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Sepsis guidelines

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https://www.readbyqxmd.com/read/28925912/epidemiologic-features-of-invasive-group-a-streptococcus-infection-in-a-rural-hospital-6-year-retrospective-report-and-literature-review
#1
Kassandra Loewen, Natalie Bocking, Cai-Lei Matsumoto, Mike Kirlew, Len Kelly
INTRODUCTION: High rates of invasive group A Streptococcus disease were suspected by clinicians in northwestern Ontario. Patients with sepsis were being encountered with bacteremia positive for group A Streptococcus. This study was designed to assess the incidence of invasive group A Streptococcus infection in the region and provide best-practice treatment information. METHODS: We performed a retrospective chart review at the Sioux Lookout Meno Ya Win Health Centre (SLMHC) from 2009 to 2014 to examine rates of infection due to invasive group A Streptococcus and outcomes...
2017: Canadian Journal of Rural Medicine
https://www.readbyqxmd.com/read/28923865/an-in-vitro-comparison-of-ceftolozane-tazobactam-compared-to-traditional-beta-lactams-as-an-alternative-to-combination-antimicrobial-therapy-for-pseudomonas-aeruginosa
#2
Kellie J Goodlet, David P Nicolau, Michael D Nailor
Background: Guidelines for sepsis, febrile neutropenia, and hospital-acquired pneumonia include empiric regimens incorporating two antibiotics from different classes with activity against Pseudomonas aeruginosa for select at-risk patients to increase the likelihood of susceptibility to at least one agent.Objectives: The activity and cross-resistance rates of ceftolozane/tazobactam were compared to β-lactam comparators cefepime, ceftazidime, piperacillin/tazobactam, and meropenem alone and cumulatively with ciprofloxacin or tobramycin against P...
September 18, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28918911/mortality-of-severe-septic-patients-between-physician-s-high-and-low-care-volumes
#3
Chun-Yao Lin, Jo-Chi Tseng, Chih-Yu Huang, Chien-Ming Chu, Huang-Pin Wu
BACKGROUND: Patients with severe sepsis frequently require intensive care unit (ICU) admission and different ICU care models may influence their outcomes. The mortality of severe septic patients between physician's high and low care volume remains unclear. METHODS: We analyzed the data from a three-year prospective observation study, which was performed in an adult medical ICU of Chung Gung Memorial Hospital, Keelung. The data included initial bundle therapies based on the Surviving Sepsis Campaign (SSC) guidelines for patients with severe sepsis...
August 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28916120/does-early-and-appropriate-antibiotic-administration-improve-mortality-in-emergency-department-patients-with-severe-sepsis-or-septic-shock
#4
Robert Sherwin, Michael E Winters, Gary M Vilke, Gabriel Wardi
BACKGROUND: Severe sepsis and septic shock remain significant public health concerns. Appropriate emergency department management includes early recognition, hemodynamic resuscitation, source control, and prompt antibiotic administration. Current international guidelines strongly recommend administration of early and appropriate antibiotics for patients with severe sepsis and septic shock. Interestingly, a recent Cochrane Review found insufficient evidence to provide a similar recommendation on antibiotic administration...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28914210/-sepsis-new-insights-new-definition
#5
W J Wiersinga, A R H van Zanten, K A Kaasjager, T van der Poll
- Incidence of sepsis is increasing, partly due to an ageing population, increased use of immunosuppressants, and antibiotic resistance. Sepsis survival has improved substantially, in part because of continuously improving intensive care and implementation of evidence-based guidelines.- Sepsis is defined as 'life-threatening organ dysfunction due to a dysregulated host response to infection'. The Sequential Organ Failure Assessment (SOFA) score can be used to estimate organ dysfunction severity.- In this article, we discuss the new sepsis definitions - including reactions to these definitions, an overview of current insights in sepsis pathogenesis, and the new treatment guidelines...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28901786/effect-of-gestational-age-on-the-epidemiology-of-late-onset-sepsis-in-neonatal-intensive-care-units-a-review
#6
Elsa de Palma Afonso, Stijn Blot
Neonatal sepsis is a major cause of morbidity and mortality. Late-onset sepsis affects a significant percentage of infants admitted to the neonatal intensive care unit (NICU). Most affected newborns are preterm or low birth weight, but late-onset sepsis also affects late preterm and term infants. Understanding how gestational age affects the epidemiology of late-onset sepsis can be of use when defining strategies for its prevention and clinical management in NICU. Areas covered: Available evidence suggests the incidence and mortality of late-onset sepsis is higher in preterm and VLBW infants, but pathogen distribution and risk exposure is similar across all infants admitted to NICU...
September 13, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28885400/internal-validation-of-the-sepsis-in-obstetrics-score-to-identify-risk-of-morbidity-from-sepsis-in-pregnancy
#7
Catherine M Albright, Phinnara Has, Dwight J Rouse, Brenna L Hughes
OBJECTIVE: To prospectively validate the Sepsis in Obstetrics Score, a pregnancy-specific sepsis scoring system, to identify risk for intensive care unit (ICU) admission for sepsis in pregnancy. METHODS: This is a prospective validation study of the Sepsis in Obstetrics Score. The primary outcome was admission to the ICU for sepsis. Secondary outcomes included admission to a telemetry unit and time to administration of antibiotic therapy. We evaluated test characteristics of a predetermined score of 6 or greater...
September 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28885390/epidemiology-of-admissions-from-the-emergency-department-among-febrile-infants-younger-than-90-days-in-the-united-states-2002-to-2012
#8
Diana K Nguyen, Ross J Fleischman, Scott Friedlander, Kenneth M Zangwill
BACKGROUND AND OBJECTIVES: Febrile infants younger than 90 days are often subjected to invasive diagnostic evaluation and hospitalization to monitor for serious bacterial infection (SBI) despite recent changes in SBI risk and advances in diagnostics. Nationwide provider practices, over time, are unknown for this group. Our objective was to determine the likelihood of admission and associated complications of care for such infants, particularly those at lowest risk for SBI. METHODS: This is a retrospective cohort study including multisite emergency department (ED) visits using administrative data from the Pediatric Emergency Care Applied Research Network Core Data Project...
September 5, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28885216/microcirculation-measurements-barriers-for-use-in-clinical-routine
#9
Dietrich Henzler, Matthias Scheffler, Arne Westheider, Thomas Köhler
BACKGROUND: In patients with shock, inflammation and sepsis alterations in microcirculation are common problems. Although the pathophysiologic consequences are well understood, measurements of microcirculation have not entered clinical routine so far. OBJECTIVE: To characterize the requirements for clinical microcirculation measurement techniques and the barriers for implementation into routine practice. METHODS: Clinical review of reliability, reproducibility, validity, availability and usefulness of clinically available measurement techniques to be used in patients with sepsis or cardiac surgery with cardiopulmonary bypass...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28876695/the-role-of-procalcitonin-as-a-diagnostic-marker-of-bacterial-sepsis-in-burns
#10
D L Wineberg, D Kruger
BACKGROUND: Patients with burn wounds are at high risk of infection. Since sepsis contributes significantly to morbidity and mortality, early diagnosis is essential. Procalcitonin (PCT) is a biomarker released in response to inflammation and specifically bacterial infection. It may therefore be a useful biomarker for sepsis in burns. METHOD: All adult patients admitted to two Burns Intensive Care Units in Johannesburg were included in a retrospective data review...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28872708/validation-of-an-automated-immune-turbidimetric-assay-for-serum-gelsolin-and-its-possible-clinical-utility-in-sepsis
#11
Zoltán Horváth-Szalai, Péter Kustán, Balázs Szirmay, Ágnes Lakatos, Per H Christensen, Tamás Huber, Beáta Bugyi, Diána Mühl, Andrea Ludány, Attila Miseta, Gábor L Kovács, Tamás Kőszegi
BACKGROUND: Studies showing the potential predictive value of the actin-binding protein gelsolin, in critically ill patients are scarce. Moreover, even up to now a rapid automated measurement of gelsolin has still remained a challenge. Therefore, we developed and validated an automated serum gelsolin immune turbidimetric assay for possible clinical use. METHODS: Validation of serum gelsolin assay was performed on a Cobas 8000/c502 analyzer (Roche) according to the second edition of Eurachem guidelines...
September 5, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28859955/human-placentophagy-a-review
#12
REVIEW
Alex Farr, Frank A Chervenak, Laurence B McCullough, Rebecca N Baergen, Amos Grünebaum
Placentophagy or placentophagia, the postpartum ingestion of the placenta, is widespread among mammals; however, no contemporary human culture incorporates eating placenta postpartum as part of its traditions. At present, there is an increasing interest in placentophagy among postpartum women, especially in the United States. The placenta can be eaten raw, cooked, roasted, dehydrated, or encapsulated or through smoothies and tinctures. The most frequently used preparation appears to be placenta encapsulation after steaming and dehydration...
August 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28858918/implementation-of-the-surviving-sepsis-campaign-guidelines
#13
Vikramjit Mukherjee, Laura Evans
PURPOSE OF REVIEW: Early identification and appropriate management of sepsis improves outcomes. Despite convincing data showing the benefits of early recognition and treatment of sepsis and septic shock, implementation of such evidence-based therapy is suboptimal. This review describes methods that have been shown to improve bedside application of the evidence-based guidelines. RECENT FINDINGS: The Surviving Sepsis Campaign (SSC) has developed guidelines for the management of severe sepsis and septic shock...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28851407/restricted-fluid-resuscitation-in-sepsis-associated-hypotension-refresh-study-protocol-for-a-pilot-randomised-controlled-trial
#14
Stephen P J Macdonald, David McD Taylor, Gerben Keijzers, Glenn Arendts, Daniel M Fatovich, Frances B Kinnear, Simon G A Brown, Rinaldo Bellomo, Sally Burrows, John F Fraser, Edward Litton, Juan Carlos Ascencio-Lane, Matthew Anstey, David McCutcheon, Lisa Smart, Ioana Vlad, James Winearls, Bradley Wibrow
BACKGROUND: Guidelines recommend an initial intravenous (IV) fluid bolus of 30 ml/kg isotonic crystalloid for patients with sepsis and hypotension. However, there is a lack of evidence from clinical trials to support this. Accumulating observational data suggest harm associated with the injudicious use of fluids in sepsis. There is currently equipoise regarding liberal or restricted fluid-volume resuscitation as first-line treatment for sepsis-related hypotension. A randomised trial comparing these two approaches is, therefore, justified...
August 29, 2017: Trials
https://www.readbyqxmd.com/read/28851302/maternal-mortality-audit-in-suriname-between-2010-and-2014-a-reproductive-age-mortality-survey
#15
Lachmi R Kodan, Kim J C Verschueren, Jos van Roosmalen, Humphrey H H Kanhai, Kitty W M Bloemenkamp
BACKGROUND: The fifth Millennium Development Goal (MDG-5) aimed to improve maternal health, targeting a maternal mortality ratio (MMR) reduction of 75% between 1990 and 2015. The objective of this study was to identify all maternal deaths in Suriname, determine the extent of underreporting, estimate the reduction, audit the maternal deaths and assess underlying causes and substandard care factors. METHODS: A reproductive age mortality survey was conducted in Suriname (South-American upper-middle income country) between 2010 and 2014 to identify all maternal deaths in the country...
August 29, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28845902/persistence-of-delirium-after-cessation-of-sedatives-and-analgesics-and-impact-on-clinical-outcomes-in-critically-ill-patients
#16
Michael T Kenes, Joanna L Stollings, Li Wang, Timothy D Girard, E Wesley Ely, Pratik P Pandharipande
STUDY OBJECTIVE: As delirium is a common manifestation in critically ill patients and is associated with worse clinical outcomes, we sought to characterize the reversibility of delirium after discontinuation of sedation and to determine whether sedation-associated delirium that rapidly reverses impacts clinical outcomes. DESIGN: Post hoc subgroup analysis of prospectively collected data from a previously published study. PATIENTS: Seventy adults admitted to a medical intensive care unit (ICU) between March and July 2012 who required mechanical ventilation with continuous analgesia and/or sedation and underwent a spontaneous awakening trial (SAT)...
August 28, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28845789/international-surviving-sepsis-campaign-guidelines-2016-the-perspective-from-low-income-and-middle-income-countries
#17
Gentle S Shrestha, Arthur Kwizera, Ganbold Lundeg, John I Baelani, Luciano C P Azevedo, Rajyabardhan Pattnaik, Rashan Haniffa, Srdjan Gavrilovic, Nguyen Thi Hoang Mai, Niranjan Kissoon, Rakesh Lodha, David Misango, Ary Serpa Neto, Marcus J Schultz, Arjen M Dondorp, Jonarthan Thevanayagam, Martin W Dünser, A K M Shamsul Alam, Ahmed M Mukhtar, Madiha Hashmi, Suchitra Ranjit, Akaninyene Otu, Charles Gomersall, Jacinta Amito, Nicolas Nin Vaeza, Jane Nakibuuka, Pierre Mujyarugamba, Elisa Estenssoro, Gustavo A Ospina-Tascón, Sanjib Mohanty, Mervyn Mer
No abstract text is available yet for this article.
September 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28842112/rcr-audit-of-compliance-with-uk-guidelines-for-the-prevention-and-detection-of-acute-kidney-injury-in-adult-patients-undergoing-iodinated-contrast-media-injections-for-ct
#18
L H Cope, K J Drinkwater, D C Howlett
AIM: To determine radiology departmental compliance with current UK guidance on contrast-induced acute kidney injury (CI-AKI) and to provide data on the incidence of clinically significant post-contrast AKI (PC-AKI) in computed tomography (CT) practice. MATERIALS AND METHODS: A questionnaire was sent to all UK acute National Health Service (NHS) providers (NHS boards in Scotland, local health boards in Wales, NHS trusts in England and health and social care trusts in Northern Ireland) to assess compliance of provider protocols with current UK guidelines for the prevention, recognition, and management of CI-AKI...
August 22, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28832916/reduced-incidence-of-neonatal-early-onset-group-b-streptococcal-infection-after-promulgation-of-guidelines-for-risk-based-intrapartum-antibiotic-prophylaxis-in-sweden-analysis-of-a-national-population-based-cohort
#19
Stellan Håkansson, Maria Lilja, Bo Jacobsson, Karin Källén
INTRODUCTION: To investigate the incidence of neonatal early-onset group B streptococcal (GBS) infection in Sweden after promulgation of guidelines (2008) for risk factor-based intrapartum antibiotic prophylaxis, and evaluate the presence of risk factors and obstetric management in mothers. MATERIAL AND METHODS: National registers were searched for infants with early-onset GBS infection during 2006-2011. Medical records of cases and case mothers were abstracted...
August 19, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28818544/trends-in-antimicrobial-resistance-in-bloodstream-infection-isolates-at-a-large-urban-hospital-in-malawi-1998-2016-a-surveillance-study
#20
Patrick Musicha, Jennifer E Cornick, Naor Bar-Zeev, Neil French, Clemens Masesa, Brigitte Denis, Neil Kennedy, Jane Mallewa, Melita A Gordon, Chisomo L Msefula, Robert S Heyderman, Dean B Everett, Nicholas A Feasey
BACKGROUND: Bacterial bloodstream infection is a common cause of morbidity and mortality in sub-Saharan Africa, yet few facilities are able to maintain long-term surveillance. The Malawi-Liverpool-Wellcome Trust Clinical Research Programme has done sentinel surveillance of bacteraemia since 1998. We report long-term trends in bloodstream infection and antimicrobial resistance from this surveillance. METHODS: In this surveillance study, we analysed blood cultures that were routinely taken from adult and paediatric patients with fever or suspicion of sepsis admitted to Queen Elizabeth Central Hospital, Blantyre, Malawi from 1998 to 2016...
August 14, 2017: Lancet Infectious Diseases
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