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antimicrobial in icu

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https://www.readbyqxmd.com/read/28431848/epidemiology-of-device-associated-infections-in-an-intensive-care-unit-of-a-teaching-hospital-in-nepal-a-prospective-surveillance-study-from-a-developing-country
#1
Narayan Prasad Parajuli, Subhash Prasad Acharya, Santosh Dahal, Jaya Prasad Singh, Shyam Kumar Mishra, Hari Prasad Kattel, Basista Prasad Rijal, Bharat Mani Pokhrel
BACKGROUND: Device-associated health care-acquired infections (DA-HAIs) in intensive care unit patients are a major cause of morbidity, mortality, and increased health care costs. METHODS: A prospective, structured clinicomicrobiological surveillance was carried out for 3 common DA-HAIs: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) present in the patients of an intensive care unit of a teaching hospital in Nepal...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28421643/empiric-antibiotic-regimens-for-neonatal-sepsis-in-australian-and-new-zealand-neonatal-intensive-care-units
#2
Jeremy P Carr, David P Burgner, Rohan S Hardikar, Jim P Buttery
AIM: Neonatal sepsis remains an important cause of morbidity and mortality, and requires prompt empiric treatment. However, only a minority of babies who receive antibiotics for suspected sepsis have an infection. Antimicrobial exposure in infancy has important short- and long-term consequences. There is no consensus regarding empirical antimicrobial regimens. METHODS: The study included a survey of empiric antimicrobial regimens in all tertiary neonatal intensive care units in Australia and New Zealand in 2013-2014...
April 19, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28419005/clinical-utility-of-polymerase-chain-reaction-testing-for-streptococcus-pneumoniae-in-pediatric-cerebrospinal-fluid-samples-a-diagnostic-accuracy-study-of-more-than-2000-samples-from-2004-2015
#3
Abdullah Alqayoudhi, Maryke Nielsen, Nicola O'Sullivan, Mary Corcoran, Patrick J Gavin, Karina M Butler, Robert Cunney, Richard J Drew
The aim of this retrospective study was to review the diagnostic accuracy of real-time polymerase chain reaction (PCR) testing of cerebrospinal fluid (CSF) samples for Streptococcus pneumoniae DNA in comparison with traditional bacterial culture. The hypothesis was that PCR is more sensitive than culture and would detect more cases of pneumococcal meningitis, particularly in children treated with antimicrobials before CSF sampling occurred. Patients younger than 16 years who had a CSF sample tested for S.pneumoniae DNA by PCR between 2004 and 2015 were included...
April 17, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28417069/clostridium-difficile-bacteremia-report-of-two-cases-in-french-hospitals-and-comprehensive-review-of-the-literature
#4
Mouna Doufair, Catherine Eckert, Laurence Drieux, Come Amani-Moibeni, Liliane Bodin, Michel Denis, Jean Didier Grange, Guillaume Arlet, Frédéric Barbut
We report two cases of bacteremia due to Clostridium difficile from two French hospitals. The first patient with previously diagnosed rectal carcinoma underwent courses of chemotherapy, and antimicrobial treatment, and survived the C. difficile bacteremia. The second patient with colon perforation and newly diagnosed lung cancer underwent antimicrobial treatment in an ICU but died shortly after the episode of C. difficile bacteremia. A review of the literature allowed the identification of 137 cases of bacteremia between July 1962 and November 2016...
2017: IDCases
https://www.readbyqxmd.com/read/28413268/novel-propofol-derivatives-and-implications-for-anesthesia-practice
#5
REVIEW
Aiden Y Feng, Alan D Kaye, Rachel J Kaye, Kumar Belani, Richard D Urman
Propofol (2,6-diisopropylphenol) is the most commonly used intravenous agent for induction of anesthesia. It is also used for maintenance of anesthesia and sedation in both Intensive Care Units and outpatient procedural settings. Its success in the clinical setting has been a result of its rapid onset, short duration of action, and minimal side effects despite disadvantages associated with its oil emulsion formulation. Early attempts to alter the standard emulsion or to develop new formulations with cyclodextrins and micelles to resolve issues with pain upon injection, the need for antimicrobial agents, and possible hyperlipidemia have mostly failed...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28407067/evaluation-of-a-second-sign-process-for-antimicrobial-prior-authorization
#6
Aimee M Dassner, Jennifer E Girotto
Background.: A second-sign prospective restriction of select broad-spectrum antimicrobials was fully implemented in January 2015 as a pediatric antimicrobial stewardship program (ASP) initiative to help ensure the most appropriate empiric use of ceftaroline, cefepime, fidaxomicin, linezolid, and vancomycin (intravenous). The objective of this evaluation is to assess the effectiveness of a forced second-sign process in the electronic medical record as a pediatric ASP strategy. We anticipated that the second-sign process for antibiotics would increase the appropriateness of empiric antibiotic use, as defined by preapproved criteria, clinical pathways, national guidelines, and pediatric-specific infectious diseases reference texts, while not causing significant delay in the initial administration of antibiotic therapy...
April 12, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28400686/convergence-of-minds-for-better-patient-outcome-in-intensive-care-unit-infections
#7
Chand Wattal, Yash Javeri, Neeraj Goel, Debashish Dhar, Sonal Saxena, Sarman Singh, Jaswinder Kaur Oberoi, B K Rao, Purva Mathur, Vikas Manchanda, Vivek Nangia, Arti Kapil, Ashok Rattan, Supradip Ghosh, Omender Singh, Vinod Singh, Iqbal Kaur, Sanghamitra Datta, Sharmila Sen Gupta
BACKGROUND: There is emergence of resistance to the last-line antibiotics such as carbapenems in Intensive Care Units (ICUs), leaving little effective therapeutic options. Since there are no more newer antibiotics in the armamentarium in the near future, it has become imperative that we harness the interdisciplinary knowledge for the best clinical outcome of the patient. AIMS: The aim of the conference was to utilize the synergies between the clinical microbiologists and critical care specialists for better patient care and clinical outcome...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28395369/antibiotics-prescriptions-in-the-neonatal-intensive-care-unit-how-to-overcome-everyday-challenges
#8
D Donà, E Mozzo, V Mardegan, U Trafojer, P Lago, S Salvadori, E Baraldi, C Giaquinto
Antimicrobial prescriptions in neonatal intensive care units (NICUs) represent a point of concern for the emergence of MDROs and for morbidity associated with prolonged antibiotic exposure (e.g., invasive candidiasis, necrotizing enterocolitis, and late-onset sepsis). Antimicrobial stewardship programs (ASPs) have shown to be a valuable tool for the prevention of resistance with the goals of optimizing clinical outcomes while decreasing unnecessary prescribing. The most frequent ASP strategies include the correct collection and interpretation of microbiological specimens, prescription of the narrowest-spectrum antibiotic appropriate for a particular case, and de-escalation or discontinuation of therapy in defined situations...
April 10, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28384858/antimicrobial-resistance-surveillance-among-intensive-care-units-of-a-tertiary-care-hospital-in-southern-india
#9
Kailash Moolchandani, Apurba Sankar Sastry, R Deepashree, Sujatha Sistla, B N Harish, Jharna Mandal
INTRODUCTION: Hospital Acquired Infections (HAIs) are the rising threat in the health care facilities across the globe. As most Intesive Care Unit (ICU) patients are frequently on broad spectrum antimicrobials, this induces selective antibiotic pressure which leads to development of Antimicrobial Resistance (AMR) among the microorganisms of ICUs. AIM: To study the occurrence of different types of HAIs in patients admitted to various ICUs of JIPMER and the AMR pattern of the bacterial pathogens isolated from them...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28366686/icu-acquired-candidaemia-in-france-epidemiology-and-temporal-trends-2004-2013-a-study-from-the-rea-raisin-network
#10
Olivier Baldesi, Sébastien Bailly, Stéphane Ruckly, Alain Lepape, François L'Heriteau, Martine Aupee, Sandrine Boussat, Caroline Bervas, Anais Machut, Anne Berger-Carbonne, Anne Savey, Jean François Timsit
OBJECTIVE: Candidaemia is a life-threatening infectious disease, associated with septic shock, multiple organ failure, and a high mortality rate. In France, reported data on the incidence of ICU-acquired candidaemia and the causative Candida species are scarce. The objective of this study was to determine temporal trends in epidemiology and risk factors of intensive care unit-acquired candidaemia (ICU-Cand) and ICU mortality among a very large population of ICU patients. METHOD: Demographics, patient risk factors, invasive device exposure and nosocomial infection in ICU patient were collected from 2004 to 2013 in a national network of 213 ICUs: REA-RAISIN...
March 31, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28365878/biofilm-formation-antibiotic-susceptibility-and-rapd-genotypes-in-pseudomonas-aeruginosa-clinical-strains-isolated-from-single-centre-intensive-care-unit-patients
#11
Martina Vaněrková, Barbora Mališová, Iva Kotásková, Veronika Holá, Filip Růžička, Tomáš Freiberger
The aim of this study was to analyse genotypes, antimicrobial susceptibility patterns and serotypes in Pseudomonas aeruginosa clinical strains, including the clonal dissemination of particular strains throughout various intensive care units in one medical centre. Using random amplified polymorphic DNA (RAPD-PCR) and P. aeruginosa antisera, 22 different genotypes and 8 serotypes were defined among 103 isolates from 48 patients. No direct association between P. aeruginosa strain genotypes and serotypes was observed...
April 1, 2017: Folia Microbiologica
https://www.readbyqxmd.com/read/28365324/clinical-features-and-antimicrobial-resistance-profiles-of-important-enterobacteriaceae-pathogens-in-guangzhou-representative-of-southern-china-2001-2015
#12
Jinhong Xie, Brian M Peters, Bing Li, Lin Li, Guangchao Yu, Zhenbo Xu, Mark E Shirtliff
OBJECT: This surveillance aimed to investigate the antimicrobial resistance profiles of Enterobacteriaceae pathogens in Southern China during 2001-2015. METHODS: A total of 6858 Enterobacteriaceae isolates were collected, including 4276 E. coli, 1992 K. pneumoniae and 590 Enterobacter spp. Disk diffusion method and minimum inhibitory concentrations method were used for susceptibility testing, with results interpreted by the CLSI (2015). RESULTS: Urinary tract remained the dominant isolated site among E...
March 29, 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/28359546/attributable-mortality-of-hospital-acquired-bloodstream-infections-in-ireland
#13
M Brady, A Oza, R Cunney, K Burns
AIM: To estimate the attributable mortality of hospital-acquired bloodstream infections (HA-BSI) in Ireland. METHODS: A retrospective case-cohort study was conducted, based on notifications from Irish microbiology laboratories and administrative patient records from six Irish hospitals from January 2007 to December 2013. Probabilistic linkage was used to link 1252 cases of bloodstream infection from a cohort of 343,189 hospitalized patients. Independent predictors of mortality were determined using a multi-variable logistic regression model, and included: patient age, emergency or re-admission to hospital, length of stay in an intensive care unit, number of procedures, number of diagnoses, major diagnostic category and presence of HA-BSI...
February 9, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28358803/efficacy-of-polymyxin-b-immobilized-fiber-hemoperfusion-for-patients-with-septic-shock-caused-by-gram-negative-bacillus-infection
#14
Nobuyuki Saito, Kazuhiro Sugiyama, Testu Ohnuma, Takashi Kanemura, Michitaka Nasu, Yuya Yoshidomi, Yuta Tsujimoto, Hiroshi Adachi, Hiroyuki Koami, Aito Tochiki, Kota Hori, Yukiko Wagatsuma, Hisashi Matsumoto
Septic shock-associated mortality in intensive care units (ICUs) remains high, with reported rates ranging 30-50%. In particular, Gram-negative bacilli (GNB), which induce significant inflammation and consequent multiple organ failure, are the etiological bacterial agent in 40% of severe sepsis cases. Hemoperfusion using polymyxin B-immobilized fiber (PMX), which adsorbs endotoxin, is expected to reduce the inflammatory sepsis cascade due to GNB. However, the clinical efficacy of this treatment has not yet been demonstrated...
2017: PloS One
https://www.readbyqxmd.com/read/28353453/a-change-for-the-antibacterial-treatment-policy-to-decrease-carbapenem-consumption-at-a-haematopoietic-stem-cell-transplantation-centre
#15
Gõkhan Metan, Leylagül Kaynar, Nuran Yozgat, Ferhan Elmali, Cemile Altay Kürkçüoglu, Emine Alp, Mustafa Çetin
After experiencing a high rate of carbapenem-resistant Gram-negative bacilli infections in febrile neutropenic patients, a two-stage intervention was introduced in the haematopoietic stem cell transplantation (HSCT) centre. During the first eight months of 2014, carbapenems remained the first choice for the empirical treatment of febrile neutropenia while the use of piperacillin/tazobactam (TZP) was encouraged in patients with stable clinical condition. When blood cultures were reported as negative and the patient was clinically stable the carbapenem/TZP treatment was stopped regardless of continuous fever and neutrophil count...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28353451/the-prevalence-and-resistance-patterns-of-pseudomonas-aeruginosa-in-a-tertiary-care-hospital-in-kosovo
#16
Greta Lila, Gjyle Mulliqi-Osmani, Rrezarta Bajrami, Arsim Kurti, Elvir Azizi, Lul Raka
Pseudomonas aeruginosa is a Gram-negative bacterium that continues to a leading cause of opportunistic nosocomial infections. The rapid increase in drug resistance in clinical isolates of this pathogen is a worldwide concern. The aim of this study was to investigate the distribution rate, prevalence and resistance patterns of P. aeruginosa in clinical specimens from the University Clinical Centre of Kosovo (UCCK). During a three-year period, 553 P. aeruginosa isolates were collected from patients admitted to a variety of UCCK units...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28350900/gram-positive-bacterial-infections-research-priorities-accomplishments-and-future-directions-of-the-antibacterial-resistance-leadership-group
#17
Sarah B Doernberg, Thomas P Lodise, Joshua T Thaden, Jose M Munita, Sara E Cosgrove, Cesar A Arias, Helen W Boucher, G Ralph Corey, Franklin D Lowy, Barbara Murray, Loren G Miller, Thomas L Holland
Antimicrobial resistance in gram-positive bacteria remains a challenge in infectious diseases. The mission of the Gram-Positive Committee of the Antibacterial Resistance Leadership Group (ARLG) is to advance knowledge in the prevention, management, and treatment of these challenging infections to improve patient outcomes. Our committee has prioritized projects involving methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) due to the scope of the medical threat posed by these pathogens...
March 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28349179/current-challenges-in-the-management-of-sepsis-in-icus-in-resource-poor-settings-and-suggestions-for-the-future
#18
REVIEW
Marcus J Schultz, Martin W Dunser, Arjen M Dondorp, Neill K J Adhikari, Shivakumar Iyer, Arthur Kwizera, Yoel Lubell, Alfred Papali, Luigi Pisani, Beth D Riviello, Derek C Angus, Luciano C Azevedo, Tim Baker, Janet V Diaz, Emir Festic, Rashan Haniffa, Randeep Jawa, Shevin T Jacob, Niranjan Kissoon, Rakesh Lodha, Ignacio Martin-Loeches, Ganbold Lundeg, David Misango, Mervyn Mer, Sanjib Mohanty, Srinivas Murthy, Ndidiamaka Musa, Jane Nakibuuka, Ary Serpa Neto, Mai Nguyen Thi Hoang, Binh Nguyen Thien, Rajyabardhan Pattnaik, Jason Phua, Jacobus Preller, Pedro Povoa, Suchitra Ranjit, Daniel Talmor, Jonarthan Thevanayagam, C Louise Thwaites
BACKGROUND: Sepsis is a major reason for intensive care unit (ICU) admission, also in resource-poor settings. ICUs in low- and middle-income countries (LMICs) face many challenges that could affect patient outcome. AIM: To describe differences between resource-poor and resource-rich settings regarding the epidemiology, pathophysiology, economics and research aspects of sepsis. We restricted this manuscript to the ICU setting even knowing that many sepsis patients in LMICs are treated outside an ICU...
March 27, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28339914/infant-colonization-with-methicillin-resistant-staphylococcus-aureus-or-vancomycin-resistant-enterococci-preceding-neonatal-intensive-care-unit-discharge
#19
Sarah A Clock, Haomiao Jia, Sameer Patel, Yu-Hui Ferng, Luis Alba, Susan Whittier, Patricia DeLaMora, Setareh Tabibi, Jeffrey Perlman, David Paul, Theoklis Zaoutis, Elaine Larson, Lisa Saiman
Rates of colonization with methicillin-resistant Staphylococcus aureus (MRSA) and/or vancomycin-resistant enterococci (VRE) were determined for 1320 infants within 7 days of neonatal intensive care unit discharge. Overall, 4% and 1% of the infants were colonized with MRSA or VRE, respectively. Predictors identified in fixed-effects models were surgery during hospitalization (for MRSA colonization) and prolonged antimicrobial treatment (for VRE colonization).
March 1, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28339675/high-reported-rates-of-antimicrobial-resistance-in-indian-neonatal-and-pediatric-blood-stream-infections
#20
Dhanya Dharmapalan, Anita Shet, Vijay Yewale, Mike Sharland
Background.: There is real shortage of national data on antimicrobial resistance rates in Indian neonates and children. A descriptive review was conducted to determine the patterns of antimicrobial resistance in isolates of blood stream infection among hospitalized children in India. Methods.: Published and gray literature on antibiotic resistance in children was searched using "Google Scholar", "Scopus", and "PubMed" databases between January 2000 and July 2015...
February 18, 2017: Journal of the Pediatric Infectious Diseases Society
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