Abstract In preventing invasive fungal disease ( IFD ) in patients with acute myelogenous leukemia ( AML ) or myelodysplastic syndrome ( MDS ), clinical trials demonstrated efficacy of posaconazole over fluconazole and itraconazole. However, effectiveness of posaconazole has not been investigated in the United States in real‐world setting outside the environment of controlled clinical trial. We performed a single‐center, retrospective cohort study of 130 evaluable patients ≥18 years of age admitted to Duke University Hospital between 2004 and 2010 who received either posaconazole or fluconazole as prophylaxis during first induction or first reinduction chemotherapy for AML or MDS . The primary endpoint was possible, probable, or definite breakthrough IFD . Baseline characteristics were well balanced between groups, except that posaconazole recipients received reinduction chemotherapy and cytarabine more frequently. IFD occurred in 17/65 (27.0%) in the fluconazole group and in 6/65 (9.2%) in the posaconazole group ( P = 0.012). Definite/probable IFD s occurred in 7 (10.8%) and 0 patients (0%), respectively ( P = 0.0013). In multivariate analysis, fluconazole prophylaxis and duration of neutropenia were predictors of IFD . Mortality was similar between groups. This study demonstrates superior effectiveness of posaconazole over fluconazole as prophylaxis of IFD in AML and MDS patients. Such superiority did not translate to reductions in 100‐day all‐cause mortality.
Among the 219 vancomycin-resistant Enterococcus faecium isolates collected in 20 Taiwanese hospitals from 2006 to 2010, all were susceptible to linezolid and daptomycin, and 98.6% were susceptible to tigecycline. There was a shift toward higher tigecycline MIC values (MIC(90)s) from 2006-2007 (0.06 μg/ml) to 2008-2010 (0.12 μg/ml). The MIC(90)s of daptomycin and linezolid remained stationary. Although pulsotypes among the isolates from the 20 hospitals varied, intrahospital spreading of several clones was identified in 13 hospitals.
Background: The Tigecycline In-Vitro Surveillance in Taiwan (TIST), initiated in 2006, is a nationwide surveillance program designed to monitor longitudinally the in vitro activities of tigecycline against commonly encountered resistant bacteria in Taiwan. This study aims to compare the in vitro activities of tigecycline against clinical isolates of Acinetobacter baumannii by using two susceptibility methods. Methods: A total of 393 isolates of A. baumannii were collected from various sources of patients treated at 20 teaching hospitals. Minimum inhibitory concentrations (MICs) and diameters of inhibitory zone for tigecycline were determined by the broth microdilution methods and the disk diffusion method, respectively. The results were interpreted by the MIC criteria provided by U.S. FDA tigecycline susceptibility breakpoints listed for Enterobacteriaceae (S, ≤2 μg/mL; I, 4 μg/mL; R, ≥8 μg/mL) and by the disk diffusion breakpoints (S, ≤16 mm; I, 13–15 mm; R, ≥12 mm) recommended by Jones et al (J. Clin. Microbiol 2007;45:227–30). A very major error (VME) rate of < 1%, major error (MaE) rate of <5%, and a total error rate of <20% were considered acceptable. Results: Percentages of susceptible, intermediate, and resistant isolates determined by the broth microdilution method (disk diffusion method) are 81.7% (88.3%), 12.0% (8.9%), and 6.3% (2.8%), respectively. VME, MaE, minor error, and total error rates were 0.5% (2/393), 8.9% (35/393), 37.4% (147/393), and 46.8% (184/393), respectively. Conclusion: Comparison with the broth microdilution method for tigecycline against A. baumannii, the disk diffusion method tends to have a high false-susceptibility rate and have an unacceptable high VME.
Preliminary results from epidemiological and laboratory studies on the new H1N1 influenza virus show that the 7-20 years age group suffered the highest morbidity; some adults over 20 years of age were also affected. The influenza epidemic caused by the H1N1 virus was characterized by slow spread, unevenness of attack rates, and the occurrence of many mild cases and inapparent infections. At least up to the end of 1977 there was concurrent persistence and spread of both H1N1 and H3N2 viruses. The H and N antigens of the new H1N1 virus, as well as its behaviour toward nonspecific inhibitors, were found to be closely similar to the old H1N1 virus prevalent during the first half of the 1950s. Most of the new H1N1 isolates in eggs were found to be temperature sensitive.
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