An Atypical Presentation of Gonococcal Endocarditis.

A 53-year-old male presented following cardiac arrest, followed by cardiopulmonary resuscitation. He was found to have myocardial infarction, bihemispheric cerebral embolization and mitral valve endocarditis. Mitral valve replacement was performed and was detected on PCR.

Impact of Povidone Application to Nares in Addition to Chlorhexidine Bath in Critically Ill Patients on Nosocomial Bacteremia and Central Line Blood Stream Infection.

Nosocomial Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia results in a significant increase in morbidity and mortality in hospitalized patients. We aimed to analyze the impact of applying 10% povidone iodine (PI) twice daily to both nares in addition to chlorhexidine (CHG) bathing on nosocomial (MRSA) bacteremia in critically ill patients. A quality improvement study was completed with pre and post-design.

Evaluating the Efficacy of Eravacycline and Omadacycline against Extensively Drug-Resistant Patient Isolates.

For decades, the spread of multidrug-resistant (MDR) has been rampant in critically ill, hospitalized patients. Traditional antibiotic therapies against this pathogen have been failing, leading to rising concerns over management options for patients. Two new antibiotics, eravacycline and omadacycline, were introduced to the market and have shown promising results in the treatment of Gram-negative infections.

Evaluating the Effectiveness of Hospital Antiseptics on Multidrug-Resistant : Understanding the Relationship between Microbicide and Antibiotic Resistance.

hospital infections are difficult to treat due to the rapid emergence of multidrug-resistant (MDR) strains. In addition, can survive in numerous adverse environments, including in the presence of common hospital antiseptics. We hypothesized that in addition to accumulating drug resistance determinants, MDR strains also accumulate mutations that allow for greater microbicide tolerance when compared to pan-susceptible (PS) strains.

Malignant Fungating Wounds of the Head and Neck: Management and Antibiotic Stewardship.

Objective: Malignant fungating wounds (MFWs) are unfortunate and underreported manifestations of some advanced head and neck cancers. The management of MFWs is complex and challenging. MFWs are often mistaken for infectious processes/abscesses and treated indiscriminately with oral or intravenous antibiotics.

A model for bringing TB expertise to HIV providers: Medical consultations to the CDC-funded Regional Tuberculosis Training and Medical Consultation Centers, 2013-2017.

Background: Persons living with human immunodeficiency virus (HIV) are at a greater risk of developing tuberculosis (TB) compared to people without HIV and of developing complications due to the complexity of TB/HIV coinfection management.

Methods: During 2013-2017, the Centers for Disease Control and Prevention (CDC) funded 5 TB Regional Training and Medical Consultation Centers (RTMCCs) (now known as TB Centers of Excellence or COEs) to provide medical consultation to providers for TB disease and latent TB infection (LTBI), with data entered into a Medical Consultation Database (MCD). Descriptive analyses of TB/HIV-related consultations were conducted using SAS® software, version [9.

Zoonotic and vector-borne parasites and epilepsy in low-income and middle-income countries.

Zoonotic and vector-borne parasites are important preventable risk factors for epilepsy. Three parasitic infections - cerebral malaria, Taenia solium cysticercosis and onchocerciasis - have an established association with epilepsy. Parasitoses are widely prevalent in low-income and middle-income countries, which are home to 80% of the people with epilepsy in the world.

Risk of Clostridium difficile infection in intensive care unit patients with sepsis exposed to metronidazole.

Background: Antimicrobial agents used to treat Clostridium difficile infection (CDI), such as metronidazole and vancomycin, have been used during antibiotic treatment of other infections to try to prevent the development of CDI. We evaluated the hypothesis that intensive care unit (ICU) patients who receive metronidazole as part of an antibiotic treatment regimen for sepsis have a lower risk of subsequently developing CDI.

Methods: This was a nested case-control study in a cohort of ICU patients who received antibiotic therapy for sepsis.

Salmonella aortitis treated with endovascular aortic repair.

Salmonella aortitis is a known complication of Salmonella infection that usually requires surgical therapy. It is unknown whether endovascular aortic repair (EVAR) is an acceptable alternative to conventional aortic surgery for patients with Salmonella aortitis who are at high risk for perioperative complications. We therefore report 2 cases of Salmonella aortitis treated with EVAR and review the literature to further characterize previously published cases.

Resistant gram-negative infections.

This article reviews the global crisis of resistant gram-negative bacilli in the intensive care unit. The authors discuss drugs used for treating these infections and the different strategies used to maximize the effect of antimicrobials.

Complete nucleotide sequences of blaKPC-4- and blaKPC-5-harboring IncN and IncX plasmids from Klebsiella pneumoniae strains isolated in New Jersey.

Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae have emerged as major nosocomial pathogens. bla(KPC), commonly located on Tn4401, is found in Gram-negative bacterial strains, with the two most common variants, bla(KPC-2) and bla(KPC-3), identified in plasmids with diverse genetic backgrounds. In this study, we examined bla(KPC-4)- and bla(KPC-5)-bearing plasmids recovered from two K.

Multiplex real-time PCR for detection of an epidemic KPC-producing Klebsiella pneumoniae ST258 clone.

We describe a multiplex real-time PCR assay capable of identifying both the epidemic Klebsiella pneumoniae ST258 clone and bla(KPC) carbapenemase genes in a single reaction. The assay displayed excellent sensitivity (100%) and specificity (100%) for identification of ST258 clone and bla(KPC) in a collection of 75 K. pneumoniae isolates comprising 41 sequence types.

Antiepileptic drug selection for people with HIV/AIDS: evidence-based guidelines from the ILAE and AAN.

A joint panel of the American Academy of Neurology (AAN) and the International League Against Epilepsy (ILAE) convened to develop guidelines for selection of antiepileptic drugs (AEDs) among people with HIV/AIDS. The literature was systematically reviewed to assess the global burden of relevant comorbid entities, to determine the number of patients who potentially utilize AEDs and antiretroviral agents (ARVs), and to address AED-ARV interactions. Key findings from this literature search included the following: AED-ARV administration may be indicated in up to 55% of people taking ARVs.