Xenotransplant-associated infections

Xenotransplantation is considered increasingly as a solution to the current shortage of human organs for allotransplantation. In addition, it is being investigated as a treatment for a number of other diseases such as Parkinson's disease, diabetes mellitus, and acquired immunodeficiency disease. The potential risk of novel zoonotic infections is a concern associated with these procedures. Accordingly, the role of animal microbial agents must be critically examined. This review examines the concerns and proposed mechanisms for xenogeneic infections and details what is known and what still needs to be learned as the field of xenotransplantation progresses. Emphasis is placed on microbial agents of baboons and swine because they are currently the most common species considered as donor sources for xenotransplantation.     

Staphylococcal infections

All the forms of staphylococcal infections require cooperation among microbiologists, immunologists and clinicians. In case of any acute staphylococcus process, the curative tactics is based on an effective chemotherapy sometimes completed by a radical surgical intervention. In case of chronic forms, however, the antibiotics therapy is considered to be problematic. It is the specific immunotherapy by means of specific vaccine with polyvalent action, containing all pathogenetically significant antigens, that is considered by the authors to be a reliable base of the therapy of chronic staphylococcus infections. The specific polyvalent phage lysate is used for local application. It has to be pointed out that this therapy requires a complex curative regimen, i.e. regulation of the deficiency of serum immunoglobulines, administration of antibiotics, amelioration of the tissue trophism of the area concerned, suitable therapy by means of vitamines and diet. If necessary, surgical technique and tactics are an important part of the entire complex curative method.     

Intra-abdominal infections

Intra-abdominal infections in the hospitalized patient differ from those arising in the community in their clinical presentation, sites of involvement, and characteristic microbiology. They are also associated with greater morbidity and mortality. New onset organ dysfunction, more than acute abdominal pain and tenderness, is the predominant clinical manifestation. Successful management depends on aggressive resuscitation and hemodynamic support, administration of adequate antimicrobial therapy, and the timely use of source control measures appropriate to the clinical situation.     

Catheter-related infections

Nosocomial infections are a leading cause of morbidity and mortality among hospitalized patients. These infections have made newspaper headlines recently in many countries, and both patients and their relatives are now perfectly aware of their existence and of the risks which are inherent to any medical activity. However, significant improvements in the knowledge of the pathophysiology and epidemiology of nosocomial infections allow us to prevent them efficiently. Accordingly, they should no longer be considered as an inevitable tribute to pay to the continuous progress of medicine, but as a real challenge in the process of improving the quality of patient care. This is particularly the case for bloodstream infections, of which at least 80% are considered to be catheter associated. This paper reviews the epidemiology and impact of infections associated with the use of intravenous catheters. Principles of therapy are reviewed, as well as major aspects of prevention.     

Urinary tract infections

World Journal of Microbiology and Biotechnology -     

Life-threatening clostridial infections

Life-threatening soft tissue infections caused by Clostridium species have been described in the medical literature for hundreds of years largely because of their fulminant nature, distinctive clinical presentations and complex management issues. The Clostridium species perfringens, septicum and histolyticum are the principal causes of trauma-associated gas gangrene and their incidence increases dramatically in times of war, hurricanes, earthquakes and other mass casualty conditions. Recently, there has also been an increased incidence of spontaneous gas gangrene caused by Clostridium septicum in association with gastrointestinal abnormalities and neutropenia. Similarly, over the last 15 years there has been increased recognition of a toxic shock-like syndrome associated with Clostridium sordellii in individuals skin-popping black tar heroin, in women undergoing childbirth or other gynecologic procedures including medically-induced abortion. Like their cousins Clostridium tetanus and Clostridium botulinum, the pathogenesis of these clostridial infections is largely the consequence of potent exotoxin production. Strategies to inhibit toxin production, neutralize circulating toxins and prevent their interaction with cells of the innate immune response are sorely needed. Recent studies have elucidated novel targets that may hold promise for newer therapeutic modalities.     

Opportunistic zygomycotic infections

This is a literature review of 361 opportunistic fungal infections caused by the Zygomycetes. The clinical and laboratory diagnosis, pathogenesis, management, treatment, and outcome of infection are discussed. The Zygomycetes are a group of opportunistic fungi (orders Mucorales and Entomophthorales) which cause severe infections which may be fatal. Early clinical recognition, prompt diagnostic procedures, control of underlying disease and treatment with high doses of amphotericin B and aggressive surgery increases survival in an otherwise lethal infection.