| Tool identifies infection clusters; rate of T cell drop not helpful in decision to start treating HIV February 21, 2010 |
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Biology
In research published this week in PLoS Medicine, Susan Huang and colleagues describe the use of a novel automated cluster detection tool, WHONET-SaTScan, made by integrating two freely available software packages, to identify hospital infection clusters. After applying the software to microbiology data from patients admitted to a 750-bed academic medical center in the US across four years (2002-2006), the authors found that the tool identified a number of hospital clusters that had not been detected by routine methods. It also classified many previously identified clusters as events likely to occur because of normal random fluctuations and hence not requiring further control measures. The authors state "this automated method has the potential to provide valuable real-time guidance both by identifying otherwise unrecognized outbreaks and by preventing the unnecessary implementation of resource-intensive infection control measures that interfere with regular patient care." Citation: Huang SS, Yokoe DS, Stelling J, Placzek H, Kulldorff M, et al. (2010) Automated Detection of Infectious Disease Outbreaks in Hospitals: A Retrospective Cohort Study. PLoS Med 7(2): e1000238. doi:10.1371/journal.pmed.1000238 Funding: This work was funded by US National Institutes of Health (MIDAS, 1U01 GM076672, Platt; (http://www.nigms.nih.gov/Initiatives/MIDAS/) and NIH RR025040-02 (Stelling). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: RP has received research grants from Sanofi-Aventis, GlaxoSmithKline, Pfizer, and TAP Pharmaceuticals in the past two years. DSY has received research support from Sage Products. MK developed the space-time permutation scan statistic method and the free SaTScan software that were used and evaluated in the study. All other authors report no disclosures. IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000238 PRESS-ONLY PREVIEW OF THE ARTICLE: www.plos.org/press/plme-07-02-huang.pdf CONTACT:
Published this week in open access journal PLoS Medicine, Marcel Wolbers (Wellcome Trust Major Overseas Program, Oxford University Clinical Research Unit) and colleagues find that the rate of CD4 T cell decline is not useful in deciding when to start HIV treatment. Wolbers and colleagues analyzed data from several thousand cohort study participants with HIV (the CASCADE collaboration) and found that the CD4 cell slope does not improve the prediction of clinical outcome in patients with a CD4 cell count above 350 cells/μl. The authors state "the findings of this study strongly suggest that knowledge of the current CD4 cell count and an assessment of other established risk factors for progression to AIDS are sufficient when deciding whether to initiate cART in symptom-free HIV-positive patients." Citation: Wolbers M, Babiker A, Sabin C, Young J, Dorrucci M, et al. (2010) Pretreatment CD4 Cell Slope and Progression to AIDS or Death in HIV-Infected Patients Initiating Antiretroviral Therapy—The CASCADE Collaboration: A Collaboration of 23 Cohort Studies. PLoS Med 7(2): e1000239. doi:10.1371/journal.pmed.1000239 Funding: CASCADE has been funded through grants BMH4-CT97-2550, QLK2-2000-01431, QLRT-2001-01708, and LSHP-CT-2006-018949 from the European Union. MW and HCB are supported by research grants from sante suisse and the Gottfried and Julia-Bangerter-Rhyner Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: HCB received travel grants, honoraria, and unrestricted research grants from various pharmaceutical companies including, GlaxoSmithKline, Bristol-Myers-Squibb, Gilead, Roche, Abbott, Tibotec, and Boehringer-Ingelheim. The research of MW, JY, and HCB is supported by unrestricted grants from sante suisse and the Gottfried and Julia Bangerter-Rhyner-Foundation. The Medical Research Council, Clinical Trials HIV Group, led by AB, received IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000239 PRESS-ONLY PREVIEW OF THE ARTICLE: www.plos.org/press/plme-07-02-wolbers.pdf CONTACT: |
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