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antibiotic, resistance, icu, hepatitis,

Nick Daneman, Asgar H Rishu, Ruxandra Pinto, Pierre Aslanian, Sean M Bagshaw, Alex Carignan, Emmanuel Charbonney, Bryan Coburn, Deborah J Cook, Michael E Detsky, Peter Dodek, Richard Hall, Anand Kumar, Francois Lamontagne, Francois Lauzier, John C Marshall, Claudio M Martin, Lauralyn McIntyre, John Muscedere, Steven Reynolds, Wendy Sligl, Henry T Stelfox, M Elizabeth Wilcox, Robert A Fowler
BACKGROUND: Shorter-duration antibiotic treatment is sufficient for a range of bacterial infections, but has not been adequately studied for bloodstream infections. Our systematic review, survey, and observational study indicated equipoise for a trial of 7 versus 14 days of antibiotic treatment for bloodstream infections; a pilot randomized clinical trial (RCT) was a necessary next step to assess feasibility of a larger trial. METHODS: We conducted an open, pilot RCT of antibiotic treatment duration among critically ill patients with bloodstream infection across 11 intensive care units (ICUs)...
February 17, 2018: Trials
Jeffrey J Cies, Richard J LaCoursiere, Wayne S Moore, Arun Chopra
Aztreonam, a broad-spectrum monobactam, is typically reserved for multidrug resistant (MDR) infections. Pharmacokinetic (PK) data to guide dosing in children, however, are limited to healthy volunteers or nonintensive care unit (ICU) patients. Impaired antibiotic delivery into tissue remains a major concern and may explain the high morbidity and mortality associated with MDR infections. Therefore, evaluating the PK changes in pediatric ICU patients is necessary to elucidate the most appropriate antimicrobial regimen...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Sunil Taneja, Pramod Kumar, Vikas Gautam, Ajay Duseja, Virendra Singh, Radha K Dhiman, Yogesh Chawla
INTRODUCTION: Burkholderia cepacia complex (Bcc) is non-fermenting Gram-negative bacillus and has been rarely reported to cause spontaneous bacterial peritonitis (SBP) in decompensated cirrhosis. OBJECTIVE: This study was done to evaluate the clinical presentation of cirrhotic patients with SBP due to Bcc and to determine its impact on clinical outcome. METHODS: This is a retrospective, observational study conducted during the period from 1st January 2013 through 31st March 2015...
June 2017: Journal of Clinical and Experimental Hepatology
Hideharu Hagiya, Ken Tasaka, Toshiaki Sendo, Fumio Otsuka
OBJECTIVES: Stenotrophomonas maltophilia shows wide-spectrum resistance to antimicrobials and causes various infections in immunocompromised or critically ill patients with high mortality. In this era of antibiotics resistance, a revival of old antibiotics is now featured. We examined the clinical usefulness of latamoxef (LMOX) for the treatment of S. maltophilia infection. PATIENTS AND METHODS: The observational study was retrospectively performed at Okayama University Hospital (Okayama, Japan) from January 2011 to December 2013...
2015: Infection and Drug Resistance
Tobias Welte
Community-acquired pneumonia (CAP) is a curable disease. Both the European and American clinical practice guidelines provide algorithms how to manage patients with CAP. However, as populations worldwide are ageing and bacteria are becoming multidrug resistant, it is necessary to address the major factors that put patients at risk of poor outcome. These may include age, comorbidities, the settings where pneumonia was acquired or treated, the need for hospitalisation or ICU admission, likely causative pathogen (bacteria or virus) in a certain region and their local susceptibility pattern...
February 2015: Respiratory Medicine
Manuel Romero-Gómez, Sara Montagnese, Rajiv Jalan
Hepatic encephalopathy in a hospitalized cirrhotic patient is associated with a high mortality rate and its presence adds further to the mortality of patients with acute-on-chronic liver failure (ACLF). The exact pathophysiological mechanisms of HE in this group of patients are unclear but hyperammonemia, systemic inflammation (including sepsis, bacterial translocation, and insulin resistance) and oxidative stress, modulated by glutaminase gene alteration, remain as key factors. Moreover, alcohol misuse, hyponatremia, renal insufficiency, and microbiota are actively explored...
February 2015: Journal of Hepatology
J Verhaegen, J Flamaing, W De Backer, B Delaere, K Van Herck, F Surmont, Y Van Laethem, P Van Damme, W Peetermans
This epidemiological study examined morbidity and case fatality of invasive pneumococcal disease (IPD) in adults in Belgium as well as distribution and antibiotic susceptibility of Streptococcus pneumoniae serotypes.Adults hospitalised with microbiologically proven IPD were prospectively enrolled. The study started in 2009 with patients aged ≥50 years, whereas in 2010 and 2011, patients aged ≥18 years were included. The clinical presentation, patient profile, treatment, outcome, and mortality were recorded during hospitalisation...
2014: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
S Nayak, A Nandwani, A Rastogi, V Gupta
Linezolid, a member of oxazolidinone antibiotic class, is a relatively well-tolerated drug with few side effects. It is active against gram-positive cocci, including multidrug resistant staphylococci and enterococci. We report a case of a 54-year-old diabetic male with alcoholic cirrhosis admitted in intensive care unit with altered sensorium. He was diagnosed as a case of hepatic failure secondary to hepatitis E infection and enterococcal urosepsis. He was started on linezolid based on the urine culture sensitivity report...
September 2012: Indian Journal of Nephrology
Tracey Mackling, Tejas Shah, Vivian Dimas, Kristine Guleserian, Mahesh Sharma, Joseph Forbess, Monica Ardura, Jami Gross-Toalson, Ying Lee, Janna Journeycake, Aliessa Barnes
There are minimal data regarding chronic management of single-ventricle ventricular assist device (VAD) patients. This study aims to describe our center's multidisciplinary team management of single-ventricle patients supported long term with the Berlin Heart EXCOR Pediatric VAD. Patient #1 was a 4-year-old with double-outlet right ventricle with aortic atresia, L-looped ventricles, and heart block who developed heart failure 1 year after Fontan. She initially required extracorporeal membrane oxygenation support and was transitioned to Berlin Heart systemic VAD...
June 2012: Artificial Organs
E Cremaschi, U Maggiore, C Maccari, C Cademartiri, R Andreoli, E Fiaccadori
We report on a patient with biliary sepsis due to Vancomycin-resistant Enterococcus faecium (VRE) treated with linezolid (LNZ), who had both hepatic failure and acute kidney injury requiring daily sustained low-efficiency dialysis (SLED), a new intermittent, prolonged diffusive modality of renal replacement therapy for ICU patients. Following cholecystostomy and peritoneal drain insertion, serum, bile and peritoneal fluid serial samples were simultaneously collected for LNZ concentration measurement (chromatography/mass spectrometry)...
November 2010: Minerva Anestesiologica
Ping Wang, Lin Dong, Lu Zhang, Li-jun Xia
OBJECTIVE: To investigate the etiology and epidemic characteristics of hospital acquired pneumonia (HAP) in children. METHOD: A retrospective hospital infection study was performed in 52,639 children admitted to our hospital from January 2005 to December 2008. RESULT: Six hundred and ninety eight patients were diagnosed as HAP. The incidence of HAP was 1.33%, among which, 108 (15.47%) cases were early-onset HAP and 590 (84.53%) were late-onset HAP...
June 2010: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Nickolas D Zaller, Michael A Yokell, Alexandra Jeronimo, Jeffrey P Bratberg, Patricia Case, Josiah D Rich
OBJECTIVE: To report and describe the possible correlation of a change in syringe sale policy at a community pharmacy with an adverse clinical outcome. SETTING: Providence, RI, in summer 2009. PATIENT DESCRIPTION: 27-year-old white woman with a long-standing history of chronic relapsing opiate addiction and human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfection. CASE SUMMARY: The patient presented to the hospital emergency department with 5 days of severe diffuse pain, swelling in her hands and feet, and several days of rigors with fevers, sweats, and chills...
September 2010: Journal of the American Pharmacists Association: JAPhA
Kenneth M Wener, Vered Schechner, Howard S Gold, Sharon B Wright, Yehuda Carmeli
Antibiotic exposure exerts strong selective pressure and is an important modifiable risk factor for antibiotic resistance. We aimed to identify the role of various antibiotics as risk factors for the isolation of extended-spectrum-beta-lactamase (ESBL)-producing Klebsiella spp. in hospitalized patients at a tertiary-care hospital. A parallel multivariable model was created to compare two groups of cases with either nosocomially acquired ESBL- or non-ESBL-producing Klebsiella spp. to a common control group of hospitalized patients (a case-case-control design)...
May 2010: Antimicrobial Agents and Chemotherapy
W M Mackin
XOMA is developing Neuprex, an injectable recombinant protein fragment (rBPI-21) of the naturally-occurring bactericidal/permeability increasing (BPI) protein, for serious infections and infectious complications of trauma and surgery. Neuprex is the most advanced compound from XOMA's BPI platform. Neuprex is planning to commence a clinical trial for at least one additional indication in 1998 [293193]. Meningococcemia The lead indication for Neuprex is meningococcemia, for which phase III trials are expected to be completed in the second half of 1998 [275644]...
October 1998: IDrugs: the Investigational Drugs Journal
Hui-Xing Chen, Lu Yin, Cheng-Hong Peng, Guang-Wen Zhou, Bai-Yong Shen, Hao Chen, Chuan Shen, Hong-Wei Li
BACKGROUND: Multivisceral transplantation (MTX, or cluster transplantation) is defined as the transplantation of three or more abdominal organs en bloc, namely the liver together with the pancreatoduodenal complex, the stomach as well as the small bowel with/without the right hemicolon. Up to May 1999, only 72 cases were reported to the Intestinal Transplant Registry. Organ cluster transplantation may carry with complex hemodynamic alterations. Based on our experience in two cases of abdominal cluster transplantation, we describe the technical details of multivisceral transplantation and the management of hemodynamic changes...
February 2006: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Said Motaouakkil, Boubaker Charra, Abdelhamid Hachimi, Hicham Nejmi, Abdellatif Benslama, Naima Elmdaghri, Habiba Belabbes, Mohamed Benbachir
INTRODUCTION: The increased incidence of nosocomial infections by multi-drug resistant Acinetobacter baumannii creates demand on the application of some combinations of older antimicrobials on that species. We conducted the present observational study to evaluate the efficacy of intravenous and aerosolized colistin combined with rifampicin in the treatment of critically patients with nosocomial infections caused by multiresistant A. baumannii. PATIENTS AND METHODS: Critically ill patients with nosocomial infections caused by A...
October 2006: Journal of Infection
Loren G Miller, Francoise Perdreau-Remington, Gunter Rieg, Sheherbano Mehdi, Josh Perlroth, Arnold S Bayer, Angela W Tang, Tieu O Phung, Brad Spellberg
BACKGROUND: Necrotizing fasciitis is a life-threatening infection requiring urgent surgical and medical therapy. Staphylococcus aureus has been a very uncommon cause of necrotizing fasciitis, but we have recently noted an alarming number of these infections caused by community-associated methicillin-resistant S. aureus (MRSA). METHODS: We reviewed the records of 843 patients whose wound cultures grew MRSA at our center from January 15, 2003, to April 15, 2004. Among this cohort, 14 were identified as patients presenting from the community with clinical and intraoperative findings of necrotizing fasciitis, necrotizing myositis, or both...
April 7, 2005: New England Journal of Medicine
Katja de With, Jobst Bergner, Reinhard Bühner, Frank Dörje, Christa Gonnermann, Manfred Haber, Michael Hartmann, Ulrich Rothe, Egid Strehl, Michaela Steib-Bauert, Winfried V Kern
BACKGROUND: Excessive antibiotic use increases the risk of development and dissemination of bacterial resistance. A comparative analysis of the correlation between hospital antibiotic consumption and rates of bacterial resistance is needed for a better understanding of the complex relationship between antibiotic use and resistance. Apart from economic and market research studies, estimates of antibiotic consumption in German hospitals, however, are not available. METHODS: In a pilot project (INTERUNI-II), retrospective data from eight university hospital pharmacies covering the period 1998, 1999, and 2000 were collected to obtain estimates for the antibiotic use densities in the medical services of teaching hospitals...
July 15, 2004: Medizinische Klinik
Daliana Peres-Bota, Hector Rodriguez, George Dimopoulos, Alessandra DaRos, Christian Mélot, Marc J Struelens, Jean-Louis Vincent
OBJECTIVES: To evaluate the outcome of critically ill patients infected with antimicrobial resistant microorganisms, and to analyse the factors involved in the development of antimicrobial resistance. METHODS: All patients admitted to a 31-bed mixed medico-surgical intensive care unit who developed a nosocomial infection were prospectively followed until discharge or death. RESULTS: Of 949 consecutive patients admitted, 186 developed a nosocomial infection: 79 with an antimicrobial-resistant pathogen and 107 with susceptible strains...
November 2003: Journal of Infection
P De Bellis, M Bonfiglio, G Gerbi, P Bacigalupo, G Buscaglia, P Guido, B Massobrio
AIM: Fungal infections have become one of the emerging complications in intensive care patients and the morbidity and mortality linked to these infections underlines the importance of managing these pathologies. METHODS: The clinical and laboratory difficulties of diagnosing candidiasis prompted us to identify patients at risk and to intervene as soon as possible, where there was the "suspicion" of active infection, using adequate, so-called "empiric" treatment...
March 2003: Minerva Anestesiologica
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