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Diarrhoeagenic microbes by real‐time PCR in Rwandan children under 5 years of age with acute gastroenteritis
Abstract Acute gastroenteritis is a main cause of disease and death among children in low‐income countries. The causality rates and pathogenic characteristics of putative aetiological agents remain insufficiently known. We used real‐time PCR targeting 16 diarrhoeagenic agents to analyse stool samples from children ≤5.0 years old with acute diarrhoea in Rwanda. Among the 880 children (median age 14.2 months; 41% female) at least one pathogen was detected in 92% and two or more agents in 63% of cases. Rotavirus was detected in 36.9%, adenovirus in 39.7%, enterotoxigenic Escherichia coli (ETEC) with genes for labile (...
Source: Clinical Microbiology and Infection - August 11, 2014 Category: Microbiology Authors: J.‐C. Kabayiza, M. E. Andersson, S. Nilsson, C. Baribwira, G. Muhirwa, T. Bergström, M. Lindh Tags: Original Article Source Type: research

Escherichia coli bacteraemia in pregnant women is life‐threatening for foetuses
Abstract In order to improve knowledge on Escherichia coli bacteraemia during pregnancy, we studied clinical data and performed molecular characterization of strains for 29 E. coli bacteraemia occurring in pregnant women. Bacteraemia mostly occurred in the third trimester of pregnancy (45%) and was community‐acquired (79%). Portals of entry were urinary (55%) and genital (45%). E. coli strains belonged mainly to phylogroups B2 (72%) and D (17%). Four clonal lineages (i.e. sequence type complex (STc) 73, STc95, STc12 and STc69) represented 65% of the strains. The strains exhibited a high number of virulence factor codin...
Source: Clinical Microbiology and Infection - August 11, 2014 Category: Microbiology Authors: L. Surgers, A. Bleibtreu, C. Burdet, O. Clermont, C. Laouénan, A. Lefort, F. Mentré, B. Carbonne, E. Bingen, J.‐L. Meynard, E. Denamur, Tags: Original Article Source Type: research

Combating the spread of carbapenemases in Enterobacteriaceae: a battle that infection prevention should not lose
Abstract The emergence of carbapenemases in Enterobacteriaceae has raised global concern among the scientific, medical and public health communities. Both the CDC and the WHO consider carbapenem‐resistant Enterobacteriaceae (CRE) to constitute a significant threat that necessitates immediate action. In this article, we review the challenges faced by laboratory workers, infection prevention specialists and clinicians who are confronted with this emerging infection control issue. (Source: Clinical Microbiology and Infection)
Source: Clinical Microbiology and Infection - August 11, 2014 Category: Microbiology Authors: P. Savard, T. M. Perl Tags: Review Source Type: research

The impact of infectious disease specialists on antibiotic prescribing in hospitals
We present a narrative review of the impact of infectious disease specialists (IDSs) on the quality and quantity of antibiotic use in acute‐care hospitals, and discuss the main factors that could limit the efficacy of IDS recommendations. A total of 31 studies were included in this review, with a wide range of infections, hospital settings, and types of antibiotic prescription. Seven of 31 studies were randomized controlled trials, before/after controlled studies, or before/after uncontrolled studies with interrupted time‐series analysis. In almost all studies, IDS intervention was associated with a significant improve...
Source: Clinical Microbiology and Infection - August 11, 2014 Category: Microbiology Authors: C. Pulcini, E. Botelho‐Nevers, O. J. Dyar, S. Harbarth Tags: Review Source Type: research

Diarrhoea in general practice: when should a Clostridium difficile infection be considered? Results of a nested case‐control study
In conclusion, C. difficile is relatively frequent in general practice. Currently, testing for C. difficile is rare and only 40% of CDI in general practice is detected. Following recommendations that are based on traditional risk factors for CDI, would improve detection of CDI. (Source: Clinical Microbiology and Infection)
Source: Clinical Microbiology and Infection - August 11, 2014 Category: Microbiology Authors: M. P. M. Hensgens, O. M. Dekkers, A. Demeulemeester, A. G. M. Buiting, P. Bloembergen, B. H. B. Benthem, S. Le Cessie, E. J. Kuijper Tags: Original Article Source Type: research

Changes in the treatment of Enterococcus faecalis infective endocarditis in Spain in the last 15 years: from ampicillin plus gentamicin to ampicillin plus ceftriaxone
Abstract The aim of this study was to assess changes in antibiotic resistance, epidemiology and outcome among patients with Enterococcus faecalis infective endocarditis (EFIE) and to compare the efficacy and safety of the combination of ampicillin and gentamicin (A+G) with that of ampicillin plus ceftriaxone (A+C). The study was a retrospective analysis of a prospective cohort of EFIE patients treated in our centre from 1997 to 2011. Thirty patients were initially treated with A+G (ampicillin 2 g/4 h and gentamicin 3 mg/kg/day) and 39 with A+C (ampicillin 2 g/4 h and ceftriaxone 2 g/12 h) for 4–6 weeks. Increased...
Source: Clinical Microbiology and Infection - August 11, 2014 Category: Microbiology Authors: J. M. Pericas, C. Cervera, A. Rio, A. Moreno, C. Garcia de la Maria, M. Almela, C. Falces, S. Ninot, X. Castañeda, Y. Armero, D. Soy, J. M. Gatell, F. Marco, C. A. Mestres, J. M. Miro, Tags: Original Article Source Type: research

Enterovirus infections in England and Wales, 2000–2011: the impact of increased molecular diagnostics
Abstract There have recently been significant changes in diagnostic practices for detecting enterovirus (EV) infections across England and Wales. Reports of laboratory‐confirmed EV infections submitted by National Health Service (NHS) hospital laboratories to Public Health England (PHE) over a 12‐year period (2000–2011) were analysed. Additionally, the PHE Virus Reference Department (VRD) electronic database containing molecular typing data from 2004 onwards was interrogated. Of the 13 901 reports, there was a decline from a peak of 2254 in 2001 to 589 in 2006, and then an increase year‐on‐year to 1634 in 2011. ...
Source: Clinical Microbiology and Infection - August 11, 2014 Category: Microbiology Authors: S. Kadambari, A. Bukasa, I. O. Okike, R. Pebody, D. Brown, C. Gallimore, J. Xerry, M. Sharland, S. N. Ladhani Tags: Original Article Source Type: research

Validity of self ‐reported vaccination status among French healthcare students
This study, performed on healthcare students in Paris (France), aimed to evaluate this validity for occupational vaccinations. The validity of self‐reported vaccination status was compared with written information. A total of 432 students were enrolled. Sensitivity rates for BCG, hepatitis B and measles were over 74%. For diphtheria‐tetanus‐polio and pertussis, sensitivity was below 50%. Specificity was between 70 and 95% for dTP‐pertussis, and below 35% for all others. Overall, the validity of self‐reported information was low, meaning that checking medical records remains the preferable strategy for assessing i...
Source: Clinical Microbiology and Infection - August 10, 2014 Category: Microbiology Authors: P. Loulergue, C. Pulcini, S. Massin, M. Bernhard, L. Fonteneau, D. Levy ‐Brühl, J.‐P. Guthmann, O. Launay Tags: Research Note Source Type: research

Diarrhoeagenic microbes by real ‐time PCR in Rwandan children under 5 years of age with acute gastroenteritis
Abstract Acute gastroenteritis is a main cause of disease and death among children in low‐income countries. The causality rates and pathogenic characteristics of putative aetiological agents remain insufficiently known. We used real‐time PCR targeting 16 diarrhoeagenic agents to analyse stool samples from children ≤5.0 years old with acute diarrhoea in Rwanda. Among the 880 children (median age 14.2 months; 41% female) at least one pathogen was detected in 92% and two or more agents in 63% of cases. Rotavirus was detected in 36.9%, adenovirus in 39.7%, enterotoxigenic Escherichia coli (ETEC) with genes for labile (...
Source: Clinical Microbiology and Infection - August 10, 2014 Category: Microbiology Authors: J. ‐C. Kabayiza, M. E. Andersson, S. Nilsson, C. Baribwira, G. Muhirwa, T. Bergström, M. Lindh Tags: Original Article Source Type: research

Risk factors for carbapenem ‐resistant Klebsiella pneumoniae bloodstream infection among rectal carriers: a prospective observational multicentre study
Abstract Knowledge of carbapenem‐resistant Klebsiella pneumoniae (CR‐KP) colonization is important to prevent nosocomial spread but also to start prompt adequate antibiotic therapy in patients with suspicion of infection. However, few studies have examined the incidence and risk factors for CR‐KP bloodstream infection (BSI) among rectal carriers. To identify risk factors for CR‐KP BSI among carriers, we performed a multicentre prospective matched case–control study of all adult CR‐KP rectal carriers hospitalized in five tertiary teaching hospitals in Italy over a 2‐year period. Carriers who developed CR‐KP ...
Source: Clinical Microbiology and Infection - August 10, 2014 Category: Microbiology Authors: M. Giannella, E. M. Trecarichi, F. G. De Rosa, V. Del Bono, M. Bassetti, R. E. Lewis, A. R. Losito, S. Corcione, C. Saffioti, M. Bartoletti, G. Maiuro, C. S. Cardellino, S. Tedeschi, R. Cauda, C. Viscoli, P. Viale, M. Tumbarello Tags: Original Article Source Type: research

Changes in the treatment of Enterococcus faecalis infective endocarditis in Spain in the last 15  years: from ampicillin plus gentamicin to ampicillin plus ceftriaxone
Abstract The aim of this study was to assess changes in antibiotic resistance, epidemiology and outcome among patients with Enterococcus faecalis infective endocarditis (EFIE) and to compare the efficacy and safety of the combination of ampicillin and gentamicin (A+G) with that of ampicillin plus ceftriaxone (A+C). The study was a retrospective analysis of a prospective cohort of EFIE patients treated in our centre from 1997 to 2011. Thirty patients were initially treated with A+G (ampicillin 2 g/4 h and gentamicin 3 mg/kg/day) and 39 with A+C (ampicillin 2 g/4 h and ceftriaxone 2 g/12 h) for 4–6 weeks. Increased...
Source: Clinical Microbiology and Infection - August 10, 2014 Category: Microbiology Authors: J. M. Pericas, C. Cervera, A. Rio, A. Moreno, C. Garcia de la Maria, M. Almela, C. Falces, S. Ninot, X. Casta ñeda, Y. Armero, D. Soy, J. M. Gatell, F. Marco, C. A. Mestres, J. M. Miro, Tags: Original Article Source Type: research

Escherichia coli bacteraemia in pregnant women is life ‐threatening for foetuses
Abstract In order to improve knowledge on Escherichia coli bacteraemia during pregnancy, we studied clinical data and performed molecular characterization of strains for 29 E. coli bacteraemia occurring in pregnant women. Bacteraemia mostly occurred in the third trimester of pregnancy (45%) and was community‐acquired (79%). Portals of entry were urinary (55%) and genital (45%). E. coli strains belonged mainly to phylogroups B2 (72%) and D (17%). Four clonal lineages (i.e. sequence type complex (STc) 73, STc95, STc12 and STc69) represented 65% of the strains. The strains exhibited a high number of virulence factor codin...
Source: Clinical Microbiology and Infection - August 10, 2014 Category: Microbiology Authors: L. Surgers, A. Bleibtreu, C. Burdet, O. Clermont, C. Laou énan, A. Lefort, F. Mentré, B. Carbonne, E. Bingen, J.‐L. Meynard, E. Denamur, Tags: Original Article Source Type: research

A case ‐control study to identify predictors of 14‐day mortality following carbapenem‐resistant Acinetobacter baumannii bacteraemia
Abstract Carbapenem‐resistant Acinetobacter baumannii (CRAB) is an increasingly common nosocomial pathogen. We sought to identify clinical and microbiological predictors of 14‐day mortality among patients with CRAB bacteraemia. This case‐control study included all adult patients in one Israeli hospital with CRAB on blood culture between July 2008 and June 2011. Cases were defined as patients who died within 14 days of bacteraemia onset and controls as patients who survived over 14 days. Sequence‐typing of the blaOXA‐51‐like gene and REP‐PCR identified CRAB clone groups. Logistic regression was performed to ...
Source: Clinical Microbiology and Infection - August 10, 2014 Category: Microbiology Authors: A. Nutman, R. Glick, E. Temkin, M. Hoshen, R. Edgar, T. Braun, Y. Carmeli Tags: Original Article Source Type: research

Enterovirus infections in England and Wales, 2000 –2011: the impact of increased molecular diagnostics
Abstract There have recently been significant changes in diagnostic practices for detecting enterovirus (EV) infections across England and Wales. Reports of laboratory‐confirmed EV infections submitted by National Health Service (NHS) hospital laboratories to Public Health England (PHE) over a 12‐year period (2000–2011) were analysed. Additionally, the PHE Virus Reference Department (VRD) electronic database containing molecular typing data from 2004 onwards was interrogated. Of the 13 901 reports, there was a decline from a peak of 2254 in 2001 to 589 in 2006, and then an increase year‐on‐year to 1634 in 2011. ...
Source: Clinical Microbiology and Infection - August 10, 2014 Category: Microbiology Authors: S. Kadambari, A. Bukasa, I. O. Okike, R. Pebody, D. Brown, C. Gallimore, J. Xerry, M. Sharland, S. N. Ladhani Tags: Original Article Source Type: research

Rapid spread of emerging Zika virus in the Pacific area
(Source: Clinical Microbiology and Infection)
Source: Clinical Microbiology and Infection - August 4, 2014 Category: Microbiology Authors: D. Musso, E. J. Nilles, V.‐M. Cao‐Lormeau Tags: Infection Hot Topic Source Type: research