Multidrug-resistant organisms (MDROs) are frequently defined as bacteria with resistance to three or more classes of antimicrobials. Common examples include methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamases (ESBL)–producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae (CRE) and vancomycin-resistant Enterococci (VRE). The challenges of managing these infections are illustrated in the following two cases.
With increasing affordability and availability of international travel, many endemic infections once restricted to overseas regions are now not uncommonly seen in our locality. Three cases of important arthropod-borne infections from returned travellers are reported and discussed.
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Macrolide antibiotics are derived from the Streptomycesspecies. These contain either 14-membered (erythromycin [ERM],clarithromycin [CAM], roxithromycin [RXM]), 15-membered(azithromycin [AZM]) or 16-membered (spiramycin, josamycin,midecamycin) macrocyclic lactone rings. They inhibit proteinsynthesis by reversibly binding to the 23S ribosomal RNA (rRNA)in the 50s subunit of the bacterial ribosome. Traditionally,macrolides are used as first-line agents in respiratory, skin,soft tissue, and urogenital infections, and they are also activeagainst gram-positive cocci and atypical pathogens.
Acquired immunodeficiency syndrome (AIDS) remains as one of the world’s leading causes of mortality in global public health. Dr Charles Hicks shared his insights into the increasing role of dolutegravir (DTG; Tivicay, GSK) – an integrase strand transfer inhibitor (INSTI) – in HIV therapy during the 4th National AIDS Conference 2018 at Swiss Garden International Hotel and Residences, Kuala Lumpur.
Cryptococcosis is more common in nonhuman immunodeficiency virus (HIV) nontransplant (NHNT) patients, and this population tends to have more localized pulmonary cryptococcosis and significantly higher 90-day mortality, reports a study.