Clinical Microbiology Newsletter最新文献

Sepsis is a serious medical condition that continues to be a leading cause of hospital admission and mortality worldwide. Blood cultures play a crucial role in identifying the source of sepsis and thus directing appropriate treatment for improved patient outcomes. Blood culture data are not only utilized for patient treatment but also have utility for infection control and epidemiological purposes. An important challenge facing blood culture results and interpretation is contamination, which can have negative effects on patient care and health care costs, including in the clinical microbiology laboratory. This article reviews the process of blood culture collection, from the decision to collect blood cultures to processing, testing, and reporting. Strategies for blood culture optimization are discussed, along with data to support practices that can lead to improved patient care, diagnostic stewardship, and fiscal responsibility.

Identification and interpretation of microorganisms on histopathology is a skill set critical for both anatomic pathologists and clinical microbiologists. Microorganisms, and fungi in particular, develop structural properties differently within tissue than on an agar plate. For proper diagnoses the interpreter must be familiar with both phenotypes. Here, we review the specifics of fungal growth in tissue, including organism morphology, host reaction, and limitations for accurate histology identification.

The aims of this reviews are to provide a background on sepsis and to discuss the role of multidisciplinary sepsis teams for those who may not provide direct patient care but play an important role in supporting those that manage patients with sepsis. Sepsis, a life-threatening organ dysfunction due to a dysregulated host response to infection, is one of the leading causes of death worldwide. Considered a medical emergency, prompt laboratory results and administration of appropriate antibiotics are critical. Numerous sepsis guidelines have been published, including the use of standardized bundles that can result in reduced mortality and better patient outcomes. Key to successful outcomes are early recognition and appropriate therapy, which is guided by multidisciplinary sepsis intervention teams; rapid laboratory testing, including Gram stains; molecular mass spectrometry; and clinical and electronic early warning surveillance systems that offer a systematic machine learning application to analyze patients’ medical data and send an alert to providers in real time to allow earlier intervention.

Whipple’s disease was formally described more than 100 years ago; nonetheless, only recently have investigators identified, cultivated, and characterized the causative agent, Tropheryma whipplei, and deciphered some of its complex associations with human hosts. The acquisition of knowledge about T. whipplei, a Gram-positive bacterium in the class Actinobacteria, accelerated at an extraordinarily rapid pace during the first two decades of the 21st century, to include the recognition of asymptomatic carriage, localized disease, and acute infections caused by this peculiar bacterium. This review discusses current knowledge of the microbiology and epidemiology of T. whipplei, the expanding clinical spectrum of disease caused by the pathogen, its treatment, and historical and diagnostic assays that facilitate the diagnosis of the various diseases caused by this enigmatic bacterium.

The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Lice have been a burden on humans since antiquity. The species implicated in human infestations, the head louse (Pediculus humanus capitis), body louse (Pediculus humanus humanus), and pubic louse (Pthirus pubis), are very well adapted to the human host and are readily transmissible between and among individuals. In addition to dermal reactions and social stigmas associated with louse infestations, the body lice are of additional medical and public health concern in the spreading of bacterial agents associated with louse-borne relapsing fever, epidemic typhus, and trench fever. In the United States, pthiriasis, caused by P. pubis, is classified as a sexually transmitted infection. In this review, we provide an update on the taxonomy, epidemiology, biology, evolution, clinical importance, treatment and control, diagnosis, and reporting of parasitic human lice.

Parvovirus B19 is a small, non-enveloped, single-stranded DNA virus with global distribution. It is primarily known for being the causative agent of fifth disease, also known as erythema infectiosum, a common self-limiting childhood disease characterized by the development of a rash. During infection, it targets erythroid progenitor cells in bone marrow, where it replicates and ultimately induces cellular apoptosis. In the correct patient population, it may be responsible for the development of arthropathy, aplastic crisis, nonimmune hydrops fetalis, viral-associated hepatitis, and myocarditis. However, most infections are asymptomatic and remain undetected. Here, we review the nature of this virus to provide information about its biology; interactions with the human host; how those interactions shape the clinical presentation; and, finally, the available diagnostic approaches.