https://www.medpagetoday.com/upload/2011/4/4/Clin%20Infect%20Dis.-2002-O'Grady-1281-307.pdf

Guidelines for the Prevention of Intravascular Catheter-related Infections

Naomi P. O'Grady, M.D., Mary Alexander, R.N. Lillian A. Burns, M.T., M.P.H., C.I.C. E. Patchen Dellinger, M.D. Jeffery Garland, M.D., S.M. Stephen O. Heard, M.D. Pamela A. Lipsett, M.D. Henry Masur, M.D. Leonard A. Mermel, D.O., Sc.M. Michele L. Pearson, M.D. Issam I. Raad, M.D. Adrienne Randolph, M.D., M.Sc. Mark E. Rupp, M.D. Sanjay Saint, M.D., M.P.H. and the Healthcare Infection Control Practices Advisory Committee (HICPAC).

/pdf/guidelines-for-the-prevention-of-intravascular-catheter-4xarsoczlz.pdf

Guidelines for the prevention of intravascular catheter-related infections, 2011

We investigated SARS-CoV-2 potential tropism by surveying expression of viral entry-associated genes in single-cell RNA-sequencing data from multiple tissues from healthy human donors. We co-detected these transcripts in specific respiratory, corneal and intestinal epithelial cells, potentially explaining the high efficiency of SARS-CoV-2 transmission. These genes are co-expressed in nasal epithelial cells with genes involved in innate immunity, highlighting the cells' potential role in initial viral infection, spread and clearance. The study offers a useful resource for further lines of inquiry with valuable clinical samples from COVID-19 patients and we provide our data in a comprehensive, open and user-friendly fashion at www.covid19cellatlas.org.

/pdf/sars-cov-2-entry-factors-are-highly-expressed-in-nasal-2fjvaeexk1.pdf

SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes.

EXECUTIVE SUMMARYSoft-tissue infections are common, generally of mild tomodest severity, and are easily treated with a variety ofagents. An etiologic diagnosis of simple cellulitis is fre-quently difﬁcult and generally unnecessary for patientswith mild signs and symptoms of illness. Clinical as-sessment of the severity of infection is crucial, and sev-eral classiﬁcation schemes and algorithms have beenproposed to guide the clinician [1]. However, mostclinical assessments have been developed from eitherretrospective studies or from an author’s own “clinicalexperience,” illustrating the need for prospectivestudieswith deﬁned measurements of severity coupled to man-agement issues and outcomes.Until then, it is the recommendation of this com-mittee that patients with soft-tissue infection accom-panied by signs and symptoms of systemic toxicity (e.g.,fever or hypothermia, tachycardia [heart rate,

/pdf/practice-guidelines-for-the-diagnosis-and-management-of-skin-4b42oom5lk.pdf

Practice Guidelines for the Diagnosis and Management of Skin and Soft-Tissue Infections

A panel of national experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2005 guidelines for the treatment of skin and soft tissue infections (SSTIs). The panel's recommendations were developed to be concordant with the recently published IDSA guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections. The focus of this guideline is the diagnosis and appropriate treatment of diverse SSTIs ranging from minor superficial infections to life-threatening infections such as necrotizing fasciitis. In addition, because of an increasing number of immunocompromised hosts worldwide, the guideline addresses the wide array of SSTIs that occur in this population. These guidelines emphasize the importance of clinical skills in promptly diagnosing SSTIs, identifying the pathogen, and administering effective treatments in a timely fashion.

/pdf/practice-guidelines-for-the-diagnosis-and-management-of-skin-3yst6uf27k.pdf

Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America

Pneumocystis carinii pneumonia has emerged as a significant cause of morbidity and mortality in immunocompromised patients with and without AIDS To determine differences in P carinii pneumonia in patients with and without AIDS, the P carinii parasite numbers, lung inflammatory cell populations, gas exchange, and survival were assessed in a series of 75 consecutive patients with P carinii pneumonia Bronchoalveolar lavage was used to quantify the parasite and inflammatory cell numbers in these patients The data from this study indicate: (1) patients with P carinii pneumonia and AIDS have significantly greater numbers of P carinii per ml of lavage compared to other immunocompromised patients with P carinii pneumonia (p < 00001); (2) patients with P carinii pneumonia and AIDS also have significantly fewer neutrophils recovered in the lavage compared to other immunocompromised patients with P carinii pneumonia (p = 00001); (3) patients with AIDS and P carinii pneumonia have higher arterial oxygen

Pneumocystis carinii Pneumonia: Differences in Lung Parasite Number and Inflammation in Patients with and without AIDS

Amiodarone Pulmonary Toxicity: Recognition and Pathogenesis (Part I)

The minimal inhibitory concentrations of 601 clinical isolates of anaerobic bacteria to 10 different antimicrobial agents were determined by an agar-dilution technique. Nearly all strains were resistant to kanamycin and gentamicin, although moderate activity to both drugs was noted with Fusobacterium sp., anaerobic cocci, some strains of Bacteroides melaninogenicus , and nonsporeforming gram-positive bacilli. Chloramphenicol at 12.5 μg/ml inhibited all but three of the strains tested. Tetracycline at 6.25 μg/ml had high activity against all groups tested, with the exception that only 39% of strains of Bacteroides fragilis were inhibited at this concentration. Excluding certain species of Bacteroides , the majority of anaerobes were inhibited by penicillin at 3.1 μg/ml or less and by cephalothin at 12.5 μg/ml or less. Lincomycin at 6.2 μg/ml or less was active against nearly all strains. Erythromycin at a concentration of 3.1 μg/ml was active against B. fragilis ; however, erythromycin was less active against the other groups. Most of the minimal inhibitory concentrations of lincomycin exceeded those of clindamycin by fourfold. Rifampin inhibited virtually all strains at 3.1 μg/ml.

In Vitro Antimicrobial Susceptibility of Anaerobic Bacteria Isolated from Clinical Specimens

• From January 1977 to June 1980, coagulase-negative staphylococci caused bacteremia in 22 (17%) of 130 patients receiving immunosuppressive therapy and were the most common cause of all bacteremias. Sixteen (73%) of the 22 patients had granulocytopenia, and eight were isolated in a laminar air-flow room. A Broviac or Hickman central intravenous (IV) catheter was present in 20 (91%) of 22 patients, and soft-tissue inflammation at the catheter exit site was a significant risk factor for bacteremia. Except for debilitating fevers and local mucocutaneous infections, there were no distinguishing clinical features in patients with bacteremia. Most infections responded to cefazolin sodium or vancomycin hydrochloride therapy; catheter removal was necessary in only seven patients. These data show that coagulase-negative staphylococci can be important pathogens in patients receiving immunosuppressive therapy, even when the patients are isolated in a laminar air-flow room, if normal mucocutaneous, host-defense barriers are interrupted by IV catheter-insertion or chemotherapy. ( Arch Intern Med 1983;143:32-36)

Coagulase-negative staphylococcal bacteremia in patients receiving immunosuppressive therapy.

Patients randomized to receive or not to receive prophylactic leukocyte transfusions were evaluated prospectively for serologic, histologic, and cultural evidence of cytomegalovirus infection. Recipients of prophylactic leukocyte transfusions and control subjects were similar with regard to age, sex, underlying disease, immunosuppressive therapy, and number of other transfusions. The recipients of prophylactic leukocyte transfusions (mean, 23.1) had significantly more cytomegalovirus infections (19 of 31 versus seven of 27, p = 0.01) than did control patients receiving no leukocytes or only therapeutic leukocyte transfusions (mean, 3.8). Twenty-seven of 66 donors of leukocytes were seropositive for cytomegalovirus complement-fixation antibody, but cytomegalovirus was not isolated from any of 62 leukocyte transfusions cultured for virus. These results are consistent with the hypothesis that latent cytomegalovirus may be present in leukocytes of blood donors with previous cytomegalovirus infection and after transfusion may be activated to produce active cytomegalovirus infection.

William J. Martin

Papers

Pneumocystis carinii Pneumonia: Differences in Lung Parasite Number and Inflammation in Patients with and without AIDS

Amiodarone Pulmonary Toxicity: Recognition and Pathogenesis (Part I)

In Vitro Antimicrobial Susceptibility of Anaerobic Bacteria Isolated from Clinical Specimens

Coagulase-negative staphylococcal bacteremia in patients receiving immunosuppressive therapy.

Cytomegalovirus Infections Associated with Leukocyte Transfusions