Pneumococcal Vaccine: The Good, the Bad, and the Uncertain
Conjugated pneumococcal vaccine works, but pockets of disease remain.
By Peggy Sue Weintrub, MD
May 23, 2007
Covering:
Grijalva CG et al., Lancet 2007 Apr 7; 369:1179-86
Singleton RJ et al., JAMA 2007 Apr 25; 297:1784-92
A Noninvasive Method for Diagnosing Pneumocystis Pneumonia
Infectious Diseases Summary and Comment
A ß-D-glucan level >31 pg/mL was found to be a useful marker for the diagnosis of pneumocystis pneumonia.
By Thomas Glück, MD
May 23, 2007
Covering:
Tasaka S et al., Chest 2007 Apr; 131:1173-80
Pneumocystis jiroveci Pneumonia in Renal-Transplant Recipients
Infectious Diseases Summary and Comment
Twenty-two cases occurred in a single renal-transplant program during an 11-month period; the outbreak ended with the institution of antibiotic prophylaxis during month 10.
By Neil M. Ampel, MD
May 23, 2007
Covering:
de Boer MGJ et al., Clin Infect Dis 2007 May 1; 44:1143-9
Hughes WT., Clin Infect Dis 2007 May 1; 44:1150-1
Do PPIs Increase Risk for CAP?
Infectious Diseases Summary and Comment
In a large population-based case-control study, the use of proton-pump inhibitors was associated with increased risk for community-acquired pneumonia.
By Daniel J. Diekema, MD, MS
May 23, 2007
Covering:
Gulmez SE et al., Arch Intern Med 2007 May 14; 167:950-5
Population Effects of Infant Pneumococcal Vaccine
General Medicine Summary and Comment
Admission rates for all-cause infant pneumonia fell sharply after this vaccine was introduced.
By Bruce Soloway, MD
May 22, 2007
Covering:
Grijalva CG et al., Lancet 2007 Apr 7; 369:1179-86
Antibiotic Prescriptions for Viral URIs: We’re Making Progress!
Emergency Medicine Summary and Comment
Prescriptions decreased by 20% from 1993 through 2004.
By Diane M. Birnbaumer, MD, FACEP
May 18, 2007
Covering:
Vanderweil SG et al., Acad Emerg Med 2007 Apr; 14:366-9
Oral Decontamination and VAP
Infectious Diseases Summary and Comment
Oral decontamination with antiseptics decreased the risk for ventilator-associated pneumonia but did not reduce mortality rates or duration of ICU stay.
By Stephen G. Baum, MD
May 16, 2007
Covering:
Chan EY et al., BMJ 2007 Apr 28; 334:889
Brun-Buisson C., BMJ 2007 Apr 28; 334:861
Community-Acquired MRSA plus Influenza Can Cause Life-Threatening Pneumonia
Emergency Medicine Summary and Comment
This severe illness can be fatal within 4 days of respiratory symptom onset.
By Diane M. Birnbaumer, MD, FACEP
May 11, 2007
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Morb Mortal Wkly Rep 2007 Apr 13; 56:325-9
How Common Are Atypical Pathogens in Community-Acquired Pneumonia?
General Medicine Summary and Comment
Atypical pathogens were identified in about 20% to 30% of CAP cases worldwide.
By Allan S. Brett, MD
May 10, 2007
Covering:
Arnold FW et al., Am J Respir Crit Care Med 2007 May 15; 175:1086-93
Should Infants with Bronchiolitis Have Chest X-Rays?
Infectious Diseases Summary and Comment
Chest radiography increases antibiotic use for infants with bronchiolitis.
By Robert S. Baltimore, MD
May 2, 2007
Covering:
Schuh S et al., J Pediatr 2007 Apr; 150:429-33
Patterns of Airway Colonization in Ventilated Patients
Infectious Diseases Summary and Comment
Culture of upper-airway specimens may be useful in diagnosing suspected VAP because the responsible pathogens colonize the entire respiratory tract as a monoclonal population.
By Thomas Glück, MD
May 2, 2007
Covering:
Berdal JE et al., Clin Microbiol Infect 2007 May; 13:476-80
Antimicrobial Resistance in Pseudomonas
Infectious Diseases Summary and Comment
Sequential sampling reveals that resistance develops in <$EMPH_O>Pseudomonas<$EMPH_C> strains within 6 to 10 days after antibiotic exposure and sometimes persists for lengthy periods thereafter.
By Thomas Glück, MD
May 2, 2007
Covering:
Reinhardt A et al., Antimicrob Agents Chemother 2007 Apr; 51:1341-50
Neuraminidase Inhibitor Resistance in Influenza B
Infectious Diseases Summary and Comment
Infection with neuraminidase-resistant influenza B virus — and possibly transmission of resistant virus — has been recognized in Japan.
By Richard T. Ellison III, MD
April 25, 2007
Covering:
Hatakeyama S et al., JAMA 2007 Apr 4; 297:1435-42
Baculovirus-Derived Influenza Vaccine Is Safe and Immunogenic
Infectious Diseases Summary and Comment
A trivalent influenza vaccine containing baculovirus-expressed hemagglutinin proteins appears safe and immunogenic in healthy adult volunteers.
By Richard T. Ellison III, MD
April 25, 2007
Covering:
Treanor JJ et al., JAMA 2007 Apr 11; 297:1577-82
Community-Acquired Pneumonia
Infectious Diseases Clinical Practice Guideline Watch
This guideline unifies the approach to CAP management and emphasizes implementation strategies rather than changes in antimicrobial regimens.
By Stephen G. Baum, MD
April 25, 2007
Covering:
Mandell LA et al., Clin Infect Dis 2007 Mar 1; 44:S27-72
Steroid Therapy for ARDS, Revisited
General Medicine Summary and Comment
Free
A moderate dose, started early and tapered over several weeks, provided benefit.
By Allan S. Brett, MD
April 24, 2007
Covering:
Meduri GU et al., Chest 2007 Apr; 131:954-63
Annane D., Chest 2007 Apr; 131:945-6
Does Nitric Oxide Help in Acute Lung Injury?
General Medicine Summary and Comment
Once again, nitric oxide’s theoretical benefits did not translate into real ones.
By Keith I. Marton, MD
April 24, 2007
Covering:
Adhikari NKJ et al., BMJ 2007 Apr 14; 334:779
Ferguson ND., BMJ 2007 Apr 14; 334:757-8
Chest X-Rays Not Necessary in Bronchiolitis
General Medicine Summary and Comment
. . .especially for children who do not have respiratory distress or marked hypoxia.
By Robert A. Dershewitz, MD, MSc
April 24, 2007
Covering:
Schuh S et al., J Pediatr 2007 Apr; 150:429-33
Another Cause for Wheezing?
Infectious Diseases Summary and Comment
Human bocavirus was detected in 19% of wheezing children but was found alone in only 5%.
By Neil M. Ampel, MD
April 18, 2007
Covering:
Allander T et al., Clin Infect Dis 2007 Apr 1; 44:904-10
Chronic Cough? Consider Pertussis
Infectious Diseases Summary and Comment
At a Tennessee university, 27% of undergraduates with chronic cough had serologic evidence of recent pertussis.
By Neil M. Ampel, MD
April 18, 2007
Covering:
Craig AS et al., Am J Med 2007 Apr; 120:364-8
Vitamins and CAP Risk
Infectious Diseases Summary and Comment
In healthy young and middle-aged women, higher supplemental and dietary vitamin intake was not associated with lower risk for community-acquired pneumonia.
By Neil M. Ampel, MD
April 18, 2007
Covering:
Neuman MI et al., Am J Med 2007 Apr; 120:330-6
Avian Influenza Viruses in Migratory Waterfowl
Infectious Diseases Summary and Comment
Avian influenza viruses are widely distributed in birds; wild birds can be a sentinel population.
By Mary E. Wilson, MD
April 18, 2007
Covering:
Wallensten A et al., Emerg Infect Dis 2007 Mar; 13:404-11
Gaidet N et al., Emerg Infect Dis 2007 Apr; 13:626-9
Partial Resistance of Influenza B to Neuraminidase Inhibitors
General Medicine Summary and Comment
Free
Emergence of resistant strains and their transmissibility are both worrisome.
By Thomas L. Schwenk, MD
April 3, 2007
Covering:
Hatakeyama S et al., JAMA 2007 Apr 4; 297:1435-42
Moscona A and McKimm-Breschkin J., JAMA 2007 Apr 4; 297:1492-3
The 4-Hour Rule for Administering Antibiotics for CAP: Is It Possible?
Emergency Medicine Summary and Comment
Free
Meeting the 90% threshold for the 4-hour antibiotic standard may not be feasible.
By Richard D. Zane, MD, FAAEM
March 23, 2007
Covering:
Fee C and Weber EJ., Ann Emerg Med 2007 Jan 6
Bugs on a Plane
General Medicine Summary and Comment
Influenza and parainfluenza viruses were the most common respiratory pathogens in sick passengers.
By Abigail Zuger, MD
March 22, 2007
Covering:
Luna LK et al., J Infect Dis 2007 Mar 1; 195:675-9
Pavia AT., J Infect Dis 2007 Mar 1; 195:621-2
