摘要:

Pseudomonas aeruginosainfection continues to be a threat to cancer patients, especially if they are neutropenic. As many as 50% of infections are community acquired. Prompt, effective therapy results in cures in about 80% of patients, although the presence of shock or pneumonia indicates a poor prognosis. Antibiotic resistance is an increasing problem.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Patients with lymphoid malignancies such as chronic lymphocytic leukemia, particularly those who receive the newer purine analogs, are at increased risk for infectious morbidity and mortality. Defects in cell-mediated immunity appear to be a major predisposing factor in these patients. An expanding spectrum of pathogens associated with lymphocytopenia and depletion of CD4 has been described in the setting of therapy with purine analogs. During the past 2 years new knowledge about the immunosuppression related to that treatment has continued to accumulate.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Different approaches have developed over time regarding the empirical antimicrobial therapy of fever in neutropenic patients. The use of intravenous antibiotics remains the standard approach. Clinical criteria and ‘low-risk’ prediction rules have been developed that help select patients in whom oral therapy is well tolerated and who may be eligible for outpatient management. Comorbidity and clinical status at presentation remain important criteria in the risk-assessment process. Outpatient management requires additional assessment of non-medical criteria. Patients without documented infection and who have responded to initial therapy may benefit from simplified therapy such as a switch to oral drugs and/or outpatient management. Discontinuation of therapy may be considered in selected cases. Risk assessment in neutropenic patients with persistent unexplained fever is challenging. Available data suggest that broadening of the antibacterial coverage is of limited value. Instead, definition of the risk of fungal infection by using clinical criteria, imaging and laboratory studies, as well as the identification of those patients likely to benefit from antifungal therapy, appear to be of critical importance.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Infections remain a major complication of hematopoietic stem cell transplantation, with recent trends indicating that fungal pathogens have become one of the most common causes of death. Attention has turned to the use of prophylactic antifungal medications to prevent infection with bothCandidaandAspergillusspecies. Recent studies, which are reviewed within, indicate success in preventing infections caused by azole-susceptibleCandidaspecies, accompanied by improved transplant-related mortality rates in high-risk patients. Further studies are necessary to develop strategies to prevent infection withAspergillusspecies.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Bone marrow transplant recipients are at increased risk of a variety of infections from endogenous and exogenous sources. Various practices, including the use of prophylactic agents and a controlled environment are often employed in the name of infection control. Comparable data are lacking because of non-unified definitions of infection and endpoints. Antibiotic-resistant bacteria and fungi are being isolated more frequently as a result of selective pressure.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The spread of nosocomially acquired, antibiotic-resistant microorganisms has grown dramatically over the past 20 years and has increasingly attracted the attention of academic inquiry. This article reviews recent epidemiological data about the trends and patterns of nosocomial transmission, presents clinical studies investigating mechanisms of cross-transmission, and discusses recent literature on preventive strategies aimed at reducing hand-carriage of antibiotic-resistant pathogens.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Diagnostic tests are important tools for surveillance in healthcare epidemiology. Recent studies regarding the use of diagnostic tests for detecting the following epidemiologically important conditions or pathogens are reviewed: vancomycin-resistant enterococci,Legionella, influenza, ventilator-associated pneumonia,Clostridium difficile, bloodstream infection, and tuberculosis.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Important characteristics of hospital infection control are specific to pediatric facilities. For example, colonization and infection with vancomycin-resistant enterococci, which are widely spread in many units housing adult patients, are uncommon in children, especially in the neonatal intensive care unit where vancomycin use is heavy. Characteristics of the neonatal intensive care unit, such as the insulated environment and infrequent treatment with antibiotics with broad anaerobic activity, likely account for this finding. Artificial fingernails have been discovered to promote colonization with potential pathogens; their implication in recent nursery epidemics emphasizes the need to prohibit their use in this environment in particular. Finally, nosocomial viral infections occur with regularity in pediatric hospitals. Programs that successfully and cost-effectively control hospital spread of respiratory syncytial virus, however, demonstrate that rational, multifaceted interventions can nearly eliminate transmission of certain viral pathogens on the pediatric wards.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Long-term care facilities house individuals that have usually been transferred from acute-care institutions. For this reason, carriage of methicillin-resistantStaphylococcus aureus(MRSA), resistant Gram-negative bacilli and vancomycin-resistant enterococci (VRE) is relatively frequent. As these patients are readmitted to acute-care institutions, they reintroduce these organisms into those settings. It is notable that studies of these resistant organisms in long-term care facilities demonstrate little transfer between patients. Transmission of these bacteria and the development of infection in nursing homes are both uncommon events. Resources are best devoted to infection-control basics than to isolation of patients colonized or infected with these organisms.

ISSN:0951-7375    

出版商:OVID    

年代:2001

数据来源: OVID