Emphysematous Liver Abscess and Disseminated Hypervirulent Klebsiella pneumoniae Infection in a Patient from Southern India.

The pyogenic liver abscess is usually polymicrobial and is seen as a complication of biliary disease or peritonitis. Over the past three decades, monomicrobial liver abscess caused by Klebsiella pneumoniae is being increasingly reported from South East Asian countries like Taiwan and Korea. It is a community-acquired infection caused by a distinct strain, hypervirulent K. pneumoniae, different from classical strain related to the healthcare-associated Klebsiella infections. Diabetes mellitus is a significant risk factor. Reports of the disseminated infection due to hypervirulent Klebsiella are very few in Indian literature. We report the successful management of a diabetic patient with emphysematous liver abscess, brain abscess, and meningitis caused by hypervirulent K. pneumoniae infection. How to cite this article: Nayak AR, Ramadoss R, Ramanathan V, Honnarudraiah NK. Emphysematous Liver Abscess and Disseminated Hypervirulent Klebsiella pneumoniae Infection in a Patient from Southern India. Indian J Crit Care Med 2022;26(3):381-383.

Migration of health workers in the Pacific Islands: a bottleneck to health development.

Human resources for health (HRH) are a crucial component of a well-functioning health system. Problems in the global HRH supply and distribution are an obstacle to achieving the health-related Millennium Development Goals and other health outcomes. The Pacific Island region, covering 20,000 to 30,000 islands in the South Pacific Ocean, is suffering a serious HRH crisis. Yet updated evidence and data are not available for the 22 Pacific Island Countries and Territories. The objective of this study was thus to explore the current HRH situation in the Pacific Island region, focusing particularly on the issue of health workforce migration. HRH trends and gaps differ by country, with some showing increases in HRH density over the past 20 years whereas others have made negligible progress. Currently, three Pacific Island countries are facing critical HRH shortages, a worsening of the situation from 2006, when HRH issues were first brought to widespread global attention. In this region, skilled personnel migration is a major issue contributing to the limited availability of HRH. Political commitment from source and destination countries to strengthen HRH would be a key factor toward increasing efforts to train new health personnel and to implement effective retention strategies.

A novel serum assay for breast epithelial antigen using a fusion protein.

Serum levels of breast epithelial antigens (BrE-Ags) are presently used in the follow-up of breast cancer patients. Available assays do not have optimal sensitivity and rely on reagents that could vary in their source and purity. A novel competitive solid-phase radioimmunoassay was developed for BrE-Ags that consists of the NP5 fusion protein, produced in Escherichia coli, that is composed of beta-galactosidase and polypeptide sequence obtained from a breast carcinoma cell line cDNA library, and anti-human milk fat globule monoclonal antibody Mc5. The fusion protein carries an altered epitope sequence (mimotope) that is similar, but not identical, to that found in the native antigen. This new competitive assay configuration has two essential features, a solid-phase affinity step that purifies the fusion protein carrying the mimotope for Mc5 and a competitive step that provides quantitation. Serum values for this assay show high specificity and sensitivity for breast cancer patients when compared to normal subjects and post-surgical breast cancer patients during their disease-free period.