Volume 18, Number 6—June 2012

Bacterial infection after liver transplant is fairly common, mostly because liver transplant patients are severely ill and the surgery is very complex. Adding to the seriousness of this situation is that some bacteria are resistant to many antimicrobial drugs. However, treating all infections as drug resistant would lead to even more drug resistance, so only patients at highest risk should receive the most powerful drugs. But who is at highest risk? A recent study in France screened fecal samples of liver transplant candidates and found that post-operative infections were most likely for those patients who already had certain bacteria in their feces before surgery. Thus, fecal screening for those multiresistant bacteria should be considered for all liver transplant candidates so that if post-operative infection develops, those at high risk can receive the most specific drugs right away.

Decreases in health care–related isolates accounted for all reductions in MRSA during 2007–2010.

Isolates represent multiple genetic lineages, a finding consistent with multiple emergences from endemic reservoirs.

Educational outreach should inform the public about dangers of translocation of wild animals and general aspects of rabies.

Such isolates should undergo drug susceptibility testing periodically to detect emerging resistance.

Virus evolution should be monitored because frequent reassortment, which contributes to virus diversity, creates the potential for more severe infections.

High prevalence within families might reflect a specific immune condition.

European boars could be used as sentinel animals to detect A. phagocytophilum strains that cause human infections.

“Doctor” fish might not be such good doctors after all. These fish are used for the increasingly popular spa treatment called fish pedicures. During these sessions, spa patrons immerse their feet in water, allowing the live fish to feed on dead skin, mainly for cosmetic reasons. However, examinations of doctor fish destined for these spas found that they can carry harmful bacteria. Thus, although reports of human infection after fish pedicures are few, there may be some risks. Spa patrons who have underlying medical conditions (such as diabetes, immunosuppression, or even simple breaks in the skin) are already discouraged from taking such treatments. However, spas that offer fish pedicures should also consider using only disease-free fish reared in controlled facilities under high standards of husbandry and welfare.