[BRUCELLA MELITENSIS (BM) BACTEREMIA IN HOSPITALIZED ADULT PATIENTS IN SOUTHERN ISRAEL].

Background: Southern Israel is endemic for Brucella melitensis (BM) infection.

Aims: This study aims to describe clinical manifestations and laboratory abnormalities in hospitalized adults with BM-bacteremia and to assess the relationship between various laboratory parameters, outcomes and complications of brucellosis.

Methods: This is a retrospective study.

Prevalence and characteristics of fibromyalgia among HIV-positive patients in southern Israel.

Objectives: Fibromyalgia and chronic pain have previously associated with HIV infection for over two decades. We aimed to evaluate the prevalence of FMS symptoms in an ethnically heterogeneous population of HIV-infected individuals in southern Israel, applying the proposed new diagnostic criteria for diagnosis of fibromyalgia symdrome (FMS).

Methods: 156 HIV-positive patients followed at the AIDS clinic of the Soroka University Medical Center (SUMC) who gave written informed consent were recruited in the trial.

[The computerized patient record as a tool to improve monitoring and prevention of hospital acquired infections].

One of the major issues medical institutions deal with is hospital acquired infections (HAI's) and the invasion of antibiotic resistant organisms into these institutions. Antibiotic resistance influences morbidity, mortality and costs. In order to effectively manage the field of infection control of HAI's we constructed computerized clinical tools.

[Prevalence of sexually transmitted diseases (STD) in HIV positive women in southern Israel].

Background: Co-infection of HIV and other sexualLy transmitted diseases (STDs) is common. The Centers for Disease Control and Prevention (CDC) recommends routine yearly screening for STDs in HIV carriers. There is only scarce data on the prevalence of STD in HIV positive individuals in Israel and no current recommendations on this issue are available.

Tuberculosis in African refugees from the Eastern Sub-Sahara region.

Background: The southern region of Israel has recently experienced an influx of African refugees from the Eastern Sub-Sahara desert area. These influxes have led to a significant increase in incidence of tuberculosis (TB) in that region.

Objectives: To review the data of African refugees diagnosed with TB between January 2008 and August 2010 at a tertiary care regional hospital.

A randomized, double-blind, placebo-controlled trial of selective digestive decontamination using oral gentamicin and oral polymyxin E for eradication of carbapenem-resistant Klebsiella pneumoniae carriage.

Objective: To assess the effectiveness of selective digestive decontamination (SDD) for eradicating carbapenem-resistant Klebsiella pneumoniae (CRKP) oropharyngeal and gastrointestinal carriage.

Design: A randomized, double-blind, placebo-controlled trial with 7 weeks of follow-up per patient.

Setting: A 1,000-bed tertiary-care university hospital.

A multifaceted intervention strategy for eradication of a hospital-wide outbreak caused by carbapenem-resistant Klebsiella pneumoniae in Southern Israel.

Objective: To devise a local strategy for eradication of a hospital-wide outbreak caused by carbapenem-resistant Klebsiella pneumoniae (CRKP).

Design: Quasi-experimental, before-and-after, interrupted time-series study.

Setting: A 1,000-bed tertiary-care university teaching hospital.

Eritrean and Sudanese migrants presenting with malaria in Israel.

In Israel, a malaria-free country, we have noticed lately an increase of hospital admissions with malaria, parallel to the rise in the number of Eritrean and Sudanese migrants. Eritrea and Sudan are malaria-endemic countries; Plasmodium falciparum accounts for 85-90% and Plasmodium vivax accounts for 10-15% of malaria species in these areas. We aimed to describe the features of malaria in this migrant population by conducting a retrospective descriptive study of Eritrean and Sudanese migrants admitted with malaria during 1/2009-4/2010.

Risk factors for developing clinical infection with carbapenem-resistant Klebsiella pneumoniae in hospital patients initially only colonized with carbapenem-resistant K pneumoniae.

Background: This study examined predictors of carbapenem-resistant Klebsiella pneumoniae (CRKP) colonization and risk factors for the development of CRKP infection in patients initially only colonized with CRKP.

Methods: A total of 464 patients with CRKP rectal colonization (CRKP-RC) were identified. Two case-control studies were performed, one comparing risk factors for CRKP-RC in patients who did not develop CRKP infection (CRKP-IN) versus patients without CRKP-RC and CRKP-IN, and the other comparing CRKP-RC patients who did not develop CRKP-IN with those who did.

Risk factors for community-acquired pneumonia with influenza A/H1N1 in southern Israel.

Objectives: To determine the risk factors for community-acquired pneumonia (CAP) with influenza A/H1N1 flu in our region.

Methods: Adult patients with CAP from July 2009 to February 2010 who were screened for influenza A/H1N1 were identified retrospectively. This was a retrospective case-control study.

The prevalence of human papillomavirus and cervical cytology abnormalities in women infected with human immunodeficiency virus in southern Israel.

Background: Concomitant human immunodeficiency virus (HIV) and human papillomavirus (HPV) infection increases both HPV persistence and the risk of invasive cervical cancer. An estimation of HPV prevalence among HIV-positive women in Israel would contribute to improving care for this population and preventing morbidity and mortality related to cervical cancer.

Objectives: To determine the prevalence of HPV infection and cervical cytology abnormalities, and to assess the possible influence of HIV infection on HPV carriage in HIV-positive women attending the Infectious Disease Clinic at Soroka University Medical Center.

Attributable mortality rate for carbapenem-resistant Klebsiella pneumoniae bacteremia.

Objective: To determine the attributable (direct) mortality and morbidity caused by carbapenem-resistant Klebsiella pneumoniae bacteremia.

Design: A matched retrospective, historical cohort design, using a stepwise procedure to stringently match the best control subjects to the best case subjects.

Setting: A 1,000-bed tertiary-care university teaching hospital.

Syphilis and HIV co-infection.

Syphilis is a complex disease, which is sexually transmitted. The incidence of syphilis is rising all over the world, partly due to the increased transmission in HIV patients and other high risk groups such as men who have sex with men. Interestingly syphilis itself facilitates HIV infection in several ways.

Epidemiological and clinical characteristics of methicillin sensitive Staphylococcus aureus (MSSA) bacteriuria.

Objectives: To determine the frequency of MSSA bacteriuria in our hospital, ascertain nosocomial and community-acquired risk factors, identify specific epidemiological characteristics among bacteriuric patients with/without MSSA bacteremia.

Methods: Adult patients with MSSA bacteriuria during 44 months identified retrospectively; their files reviewed for demographics, Charlson Comorbidity Index, urinary tract infection, clinical data, predisposing factors, urinary catheter data, treatment, and outcome.

Results: 106 patients (mean age 56 (SD 22) years; 43% females) with MSSA bacteriuria were identified, comprising 0.

Maternal urinary tract infection: is it independently associated with adverse pregnancy outcome?

Objective: This population-based study was aimed to determine whether there is an association between urinary tract infections (UTI) during pregnancy, among patients in whom antibiotic treatment was recommended, and maternal and perinatal outcome.

Methods: A retrospective population-based study comparing all singleton pregnancies of patients with and without UTI was performed. Multiple logistic regression models were performed to control for confounders.

Auditing and benchmarking of azithromycin utilization in primary care military clinics.

Despite widespread azithromycin use, no audit has targeted this drug to date. Azithromycin was audited in primary military clinics between July 1, 2003 and December 31, 2003 (period 1). Consumption (defined daily doses/1000 visits) and economic expenditure of penicillin V, amoxicillin, erythromycin, and azithromycin were evaluated.

Direct effect of human immunodeficiency virus protease inhibitors on neutrophil function and apoptosis via calpain inhibition.

Impairment of neutrophil functions and high levels of apoptotic neutrophils have been reported in human immunodeficiency virus (HIV) patients. The aim of the present study was to investigate the direct in vitro effects of the different HIV protease inhibitors (PIs) on neutrophil functions and apoptosis and to explore their mechanisms of action. The effects of nelfinavir (NFV), saquinavir (SQV), lopinavir (LPV), ritonavir (RTV), and amprenavir (APV) in the range of 5 to 100 microg/ml on neutrophil function, apoptosis, and mu-calpain activity were studied.

Shewanella spp. infection following treatment for upper gastrointestinal bleeding.

Shewanella spp. are an uncommon cause of human infection, with exposure to water being the commonest source. We report a patient with a malignancy and upper gastrointestinal bleeding who underwent a gastric lavage followed by an endoscopy as part of her investigations.

Impaired neutrophil functions in the pathogenesis of an outbreak of recurrent furunculosis caused by methicillin-resistant Staphylococcus aureus among mentally retarded adults.

Staphylococcus aureus is an important cause of skin infections. We recently described an outbreak of recurrent furunculosis involving methicillin-resistant S. aureus among mentally retarded adults.

Prospective study of empiric monotherapy with ceftazidime for low-risk grade IV febrile neutropenia after cytotoxic chemotherapy in cancer patients.

Purpose: It was the aim of this study to evaluate the results of a prospective study in a single medical center using ceftazidime monotherapy in cancer patients with chemotherapy-induced grade IV febrile neutropenia and a low risk for gram-negative bacteremia.

Subjects And Methods: Thirty-eight patients were admitted with low-risk grade IV febrile neutropenia after chemotherapy for solid tumors. The median patient age was 57 years (range 18-74).

Disagreement in the interpretation of chest radiographs among specialists and clinical outcomes of patients hospitalized with suspected pneumonia.

Background: Pneumonia is diagnosed by a combination of clinical symptoms and findings on chest X-ray (CXR). However, there is often disagreement, even among experts, upon the interpretation of the CXR. The purpose of this study was to compare the agreement rates in CXR interpretation of suspected community-acquired pneumonia (CAP) between a radiologist, a pulmonologist, an infectious disease specialist, and an internal medicine staff and to establish the correlation of such an agreement with the length of hospitalization and 30-day mortality rate.

Antibiotic drug advertising in medical journals.

Advertising is a leading strategy for drug promotion. We analysed 779 advertisements in 24 medical journals, 25% of which featured antibiotics. Antibiotic advertisements showed differences compared to those of other drugs.

Atraumatic rupture of the spleen associated with hemophagocytic syndrome and isolated splenic peliosis. Case report.

Atraumatic rupture of the spleen is an uncommon condition that may be associated with various etiologies. The hemophagocytic syndrome (HS) and isolated splenic peliosis are two rare conditions, each of which has previously been described in association with splenic rupture. We describe a unique case of atraumatic splenic rupture in which concurrent HS and splenic peliosis were diagnosed following splenectomy.