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PubMed1999

Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Infectious Diseases Society of America (IDSA).

This is part of the series of practice guidelines commissioned by the Infectious Diseases Society of America (IDSA) through its Practice Guidelines Committee. The purpose of this guideline is to provide assistance to clinicians in the diagnosis and treatment of two specific types of urinary tract infections (UTIs): uncomplicated, acute, symptomatic bacterial cystitis and acute pyelonephritis in women. The guideline does not contain recommendations for asymptomatic bacteriuria, complicated UTIs, Foley catheter-associated infections, UTIs in men or children, or prostatitis. The targeted providers are internists and family practitioners. The targeted groups are immunocompetent women. Criteria are specified for determining whether the inpatient or outpatient setting is appropriate for treatment. Differences from other guidelines written on this topic include use of laboratory criteria for diagnosis and approach to antimicrobial therapy. Panel members represented experts in adult infectious diseases and urology. The guidelines are evidence-based. A standard ranking system is used for the strength of the recommendation and the quality of the evidence cited in the literature reviewed. The document has been subjected to external review by peer reviewers as well as by the Practice Guidelines Committee and was approved by the IDSA Council, the sponsor and supporter of the guideline. The American Urologic Association and the European Society of Clinical Microbiology and Infectious Diseases have endorsed it. An executive summary and tables highlight the major recommendations. Performance measures are described to aid in monitoring compliance with the guideline. The guideline will be listed on the IDSA home page at http://www.idsociety.org It will be evaluated for updating in 2 years.

Acute Disease↗

PubMed2004

[Evaluation of the nursing specialization course in infectious diseases at the FIOCRUZ (1997-1999)].

This study describes the experience of implanting and developing the specialization course in Infectious Disease Nursing, as well as its implementation within the Evandro Chagas, clinical research center at the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil, from 1997 to 1999. From the historical perspective of the hospital and infectious diseases, this research aims to demonstrate the experience accumulated in the human resource formation process. It justifies a specialization course in infectious diseases to the extent that, in underdeveloped and developing countries, the profile of morbidity/mortality causes is still important. It sets forth the process of adjusting the course, evaluated by the coordinators, teaching staff and students, throughout its development, and deals with the significance of such training in the private and professional lives of its graduates, most of whom entered the labor market and are engaged in educational activities, with an expressive promotion of new practices in health services.

Brazil↗

PubMed1999

A Kermack-McKendrick model applied to an infectious disease in a natural population.

The dynamics of a fatal infectious disease in a population regulated by density-dependent constraints are represented as a system of nonlinear integral equations. Survival probabilities and disease transmission coefficients may vary with the time elapsed since infection, and horizontal and vertical modes of transmission are allowed for. Criteria for the existence and stability of steady states are derived, and an example based on the dynamics of tuberculosis is presented. Finally, the relative merits of this approach, and the familiar compartmental models based on differential equations are discussed.

Communicable Diseases↗

PubMed2002

Structure and performance of infectious disease surveillance and response, United Republic of Tanzania, 1998.

OBJECTIVE: To assess the structure and performance of and support for five infectious disease surveillance systems in the United Republic of Tanzania: Health Management Information System (HMIS); Infectious Disease Week Ending; Tuberculosis/Leprosy; Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome; and Acute Flaccid Paralysis/Poliomyelitis. METHODS: The systems were assessed by analysing the core activities of surveillance and response and support functions (provision of training, supervision, and resources). Data were collected using questionnaires that involved both interviews and observations at regional, district, and health facility levels in three of the 20 regions in the United Republic of Tanzania. FINDINGS: An HMIS was found at 26 of 32 health facilities (81%) surveyed and at all 14 regional and district medical offices. The four other surveillance systems were found at <20% of health facilities and <75% of medical offices. Standardized case definitions were used for only 3 of 21 infectious diseases. Nineteen (73%) health facilities with HMIS had adequate supplies of forms; 9 (35%) reported on time; and 11 (42%) received supervision or feedback. Four (29%) medical offices with HMIS had population denominators to use for data analyses; 12 (86%) were involved in outbreak investigations; and 11 (79%) had conducted community prevention activities. CONCLUSION: While HMIS could serve as the backbone for IDSR in the United Republic of Tanzania, this will require supervision, standardized case definitions, and improvements in the quality of reporting, analysis, and feedback.

Communicable Disease Control↗

PubMed1998

Prevalence of infectious diseases and associated symptoms in wastewater treatment workers.

Wastewater treatment workers (WWTW) are potentially exposed to a variety of infectious agents and toxic materials. We conducted a retrospective epidemiological study to examine the prevalence of infectious diseases and associated symptoms in WWTW. From a possible 242 WWTW, 150 completed a questionnaire that provided data pertaining to the diagnosis of an infectious disease or the prevalence of associated symptoms over a 12-month period. Comparison data were obtained from questionnaires completed by 54 college maintenance and oil refinery workers. The WWTW exhibited a significantly higher prevalence of gastroenteritis, gastrointestinal symptoms (specifically abdominal pain), and headaches. No significant differences were found with regard to respiratory and other symptoms. Employees classified by exposure categories did not exhibit significant differences in the prevalence of symptoms. While significant differences were found with regard to the health status of WWTW and controls, it appears that these risks are confined to symptoms and infectious diseases associated with the gastrointestinal system and are not inclusive of all such symptoms or diseases.

Adult↗

PubMed2004

The use and interpretation of quasi-experimental studies in infectious diseases.

Quasi-experimental study designs, sometimes called nonrandomized, pre-post-intervention study designs, are ubiquitous in the infectious diseases literature, particularly in the area of interventions aimed at decreasing the spread of antibiotic-resistant bacteria. Little has been written about the benefits and limitations of the quasi-experimental approach. This article outlines a hierarchy of quasi-experimental study design that is applicable to infectious diseases studies and that, if applied, may lead to sounder research and more-convincing causal links between infectious diseases interventions and outcomes.

Communicable Diseases↗

PubMed2003

Association between hepatitis C infection and other infectious diseases: a case for targeted screening?

OBJECTIVE: Hepatitis C virus (HCV) shares risk factors and routes of transmission with several other infectious agents. However, the prevalence of comorbid infectious disorders among HCV-infected patients remains unknown. To analyze the association between HCV and several categories of infectious disorders, we carried out a case-control study using information from 172 hospitals contained in the computerized databases of the Department of Veterans Affairs. METHODS: We identified all HCV-infected patients who were hospitalized during 1992-1999. For each case, four control subjects without HCV were randomly chosen from hospitalized patients and were matched with cases on the year of admission. The frequencies of several predefined infectious disease diagnoses were compared between cases and control subjects, and the strength of these associations were assessed in multivariable logistic regression analyses. RESULTS: We identified 34,204 HCV-infected patients (cases) and 136,816 control subjects without HCV. Patients in the case group were younger (48.4 yr vs 59.8 yr), were more frequently nonwhite (38.5% vs 26.5%), and were more likely to have served in Vietnam (68.1% vs 33.0%); all p < 0.0001. Compared with control subjects, patients with HCV had a significantly higher prevalence of other blood-borne virus infections, including HIV (14.1% vs 3.0%) and hepatitis B (22.4% vs 0.7%); immunodeficiency-related infections, including cytomegalovirus (0.6% vs 0.2%), toxoplasmosis (0.3% vs 0.1%), cryptococcosis (0.4% vs 0.1%), and tuberculosis (3.3% vs 1.3%); sexually transmitted diseases, including gonococcus (0.5% vs 0.1%), chlamydia (1.6% vs 0.7%), syphilis (2.0% vs 0.6%), and genital herpes (1.0% vs 0.3%); and bacterial infection, including peritonitis, sepsis, endocarditis, cellulitis, and carbuncles (all p < 0.0001). After excluding potentially immunocompromised patients, including those with HIV, organ transplant, and cirrhosis, HCV remained significantly associated with CMV, cryptococcus, tuberculosis, and sexually transmitted diseases. Similar results were obtained when the analyses were restricted to Vietnam-era veterans. CONCLUSIONS: Several infectious diseases are more common among HCV-infected patients compared with those without HCV infection. These findings support an approach of targeted screening for HCV among patients with these infectious diseases.

Case-Control Studies↗

PubMed1987

A comparison of incidence trends for esophageal atresia and tracheoesophageal fistula, and infectious disease.

There has been a suggestion that esophageal atresia with tracheoesophageal fistula (EA/TEF) may be related to the occurrence of infectious disease in the population during the time of early gestation. There is therefore a need for further data on trends in incidence related to infectious diseases. Data on the occurrence of EA/TEF with and without additional congenital malformations may also be relevant. The British Columbia Health Surveillance Registry is population-based with excellent case ascertainment of birth defects, and data are available on the incidence of infectious diseases for B.C., allowing comparison of trends to be made. One hundred forty-nine cases of EA/TEF occurred among 534,834 consecutive livebirths during the period 1966-1980 for an incidence rate of 1/3,590. No significant (p less than 0.05) annual, seasonal or monthly incidence trends were observed. In addition, the occurrence of EA/TEF could not be correlated with the prior incidence of infectious hepatitis, rubella, salmonella, or rubeola. Fifty-five percent of individuals with EA/TEF had congenital malformations in other systems, most frequently cardiovascular, gastrointestinal, and genitourinary. Most individuals with additional congenital malformations had multiple system involvement.

British Columbia↗

PubMed1986

[Work experience of the Minsk City Epidemiological Health Station in organizing a system for the epidemiological health surveillance of infectious diseases].

The system of the sanitary and epidemiological surveillance of infectious diseases comprises three aspects: supply of information, epidemiological and sanitary-hygienic surveillance. The system ensures the reliable epidemiological diagnosis, close collaboration in the work of specialists of sanitary and epidemiological departments, the differentiated surveillance of epidemiologically important objects, and the effectiveness of measures aimed at decreasing the infectious diseases incidence rates.

Communicable Disease Control↗

PubMed1978

An overview of public policy and infectious diseases.

Major problems face this nation's health care system; infectious disease and their management are a major and growing part of these problems. It is clear from available information that 40 years after the introduction of the sulfonamides, infection and its management remain an enormously important cause of morbidity and mortality. We are far from being in the "post-infectious-disease era." Unless society and the medical profession understand this and take vigorous remedial steps, our problems may intensify, despite the availability of a remarkable effective group of therapeutic agents.

Economics, Medical↗

PubMed1993

Affected by the tooth of time: legislation on infectious diseases control in five European countries.

The exercise of compulsory powers for the protection of society against the spread of infectious diseases may impose severe restrictions on individual liberty. The law should therefore enable public health officials to strike the proper balance between public health and individual rights. An overview of the infectious diseases control legislation of five European countries (Germany, Switzerland, England, Sweden and the Netherlands) shows outdated medical approaches to infectious diseases, deficiencies in substantive statutory criteria and a lack of suitable procedural protection. The law has to be modified not only to fit current epidemiological insights, but also to give full weight to evolving individual rights.

Communicable Disease Control↗

PubMed2005

[Emergent infectious diseases: importance for public health, epidemiology, promoting factors, and prevention].

At the end of the 70s, it was said that eradicating infectious diseases was possible. With the occurrence of AIDS and the discovery of new pathogens the come-back of infectious diseases was noted, 15 to 20 years later, and the concept of emerging infections was defined. An emerging infection is the appearance of a new infection or the increase of its incidence if not new. It also includes infections for which the incidence could increase because of favorable conditions. Several scenarios can be proposed: 1) the appearance of a new infection (AIDS or SARS); 2) the appearance of a known infection where it did not exist previously (West Nile virus infection in the USA); 3) an infection that existed but that was not diagnosed or could not be linked precisely to a particular infectious agent (hepatitis C before the discovery of the hepatitis C virus; 4) a known infection that increases its usual incidence (outbreaks...); 5) infectious diseases for which current conditions may facilitate transmission (decrease of immunization coverage...). The deliberate release of a biological agent is one of the possible scenarios of emergence. Qualitative changes of infectious agents such as the resistance to anti-infectious agents may also contribute, through a selection mechanism, to the emergence of new infectious threat. Emerging infections result from the interaction between the agent, the host, and environment evolving according to human activity. Surveillance, research, laboratory capacity, and an effective public health system are key factors for their control.

Communicable Diseases, Emerging↗

PubMed2004

The ADVIA Centaur immunoassay system--designed for infectious disease testing.

The ability to automate immunodiagnostics testing is critical for the efficiency of clinical laboratories. For automation of Infectious Disease testing, special design considerations must be made to ensure the integrity of the testing result while at the same time delivering productivity. The ADVIA Centaur was designed with the intent of performing a complete Infectious Disease panel including HBV, HCV, and HIV markers. Features such as disposable sample tips, sample and reagent delivery verification, and clog and clog detection have been incorporated in the design for assay robustness. Productivity features deliver best in class throughput performance for the Infectious Disease assays. Moreover, the underlying technology incorporating flexible assay protocols, universal solid phases and proprietary acridinium ester technology contribute to the assay design flexibility and analytical performance of the ADVIA Centaur immunoassay system.

AIDS Serodiagnosis↗

PubMed2004

Nutrition and infectious diseases in developing countries and problems of acquired immunodeficiency syndrome.

Infectious diseases are the major causes of death and morbidity in underdeveloped countries, particularly in children. Increasing evidence suggests that malnutrition-both Protein-Energy type Malnutrition (PEM) and essential micronutrient (vitamins, trace minerals, essential amino acids, polyunsaturated fatty acids) type-is the underlying reason for increased susceptibility to infections. On the other hand, certain infectious diseases also cause malnutrition, which results in a vicious cycle. Before its viral origin was known, acquired immunodeficiency syndrome (AIDS) had been termed the thin disease because cachexia was AIDS' main clinical manifestation. The relationship between infection and malnutrition is well documented in the literature. Our experience supports this. Preventive and therapeutic measures are suggested.

Acquired Immunodeficiency Syndrome↗

PubMed1953

The cardiovascular system in acute infectious disease.

Myocarditis may result from a wide variety of acute infectious diseases, but electrocardiographic abnormalities interpreted as indicating myocarditis may arise from a number of other causes. Among the factors which may cause myocarditis are direct invasion by an organism, the toxic products of an organism, hypersensitivity to the products of an organism, drugs used in therapy, deficiency in nutrients, electrolyte imbalance, and, rarely, fever. Recently emphasis has been placed on the finding that circulatory failure in acute infectious diseases is often primarily peripheral, although heart failure due to myocarditis is not uncommon.

Acute Disease↗

PubMed2001

Genetics of susceptibility to human infectious disease.

Before Robert Koch's work in the late nineteenth century, diseases such as tuberculosis and leprosy were widely believed to be inherited disorders. Heritability of susceptibility to several infectious diseases has been confirmed by studies in the twentieth century. Infectious diseases, old and new, continue to be an important cause of mortality worldwide. A greater understanding of disease processes is needed if more effective therapies and more useful vaccines are to be produced. As part of this effort, developments in genetics have allowed a more systematic study of the impact that the human genome and infectious disease have on each other.

Biological Evolution↗

PubMed2006

Seasonality and the dynamics of infectious diseases.

Seasonal variations in temperature, rainfall and resource availability are ubiquitous and can exert strong pressures on population dynamics. Infectious diseases provide some of the best-studied examples of the role of seasonality in shaping population fluctuations. In this paper, we review examples from human and wildlife disease systems to illustrate the challenges inherent in understanding the mechanisms and impacts of seasonal environmental drivers. Empirical evidence points to several biologically distinct mechanisms by which seasonality can impact host-pathogen interactions, including seasonal changes in host social behaviour and contact rates, variation in encounters with infective stages in the environment, annual pulses of host births and deaths and changes in host immune defences. Mathematical models and field observations show that the strength and mechanisms of seasonality can alter the spread and persistence of infectious diseases, and that population-level responses can range from simple annual cycles to more complex multiyear fluctuations. From an applied perspective, understanding the timing and causes of seasonality offers important insights into how parasite-host systems operate, how and when parasite control measures should be applied, and how disease risks will respond to anthropogenic climate change and altered patterns of seasonality. Finally, by focusing on well-studied examples of infectious diseases, we hope to highlight general insights that are relevant to other ecological interactions.

Animal Diseases↗

PubMed2000

Relationship between plasma retinol and infectious diseases in the elderly. A case-control study.

This study assessed the relationship between plasma retinol deficiency and infectious diseases. The plasma retinol, anthropometric (Body Mass Index, triceps skinfold thickness, mid-arm muscle circumference) and biological indices (proteins, albumin, transferrin, prealbumin, retinol binding protein) of protein-energy malnutrition of 63 patients with infectious diseases (ID) were compared to those of two control groups of similar age: 527 patients with other diseases (C1) and 92 healthy people (C2). Plasma retinol, albumin, transferrin and prealbumin were significantly lower in the ID group than in the C1 group. A lower body mass index was noted in men only. The ID and C1 groups had lower values for all indices (except for mid-arm muscle circumference). The ID group had lower albumin, transferrin, and prealbumin than the C1 group. The percentage of patients with plasma retinol below 300 microg/l was higher in the ID group (48.0% in men, 39% in women) than in the C1 group (25.0 and 21.5%); the odds ratio adjusted on age and sex equaled 2.46, 95% CI (1.39-4.37). It was lower than 2% in the C2 group. The results obtained with multiple regression analysis showed that, in the patients, the association between plasma retinol and infectious diseases remained significant when age, sex, anthropometric and biological indices were taken into account. Consequently, it is useful to check up the food intake habits of the elderly.

Aged↗