Monthly Archives: December 2010

Non‐antimicrobial “Outside the Box” CDI Management

Non‐antimicrobial, or “outside the box,” approaches to CDI treatment and prevention can be divided into 3 groups: intraluminal toxin binders or neutralizers, biotherapeutics to restore the protective microbiota, and antibodies (active and passive) to improve CDI immunity (Table 1). The attraction of these approaches is that they all avoid the continued suppression of normal bacterial […]

Management of Clostridium difficile Infection. Part 2

Intravenous tigecycline has been reported as an effective treatment for severe CDI in one small series (4 patients) and one case report. Tigecycline was used as adjunctive treatment for these patients who had failed to respond to metronidazole and vancomycin, or, in one case, tigecycline was used as primary treatment. Fecal concentrations of tigecycline may […]

Management of Clostridium difficile Infection

Rifaximin has FDA approval for indications other than CDI but has also been used to treat CDI. Rifaximin was compared with vancomycin in a small study (20 patients) that showed comparable cure rates. Recently, rifaximin has been used as an adjunct agent to treat patients with multiple CDI recurrences. We used a 2‐week course of […]

Management of Clostridium difficile Infection

Antimicrobials have been the agents of choice for treatment of Clostridium difficile infection (CDI) for >30 years, primarily metronidazole and vancomycin. Antimicrobials have been highly successful and are likely to continue to play a major role in the treatment of patients who already have CDI. However, there remain several areas of CDI treatment that are […]

AIDS‐Associated Penicillium marneffei Infection of the Central Nervous System. Part 3

To our knowledge, P. marneffei has never been described as a CNS pathogen. P. marneffei was isolated from the meninges of 1 patient in a review of 155 published penicilliosis cases and from 3 of 20 CSF specimens in a case series of 80 patients with penicilliosis from Thailand. However, the clinical features of those […]

AIDS‐Associated Penicillium marneffei Infection of the Central Nervous System. Part 2

Outcomes. Three patients survived and had experienced improvement of symptoms at hospital discharge, 1 was transferred to another hospital for tuberculosis treatment after his condition deteriorated, 12 died within 24–72 h after hospital admission, and 5 were taken from the hospital to die at home, which is common practice in Vietnam. Patients taken home to […]

AIDS‐Associated Penicillium marneffei Infection of the Central Nervous System

Penicillium marneffei is emerging as an important opportunistic pathogen among human immunodeficiency virus (HIV)–infected and immunocompromised residents of (and travelers to) Southeast Asia, Northeastern India, and Southern China. No definitive mode of acquisition has been found, but inhalation has been implicated. The infection has been described in both immunocompromised (>80%) and immunocompetent individuals. Immunocompromised individuals […]


RT‐PCR.Total nucleic acid was extracted from specimens by using the NucliSens easyMAG extraction system (bioMérieux) according to the manufacturer’s instructions. Twelve microliters of extracted nucleic acid was used to prepare complementary DNA (cDNA) by using an Invitrogen Superscript III kit (Invitrogen) with random primer, as described elsewhere. For detection of influenza A virus, 2 μL […]

Protective Efficacy of Seasonal Influenza Vaccination. Part 5

Our results mirror those from an earlier trial conducted in the United Kingdom, which found that children who received influenza A vaccine had a lower risk of A/England infection in 1972 but later appeared to lack cross‐protection against A/Port Chalmers in 1974, compared with other children who had received influenza B vaccine. Similarly, in the […]

Protective Efficacy of Seasonal Influenza Vaccination. Part 4

We did not identify any statistically significant differences in attack rates of seasonal and pandemic influenza infection or clinical influenza among the household contacts of children who received TIV or placebo, although our study had limited power to detect such differences. Results were similar when stratified by winter and summer seasons. Of 91 children and […]