Failure of penicillin prophylaxis in laboratory acquired leptospirosis

Gilks, Charles F.; Lambert, H P; Broughton, E.S.; Baker, C. C.

doi:10.1136/pgmj.64.749.236

Cited by 22 publications

(10 citation statements)

References 11 publications

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“…once per week is sometimes recommended as prophylaxis for persons with exposure to environments at high risk for leptospirosis (e.g. swimming through jungle waters, kayaking in developing countries); however, infection may not be prevented [4,25,26]. Although doxycycline prophylaxis does not prevent leptospiral infection in an endemic area, it has a signifi cant protective eff ect in reducing the morbidity and mortality during outbreaks [27].…”

Section: Discussionmentioning

confidence: 99%

Outbreak of leptospirosis among triathlon participants in Langau, Austria, 2010

Radl

Müller

Revilla‐Fernández

et al. 2011

Wien Klin Wochenschr

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We report on the first documented outbreak of leptospirosis in Austria. In July 2010, four cases of serologically confirmed leptospirosis occurred in athletes after a triathlon held in Langau. Heavy rains preceded the triathlon (rainfall: 22 mm). The index case (Patient A) was a 41-year-old previously healthy male, who was admitted to hospital A on July 8 with a four-day history of fever up to 40°C that began 14 days after attending the triathlon event. On July 7, patient B, a 42-year-old male, was admitted to the same hospital, with signs and symptoms of kidney failure. Hemodialysis was performed every other day for 3 weeks. While the serum drawn on the day of admission was negative for antibodies against Leptospira, a specimen from July 28 tested positive with Leptospira interrogans. On July 11, patient C, a 40-year-old male, was admitted to hospital B for nephritis. On July 14, patient D, a 44-year-old male, was admitted to hospital C with a ten days history of intermittent fever, mild dry cough and headache. Our report underlines that in Austria recreational users of bodies of freshwater must be aware of an existing risk of contracting leptospirosis, particularly after heavy rains. The suppressive influence of a triathlon on the immune system is well documented and therefore an outbreak in this population group can be seen as a sensitive indicator concerning possible risk for the general population.

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Section: Discussionmentioning

confidence: 99%

Outbreak of leptospirosis among triathlon participants in Langau, Austria, 2010

Radl

Müller

Revilla‐Fernández

et al. 2011

Wien Klin Wochenschr

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“…Doxycycline may be used as a chemoprophylaxis strategy against both malaria and leptospirosis for patients who anticipate having a relatively high level of exposure. Clinical trials are needed to validate antibiotics with longer serum half-lives, such as azithromycin.Gilks [64]1988 Postgrad. Med.…”

Section: Table A1mentioning

confidence: 99%

The Use of Chemoprophylaxis after Floods to Reduce the Occurrence and Impact of Leptospirosis Outbreaks

Schneider

Hernández

Min

et al. 2017

IJERPH

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Record-breaking and devastating rainfall events have occurred in the past decade. Rain and floods are considered the main risk factors for leptospirosis and several outbreaks have been reported following extreme weather events. In such situations, one possible intervention to prevent leptospirosis cases in high-risk groups is the use of chemoprophylaxis. However, not enough evidence of its effect is available. The objectives of this study were to review the literature on the current practices of chemoprophylaxis for leptospirosis and to explore, using a mathematical model, how various chemoprophylaxis scenarios may affect the progression of a leptospirosis outbreak. Twenty-six peer-reviewed publications were selected (10 quantitative studies, two systematic reviews and 14 articles of other types). Oral doxycycline was the most used antibiotic for chemoprophylaxis of leptospirosis. Post-exposure prophylaxis was assessed in four studies following a natural disaster. Although evidence of the effectiveness of post-exposure prophylaxis is inconsistent, the direction of association supported a protective effect for morbidity and mortality. The theoretical model showed how the assumed benefit of chemoprophylaxis was influenced by the time and rate of administration. Future models should consider the heterogeneity of affected communities, improved estimates of the effect of chemoprophylaxis on leptospirosis infection and disease, as well as potential detrimental impacts. Additional research is critical to provide clear evidence-based recommendations for leptospirosis control during an outbreak. The results of this study suggest that chemoprophylaxis may provide some protection in reducing the number of leptospirosis cases after a high-risk exposure; however, the effective benefit may depend on a variety of factors such as the timing and coverage of prophylaxis. The information summarized can be used to support decision-making during a high-risk event.

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“…Pike (110) reported 67 laboratory-associated cases of leptospirosis and 10 deaths. Infection related to occupational exposure usually is caused by accidental parenteral inoculation, direct or indirect contact with cultures or infected materials (especially urine), and animal bites (40,142,147).…”

Section: Bacteriamentioning

confidence: 99%

Laboratory-associated infections and biosafety

Sewell¹

1995

Clin Microbiol Rev

268

141

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An estimated 500,000 laboratory workers in the United States are at risk of exposure to infectious agents that cause disease ranging from inapparent to life-threatening infections, but the precise risk to a given worker unknown. The emergence of human immunodeficiency virus and hantavirus, the continuing problem of hepatitis B virus, and the reemergence of Mycobacterium tuberculosis have renewed interest in biosafety for the employees of laboratories and health care facilities. This review examines the history, the causes, and the methods for prevention of laboratory-associated infections. The initial step in a biosafety program is the assessment of risk to the employee. Risk assessment guidelines include the pathogenicity of the infectious agent, the method of transmission, worker-related risk factors, the source and route of infection, and the design of the laboratory facility. Strategies for the prevention and management of laboratory-associated infections are based on the containment of the infectious agent by physical separation from the laboratory worker and the environment, employee education about the occupational risks, and availability of an employee health program. Adherence to the biosafety guidelines mandated or proposed by various governmental and accrediting agencies reduces the risk of an occupational exposure to infectious agents handled in the workplace.

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Failure of penicillin prophylaxis in laboratory acquired leptospirosis

Cited by 22 publications

References 11 publications

Outbreak of leptospirosis among triathlon participants in Langau, Austria, 2010

Outbreak of leptospirosis among triathlon participants in Langau, Austria, 2010

The Use of Chemoprophylaxis after Floods to Reduce the Occurrence and Impact of Leptospirosis Outbreaks

Laboratory-associated infections and biosafety

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