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health care associated pneumonia

Iolanda Alves Braga, Paola Amaral de Campos, Paulo Pinto Gontijo Filho, Rosineide Marques Ribas
BACKGROUND: Healthcare-associated infection (HAI) represents a major problem for patient safety worldwide. AIM: To provide an up-to-date picture of the extent, aetiology, risk factors and patterns of infections in intensive care units (ICUs) in 28 Brazilian hospitals of different sizes. METHODS: A one-day point prevalence survey in 2016 enrolled the ICU of hospitals from the 12 meso regions located in the State of Minas Gerais, Southeast region of Brazil...
March 6, 2018: Journal of Hospital Infection
Adina Kleinerüschkamp, Patrick Meybohm, Niels Straub, Kai Zacharowski, Suma Choorapoikayil
BACKGROUND: Patient blood management (PBM) is a multidisciplinary concept focused on the management of anaemia, minimisation of iatrogenic blood loss and rational use of allogeneic blood products. The aims of this study were: (i) to analyse post-operative outcome in patients with liberal vs restrictive exposure to allogeneic blood products and (ii) to evaluate the cost-effectiveness of PBM in patients undergoing surgery. MATERIALS AND METHODS: A systematic literature review and meta-analysis were performed to compare post-operative complications in predominantly non-transfused patients (restrictive transfusion group) and patients who received one to three units of red blood cells (liberal transfusion group)...
February 16, 2018: Blood Transfusion, Trasfusione del Sangue
Nathan Ford, Graeme Meintjes, Alexandra Calmy, Helen Bygrave, Chantal Migone, Marco Vitoria, Martina Penazzato, Lara Vojnov, Meg Doherty
In 2017, the World Health Organization (WHO) published guidelines for the management of advanced human immunodeficiency virus (HIV) disease within a public health approach. Recent data suggest that more than a third of people starting antiretroviral therapy (ART) do so with advanced HIV disease, and an increasing number of patients re-present to care at an advanced stage of HIV disease following a period of disengagement from care. These guidelines recommend a standardized package of care for adults, adolescents, and children, based on the leading causes of morbidity and mortality: tuberculosis, severe bacterial infections, cryptococcal meningitis, toxoplasmosis, and Pneumocystis jirovecii pneumonia...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Mónica J Pajuelo, Cynthia Anticona Huaynate, Malena Correa, Holger Mayta Malpartida, Cesar Ramal Asayag, Juan R Seminario, Robert H Gilman, Laura Murphy, Richard A Oberhelman, Valerie A Paz-Soldan
BACKGROUND: Delays in receiving adequate care for children suffering from pneumonia can be life threatening and have been described associated with parents' limited education and their difficulties in recognizing the severity of the illness. The "three delays" was a model originally proposed to describe the most common determinants of maternal mortality, but has been adapted to describe delays in the health seeking process for caregivers of children under five. This study aims to explore the caregivers' perceived barriers for seeking and receiving health care services in children under five years old admitted to a referral hospital for community-acquired pneumonia in the Peruvian Amazon Region using the three-delays model framework...
March 1, 2018: BMC Health Services Research
Elisa Jiménez, Nicolás Valls, Patricio Astudillo, Cristian Valls, Gabriel Cavada, Alejandra Sandoval, Angélica Alegría, Gabriela Ortega, Daniela Núñez, Patricia Mena
BACKGROUND: Antibiotics (ATB) are drugs widely used in hospitalized newborns. The indiscriminate use of ATBs promote the rise of resistant bacteria to the most commonly indicated antimicrobials. In addition, ATB prescription presents associations to morbidity, such as bronchopulmonary dysplasia, necrotizing enterocolitis, late sepsis and even death. All of the above leads to an increase in health care costs. AIM: To record and to evaluate trends of antibiotic use over time in hospitalized NB in the Neonatology Unit at Dr...
December 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
James A McKinnell, Shelby Corman, Dipen Patel, Grace H Leung, Lynne M Gordon, Thomas P Lodise
PURPOSE: Clinicians and stewardship programs are challenged with positioning of novel, higher priced antibiotic agents for the treatment of clinical infections. We developed a decision-analytic model to describe costs, including drug, total treatment costs, and health care outcomes, associated with telavancin (TLV) compared with vancomycin (VAN) for patients with Staphylococcus aureus (SA) hospital-acquired bacterial pneumonia (HABP). METHODS: This decision-analytic model assessed the treatment of SA-HABP with TLV versus VAN...
February 14, 2018: Clinical Therapeutics
Viviana Sotomayor, Rodrigo A Fasce, Natalia Vergara, Felipe De la Fuente, Sergio Loayza, Rakhee Palekar
BACKGROUND: Influenza is a vaccine preventable disease that causes important morbidity and mortality worldwide. Estimating the burden of influenza disease is difficult. However, there are some methods based in surveillance data and laboratory testing that can be used for this purpose. OBJECTIVES: Estimating the burden of serious illness from influenza by means of hospitalization and death records during the period between 2012 and 2014, and using information from Severe Acute Respiratory Illness (SARI) surveillance...
February 14, 2018: Influenza and Other Respiratory Viruses
Peter Hobson, Jolyon Meara
OBJECTIVE: This investigation reports the cause and the quality of death certification in a community cohort of patients with Parkinson's disease (PD) and controls at 18 years. SETTING: Denbighshire North Wales, UK. PARTICIPANTS: The community-based cohorts consisted of 166 patients with PD and 102 matched controls. PRIMARY OUTCOMES: All-cause mortality was ascertained at 18 years by review of hospitals' primary care records and examination of death certificates obtained from the UK General Register Office...
February 14, 2018: BMJ Open
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
Kelser de Souza Kock, Rosemeri Maurici
AIM: To evaluate the predictive capability of respiratory mechanics for the development of ventilator-associated pneumonia (VAP) and mortality in the intensive care unit (ICU) of a hospital in southern Brazil. METHODS: A cohort study was conducted between, involving a sample of 120 individuals. Static measurements of compliance and resistance of the respiratory system in pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) modes in the 1st and 5th days of hospitalization were performed to monitor respiratory mechanics...
February 4, 2018: World Journal of Critical Care Medicine
María Luisa Cantón-Bulnes, María Ascensión González-García, Manuela García-Sánchez, Ángel Arenzana-Seisdedos, José Garnacho-Montero
OBJECTIVES: The main objective was to determine whether ventilator-associated tracheobronchitis (VAT) is related to increased length of ICU stay. Secondary endpoints included prolongation of hospital stay, as well as, ICU and hospital mortality. DESIGN: A retrospective matched case-control study. Each case was matched with a control for duration of ventilation (± 2 days until development of ventilator-associated tracheobronchitis), disease severity (Acute Physiology and Chronic Health Evaluation II) at admission ± 3, diagnostic category and age ±10 years...
February 5, 2018: Enfermedades Infecciosas y Microbiología Clínica
Nawfal Aljerian, Saleh Alhaidar, Ali Alothman, Wijdan AlJohi, Faisal Abdullah Albaqami, Suliman Abdullah Alghnam
BACKGROUND: In Saudi Arabia, injury is the leading cause of death. Even if nonfatal, the impact of injuries on population health is enormous, as thousands of young patients suffer permanent disabilities every year. Unlike in developed countries, private transportation (PT) is a common means to transport trauma patients. Outcome differences between patients transported via PT relative to emergency medical services (EMS) has not been previously explored. OBJECTIVES: To evaluate the association between transportation mode and in-hospital complications among trauma patients...
January 2018: Annals of Saudi Medicine
Meseret Ekubay, Aster Berhe, Engida Yisma
Background: Breast milk is comprised of the essential nutrients that an infant needs in the first six months of life. Timely initiation of breastfeeding guarantees that infants receive the colostrum, 'the first breastmilk', which contains antibodies that protect the newborn against diseases. Breastfeeding within the first hour of life prevents newborn death due to sepsis, pneumonia, diarrhea and hypothermia. Although breastfeeding is a common practice in sub-Saharan Africa, evidence show that early initiation of breastfeeding is low...
2018: International Breastfeeding Journal
Rebekah M Martin, Michael A Bachman
Klebsiella pneumoniae is a Gram-negative pathogen that has a large accessory genome of plasmids and chromosomal gene loci. This accessory genome divides K. pneumoniae strains into opportunistic, hypervirulent, and multidrug-resistant groups and separates K. pneumoniae from two closely related species, Klebsiella variicola and Klebsiella quasipneumoniae. Some strains of K. pneumoniae act as opportunistic pathogens, infecting critically ill and immunocompromised patients. These K. pneumoniae are a common cause of health-care associated infections including pneumonia, urinary tract infections (UTIs), and bloodstream infections...
2018: Frontiers in Cellular and Infection Microbiology
Jessica A Schults, Marie Cooke, Debbie A Long, Andreas Schibler, Robert S Ware, Marion L Mitchell
INTRODUCTION: Endotracheal suction (ETS) is a frequent and necessary airway intervention for the intubated child. The aim of ETS is to clear the endotracheal tube and airways of respiratory secretions; however, the methods of performing ETS are varied. Internationally a number of ETS treatments are in use. Many have not been rigorously evaluated in a randomised controlled trial setting, and it is uncertain whether any are associated with better outcomes for the critically ill child. With approximately 50% of paediatric intensive care admissions requiring intubation, ETS interventions that maximise the efficacy and minimise the complications of ETS could translate to improved health for substantial numbers of critically ill children, and significant cost savings...
January 31, 2018: BMJ Open
Mamta Dhaneria, Sachin Jain, Poonam Singh, Aditya Mathur, Cecilia Stålsby Lundborg, Ashish Pathak
Very little is known about laboratory-confirmed blood stream infections (LCBIs) in neonatal intensive care units (NICUs) in resource-limited settings. The aim of this cohort study was to determine the incidence, risk factors, and causative agents of LCBIs in a level-2 NICU in India. The diagnosis of LCBIs was established using the Centre for Disease Control, USA criteria. A predesigned questionnaire containing risk factors associated with LCBIs was filled-in. A total of 150 neonates (43% preterm) were included in the study...
January 30, 2018: Diseases (Basel)
Lianping Yang, Chaojie Liu, Cunrui Huang, Dana B Mukamel
BACKGROUND: Reducing 30-day hospital readmissions has become a focus of the current national payment policies. Medicare requires that hospitals collect and report patients' experience with their care as a condition of payment. However, the extent to which patients' experience with hospital care is related to hospital readmission is unknown. METHODS: We established multivariate regression models in which 30-day risk-adjusted readmission rates were the dependent variables and patients' perceptions of the responsiveness of the hospital staff and communication (as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores) were the independent variables of interest...
January 29, 2018: BMC Health Services Research
Elisa Demonchy, Johan Courjon, Estelle Ughetto, Matthieu Durand, Karine Risso, Rodolphe Garraffo, Pierre-Marie Roger
INTRODUCTION: The emergence of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) infections requires therapeutic tool reassessment. We report the efficacy of a cefoxitin-based antibiotic therapy for ESBL-E prostatitis. METHODS: We conducted a prospective study including patients with ESBL-E prostatitis, resistant to cotrimoxazole and fluoroquinolones from January 2014 to March 2016. Cefoxitin was administered by continuous infusion for three weeks in the case of acute prostatitis or six weeks in the case of chronic prostatitis with intravenous fosfomycin for the first five days...
January 25, 2018: International Journal of Antimicrobial Agents
María Victoria Ovalle, Sandra Yamile Saavedra, María Nilse González, Andrea Melissa Hidalgo, Carolina Duarte, Mauricio Beltrán
INTRODUCTION: The Colombian National Antimicrobial Resistance Monitoring System for the surveillance of healthcare-associated infections was set up to meet this problem in the third quarter of 2012. OBJECTIVE: To describe resistance profiles and laboratory-based surveillance based on the information collected by the System. MATERIALS AND METHODS: We conducted a retrospective and descriptive study of the information notified to the Colombian Public Health Surveillance System (Sivigila), and in the Whonet databases covering the period from July 2012 to December 2014 provided by the primary data-generating units in the country, as well as laboratory surveillance results from 1,642 phenotypic and genotypic tests on carbapenemase isolates (927 from Enterobacteriaceae, 614 from Pseudomonas spp...
December 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
Adam E M Eltorai, Grayson L Baird, Ashley Szabo Eltorai, Joshua Pangborn, Valentin Antoci, H Allethaire Cullen, Katherine Paquette, Kevin Connors, Jacqueline Barbaria, Kimberly J Smeals, Saurabh Agarwal, Terrance T Healey, Corey E Ventetuolo, Frank W Sellke, Alan H Daniels
BACKGROUND: Incentive spirometry (IS) is widely used to prevent postoperative pulmonary complications, despite limited clinical effectiveness data and a lack of standardized use protocols. We sought to evaluate health care professionals' perspectives on IS effectiveness and use procedures. METHODS: An online survey was distributed via social media and newsletters to relevant national nursing and respiratory care societies. Attitudes concerning IS were compared between the American Association for Respiratory Care (AARC) and the nursing societies...
January 23, 2018: Respiratory Care
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