We bring you the latest news from the healthcare about the health care in the United Kingdom. Do your have news for us? Contact the editor. Watch also this special movie.

dinsdag 7 november 2017

The Lancet: [Correspondence] Persistent carbapenem-resistant Klebsiella pneumoniae: a Trojan horse

[Correspondence] Persistent carbapenem-resistant Klebsiella pneumoniae: a Trojan horse
In The Lancet Infectious Diseases, Danxia Gu and colleagues1 reported the emergence and evolution of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-HvKP) strains, which have caused fatal infections at the Second Affiliated Hospital of Zhejiang University (Hangzhou, China). Although little is known about the pathogenesis of CR-HvKP, this novel strain can cause severe symptoms such as sepsis with high mortality. Nevertheless, CR-HvKP was found to account for only 3% of infections caused by the ST11 carbapenem-resistant K pneumoniae (CRKP) strains across China.
Read more

[Correspondence] Emergence of carbapenem-resistant hypervirulent Klebsiella pneumoniae
Danxi Gu and coworkers1 reported a fatal outbreak of ventilator-associated pneumonia caused by ST11 carbapenem-resistant hypervirulent Klebsiella pneumoniae (ST11 CR-HvKP) in the intensive care unit of a Chinese hospital. This novel strain poses a considerable threat to public health because of its high transmissibility, and several studies in China and India2–5 have reported similar ST11 strains with hyper-resistance and hypervirulence. The worldwide prevalence of this new strain needs to be assessed urgently to facilitate the design of appropriate infection control policies.
Read more

[Articles] Lopinavir plus nucleoside reverse-transcriptase inhibitors, lopinavir plus raltegravir, or lopinavir monotherapy for second-line treatment of HIV (EARNEST): 144-week follow-up results from a randomised controlled trial
Protease inhibitor plus raltegravir offered no advantage over protease inhibitor plus NRTI in virological efficacy or safety. In the primary analysis, protease inhibitor plus raltegravir did not meet non-inferiority criteria. A regimen of protease inhibitor with NRTIs remains the best standardised second-line regimen for use in programmes in resource-limited settings.
Read more

[Comment] The unexpected success of NRTIs in second-line treatment
Genotype-defined resistance to antiretrovirals supposedly predicts future virological failure. Findings from clinical studies, including the 144 week results from the EARNEST trial, published in The Lancet Infectious Diseases,1 challenge this decades-long dogma, certainly when it comes to nucleoside analogues.
Read more

[Articles] Immunogenicity and safety of one versus two doses of tetravalent dengue vaccine in healthy children aged 2–17 years in Asia and Latin America: 18-month interim data from a phase 2, randomised, placebo-controlled study
TDV was well tolerated and immunogenic against all four dengue serotypes, irrespective of baseline dengue serostatus. These data provide proof of concept for TDV and support the ongoing phase 3 efficacy assessment of two doses 3 months apart.
Read more