Canadian Journal of Infectious Diseases & Medical Microbiology

TABLE OF CONTENTS      September/October 2014 • Volume 25 • Issue 5

Bill C-442: Shining the limelight on the Lyme-like?
KB Laupland, L Valiquette

Antimicrobial stewardship in daily practice: Managing an important resource
N Le Saux, Canadian Paediatric Society, Infectious Diseases and Immunization Committee

A 39-year-old female immigrant with chronic diarrhea
ON Nadhem, RA Halloush, FA Khasawneh

Bacterial meningitis in the absence of cerebrospinal fluid pleocytosis: A case report and review of the literature
R Hase, N Hosokawa, M Yaegashi, K Muranaka

Bacterial meningitis is typically diagnosed with a lumbar puncture, which usually reveals an elevated opening pressure and high white blood cell count. In this article, the authors report a case involving an 83-year-old woman who had normal cerebrospinal fluid findings on presentation, but who was subsequently found to have meningitis caused by Neisseria meningitidis. The authors discuss potential reasons for normal cerebrospinal fluid findings in the context of meningitis.

An atypical cause of atypical chest pain
A Zaheen, RA Siemieniuk, P Gudgeon

The authors of this article report a case involving a 57-year-old man with longstanding HIV infection who presented with fever and acute chest pain, which was determined to be caused by an infection of the manubriosternal joint. The course of treatment is described and a literature review summarizing the published cases of this rare infection is presented.

Dokdonella koreensis bacteremia: A case report and review of the literature
B Lee, MR Weinstein

Dokdonella koreensis is a recently discovered organism that was isolated from an island in Korea in 2006. The authors describe a case involving a 75-year-old man undergoing chemotherapy for acute myeloid leukemia who developed a bloodstream infection that was eventually discovered to be due to D koreensis. The authors discuss the similarities between this case and the only other reported case of infection due to D koreensis reported in the literature.

Nutritional supplementation with the mushroom Agaricus sylvaticus reduces oxidative stress in children with HIV
MS Figueira, LA Sá, AS Vasconcelos, DR Moreira, PSOC Laurindo, DRG Ribeiro, RS Santos, P Guzzo, MF Dolabela, S Percario

Oxidative stress has been implicated in the progression of HIV and other diseases. The authors of this article aimed to evaluate the effects of supplementation with a mushroom known to exhibit antioxidant properties on the oxidative status of children with HIV. Extensive measurements of oxidative stress markers and antioxidant capacity were obtained before and after 90 days of supplementation with the mushroom extract.

Hospital ward design and prevention of hospital-acquired infections: A prospective clinical trial
J Ellison, D Southern, D Holton, E Henderson, J Wallace, P Faris, WA Ghali, J Conly

Several factors related to the hospital environment may affect the spread of hospital-acquired infections including ward design characteristics such as the number and location of handwashing stations and washrooms, and the number of beds per room. However, opportunities to study the effects of these factors are rare. The authors of this study conducted an analysis of the number of hospital-acquired infections in an older, ‘historic design’ hospital ward compared with a recently built ‘new design’ ward.

Serum voriconazole level variability in patients with hematological malignancies receiving voriconazole therapy
L Saini, JT Seki, D Kumar, EG Atenafu, DEC Cole, BYL Wong, A Božović, JM Brandwein

Voriconazole is an important antifungal agent used to treat invasive fungal infections; however, its administration can be difficult because of the narrow range between the level required for therapeutic efficacy and the level at which there is risk for hepatic and neurological toxicity. The purpose of this study was to elucidate the relationships among oral dosage, voriconazole levels and liver enzyme levels among leukemia patients.

Correlates of illness severity in infectious mononucleosis
J Odame, J Robinson, N Khodai-Booran, S Yeung, T Mazzulli, D Stephens, UD Allen

Infectious mononucleosis is caused by Epstein-Barr virus and can lead to complications, including hepatitis and hematological abnormalities, in a subset of patients. The authors of this article assessed measures of illness severity as well as viral load at presentation and six weeks later among a cohort of individuals <25 years of age for the purpose of informing the management of patients with infectious mononucleosis.

Factors associated with noncompletion of latent tuberculosis infection treatment in an inner-city population in Edmonton, Alberta
K Malejczyk, J Gratrix, A Beckon, D Moreau, G Williams, D Kunimoto, R Ahmed

One of the most useful strategies to control the spread of tuberculosis is treating latent tuberculosis infections. Certain populations at higher risk for tuberculosis infection, such as homeless individuals, are also at increased risk for treatment nonadherence. This article describes the treatment completion rate for latent tuberculosis infections at a health clinic in Edmonton, Alberta, including an assessment of the correlates of noncompletion as well as potential means to improve treatment adherence.

Effects of breakpoint changes on carbapenem susceptibility rates of Enterobacteriaceae: Results from the SENTRY Antimicrobial Surveillance Program (United States, 2008 to 2012)
RP Rennie, RN Jones

Antibiotic susceptibility breakpoints are determined at the time of clinical approval for a given drug, but may need to be revised to incorporate additional evidence obtained after approval of the drug. The breakpoints for several common carbapenems were updated between 2010 and 2013. The authors aimed to calculate the change in susceptibility rates for these drugs as a result of the updates to the breakpoints, using susceptibility data of various Enterobacteriaceae species from the North American SENTRY Antimicrobial Surveillance Program.

Bacteremia caused by Eggerthella lenta in an elderly man with a gastrointestinal malignancy: A case report
D Wong, F Aoki, E Rubinstein

Eggerthella lenta is normally found in the digestive tract, but can cause systemic infections in patients with disrupted mucosal lining due to gastrointestinal diseases or in patients with a compromised immune system. This article describes an 86-year-old man with a systemic E lenta infection that was eventually traced to a gastrointestinal cancer. The authors highlight the high mortality rate associated with this infection and the importance of determining the source of the infection.