Burkholderia mallei and Burkholderia pseudomallei: the causative micro-organisms of glanders and melioidosis.

Burkholderia mallei and Burkholderia pseudomallei are the causative micro-organisms of Glanders and Melioidosis, respectively. Although now rare in Western countries, both micro-organisms have recently gained much interest because of their unique potential as bioterrorism agents. This paper reviews the epidemiology, pathogenesis, diagnosis and treatment of Melioidosis and Glanders.

Treatment options for multidrug-resistant Acinetobacter species.

Multidrug-resistant Acinetobacter spp. are emerging nosocomial pathogens and have become a leading cause of Gram-negative infections in many parts of the world. Acinetobacter spp.

From folklore to scientific evidence: breast-feeding and wet-nursing in islam and the case of non-puerperal lactation.

Breast-feeding practice has an important medical and socio-cultural role. It has many anthropological aspects concerning the "power structures" that find their expression in breast-feeding and the practices that formed around it, both socially, scientifically, and legally-speaking. Breast-feeding has been given much attention by religions and taboos, folklore, and misconception abound around it making it a topic of genuine curiosity.

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.

Impact of 4% chlorhexidine whole-body washing on multidrug-resistant Acinetobacter baumannii skin colonisation among patients in a medical intensive care unit.

The prevalence of skin colonisation with Acinetobacter baumannii (ACBA) on admission to the medical intensive care unit (MICU) was studied in an institution endemic for ACBA bloodstream infections (BSIs). The impact of 4% chlorhexidine gluconate (4% CG) whole-body washing on the patients' ACBA skin colonisation was also determined. A prospective cohort trial in a MICU during March 2002 to December 2003 was performed, with a comparison between the prevalence and incidence of ACBA-BSIs obtained after intervention and retrospectively.

Candida albicans masquerading as gram-negative bacilli in the clinical laboratory.

We report misidentification of Candida albicans as Gram-negative bacilli owing to colony morphology on MacConkey agar and subsequent inoculation into GN-ID/VITEK-2. ATCC and clinical Candida strains (n = 24) masqueraded as various bacterial species when experimentally inoculated into GN-ID cards. This phenomenon should be considered when peculiar taxa or susceptibility are encountered.

Clinical features and laboratory diagnosis of infection with the potential bioterrorism agents burkholderia mallei and burkholderia pseudomallei.

Burkholderia mallei and Burkholderia pseudomallei are the causative organisms of Glanders and Melioidosis, respectively. Although now rare in Western countries, both organisms have recently gained much interest because of their unique potential as bioterrorism agents. These organisms are less familiar to medical and laboratory personnel than other select bioterrorism bacterial agents and thus heightened awareness of Glanders and Melioidosis is crucial in order to enable adequate emergency preparedness and response to deliberate release of B.

Conservative management of implantable cardioverter defibrillator-related endocarditis due to Bacillus spp.

Endocarditis is a devastating complication of implantable cardioverter-defibrillator (ICD) therapy. Partial or complete device removal has been advocated for the treatment of this condition although controlled data are lacking. We present a case of ICD-related endocarditis caused by Bacillus spp.

Prevention of catheter-related bloodstream infections in the neonatal intensive care setting.

Nosocomial infection causes substantial morbidity and mortality among neonates treated in the neonatal intensive care setting. Colonization and subsequent infection of central venous catheters leading to catheter-related bloodstream infection is among the most common causes of nosocomial sepsis in this patient population. Prevention of catheter-related bloodstream infection is a major challenge and numerous strategies have been attempted in this context with varying success.

"All-in-one-plate" E-test and disk diffusion susceptibility co-testing for multiresistant Acinetobacter baumannii.

Multiresistant Acinetobacter baumannii requires ancillary manual susceptibility testing with the E-test and disk diffusion when tested with the VITEK-2 system (bioMérieux, Marcy l'Etoile, France). In the study presented here, the E-test and disk diffusion were combined in a single plate, and the method was verified by comparing categorical agreement of combined and control plates. There were no very major, major or minor errors, and similar results were obtained for all ten representative bacterial strains used as controls.

Reduction of blood culture contamination rate by an educational intervention.

The efficacy of an educational intervention to prevent blood culture contamination (BCC) in internal medicine was studied in two medical wards in a busy tertiary-care hospital in which blood cultures were obtained by physicians rather than dedicated phlebotomists. Baseline BCC rates were 5.7% and 7.

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.

Prevalence and clinical significance of pleural microbubbles in computed tomography of thoracic empyema.

Aim: To determine the prevalence and clinical significance of pleural microbubbles in thoracic empyema.

Materials And Methods: The charts of 71 consecutive patients with empyema were retrospectively reviewed for relevant demographic, laboratory, microbiological, therapeutic and outcome data. Computed tomography (CT) images were reviewed for various signs of empyema as well as pleural microbubbles.

An outbreak of leptospirosis among Israeli troops near the Jordan River.

An outbreak of leptospirosis that involved 7 of a team of 27 Israeli troops occurred following a military exercise in northern Israel near the Jordan River. The organism implicated in the outbreak was Leptospira interrogans serovar Hardjo. The clinical course was uncomplicated and all patients fully recovered.

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.

Surveillance of chronic haemodialysis-associated infections in southern Israel.

During a 12-month surveillance period, haemodialysis (HD) patients in southern Israel were categorised according to the type of vascular access site (VAS), i.e., arteriovenous (AV) fistula, synthetic AV graft, and cuffed or non-cuffed vascular catheters.

Unmasking of carnitine palmitoyltransferase deficiency during an acute exacerbation of asthma complicated by rhabdomyolysis in a soldier.

Rhabdomyolysis is a life-threatening condition that may result from various etiologies. We report a rare case of severe rhabdomyosis in a soldier after a mild acute asthma exacerbation. Further work-up revealed an underlying deficiency of type II carnitine palmitoyltransferase.

Impact of regular attendance by infectious disease specialists on the management of hospitalised adults with community-acquired febrile syndromes.

The impact of attendance by infectious disease specialists (IDS) on hospitalised adults with community-acquired infection was assessed by studying 402 consecutive febrile adults who were admitted randomly to either of two internal medicine wards over a 4-month period and given intravenous antibiotics. In ward 1, patients were attended by IDS, whereas those in ward 2 were attended by physicians from other specialties. In total, 160 patients were treated in ward 1 and 242 in ward 2 (median age 66 years; 49% male).

Prevention of infections associated with permanent cardiac antiarrhythmic devices by implementation of a comprehensive infection control program.

Objective: To implement a comprehensive infection control (IC) program for prevention of cardiac device-associated infections (CDIs).

Design: Prospective before-after trial with 2 years of follow-up.

Setting: A tertiary-care, university-affiliated medical center.