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Biomedical subjects

Methee Chayakulkeeree

Publications and source records attributed to Methee Chayakulkeeree.

7 recordsLinked to original sources

Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM.

Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidiasis primarily affect patients who are immunocompromised or critically ill. In contrast, mucocutaneous forms of candidiasis, such as oral thrush and vulvovaginal candidiasis, can occur in otherwise healthy individuals. Although mucocutaneous candidiasis is generally not life-threatening, it can cause considerable discomfort, recurrent infections, and complications, particularly in patients with underlying conditions such as diabetes or in those taking immunosuppressive therapies. The rise of difficult-to-treat Candida infections is driven by new host factors and antifungal resistance. Pathogens, such as Candida auris (Candidozyma auris) and fluconazole-resistant Candida parapsilosis, pose serious global health risks. Recent taxonomic revisions have reclassified several Candida spp, potentially causing confusion in clinical practice. Current management guidelines are limited in scope, with poor coverage of emerging pathogens and new treatment options. In this Review, we provide updated recommendations for managing Candida infections, with detailed evidence summaries available in the appendix.

Humans↗

Cryptococcosis.

In the past 2 decades, Cryptococcus has emerged in its clinical significance and as a model yeast for understanding molecular pathogenesis. C neoformans and C gattii are currently considered major primary and secondary pathogens in a wide array of hosts that are known to be immunocompromised or apparently immunocompetent. A recent outbreak of C gattii infections further underscores the clinical importance of the yeast through its epidemiology and pathogenicity features. With an enlarging immunosuppressed population caused by HIV infection, solid organ transplantation, and clinical use of potent immunosuppressives, such as cancer chemotherapy, monoclonal antibodies, and corticosteroids, this fungus has become a well-established infectious complication of modern medicine. This article examines current issues in cryptococcal infections, including new classification, epidemiology, pathogenesis, and specific clinical aspects.

Cryptococcosis↗

Brain abscess due to Listeria monocytogenes: first case report in Thailand.

Brain abscess with bacteremia caused by Listeria monocytogenes in a young woman with immune thrombocytopenic purpura was reported. The clinical features included fever, headache, and left-side weakness. Computed tomography and magnetic resonance imaging of the brain showed a large single abscess at the right frontoparietal area. L. monocytogenes was isolated from a blood culture. The patient promptly received a surgical drainage. Because she had a history of penicillin allergy, and the organism was resistant to ampicillin, she was treated with trimethoprim-sulfamethoxazole (TMP-SMX) alone for 12 months. During a one-year follow-up period, the patient improved and her neurological deficit gradually recovered. This is the first case of listerial brain abscess in Thailand that was successfully treated with TMP-SMX monotherapy and surgical drainage.

Adult↗

Hantavirus infection in Thailand: first clinical case report.

This study involved 115 cases of Fever of Unknown Origin (FUO) in patients who were admitted to the Department of Medicine, Siriraj Hospital from May 1999 to November 2000. Among the patient sera screened by ELISA for IgG Hantavirus, five were positive for IgG Hantavirus-reacting antibodies and eight tested positive for IgM Hantavirus-reacting antibodies. One serum had both IgG and IgM antibodies. The patient exhibited acute encephalitic febrile illness, thrombocytopenia, high AST and ALT levels, and prolonged coagulation time. It appears that a form of the Hantaan virus is circulating in Thailand, which can infect humans and be pathogenic in some instances.

Adolescent↗

Hantavirus infection in Thailand: first clinical case report.

This study involved 115 cases of fever of unknown origin (FUO) patients who were admitted to the Department of Medicine, Siriraj Hospital from May 1999 to November 2000. Among the patient sera screened by ELISA for IgG Hantavirus, five were positive for IgG Hantavirus-reacting antibodies and eight tested positive for IgM Hantavirus-reacting antibodies. One serum had both IgG and IgM antibodies. The patient exhibited acute encephalitic febrile illness, thrombocytopenia, high AST and ALT levels, and prolonged coagulation time. It appears that a form of the Hantaan virus is circulating in Thailand, which can infect humans and be pathogenic in some instances.

Adolescent↗

Epidemiology of extended-spectrum beta-lactamase producing gram-negative bacilli at Siriraj Hospital, Thailand, 2003.

A cross-sectional study was conducted from August to September, 2003 to determine the prevalence and risk factors in acquiring extended-spectrum beta-lactamase (ESBL) producing gram-negative bacilli (GNB) in patients admitted to Siriraj Hospital and the outcomes of these infections. Of 346 isolates of gram-negative bacteria in 249 patients, 102 isolates from 87 patients were colonization only, but 244 isolates from 162 patients were infections. The common GNB were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacter cloacae. The overall prevalence of ESBL producers was 30.1%. K. pneumoniae had a very high prevalence of ESBL producers (56.9%). The urinary tract was the most common site for ESBL- producing GNB infections. Nosocomial infections, duration from admission to infection, peripheral line, urinary catheterization, nasogastric tube insertion and previous use of beta-lactams, cephalosporins and fluoroquinolones were associated with acquiring ESBL-producing GNB infections. ESBL-producing GNB were significantly more resistant to antimicrobial agents. More than 80% of ESBL-producing GNB were susceptible to carbapenems. Mortality in patients infected with ESBL-producing GNB (41.3%) was significantly higher than those infected with non- ESBL-producing GNB (19.8%).

Carbapenems↗

Risk index for predicting complications and prognosis in Thai patients with neutropenia and fever.

BACKGROUND: New strategies in the treatment of febrile neutropenic patients have been proposed during the past decade. It is more and more widely accepted that febrile neutropenic patients are a heterogeneous population and they have varying risks for complications and death. However, most of the data have been collected from patients in Western countries. The purpose of the study was to identify types of infection and etiologic organisms in febrile neutropenic patients at Siriraj Hospital, Thailand, and also to develop a prediction model in order to identify patients who are expected to have a favorable outcome or a low-risk subset. METHOD: The medical records of chemotherapy-induced neutropenic patients with fever hospitalized at Siriraj Hospital, Thailand, from January 1999 to December 2000 were analyzed. Data included patient characteristics, epidemiological data and the potential factors at the onset of fever for predicting patient outcome. A scoring system for predicting patients with favorable outcome was developed. The scoring system developed from this study was compared with a previously used scoring system. RESULTS: Of 220 patients with 267 febrile neutropenic episodes, 71.8 per cent had hematologic malignancies and 28.2 per cent had solid tumors. Bacteremia was found in 61 episodes (22.8%) and gram negative bacilli were the most common causative organism in bacteremia (88.6%). Overall mortality was 17.7 per cent. Multivariate analysis revealed that the factors predicting outcome were burden of illness, control of cancer, duration of neutropenia and dehydration. The scoring system developed from this set of data revealed that a score > or = 16 identified patients with a favorable outcome with a specificity of 90.2 per cent, sensitivity of 76.6 per cent and positive predictive value of 85.4 per cent. CONCLUSION: The causative organisms of bacterial infections in febrile neutropenic patients in Thailand are still gram negative bacteria. The locally developed risk index has a fair accuracy to identify patients with favorable outcome and may be used to identify patients suitable for less aggressive treatment strategies.

Adolescent↗