INFECTIOUS DISEASE UPDATES AUGUST 2013

1.Obesity as a risk factor for Clostridium difficile infection.-CID-August 15,2013. Israeli Study 6300 patients were hspitalized in this study178 with Clostrdium difficile infection.The only factors that were significant–a. previous intra-abdominal surgery and  b.obesity.They also point out in the discussion that “obesity is an  independent predictor of nosocomial bacteremia in elderly patients and septic shock, ventilator associated pneumonia and catheter associated sepsis in critically ill patients.”Obesity has been associated witha higher rate of intensive care unit admissions and/or death in the 2009 Influenza A pandemic.” Obesity must now be considered as one of the most common immunosuppressive conditions. To add to the above pressure ulcers, earlier need for prosthetic joints and premature disability claims.

2.Safety of Zoster Vaccine in Elderly Patients Following Documented Herpes Zoster—CID Aug 2013 Showed that it is safe to administer vaccine in those who have previously had zoster. This is not too surprising —but needed information.Bigger question is –in an expensive vaccine–does it confer additional protection re occurence of additional episodes of shingles if an individual has had at least 1 episode of shingles. The Current Practice Recommendations are to give a dose of Zostavax to all individual greater than age 60 whether they have had an episode of Zoster or not.

3. CMV and Alzheimers Disease –Interesting observations from the Rush Alzheimers Disease Center in Chicago showing an association between CMV and Alzheimers.