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Clinical Infectious Diseases 15 August 2013 Volume 57 Number 4 i News iii In the Literature IDSA GUIDELINE 485 On the cover: Father Thames Introducing His Offspring to the Fair City of London, wood engraving in Punch (magazine), 1858. Museum of London, London, Great Britain. The Art Archive at Art Resource, NY. Reproduced with permission. This caricature in which Father Thames introduces his offspring, primary among which is cholera, appeared on the cover of Punch on 3 July 1858, at the peak of the scandal referred to as the “Great Stink” of London caused by industrial development and sewage pumped into the River Thames. By the 1850s, the Thames resembled a fermenting cesspit, polluted by the sewers that disgorged untreated waste, rubbish and offal thrown into it from slaughter-houses, tanneries, and factories. (See Clinical Infectious Diseases 1 February 2012 cover). Part of the problem was due to the introduction of flush toilets (“water closets”), first exhibited in 1851 at the Crystal Palace of the Great Exhibition of London. Replacing the chamber-pots that most Londoners had used, these dramatically increased the volume of water and waste that was now poured into existing cesspits or holding tanks. These often overflowed into street drains designed originally to cope with rainwater, but now also used to carry outfalls from factories, slaughterhouses, and other activities, contaminating the city and abetting the spread of cholera before emptying into the River Thames. (Mary & Michael Grizzard, Cover Art Editors) A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2013 Recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM) Ellen Jo Baron, J. Michael Miller, Melvin P. Weinstein, Sandra S. Richter, Peter H. Gilligan, Richard B. Thomson Jr., Paul Bourbeau, Karen C. Carroll, Sue C. Kehl, W. Michael Dunne, Barbara Robinson-Dunn, Joseph D. Schwartzman, Kimberle C. Chapin, James W. Snyder, Betty A. Forbes, Robin Patel, Jon E. Rosenblatt, and Bobbi S. Pritt ARTICLES AND COMMENTARIES 489 Obesity as a Risk Factor for Clostridium difficile Infection Jihad Bishara, Raymond Farah, Julnar Mograbi, Wissam Khalaila, Omar Abu-Elheja, Mahmud Mahamid, and William Nseir In this retrospective, case-control study, using a multivariable model of conditional logistic regression for matched pairs, obesity was found to be a significant and independent risk factor for Clostridium difficile infection. Further restriction and prudent use of antibiotics in obese patients are recommended. 494 Does Empirical Clostridium difficile Infection (CDI) Therapy Result in False-Negative CDI Diagnostic Test Results? Venkata C. K. Sunkesula, Sirisha Kundrapu, Christine Muganda, Ajay K. Sethi, and Curtis J. Donskey Patients with suspected Clostridium difficile infection (CDI) often receive empirical therapy prior to diagnostic testing. We demonstrated that such therapy can result in false-negative CDI test results if there are delays in collection of stool specimens. 501 Suspected Early Lyme Neuroborreliosis in Patients With Erythema Migrans Katarina Ogrinc, Stanka Lotrič-Furlan, Vera Maraspin, Lara Lusa, Tjaša Cerar, Eva Ružič-Sabljič, and Franc Strle Cerebrospinal fluid was analyzed in patients with erythema migrans and symptoms/signs suggesting nervous system involvement. Several epidemiologic, clinical, and microbiologic differences were found between patients with and without pleocytosis. Predictive values of pleocytosis for microbiologically proven Lyme neuroborreliosis were established. 510 Editorial Commentary: Toward a Better Understanding of European Lyme Neuroborreliosis Gary P. Wormser and John J. Halperin 513 Aspergillosis due to Voriconazole Highly Resistant Aspergillus fumigatus and Recovery of Genetically Related Resistant Isolates From Domiciles Jan W. M. van der Linden, Simone M. T. Camps, Greetje A. Kampinga, Jan P. A. Arends, Yvette J. Debets-Ossenkopp, Pieter J. A. Haas, Bart J. A. Rijnders, Ed J. Kuijper, Frank H. van Tiel, János Varga, Anna Karawajczyk, J. Zoll, Willem J. G. Melchers, and Paul E. Verweij 552 Kenneth V. I. Rolston 555 Editorial Commentary: Voriconazole Resistance in Aspergillus fumigatus: Should We Be Concerned? David W. Denning and Paul Bowyer 524 Population Pharmacokinetics of Intravenous Polymyxin B in Critically Ill Patients: Implications for Selection of Dosage Regimens Ana M. Sandri, Cornelia B. Landersdorfer, Jovan Jacob, Márcio M. Boniatti, Micheline G. Dalarosa, Diego R. Falci, Tainá F. Behle, Rosaura C. Bordinhão, Jiping Wang, Alan Forrest, Roger L. Nation, Jian Li, and Alexandre P. Zavascki Our model suggests that when approximately 50% of isolates are NAP1/BI/027, fidaxomicin use for Clostridium difficile infection is not cost-effective at its current cost. However, typing and treatment with fidaxomicin based on strain may be more promising depending on its costs. PHOTO QUIZ 562 INVITED ARTICLES 564 Matrix-assisted laser desorption ionization–time of flight mass spectrometry is a new clinical microbiologic laboratory tool that enables rapid, cost-effective, and accurate identification of bacteria and fungi growing in cultures. Limitations include a requirement for culture and lack of provision of antimicrobial susceptibility results. 573 Antifungal Therapy and Management of Complications of Cryptococcosis due to Cryptococcus gattii Sharon C.-A. Chen, Tony M. Korman, Monica A. Slavin, Deborah Marriott, Karen Byth, Narin Bak, Bart J. Currie, Krispin Hajkowicz, Christopher H. Heath, Sarah Kidd, William J. H. McBride, Wieland Meyer, Ronan Murray, E. Geoffrey Playford, and Tania C. Sorrell; for the Australia and New Zealand Mycoses Interest Group (ANZMIG) Cryptococcus Study Induction amphotericin plus 5-flucytosine is indicated for Cryptococcus gattii lung (2 weeks) and neurologic disease (6 weeks), followed by fluconazole (total course 6–12 and 18 months, respectively). Shunting for raised intracranial pressure is frequent. Immune reconstitution inflammatory syndrome occurs in 9% of cases. CLINICAL PRACTICE Clinical Reasoning for the Infectious Disease Specialist: A Primer to Recognize Cognitive Biases Amanda Vick, Carlos A. Estrada, and J. Martin Rodriguez In a multicenter study of a cohort of 2140 pulmonary patients with suspected tuberculosis disease in 2008–2010, we evaluate the use, effectiveness, health-system benefits, and cost-effectiveness of MTD Nucleic Acid Amplification Testing for diagnosing tuberculosis disease at 4 US sites. 543 MEDICAL MICROBIOLOGY Matrix-Assisted Laser Desorption Ionization– Time of Flight Mass Spectrometry in Clinical Microbiology Robin Patel The Health-System Benefits and Cost-effectiveness of Using Mycobacterium Tuberculosis Direct Nucleic Acid Amplification Testing to Diagnose Tuberculosis Disease in the United States Suzanne M. Marks, Wendy Cronin, Thara Venkatappa, Gina Maltas, Sandy Chon, Sharon Sharnprapai, Mary Gaeddert, Jane Tapia, Susan E. Dorman, Sue Etkind, Claud Crosby, Henry M. Blumberg, and John Bernardo Generalized Pain in a 20-Year-Old Man With Chronic Granulomatous Disease (Answer on pages 616–7.) This is the first population pharmacokinetic study demonstrating that doses of intravenous polymyxin B are best scaled by total body weight and should not be based on renal function. 532 Is Fidaxomicin Worth the Cost? An Economic Analysis Sarah M. Bartsch, Craig A. Umscheid, Neil Fishman, and Bruce Y. Lee The emergence of voriconazole highly resistant Aspergillus fumigatus is reported in Dutch university hospitals. Patients with azole-resistant invasive aspergillosis failed voriconazole therapy. Resistant isolates with identical resistance mechanisms were recovered from domiciles, indicating an environmental route of resistance selection. 521 Editorial Commentary: Cryptococcosis due to Cryptococcus gattii Infectious disease specialists are frequently consulted for diagnostic and therapeutic guidance regarding challenging cases. Using a casebased approach, we review and reflect upon diagnostic errors, clinical reasoning, and cognitive biases and provide strategies that may aid in their prevention. 579 HEALTHCARE EPIDEMIOLOGY Infection Prevention in the Cancer Center Kerri A. Thom, Michael Kleinberg, and Mary-Claire Roghmann In this review, we focus on infection prevention measures, including surveillance, prophylaxis, and prevention, that are specific to patients, healthcare personnel, and visitors in the cancer center setting. HIV/AIDS 586 Relationship Between Weight, Efavirenz Exposure, and Virologic Suppression in HIV-Infected Patients on Rifampin-Based Tuberculosis Treatment in the AIDS Clinical Trials Group A5221 STRIDE Study 619 Samad E. J. Golzari, Kamyar Ghabili, Arash Aslanabadi, Hadi Mohammad Khanli, Amir Mohammad Bazzazi, Babak Sabermarouf, Reza Piri, and Ata Mahmoodpoor 619 Anne F. Luetkemeyer, Susan L. Rosenkranz, Darlene Lu, Florence Marzan, Prudence Ive, Evelyn Hogg, Susan Swindells, Constance A. Benson, Beatriz Grinsztejn, Ian M. Sanne, Diane V. Havlir, and Francesca Aweeka; for the Adult AIDS Clinical Trials Group A5221 Study Team In human immunodeficiency virus (HIV)/tuberculosis–coinfected patients, coadministration of efavirenz (EFV) and rifampin-based tuberculosis therapy was associated with a trend toward higher, not lower, EFV trough concentrations compared to EFV alone. Neither weight ≥50 kg nor ≥60 kg was associated with decreased HIV virologic suppression. 594 Skewing of the CD4+ T-Cell Pool Toward Monofunctional Antigen-Specific Responses in Patients With Immune Reconstitution Inflammatory Syndrome in The Gambia 604 Prediction of HIV Drug Resistance Based on Virologic, Immunologic, Clinical, and/or Adherence Criteria in the Stratall ANRS 12110/ ESTHER Trial in Cameroon Charlotte Boullé, Charles Kouanfack, Gabrièle Laborde-Balen, Avelin Fobang Aghokeng, Sylvie Boyer, Maria Patrizia Carrieri, Serge Kazé, Jean-Marc Mben, Marlise Dontsop, Bruno Spire, Martine Peeters, Eitel Mpoudi-Ngolé, Eric Delaporte, and Christian Laurent, for the Stratall ANRS 12110/ESTHER Study Group Epidemiologic Characteristics of Cases for Influenza A(H7N9) Virus Infections in China Wenyi Zhang, Liya Wang, Wenbiao Hu, Fan Ding, Hailong Sun, Shenlong Li, Liuyu Huang, and Chengyi Li 620 Lack of Association Between Interleukin 28B Polymorphisms and Spontaneous Viral Clearance in Hepatitis B Virus Patients Yun Liao, Yi Li, Bei Cai, Jie Chen, and Lanlan Wang 622 Reply to Liao et al Wai-Kay Seto, Danny Ka-Ho Wong, Ching-Lung Lai, and Man-Fung Yuen 622 Harry Wilson, Bouke C. de Jong, Kevin Peterson, Assan Jaye, Beate Kampmann, Martin O. C. Ota, and Jayne S. Sutherland Responses to tuberculosis antigens were analyzed in a longitudinal cohort of patients with immune reconstitution inflammatory syndrome (IRIS). IRIS patients had a slow recovery of general T-cell responses (both CD4+ and CD8+) but specific increases in monofunctional CD4+IFN-γ+ responses to tuberculosis antigens during IRIS. Infectious Threats After Iran’s Bushehr Earthquake Evolutionary Characteristics of A/Hangzhou/1/ 2013 and Source of Avian Influenza Virus H7N9 Subtype in China Chenglong Xiong, Zhijie Zhang, Qingwu Jiang, and Yue Chen 624 Do Patient Data Really Support the Clinical and Laboratory Standards Institute Recommendation for Lowering Third-Generation Cephalosporin Interpretive Breakpoints? Pranita D. Tamma and John H. Powers 625 Understanding Increased Mortality in Clostridium difficile–Infected Older Adults Seth T. Walk, Dejan Micic, Andrzej T. Galecki, Vincent B. Young, and David M. Aronoff 626 Reply to Walk et al A. S. Walker, D. W. Eyre, D. W. Crook, T. E. A. Peto, and M. H. Wilcox 608 Long-term Outcomes of a Cell Phone–Delivered Intervention for Smokers Living With HIV/AIDS Ellen R. Gritz, Heather E. Danysh, Faith E. Fletcher, Irene Tami-Maury, Michelle Cororve Fingeret, Rachel Marks King, Roberto C. Arduino, and Damon J. Vidrine Smokers with human immunodeficiency virus/AIDS receiving a cell phone–based intervention with supportive counseling were more likely to demonstrate smoking abstinence over 12 months compared to smokers receiving usual care. The greatest impact was at 3 months, and intervention efficacy decreased over time. CORRESPONDENCE 618 Testing Antimicrobial Drugs Subhash C. Arya and Nirmala Agarwal 627 How Much Is a Life Worth? Food for Thought Mark E. Lustberg and Karri A. Bauer BOOK REVIEW 629 Medically Important Fungi 5th ed. Joshua D. Nosanchuk ELECTRONIC ARTICLES e22 A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2013 Recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM) Ellen Jo Baron, J. Michael Miller, Melvin P. Weinstein, Sandra S. Richter, Peter H. Gilligan, Richard B. Thomson Jr., Paul Bourbeau, Karen C. Carroll, Sue C. Kehl, W. Michael Dunne, Barbara Robinson-Dunn, Joseph D. Schwartzman, Kimberle C. Chapin, James W. Snyder, Betty A. Forbes, Robin Patel, Jon E. Rosenblatt, and Bobbi S. Pritt e122 Genotype 4 Hepatitis E Virus in France: An Autochthonous Infection With a More Severe Presentation Asma Jeblaoui, Stephanie Haim-Boukobza, Eric Marchadier, Camelia Mokhtari, and Anne-Marie Roque-Afonso Among hepatitis E virus (HEV) infections diagnosed in 2011 by the French Reference Centre for HEV, 9 were due to genotype 4, which until recently was limited to Asia. Sequences from autochthonous cases formed a single cluster very similar to Belgian swine sequences. Clinical presentation differed from genotype 3 infections. e127 First Isolation of Mimivirus in a Patient With Pneumonia Hanene Saadi, Isabelle Pagnier, Philippe Colson, Jouda Kanoun Cherif, Majed Beji, Mondher Boughalmi, Saïd Azza, Nicholas Armstrong, Catherine Robert, Ghislain Fournous, Bernard La Scola, and Didier Raoult Our study is the first to describe the isolation of a giant virus from a patient. Our finding is important conceptually because it is evidence for the presence and pathogenicity of giant viruses in humans, specifically as causative agents of pneumonia. The electronic articles listed above are freely available in this issue of Clinical Infectious Diseases online (http://cid.oxfordjournals.org/ content/current).