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https://www.readbyqxmd.com/read/29474320/temporal-trends-in-incidence-sepsis-related-mortality-and-hospital-based-acute-care-after-sepsis
#1
Nathaniel Meyer, Michael O Harhay, Dylan S Small, Hallie C Prescott, Kathryn H Bowles, David F Gaieski, Mark E Mikkelsen
OBJECTIVES: A growing number of patients survive sepsis hospitalizations each year and are at high risk for readmission. However, little is known about temporal trends in hospital-based acute care (emergency department treat-and-release visits and hospital readmission) after sepsis. Our primary objective was to measure temporal trends in sepsis survivorship and hospital-based acute care use in sepsis survivors. In addition, because readmissions after pneumonia are subject to penalty under the national readmission reduction program, we examined whether readmission rates declined after sepsis hospitalizations related to pneumonia...
March 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29473687/effectiveness-of-oral-chlorhexidine-for-the-prevention-of-nosocomial-pneumonia-and-ventilator-associated-pneumonia-in-intensive-care-units-overview-of-systematic-reviews
#2
REVIEW
F Rabello, V E Araújo, Sms Magalhães
OBJECTIVE: To summarize evidence regarding the effectiveness of using chlorhexidine for oral healthcare on patients in the intensive care unit for the prevention of nosocomial pneumonia and ventilator-associated pneumonia. METHODS: This overview of systematic reviews was developed using articles found in PUBMED, Cochrane Library, LILACS, CRD, CINHAL, manual search and grey literature. RESULTS: Of the total 16 systematic reviews, 14 included meta-analysis...
February 23, 2018: International Journal of Dental Hygiene
https://www.readbyqxmd.com/read/29471470/a-registry-for-patients-with-asplenia-hyposplenism-reduces-the-risk-of-infections-with-encapsulated-organisms
#3
Alicia Arnott, Penelope Jones, Lucinda J Franklin, Denis Spelman, Karin Leder, Allen C Cheng
Background: Overwhelming post-splenectomy infection (OPSI) is a serious complication of asplenia. Clinical guidelines recommend a number of measures to reduce the risk of OPSI, but awareness and adherence to preventative measures is generally poor. We aimed to determine whether a registry for asplenic/hyposplenic patients was associated with a reduction in the incidence of infection with encapsulated bacteria. Methods: We performed a retrospective cohort study of asplenic/hyposplenic patients in the state of Victoria, Australia who registered with Spleen Australia from 2003 - 2014...
February 17, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29470254/how-can-we-improve-clinical-research-in-pneumonia
#4
Julio A Ramirez
PURPOSE OF REVIEW: The primary challenges in the field of clinical research include a lack of support within existing infrastructure, insufficient number of clinical research training programs and a paucity of qualified mentors. Most medical centers offer infrastructure support for investigators working with industry sponsors or government-funded clinical trials, yet there are a significant amount of clinical studies performed in the field of pneumonia which are observational studies...
February 20, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29467200/effectiveness-versus-efficacy-trials-in-copd-how-study-design-influences-outcomes-and-applicability
#5
Ashley Woodcock, Isabelle Boucot, David A Leather, Jodie Crawford, Susan Collier, Nawar Diar Bakerly, Emma Hilton, Jørgen Vestbo
Guidelines for chronic obstructive pulmonary disease (COPD) management are based largely on results from double-blind randomised controlled trials (RCTs) of efficacy. These trials have high internal validity and test whether a drug is efficacious, but they are conducted in highly selected populations that may differ significantly from patients with COPD seen in routine practice.We compared the baseline characteristics, healthcare use and outcomes between the Salford Lung Study (SLS), an open-label effectiveness RCT, with six recent large-scale efficacy RCTs...
February 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29462444/business-travel-associated-illness-a-geosentinel-analysis
#6
Lin H Chen, Karin Leder, Kira A Barbre, Patricia Schlagenhauf, Michael Libman, Jay Keystone, Marc Mendelson, Philippe Gautret, Eli Schwartz, Marc Shaw, Sue MacDonald, Anne McCarthy, Bradley A Connor, Douglas H Esposito, Davidson Hamer, Mary E Wilson
Background: Analysis of a large cohort of business travelers will help clinicians focus on frequent and serious illnesses. We aimed to describe travel-related health problems in business travelers. Methods: GeoSentinel Surveillance Network consists of 64 travel and tropical medicine clinics in 29 countries; descriptive analysis was performed on ill business travelers, defined as persons traveling for work, evaluated after international travel 1 January 1997 through 31 December 2014...
January 1, 2018: Journal of Travel Medicine
https://www.readbyqxmd.com/read/29460754/delftia-tsuruhatensis-an-emergent-opportunistic-healthcare-associated-pathogen
#7
Alexandre Ranc, Grégory Dubourg, Pierre Edouard Fournier, Didier Raoult, Florence Fenollar
Delftia tsuruhatensis, which was first isolated in environmental samples, was rarely associated with human infections. We report on pneumonia caused by D. tsuruhatensis in an infant who underwent cardiac surgery. Retrospective analyses detected 9 other isolates from 8 patients. D. tsuruhatensis is an emergent pathogen, at least for immunocompromised patients.
March 2018: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29460284/dementia-and-risk-of-30-day-readmission-in-older-adults-after-discharge-from-acute-care-hospitals
#8
Nobuo Sakata, Yasuyuki Okumura, Kiyohide Fushimi, Miharu Nakanishi, Asao Ogawa
OBJECTIVES: To assess the association between dementia and risk of hospital readmission and to evaluate whether the effect of dementia on hospital readmission varies according to primary diagnosis. DESIGN: Retrospective cohort study. SETTING: Nationwide discharge database of acute care hospitals in Japan. PARTICIPANTS: Individuals aged 65 and older diagnosed with one of the 30 most common diagnoses and discharged from 987 hospitals between April 2014 and September 2015 (N = 1,834,378)...
February 20, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29456197/clinical-usefulness-and-accuracy-of-polymerase-chain-reaction-in-the-detection-of-bacterial-meningitis-agents-in-pediatric-cerebrospinal-fluid
#9
M Nour, A Alaidarous
Bacterial meningitis poses enormous healthcare challenges due to a high mortality, morbidity and sequelae. Neisseria (N.) meningitidis, Haemophilus (H.) influenzae, Streptococcus (S.) pneumoniae and S. agalactiae remain among the most prevalent infectious agents that cause bacterial meningitis in children. The objective of this study was the simultaneous detection of these pathogens in suspected cerebrospinal fluid (CSF) by using multiplex polymerase chain reaction (mPCR) and compare PCR results with standard diagnostics currently used in clinical practice...
February 15, 2018: Current Research in Translational Medicine
https://www.readbyqxmd.com/read/29449294/disease-characteristics-and-management-of-hospitalised-adolescents-and-adults-with-community-acquired-pneumonia-in-china-a-retrospective-multicentre-survey
#10
Liang Chen, Fei Zhou, Hui Li, Xiqian Xing, Xiudi Han, Yiming Wang, Chunxiao Zhang, Lijun Suo, Jingxiang Wang, Guohua Yu, Guangqiang Wang, Xuexin Yao, Hongxia Yu, Lei Wang, Meng Liu, Chunxue Xue, Bo Liu, Xiaoli Zhu, Yanli Li, Ying Xiao, Xiaojing Cui, Lijuan Li, Timothy M Uyeki, Chen Wang, Bin Cao
OBJECTIVES: To describe the clinical characteristics and management of patients hospitalised with community-acquired pneumonia (CAP) in China. DESIGN: This was a multicentre, retrospective, observational study. SETTING: 13 teaching hospitals in northern, central and southern China from 1 January 2014 to 31 December 2014 PARTICIPANTS: Information on hospitalised patients aged ≥14 years with radiographically confirmed pneumonia with illness onset in the community was collected using standard case report forms...
February 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29447204/comparison-of-viral-infection-in-healthcare-associated-pneumonia-hcap-and-community-acquired-pneumonia-cap
#11
Eun Sun Kim, Kyoung Un Park, Sang Hoon Lee, Yeon Joo Lee, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Choon-Taek Lee, Jae Ho Lee
BACKGROUND: Although viruses are known to be the second most common etiological factor in community-acquired pneumonia (CAP), the respiratory viral profile of the patients with healthcare-associated pneumonia (HCAP) has not yet been elucidated. We investigated the prevalence and the clinical impact of respiratory virus infection in adult patients with HCAP. METHODS: Patients admitted with HCAP or CAP, between January and December 2016, to a tertiary referral hospital in Korea, were prospectively enrolled, and virus identification was performed using reverse-transcription polymerase chain reaction (RT-PCR)...
2018: PloS One
https://www.readbyqxmd.com/read/29436438/healthcare-reconsultation-in-working-age-adults-following-hospitalisation-for-community-acquired-pneumonia
#12
Priya Daniel, Thomas Bewick, Tricia M McKeever, Mark Roberts, Deborah Ashton, Daniel Smith, Lenny Latip, Wei Shen Lim
Community-acquired pneumonia (CAP) is associated with prolonged symptom persistence during recovery. However, the effect of the residual symptom load on healthcare utilisation is unknown. The aim of this study was to quantify healthcare reconsultation within 28 days of hospital discharge for an index episode of CAP, and explore reasons for these reconsultations. Adults of working age admitted to any of four hospitals in the UK, with a primary diagnosis of CAP, were prospectively studied. Of 108 patients, 71 (65...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29434387/antimicrobial-utilization-pattern-in-pediatric-patients-in-tertiary-care-hospital-eastern-ethiopia-the-need-for-antimicrobial-stewardship
#13
Samuel Girma, Mekonnen Sisay, Getnet Mengistu, Firehiwot Amare, Dumessa Edessa
Background: Antimicrobials are among the most frequently prescribed medications for pediatric patients. However, inappropriate use of them can increase morbidity, mortality, healthcare costs, and largely antimicrobial resistance. This study aims to assess the antimicrobial utilization pattern in the pediatric ward of Hiwot Fana Specialized University Hospital. Methods: Retrospective cross-sectional study was conducted to assess the antimicrobial utilization. In this study, 403 pediatric medical records selected by systematic random sampling were reviewed...
February 2018: Hospital Pharmacy
https://www.readbyqxmd.com/read/29433440/whole-genome-analysis-of-hypervirulent-klebsiella-pneumoniae-isolates-from-community-and-hospital-acquired-bloodstream-infection
#14
Chaitra Shankar, Balaji Veeraraghavan, Laura Eve Buchnan Nabarro, Raji Ravi, Naveen Kumar Devanga Ragupathi, Priscilla Rupali
BACKGROUND: Hypervirulent K. pneumoniae (hvKp) causes severe community acquired infections, predominantly in Asia. Though initially isolated from liver abscesses, they are now prevalent among invasive infections such as bacteraemia. There have been no studies reported till date on the prevalence and characterisation of hvKp in India. The objective of this study is to characterise the hypervirulent strains isolated from bacteraemic patients for determination of various virulence genes and resistance genes and also to investigate the difference between healthcare associated and community acquired hvKp with respect to clinical profile, antibiogram, clinical outcome and molecular epidemiology...
January 8, 2018: BMC Microbiology
https://www.readbyqxmd.com/read/29433132/-the-economic-value-of-vaccinations-a-systematic-review-of-italian-economic-evaluations-and-hta-reports
#15
Francesco Di Nardo, Sara Boccalini, Giovanna Elisa Calabrò, Andrea Marcellusi, Matteo Ruggeri, Paolo Bonanni, Raffaella Vitali, Eleonora Capannini, Francesco Saverio Mennini, Americo Cicchetti, Donatella Panatto, Roberto Gasparini, Walter Ricciardi, Chiara De Waure
INTRODUCTION: Decision-making in healthcare should rely on evidence-based approaches able to make possible a transparent and robust assessment of all the aspects related to health technologies. One of the assessment elements is represented by the efficiency that is the specific objective of economic evaluations and also of Health Technology Assessment (HTA). The collection and synthesis of evidence is the first indispensable step in order to foster a proper convey of scientific knowledge to the decision-makers...
September 2017: Igiene e Sanità Pubblica
https://www.readbyqxmd.com/read/29432348/trends-of-incidence-and-risk-factors-of-ventilator-associated-pneumonia-in-elderly-patients-admitted-to-french-icus-between-2007-and-2014
#16
Cédric Dananché, Philippe Vanhems, Anaïs Machut, Martine Aupée, Caroline Bervas, François L'Hériteau, Alain Lepape, Jean-Christophe Lucet, Vincent Stoeckel, Jean-François Timsit, Anne Berger-Carbonne, Anne Savey, Thomas Bénet
OBJECTIVES: To assess trends and risk factors of ventilator-associated pneumonia according to age, particularly in the elderly admitted to French ICUs between 2007 and 2014. DESIGN: Multicenter, prospective French national Healthcare-Associated Infection surveillance network of ICUs ("Réseau REA-Raisin"). SETTINGS: Two-hundred fifty six ICUs in 246 settings in France. PATIENTS: Included were all adult patients hospitalized greater than or equal to 48 hours in ICUs participating in the network...
February 9, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29431543/high-flow-nasal-oxygen-therapy-utilization-7-year-experience-at-a-community-teaching-hospital
#17
Mihaela S Stefan, Patrick Eckert, Bogdan Tiru, Jennifer Friderici, Peter K Lindenauer, Jay S Steingrub
OBJECTIVE: To examine the use of high flow nasal cannula oxygen therapy (HFNC) between 2008 and 2014 in patients 18 years or older at a community teaching hospital. METHODS: Yearly utilization rates of HFNC, noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) were calculated among admissions with a set of cardiopulmonary diagnoses (heart failure, COPD, asthma or pneumonia). RESULTS: Among the 41,711 admissions with at least one of the above cardiopulmonary condition, HFNC was utilized in 1,128 or 27...
February 15, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29429440/neonatal-and-paediatric-bloodstream-infections-pathogens-antimicrobial-resistance-patterns-and-prescribing-practice-at-khayelitsha-district-hospital-cape-town-south-africa
#18
H Crichton, N O'Connell, H Rabie, A C Whitelaw, A Dramowski
BACKGROUND: The epidemiology of neonatal and paediatric community-acquired and healthcare-associated bloodstream infections (BSI) at South African (SA) district hospitals is under-researched. OBJECTIVE: Retrospective review of neonatal and paediatric BSI (0 - 13 years) at Khayelitsha District Hospital, Cape Town, SA, over 3 years (1 March 2012 - 28 February 2015). METHODS: We used laboratory, hospital, patient and prescription data to determine BSI rates, blood culture yield and contamination rates, pathogen profile, antimicrobial resistance, patient demographics, BSI outcome and antibiotic prescribing practice...
February 1, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29422174/efficacy-of-a-care-bundle-to-prevent-multiple-infections-in-the-intensive-care-unit-a-quasi-experimental-pretest-posttest-design-study
#19
Gulay Yazici, Hulya Bulut
BACKGROUND: Healthcare-associated infections extend hospitalization time, increase treatment costs and increase morbidity-mortality rates. OBJECTIVES: To evaluate the efficacy of a care bundle aimed at preventing three most frequent intensive care unit-acquired infections. MATERIALS AND METHOD: This quasi-experimental study occurred in an 18-bed tertiary care intensive care unit at a university hospital in Turkey. The sample consisted of 120 patients older than 18years and receiving invasive mechanical ventilation therapy, or had a central venous catheter or urinary catheter...
February 2018: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29421224/methicillin-resistant-staphylococcus-aureus-mrsa-bacteremia-correlations-between-clinical-phenotypic-genotypic-characteristics-and-mortality-in-a-tertiary-teaching-hospital-in-malaysia
#20
Pik San Sit, Cindy Shuan Ju Teh, Nuryana Idris, Sasheela Ponnampalavanar
Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is a serious infection that can result in significant morbidity and mortality. A retrospective cohort study was conducted to determine the predictors of mortality in patient with MRSA bacteremia correlating with clinical, phenotypic and genotypic characteristics of the relevant strains. Most of the bacteremia cases were healthcare-associated (P < 0.0001). Older age (P < 0.0001) and comorbidities (diabetes mellitus, hypertension and chronic kidney disease) were identified as the risk factors for MRSA bacteremia...
February 6, 2018: Infection, Genetics and Evolution
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