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Medscape, LLC is pleased to provide online continuing medical education (CME) for selected journal articles, allowing clinicians the opportunity to earn Medscape CME credit. Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide Medscape CME for physicians. The activities listed below have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.

Volume 16—2010

Volume 16, Number 12—December 2010

image of the 'Thumbnail' version of the Volume 16, Number 12—December 2010 cover of the CDC's EID journal
Medscape CME Activity
Pandemic (H1N1) 2009 Infection in Patients with Hematologic Malignancy PDF Version [PDF - 236 KB - 8 pages]
C. Liu et al.
    View Abstract

To assess outcomes of patients with hematologic malignancy and pandemic (H1N1) 2009 infection, we reviewed cases during June–December 2009 at the University of California San Francisco Medical Center. Seventeen (63%) and 10 (37%) patients had upper respiratory tract infection (URTI) and lower respiratory tract infection (LRTI), respectively. Cough (85%) and fever (70%) were the most common signs; 19% of patients had nausea, vomiting, or diarrhea. Sixty-five percent of URTI patients were outpatients; 35% recovered without antiviral therapy. All LRTI patients were hospitalized; half required intensive care unit admission. Complications included acute respiratory distress syndrome, pneumomediastinum, myocarditis, and development of oseltamivir-resistant virus; 3 patients died. Of the 3 patients with nosocomial pandemic (H1N1) 2009, 2 died. Pandemic (H1N1) 2009 may cause serious illness in patients with hematologic malignancy, primarily those with LRTI. Rigorous infection control, improved techniques for diagnosing respiratory disease, and early antiviral therapy can prevent nosocomial transmission and optimize patient care.

    Cite This Article
EID Liu C, Schwartz BS, Vallabhaneni S, Nixon M, Chin-Hong PV, Miller SA, et al. Pandemic (H1N1) 2009 Infection in Patients with Hematologic Malignancy. Emerg Infect Dis. 2010;16(12):1910-1917. https://dx.doi.org/10.3201/eid1612.100772
AMA Liu C, Schwartz BS, Vallabhaneni S, et al. Pandemic (H1N1) 2009 Infection in Patients with Hematologic Malignancy. Emerging Infectious Diseases. 2010;16(12):1910-1917. doi:10.3201/eid1612.100772.
APA Liu, C., Schwartz, B. S., Vallabhaneni, S., Nixon, M., Chin-Hong, P. V., Miller, S. A....Drew, W. L. (2010). Pandemic (H1N1) 2009 Infection in Patients with Hematologic Malignancy. Emerging Infectious Diseases, 16(12), 1910-1917. https://dx.doi.org/10.3201/eid1612.100772.
Medscape CME Activity
Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus, South Korea PDF Version [PDF - 432 KB - 5 pages]
H. Yi et al.
    View Abstract

To identify oseltamivir resistance, we analyzed neuraminidase H275Y mutations in samples from 10 patients infected with pandemic (H1N1) 2009 virus in South Korea who had influenza that was refractory to antiviral treatment with this drug. A neuraminidase I117M mutation that might influence oseltamivir susceptibility was detected in sequential specimens from 1 patient.

    Cite This Article
EID Yi H, Lee J, Hong E, Kim M, Kwon D, Choi J, et al. Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus, South Korea. Emerg Infect Dis. 2010;16(12):1938-1942. https://dx.doi.org/10.3201/eid1612.100600
AMA Yi H, Lee J, Hong E, et al. Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus, South Korea. Emerging Infectious Diseases. 2010;16(12):1938-1942. doi:10.3201/eid1612.100600.
APA Yi, H., Lee, J., Hong, E., Kim, M., Kwon, D., Choi, J....Kang, C. (2010). Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus, South Korea. Emerging Infectious Diseases, 16(12), 1938-1942. https://dx.doi.org/10.3201/eid1612.100600.

Volume 16, Number 11—November 2010

image of the 'Thumbnail' version of the Volume 16, Number 11—November 2010 cover of the CDC's EID journal
Medscape CME Activity
Sulfadoxine/Pyrimethamine Intermittent Preventive Treatment for Malaria during Pregnancy PDF Version [PDF - 137 KB - 5 pages]
P. Deloron et al.
View Summary

Adequate methods for monitoring this treatment are needed.

    View Abstract

For monitoring efficacy of sulfadoxine/pyrimethamine intermittent preventive treatment for malaria during pregnancy, data obtained from studies of children seemed inadequate. High prevalence of triple and quadruple mutants in the dihydropteroate synthase and dihydrofolate reductase genes of Plasmodium falciparum parasites contrasts with the efficacy of sulfadoxine/pyrimethamine in reducing low birthweights and placental infection rates. In light of this discrepancy, emphasis on using molecular markers for monitoring efficacy of intermittent preventive treatment during pregnancy appears questionable. The World Health Organization recently proposed conducting in vivo studies in pregnant women to evaluate molecular markers for detecting resistance precociously. Other possible alternative strategies are considered.

    Cite This Article
EID Deloron P, Bertin G, Briand V, Massougbodji A, Cot M. Sulfadoxine/Pyrimethamine Intermittent Preventive Treatment for Malaria during Pregnancy. Emerg Infect Dis. 2010;16(11):1666-1670. https://dx.doi.org/10.3201/eid1611.101064
AMA Deloron P, Bertin G, Briand V, et al. Sulfadoxine/Pyrimethamine Intermittent Preventive Treatment for Malaria during Pregnancy. Emerging Infectious Diseases. 2010;16(11):1666-1670. doi:10.3201/eid1611.101064.
APA Deloron, P., Bertin, G., Briand, V., Massougbodji, A., & Cot, M. (2010). Sulfadoxine/Pyrimethamine Intermittent Preventive Treatment for Malaria during Pregnancy. Emerging Infectious Diseases, 16(11), 1666-1670. https://dx.doi.org/10.3201/eid1611.101064.
Medscape CME Activity
Enhanced Surveillance of Coccidioidomycosis, Arizona, USA, 2007–2008 PDF Version [PDF - 187 KB - 8 pages]
C. A. Tsang et al.
View Summary

Additional public and provider education are needed to reduce delays in diagnosis.

    View Abstract

Coccidioidomycosis is endemic to the southwestern United States; 60% of nationally reported cases occur in Arizona. Although the Council of State and Territorial Epidemiologists case definition for coccidioidomycosis requires laboratory and clinical criteria, Arizona uses only laboratory criteria. To validate this case definition and characterize the effects of coccidioidomycosis in Arizona, we interviewed every tenth case-patient with coccidioidomycosis reported during January 2007–February 2008. Of 493 patients interviewed, 44% visited the emergency department, and 41% were hospitalized. Symptoms lasted a median of 120 days. Persons aware of coccidioidomycosis before seeking healthcare were more likely to receive an earlier diagnosis than those unaware of the disease (p = 0.04) and to request testing for Coccidioides spp. (p = 0.05). These findings warrant greater public and provider education. Ninety-five percent of patients interviewed met the Council of State and Territorial Epidemiologists clinical case definition, validating the Arizona laboratory-based case definition for surveillance in a coccidiodomycosis-endemic area.

    Cite This Article
EID Tsang CA, Anderson SM, Imholte SB, Erhart LM, Chen S, Park BJ, et al. Enhanced Surveillance of Coccidioidomycosis, Arizona, USA, 2007–2008. Emerg Infect Dis. 2010;16(11):1738-1744. https://dx.doi.org/10.3201/eid1611.100475
AMA Tsang CA, Anderson SM, Imholte SB, et al. Enhanced Surveillance of Coccidioidomycosis, Arizona, USA, 2007–2008. Emerging Infectious Diseases. 2010;16(11):1738-1744. doi:10.3201/eid1611.100475.
APA Tsang, C. A., Anderson, S. M., Imholte, S. B., Erhart, L. M., Chen, S., Park, B. J....Sunenshine, R. H. (2010). Enhanced Surveillance of Coccidioidomycosis, Arizona, USA, 2007–2008. Emerging Infectious Diseases, 16(11), 1738-1744. https://dx.doi.org/10.3201/eid1611.100475.

Volume 16, Number 10—October 2010

image of the 'Thumbnail' version of the Volume 16, Number 10—October 2010 cover of the CDC's EID journal
Medscape CME Activity
Bloodstream Infections among HIV-Infected Outpatients, Southeast Asia PDF Version [PDF - 291 KB - 8 pages]
J. K. Varma et al.
View Summary

Mycobacterium tuberculosis was the most common pathogen.

    View Abstract

Bloodstream infections (BSIs) are a major cause of illness in HIV-infected persons. To evaluate prevalence of and risk factors for BSIs in 2,009 HIV-infected outpatients in Cambodia, Thailand, and Vietnam, we performed a single Myco/F Lytic blood culture. Fifty-eight (2.9%) had a clinically significant BSI (i.e., a blood culture positive for an organism known to be a pathogen). Mycobacterium tuberculosis accounted for 31 (54%) of all BSIs, followed by fungi (13 [22%]) and bacteria (9 [16%]). Of patients for whom data were recorded about antiretroviral therapy, 0 of 119 who had received antiretroviral therapy for >14 days had a BSI, compared with 3% of 1,801 patients who had not. In multivariate analysis, factors consistently associated with BSI were fever, low CD4+ T-lymphocyte count, abnormalities on chest radiograph, and signs or symptoms of abdominal illness. For HIV-infected outpatients with these risk factors, clinicians should place their highest priority on diagnosing tuberculosis.

    Cite This Article
EID Varma JK, McCarthy KD, Tasaneeyapan T, Monkongdee P, Kimerling ME, Buntheoun E, et al. Bloodstream Infections among HIV-Infected Outpatients, Southeast Asia. Emerg Infect Dis. 2010;16(10):1569-1575. https://dx.doi.org/10.3201/eid1610.091686
AMA Varma JK, McCarthy KD, Tasaneeyapan T, et al. Bloodstream Infections among HIV-Infected Outpatients, Southeast Asia. Emerging Infectious Diseases. 2010;16(10):1569-1575. doi:10.3201/eid1610.091686.
APA Varma, J. K., McCarthy, K. D., Tasaneeyapan, T., Monkongdee, P., Kimerling, M. E., Buntheoun, E....Cain, K. P. (2010). Bloodstream Infections among HIV-Infected Outpatients, Southeast Asia. Emerging Infectious Diseases, 16(10), 1569-1575. https://dx.doi.org/10.3201/eid1610.091686.
Medscape CME Activity
Changing Epidemiology of Pulmonary Nontuberculous Mycobacteria Infections PDF Version [PDF - 319 KB - 9 pages]
R. M. Thomson
View Summary

Pattern of disease has changed from cavitary disease in middle-aged men who smoke to fibronodular disease in elderly women.

    View Abstract

Nontuberculous mycobacteria (NTM) disease is a notifiable condition in Queensland, Australia. Mycobacterial isolates that require species identification are forwarded to the Queensland Mycobacterial Reference Laboratory, providing a central opportunity to capture statewide data on the epidemiology of NTM disease. We compared isolates obtained in 1999 and 2005 and used data from the Queensland notification scheme to report the clinical relevance of these isolates. The incidence of notified cases of clinically significant pulmonary disease rose from 2.2 (1999) to 3.2 (2005) per 100,000 population. The pattern of disease has changed from predominantly cavitary disease in middle-aged men who smoke to fibronodular disease in elderly women. Mycobacterium intracellulare is the main pathogen associated with the increase in isolates speciated in Queensland.

    Cite This Article
EID Thomson RM. Changing Epidemiology of Pulmonary Nontuberculous Mycobacteria Infections. Emerg Infect Dis. 2010;16(10):1576-1583. https://dx.doi.org/10.3201/eid1610.091201
AMA Thomson RM. Changing Epidemiology of Pulmonary Nontuberculous Mycobacteria Infections. Emerging Infectious Diseases. 2010;16(10):1576-1583. doi:10.3201/eid1610.091201.
APA Thomson, R. M. (2010). Changing Epidemiology of Pulmonary Nontuberculous Mycobacteria Infections. Emerging Infectious Diseases, 16(10), 1576-1583. https://dx.doi.org/10.3201/eid1610.091201.

Volume 16, Number 9—September 2010

image of the 'Thumbnail' version of the Volume 16, Number 9—September 2010 cover of the CDC's EID journal
Medscape CME Activity
Recurrent Granulibacter bethesdensis Infections and Chronic Granulomatous Disease PDF Version [PDF - 418 KB - 8 pages]
D. E. Greenberg et al.
    View Abstract

Chronic granulomatous disease (CGD) is characterized by frequent infections, most of which are curable. Granulibacter bethesdensis is an emerging pathogen in patients with CGD that causes fever and necrotizing lymphadenitis. However, unlike typical CGD organisms, this organism can cause relapse after clinical quiescence. To better define whether infections were newly acquired or recrudesced, we use comparative bacterial genomic hybridization to characterize 11 isolates obtained from 5 patients with CGD from North and Central America. Genomic typing showed that 3 patients had recurrent infection months to years after apparent clinical cure. Two patients were infected with the same strain as previously isolated, and 1 was infected with a genetically distinct strain. This organism is multidrug resistant, and therapy required surgery and combination antimicrobial drugs, including long-term ceftriaxone. G. bethesdensis causes necrotizing lymphadenitis in CGD, which may recur or relapse.

    Cite This Article
EID Greenberg DE, Shoffner AR, Zelazny AM, Fenster ME, Zarember KA, Stock F, et al. Recurrent Granulibacter bethesdensis Infections and Chronic Granulomatous Disease. Emerg Infect Dis. 2010;16(9):1341-1348. https://dx.doi.org/10.3201/eid1609.091800
AMA Greenberg DE, Shoffner AR, Zelazny AM, et al. Recurrent Granulibacter bethesdensis Infections and Chronic Granulomatous Disease. Emerging Infectious Diseases. 2010;16(9):1341-1348. doi:10.3201/eid1609.091800.
APA Greenberg, D. E., Shoffner, A. R., Zelazny, A. M., Fenster, M. E., Zarember, K. A., Stock, F....Holland, S. M. (2010). Recurrent Granulibacter bethesdensis Infections and Chronic Granulomatous Disease. Emerging Infectious Diseases, 16(9), 1341-1348. https://dx.doi.org/10.3201/eid1609.091800.
Medscape CME Activity
Illicit Drug Use and Risk for USA300 Methicillin-Resistant Staphylococcus aureus Infections with Bacteremia PDF Version [PDF - 269 KB - 9 pages]
K. M. Kreisel et al.
    View Abstract

To assess the association of illicit drug use and USA300 methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, a multicenter study was conducted at 4 Veterans Affairs medical centers during 2004–2008. The study showed that users of illicit drugs were more likely to have USA300 MRSA bacteremia (in contrast to bacteremia caused by other S. aureus strains) than were patients who did not use illicit drugs (adjusted relative risk 3.0; 95% confidence interval 1.9–4.4). The association of illicit drug use with USA300 MRSA bacteremia decreased over time (p = 0.23 for trend). Notably, the proportion of patients with USA300 MRSA bacteremia who did not use illicit drugs increased over time. This finding suggests that this strain has spread from users of illicit drugs to other populations.

    Cite This Article
EID Kreisel KM, Johnson J, Stine O, Shardell MD, Perencevich EN, Lesse AJ, et al. Illicit Drug Use and Risk for USA300 Methicillin-Resistant Staphylococcus aureus Infections with Bacteremia. Emerg Infect Dis. 2010;16(9):1419-1427. https://dx.doi.org/10.3201/eid1609.091802
AMA Kreisel KM, Johnson J, Stine O, et al. Illicit Drug Use and Risk for USA300 Methicillin-Resistant Staphylococcus aureus Infections with Bacteremia. Emerging Infectious Diseases. 2010;16(9):1419-1427. doi:10.3201/eid1609.091802.
APA Kreisel, K. M., Johnson, J., Stine, O., Shardell, M. D., Perencevich, E. N., Lesse, A. J....Roghmann, M. (2010). Illicit Drug Use and Risk for USA300 Methicillin-Resistant Staphylococcus aureus Infections with Bacteremia. Emerging Infectious Diseases, 16(9), 1419-1427. https://dx.doi.org/10.3201/eid1609.091802.

Volume 16, Number 8—August 2010

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Medscape CME Activity
Clostridium difficile Bacteremia, Taiwan PDF Version [PDF - 148 KB - 7 pages]
N. Lee et al.
    View Abstract

To determine clinical characteristics and outcome of patients with Clostridium difficile bacteremia (CDB), we identified 12 patients with CDB in 2 medical centers in Taiwan; all had underlying systemic diseases. Five had gastrointestinal diseases or conditions, including pseudomembranous colitis (2 patients); 4 recalled diarrhea, but only 5 had recent exposure to antimicrobial drugs. Ten available isolates were susceptible to metronidazole and vancomycin. Five isolates had C. difficile toxin A or B. Of 5 patients who died, 3 died of CDB. Of 8 patients treated with metronidazole or vancomycin, only 1 died, and all 4 patients treated with other drugs died (12.5% vs. 100%; p = 0.01). C. difficile bacteremia, although uncommon, is thus associated with substaintial illness and death rates.

    Cite This Article
EID Lee N, Huang Y, Hsueh P, Ko W. Clostridium difficile Bacteremia, Taiwan1. Emerg Infect Dis. 2010;16(8):1204-1210. https://dx.doi.org/10.3201/eid1608.100064
AMA Lee N, Huang Y, Hsueh P, et al. Clostridium difficile Bacteremia, Taiwan1. Emerging Infectious Diseases. 2010;16(8):1204-1210. doi:10.3201/eid1608.100064.
APA Lee, N., Huang, Y., Hsueh, P., & Ko, W. (2010). Clostridium difficile Bacteremia, Taiwan1. Emerging Infectious Diseases, 16(8), 1204-1210. https://dx.doi.org/10.3201/eid1608.100064.
Medscape CME Activity
Correlation of Pandemic (H1N1) 2009 Viral Load with Disease Severity and Prolonged Viral Shedding in Children PDF Version [PDF - 295 KB - 8 pages]
C. Li et al.
    View Abstract

Pandemic (H1N1) 2009 virus causes severe illness, including pneumonia, which leads to hospitalization and even death. To characterize the kinetic changes in viral load and identify factors of influence, we analyzed variables that could potentially influence the viral shedding time in a hospital-based cohort of 1,052 patients. Viral load was inversely correlated with number of days after the onset of fever and was maintained at a high level over the first 3 days. Patients with pneumonia had higher viral loads than those with bronchitis or upper respiratory tract infection. Median viral shedding time after the onset of symptoms was 9 days. Patients <13 years of age had a longer median viral shedding time than those >13 years of age (11 days vs. 7 days). These results suggest that younger children may require a longer isolation period and that patients with pneumonia may require treatment that is more aggressive than standard therapy for pandemic (H1N1) 2009 virus.

    Cite This Article
EID Li C, Wang L, Eng H, You H, Chang L, Tang K, et al. Correlation of Pandemic (H1N1) 2009 Viral Load with Disease Severity and Prolonged Viral Shedding in Children. Emerg Infect Dis. 2010;16(8):1265-1272. https://dx.doi.org/10.3201/eid1608.091918
AMA Li C, Wang L, Eng H, et al. Correlation of Pandemic (H1N1) 2009 Viral Load with Disease Severity and Prolonged Viral Shedding in Children. Emerging Infectious Diseases. 2010;16(8):1265-1272. doi:10.3201/eid1608.091918.
APA Li, C., Wang, L., Eng, H., You, H., Chang, L., Tang, K....Yang, K. D. (2010). Correlation of Pandemic (H1N1) 2009 Viral Load with Disease Severity and Prolonged Viral Shedding in Children. Emerging Infectious Diseases, 16(8), 1265-1272. https://dx.doi.org/10.3201/eid1608.091918.

Volume 16, Number 7—July 2010

image of the 'Thumbnail' version of the Volume 16, Number 7—July 2010 cover of the CDC's EID journal
Medscape CME Activity
Extensive Drug Resistance in Malaria and Tuberculosis PDF Version [PDF - 106 KB - 5 pages]
C. Wongsrichanalai et al.
    View Abstract

Drug resistance in malaria and in tuberculosis (TB) are major global health problems. Although the terms multidrug-resistant TB and extensively drug-resistant TB are precisely defined, the term multidrug resistance is often loosely used when discussing malaria. Recent declines in the clinical effectiveness of antimalarial drugs, including artemisinin-based combination therapy, have prompted the need to revise the definitions of and/or to recategorize antimalarial drug resistance to include extensively drug-resistant malaria. Applying precise case definitions to different levels of drug resistance in malaria and TB is useful for individual patient care and for public health.

    Cite This Article
EID Wongsrichanalai C, Varma JK, Juliano JJ, Kimerling ME, MacArthur JR. Extensive Drug Resistance in Malaria and Tuberculosis. Emerg Infect Dis. 2010;16(7):1063-1067. https://dx.doi.org/10.3201/eid1607.091840
AMA Wongsrichanalai C, Varma JK, Juliano JJ, et al. Extensive Drug Resistance in Malaria and Tuberculosis. Emerging Infectious Diseases. 2010;16(7):1063-1067. doi:10.3201/eid1607.091840.
APA Wongsrichanalai, C., Varma, J. K., Juliano, J. J., Kimerling, M. E., & MacArthur, J. R. (2010). Extensive Drug Resistance in Malaria and Tuberculosis. Emerging Infectious Diseases, 16(7), 1063-1067. https://dx.doi.org/10.3201/eid1607.091840.

Volume 16, Number 6—June 2010

image of the 'Thumbnail' version of the Volume 16, Number 6—June 2010 cover of the CDC's EID journal
Medscape CME Activity
Invasive Aspergillosis after Pandemic (H1N1) 2009 PDF Version [PDF - 214 KB - 3 pages]
A. Lat et al.
    View Abstract

We report 2 patients with invasive aspergillosis after infection with pandemic (H1N1) 2009. Influenza viruses are known to cause immunologic defects and impair ciliary clearance. These defects, combined with high-dose corticosteroids prescribed during influenza-associated adult respiratory distress syndrome, may be novel risk factors predisposing otherwise immunocompetent patients to invasive aspergillosis.

    Cite This Article
EID Lat A, Bhadelia N, Miko B, Furuya EY, Thompson GR. Invasive Aspergillosis after Pandemic (H1N1) 2009. Emerg Infect Dis. 2010;16(6):971-973. https://dx.doi.org/10.3201/eid1606.100165
AMA Lat A, Bhadelia N, Miko B, et al. Invasive Aspergillosis after Pandemic (H1N1) 2009. Emerging Infectious Diseases. 2010;16(6):971-973. doi:10.3201/eid1606.100165.
APA Lat, A., Bhadelia, N., Miko, B., Furuya, E. Y., & Thompson, G. R. (2010). Invasive Aspergillosis after Pandemic (H1N1) 2009. Emerging Infectious Diseases, 16(6), 971-973. https://dx.doi.org/10.3201/eid1606.100165.

Volume 16, Number 5—May 2010

image of the 'Thumbnail' version of the Volume 16, Number 5—May 2010 cover of the CDC's EID journal
Medscape CME Activity
Tropheryma whipplei in Children with Gastroenteritis PDF Version [PDF - 340 KB - 7 pages]
D. Raoult et al.
    View Abstract

Tropheryma whipplei, which causes Whipple disease, is found in human feces and may cause gastroenteritis. To show that T. whipplei causes gastroenteritis, PCRs for T. whipplei were conducted with feces from children 2–4 years of age. Western blotting was performed for samples from children with diarrhea who had positive or negative results for T. whipplei. T. whipplei was found in samples from 36 (15%) of 241 children with gastroenteritis and associated with other diarrheal pathogens in 13 (33%) of 36. No positive specimen was detected for controls of the same age (0/47; p = 0.008). Bacterial loads in case-patients were as high as those in patients with Whipple disease and significantly higher than those in adult asymptomatic carriers (p = 0.002). High incidence in patients and evidence of clonal circulation suggests that some cases of gastroenteritis are caused or exacerbated by T. whipplei, which may be co-transmitted with other intestinal pathogens.

    Cite This Article
EID Raoult D, Fenollar F, Rolain J, Minodier P, Bosdure E, Li W, et al. Tropheryma whipplei in Children with Gastroenteritis. Emerg Infect Dis. 2010;16(5):776-782. https://dx.doi.org/10.3201/eid1605.091801
AMA Raoult D, Fenollar F, Rolain J, et al. Tropheryma whipplei in Children with Gastroenteritis. Emerging Infectious Diseases. 2010;16(5):776-782. doi:10.3201/eid1605.091801.
APA Raoult, D., Fenollar, F., Rolain, J., Minodier, P., Bosdure, E., Li, W....Richet, H. (2010). Tropheryma whipplei in Children with Gastroenteritis. Emerging Infectious Diseases, 16(5), 776-782. https://dx.doi.org/10.3201/eid1605.091801.

Volume 16, Number 4—April 2010

image of the 'Thumbnail' version of the Volume 16, Number 4—April 2010 cover of the CDC's EID journal
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Community-associated Methicillin-Resistant Staphylococcus aureus Strains in Pediatric Intensive Care Unit PDF Version [PDF - 351 KB - 9 pages]
A. M. Milstone et al.
    View Abstract

Virulent community-associated methicillin-resistant Staphylococcus-aureus (CA-MRSA) strains have spread rapidly in the United States. To characterize the degree to which CA-MRSA strains are imported into and transmitted in pediatric intensive care units (PICU), we performed a retrospective study of children admitted to The Johns Hopkins Hospital PICU, March 1, 2007–May 31, 2008. We found that 72 (6%) of 1,674 PICU patients were colonized with MRSA. MRSA-colonized patients were more likely to be younger (median age 3 years vs. 5 years; p = 0.02) and African American (p<0.001) and to have been hospitalized within 12 months (p<0.001) than were noncolonized patients. MRSA isolates from 66 (92%) colonized patients were fingerprinted; 40 (61%) were genotypically CA-MRSA strains. CA-MRSA strains were isolated from 50% of patients who became colonized with MRSA and caused the only hospital-acquired MRSA catheter-associated bloodstream infection in the cohort. Epidemic CA-MRSA strains are becoming endemic to PICUs, can be transmitted to hospitalized children, and can cause invasive hospital-acquired infections. Further appraisal of MRSA control is needed.

    Cite This Article
EID Milstone AM, Carroll KC, Ross T, Shangraw KA, Perl TM. Community-associated Methicillin-Resistant Staphylococcus aureus Strains in Pediatric Intensive Care Unit. Emerg Infect Dis. 2010;16(4):647-655. https://dx.doi.org/10.3201/eid1604.090107
AMA Milstone AM, Carroll KC, Ross T, et al. Community-associated Methicillin-Resistant Staphylococcus aureus Strains in Pediatric Intensive Care Unit. Emerging Infectious Diseases. 2010;16(4):647-655. doi:10.3201/eid1604.090107.
APA Milstone, A. M., Carroll, K. C., Ross, T., Shangraw, K. A., & Perl, T. M. (2010). Community-associated Methicillin-Resistant Staphylococcus aureus Strains in Pediatric Intensive Care Unit. Emerging Infectious Diseases, 16(4), 647-655. https://dx.doi.org/10.3201/eid1604.090107.

Volume 16, Number 3—March 2010

image of the 'Thumbnail' version of the Volume 16, Number 3—March 2010 cover of the CDC's EID journal
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Extensively Drug-Resistant Mycobacterium tuberculosis from Aspirates, Rural South Africa PDF Version [PDF - 252 KB - 5 pages]
S. K. Heysell et al.
    View Abstract

The yield from aspirating lymph nodes and pleural fluid for diagnosing extensively drug-resistant (XDR) tuberculosis is unknown. Mycobacterium tuberculosis was cultured from lymph node or pleural fluid aspirates of 21 patients; 7 (33%) cultures grew XDR M. tuberculosis. Additive diagnostic yield for XDR M. tuberculosis was found in parallel culture of sputum and fluid aspirate.

    Cite This Article
EID Heysell SK, Moll AP, Gandhi NR, Eksteen FJ, Babaria P, Coovadia Y, et al. Extensively Drug-Resistant Mycobacterium tuberculosis from Aspirates, Rural South Africa. Emerg Infect Dis. 2010;16(3):557-560. https://dx.doi.org/10.3201/eid1603.091486
AMA Heysell SK, Moll AP, Gandhi NR, et al. Extensively Drug-Resistant Mycobacterium tuberculosis from Aspirates, Rural South Africa. Emerging Infectious Diseases. 2010;16(3):557-560. doi:10.3201/eid1603.091486.
APA Heysell, S. K., Moll, A. P., Gandhi, N. R., Eksteen, F. J., Babaria, P., Coovadia, Y....Shah, N. (2010). Extensively Drug-Resistant Mycobacterium tuberculosis from Aspirates, Rural South Africa. Emerging Infectious Diseases, 16(3), 557-560. https://dx.doi.org/10.3201/eid1603.091486.

Volume 16, Number 2—February 2010

image of the 'Thumbnail' version of the Volume 16, Number 2—February 2010 cover of the CDC's EID journal
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Risk Factors for and Estimated Incidence of Community-associated Clostridium difficile Infection, North Carolina, USA PDF Version [PDF - 189 KB - 7 pages]
P. K. Kutty et al.
    View Abstract

We determined estimated incidence of and risk factors for community-associated Clostridium difficile infection (CA-CDI) among patients treated at 6 North Carolina hospitals. CA-CDI case-patients were defined as adults (>18 years of age) with a positive stool test result for C. difficile toxin and no hospitalization within the prior 8 weeks. CA-CDI incidence was 21 and 46 per 100,000 person-years in Veterans Affairs (VA) outpatients and Durham County populations, respectively. VA case-patients were more likely than controls to have received antimicrobial drugs (adjusted odds ratio [aOR] 17.8, 95% confidence interval [CI] 6.6–48] and to have had a recent outpatient visit (aOR 5.1, 95% CI 1.5–17.9). County case-patients were more likely than controls to have received antimicrobial drugs (aOR 9.1, 95% CI 2.9–28.9), to have gastroesophageal reflux disease (aOR 11.2, 95% CI 1.9–64.2), and to have cardiac failure (aOR 3.8, 95% CI 1.1–13.7). Risk factors for CA-CDI overlap with those for healthcare-associated infection.

    Cite This Article
EID Kutty PK, Woods CW, Sena AC, Benoit SR, Naggie S, Frederick J, et al. Risk Factors for and Estimated Incidence of Community-associated Clostridium difficile Infection, North Carolina, USA. Emerg Infect Dis. 2010;16(2):198-204. https://dx.doi.org/10.3201/eid1602.090953
AMA Kutty PK, Woods CW, Sena AC, et al. Risk Factors for and Estimated Incidence of Community-associated Clostridium difficile Infection, North Carolina, USA. Emerging Infectious Diseases. 2010;16(2):198-204. doi:10.3201/eid1602.090953.
APA Kutty, P. K., Woods, C. W., Sena, A. C., Benoit, S. R., Naggie, S., Frederick, J....McDonald, L. C. (2010). Risk Factors for and Estimated Incidence of Community-associated Clostridium difficile Infection, North Carolina, USA. Emerging Infectious Diseases, 16(2), 198-204. https://dx.doi.org/10.3201/eid1602.090953.

Volume 16, Number 1—January 2010

image of the 'Thumbnail' version of the Volume 16, Number 1—January 2010 cover of the CDC's EID journal
Medscape CME Activity
Public Health Threat of New, Reemerging, and Neglected Zoonoses in the Industrialized World PDF Version [PDF - 180 KB - 8 pages]
S. J. Cutler et al.
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Microbiologic infections acquired from animals, known as zoonoses, pose a risk to public health. An estimated 60% of emerging human pathogens are zoonotic. Of these pathogens, >71% have wildlife origins. These pathogens can switch hosts by acquiring new genetic combinations that have altered pathogenic potential or by changes in behavior or socioeconomic, environmental, or ecologic characteristics of the hosts. We discuss causal factors that influence the dynamics associated with emergence or reemergence of zoonoses, particularly in the industrialized world, and highlight selected examples to provide a comprehensive view of their range and diversity.

    Cite This Article
EID Cutler SJ, Fooks AR, van der Poel WH. Public Health Threat of New, Reemerging, and Neglected Zoonoses in the Industrialized World. Emerg Infect Dis. 2010;16(1):1-7. https://dx.doi.org/10.3201/eid1601.081467
AMA Cutler SJ, Fooks AR, van der Poel WH. Public Health Threat of New, Reemerging, and Neglected Zoonoses in the Industrialized World. Emerging Infectious Diseases. 2010;16(1):1-7. doi:10.3201/eid1601.081467.
APA Cutler, S. J., Fooks, A. R., & van der Poel, W. H. (2010). Public Health Threat of New, Reemerging, and Neglected Zoonoses in the Industrialized World. Emerging Infectious Diseases, 16(1), 1-7. https://dx.doi.org/10.3201/eid1601.081467.

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