Seroprevalence of Zika and Dengue Virus Antibodies among Migrant Workers, Taiwan, 2017.

A serosurvey of 600 workers newly arrived in Taiwan from 4 Southeast Asia countries showed that 18 (3%) were positive for Zika virus IgM; 6 (1%) fulfilled the World Health Organization criteria for laboratory-confirmed recent Zika virus infection. The incidence of Zika virus infection in Southeast Asia might be underestimated.

Incidence of Aeromonas bacteremia in Southern Taiwan: vibrio and Salmonella bacteremia as comparators.

The aim of the investigation was to describe the incidence of Aeromonas bacteremia in a city with a population of about 1.87 million inhabitants, located in southern Taiwan, between 2008 and 2010. Such data were compared with the incidences of Vibrio and Salmonella bacteremia in the same period and the incidence of Aeromonas bacteremia in other countries in the literature. The data revealed the average annual incidences of bacteremia due to Aeromonas, Vibrio, and Salmonella species were 76, 38, and 103 cases/million inhabitants, respectively. The incidence of Aeromonas bacteremia was higher than those in Western countries.

Clostridium difficile infection at a medical center in southern Taiwan: incidence, clinical features and prognosis.

BACKGROUND/PURPOSE: An increase in incidence of Clostridium difficile infection (CDI) among Western countries has been noted in recent years. Epidemiological data of CDI are scarce in Taiwan. This study is intended to depict the clinical features of CDI at a medical center in Southern Taiwan. METHODS: From January 1, 2007 to March 31, 2008, hospitalized patients with CDI (defined as the presence of gastrointestinal symptoms and fecal C. difficile toxin) were identified. Their medical records were reviewed for further evaluation. RESULTS: A total of 86 cases of CDI were identified in the study period. The incidence was 42.6 cases per 100,000 patient-days, or 3.4 cases per 1,000 discharges, and was highest in intensive care units (110.6 cases per 100,000 patient-days). Variable incidence rates were noted in different wards, and prevalence was higher in the infectious ward. Diarrhea, fever, and abdominal distension were common in 82 (95.3%), 47 (54.7%), and 29 (33.7%) patients, respectively. Metronidazole was the initial therapeutic regimen for 83 (96.5%) patients. Prolonged diarrhea was noted in 31 (36.4%) patients, especially in those on hemodialysis therapy. Recurrence was noted in 7 (8.1%) patients. Fecal carriage of vancomycin-resistant Enterococcus colonization was found in three patients after therapy for CDI. All-cause mortality rate of patients with CDI at 30 days was 23.3%. CONCLUSION: CDI is increasingly being recognized within the medical departments, and should be considered in hospitalized adults with diarrhea, fever, or abdominal distension alone, or in combination.

Comparisons of clinical characters in patients with pneumococcal and Legionella pneumonia.

BACKGROUND/PURPOSE: The etiology of pneumonia is usually unknown, but the availability of urinary pneumococcal and Legionella antigen tests can improve the diagnostic yield. Our aim was to provide clinical clues to help clinicians perform the appropriate urinary antigen tests. METHODS: A retrospective study of patients admitted to the National Cheng Kung University Hospital between July 2006 and June 2008 was conducted. Patients aged over 18 years presenting with clinical symptoms and signs, radiological findings compatible with pneumonia, and a positive pneumococcal or Legionella pneumophila urinary antigen test, were included. Medical records were reviewed for data collection. RESULTS: Overall, 55 adults with pneumonia, including 42 with pneumococcal pneumonia (PP) and 13 with Legionella pneumonia (LP), were enrolled. On admission, patients with PP tended to be older (73.5 years vs. 59.1 years; p=0.001), had lower body weights (52.0 kg vs. 69.7 kg; p < 0.001), more frequent respiratory symptoms (59.5%vs. 0%; p < 0.001), and lower systolic (123.0 mmHg vs. 141.0 mmHg; p=0.004) and diastolic blood pressures (68.3 mmHg vs. 81.7 mmHg; p=0.008), compared with patients with LP. However, those with LP had higher body temperatures (39.0°C vs. 37.5°C; p < 0.001), a higher incidence of relative bradycardia (45.5%vs. 0%; p < 0.001), diarrhea (15.4%vs. 0%; p= 0.053), and lower platelet counts (178.5 × 10(3)/mm(3)vs. 233.7 × 10(3)/mm(3); p= 0.026). Radiological findings showed that the major abnormality, lobar consolidation, was indistinguishable between LP and PP. The percentage of patients requiring intensive care (35.7%vs. 38.5%) or ventilator support (31%vs. 23.1%) and in-hospital crude mortality rates (9.5%vs. 7.7%) was similar in both groups. CONCLUSION: Some clinical and laboratory characteristics may be regarded as important clues indicating the need for an appropriate urinary antigen test in patients with pneumonia.

Tolerability of teicoplanin in 117 hospitalized adults with previous vancomycin-induced fever, rash, or neutropenia: a retrospective chart review.

BACKGROUND: Vancomycin has reliable antibacterial activity against many gram-positive pathogens but is associated with many adverse events. Teicoplanin, another glycopeptide, is associated with fewer adverse events, but its use in patients with previous vancomycin-induced adverse reactions remains controversial. OBJECTIVES: The aims of this work were to evaluate the clinical characteristics of hospitalized patients with vancomycin-induced fever (ie, drug fever), rash, or neutropenia and to examine the tolerability of teicoplanin in these patients. METHODS: This was a retrospective review of the medical charts of patients aged >or=18 years who were hospitalized between January 2002 and October 2007 at National Cheng Kung University Hospital in Tainan, Taiwan. Patients were included if they experienced drug-induced fever (ie, "drug fever"), rash, or neutropenia during vancomycin treatment. Their antimicrobial therapy was subsequently switched to teicoplanin. Clinical information and the development of drug fever, rash, or neutropenia with teicoplanin were determined from the charts. RESULTS: Antibiotic therapy was switched to teicoplanin in 117 patients with vancomycin-induced fever alone (n = 24), rash alone (n = 77), both drug fever and rash (n = 8), or neutropenia (n = 8). The mean (SD) age of these patients was 53.1 (22.8) years, and 65 (56%) were male. The major clinical indications for vancomycin therapy among these patients were wound infections (21%), respiratory tract infections (14%), and bacteremia (13%). The dosages for vancomycin ranged from 1 g every 5 days to 1 g BID, and for teicoplanin ranged from 400 mg daily to 400 mg q72h, adjusted by the degree of renal dysfunction. Overall, 12 patients with vancomycin-induced fever (n = 2), rash (n = 6), or neutropenia (n = 4) subsequently developed teicoplanin-induced fever (n = 3), rash (n = 3), or neutropenia (n = 6). Specifically, of 8 patients with vancomycin-induced neutropenia, 4 (50%) subsequently developed neutropenia after switching to teicoplanin. Vancomycin- and teicoplanin-induced neutropenia was often noted after 1 week of treatment. Among patients with vancomycin-induced fever, rash, or neutropenia, there were no differences between patients with or without teicoplanin-induced fever, rash, or neutropenia in terms of age, sex, weight, dosage or duration of vancomycin therapy, dosage of teicoplanin, or underlying disease. There was no difference in mortality rates between patients with or without teicoplanin-induced fever, rash, or neutropenia. The cause of all deaths was progression of infectious or underlying disease, unrelated to vancomycin or teicoplanin use. CONCLUSIONS: Based on this retrospective chart review of hospitalized patients with vancomycin-induced fever, rash, or neutropenia, only 10% experienced subsequent teicoplanin-induced fever, rash, or neutropenia. However, it should be noted that half of the patients with vancomycin-induced neutropenia developed teicoplanin-induced neutropenia.