Acquired infections

Infections acquired from an external source are referred to as exogenous infections. These infections may occur as a result of human-to-human transmission, contact with exogenous bacterial populations in the environment, and animal contact. Resistant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus spp. 

Nosocomial infection An infection acquired within the health care system. Generally, symptoms of infection must occur after at least 48 hours of care to be considered nosocomial. 

The agent of choice depends on location. Trimethoprim-sulfamethoxazole is used for infections acquired in the United States. For infections acquired outside the United States, the agents of choice are ciprofloxacin, norfloxacin, and azithromycin. Fluoroquinolones are generally contraindicated in children and adolescents. 

Fluoroquinolones arenot recommended for treating infections in MSM or infections acquired in Hawaii, California, or other parts of the world where high-level resistance to fluoroquinolones is reported, or in heterosexuals with a history of recent foreign travel (including exposure froma partner with a history of recent foreign travel). 

Vibrio spp. contaminate water (especially salt water due to the halophilic properties of bacteria), seafood, mollusks, crustaceans, and undercooked vegetables. In Asia, infections frequently accompany floods and other natural disasters. In the Far East and in Japan, V. parahaemolyticus infections are endemic. The causative factor is achlorhydria (often iatrogenic). The onset of Vibrio infection acquired via the orofecal pathway resembles dysentery due to frequent bloody stools (Butterton and Claderwood, 2001). 

Fey P.D., T.J. Safranek, M.E. Rupp, E.F. Duime, E. RiboL P.C. Iwen, P.A. Bradford, F.J. Angulo, and S.H. Hinrichs (2000). Ceftriaxone-resistant Salmonella infection acquired by a child from cattle. New England Journal of Medicine 342 1242-1249. 

It is fourth generation cephalosporin used mainly in serious infections including septicaemia and respiratory tract infections and infections acquired from hospitals. It is resistant to many (3-lactamases. 

Quinolones are not recommended for empiric therapy of gonococcal infections acquired in Southeast Asia, Hawaii, and the Pacific Coast of the United States. Azithromycin 2 g is an alternative agent for the treatment of gonococcal urethritis and cervicitis. ... 

Cysique LA, Mai uff P, Brew BJ (2004) Pi evalence and pattern of neui opsychological impaimient in human immunodeficiency vims-infected/acquired immunodeficiency syndrome (HIV/AIDS) padents across pre- and post-highly acdve andreti oviral dierapy eras A combined study of two cohorts. J Neur ovirol 10 350—357. 

Infections can usually be treated with penicillinase-resistant B-lactams. Infections acquired in the hospital are often antibiotic resistant strains and can only be treated with vanomycin. Vaccines are not currently available. 

Immunoglobulin estimations are valuable in detecting not only infection acquired in utero, but also that acquired in the first 6 weeks of life. 

Nosocomial infection— An infection acquired in a health care facihty. 

Wei S, Walsh P, Huang R, To SST (2000) 93G, a novel sporadic strain of hepatitis E virus in south China isolated by cell-culture. J Med Virol 61 311-318 Widdowson MA, Jaspers WJM, van der Poel WHM, Verschoor F, de Roda Husman AM, Winter HLJ, Zaaijer HL, Koopmans M (2003) Cluster of cases of acute hepatitis associated with hepatitis E virus infection acquired in The Netherlands. Clin Infec Dis 36 29-33 Williams TP, Kasorndorkbua C, Halbur PG, Haqshenas G, Guenette DK, Toth TE, Meng XJ (2001) Evidence of extrahepatic sites of replication of the hepatitis E virus in a swine model. J Clin Microbiol 39(9) 3040-3046... 

Clavel A, Bargues MD, Castillo FJ, Rubio MD, Mas-Coma S (1997) Diplogonoporiasis presumably introduced into Spain first confirmed case of human infection acquired outside the Far East. Am J Trop Med Hyg 57 317-320... 

These are cell surface molecules which are found on all mature a/fi TcR-positive cells, where they are expressed in a mutually exclusive manner, as well as on both a//3 TcR-positive and a//3 TcR-negative immature thymocytes, where they are coexpressed [145,146]. CD4 has also been found to be expressed in the brain in a pattern which is conserved in primates as well as in rodents and which is suggestive of that of a neuropeptide receptor [147]. Since CD4 has been shown to function as a receptor for HIV-1 [148], its pattern of tissue distribution is consistent with the pathological and clinical findings in HIV-1 infections (acquired immune deficiency syndrome). 

Many human diseases can be transmitted by the aerial route, particularly by droplet infection. Viral infections such as infiuenza, common cold, measles, smallpox and poliomyelitis can be spread by this route. Bacterial and fungal infections acquired by droplet infection are summarized in Tables 6.1 and 6.2. Similar and other diseases can occur in cattle and poultry. 

A cutaneous ulcer occurs in approximately 60% of patients and is the most common sign of tularemia. Ulcers are generally single lesions of 0.4 to 3.0 cm in diameter, with heaped-up edges (Figure 24-1). Lesions associated with infection acquired from mammalian vectors are usually located on the upper extremities, whereas lesions associated with infection acquired from arthropod vectors are usually located on the lower extremities. Ulcerative lesions are almost always accompanied by regional lymphadenopathy.13... 

In humans, the pathogenesis of VEE, EEE, and WEE infections acquired by aerosol—the route of biological defense concern—is unknown. Indeed, little is known of the pathogenesis following natural vector-borne infections of humans, mainly be-... 

At any given point in time, over 1.4 million people around the globe suffer from infections acquired in hospitals [9]. 

Each day, about 150 deaths occur in European Union (EU) countries due to infections acquired in hospitals [13]. 

Kullavanijaya P, Sirimachan S, Bhuddhavudhikrai P (1993) Mycobacterium marinum cutaneous infections acquired from occupations and hobbies. Int J Dermatol 32 504-507 Lacour JP, Baze PE, Castanet J, et al. (1994) Diving suit dermatitis caused be Pseudomonas aeruginosa two cases. J Am Acad Dermatol 3i[Suppl] i055-i056... 

Roland, F.P. (1970). Leg gangrene and endotoxin shock due to Vibrio parahaemolyticus an infection acquired in New England coastal waters. N. Engl.. Med. 282 1306. 

Fantini J, Tamalet C, Hammache D, Tourres C, Duclos N, Yahi N. HIV-l-induced perturbations of glycosphin-golipid metabolism are cell-specific and can be detected at early stages of HIV-1 infection. / Acquir Immune Defic Syndr Hum Retrovirol. 1998 19(3) 221-229. 

Epidemiological studies evaluating adverse effects of nosocomial infections indicate that pneumonia is the leading cause of death from infections acquired during the hospital stay. Table 3 summarizes six studies that have reported crude mortality rates of ventilator-associated pneumonia ranging from 33% to 71% (20). 

Olds JW, Kisch AL, Eberle BJ, Wilson JN. Pseudomonas aeruginosa respiratory tract infection acquired from a contaminated anesthesia machine. Am Rev Respir Dis 1972 105 628-632. 

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