[Comment] Dual antimicrobial therapy for gonorrhoea: what is the role of azithromycin?
Antimicrobial resistance in Neisseria gonorrhoeae compromises the treatment of gonorrhoea globally.1,2 After the reports of the first gonococcal strains with high-level resistance to ceftriaxone, the last remaining option for empirical gonorrhoea monotherapy, dual antimicrobial therapy (mainly ceftriaxone plus azithromycin) was implemented as the first-line treatment for uncomplicated gonorrhoea in many countries.2 –7 Azithromycin resistance is described in many countries, which might threaten this dual therapy in the longer term. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 6, 2018 Category: Infectious Diseases Authors: Magnus Unemo, Kimberly Workowski Tags: Comment Source Type: research
[Articles] A multimodal infection control and patient safety intervention to reduce surgical site infections in Africa: a multicentre, before –after, cohort study
Implementation of our intervention is feasible in African hospitals. Improvement was observed across all perioperative prevention practices. A significant effect on the overall SSI risk was observed, but with some heterogeneity between sites. Further large-scale experimental studies are needed to confirm these results and to improve the sustainability and long-term effect of such complex programmes. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 5, 2018 Category: Infectious Diseases Authors: Benedetta Allegranzi, Alexander M Aiken, Nejla Zeynep Kubilay, Peter Nthumba, Jack Barasa, Gabriel Okumu, Robert Mugarura, Alexander Elobu, Josephat Jombwe, Mayaba Maimbo, Joseph Musowoya, Ang èle Gayet-Ageron, Sean M Berenholtz Tags: Articles Source Type: research
[Comment] Cold steel might cure, but it takes a village to prevent surgical infections
Surgical infections are the most common cause of hospital-acquired infections in resource-poor settings;1 a prospective study in sub-Saharan Africa, published in 2018, reported an infection rate of one in ten surgical patients.2 Infections can double the length of hospital stay, and lead to financially devastating costs for patients, facilities, and health systems.3,4 Patients who develop infections also have a much higher risk of death than those who do not. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - March 5, 2018 Category: Infectious Diseases Authors: Kathryn Chu, Thomas G Weiser Tags: Comment Source Type: research
[Corrections] Corrections
T ängdén T, Pulcini C, Aagaard H, et al. Unavailability of old antibiotics threatens effective treatment for common bacterial infections. Lancet Infect Dis 2018; 18: 242–44—In the author byline of this Comment on page 243, the third coauthor's name was misspelt and should read “Helle Aagaard” . This correction has been made to the online version as of Feb 28, 2018. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - February 28, 2018 Category: Infectious Diseases Tags: Corrections Source Type: research
[Clinical Picture] Advanced Kaposi's sarcoma in a 2-year-old child
A 2-year-old boy with HIV infection receiving combination antiretroviral therapy (cART) for 2 months presented with a 3-month history of high-grade fever, diarrhoea, and progressive generalised lymphadenopathy (figure). Laboratory results showed severe pancytopenia (haemoglobin, 3 ·3 g/dL; neutrophil count, 0·48 cells per nL; platelets, 6 cells per nL), moderately decreased CD4 cell count (900 cells per μL [normal range>1000 cells per μL]), and low HIV-1 RNA plasma viral load (346 copies per mL). (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - February 22, 2018 Category: Infectious Diseases Authors: Cornelia Feiterna-Sperling, Ioannis Anagnostopoulos, J örg Hofmann, Renate Krüger Tags: Clinical Picture Source Type: research
[Media Watch] Looking at India's sanitation divide
Toilet: Ek Prem Katha (Toilet: A Love Story) is a movie vividly sketching the current sanitation situation in India, which is similar to many other southeast Asian countries. Nearly 600 million of India's population do not have access to a toilet. The prime ministerial initiative, the Clean India Mission by Narenda Modi, had a mixed response in many states where cultural dogma on sanitation prevails. Entangled with the culture and tradition, people prefer to defecate in the open. The religious impediment is even worse, and as a consequence eradication of open defecation is challenging. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - February 22, 2018 Category: Infectious Diseases Authors: Bipin Adhikari, Shiva Raj Mishra Tags: Media Watch Source Type: research
[Newsdesk] Research brief
Findings from a study done in three pairs of non-identical twins discordant for congenital Zika syndrome suggest that there might be a genetic basis for susceptibility to the disease. Researchers experimentally infected neural progenitor cells derived from these children and saw that cells from children with the syndrome multiplied less —and had more Zika virus in them—than cells from their unaffected sibling. There was no between-sibling difference in uninfected control cells. On sequencing, they detected no gene that solely determined susceptibility, but noted variance in RNA expression of genes associated with neura...
Source: The Lancet Infectious Diseases - February 22, 2018 Category: Infectious Diseases Authors: Dara Mohammadi Tags: Newsdesk Source Type: research
[Newsdesk] Infectious disease surveillance update
820 confirmed cases of listeriosis have been reported in South Africa since an outbreak was declared on Dec 5, 2017 —the largest outbreak of the disease. As of Jan 29, 82 deaths have been reported. Most of the reported cases were from Gauteng province (59%), which includes Pretoria and Johannesburg, Western Cape province (13%), and KwaZulu-Natal province (7%). Infants are the most affected group with 40% of cas es occurring in newborns; cases have been reported across all socioeconomic backgrounds. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - February 22, 2018 Category: Infectious Diseases Authors: Ruth Zwizwai Tags: Newsdesk Source Type: research
[Newsdesk] Typhoid conjugate vaccine gets WHO prequalification
On Jan 3, 2018, WHO announced the prequalification of a typhoid conjugate vaccine (TCV) manufactured by the Indian firm Bharat Biotech. The decision was expected after last year's endorsement by WHO's Strategic Advisory Group of Experts (SAGE) on immunisation, which recommended that the TCV be introduced for infants and children older than 6 months in typhoid-endemic countries. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - February 22, 2018 Category: Infectious Diseases Authors: Talha Burki Tags: Newsdesk Source Type: research
[Newsdesk] Increasing malaria in Venezuela threatens regional progress
Malaria in South America is declining. Documented cases fell by a third between 2010 and 2015, according to WHO, with mortality rates dropping by 37%. However, in Venezuela —where hyperinflation is 2616% and medicines are scarce—the situation is far bleaker. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - February 22, 2018 Category: Infectious Diseases Authors: Joe Parkin Daniels Tags: Newsdesk Source Type: research
[Correspondence] Use of prevalence data to study sepsis incidence and mortality in intensive care units – Authors' reply
Sam Doerken and colleagues point out relevant limitations to our observational study1 with the use of conversion formulas to estimate incidence from prevalence data. We agree and have actually pointed out this issue in our list of limitations in the discussion of study.1 However, no reliable estimates of sepsis incidence in intensive care units (ICUs) from cohort studies in Brazil currently exist. Therefore, the figures we provided, 290 (95% CI 237 ·9–351·2) cases of ICU-treated sepsis per 100 000 adult population with approximately 420 000 cases of sepsis per year in Brazil, are intended to be considered as rough ...
Source: The Lancet Infectious Diseases - February 22, 2018 Category: Infectious Diseases Authors: Alexandre Biasi Cavalcanti, Luciano Cesar Pontes Azevedo, Flavia R Machado Tags: Correspondence Source Type: research
[Correspondence] Use of prevalence data to study sepsis incidence and mortality in intensive care units
Flavia Machado and colleagues1 used a cross-sectional sampling design and a conversion formula to estimate the incidence of sepsis in Brazilian intensive care units (ICUs) and to examine factors associated with mortality. We would like to point out several important aspects regarding the conversion from prevalence to incidence and proportions, and how they can be addressed. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - February 22, 2018 Category: Infectious Diseases Authors: Sam Doerken, Micha Mandel, Walter Zingg, Martin Wolkewitz Tags: Correspondence Source Type: research
[Correspondence] Syndromic management of STIs and the threat of untreatable Mycoplasma genitalium
Takashi Deguchi1 describes issues in syndromic management of sexually transmitted infections (STIs) and in particular treatment of Mycoplasma genitalium, which shows increasing drug resistance, especially in the Asia-Pacific region, and which might become the first untreatable STI.2 Widespread syndromic use of azithromycin has increased macrolide resistance in several bacterial STIs, and the evidence that macrolide resistance is less likely to develop with an “extended” azithromycin regimen as suggested by Deguchi1 is not strong. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - February 22, 2018 Category: Infectious Diseases Authors: Catriona S Bradshaw, Patrick J Horner, J ørgen S Jensen, Peter J White Tags: Correspondence Source Type: research
[Correspondence] Emergence of recalcitrant dermatophytosis in India
Donald Cole and colleagues' Series1 on fungal infections was a knowledgeable read. In this context, as dermatologists, we want to highlight the emerging threat of extensive and difficult-to-treat dermatophytosis. Although dermatophytosis has always been among the commonest infections of the skin, the substantial change in the clinical profile of patients with an increase in the number of chronic, recurrent, or recalcitrant dermatophytosis in India is alarming, and the paucity of evidence is disheartening. (Source: The Lancet Infectious Diseases)
Source: The Lancet Infectious Diseases - February 22, 2018 Category: Infectious Diseases Authors: Anuradha Bishnoi, Keshavamurthy Vinay, Sunil Dogra Tags: Correspondence Source Type: research
[Correspondence] Xpert Ultra's place in the diagnosis of tuberculous meningitis – Authors' reply
In response to our study on the performance of GeneXpert MTB/RIF Ultra (Xpert Ultra) for diagnosis of tuberculous meningitis,1 Sarman Singh and Mani M Sankar reported their experience using low volumes of cerebrospinal fluid (CSF) for diagnosis of tuberculous meningitis.2 Additionally, Tom Boyles discusses his group's previous work on thresholds of disease likelihood above which treatment should be started for tuberculous meningitis and adapted it to Xpert Ultra using our data. Boyles reports that Xpert Ultra is likely to be more useful in ruling out tuberculous meningitis in a broader range of patients than was the origin...
Source: The Lancet Infectious Diseases - February 22, 2018 Category: Infectious Diseases Authors: Nathan C Bahr, David R Boulware, Fiona V Cresswell Tags: Correspondence Source Type: research
