無痛支氣管鏡研討會

2010-11-06 無痛支氣管鏡研討會
北榮

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孟加拉的MDRTB tx trial, 使用gatifloxacin > ofloxacin

台灣的regimen不太一樣 基本上能不用fluroquinolone就不會用 Treatment of Multidrug-Resistant Tuberculosis In an observational study, a gatifloxacin-containing regimen for at least 9 months had the highest cure rate. Multidrug-resistant tuberculosis (MDRTB) is defined as infection caused by an organism resistant to both isoniazid and rifampin. Currently recommended treatment regimens are long, often poorly tolerated, and difficult to monitor. Treatment standardization has been recommended for MDRTB in low-income areas, which generally have low levels of resistance to second-line drugs. As part of a TB treatment program in Bangladesh, researchers conducted a prospective observational study from May 1997 through December 2007 to examine the effectiveness of this strategy. Patients with laboratory-confirmed MDRTB were treated with one of six regimens based on enrollment date (i.e., without randomization). Each regimen differed from the previous one, usually by a single change. All regimens contained a fluoroq...
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H5N1沈睡中，慢慢看吧，印尼…

1/3人類H5N1病例在印尼，所以有理由相信印尼的豬也有問題 是地，豬是健康的帶菌者!! H5N1 Influenza A Infection of Pigs in Indonesia In areas with H5N1 influenza outbreaks in poultry, the virus was isolated from healthy-appearing pigs. About one third of all confirmed human H5N1 infections worldwide have occurred in Indonesia. Because pigs are believed to be "mixing vessels" for avian and human influenza viruses, investigators assessed whether pigs in Indonesia were being infected with H5N1 and whether the virus was changing receptor specificity. The researchers sampled nasal, fecal, and serum samples from healthy-appearing pigs in various districts of the country during three rainy seasons between 2005 and 2009. Among 702 nasal specimens obtained in 2005 and 2007, H5N1 was isolated from 52 (7.4%). Culture-positive pigs showed no signs of influenza-like illness. Among 300 pigs tested in 2008–2009, none were culture positive, although 3 (1%) had neutralizing antibodies to H5N1 virus. Viral sequences of the hemagglut...
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NTM在美國增加

老年婦女多(59%)，平均66歲 而且症狀不太一樣 NTMthrive within the biofilm of municipal water systems and likely infect susceptible hosts via aerosolization 最近遇到兩個NTM，一個是天天游泳的老人家，請他莫再游了 is it ok to check the swimming pool water supply? MAC佔多，klaricid + EMB + Rif? Atypical Mycobacterial Infections Might Be on the Rise Pulmonary infections are now more common than pulmonary tuberculosis. Pulmonary infections with "atypical" nontuberculous mycobacteria have been recognized for decades, but reliable estimates of their prevalence are elusive for several reasons: These infections are tricky to diagnose, geographically variable, and untracked by local or federal health departments. Several reports from around the country now suggest that infection rates are rising. Investigators reviewed all clinical isolates of nontuberculous mycobacteria obtained from Oregon residents during 2005 and 2006. Estimated prevalence of pulmonary infection was 8 to 11 cases per 100,000, with a prevalence in older people (ag...
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