Antimicrobial salvage therapy for persistent staphylococcal bacteremia using daptomycin plus ceftaroline.

Purpose: Guidelines recommend daptomycin combination therapy as an option for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia after vancomycin failure. Recent data suggest that combining daptomycin with a β-lactam may have unique benefits; however, there are very limited clinical data regarding the use of ceftaroline with daptomycin.

Methods: All 26 cases from the 10 medical centers in which ceftaroline plus daptomycin was used for treatment of documented refractory staphylococcal bacteremia from March 2011 to November 2012 were included.

Cardiac complications of infective endocarditis.

Cardiac complications caused by infective endocarditis (IE) are varied and frequently life-threatening. This article focuses on new data related to several complications, and summarizes the indications, timing, and type of valve surgery recommended in the management of IE. Several recent studies using propensity score techniques have resulted in disparate conclusions and underscore the need for randomized prospective studies to better address whether and when surgery should be performed in patients with IE.

Ankle mobility in relation to chronic venous insufficiency in HIV-positive persons with and without a history of injection drug use.

The purpose of this study was to examine ankle mobility in relation to chronic venous insufficiency (CVI) in HIV-positive persons with and without a history of injection drug use (IDU) and to examine the extent to which peripheral neuropathy further reduced ankle mobility. A cross-sectional, stratified design with quota sampling was used to recruit 27 persons with no history of IDU and 46 with a history of IDU from an infectious diseases clinic. Goniometric measurements of forefoot inversion-eversion and dorsiflexion-plantar flexion were obtained.

The impact of chronic venous insufficiency and leg function on the quality of life of HIV-positive persons.

Chronic venous insufficiency and subsequent difficulties in leg function are causally linked to injection drug use and quality of life. Because injection drug use is a risk factor for human immunodeficiency virus infection, chronic venous insufficiency would be expected to occur with a higher prevalence in HIV-positive persons, yet the impact of chronic venous insufficiency on quality of life has not been investigated in this population. A cross-sectional design with quota sampling was used to enroll 73 HIV-positive participants-- 46 injection drug users and 27 non-injection drug users -- in this quality-of-life study.

Chronic venous insufficiency in HIV-positive persons with and without a history of injection drug use.

Objective: To examine chronic venous insufficiency in human immunodeficiency virus-positive persons with and without a history of injection drug use and to examine the extent to which neuropathy further increased the risk of chronic venous insufficiency.

Design: Cross-sectional stratified design with quota sampling.

Setting: Infectious diseases clinic in a large, urban midwestern city.

Microbiology of chronic leg and pressure ulcers: clinical significance and implications for treatment.

Chronic pressure ulcers and leg ulcers are common, especially in the elderly, and are a source of much distress and disability. Health care providers must distinguish between clinically unimportant but predictable colonization of these wounds and clinically relevant infection.Infection may present as increased local pain, cellulitis, local abscess,necrotizing fasciitis, osteomyelitis, bacteremia, or sepsis.

Clinical experience with Staphylococcus lugdunensis bacteremia: a retrospective analysis.

We report a retrospective review of all cases of Staphylococcus lugdunensis bacteremia identified during a period of more than 10 years (January 1990 to May 2002) in a large medical center. Twenty-one cases occurred over that period; 20 cases were available for review. In six instances, the organism appeared to be clinically significant and was most commonly related to a vascular line infection.

Emerging infectious diseases in Mongolia.

Since 1990, Mongolia's health system has been in transition. Impressive gains have been accomplished through a national immunization program, which was instituted in 1991. Nevertheless, the country continues to confront four major chronic infections: hepatitis B and C, brucellosis, tuberculosis, and sexually transmitted diseases (STDs).

Skin and soft tissue infections in injection drug users.

Skin and soft tissue infections are the most common cause for hospital admission of injection drug users. Cutaneous and subcutaneous abscesses are the most frequent type of SSTI and occur most commonly when drug users are no longer able to inject intravenously and resort to injection directly into skin or muscle. Abscesses may be difficult to differentiate from uncomplicated cellulitis or may be confused with pseudoaneurysms, hematoma, phlegmon, or thrombosed vein.

Skin and Soft Tissue Infections in Injection Drug Users.

Skin and soft tissue infections (SSTIs) are common among injection drug users (IDUs). Subcutaneous and intramuscular injection ("skin-popping") and the injection of "speedballs" (a mixture of heroin and cocaine) are important risk factors for SSTIs in this patient population. Female IDUs appear to be at greater risk of SSTIs than male IDUs, probably because of more difficult venous access.