HIV or human immunodeficiency virus infection has assumed worldwide proportions and importance in just a span of 25 years. Continuous research is being done in many parts of the world regarding its treatment and vaccine development, and a lot of money has flown into this. However, fully understanding the mechanisms of immune depletion has still not been possible. The focus has also been on improving the quality of life of people living with HIV/AIDS through education, counselling, and nutritional support. Malnutrition further reduces the capacity of the body to fight this infection by compromising various immune parameters. Knowledge of essential components of nutrition and incorporating them in the management goes a long way in improving quality of life and better survival in HIV-infected patients.

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This study investigated the species prevalence and antibacterial resistance among enterococci isolated in Kuwait hospitals. They consisted of 415 isolates of Enterococcus faecalis (85·3 %), Enterococcus faecium (7·7 %), Enterococcus casseliflavus (4·0 %), Enterococcus avium (1·2 %), Enterococcus durans (1·0 %), Enterococcus gallinarium (0·5 %) and Enterococcus bovis (0·2 %) isolated from urine (36·6 %), blood (10·4 %), wound swabs (11·0 %), stool samples (12·0 %), high vaginal swabs (9·0 %), endocervical swabs (3·0 %) and miscellaneous sources (18·0 %). All of them were susceptible to linezolid. Fifty-two (12·5 %) isolates were ampicillin resistant but none of them produced â-lactamase. They were resistant to erythromycin (63·3 %), tetracycline (60·5 %), ciprofloxacin (40·0 %), chloramphenicol (28·0 %), vancomycin (2·6 %), and teicoplanin (2·6 %). Fourteen, 19 and 20 % of them expressed high-level resistance to gentamicin, kanamycin and streptomycin, respectively. All of the vancomycin-resistant strains carried the vanA phenotype and genotype. There was no evidence of clonal spread of the vancomycin-resistant isolates.

Staphylococcus aureus and coagulase-negative staphylococci (CNS) were isolated from the hands of food handlers in 50 restaurants in Kuwait City and studied for the production of staphylococcal enterotoxins, toxic shock syndrome toxin-1, slime and resistance to antimicrobial agents. One or a combination of staphylococcal enterotoxins A, B or C were produced by 6% of the isolates, with the majority producing enterotoxin B. Toxic shock syndrome toxin-1 was detected in c. 7% of the isolates; 47% produced slime. In all, 21% of the isolates were resistant to tetracycline and 11.2% were resistant to propamidine isethionate and mercuric chloride. There was no correlation between slime and toxin production or between slime production and antibiotic resistance. The detection of enterotoxigenic CNS on food handlers suggests that such strains may contribute to food poisoning if food is contaminated by them and held in conditions that allow their growth and elaboration of the enterotoxins. It is recommended that enterotoxigenic CNS should not be ignored when investigating suspected cases of staphylococcal food poisoning.

Cytomegalovirus (CMV) is an important and common cause of mortality and morbidity in immunocompromised patients such as those with HIV/AIDS, transplant recipients on immunosuppressive therapy, and malignant hematological disease. After primary infection with CMV the virus becomes latent in multiple organs and can later be reactivated during severe dysregulation of the immune system. A large population carry dormant virus and are thus at risk for reactivation. However, reactivation of CMV has been reported in "non-immunosuppressed patients" such as severe trauma, sepsis, shock, burns, cirrhosis and other critically ill patients lying in the intensive care units. Therefore, the intensivists are increasingly facing a dilemma of identifying such patients to treat and there is a debate if there is a scientific justification for prophylaxis in such immunocompetent patients.