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https://www.readbyqxmd.com/read/28208030/intensive-care-unit-admission-and-survival-among-older-patients-with-chronic-obstructive-pulmonary-disease-heart-failure-or-myocardial-infarction
#1
Thomas S Valley, Michael W Sjoding, Andrew M Ryan, Theodore J Iwashyna, Colin R Cooke
RATIONALE: Admission to an intensive care unit (ICU) may be beneficial to pneumonia patients with uncertain ICU needs; however, evidence regarding the association between ICU admission and mortality for other common conditions is largely unknown. OBJECTIVES: To estimate the relationship between ICU admission and outcomes for hospitalized patients with exacerbation of chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), or acute myocardial infarction (AMI)...
February 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28197738/vaccines-for-staphylococcus-aureus-and-target-populations
#2
Clarissa Pozzi, Reuben Olaniyi, Lassi Liljeroos, Ilaria Galgani, Rino Rappuoli, Fabio Bagnoli
Staphylococcus aureus is a leading pathogen in surgical site, intensive care unit, and skin infections, as well as healthcare-associated pneumonias. These infections are associated with an enormous burden of morbidity, mortality, and increase of hospital length of stay and patient cost. S. aureus is impressively fast in acquiring antibiotic resistance, and multidrug-resistant strains are a serious threat to human health. Due to resistance or insufficient effectiveness, antibiotics and bundle measures leave a tremendous unmet medical need worldwide...
February 15, 2017: Current Topics in Microbiology and Immunology
https://www.readbyqxmd.com/read/28197216/introducing-the-comprehensive-unit-based-safety-program-for-mechanically-ventilated-patients-in-saudi-arabian-intensive-care-units
#3
Raymond M Khan, Maha Aljuaid, Hanan Aqeel, Mohammed M Aboudeif, Shaimaa Elatwey, Rajeh Shehab, Yasser Mandourah, Khalid Maghrabi, Hassan Hawa, Imran Khalid, Ismael Qushmaq, Asad Latif, Bickey Chang, Sean M Berenholtz, Sultan Tayar, Khloud Al-Harbi, Amin Yousef, Anas A Amr, Yaseen M Arabi
Over the past decade, there have been major improvements to the care of mechanically ventilated patients (MVPs). Earlier initiatives used the concept of ventilator care bundles (sets of interventions), with a primary focus on reducing ventilator-associated pneumonia. However, recent evidence has led to a more comprehensive approach: The ABCDE bundle (Awakening and Breathing trial Coordination, Delirium management and Early mobilization). The approach of the Comprehensive Unit-based Safety Program (CUSP) was developed by patient safety researchers at the Johns Hopkins Hospital and is supported by the Agency for Healthcare Research and Quality to improve local safety cultures and to learn from defects by utilizing a validated structured framework...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28185742/do-we-need-a-vaccine-against-moraxella-catarrhalis-in-chronic-lung-disease-what-are-the-options-and-opportunities
#4
REVIEW
Antonia C Perez, Timothy F Murphy
Moraxella catarrhalis is the second most common cause of exacerbations in adults with COPD, resulting in enormous morbidity and mortality in this clinical setting. Vaccine development for M. catarrhalis has lagged behind the other two important causes of exacerbations in COPD, nontypeable Haemophilus influenzae and Streptococcus pneumoniae. While no licensed vaccine is currently available for M. catarrhalis, several promising candidate vaccine antigens have been identified and characterized and are close to entering clinical trials...
February 6, 2017: Vaccine
https://www.readbyqxmd.com/read/28185686/outbreak-of-kpc-2-producing-enterobacteriaceae-caused-by-clonal-dissemination-of-klebsiella-pneumoniae-st307-carrying-an-incx3-type-plasmid-harboring-a-truncated-tn4401a
#5
Jung Ok Kim, Sae Am Song, Eun-Jeong Yoon, Jeong Hwan Shin, Hyukmin Lee, Seok Hoon Jeong, Kyungwon Lee
Over a 5-month period between the end of June and the beginning of November in 2015, a KPC-producing Enterobacteriaceae outbreak occurred in a general hospital in Busan, South Korea, being associated with a total of 50 clinical isolates from 47 patients. Multilocus sequence typing and pulsed-field gel electrophoresis were carried out for strain typing and whole-genome sequencing was performed to characterize the plasmids. A clonal spread of K. pneumoniae sequence type 307 (ST307) carrying a self-transferable IncX3-type plasmid harboring blaKPC-2 was responsible for the outbreak...
December 27, 2016: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28182358/aetiology-and-significance-of-hospital-acquired-infections-in-mexico
#6
REVIEW
Nayelli M Alonso-Aguilar, Sara R Juarez-Enriquez, Graciela Castro-Escarpulli, Gildardo Rivera, Virgilio Bocanegra-Garcia, Xianwu Guo, Julieta Luna-Herrera, M G Aguilera-Arreola
Hospital-acquired infections (HAIs) are infections that develop in the hospital environment and can be acquired by a patient or hospital staff. They are complications that combine diverse risk factors that make an individual susceptible and are frequently caused by endogenous and exogenous bacterial agents. The most commonly studied etiological agents are bacteria and fungi, with the former representing the most common etiological agents reported to the Hospital Epidemiological Surveillance Network (RHOVE) between 2007 and 2012...
February 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28178979/managed-care-and-inpatient-mortality-in-adults-effect-of-primary-payer
#7
Anika L Hines, Susan O Raetzman, Marguerite L Barrett, Ernest Moy, Roxanne M Andrews
BACKGROUND: Because managed care is increasingly prevalent in health care finance and delivery, it is important to ascertain its effects on health care quality relative to that of fee-for-service plans. Some stakeholders are concerned that basing gatekeeping, provider selection, and utilization management on cost may lower quality of care. To date, research on this topic has been inconclusive, largely because of variation in research methods and covariates. Patient age has been the only consistently evaluated outcome predictor...
February 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28177854/risk-factors-for-30-day-hospital-re-admission-with-an-infectious-complication-after-lower-extremity-vascular-procedures
#8
Joseph C Melvin, Jamie B Smith, Robin L Kruse, Todd R Vogel
BACKGROUND: Lowering the 30-d re-admission rate after vascular surgery offers the potential to improve healthcare quality. This study evaluated re-admission associated with infections after open and endovascular lower extremity (LE) procedures for peripheral artery disease (PAD). METHODS: Patients admitted for elective LE procedures for PAD were selected from the Cerner Health Facts(®) database. Chi-square analysis evaluated the characteristics of the index admission associated with infection at 30-d re-admission...
February 8, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28161293/molecular-epidemiology-of-carbapenemase-producing-enterobacteriaceae-in-a-primary-care-hospital-in-japan-2010-2013
#9
Yuki Ohno, Akihiro Nakamura, Eriko Hashimoto, Hiroko Matsutani, Noriyuki Abe, Saori Fukuda, Kohno Hisashi, Masaru Komatsu, Fumihiko Nakamura
Recently, carbapenemase-producing Enterobacteriaceae (CPE) have been spreading worldwide and have become a threat in healthcare systems. We investigated the isolation frequency and molecular epidemiological characteristics of CPE isolated from clinical samples collected at a primary care hospital over the four years of 2010-2013 in Japan. CPE were detected in 17 (0.34%) of 4875 isolates by the broth microdilution method, sodium mercaptoacetate inhibition test, and modified Hodge test using meropenem disks. The frequency of CPE isolates was 0...
February 1, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28154145/estimating-the-population-level-impact-of-vaccines-using-synthetic-controls
#10
Christian A W Bruhn, Stephen Hetterich, Cynthia Schuck-Paim, Esra Kürüm, Robert J Taylor, Roger Lustig, Eugene D Shapiro, Joshua L Warren, Lone Simonsen, Daniel M Weinberger
When a new vaccine is introduced, it is critical to monitor trends in disease rates to ensure that the vaccine is effective and to quantify its impact. However, estimates from observational studies can be confounded by unrelated changes in healthcare utilization, changes in the underlying health of the population, or changes in reporting. Other diseases are often used to detect and adjust for these changes, but choosing an appropriate control disease a priori is a major challenge. The "synthetic controls" (causal impact) method, which was originally developed for website analytics and social sciences, provides an appealing solution...
February 1, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28138943/nosocomial-transmission-of-carbapenem-resistant-klebsiella-pneumoniae-elucidated-by-single-nucleotide-variation-analysis-a-case-investigation
#11
Hideharu Hagiya, Kotaro Aoki, Yukihiro Akeda, Noriko Sakamoto, Norihisa Yamamoto, Hisao Yoshida, Isao Nishi, Yoshikazu Ishii, Kazunori Tomono
Identifying transmission route of antimicrobial-resistant pathogen is essential for appropriate infection control strategy in healthcare facilities. We report the utility of single-nucleotide variation analysis in tracing nosocomial transmission of antimicrobial-resistant pathogens by describing a pseudo-outbreak case of carbapenem-resistant Klebsiella pneumoniae. The present case highlights that infection control strategy should encompass pathological dissection rooms, neglected but potentially highly contaminated places in hospitals...
January 30, 2017: Infection
https://www.readbyqxmd.com/read/28137940/antimicrobial-resistance-in-uropathogens-and-appropriateness-of-empirical-treatment-a-population-based-surveillance-study-in-indonesia
#12
Adhi Kristianto Sugianli, Franciscus Ginting, R Lia Kusumawati, Emmy Hermiyati Pranggono, Ayodhia Pitaloka Pasaribu, Firza Gronthoud, Suzanne Geerlings, Ida Parwati, Menno D De Jong, Frank Van Leth, Constance Schultsz
OBJECTIVES: Urinary tract infections (UTIs) are a common reason for empirical treatment with broad-spectrum antibiotics worldwide. However, population-based antimicrobial resistance (AMR) prevalence data to inform empirical treatment choice are lacking in many regions, because of limited surveillance capacity. We aimed to assess the prevalence of AMR to commonly used antimicrobial drugs in Escherichia coli and Klebsiella pneumoniae isolated from patients with community- or healthcare-associated UTIs on two islands of Indonesia...
January 30, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28137813/nasal-mrsa-pcr-testing-reduces-duration-of-mrsa-targeted-therapy-in-patients-with-suspected-mrsa-pneumonia
#13
Nidhu Baby, Andrew C Faust, Terri Smith, Lyndsay A Sheperd, Laura Knoll, Edward L Goodman
OBJECTIVE: To evaluate the impact of pharmacist-ordered MRSA PCR testing on the duration of empiric MRSA-targeted antibiotic therapy in patients with suspected pneumonia. METHODS: This is a retrospective analysis of patients who received vancomycin or linezolid for suspected pneumonia before and after the implementation of a pharmacist-driven protocol for nasal MRSA PCR testing. Patients were included if they were adults >18 years of age and initiated on vancomycin or linezolid for suspected MRSA pneumonia...
January 30, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28116747/pneumococcal-vaccines-for-preventing-pneumonia-in-chronic-obstructive-pulmonary-disease
#14
REVIEW
Julia Ae Walters, Joanne Ngie Qing Tang, Phillippa Poole, Richard Wood-Baker
BACKGROUND: People with chronic obstructive pulmonary disease (COPD) are at increased risk of pneumococcal disease, especially pneumonia, as well as acute exacerbations with associated morbidity and healthcare costs. OBJECTIVES: To determine the efficacy of injectable pneumococcal vaccination for preventing pneumonia in persons with COPD. SEARCH METHODS: We searched the Cochrane Airways COPD Trials Register and the databases CENTRAL, MEDLINE and Embase, using prespecified terms...
January 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28103460/-pneumocystis-pneumonia-in-107-hiv-infected-patients-admitted-to-the-department-of-infectious-diseases-at-santa-maria-hospital-lisbon-2002-2013
#15
Vilma Grilo, Aida Pereira
INTRODUCTION: Pneumocystis jirovecii pneumonia remains one of the most common opportunistic illnesses in patients infected with the human immunodeficiency virus. It is currently the most reported AIDS-defining infection in Portugal. The aims of this study were to analyze the features of a human immunodeficiency virus /Pneumocystis jirovecii pneumonia coinfected population, to compare it with the current literature, and to evaluate comparatively subpopulations of patients based on the previous knowledge of the human immunodeficiency virus infection, Pneumocystis jirovecii pneumonia diagnostic method and discharge results...
October 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28096455/multicenter-prospective-study-on-device-associated-infection-rates-and-bacterial-resistance-in-intensive-care-units-of-venezuela-international-nosocomial-infection-control-consortium-inicc-findings
#16
Gabriel D Empaire, Maria E Guzman Siritt, Victor D Rosenthal, Fernando Pérez, Yvis Ruiz, Claudia Díaz, Gabriela Di Silvestre, Evelyn Salinas, Nelva Orozco
BACKGROUND: Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety in the intensive care unit (ICU). METHODS: A DA-HAI surveillance study was conducted by the International Nosocomial Infection Control Consortium (INICC) in two adult medical/surgical ICUs at two hospitals in Caracas, Venezuela, in different periods from March 2008 to April 2015, using the US Centers for Disease Control and Prevention's National Healthcare Safety Network (CDC/NHSN) definitions and criteria, and INICC methods...
January 2017: International Health
https://www.readbyqxmd.com/read/28094205/legionnaires-disease-at-a-medical-center-in-southern-taiwan
#17
Tzu-Lun Hung, Ming-Chi Li, Li-Rong Wang, Ching-Chuan Liu, Chia-Wen Li, Po-Lin Chen, Ling-Shan Syue, Nan-Yao Lee, Wen-Chien Ko
BACKGROUND/PURPOSE: Legionella pneumophila had been recognized as a pathogen for both healthcare-associated and community-acquired pneumonia. We aimed to evaluate clinical features and outcomes of patients with Legionnaires' disease at a tertiary medical center in southern Taiwan. METHODS: From January 2005 to December 2013, a retrospective study of adult cases of Legionnaires' disease was conducted in a 1200-bed tertiary hospital. Their medical records were reviewed for further evaluation and analysis...
December 18, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28079673/differences-in-use-of-high-quality-and-low-quality-hospitals-among-working-age-individuals-by-insurance-type
#18
Ioana Popescu, Kevin C Heslin, Rosanna M Coffey, Raynard E Washington, Marguerite L Barrett, Lucy H Karnell, José J Escarce
BACKGROUND: Research suggests that individuals with Medicaid or no insurance receive fewer evidence-based treatments and have worse outcomes than those with private insurance for a broad range of conditions. These differences may be due to patients' receiving care in hospitals of different quality. RESEARCH DESIGN: We used the Healthcare Cost and Utilization Project State Inpatient Databases 2009-2010 data to identify patients aged 18-64 years with private insurance, Medicaid, or no insurance who were hospitalized with acute myocardial infarction, heart failure, pneumonia, stroke, or gastrointestinal hemorrhage...
February 2017: Medical Care
https://www.readbyqxmd.com/read/28074841/the-mito-damp-cardiolipin-blocks-il-10-production-causing-persistent-inflammation-during-bacterial-pneumonia
#19
Krishnendu Chakraborty, Mahesh Raundhal, Bill B Chen, Christina Morse, Yulia Y Tyurina, Anupriya Khare, Timothy B Oriss, Rachael Huff, Janet S Lee, Claudette M St Croix, Simon Watkins, Rama K Mallampalli, Valerian E Kagan, Anuradha Ray, Prabir Ray
Bacterial pneumonia is a significant healthcare burden worldwide. Failure to resolve inflammation after infection precipitates lung injury and an increase in morbidity and mortality. Gram-negative bacteria are common in pneumonia and increased levels of the mito-damage-associated molecular pattern (DAMP) cardiolipin can be detected in the lungs. Here we show that mice infected with Klebsiella pneumoniae develop lung injury with accumulation of cardiolipin. Cardiolipin inhibits resolution of inflammation by suppressing production of anti-inflammatory IL-10 by lung CD11b(+)Ly6G(int)Ly6C(lo)F4/80(+) cells...
January 11, 2017: Nature Communications
https://www.readbyqxmd.com/read/28063674/predictors-of-30-day-hospital-readmission-after-hip-fracture-a-systematic-review
#20
REVIEW
Adam M Ali, Charles E R Gibbons
BACKGROUND: Early readmission to hospital after hip fracture is associated with increased mortality and significant costs to the healthcare system. There is growing interest in the use of 30-day readmission rates as a metric of hospital performance. Identifying patients at increased risk of readmission after hip fracture may enable pre-emptive action to mitigate this risk and the development of effective methods of risk-adjustment to allow readmission to be used as a reliable measure of hospital performance...
February 2017: Injury
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