr. Jorge Mendoza Ramírez. Notas: https://espanol.medscape.com/verarticulo/5910846 Time stamps Introducción... 00:00 Presentación Dr. Jorge Mendoza... 00:40 Recomendaciones de la semana... 02:45 Caso clínico... 4:30 Epidemiología de la neumonía adquirida en la comunidad... 06:25. Neumonía adquirida en la comunidad en tiempos de COVID-19... 07:50 Esteroides en neumonía adquirida en la comunidad... 9:05 Evidencia clínica...12:00 Estudio CAPE COD... 20:23 Cómo usar esteroides en pacientes con neumonía adquirida en la comunidad grave... 23:50 Esteroides e influenza... 28:00

In Yemen, the USAID-funded Systems, Health, and Resiliency Project (SHARP) is using innovative mobile solutions to increase immunization coverage for children. The project recently piloted an SMS reminder system and an Electronic Immunization Registry to share vaccination information between community midwives, health facilities, and parents. The result? A resounding win: uptake of Penta3 (the third dose of a vaccine that protects against diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type b) increased by 38%, and dropout rates dropped significantly in the pilot area. In this podcast episode, Dr. Areej Banaja, SHARP Senior Health Facility Manager, talks to Omar Al-Gundaid, SHARP Communication Manager, about these innovative interventions and getting the message out about the importance of childhood vaccinations. Dr. Areej has eight years of experience in the clinical and public health sectors with international nongovernmental organizations and UN agencies. She has worked in humanitarian and fragile settings, focusing on emergency and outbreak response, supply chain management, and child health. Prior to joining JSI, Dr. Areej was a child health officer at the UNICEF Yemen country office, where she played a key role in the national response to outbreaks of cholera, diphtheria, and COVID-19. SHARP works to reduce maternal and infant mortality in Yemen by focusing on reproductive, maternal, newborn, child health, and nutrition coupled with support services to tackle health challenges such as COVID-19, malnutrition, and other life-threatening conditions. Learn more: https://www.jsi.com/project/systems-health-and-resiliency-project-sharp/

Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Shallow Investigation: Bacterial Meningitis, published by peetyxk on March 28, 2023 on The Effective Altruism Forum. This report consolidates a shallow investigation into Bacterial Meningitis - its effects and importance in global health, the current tractability and cost-effectiveness of leading interventions, and an evaluation of the overall promise of the cause. I estimate this report to be a result of about 60-70 hours of research and writing. This research was conducted as part of the Cause Innovation Bootcamp fellowship, with constant guidance from Dr. Akhil Bansal. Summary: Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord. It is commonly associated with infections (e.g. bacterial meningitis, viral meningitis), but it can also have non-infectious causes. The most common symptoms include fever, headache, sensitivity to light, and neck stiffness; in most cases, meningitis is treatable by addressing the underlying cause e.g. treating the causative infection. Bacterial meningitis is important from a global health perspective - it ranks 40th on the current list of diseases in terms of total DALYs lost. 4 strands of bacteria cause 50% of all meningitis-related deaths, namely meningococcus, pneumococcus, Haemophilus influenzae and group B streptococcus - all of which are vaccine-preventable. GBS (Group B Streptococcus) ranks 6th on the list of causes leading to DALYs lost in the age-group 1-10. Bacterial meningitis is heavily concentrated in the African Meningitis belt, consisting of regions in 26 countries stretching from Senegal in the West to Ethiopia in the East, and incidence is inversely related with socio-demographic index (SDI). Bacterial meningitis does not seem to be neglected Important steps seem to have been taken already to counter meningitis on a global scale; including WHO's comprehensive report on “A Global Plan to Defeat Meningitis by 2030”. While the important interventions seem tractable, they seem to be less neglected than a lot of other interventions in global health, reducing their counterfactual value. Important interventions that could yield (relatively) high cost-effectiveness seem to be Installing an integrated disease surveillance and response (IDSR) system for monitoring meningitis, and Advocating for the acceleration of the GBS vaccine development. Major uncertainties: The interventions are still ‘moderately' promising; for ex. If someone is uniquely positioned to accelerate GBS vaccine trials/distribution, or complete broad educational initiatives about infant healthcare/precautions preventing neonatal transmission, this might on the margins be a promising thing to do. On another note, the counterfactual neglectedness is low primarily due to WHO's commitments in its “Roadmap to defeating meningitis by 2030” - if not followed up/held, the counterfactual value of another route to addressing meningitis could increase significantly. I. Importance Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord. It is commonly associated with infections e.g. bacterial meningitis, viral meningitis, but it can also have non-infectious causes. The most common symptoms include fever, headache, sensitivity to light and neck stiffness; in most cases, meningitis is treatable by addressing the underlying cause e.g. an infection. Meningitis, depending on the specific pathogen (virus, bacteria, fungi etc.) is often communicable and usually transmitted through close contact. Meningitis can also be passed on by mothers to their infants, and in fact, bacterial meningitis in infants is most commonly caused by the Group B Streptococcus pathogen (GBS), passed down in the peripartum period ( thebirthing process). Since meningitis attacks the membranes of the spinal co...

3.14 Haemophilus Influenzae Microbiology review for the USMLE Step 1 exam Haemophilus influenzae is a gram negative coccobacilli that is often encapsulated, encapsulated strains are broken up into subgroups a through f, non-encapsulated strains are referred to as non-typable The most common pathogenic strain is type b, which causes disease in children and immunocompromised individuals, it is the strain that we vaccinate against The group B H. influenzae vaccine is a conjugated polysaccharide vaccine recommended as a routine childhood vaccination in the United States, provides protection against the group B strain of the bug H. influenzae mainly affects the extremes of age, very young children (younger than 5) and elderly adults (>65) In young children, it most commonly causes epiglottitis, otitis media, and meningitis, in elderly adults it is a cause of lower respiratory tract infections, especially in patients with COPD H flu infections in young children can be a medical emergency and requires treatment with antibiotics and intubation in some cases Otitis media is the most common H flu infection in children, caused by non-group B H flu, it is still the number one cause of otitis media in children  

3.04 Gram Negative Bacteria   Microbiology review for the USMLE Step 1 Exam.   Gram negative bacteria are characterized by a thin cell wall surrounded by a lipid outer membrane They do not retain the violet gram stain and appear pink after staining Gram negative bacteria can be classified by shape: cocci, coccobacilli, bacilli, and spirals Gram negative cocci include Neisseria species, which can be further categorized as maltose fermenters or non maltose fermenters Gram negative coccobacilli include: Bordetella pertussis, Haemophilus influenzae, Pasteurella, Francisella tularensis, Brucella, and Acinetobacter Gram negative bacilli can be divided into lactose fermenting and non lactose fermenting categories Lactose fermenting gram negative bacilli include: Escherichia coli, Klebsiella, Enterobacter, Citrobacter, and Serratia Non lactose fermenting gram negative bacilli can be further divided into oxidase positive and oxidase negative Oxidase positive non lactose fermenting gram negative bacilli include Pseudomonas Oxidase negative non lactose fermenting gram negative bacilli include Shigella, Yersinia, and Salmonella Gram negative spirals can be divided into oxidase positive and oxidase negative categories Oxidase positive gram negative spirals include Vibrio species, Helicobacter pylori, and Campylobacter jejuni Oxidase negative gram negative spirals include Borrelia burgdorferi (cause of lyme disease) and Treponema pallidum (cause of syphilis)

Callum and Jame discuss the HACEK organisms (apart from Haemophilus which we discussed in episode 32). Questions, comments, suggestions to idiotspodcasting@gmail.com or Tweet us @IDiots_podPrep notes for completed episodes can be found here: https://1drv.ms/u/s!AsaWoPQ9qJLShugmB2EOm8FMePNBtA?e=IKApb5If you are enjoying the podcast please leave a review on your preferred podcast app!Feel like giving back? Donations of caffeine gratefully received!https://www.buymeacoffee.com/idiotspod

Dr. Thomas Hills, a physician and research fellow based in Auckland, New Zealand, and Sarah Gregory discuss fetal loss and preterm birth caused by Haemophilus influenzae infection.

Join Jame and Callum as they talk you through Haemophilus spp. Turns out that Haemophilus influenzae isn't the cause of Influenza. We answer some questions such as: What are X and V? Suggestions and comments to idiotspodcasting@gmail.com or @IDiots_podIf you are enjoying the podcast please leave a review on your preferred podcast app!Feel like giving back? Donations of caffeine gratefully received! https://www.buymeacoffee.com/idiotspod Useful resources:-SMI on HACEK organisms https://www.gov.uk/government/publications/smi-id-12-identification-of-haemophilus-species-and-the-hacek-group-of-organisms -Dermnet page on Chancroid https://dermnetnz.org/topics/chancroid- EUCAST breakpoints page https://www.eucast.org/clinical_breakpoints 

In November 2020, the Ministry of Health Malaysia introduced the 6-in-1 vaccine for infants under the National Immunisation Programme (NIP). This hexavalent vaccine covers diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, and Hepatitis B. We get an update from Dr Ranjini Ambigapathy, member of the Malaysian Family Medicine Specialists' Association, on how well the vaccine has worked in protecting children, and why it's important not to delay other childhood vaccinations under the NIP.Image credit: Shutterstock

We are continuing through our vaccine conversation series in this episode still covering one of the vaccines our 2 month old children are given.I cover the Haemophilus influenza type  B, better known as the HIB, in full detail from the bacteria, to the dangers to the commonality to the vaccine ingredients and risks.Informed consent friends, informed consent. Subscribe and hang out with me every Wednesday to stay up to date on this show.  If you enjoy, please share this on your social media and tag me (@brookebrewer20) and give me a rating/review. Thank you!For Text updates when each episode releases textPODCAST to (248) 301-9919 Sponsors:Get your Fat Burning Collagen today (linked the chocolate flavored goodness)https://modere.co/3jxbzyBUse code 4842132 to save $10 off your first orderShow notes and references: Current CDC Vaccine Schedulehttps://www.cdc.gov/vaccines/schedules/index.htmlFDA website for package inserts: https://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm093833.htmVaccine Ingredient Summary https://vaccine.guide/vaccine-ingredients/overview/cdc-vaccine-excipient-and-media-summary/Vaccine Glossery and Detailshttps://vaccine.guide/vaccine-ingredients/overview/vaccine-ingredient-glossary-and-details/Harvard Study on VAERS reporting https://vaccine.guide/ncvia-vicp-vaers/vaccine-adverse-events-reporting-system/hhs-funded-vaers-investigation/HIB Vaccine Inserthttps://www.fda.gov/media/80438/downloadCDC HIB Data sheethttps://www.cdc.gov/vaccines/pubs/pinkbook/hib.html#vaccinesThe vaccine conversationhttp://www.thevaccineconversation.com 

Wisia Wedzicha discusses findings of a trial of a vaccine for the prevention of COPD exacerbations and provides her insights for future research.Read the full article:Non-typeable Haemophilus influenzae–Moraxella catarrhalis vaccine for the prevention of exacerbations in chronic obstructive pulmonary disease

Good morning and welcome to your Monday dose of Your Daily Meds.Bonus Review: What humoral factors stimulate parietal cell gastric acid production?Answer: A few important ones include:Histamine (H2 receptors)Acetylcholine (M1 muscarinic receptors)Gastrin (gastrin receptors)- these receptors are on the basolateral membrane.Query:Which of the following is not among the extrapyramidal side effects of antipsychotic use?AkathisiaRigidityTremorBradykinesiaOdynophagiaHave a think.Remember some Latin (or Greek?).And scroll for the chat.Query:In the case of community acquired pneumonia (CAP), which of the following organisms is more likely to affect the elderly patient with pre-existing lung disease?Mycoplasma pneumoniaeHaemophilus influenzaeLegionella pneumophilaBurkholderia pseudomalleiStaphylococcus aureusHave a think.More scroll for more chat.The Pyramids:Extrapyramidal symptoms are common side effects associated with antipsychotic usage. The incidence of these effects is reduced with the use of second generation antipsychotics. The symptoms are due to their effect as Dopamine D2 antagonists or partial agonists which can interfere with the dopamine transmission in the nigrostriatal tract.The symptoms produced by interference in this system are similar to those seen in Parkinson’s disease and include akathisa, rigidity, tremor, bradykinesia and acute dystonic reactions. So, odynophagia, painful swallowing, is not among the extrapyramidal side effects of antipsychotic use. Lung Bugs:Streptococcus pneumoniae is the most common causative agent of community acquired pneumonia (CAP).The likelihood that other organisms are involved or responsible for a clinical picture of pneumonia is based on patient age and clinical context.The age and context of the patient with CAP may suggest a causative agent, unlike radiological findings, which are often unhelpful when distinguishing organisms. Mycoplasma pneumoniae is more common in young people and rare in the elderly; unlike Haemophilus influenzae, which is more common in the elderly, especially when there is an underlying lung disease. Legionella pneumophila occurs in outbreaks and is often linked to contaminated cooling towers in hospitals and hotels. Staphylococcus aureus tends to be more common following a bout of influenza. Furthermore, foreign travel may raise the risk of less likely organisms such as Burkholderia pseudomallei in those travelling from south-east Asia.Bonus: What are some of the actions of gastric acid?Answer in tomorrow’s dose.Closing:Thank you for taking your Meds and we will see you tomorrow for your MANE dose. As always, please contact us with any questions, concerns, tips or suggestions. Have a great day!Luke.Remember, you are free to rip these questions and answers and use them for your own flashcards, study and question banks. Just credit us where credit is due. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit yourdailymeds.substack.com

Dr Maurice Hilleman was a leading American microbiologist who specialised in vaccinology and immunology. He discovered nine vaccines that are routinely recommended for children today, rendering formerly devastating diseases practically forgotten. Considered by many to be the father of modern vaccines, Hilleman was directly involved in the development of most of the vaccines available today, including those for measles, mumps, rubella, hepatitis A, hepatitis B, influenza, Japanese encephalitis, pneumococcus, meningococcus and Haemophilus influenza B. His vaccines are estimated to save nearly 8 million lives a year. Despite Hilleman's many fundamental breakthroughs leading to arguably more lives saved than any other scientist in history, he has never been a household name.Dan is joined by vaccine researcher, Paul A. Offit, who befriended Hilleman and, during the great man's last months, interviewed him extensively about his life and career. Paul and Dan discuss Hilleman's motivations and work ethic, his beginnings in working for the U.S. Military, the impact of ‘pro-disease' activists and the genius behind the foundations for immunology. See acast.com/privacy for privacy and opt-out information.

Dr Maurice Hilleman was a leading American microbiologist who specialised in vaccinology and immunology. He discovered nine vaccines that are routinely recommended for children today, rendering formerly devastating diseases practically forgotten. Considered by many to be the father of modern vaccines, Hilleman was directly involved in the development of most of the vaccines available today, including those for measles, mumps, rubella, hepatitis A, hepatitis B, influenza, Japanese encephalitis, pneumococcus, meningococcus and Haemophilus influenza B. His vaccines are estimated to save nearly 8 million lives a year. Despite Hilleman's many fundamental breakthroughs leading to arguably more lives saved than any other scientist in history, he has never been a household name.Dan is joined by vaccine researcher, Paul A. Offit, who befriended Hilleman and, during the great man's last months, interviewed him extensively about his life and career. Paul and Dan discuss Hilleman's motivations and work ethic, his beginnings in working for the U.S. Military, the impact of ‘pro-disease' activists and the genius behind the foundations for immunology. See acast.com/privacy for privacy and opt-out information.

Epiglottitis is a life threatening inflammation of the epiglottis, classically caused by Haemophilus influenzae (Hib), but other pathogens can cause it too, and should especially be considered if an immunised individual presents with epiglottitis.  The most important thing initially is to avoid distressing the child, as this could worsen airway obstruction. It is an emergency and requires early escalation in order to secure an airway. Listen in to find out more about the presentation, management and other causative pathogens!   Links and resources: Follow us on Instagram @yourekiddingrightdoctors Facebook: https://www.facebook.com/yourekiddingrightpod-107273607638323/ Our email is yourekiddingrightpod@gmail.com Make sure you hit SUBSCRIBE/FOLLOW so you don't miss out on any pearls of wisdom and RATE if you can to help other people find us! (This isn't individual medical advice, please use your own clinical judgement and local guidelines when caring for your patients)

“VAXELIS may be used to complete the hepatitis B vaccination series following 1 or 2 doses of other hepatitis B vaccines, in infants and children born of HBsAg-negative mothers and who are also scheduled to receive the other antigens in VAXELIS. However, data are not available on the safety and effectiveness of VAXELIS in such infants and children. Administration of VAXELIS following previous doses of Inactivated Polio Vaccine (IPV) VAXELIS may be administered to infants and children who have received 1 or 2 doses of IPV and are also scheduled to receive the other antigens in VAXELIS. However, data are not available on the safety and effectiveness of VAXELIS in such infants and children. Administration of VAXELIS following previous doses of Haemophilus b Conjugate Vaccines VAXELIS may be administered to infants and children who have received 1 or 2 doses of H. influenzae type b Conjugate Vaccine and are also scheduled to receive the other antigens in VAXELIS. However, “Each 0.5 mL dose contains 319 mcg (0.319 mg ) aluminum from aluminum salts used as adjuvants.Active ingredients: inactivated bacteria of diphtheria, tetanus, pertussis, Hib, and inactivated hepatitis B and polio viruses. The bacteria and viruses in VAXELIS are not alive and do not cause disease. • Other ingredients: aluminum salts, polysorbate 80, glutaraldehyde, formaldehyde, bovine serum albumin, neomycin, streptomycin, polymyxin B, ammonium thiocyanate, yeast protein, and waterwww.vaccinesafety.edu 

Microbiologia médica de Murray --- Send in a voice message: https://anchor.fm/las-poderosas-celulas-nk/message

Welcome back to USMLE Listen This is MICROBIOLOGY Chapter 6: Enterobacteriaceae! Whether you're on a run or driving, this is The PERFECT podcast to initiate your auditory learning for the USMLE Step 1! In this episode, it's all about USMLE-important Gram Enterobacteriacaea Important exam related information on gram-negative bacteria in the ENTEROBACTERIACEAE FAMILY which include E.coli, Klebsiella, Shigella, Yersinia, Proteus, Salmonella, Haemophilus, Gardnerella, Pasteurella, and Bacteroides. We will also go over bacterial infections caused by ANIMAL AND HUMAN BITES as well as the different bacteria that cause ENDOCARDITIS! Review EACH USMLE critical Enterobacteriaceae: Features Transmission & Predisposing Factors Pathogenesis Diseases Associated Treatment Important to Know Info! As always, you can email us at USMLElisten@gmail.com for your questions, anything you need to be cleared, or suggestions on how we can improve and initiate your auditory learning for the USMLE Step 1. Sources for USMLE LISTEN include First Aid, Osmosis, Uworld, and Kaplan study guides. This is Mark Labella, you can follow or message me on Instagram at markjlabella. See you in the next episode for your auditory learning at USMLE LISTEN!

This episode covers haemophilus influenzae!

Starting this month, children in Malaysia will receive a 6-in-1 vaccine, which covers diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, and Hepatitis B. This will replace the previous 5-in-1 vaccine. We get an update on why this change was made, and address some health concerns that parents have about the new vaccine. If you have any queries about the change in the immunisation schedule, you can call the Ministry of Health at 03-8883 4042/ 03-8883 4504. You can also visit the nearest public health clinic (Klinik Kesihatan) to find out more. Image Source: Shutterstock

In today's episode we discuss: —Understanding the Pathology: Do childhood vaccines help protect against SARS-CoV-2? A team of Egyptian virologists inoculated mice with common childhood vaccines (BCG, Pneumococcal, Rotavirus, Diphtheria, Tetanus, Pertussis, Hepatitis B, Haemophilus influenzae, Meningococcal, Measles, Mumps, and Rubella) and found no evidence of cross-reacting antibodies against SARS-CoV-2 in serum up to seven weeks post-vaccination, suggesting that if childhood vaccines provide protection against SARS-CoV-2, it may not be antibody mediated. —Transmission & Prevention: How often are discharged patients re-testing positive for SARS-CoV-2? A review of 62 studies evaluating recurrence of SARS-CoV-2 viral RNA in discharged COVID-19 patients found that the proportion of patients with re-positive RT-PCR ranged from 2.4% to 69.2% across studies, occurring from 1-38 days after discharge, which was attributed to false-negative tests prior to discharge, false positive tests following discharge, reinfection, reactivation, and intermittent viral shedding. —Adjusting Practice During COVID-19: What treatment options should physicians consider for patients with psoriasis? Following a literature review, dermatologists from Tehran, Iran recommend not starting immunosuppressive drugs for psoriatic patients due to an increased risk of acquiring COVID-19 and instead encourage initiating and continuing low-risk immunomodulating drugs as a safer modality. —R&D: Diagnosis & Treatments: Is there a correlation between vitamin D levels and COVID-19 severity? A retrospective study conducted by various medical institutions in Tehran, Iran investigated 73 subjects with confirmed COVID-19 and found mean serum vitamin D (25[OH]D) concentrations were significantly lower in the deceased compared to discharged patients, and higher 25(OH)D levels were associated with less extensive lung involvement, suggesting a potential correlation between vitamin D status and clinical course, extent of lung involvement, and patient outcome in COVID-19. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/covid19lst/support

This free iTunes segment is just one tiny snippet of the fully-loaded 3-hour monthly Peds RAP show. Earn CME on your commute while getting the latest practice-changing peds information: journal article breakdowns, evidence-based topic reviews, critical guideline updates, conversations with experts, and so much more. Sign up for the full show at hippoed.com/PEDSRAPPOD. Pediatric ID specialist Michael Neely, MD, and Michael Cosimini, MD discuss how cephalosporins work and which bugs they do and do not kill. Pearls: In general, cephalosporins do not cover anaerobes, enterococcus, listeria and MRSA. Oral cephalosporins are generally not first line in pediatrics.  Some exceptions include the treatment of UTIs and some skin and soft tissue infections; group A strep and sinopulmonary infections in penicillin allergic patients are other common indications. 1st generation cephalosporins do have gram positive coverage, but do not work well against strep pneumo, MRSA, enterococcus. They do cover some enteric gram negative bacteria, the “PECK” organisms.   What are cephalosporin antibiotics and how do they compare to penicillins?  Chemically, both penicillins and cephalosporins are beta-lactam antibiotics, with the beta-lactam portion responsible for bacterial killing.  The chemical portions off the beta-lactam ring make the antibiotics different. Beta-lactam antibiotics work by binding to the penicillin-binding protein on the bacterial cell wall.  These proteins have structural functions that maintain the integrity of the bacterial cell wall and therefore, when these antibiotics bind, the penicillin-binding protein is disrupted, the cell wall falls apart and the bacterial dies.       How do you keep a straight spectrum of activity for antibiotics?  To help with this, think of bacteria into big categories: gram-positive, gram-negative and “other”. Gram-positive bacteria include: Staph aureus (MSSA, MRSA), Streptococcus (Group A Strep, Group B Strep, Strep pyogenes, Strep viridans), Enterococcus, Pneumococcus, Listeria Gram-negative bacteria are a much bigger group and can be divided into: Respiratory gram-negatives include Moraxella, Haemophilus, Meningococcus Enteric gram-negatives include the “PECK” bacteria: Proteus, E.coli, Klebsiella What bacteria do cephalosporins not cover?  In general, cephalosporins do not cover anaerobic bacteria, enterococcus, listeria and MRSA.  There are a few exceptions to this rule. Cefoxitin (a second generation cephalosporin), for example, does have anaerobic coverage.  It is commonly used in the treatment of PID as it covers enteric anaerobes and Neisseria gonorrhea. There is a 5th generation cephalosporin that does cover MRSA (discussed later). Are cephalosporins well absorbed?  Generally speaking, cephalosporins in oral formulations are not as well absorbed as penicillins and are more difficult to get where they need to go outside the urinary tract. Also, generally speaking, no beta-lactam really gets into the spinal fluid in very high concentrations; all of them do have better penetration when there is inflammation.  Practically, remember that the penetration into the CSF between ampicillin and ceftriaxone is negligible. What bacteria do first generation cephalosporins cover?  Although the classic teaching is that cephalosporins are good for gram-positive coverage (staph and strep), this is not a hard and fast rule.  As stated, enterococcus is not covered by any cephalosporin and MRSA is not covered by most cephalosporins.  First generation cephalosporins are also good for coverage of the “PECK” enteric gram negative bacteria, but not good for coverage of other gram negative bacteria.  These organisms tend to cause UTIs and therefore, first generation cephalosporins (for example, cephalexin) are frequently used for UTI treatment. Of course, resistance can occur.    Even though strep pneumo is a gram-positive organism, when it comes to first generation cephalosporins, it acts like a gram-negative organism and therefore, first generation cephalosporins do not work well against strep pneumo.   What about bacteria that develop resistance?  A patient with an E. Coli UTI, for example, may have a microbiology laboratory report stating that the E. Coli is resistant to a first generation cephalosporin but the patient is still getting better.  This may have to do with the type of infection the patient had; for example, a healthy patient with a simple cystitis may have been able to stay well hydrated and the normal immune system was able to clear the E. Coli. This question can also be answered in the context of breakpoints, that is when the bacteria become susceptible or resistant to the antibiotic depending on the site of infection.  Some labs will actually label a bacteria resistant or susceptible depending on whether the infection is in the urine, spinal fluid or blood. Therefore, if a lab that reports site-specific breakpoints suggests that an E. Coli is resistant to a first generation cephalosporin in the urine, the lab has already taken into account the higher concentration of drug in the urine.  Similarly, a pneumococcal isolate that may be resistant to ceftriaxone in the CNS may be susceptible to ceftriaxone as a pneumonia because there are much higher concentrations of ceftriaxone in the lungs than in the spinal fluid. When should a skin or soft tissue infection be treated with a first-generation cephalosporin?  When should MRSA be suspected? This can be a tricky question as an outpatient, but there are some clues to gauge whether or not the infection may be caused by MRSA.   One, it is helpful to know the community prevalence of MRSA.  In some communities, community acquired staph aureus infections are up to 80-90% MRSA.  In these communities, MRSA coverage should of course be given. If the prevalence is much lower, using a first generation cephalosporin, such as cephalexin may be reasonable.   Other clues can be more specific to the patient the their families.  Is the patient or family known to be colonized with MRSA? Have they had an MRSA infection in the past? If MRSA coverage is needed, either trimethoprim-sulfa or clindamycin generally is a good approach.  A randomized controlled trial published in the NEJM showed no difference in outcomes when treating a known MRSA infection. Miller LG et al.  Clindamycin versus trimethoprim-sulfamethoxazole for uncomplicated skin infections.  N Engl J Med. 2015 Mar 19;372(12): 1093-103. https://www.ncbi.nlm.nih.gov/pubmed/25785967 In general, the quality of the infection does not help point to MRSA or not.  There is some suggestion that if there is a soft-tissue abscess this is more likely staph aureus and if there is just pure erythema, tenderness and warmth without abscess, this is more likely to be Group A strep.   Remember, no matter what antibiotic is started for cellulitis (or any infection, for that matter), follow up is essential.  If you are on the right antibiotics, cellulitis should be improving within 24 hours.

Acute otitis media is a bacterial infection of the temporal bone's mucosally lined air storage spaces typically caused by Streptococcus pneumoniae, Haemophilus influenzae, or Streptococcus pyogenes. The disease is often accompanied by mastoid tenderness caused by the presence of pus in the mastoid air cells. Here, material forms within the middle ear cleft and the pneumatized mastoid air cells and petrous apex. This disease is usually precipitated by a viral upper respiratory tract infection that obstructs the eustachian tube and results in the accumulation of infected fluid and mucous. Key symptoms include fever, decreased hearing, aural pressure, and otalgia accompanied by a physical finding of erythema and decreased tympanic membrane mobility. With appropriate counseling, spontaneous healing of the tympanic membrane occurs in most cases. If, however, the perforation continues for a prolonged period of time, the patient may develop chronic otitis media. Swelling over the mastoid bone or the association of cranial neuropathies or central findings indicates severe illness requiring urgent care. Acute otitis media can often be treated successfully with a combination of antibiotics and nasal decongestants. The antibiotics of choice are frequently amoxicillin (80-90 mg/kg/day divided twice daily), erythromycin with sulfonamide (50 mg/kg/day and 150 mg/kg/day respectively), cefaclor (20-40 mg/kg/day), and amoxicillin-clavulanate (20-40 mg/kg/day). The practitioner should only resort to surgical drainage of the middle ear when the patient suffers from severe otalgia or otitis complications. Reoccurring acute otitis media can be managed with long-term antibiotic prophylaxis (typically single daily doses of sulfamethoxazole (500 mg) or amoxicillin (250 or 500 mg) over 1 to 3 months). On the other hand, if the otitis media is recurring but the patient is immunocompromised, tympanocentesis can be resorted to. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.09.10.281741v1?rss=1 Authors: Yakovlieva, L., Ramirez-Palacios, C., Marrink, S.-J., Walvoort, M. Abstract: Processivity is an important feature of enzyme families such as DNA polymerases, polysaccharide synthases and protein kinases, to ensure high fidelity in biopolymer synthesis and modification. Here we reveal processive character in the family of cytoplasmic protein N-glycosyltransferases (NGTs). Through various activity assays, intact protein mass spectrometry and proteomics analysis, we established that NGTs from non-typeable Haemophilus influenzae and Actinobacillus pleuropneumoniae modify an adhesin protein fragment in a semi-processive manner. Molecular modeling studies suggest that the processivity arises from the shallow substrate binding groove in NGT, that promotes the sliding of the adhesin over the surface to allow further glycosylations without temporary dissociation. We hypothesize that the processive character of these bacterial protein glycosyltransferases is the mechanism to ensure multisite glycosylation of adhesins in vivo, thereby creating the densely glycosylated proteins necessary for bacterial self-aggregation and adherence to human cells, as a first step towards infection. Copy rights belong to original authors. Visit the link for more info

Chancroid is a sexually transmitted disease caused by the short gram negative bacillus Haemophilus ducreyi. The incubation period ranges from three to five days. At the location of inoculation, a vesicopustule develops that breaks down to form a painful, soft ulcer with a necrotic base, surrounding erythema, and undermined edges. There may be multiple lesions due to autoinoculation. The adenitis is usually unilateral and is composed of tender, matted nodules of moderate size with overlying erythema. The patient may also present with lymph node involvement, chills, malaise, and fever. While women typically have no external signs of infection, balanitis and phimosis are frequent complications in men. The diagnosis is established by culturing a swab of the lesion onto a special medium. To treat the disease, a single dose of azithromycin (1g orally) or ceftriaxone (250 mg intramuscularly) is effective as is erythromycin (500 mg orally four times a day for seven days) or ciprofloxacin (500 mg orally twice a day for three days). --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

In August of 1918, a horrific second wave of the Spanish Flu crashed across the world. In this episode, the third of a four-part series exploring hydroxychloroquine and COVID-19, I’ll explore this single moment in time, through the mysterious origins of the Spanish Flu and historiographical controversies, scientific missions to mass burial sites in remote Alaskan villages, the ill-fated journey of the HMS Mantua, debates about how to count victims of a pandemic, and the mystery behind Pfeiffer’s bacillus. Plus a new #AdamAnswers about that annoying yellow on blue powerpoint template so common in the medical field!   Sources: Viboud, C. et al. Age- and Sex-Specific Mortality Associated With the 1918–1919 Influenza Pandemic in Kentucky. J Infect Dis 207, 721–729 (2013). Oxford, J. S. & Gill, D. A possible European origin of the Spanish influenza and the first attempts to reduce mortality to combat superinfecting bacteria: an opinion from a virologist and a military historian. Hum Vacc Immunother 15, 2009–2012 (2019). Epps, H. L. V. Influenza: exposing the true killer. J Exp Medicine 203, 803–803 (2006). Patterson, S. W. & Williams, F. E. PFEIFFER’S BACILLUS AND INFLUENZA. Lancet 200, 806–807 (1922). Taubenberger, J. K. & Morens, D. M. The 1918 Influenza Pandemic and Its Legacy. Csh Perspect Med a038695 (2019) doi:10.1101/cshperspect.a038695. Trilla, A., Trilla, G. & Daer, C. The 1918 “Spanish Flu” in Spain. Clin Infect Dis 47, 668–673 (2008). Taubenberger, J. K. The origin and virulence of the 1918 “Spanish” influenza virus. P Am Philos Soc 150, 86–112 (2006). Heinz, E. The return of Pfeiffer’s bacillus: Rising incidence of ampicillin resistance in Haemophilus influenzae. Microb Genom 4, (2018). Barry, J. M. The site of origin of the 1918 influenza pandemic and its public health implications. J Transl Med 2, 3 (2004). Johnson, N. P. A. S. & Mueller, J. Updating the Accounts: Global Mortality of the 1918-1920 “Spanish” Influenza Pandemic. B Hist Med 76, 105–115 (2002).   Tomkins SM, Colonial Administration in British Africa during the Influenza Epidemic of 1918-19. Canadian Journal of African Studies / Revue Canadienne des Études Africaines. Vol. 28, No. 1 (1994), pp. 60-83 (24 pages) Qiang Liu et al, The cytokine storm of severe influenza and development of immunomodulatory therapy. Cell Mol Immunol. 2016 Jan; 13(1): 3–10. Spreeuwenberg et al. Reassessing the Global Mortality Burden of the 1918 Influenza Pandemic.Am J Epidemiol . 2018 Dec 1;187(12):2561-2567. doi: 10.1093/aje/kwy191. R. F. J. Pfeiffer: Vorläufige Mittheilungen über den Erreger der Influenza. Deutsche medicinische Wochenschrift, Berlin, 1892, 18: 28. Die Aetiologie der Influenza. Zeitschrift für Hygiene und Infektionskrankheiten, 1893, 13: 357-386.

Bacterial pathogens like Streptococcus suis and Haemophilus parasuis continue to cause major issues for growing and adult pigs. Dr. Brad Leuwerke offers some good solutions. The post ‘Controlled colonization' builds immune response to bacterial pathogens appeared first on Pig Health Today.

Bacterial pathogens like Streptococcus suis and Haemophilus parasuis continue to cause major issues for growing and adult pigs. Dr. Brad Leuwerke offers some good solutions. The post ‘Controlled colonization’ builds immune response to bacterial pathogens appeared first on Pig Health Today.

Episode 45 This time on Conspiracy Theoryology, we wrap up on discussion of the Spanish Flu, exploring the medical knowledge of the time, what we now know to be true, and some other influences and conditions that may have attributed to the most lethal viral outbreak of the 20th century, and, in light of our recent events, how it really compares to the first truly global pandemic panic of the 21st century. The Spanish flu pandemic was certainly deadly but it did not kill 50 million people. Not without the help of its friends. You know, famine, malnutrition, and world war 1. Horrible roommates, all of them.  Up until this year, the effort to hyperbolize severity of the Spanish flu has been extremely popular, because fear is a great motivator. And that motivation ya been very profitable for the pharmaceutical industry for 40 year. The bogeyman of annual flu has led the charge into a vaccination mindset that makes a lot of money for the industry and gives a great deal of power to those that wield political influence.  Unfortunately, that same exaggeration is now yielding its fruits, and has caused the public to react in an irrational manner to the Covid19 pandemic. And when I say public, I mean everyone. Both sides of the opinion spectrum.  So, you have probably noticed that there was a large gap between part 3 of this series and this episode. In truth, I didn’t know how to frame this discussion, in light of current events. Up until March of 2020, research on the Spanish flu was academic and historical. There was very little reference to any modern context other than the oft repeated phrase “It’s not of, but when.”  A very convenient phrase to use to maintain fear and worry, without having to actually provide any real information proving the statement.  Now, though, I challenge you to go to your search engine of choice and find information on Spanish flu. The first page of results will undoubtedly be filled with recent articles comparing the Spanish flu to COVID 19. The two events have become entwined. I cannot present historical factors of Spanish flu, without now providing context for viewing the current pandemic. Likewise, we can better understand the true behavior of the Spanish flu pandemic given a current framework with which to compare.  To not do either of those things would be as irresponsible as those that have made the point to draw extreme views through comparison of the two events. That said, let’s first understand the death toll of the Spanish flu. After we explore the many factors that influenced the mortality rate, we can wrap up this discussion talking COVID.    Several Factors influenced and bolstered the severity of the pandemic. First being the approach to calculate the mortality impact. The number has grown steadily since early estimates in the 1990s. 20MM to 50MM in 2005, to upwards of 100MM (5% of the global population). But a reassessment in 2018 put a more realistic number at 15-17MM.   Conspiracy Theoryology Store - https://www.zazzle.com/store/theoryologypod www.conspiracytheoryology.com email - contact@conspiracytheoryology.com Twitter - @TheoryologyPod | Facebook - @TheoryologyPodcast | Patreon - www.patreon.com/conspiracytheoryology Music is by adamhenrygarcia.bandcamp.com Links:   https://academic.oup.com/aje/article/187/12/2561/5092383 https://en.wikipedia.org/wiki/Haemophilus_influenzae https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109405/ https://slate.com/technology/2012/12/spanish-flu-mystery-why-dont-scientists-understand-the-1918-flu-even-after-digging-up-its-victims.html https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2376985/ https://i2.wp.com/www.compoundchem.com/wp-content/uploads/2014/05/Chemical-Warfare-World-War-1-Poison-Gases1.png?ssl=1 https://www.sciencedaily.com/releases/2009/10/091002132346.htm https://www.nytimes.com/2009/10/13/health/13aspirin.html https://academic.oup.com/cid/article/49/9/1405/301441 https://academic.oup.com/jid/article/196/11/1717/886065 https://www.smithsonianmag.com/history/ten-myths-about-1918-flu-pandemic-180967810/ 

In this episode Dr. Grady Donohoe and Dr. Garrett Panno discuss several strategies to support the various systems in your body that play a role in how your body fights off disease. Also, Garrett has some big news to share with us!! Episode Contents: 2:05 - Wholistic Mindset To Fighting Off Disease 3:45 - Barrier Systems (Skin, GI Tract, Lungs) 7:50 - The Gut and Probiotics 17:00 - High Carbs, Insulin Resistance and Immune System 20:45 - Stress Responses and the HPA Axis 24:05 - Sleep Strategies 27:30 - Posture and the Lymphatic System 30:03 - Circulation, Detoxification, and Elimination Considerations 39:04 - Vitamin D - Immune Modulator 42:23 - Vitamin A and C 47:50 - Garrett's Big Announcement! PLEASE SUBSCRIBE TO THE PODCAST For more Diabuddies content follow us on The Diabuddies Podcast Facebook page. Twitter: @TheDiabuddies Instagram: @thediabuddiespodcast You can email us at TheDiabuddiesPodcast@gmail.com   Resources/Links Discussed in the episode:   Immunomodulatory and anti-inflammatory effects of probiotics in multiple sclerosis: a systematic review (2019): https://www.ncbi.nlm.nih.gov/pubmed/31752913         Influence of Resveratrol on the Immune Response (2019): https://www.ncbi.nlm.nih.gov/pubmed/31035454         Modulation of immunity and inflammatory gene expression in the gut in Inflammatory diseases of the gut and in the liver by probiotics. https://www.ncbi.nlm.nih.gov/pubmed/25400447         Resveratrol therapeutic combines both antimicrobial and immunomodulatory properties against respiratory infection by nontypeable Haemophilus influenzae (2017): https://www.ncbi.nlm.nih.gov/pubmed/29038519         Resveratrol reduces liver endoplasmic stress and improves insulin sensitivity in vivo and in vitro (2019): https://www-ncbi-nlm-nih-gov.uws.idm.oclc.org/pmc/articles/PMC6505469/         Role of immune cells in obesity induced low grade inflammation and insulin resistance (2017): https://www.ncbi.nlm.nih.gov/pubmed/28285710         Vitamin D as an Immunomodulator: Risks with Deficiencies and Benefits of Supplementation (2015): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939543/         Vitamin D Nutrient, Hormone and Immunomodulator (2018): https://www.ncbi.nlm.nih.gov/pubmed/30400332

Today we will talk about two organisms that share a genus...and not much else; Haemophilus influenzae and Haemophilus ducreyi. --- Send in a voice message: https://anchor.fm/bradleysmicroboardreview/message Support this podcast: https://anchor.fm/bradleysmicroboardreview/support

Editor's Summary by JAMA Fishbein Fellow Angel Desai, MD, for the December 24/31, 2019, issue

Neste episódio, Prof. Rafael Frandoloso nos falará sobre o agente, explicando de maneira clara a importância da sorotipificação e das principais ferramentas para alcançar um diagnóstico correto dessa enfermidade no campo. Um podcast super completo e que você não pode perder! É médico veterinário formado na Universidade de Passo Fundo (UPF) e possui doutorado em Imunologia e Microbiologia Veterinária pela Universidade de León (ULE) - Espanha e pós-doutorado em Imunologia e Biologia Estrutural de Antígenos pela Universidade de Calgary - Canadá. É docente dos cursos de graduação em Medicina Veterinária e Medicina e, de Pós-Graduação em Bioexperimentação (Mestrado e Doutorado) da UPF. Ainda, é professor internacional honorífico da Faculdade de Veterinária da ULE e Acadêmico Correspondente Internacional da Academia de Ciências Veterinárias de Castilla y León, Espanha. Na pesquisa atua no desenvolvimento de vacinas e de métodos de diagnósticos contra patógenos de interesse veterinário e humano. Na linha veterinária, suas pesquisas abordam o sistema imunológico suíno e sua relação com diversos patógenos, em especial, com o Glaesserella (Haemophilus) parasuis. Na linha humana, estuda o vírus da hepatite E e sua implicação com casos de hepatites.

Three bacterial diseases considered under control recently flared up creating new challenges in hog operations. The older diseases include Haemophilus parasuis (parasuis), Streptococcus suis (strep) and erysipelas. The post Resurgence of ‘old' bacterial diseases in pigs: Why? appeared first on Pig Health Today.

Three bacterial diseases considered under control recently flared up creating new challenges in hog operations. The older diseases include Haemophilus parasuis (parasuis), Streptococcus suis (strep) and erysipelas. The post Resurgence of ‘old’ bacterial diseases in pigs: Why? appeared first on Pig Health Today.

A look at this common and controversial topic. Hosts: Brian Gilberti, MD Audrey Bree Tse, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Acute_Otitis_Media.mp3 Download Leave a Comment Tags: Pediatrics Show Notes Background: The most common infection seen in pediatrics and the most common reason these kids receive antibiotics The release of the PCV (pneumococcal conjugate vaccine), or Prevnar vaccine, has made a big difference since its release in 2000 (Marom 2014) This, along with more stringent criteria for what we are calling AOM, has led to a significant decrease in the number of cases seen since then 29% reduction in AOM caused by all pneumococcal serotypes among children who received PCV7 before 24 months of age The peak incidence is between 6 and 18 months of age Risk factors: winter season, genetic predisposition, day care, low socioeconomic status, males, reduced duration of or no breast feeding, and exposure to tobacco smoke. The predominant organisms: Streptococcus pneumoniae, non-typable Haemophilus influenzae (NTHi), and Moraxella catarrhalis. Prevalence rates of infections due to Streptococcus pneumoniae are declining due to widespread use of the Prevnar vaccine while the proportion of Moraxella and NTHi infection increases with NTHi now the most common causative bacterium Strep pneumo is associated with more severe illness, like worse fevers, otalgia and also increased incidence of complications like mastoiditis. Diagnosis The diagnosis of acute otitis media is a clinical one without a gold standard in the ED (tympanocentesis) Ear pain (+LR 3.0-7.3), or in the preverbal child,

A look at this common and controversial topic. Hosts: Brian Gilberti, MD Audrey Bree Tse, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Acute_Otitis_Media.mp3 Download Leave a Comment Tags: Pediatrics Show Notes Background: The most common infection seen in pediatrics and the most common reason these kids receive antibiotics The release of the PCV (pneumococcal conjugate vaccine), or Prevnar vaccine, has made a big difference since its release in 2000 (Marom 2014) This, along with more stringent criteria for what we are calling AOM, has led to a significant decrease in the number of cases seen since then 29% reduction in AOM caused by all pneumococcal serotypes among children who received PCV7 before 24 months of age The peak incidence is between 6 and 18 months of age Risk factors: winter season, genetic predisposition, day care, low socioeconomic status, males, reduced duration of or no breast feeding, and exposure to tobacco smoke. The predominant organisms: Streptococcus pneumoniae, non-typable Haemophilus influenzae (NTHi), and Moraxella catarrhalis. Prevalence rates of infections due to Streptococcus pneumoniae are declining due to widespread use of the Prevnar vaccine while the proportion of Moraxella and NTHi infection increases with NTHi now the most common causative bacterium Strep pneumo is associated with more severe illness, like worse fevers, otalgia and also increased incidence of complications like mastoiditis. Diagnosis The diagnosis of acute otitis media is a clinical one without a gold standard in the ED (tympanocentesis) Ear pain (+LR 3.0-7.3), or in the preverbal child,

Ken Haller is 64, but he vividly remembers having measles when he was 7. And mumps when he was 10. And chickenpox when he was 11, which required him to keep socks on his hands so he wouldn't gouge his skin from scratching. He still has a faint scar on his nose from one pustule he scratched too intensely. Haller is also a pediatrician who has treated babies who developed meningitis from Haemophilus influenzae (now vaccine-preventable) and became blind—or died.

We all know the names, penicillin, Z-pack, Amoxicillin, and Bactrim and we have been taking them for as long as we have been breathing, but do we really know what antibiotics are, how they work, and what they do to our bodies? Antibiotics, in a nutshell, kill bacteria, the bad ones and the good ones and if you have a viral infection no amount of antibiotic treatment will be any help and ultimately can be detrimental to your overall health. In this episode, Dr. Swain teaches Stacy all about antibiotics, how he prescribes the right one for a diagnosis, and why prescribing a patient an antibiotic (or not) is one of the hardest things he has to do every day. Plus, Dr. Swain explains common, and severe antibiotic side effects, allergies, resistance, and why there is not a one size fits all approach to prescribing these life-saving drugs. Big Questions? What is an antibiotic, and how do they work? How many types of antibiotics are available? What is an antibiotic allergy and what are typical reactions? What are the common and severe side effects for antibiotics Why it’s beneficial not to take an antibiotic on an empty stomach? How does a doctor know which specific antibiotic to prescribe What are the three most common type of bacteria? Are doctors prescribing too many antibiotics and why is this dangerous? What is antibiotic resistance?   Need an Appointment or Sinus Consultation? Call Dr. Swain’s nursing staff at 251-470-8823 or schedule an appointment here. Quotables & Tweetables? I would name the show to antibiotic or not to antibiotic because that is the question that doctor's face all day long. - Dr. Swain If I'm going to err, I'm going to err on giving this person an antibiotic because I don't want my patients to get sicker. - Dr. Swain Viral illnesses will not respond to antibiotic treatment. - Dr. Swain An antibiotic is a chemical that we use to kill bacteria. We use some antibiotics, they have different properties, obviously for killing different types of bacteria for different kinds of infections and some antibiotics actually have anti-inflammatory properties. - Dr. Swain Sometimes we use antibiotics because they have a specific biochemical pathway that we use to decrease inflammation. - Dr. Swain The easiest way to think about antibiotics is in terms of different categories. There are penicillin-based antibiotics. Then there are cephalosporin antibiotics, there are lots of those. And then there are fluoroquinolone antibiotics, and there are lots of those. And so we have antibiotics that are classified into what they do, and then in terms of those families. - Dr. Swain The Food and Drug Administration is really vigilant about making sure that there's not an antibiotic that has side effects that need to be monitored or observed and they just need to make sure the drug is safe. - Dr. Swain Sometimes people can get severe reactions where they even have their skin started peeling off or have trouble breathing or have the swelling of their throat or their mouth or their tongue. And so those are obviously the more severe reactions, but it can vary. - Dr. Swain One of the common side effects of just taking antibiotics is to have your stomach upset sometimes, or you get a little bit of nauseated. That's just a side effect of taking the medication. - Dr. Swain We tell people don't take an antibiotic on an empty stomach. You always want to take it with food to kind of buffer the GI side effects with it. - Dr. Swain Basically, this chemical that you're taking goes and attacks the bacteria, and it does so in different ways. It can kill the bacteria. There are bacteriocidal antibiotics, where it kills the bacteria, and there are bacteriostatic antibiotics that kind of prevent the bacteria from growing. Depending on the situation, you would use a different kind of drug. - Dr. Swain The three most common types of bacteria for those is usually strep pneumonia, Moraxella catarrhalis, and Haemophilus influenza. - Dr. Swain Sometimes when people are really sick, you're not going to wait four or five days until you get a lab report back before you initiate antibiotic treatment. - Dr. Swain If you have a viral illness like mononucleosis, you can use all the antibiotics and the world, it's not going to affect the mononucleosis. It's a viral illness, The hard part about all this is usually when you have a sinus infection, it doesn't start with bacteria just jumping in your sinus. It starts with a cold, it starts with a viral illness, and then you get swelling and mucosal thickening and stasis of the secretions, and the little sinus cavity in there closes off, and then you start getting the yellow discharge, and the pain in your teeth and you know, the purulent drainage and that's when you know you've got a sinus infection and that's when you need an antibiotic. - Dr. Swain It's hard sometimes to look at somebody and go, okay. I know you feel terrible, but this is a cold. This is a viral illness. Take some Motrin and Tylenol and oh, by the way in a week, your either going to get over this or you're not, and then we're going to start antibiotics then. - Dr. Swain A patient doesn’t want to get worse, and they think they want an antibiotic now. That's reasonable thinking, but sometimes that is not necessarily the best thing to do in terms of trying to use antibiotics appropriately and ultimately keep that person safe. You don't want to be on so many antibiotics that they don't work when you need them. - Dr. Swain Generally, you do not want to start any antibiotics if you don't need them. - Dr. Swain Communicating your medical and illness history is one of the most effective ways of getting the right diagnosis and proper treatments. - Dr. Swain There are some situations where you would start an antibiotic early, but for the majority of people, if you've got a run of the mill upper respiratory tract infection we try to get those people to use the over the counter medicines initially for the first 24, 48, 72 hours and see what's going on with them. - Dr. Swain Every patient situation is different, and there's nothing like examining someone and getting their history. There's is not a one size fits all approach for antibiotic treatment. - Dr. Swain When suffering from a cold and you start to feel the pain in your teeth, and they're starting to feel swollen, that's when they need to give your doctor a call and get an appointment. - Dr. Swain   Need an Appointment or Sinus Consultation? Call Dr. Swain’s nursing staff at 251-470-8823 or schedule an appointment here. Subscribe to The Swain Sinus Show Never miss a new episode of our show. Please subscribe to our show on iTunes, Overcast, Stitcher, and any other place you find your favorite podcasts.

Dave Rasko uses comparative bacterial genomics to find DNA sequences that influence virulence or antibiotic resistance. Dave talks about his studies of E. coli, Acinetobacter baumanii, and B. anthracis, and the state of bacterial genomics past, present, and future. Host: Julie Wolf Subscribe (free) on iPhone, Android, RSS, or by email. You can also listen on your mobile device with the ASM Podcast app. Julie's biggest takeaways: Genome sequencing speed has significantly increased: The first bacterial genome sequenced, Haemophilus influenzae, took about 10 years to complete. The first organism with two sequenced genomes was Helicobacter pylori, published in 1999, and the first organism with three published genomes was Escherichia coli. Rasko’s initial project at TIGR to sequence 11 E. coli genomes took about 2 years. Today, Rasko’s lab can sequence 500 genomes in about five days.   In E. coli, up to half of the genome can differ between two strains. The core genome is the collection of genes that will be shared among all isolates of a particular species. Core gene conservation varies among species and is important to consider in analyses for one’s species of interest.   Working on the Amerithrax investigation was unlike many other scientific inquiries for many reasons, including that the Federal Bureau of Investigation only gave the scientists involved the information pieces necessary to conduct their studies. Rasko and collaborators sequenced the genomes of spores within the samples, and found that the morphology of the colonies that grew were associated with genetic differences between the spores within the sample, linking phenotype and genotype.   While comparative genomics can provide a lot of information, there are some phenomena that will always require further study. For example, Rasko is researching isolates of A. baumanii and Klebiella pneumoniae that quickly develop drug resistance when grown in sub-inhibitory drug concentrations. The genomic sequences of resistant or susceptible strains show no difference in DNA sequence, suggesting the phenotype is due to transcriptional changes. Featured Quotes (in order of appearance) “Genomics is fun in that we can hypothesize all day long, every day. It’s really the start of a lot of very very hard work figuring out why.” “There’s a lot of DNA pieces that we don’t fully understand how they moved, where they moved, where they came from. In some cases, there’s evidence to say where they came from; in terms of G-C content and coding biases, we can make some assumptions, but in the grand scheme of things, we have no idea where they’re coming from! In some cases, we’ll see them dominant throughout a lineage, and in some cases we’ll see them in sporadic isolates around the entire phylogenetic tree. . .We all thought genomics was going to solve so many problems, and it’s really just made it more difficult!” “Plasmids tend to be mobile and exchangeable, and the pieces tend to be - I tend to think of them as legos, in the fact that you can put a plasmid together in a bunch of different ways.” “I think a lot of conventional PCR fails and people assume that it’s because it’s negative, and not necessarily that it fails because of diversity.” “Many microbiologists think of that colony on a plate as a clone. I force the people in my group to think about it a little differently, because it’s really what I like to call ‘genome space’. They’re not all the same; bacteria are constantly evolving. There’s changes all the time, some of them are positive, some of the are negative, the negative ones get lost, the positive ones unusually become dominant - and then there’s lots of neutral changes that just kind of hang out.” “Genomes really normalized everything. Before that, there were certain labs that could clone and there were certain labs that could sequence, and it was a little bit restrictive to the elite labs who had those resources. Now with the genome sequences out there, everyone was starting from the same place.” “You really have to understand your organism to make the bioinformatics work.” Links for this episode Rasko lab at the University of Maryland FBI summary of Amerithrax investigation 2011 PNAS report on B. anthracis comparative genomics Bugs N the ‘hood HOM Tidbit: Stanley Falkow gives both video history and written history of plasmid biology Save on Microbe 2018, use code: asmpod Send your stories about our guests and/or your comments to jwolf@asmusa.org.

In this episode Dr. Sara Kim discusses the history, diagnosis, consequences, and treatment of bacterial vaginosis.    feedback@obgyn.fm   ACOG. Vaginisits Practice Bulletin. (2015). Chawla, R. B., Preena; Chadha, Sanjim; Grover, Sujatha; Garg, Suneela. Comparison of Hay's Criteria with Nugent's Scoring System for Diagnosis of Bacterial Vaginosis. Biomed Research International 2013 (2013). Eschenbach, D. A. History and review of bacterial vaginosis. American Journal of Obstetrics and Gynecology 169, 441-445 (1993). Fettweis, J. B., J Paul; Serrano, Myrna; Sheth, Nihar; Girerd, Philippe; Edwards, David; Strauss, Jerome; Jefferson, Kimberly; Buck, Gregory, Vaginal Microbiome Consortium. Differences in vaginal microbiome in African American women versus women of European ancestry. Microbiology 160, 2272-2282 (2014). Greenwood, J. P., MJ. Transfer of Haemophilus vaginalis Gardner and Dukes to a New Genus, Gardnerella: G. vaginalis (Gardner and Dukes). International Journal of Systematic Bacteriology 30, 170-178 (1980). Hillier, S. N., Robert; Eschenbach, David; Krohn, Marijane; Gibbs, Ronald; Martin, David; Cotach, Mary Frances; Edelman, Robert; Pastorek, Joseph; Rao, Vijaya; McNellis, Donald; Regan, Joan; Carey, Christopher; Klebanoff, Mary A. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. New England Journal of Medicine 333, 1737-1742 (1995). Koumans, E. S., Maya; Bruce, Carol; McQuillan, Geraldine; Kendrick, Juliette; Sutton; MAdeline; Markowitz, Lauri. The Prevalence of Bacterial Vaginosis in the United States, 2001-2004; Associations with Symptosm, Sexual Behaviors, and Reproductive Health. Sexually Transmitted Diseaese 34, 864-869 (2007). Lachiewicz, M. M., Laura; Jaiyeoba, Oluwatosin. Pelvic Surgical Site Infection in Gynecologic Surgery. Infectious Diseases in Obstetrics and Gynecology 2015 (2014). Larsson, P.-G. a. C., Bodil. Does pre- and postoperative metronidazole treatment lower vaginal cuff infection rate after abdominal hysterectomy among women with bacterial vaginosis? Infect Dis Obstet Gynecol 10, 133-140 (2002). Lin, L. S., J; Kimber, N; Shott, S; Tangora, J; Aroutcheva, A; Mazees, MB; Wells, A; Cohen, A; Faro, S. The Role of Bacterial Vaginosis in Infection After Major Gynecologic Surgery. Infectious Diseases in Obstetrics and Gynecology 7 (1999). Ling, Z. L., Xia; Chen, Weiguan; Luo, Yueqiu; Yuan, Li; Xia, Yaxian; Nelson, KAren; Shalei, Huang; Zhang, Shaoen; Wang, Yuezhu; Yuan, Jieli; Li, Lanjuan; Xiang, Charlie. The Restoration of the Vaginal Microbiota After Treatment for Bacterial Vaginosis with Metronidazole or Probiotics. Microbial Ecology 65, 773-780 (2013). Menard, J.-P. Antibaterical treatment of bacterial vaginosis: current and emerging therapies. International Journal of Women's Health 3, 295-305 (2011). Muthuamy, S. E., Selvi. Comparison of Amsel's Criteria, Nugent Score and Culture for the Diagnosis of Bacterial Vaginosis. National Journal of Laboratory Medicine 5, 37-40 (2016). Onderdonk, A. D., Mary L; Fichorova, Raina N. The Human Microbiome during Bacterial Vaginosis. Clinical Microbiology Reviews 29, 223-238 (2016). Tebes, C. L., Catherine; Sinnott, John. The effect of treating bacterial vaginosis on preterm labor. Infect Dis Obstet Gynecol 11, 123-129 (2003). Xiao, B. N., Xiaoxi; Wang, Ben; Du, Pengcheng; Na, Risu; Chen, Chen; Liao, Qinping. Predictive value of the composition of the vaginal microbiota in bacterial vaginosis, a dynamic study to identify recurrence-related flora. Scientific Reports Nature 6, doi:10.1038/srep26674 (2015).

Neste episódio, o Médico Veterinário Ricardo Lippke aborda as principais características do agente causador, a importância da doença, principais sinais clínicos e os desafios recorrentes deste problema. Não perca! Ricardo Tesche Lippke, Médico Veterinário pela UDESC, mestre pela UFRGS com ênfase em sanidade suína. Atualmente, é supervisor técnico da empresa Boehringer Ingelheim Saúde Animal.

Microbial colonization and lung function in adolescents with cystic fibrosis. Hector A, Kirn T, Ralhan A, Graepler-Mainka U, Berenbrinker S, Riethmueller J, Hogardt M, Wagner M, Pfleger A, Autenrieth I, Kappler M, Griese M, Eber E, Martus P, Hartl D. J Cyst Fibros. 2016 May;15(3):340-9. doi: 10.1016/j.jcf.2016.01.004. Epub 2016 Feb 5. Abstract With intensified antibiotic therapy and longer survival, patients with cystic fibrosis (CF) are colonized with a more complex pattern ofbacteria and fungi. However, the clinical relevance of these emerging pathogens for lung function remains poorly defined. The aim ofthis study was to assess the association of bacterial and fungal colonization patterns with lung function in adolescent patients with CF. Microbial colonization patterns and lung function parameters were assessed in 770 adolescent European (German/Austrian) CF patients in a retrospective study (median follow-up time: 10years). Colonization with Pseudomonas aeruginosa and MRSA were most strongly associated with loss of lung function, while mainly colonization with Haemophilus influenzae was associated with preservedlung function. Aspergillus fumigatus was the only species that was associated with an increased risk for infection with P. aeruginosa.Microbial interaction analysis revealed three distinct microbial clusters within the longitudinal course of CF lung disease. ...

Microbial colonization and lung function in adolescents with cystic fibrosis. Hector A, Kirn T, Ralhan A, Graepler-Mainka U, Berenbrinker S, Riethmueller J, Hogardt M, Wagner M, Pfleger A, Autenrieth I, Kappler M, Griese M, Eber E, Martus P, Hartl D. J Cyst Fibros. 2016 May;15(3):340-9. doi: 10.1016/j.jcf.2016.01.004. Epub 2016 Feb 5. Abstract With intensified antibiotic therapy and longer survival, patients with cystic fibrosis (CF) are colonized with a more complex pattern ofbacteria and fungi. However, the clinical relevance of these emerging pathogens for lung function remains poorly defined. The aim ofthis study was to assess the association of bacterial and fungal colonization patterns with lung function in adolescent patients with CF. Microbial colonization patterns and lung function parameters were assessed in 770 adolescent European (German/Austrian) CF patients in a retrospective study (median follow-up time: 10years). Colonization with Pseudomonas aeruginosa and MRSA were most strongly associated with loss of lung function, while mainly colonization with Haemophilus influenzae was associated with preservedlung function. Aspergillus fumigatus was the only species that was associated with an increased risk for infection with P. aeruginosa.Microbial interaction analysis revealed three distinct microbial clusters within the longitudinal course of CF lung disease. ...

Microbial colonization and lung function in adolescents with cystic fibrosis. Hector A, Kirn T, Ralhan A, Graepler-Mainka U, Berenbrinker S, Riethmueller J, Hogardt M, Wagner M, Pfleger A, Autenrieth I, Kappler M, Griese M, Eber E, Martus P, Hartl D. J Cyst Fibros. 2016 May;15(3):340-9. doi: 10.1016/j.jcf.2016.01.004. Epub 2016 Feb 5. Abstract With intensified antibiotic therapy and longer survival, patients with cystic fibrosis (CF) are colonized with a more complex pattern ofbacteria and fungi. However, the clinical relevance of these emerging pathogens for lung function remains poorly defined. The aim ofthis study was to assess the association of bacterial and fungal colonization patterns with lung function in adolescent patients with CF. Microbial colonization patterns and lung function parameters were assessed in 770 adolescent European (German/Austrian) CF patients in a retrospective study (median follow-up time: 10years). Colonization with Pseudomonas aeruginosa and MRSA were most strongly associated with loss of lung function, while mainly colonization with Haemophilus influenzae was associated with preservedlung function. Aspergillus fumigatus was the only species that was associated with an increased risk for infection with P. aeruginosa.Microbial interaction analysis revealed three distinct microbial clusters within the longitudinal course of CF lung disease. ...

Microbial colonization and lung function in adolescents with cystic fibrosis. Hector A, Kirn T, Ralhan A, Graepler-Mainka U, Berenbrinker S, Riethmueller J, Hogardt M, Wagner M, Pfleger A, Autenrieth I, Kappler M, Griese M, Eber E, Martus P, Hartl D. J Cyst Fibros. 2016 May;15(3):340-9. doi: 10.1016/j.jcf.2016.01.004. Epub 2016 Feb 5. Abstract With intensified antibiotic therapy and longer survival, patients with cystic fibrosis (CF) are colonized with a more complex pattern ofbacteria and fungi. However, the clinical relevance of these emerging pathogens for lung function remains poorly defined. The aim ofthis study was to assess the association of bacterial and fungal colonization patterns with lung function in adolescent patients with CF. Microbial colonization patterns and lung function parameters were assessed in 770 adolescent European (German/Austrian) CF patients in a retrospective study (median follow-up time: 10years). Colonization with Pseudomonas aeruginosa and MRSA were most strongly associated with loss of lung function, while mainly colonization with Haemophilus influenzae was associated with preservedlung function. Aspergillus fumigatus was the only species that was associated with an increased risk for infection with P. aeruginosa.Microbial interaction analysis revealed three distinct microbial clusters within the longitudinal course of CF lung disease. ...

Sat, 18 Jul 2015 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/18891/ https://edoc.ub.uni-muenchen.de/18891/1/Frank_Andreas.pdf Frank, Andreas

Dr. Myron M. Levine Director of the Center for Vaccine Development at the University of Maryland School Of Medicine gives the 2011 McAuley Oration. Dr. Levine’s clinical research has involved studies of pathogenesis and the assessment of a variety of vaccines in adults and children in Maryland, as well as in many developing countries. He designed, arranged and supervised the performance of several large-scale, randomized, controlled field trials investigating the efficacy of live oral typhoid vaccines (which led to licensure of Ty21a by the FDA) and a vaccine to prevent invasive disease caused by Haemophilus influenzae type b. He is the recipient of the Albert B. Sabin Gold Medal Award for lifetime achievement in the area of vaccine development and implementation. Held November 7, 2011.

A continuación: Coger un resfriado, Glo Germ, el vino tinto y las enfermedades transmitidas por los alimentos, y el asma en los recién nacidos.Coger un resfriado¿Puede que resfriarse de vez en cuando durante la infancia ayude a mantenerse más sano el resto de la vida? Una investigación reciente demuestra que las enfermedades comunes de la infancia pueden hacer precisamente eso.Los animales de laboratorio en condiciones estériles pueden estar a salvo de las infecciones, pero sus sistemas inmune y digestivo no se desarrollan adecuadamente y pueden sufrir daños neurológicos.Gerald Callahan, microbiólogo de la Universidad Estatal de Colorado, dice que también se sabe que los chicos que se crían en hogares que están demasiado limpios tienen más riesgo de desarrollar alergias y asma. Por el contrario enfermar de niño es crucial para convertirse en un adulto sano.Según Callahan, entre la infección y un niño en desarrollo se establece una íntima interacción que no puede recuperarse más tarde en la edad adulta.Callahan opina que un uso excesivo de productos de limpieza del hogar puede ser dañino para la salud de los niños, no sólo por sus componentes químicos sino también porque pueden matar todos los microbios.                        A Callahan le gusta explicar que todos sabemos que nuestros hijos van a encontrarse con malas personas cuando crezcan, pero no tratamos de protegerlos de todo el mundo porque sabemos que ello podría ser contraproducente.Las bacterias ayudan a nuestro sistema digestivo, fortalecen nuestro sistema inmune y aportan energía a nuestras células. Por ello es importante que lleguemos a conocer unas pocas antes de hacernos mayores.Glo GermGlo Germ y “estornudo spray”. Suenan como términos de un libro de niños del Doctor Seuss, pero en la Escuela Episcopal San Lucas de Mobile en Alabama son importantes herramientas para la enseñanza de la higiene.                                    Una lección muy popular utiliza un  producto llamado “Glo Germ”. Los profesores cubren las manos de sus estudiantes con un polvo inofensivo, les hacen lavarse las manos y después utilizan luz ultravioleta para localizar las áreas que no se han lavado bien.                                 Diane McCleery es una enfermera diplomada en el San Lucas. Sostiene que el Glo Germ penetra en todos los rincones y ranuras, a los que las bacterias y virus llamarían hogar y por ello el Glo Germ es tan difícil de quitar como lo son las bacterias y los virus.  McCleery afirma que ésta suele ser la primera vez que los estudiantes adquieren una apreciación visual de cómo es el medio que existe bajo las uñas de sus dedos y de todas las hendiduras y grietas alrededor de sus nudillos, y de este modo comprenden lo importante que es utilizar grandes cantidades de jabón y agua,  en vez de dejar correr agua tibia sobre sus manos durante un segundo y después medio secarlas con una toalla.                            Los estudiantes tienen también una clase llamada “estornudo spray” para demostrar cómo pueden extenderse  las infecciones. En primer lugar frotan sus manos con una loción y después las cubren con una sustancia que reluce. Entonces se lavan las manos minuciosamente y prosiguen su jornada con normalidad. Al final del día el brillo que no se lavaron está por todas partes: en los  sacapuntas, sobre los pupitres y los pomos de las puertas.McCleery asegura que estos programas ayudan a reforzar las reglas acerca de la higiene que los padres enseñan en casa, y resultan divertidos. El vino tinto y las enfermedades transmitidas por los alimentosUn vaso de vino tinto puede constituir un agradable complemento para su comida pero puede ser algo más. El vino tinto puede también ayudarle a defenderse de una intoxicación alimenticia. Azlin Mustafa, profesora de la Universidad de Missouri en Columbia, ha estudiado el efecto del vino sobre los patógenos y sobre los microbios llamados bacterias probióticas, que favorecen la digestión y la salud. Puso en remojo patógenos y bacterias probióticas en diferentes clases de vino tinto.Afirma que muchos de esos vinos, y con independencia de la temperatura, tuvieron un efecto inhibidor frente a los cinco patógenos ensayados pero no frente a las bacterias probióticas. De acuerdo con Mustafa los más eficaces inhibidores de patógenos transmitidos por los alimentos fueron los vinos elaborados con las uvas cabernet, pinot noir, syrah y merlot. También observó que el vino blanco no tenía el mismo impacto; a los patógenos no parecía molestarles en absoluto el vino blanco. Mustafa dice que sospecha que el vino tinto contiene elevadas concentraciones de compuestos polifenólicos que pueden ser tóxicos para los patógenos. En la siguiente fase de su investigación planea estudiar cómo el vino tinto inhibe los patógenos mientras no afecta a las bacterias beneficiosas.El asma en los recién nacidosUnos investigadores han encontrado que los recién nacidos que padecen determinadas infecciones bacterianas, tales como las que origina Streptococcus pneumoniae y Haemophilus influenzae, tienen más probabilidades de desarrollar asma hacia los cinco años.Dichos investigadores, pertenecientes al Hospital Universitario de Copenhagen, hicieron análisis de estas bacterias en niños de un mes. El veinte y uno por ciento dieron positivo aunque no estaban enfermos, pero a los cinco años un tercio de los infectados habían desarrollado asma, frente a sólo el diez por ciento de los no infectados.El director del equipo, Hans Bisgaard, dice que de alguna manera existe una asociación entre la colonización por dichas bacterias al nacer y el desarrollo posterior del asma en el transcurso de la vida.                Bisgaard señala que el hallazgo puede significar que las bacterias causan asma. O podría indicar que los niños que están predispuestos al asma están también más dispuestos a contraer esas infecciones bacterianas. Sólo más investigaciones nos podrán decir cuál de las respuestas es correcta y si tratando las infecciones podría ayudarse a prevenir el asma. En todo caso Bisgaard apunta que los médicos ya pueden comenzar a usar estos hallazgos para identificar los niños con riesgo.

Once viewed as an infrequent disease of young pigs, Glässer’s disease has emerged as a major pathogen affecting naïve swine herds. Current trends recognize Haemophilus parasuis (HPS)serovar 5 as one of the most virulent and most prevalent serovars capable of eliciting sudden death and systemic Glässer's disease in swine. The prudent use of antimicrobials is considered to be an important component in the control of the septicemic spread of a HPS infection within a pig. Tulathromycin, a triamilide antibiotica, is an approved antimicrobial in many countries however its efficacy against HPS has not been completely examined. The objective of this study was to evaluate the efficacy of two different tulathromycin treatments in commercially weaned piglets challenged intratracheally with HPS serovar 5. A total of 27 piglets were infected with 5 x 10 (8) CFU HPS serovar 5. Eighteen of these piglets were administed two tulathromycin treatments at different times (7 days, 4 days)prior to infection and nine piglets served as controls. After challenge, severe clinical signs, pathological and histopathological lesions indicative of Glässer’s disease were seen in all pigs infected with HPS. Furthermore, pyelitis was observed in seven challenged pigs. This is the first study which reports the findings of these lesions in HPS infected pigs and further studies are required to confirm these findings. Based on the results of the clinical examinations, gross and histopathological lesions, the administration of the two tulathromycin treatments 4 and 7 days prior to the experimental HPS infection did not appear to have a significant antimicrobial effect against the infection dose and serovar used in this study. Factors such as unsuitable application times or the high challenge inoculum dose may have contributed to these findings. Further studies examining the efficacy of tulathromycin taking these changes into consideration are necessary.

Background: Bacterial meningitis in children causes high rates of mortality and morbidity. In a recent clinical trial, oral glycerol significantly reduced severe neurological sequelae in paediatric meningitis caused by Haemophilus influenzae type b, and a tendency towards a benefit of adjunctive glycerol was seen in pneumococcal meningitis. Methods: Here we examined the effects of glycerol in pneumococcal meningitis of infant rats and adult mice. All animals received ceftriaxone, and glycerol or placebo. Brain damage, hearing loss, and inflammatory parameters were assessed. Results: Clinically and by histopathology, animals treated with glycerol or placebo did not differ. While both groups showed equally high levels of matrix metalloproteinase-9 at 24 h after infection, a significant difference in favour of glycerol was observed at 40 h after infection. However, this difference in matrix metalloproteinase-9 in late disease did not result in an improvement of histopathologic parameters. Conclusion: No benefit of adjunctive glycerol was found in these models of pneumococcal meningitis.

The aim of this study was to describe the serological course of H. parasuis in three farms during a present coinfection with M. hyorhinis, PRRSV and PCV2. The examinations occurred in three breeding farms and their complementary finishing units. A clinical examination and blood sampling was done in regular two-week intervals of animals from the 1st to the 11th week of life and the same was done with animals between the 14th and 22nd week of life but in four-week intervals. Furthermore, blood samples were taken from sows in the first week after farrowing. The detection of antibodies against H. parasuis, M. hyorhinis, PCV2 and PRRSV was done using ELISA. The increased lameness that was seen in farm 1 from the 14th week of life was due to H. parasuis because of a simultaneous occurrence in the rise of the antibody titer and the seroprevalence for H. parasuis. In the second and third farm, H. parasuis probably played a role as a cofactor in the porcine respiratory disease complex (PRDC). A correspondent increase in the age of the animals and the clinical scores could be detected for all three farms. In addition, an increase in the occurrence of multiple infections was observed during the finishing period. Double and single infections were present in most of the examined animals, and PCV2 was involved in all cases. Antibodies against PCV2 were found in all animals at the end of the finishing period. A significant association was detected for the mutual occurrence of H. parasuis and PCV2 in the 18th week of life. A synergism of both agents cannot be fully ascertained because of the time at which the significant mutual detection occurred. The tendency of both PCV2 and PRRSV to mutually occur was observed but a significant association was not found. A significant correlation between the antibodies of the sows and their piglets was found for all examined agents in the first week of life. In the first week of life, identical antibody titers for H. parasuis were measured in the sows and piglets and the PRRSV and PCV2 antibody titers of the piglets were even higher in the first week of life. The drop in the antibody titer in the following week of life depended on the specific agent and the starting antibody titer of the piglet in the first week of life. This fall was prolonged if the antibody titer in the first week of life was very high. High antibody titers in the sows are a prerequisite for a good passive immunity in piglets in the first week of life. The maternal immunity against H. parasuis, PRRSV and PCV2 can be improved by sow vaccination. No uniform seroconversion time was found for the four examined agents in the three farms. Thus the seroconversion of H. parasuis and M. hyorhinis began in the ninth and eleventh week of life; PCV2 began in the 9th, 11th, 18th week and PRRSV in the 14th and 18th week of life. Therefore a farm specific serological profile for every relevant agent should be done. In farm 2 and also in farm 3, a mutual seroconversion time in the 9th and 11th week of life was detected for H. parasuis, M. hyorhinis and PCV2. This points to a mutual infection time for these three agents at different times in the respective farms. A simultaneous seroconversion for PRRSV and PCV2 in the 18th week of life was observed in farm 1. Mutual agent influence is possible for H. parasuis, M. hyorhinis and PCV2 and probable for PRRSV and PCV2. The present study demonstrates the difficulty of the interpretation of serological profiles and indicates that an appropriate interpretation of the serological profile can only be done when the clinical signs are also taken into consideration.

Background: Haemophilus influenzae type b (Hib) vaccination led to a significant decrease in invasive bacterial infections in children. The aim of this study was to assess a potential shift to more non-type b invasive infections in a population with high Hib vaccination coverage and to compare the burden of suffering between children with Hib, capsulated non-b and non-capsulated Hi infections. Methods: Cases with confirmed invasive Hi infections were ascertained through two independent nationwide active surveillance systems in 1998-2005. Information on possible predisposing conditions and clinical information was available from 2001 onwards. Results: The total number of reported non-type b Hi cases varied between 10 cases in 1998, 27 in 2000 and 14 in 2005. In each year, non-capsulated serotypes outnumbered capsulated non-type b ones. 192 cases were detected in 2001-2005, more than one half was non-type b and 88% of the non-type b cases were non-capsulated. For cases with Hib/capsulated non-type b infections the most common clinical presentation was meningitis (67% each); 89%/78% had no potential predisposing condition, 75%/72% completely recovered from disease and 6% (each) died. In contrast, meningitis was diagnosed in 34% of the non-capsulated Hi infections, septicaemia in 28% and pneumonia 21%; 62% had no potential predisposing condition, 83% completely recovered and 3% died. Conclusion: There was no increase in non-type b Hi invasive infections during 8 years of active surveillance in Germany. Invasive disease due to non-type b Hi is not confined to children with risk factors. In patients with capsulated non-type b Hi infections the proportion of meningitis cases is similar to Hib, but double as high as in non-capsulated Hi.

Guest: Harry Keyserling, MD Host: Jennifer Shu, MD, FAAP A single vaccine is now available for immunization against diphtheria, tetanus, pertussis, polio, and Haemophilus influenzae type b. As we consider offering this to our pediatric patients, what are the vaccine's unique challenges and benefits? How does this combination vaccine compare with other options for immunization? Host Dr. Jennifer Shu examines these questions and more with Dr. Harry Keyserling, professor of pediatrics in the division of infectious diseases at Emory University School of Medicine.

Nach wie vor spielen die von enteropathogene Yersinien hervorgerufenen Erkrankungen eine wichtige Rolle im Bereich der gesamten klinischen Medizin. Neben akuten Erkrankungen (Yersiniosen), die vor allem bei Kleinkindern, alten und abwehrgeschwächten Patienten vorkommen, sind es auch die verschiedenen immunologischen Folgeerkrankungen, wie Arthritiden oder das Reitersyndrom, die im besonderen Yersinia enterocolitica in den Fokus des wissenschaftlichen Interesses rücken und eine molekularbiologische Analyse der Infektionsmechanismen nötig machen. Eine besondere Bedeutung kommt dem hochkonservierte Virulenzplasmid pYV zu, das für ein TypIII- Proteinsekretionssystem und für das Yersinien Adhäsin YadA (Autotransporter, TypV-Sekretionssystem) kodiert. YadA ist der Prototyp einer Gruppe von Autotransportern, deren struktureller Aufbau sich von allen anderen bisher bekannten Autotransporterklassen unterscheidet, vor allem im Bereich des Membranankers, des Teils also, der für den Einbau des Proteins in die Membran, den Transport der funktionellen Domäne durch die Membran, die Oligomerisierung und die Stabilität des Gesamtproteins verantwortlich ist. Auf Grund dieser aus molekularbiologischer Sicht zentralen Rolle, die der Membrananker für das Funktionieren des Adhäsins und Autotransports von YadA spielt, war es das Ziel der vorliegenden Arbeit mehr über die Topologie und strukturellen Eigenschaften sowie des Oligomerisierungs- und Transportmechanismus dieser C-terminalen Domäne von YadA in Erfahrung zu bringen. Der Membrananker selbst besteht aus vier C-terminalem ß-Faltblättern (Anker-Bereich) sowie dem N-terminalem linker-Bereich, der Verbindung zur funktionellen Passagierdomäne herstellt. In den linker-Bereich von N-terminal verkürzten YadA-Mutanten wurden FLAG-Sondensequenzen einkloniert, die mit speziell an diese FLAG-markierten Bereiche bindenden monoklonalen Antikörper nachgewiesen werden können und so eine Aussage über extrazelluläre oder intrazelluläre lokalisierte Domänen möglich machen. Die Ergebnisse dieser Versuche legen nahe, dass nahezu der gesamte linker-Bereich innerhalb der Membran, also der vom Ankerbereich gebildeten transmembranösen Pore, befindet. Weiterhin wurde versucht, mittels Cystein-Scanning-Mutagenese die FLAG-Experimente zu bestätigen, was nicht gelang, weil die eingefügten Cysteinreste in YadA nicht spezifisch mit Biotinmalleimid reagierten. In einem weiteren Versuch wurde der gesamte YadAMembrananker gegen Membrananker anderer Mitglieder der Oca-Familie (UspA1 von Moraxella catarrhalis, EibA von Escherichia coli, Hia von Haemophilus influenza)ausgetauscht. Es stellte sich heraus, dass alle so hergestellten YadA-Hybridproteine exprimiert und an der Bakterienoberfläche exponiert werden. Jedoch zeigten sich Unterschiede bei der Funktionalität der Hybridadhäsine, vor allem in der Serumresistenz, der Autoagglutination und der Oligomerenstabilität. Die durchgeführten Untersuchungen bestätigen das bestehende Modell des YadAMembranankers als Autotransporter und unterstützen die Einteilung von YadA, EibA, UspA1 und Hia in eine einheitliche Klasse von Autotransportern, die als Oca-Familie bezeichnet wird. Darüber hinaus konnte gezeigt werden, dass die N-terminale YadAPassagierdomäne von unterschiedlichen Autotransporterdomänen über die äußere Bakterienmembran transloziert wird.

Die Mukoviszidose (engl: cystic fibrosis, CF) ist die häufigste autosomal-rezessiv vererbte Stoffwechselerkrankung der kaukasischen Bevölkerung. Der Defekt des Cystic Fibrosis Transmembrane Conductance Regulator, einem membranständigen Chloridionenkanal, manifestiert sich an diversen Organsystemen, wobei Infektionen des Respirationstraktes im Vordergrund stehen. CF-Patienten produzieren ein viskoses Tracheobronchialsekret, welches die mukoziliäre Clearance behindert. In der Folge etablieren sich chronisch verlaufende Lungeninfektionen mit einem CF-typischen Erregerspektrum (v.a. Pseudomonas aeruginosa, Staphylococcus aureus, Burkholderia cepacia-Komplex, Haemophilus influenzae und Stenotrophomonas maltophilia), die letztendlich lebenslimitierend sind. Durch die frühzeitige und regelmäßige Gabe von Antibiotika wird versucht, die inflammatorische und erregerassoziierte Schädigung des Lungengewebes zu kontrollieren. Dabei ist eine mikrobiologische Diagnostik, die die Erreger schnell und mit hoher Sensitivität und Spezifität identifiziert, von großer Bedeutung. Die Fluoreszenz in situ Hybridisierung (FISH) mit markierten Oliginukleotidsonden zum Nachweis ribosomaler RNS ist eine spezifische und sensitive Methode zum Erregernachweis. Sie benötigt im Vergleich zum mindestens 48h in Anspruch nehmenden kulturellen Nachweis nur wenige Stunden und erfasst auch bereits nicht mehr kultivierbare Erreger, z.B. nach erfolgter Antibiotikatherapie. Das relativ begrenzte Erregerspektrum der Lungeninfektionen bei CF bietet gute Voraussetzungen für den Einsatz der FISH-Diagnostik. Als problematisch hat sich hierbei das viskose und inhomogene CF-Sputum erwiesen, das aufgrund seiner Zusammensetzung bei der Hybridisierung mit fluoreszenzmarkierten Sonden eine ausgeprägte Hintergrundfluoreszenz zeigt. Ziel dieser Arbeit war es, den Einsatz der FISH-Technik zum Nachweis CF relevanter Erreger weiter zu optimieren. Zum einen sollte der Einfluss, den die Probenlagerung bis zur Weiterverarbeitung auf den Erregernachweis hat, untersucht werden. Dabei erwies sich 4ºC als geeignete Lagerungstemperatur, da die Mikroorganismen trotz Verringerung der Ribosomenzahl und damit etwas abgeschwächtem Fluoreszenzsignal bis zu 72h nach Probenentnahme mit FISH unverändert sensitiv nachweisbar sind, ohne dass eine Überwucherung langsamer wachsender Keime eintritt. Zum anderen sollte eine Minimierung der Hintergrundfluoreszenz erreicht werden. Verschiedene Modifikationen des Hybridisierungsprotokolls wurden miteinander verglichen. Durch die Absättigung unspezifischer Bindungsstellen der Oligonukleotidsonden mittels einer 30minütigen Vorinkubation mit freiem Biotin wurde die Hintergrundfluoreszenz erfolgreich vermindert, wobei die markierten Bakterien unverändert gut nachweisbar waren. Um die quantitative Auswertung der Sputumproben zu vereinfachen, wurde weiter ein Protokoll zur Analyse der FISH-Proben im Durchflusszytometer entwickelt. Durch diese schnelle, automatisierte Technik entfällt die zeitraubende manuelle Auswertung der Proben. Eine Integration dieser neu entwickelten Ergänzungen in bestehende Protokolle vereinfacht und beschleunigt die mikrobielle Diagnostik CF-typischer Erreger und eröffnet die Möglichkeit eines größeren Probendurchsatzes ohne zusätzliche Kosten.

Background: Following the introduction of conjugate vaccines against invasive Haemophilus influenzae type b (Hib) disease in Germany, the incidence of Hib disease dramatically decreased. Hib conjugate vaccines were combined with diphtheria, tetanus and acellular pertussis antigens (DTaP/Hib) and gradually replaced by higher-valent vaccines, additionally incorporating inactivated polio virus and - since the end of 2000 - hepatitis B (DTaP-IPV-HB/Hib or hexavalent vaccines). Recently, an increasing incidence of invasive Hib disease in children and an increasing number of vaccine failures have been reported from some European countries, which coincided with the introduction of combination vaccines containing the acellular pertussis component. Previous data in Germany showed no such increase and vaccine effectiveness (VE) of DTaP/Hib and DTaP-IPV/Hib combination vaccines against invasive Hib disease was estimated to be high. Since Germany is the first country who introduced hexavalent vaccines, insufficient data on the impact of hexavalent vaccines on invasive Hib disease and on the VE against invasive Hib disease in children exist. Aim: To assess (1) annual numbers of Hib cases and vaccine failures of Hib vaccines before and after the introduction of hexavalent vaccines in German children, (2) annual incidences of invasive Hib disease before and after the introduction of hexavalent vaccines in German children and to estimate (3) VE of hexavalent vaccines against invasive Hib disease in German children. Subjects and Methods: Invasive Haemophilus influenzae (Hi) infections in children less than 10 years were ascertained from 1998 to 2004 through two independent nation-wide active surveillance systems, one hospital- and one laboratory-based. Species confirmation and capsular testing was performed in the national consulting laboratory for Hi. Cases were defined by any hospitalisation due to a systemic infection clinically compatible with an invasive Hi disease and with isolation of Hi from a normally sterile body site. Annual case numbers and incidences were adjusted for underreporting and for differences in the proportion of typed cases over time. VE was determined with a case-cohort approach using Cox regression with time-dependent covariates. In this analysis, Hib cases born between August 2000 and June 2003, aged 2 months or older and ascertained from August 2000 to December 2003 were included for case-cohort analysis and a ‘sub’-cohort of children born in the same time frame as the cases was randomly sampled in a nationwide immunisation survey. Children receiving two/three Hib doses (depending on vaccine type) in the first year of life, without booster, were defined as ‘fully primed’, children receiving a single dose in the second year of life, regardless of priming, as receiving a ‘2nd year dose’ and children receiving a booster dose at the age of 11 months or later following full priming as receiving the ‘full immunisation’. Results: In the two surveillance systems annual response rates since 1998 were >90%, the proportion of untyped Hi cases decreased from 25% of all reported cases in 1998 to 15% in 2004 and the proportion typed in the national consulting laboratory increased from 55% of all reported cases in 1998 to 70% in 2004. The annual number of Hi cases decreased from 51 in 1998 to 27 cases in 2004. Hib cases fluctuated between 28 in 1998 and 4 in 2004. Of all 117 Hib cases detected since 1998, 64 were not vaccinated and 52 were vaccinated at least once. 92% of the unvaccinated Hib cases and 53% of the vaccinated Hib cases could have received at least one (additional) dose if timing of general recommendations would have been followed. Of all vaccinated Hib cases, 12 had been vaccinated with at least one dose of a hexavalent vaccine. Overall annual incidence rates of Hi disease were relatively constant throughout the years 1998 through 2004 (0.8-0.4/100,000). Annual incidences of Hib disease ranged between 0.3 and 0.1 per 100,000 in 1998 and 2004, respectively, with the highest incidence in the 3-11 month age-group (1.7/100,000 in 2003). Adjustment for underreporting and differences in typing gave no evidence of an increasing trend of Hib disease in German children. Twenty-seven cases were eligible for VE calculation; 17 were unvaccinated and 10 vaccinated with hexavalent vaccines; of these, 5 received an incomplete primary series, 5 received the full primary series and none a 2nd year dose or the full immunisation before disease onset. In the immunisation survey, response rate was 63% and interviewed households were representative for age-eligible children in Germany according to geographical and social distributions. 1303 valid interviews of children born from 1 August 2000 onwards were available. Median age at vaccination with the complete primary series of hexavalent vaccines was 6.0 months and 14.4 months for the full immunisation. Effectiveness of hexavalent vaccines against invasive Hib infection was 75.5% (95% CI: 31.4-91.3) for incomplete primary series and 91.8% (95% CI: 73.6-97.5) for the full primary series. For the 2nd year dose - but no full immunisation - and full immunisation vaccine effectiveness was 100.0% (95% CI: 99.5-100.0 and 99.9-100.0, respectively). Conclusion: Four years after the introduction of hexavalent vaccines in Germany, there was no indication of increasing incidence of invasive Hib disease or increasing number of vaccine failures in children. Hexavalent vaccines continue to show the high effectiveness against invasive Hib disease observed for other DTaP-containing Hib vaccines in Germany. Sustained surveillance – especially for fully immunised children - should confirm protection induced by hexavalent vaccines.

Objectives: To determine trends in the prevalence and aetiological distribution of genital ulcer syndrome (GUS) in a cohort of female bar workers and to assess factors associated with these trends.Methods: An open cohort of 600 women at high risk of HIV and sexually transmitted infection (STI) was offered screening and treatment for STI at 3-month intervals. The prevalence of GUS and associated aetiological agents (Herpes simplex virus (HSV), Treponema pallidum and Haemophilus ducreyi) were monitored over 27 months through clinical examination, dry lesion swabbing and multiplex polymerase chain reaction. The effects of HIV status and other factors on the prevalence trends of STI were assessed.Results: A total of 753 women were recruited into the cohort over 10 examination rounds. At recruitment, the seroprevalence was 67% for HIV and 89% for HSV type 2 (HSV-2). During follow-up, 57% of ulcers had unknown aetiology, 37% were due to genital herpes and 6% to bacterial aetiologies, which disappeared completely in later rounds. The absolute prevalence of genital herpes remained stable at around 2%. The proportion of GUS caused by HSV increased from 22% to 58%, whereas bacterial causes declined. These trends were observed in both HIV-negative and HIV-positive women.Conclusions: The changes observed in the frequency and proportional distribution of GUS aetiologies suggest that regular STI screening and treatment over an extended period can effectively reduce bacterial STI and should therefore be sustained. However, in populations with a high prevalence of HSV-2, there remains a considerable burden of genital herpes, which soon becomes the predominant cause of GUS. Given the observed associations between genital herpes and HIV transmission, high priority should be given to the evaluation of potential interventions to control HSV-2 either through a vaccine or through episodic or suppressive antiviral therapy and primary prevention.

Background/aims: Contaminated ophthalmic solutions represent a potential cause of avoidable ocular infection. This study aimed to determine the magnitude and pattern of microbial contamination of multi-dose ocular solutions at the Department of Ophthalmology, University of Nairobi, at the Kenyatta National Hospital, Kenya.Methods: 101 vials were obtained for microbial examination after an average use of 2 weeks. The dropper tip and the residual eye drop were examined for contamination. The specimens were cultured, the number of colonies counted, the organisms identified and susceptibility testing to selected antimicrobial agents was done.Results: Six (6%) of the 101 analysed vials were contaminated: 4/77 vials (5%) from a multi-user setting and 2/24 vials (8%) from a single user setting. Three contaminations (3/38, 8%) occurred in vials from the eye ward, another three (3/59, 5%) in vials from the outpatient clinic. Most bacteria identified belonged to the normal commensal flora of the eye. Isolated contaminants were micrococci (n = 2), Staphylococcus epidermidis, Haemophilus sp, Bacillus sp and a Gram negative rod. The dropper tip was more often contaminated (n = 6) than the residual solution (n = 1), and only one vial showed a contamination of both the drop and the tip.Conclusion: Our data show a contamination rate of 6%, which is in the lower range of data published on the contamination of eye drops elsewhere (0.07% to 35.8%).

In dieser Arbeit werden verschiedene Assoziationen zwischen den von der STIKO empfohlenen Standardimpfungen (gegen Diphtherie, Tetanus, Pertussis, Haemophilus influenzae Typ b, Poliomyelitis, Hepatitis B, Masern, Mumps und Röteln) und schweren unerwünschten Ereignissen nach einer Impfung anhand aktueller Studienergebnisse zusammengestellt und auf Ihre Stichhaltigkeit geprüft. Die Bewertung der einzelnen Studien erfolgt dabei nach den vom „Oxford Centre for Evidence-based Medicine“ aufgestellten „Levels of Evidence“.

Third-generation cephalosporins in oral formulations have become an increasingly important first-line choice against common bacterial infections. Cefixime is one such agent, which possesses excellent efficacy against a broad spectrum of pathogens, including Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis. Clinical success rates are similar to cefaclor, clarithromycin, and other cephalosporins. Importantly, cefixime also possesses excellent activity against beta-lactamase-producing strains. The pharmacodynamic features of the drug include a half-life of 3-4 h and a C-max of 4.4 mu g/ml, well above the MIC90 for susceptible pathogens, permitting once-daily dosing. In this brief overview, the bacteriological and clinical efficacy of cefixime is discussed, as well as its indications.