Recognition of common sexually transmitted infection (STI) syndromes allows more efficient diagno... more Recognition of common sexually transmitted infection (STI) syndromes allows more efficient diagnosis and treatment. These evidence-based guidelines provide advice on the management of STIs, including the use of the appropriate diagnostic methods and therapeutic regimens. Early and appropriate therapy has the potential to significantly reduce the long-term complications of STIs. The prevention of further infection through the counselling and treatment of partners contributes to the sexual health of patients.
This guideline is focused on the diagnostics and treatment of acute, recurrent and relapsing urin... more This guideline is focused on the diagnostics and treatment of acute, recurrent and relapsing urinary tract infections in adults and children. Sexually transmitted diseases are not addressed, but must be considered in differential diagnostics. The resistance prevalence of the causative microbes and the ecological adverse effects of antimicrobial agents were considered important factors in selecting optimal therapeutic choices for the guideline. Diagnosis and management of cystitis in otherwise healthy women aged 18-65 years can be based on structured telephone interviews. Primary antimicrobiotic drugs are nitrofurantoin, pivmesillinam and trimetoprim for three days.
International Journal of Pediatric Otorhinolaryngology, 2002
We studied the effect of concomitant nasopharyngeal carriage of β-lactamase producing Moraxella c... more We studied the effect of concomitant nasopharyngeal carriage of β-lactamase producing Moraxella catarrhalis and Haemophilus influenzae on the occurrence of penicillin resistance of Streptococcus pneumoniae. We took nasopharyngeal samples from 306 children with recurrent otitis media and a history of several antibiotic treatments. We could isolate at least one of the pathogens in 89 subjects. Of these children 13% carried
This retrospectively collected laboratory-based surveillance data includes 575 healthcare-associa... more This retrospectively collected laboratory-based surveillance data includes 575 healthcare-associated BSIs in 350 patients with haematological malignancy in Tampere University Hospital, Finland, during 1999-2001 and 2005-2010. The most common underlying diseases were acute myelogenous leukemia (n=283, 49%), followed by myeloma (n=87, 15%) and acute lymphocytic leukemia (n=76, 13%). The overall rate was 9.1 BSIs per 1000 patient-days. Gram-positive BSIs predominated and the most common pathogens were coagulase-negative staphylococci (23%), viridans streptococci (11%), enterococci (9%) and Escherichia coli (9%). Fungi caused 2% of BSIs. 7-day and 28-day case fatalities were 5% and 10% and were highest in BSIs caused by Pseudomonas aeruginosa (19% and 34%, respectively). The median age of patients with BSI has increased; it was 55.0 years during 1999-2001, compared to 59.0 years in 2005-2007 and 59.0 years in 2008-2010 (p<0.0001). Gram-positive bacteria predominated in this material....
Urinary tract infection (UTI) is a common disease with significant morbidity and economic burden,... more Urinary tract infection (UTI) is a common disease with significant morbidity and economic burden, accounting for a significant part of the workload in clinical microbiology laboratories. Current clinical chemisty point-of-care diagnostics rely on imperfect dipstick analysis which only provides indirect and insensitive evidence of urinary bacterial pathogens. An electronic nose (eNose) is a handheld device mimicking mammalian olfaction that potentially offers affordable and rapid analysis of samples without preparation at athmospheric pressure. In this study we demonstrate the applicability of ion mobility spectrometry (IMS) -based eNose to discriminate the most common UTI pathogens from gaseous headspace of culture plates rapidly and without sample preparation. We gathered a total of 101 culture samples containing four most common UTI bacteries: E. coli, S. saprophyticus, E. faecalis, Klebsiella spp and sterile culture plates. The samples were analyzed using ChemPro 100i device, con...
Recognition of common sexually transmitted infection (STI) syndromes allows more efficient diagno... more Recognition of common sexually transmitted infection (STI) syndromes allows more efficient diagnosis and treatment. These evidence-based guidelines provide advice on the management of STIs, including the use of the appropriate diagnostic methods and therapeutic regimens. Early and appropriate therapy has the potential to significantly reduce the long-term complications of STIs. The prevention of further infection through the counselling and treatment of partners contributes to the sexual health of patients.
We describe an immunocompromised patient with disseminated Legionella pneumophila infection. A ch... more We describe an immunocompromised patient with disseminated Legionella pneumophila infection. A chronic leg ulcer was probably the port of entry for the infection. Treatment required several operations and prolonged antimicrobial treatment. To our knowledge, this is the first case report of Legionella soft tissue infection and pneumonia treated with tigecycline.
International Journal of Infectious Diseases, 2013
The decision on the right empirical treatment in bacteremia places particular demands on the clin... more The decision on the right empirical treatment in bacteremia places particular demands on the clinician. As long as no microbiological diagnosis can be immediately drawn, the clinical diagnosis together with knowledge of local antimicrobial resistance must determine the antimicrobial choice. The use of several amplification, hybridization, and mass spectrometry methods has been studied in patient cohorts in comparison with blood culture-based conventional techniques. However, no clinical outcome trials have been conducted in which the use of these novel methods would guide antimicrobial therapy. Local differences in bacterial antimicrobial resistance cause differences in the regional need for molecular methods for the early detection of resistance mechanisms. The implementation of novel methods in clinical use requires active discussion between laboratory experts and clinicians. Providing rapid susceptibility results using conventional methods can lead to timely changes to appropriate antimicrobial therapy and the costs are lower than with the molecular methods. Gram-stain information in combination with clinical data is an underestimated, underused, rapid, and economical means of assessing the etiology of blood stream infection.
The Pediatric Infectious Disease Journal, Mar 1, 2010
Since many pathogens colonize the child&amp;amp;amp;amp;amp;amp;amp;amp;#39;s oro/nasopharynx... more Since many pathogens colonize the child&amp;amp;amp;amp;amp;amp;amp;amp;#39;s oro/nasopharynx in a similar manner, elimination of diseases such as those caused by Haemophilus influenzae type b (Hib) has a potential of augmenting other serious infections. Streptococcus pneumoniae is an agent of special interest now that Hib conjugates have been used widely for more than 2 decades. All blood and cerebrospinal fluid isolations of Hib and S. pneumoniae were collected prospectively from 85,000 Finnish children at age 0-15 years by one central laboratory during 27 years. Hib vaccination, launched in 1986-1988, led to a quick decline of cases until the last was detected in 1991. In the next few years, the incidence of bacteremic S. pneumoniae infections increased, but now for 15 years, the numbers of cases have been slowly declining. This finding is not explained by less active sample-taking because the number of blood cultures have almost doubled in the past years. Large-scale Hib vaccination does not increase the incidence of pneumococcal diseases which continue their year-to-year fluctuation at low levels. Only a years-long follow-up permits conclusions on a vaccination&amp;amp;amp;amp;amp;amp;amp;amp;#39;s potential influence on the epidemiology of other diseases.
ABSTRACT Background: In November 2007, a large gastroenteritis outbreak due to faecal contaminati... more ABSTRACT Background: In November 2007, a large gastroenteritis outbreak due to faecal contamination of water supply took place in the city Nokia (pop. 30 000), Finland. A large volume of treated waste water was mixed with clean mains water by accident, polluting the water of one third of the city. Methods: The magnitude, disease spectrum and microbial causes of the event were investigated. Descriptive data was collected on patients consulting local health centre or admitted to Tampere University Hospital. Postal questionnaire surveys were conducted in three populations: the polluted area of Nokia, the unpolluted area, and a control municipality in the same region. 1000 persons were randomly sampled from each population,. A case was defined as a person with acute diarrhoea or vomiting between 28th November 2007 and 20th January 2008. Results: According to the survey, over 5 000 persons met the case definition in the polluted area. The attack rates were 8-fold and 3-fold in the polluted and unpolluted area of Nokia, respectively, compared with the control municipality. Approximately 1 000 patients visited the health centre because of gastroenteritis within one month of the incident, and 187 were admitted to the University Hospital, of whom 128 (68 %) were children. Campylobacter, norovirus and Giardia lamblia were the most common pathogens, but also salmonella, rotavirus and Clostridium difficile were detected. Conclusion: Although the attack rate in the polluted area was very high, considerable excess morbidity was also detected in the unpolluted area of the city, as compared to the control municipality. There was unusually high diversity in the causative agents. The study design allowed estimation of true excess morbidity, which is also important when estimating the health-economical cost attributable to the outbreak.
Recognition of common sexually transmitted infection (STI) syndromes allows more efficient diagno... more Recognition of common sexually transmitted infection (STI) syndromes allows more efficient diagnosis and treatment. These evidence-based guidelines provide advice on the management of STIs, including the use of the appropriate diagnostic methods and therapeutic regimens. Early and appropriate therapy has the potential to significantly reduce the long-term complications of STIs. The prevention of further infection through the counselling and treatment of partners contributes to the sexual health of patients.
This guideline is focused on the diagnostics and treatment of acute, recurrent and relapsing urin... more This guideline is focused on the diagnostics and treatment of acute, recurrent and relapsing urinary tract infections in adults and children. Sexually transmitted diseases are not addressed, but must be considered in differential diagnostics. The resistance prevalence of the causative microbes and the ecological adverse effects of antimicrobial agents were considered important factors in selecting optimal therapeutic choices for the guideline. Diagnosis and management of cystitis in otherwise healthy women aged 18-65 years can be based on structured telephone interviews. Primary antimicrobiotic drugs are nitrofurantoin, pivmesillinam and trimetoprim for three days.
International Journal of Pediatric Otorhinolaryngology, 2002
We studied the effect of concomitant nasopharyngeal carriage of β-lactamase producing Moraxella c... more We studied the effect of concomitant nasopharyngeal carriage of β-lactamase producing Moraxella catarrhalis and Haemophilus influenzae on the occurrence of penicillin resistance of Streptococcus pneumoniae. We took nasopharyngeal samples from 306 children with recurrent otitis media and a history of several antibiotic treatments. We could isolate at least one of the pathogens in 89 subjects. Of these children 13% carried
This retrospectively collected laboratory-based surveillance data includes 575 healthcare-associa... more This retrospectively collected laboratory-based surveillance data includes 575 healthcare-associated BSIs in 350 patients with haematological malignancy in Tampere University Hospital, Finland, during 1999-2001 and 2005-2010. The most common underlying diseases were acute myelogenous leukemia (n=283, 49%), followed by myeloma (n=87, 15%) and acute lymphocytic leukemia (n=76, 13%). The overall rate was 9.1 BSIs per 1000 patient-days. Gram-positive BSIs predominated and the most common pathogens were coagulase-negative staphylococci (23%), viridans streptococci (11%), enterococci (9%) and Escherichia coli (9%). Fungi caused 2% of BSIs. 7-day and 28-day case fatalities were 5% and 10% and were highest in BSIs caused by Pseudomonas aeruginosa (19% and 34%, respectively). The median age of patients with BSI has increased; it was 55.0 years during 1999-2001, compared to 59.0 years in 2005-2007 and 59.0 years in 2008-2010 (p<0.0001). Gram-positive bacteria predominated in this material....
Urinary tract infection (UTI) is a common disease with significant morbidity and economic burden,... more Urinary tract infection (UTI) is a common disease with significant morbidity and economic burden, accounting for a significant part of the workload in clinical microbiology laboratories. Current clinical chemisty point-of-care diagnostics rely on imperfect dipstick analysis which only provides indirect and insensitive evidence of urinary bacterial pathogens. An electronic nose (eNose) is a handheld device mimicking mammalian olfaction that potentially offers affordable and rapid analysis of samples without preparation at athmospheric pressure. In this study we demonstrate the applicability of ion mobility spectrometry (IMS) -based eNose to discriminate the most common UTI pathogens from gaseous headspace of culture plates rapidly and without sample preparation. We gathered a total of 101 culture samples containing four most common UTI bacteries: E. coli, S. saprophyticus, E. faecalis, Klebsiella spp and sterile culture plates. The samples were analyzed using ChemPro 100i device, con...
Recognition of common sexually transmitted infection (STI) syndromes allows more efficient diagno... more Recognition of common sexually transmitted infection (STI) syndromes allows more efficient diagnosis and treatment. These evidence-based guidelines provide advice on the management of STIs, including the use of the appropriate diagnostic methods and therapeutic regimens. Early and appropriate therapy has the potential to significantly reduce the long-term complications of STIs. The prevention of further infection through the counselling and treatment of partners contributes to the sexual health of patients.
We describe an immunocompromised patient with disseminated Legionella pneumophila infection. A ch... more We describe an immunocompromised patient with disseminated Legionella pneumophila infection. A chronic leg ulcer was probably the port of entry for the infection. Treatment required several operations and prolonged antimicrobial treatment. To our knowledge, this is the first case report of Legionella soft tissue infection and pneumonia treated with tigecycline.
International Journal of Infectious Diseases, 2013
The decision on the right empirical treatment in bacteremia places particular demands on the clin... more The decision on the right empirical treatment in bacteremia places particular demands on the clinician. As long as no microbiological diagnosis can be immediately drawn, the clinical diagnosis together with knowledge of local antimicrobial resistance must determine the antimicrobial choice. The use of several amplification, hybridization, and mass spectrometry methods has been studied in patient cohorts in comparison with blood culture-based conventional techniques. However, no clinical outcome trials have been conducted in which the use of these novel methods would guide antimicrobial therapy. Local differences in bacterial antimicrobial resistance cause differences in the regional need for molecular methods for the early detection of resistance mechanisms. The implementation of novel methods in clinical use requires active discussion between laboratory experts and clinicians. Providing rapid susceptibility results using conventional methods can lead to timely changes to appropriate antimicrobial therapy and the costs are lower than with the molecular methods. Gram-stain information in combination with clinical data is an underestimated, underused, rapid, and economical means of assessing the etiology of blood stream infection.
The Pediatric Infectious Disease Journal, Mar 1, 2010
Since many pathogens colonize the child&amp;amp;amp;amp;amp;amp;amp;amp;#39;s oro/nasopharynx... more Since many pathogens colonize the child&amp;amp;amp;amp;amp;amp;amp;amp;#39;s oro/nasopharynx in a similar manner, elimination of diseases such as those caused by Haemophilus influenzae type b (Hib) has a potential of augmenting other serious infections. Streptococcus pneumoniae is an agent of special interest now that Hib conjugates have been used widely for more than 2 decades. All blood and cerebrospinal fluid isolations of Hib and S. pneumoniae were collected prospectively from 85,000 Finnish children at age 0-15 years by one central laboratory during 27 years. Hib vaccination, launched in 1986-1988, led to a quick decline of cases until the last was detected in 1991. In the next few years, the incidence of bacteremic S. pneumoniae infections increased, but now for 15 years, the numbers of cases have been slowly declining. This finding is not explained by less active sample-taking because the number of blood cultures have almost doubled in the past years. Large-scale Hib vaccination does not increase the incidence of pneumococcal diseases which continue their year-to-year fluctuation at low levels. Only a years-long follow-up permits conclusions on a vaccination&amp;amp;amp;amp;amp;amp;amp;amp;#39;s potential influence on the epidemiology of other diseases.
ABSTRACT Background: In November 2007, a large gastroenteritis outbreak due to faecal contaminati... more ABSTRACT Background: In November 2007, a large gastroenteritis outbreak due to faecal contamination of water supply took place in the city Nokia (pop. 30 000), Finland. A large volume of treated waste water was mixed with clean mains water by accident, polluting the water of one third of the city. Methods: The magnitude, disease spectrum and microbial causes of the event were investigated. Descriptive data was collected on patients consulting local health centre or admitted to Tampere University Hospital. Postal questionnaire surveys were conducted in three populations: the polluted area of Nokia, the unpolluted area, and a control municipality in the same region. 1000 persons were randomly sampled from each population,. A case was defined as a person with acute diarrhoea or vomiting between 28th November 2007 and 20th January 2008. Results: According to the survey, over 5 000 persons met the case definition in the polluted area. The attack rates were 8-fold and 3-fold in the polluted and unpolluted area of Nokia, respectively, compared with the control municipality. Approximately 1 000 patients visited the health centre because of gastroenteritis within one month of the incident, and 187 were admitted to the University Hospital, of whom 128 (68 %) were children. Campylobacter, norovirus and Giardia lamblia were the most common pathogens, but also salmonella, rotavirus and Clostridium difficile were detected. Conclusion: Although the attack rate in the polluted area was very high, considerable excess morbidity was also detected in the unpolluted area of the city, as compared to the control municipality. There was unusually high diversity in the causative agents. The study design allowed estimation of true excess morbidity, which is also important when estimating the health-economical cost attributable to the outbreak.
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Papers by Risto Vuento