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antimicrobial in icu

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https://www.readbyqxmd.com/read/28630687/emerging-antimicrobial-resistance-in-early-and-late-onset-neonatal-sepsis
#1
Lamiaa Mohsen, Nermin Ramy, Dalia Saied, Dina Akmal, Niveen Salama, Mona M Abdel Haleim, Hany Aly
BACKGROUND: Compared to developed countries, the use of antimicrobials in Egypt is less regulated and is available over the counter without the need for prescriptions. The impact of such policy on antimicrobial resistance has not been studied. This study aimed to determine the prevalence of early and late onset sepsis, and the frequency of antimicrobial resistance in a major referral neonatal intensive care unit (NICU). METHODS: The study included all neonates admitted to the NICU over a 12-month period...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28630685/effectiveness-of-surface-coatings-containing-silver-ions-in-bacterial-decontamination-in-a-recovery-unit
#2
Rafael Manuel Ortí-Lucas, Julio Muñoz-Miguel
BACKGROUND: HAIs remain a frequent complication for hospitalised patients and pose a challenge that must be tackled by our health systems. METHODS: Quasi-experimental study. In order to determine the antimicrobial effectiveness of surface coating agents containing silver ions (BactiBlock®) the degree of contamination of several surfaces in two ICU wards was compared. The association between application of Bactiblock® and surface contamination was analysed using a relative risk (RR)...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28629754/improving-compliance-with-surgical-antibiotic-prophylaxis-guidelines-a-multicenter-evaluation
#3
Cristiane Schmitt, Rubia Aparecida Lacerda, Ruth Natalia Teresa Turrini, Maria Clara Padoveze
BACKGROUND: Improving surgical antibiotic prophylaxis (SAP) use is an important element in the control of antimicrobial resistance. However, compliance with SAP guidelines is unsatisfactory. This study investigated the level of compliance with SAP guidelines in neurosurgery, and institutional characteristics associated with compliance. METHODS: This study assessed surgeries in 9 Brazilian hospitals. Medical record reviews and a structured questionnaire were used to assess compliance and to describe institutional characteristics...
June 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28625166/impact-of-gram-stain-results-on-initial-treatment-selection-in-patients-with-ventilator-associated-pneumonia-a-retrospective-analysis-of-two-treatment-algorithms
#4
Jumpei Yoshimura, Takahiro Kinoshita, Kazuma Yamakawa, Asako Matsushima, Naoki Nakamoto, Toshimitsu Hamasaki, Satoshi Fujimi
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common and serious problem in intensive care units (ICUs). Several studies have suggested that the Gram stain of endotracheal aspirates is a useful method for accurately diagnosing VAP. However, the usefulness of the Gram stain in predicting which microorganisms cause VAP has not been established. The purpose of this study was to evaluate whether a Gram stain of endotracheal aspirates could be used to determine appropriate initial antimicrobial therapy for VAP...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28619105/patterns-of-antimicrobial-resistance-in-intensive-care-unit-patients-a-study-in-vietnam
#5
Giang M Tran, Thao P Ho-Le, Duc T Ha, Chau H Tran-Nguyen, Tuyet S M Nguyen, Thao T N Pham, Tuyet A Nguyen, Dung A Nguyen, Hoa Q Hoang, Ngoc V Tran, Tuan V Nguyen
BACKGROUND: Antimicrobial resistance has emerged as a major concern in developing countries. The present study sought to define the pattern of antimicrobial resistance in ICU patients with ventilator-associated pneumonia. METHODS: Between November 2014 and September 2015, we enrolled 220 patients (average age ~ 71 yr) who were admitted to ICU in a major tertiary hospital in Ho Chi Minh City, Vietnam. Data concerning demographic characteristics and clinical history were collected from each patient...
June 15, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28618727/analysis-of-epidemiology-and-risk-factors-for-mortality-in-ventilator-associated-pneumonia-attacks-in-intensive-care-unit-patients
#6
Ayşe But, Meltem Arzu Yetkin, Dilek Kanyilmaz, Halide Aslaner, Aliye Baştuğ, Adalet Aypak, Pınar Öngürü, Esragül Akinci, Nevzat Mehmet Mutlu, Hürrem Bodur
BACKGROUND/AIM: The aim of this study was to investigate the epidemiologic characteristics, the causative microorganisms and their antimicrobial susceptibility patterns, and the prognostic risk factors for mortality in critically ill patients with ventilator-associated pneumonia (VAP). MATERIALS AND METHODS: In this retrospective observational study, all the critically ill patients with VAP hospitalized in a medical/surgical intensive care unit (ICU) between January 2010 and June 2015 were evaluated...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28617807/treatment-with-macrolides-and-glucocorticosteroids-in-severe-community-acquired-pneumonia-a-post-hoc-exploratory-analysis-of-a-randomized-controlled-trial
#7
Adrian Ceccato, Catia Cilloniz, Otavio T Ranzani, Rosario Menendez, Carles Agusti, Albert Gabarrus, Miquel Ferrer, Oriol Sibila, Michael S Niederman, Antoni Torres
BACKGROUND: Systemic corticosteroids have anti-inflammatory effects, whereas macrolides also have immunomodulatory activity in addition to their primary antimicrobial actions. We aimed to evaluate the potential interaction effect between corticosteroids and macrolides on the systemic inflammatory response in patients with severe community-acquired pneumonia to determine if combining these two immunomodulating agents was harmful, or possibly beneficial. METHODS: We performed a post-hoc exploratory analysis of a randomized clinical trial conducted in three tertiary hospitals in Spain...
2017: PloS One
https://www.readbyqxmd.com/read/28596021/pharmacist-driven-antimicrobial-stewardship-in-intensive-care-units-in-east-china-a-multicenter-prospective-cohort-study
#8
Zhongwang Li, Baoli Cheng, Kai Zhang, Guohao Xie, Yan Wang, Jinchao Hou, Lihua Chu, Jialian Zhao, Zhijun Xu, Zhongqiu Lu, Huaqin Sun, Jian Zhang, Zhiyi Wang, Haiya Wu, Xiangming Fang
BACKGROUND: Antimicrobial stewardship programs, particularly pharmacist-driven programs, help reduce the unnecessary use of antimicrobial agents. The objective of this study was to assess the influence of pharmacist-driven antimicrobial stewardship on antimicrobial use, multidrug resistance, and patient outcomes in adult intensive care units in China. METHOD: We conducted a multicenter prospective cohort study with a sample of 577 patients. A total of 353 patients were included under a pharmacist-driven antimicrobial stewardship program, whereas the remaining 224 patients served as controls...
June 5, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28578555/infections-due-to-acinetobacter-baumannii-in-the-icu-treatment-options
#9
Joseph P Lynch, George G Zhanel, Nina M Clark
Bacteria within the genus Acinetobacter (principally A. baumannii-calcoaceticus complex [ABC]) are gram-negative coccobacilli that may cause nosocomial infections in critically ill or debilitated patients (particularly ventilator-associated pneumonia and infections of the bloodstream, urinary tract, and wounds). Treatment of Acinetobacter infections is difficult, as Acinetobacter spp. are intrinsically resistant to multiple antimicrobial agents, and have a remarkable ability to acquire new resistance determinants via mechanisms that include plasmids, transposons, integrons, and resistance islands...
June 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28578550/ventilator-associated-pneumonia-the-role-of-emerging-diagnostic-technologies
#10
Marin H Kollef, Carey-Ann D Burnham
Antibiotic resistance has emerged as a key determinant of outcome in patients with serious infections along with the virulence of the underlying pathogen. Within the intensive care unit (ICU) setting, ventilator-associated pneumonia (VAP) is a common nosocomial infection that is frequently caused by multidrug-resistant bacteria. Antimicrobial resistance is a growing challenge in the care of critically ill patients. Escalating rates of antibiotic resistance add substantially to the morbidity, mortality, and cost related to infection in the ICU...
June 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28562751/carbapenem-resistant-acinetobacter-baumannii-contamination-in-an-intensive-care-unit
#11
Otávio Hallal Ferreira Raro, Stephanie Wagner Gallo, Carlos Alexandre Sanchez Ferreira, Sílvia Dias de Oliveira
INTRODUCTION: Acinetobacter baumannii is a major pathogen causing infections in intensive care units (ICUs). In this study, we aimed to evaluate the presence of A. baumannii in an ICU environment and gloves from ICU workers and to characterize the antimicrobial resistance of the isolates in comparison with those isolated from ICU patients at the same hospital. METHODS: ICU samples were collected from March to November 2010. Isolates biochemically characterized as Acinetobacter calcoaceticus-Acinetobacter baumannii complex were evaluated by PCR targeting the 16S rDNA and bla OXA-51 genes...
March 2017: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/28562638/every-antibiotic-every-day-maximizing-the-impact-of-prospective-audit-and-feedback-on-total-antibiotic-use
#12
Tonya J Campbell, Melissa Decloe, Suzanne Gill, Grace Ho, Janine McCready, Jeff Powis
BACKGROUND: The success of antimicrobial stewardship is dependent on how often it is completed and which antimicrobials are targeted. We evaluated the impact of an antimicrobial stewardship program (ASP) in three non-ICU settings where all systemic antibiotics, regardless of spectrum, were targeted on the first weekday after initiation. METHODS: Prospective audit and feedback (PAAF) was initiated on the surgical, respiratory, and medical wards of a community hospital on July 1, 2010, October 1, 2010, and April 1, 2012, respectively...
2017: PloS One
https://www.readbyqxmd.com/read/28557559/aggressive-antimicrobial-initiation-for-suspected-intensive-care-unit-acquired-infection-is-associated-with-decreased-long-term-survival-after-critical-illness
#13
Christopher A Guidry, Tjasa Hranjec, Puja M Shah, Zachary C Dietch, Taryn E Hassinger, Nathan R Elwood, Robert G Sawyer
BACKGROUND: The long-term significance of early and prolonged antibiotic use in critically ill patients is yet to be described. Several studies suggest that antimicrobial exposure may have as yet unrecognized long-term effects on clinically meaningful outcomes. Our group previously conducted a quasi-experimental, before and after observational cohort study of hemodynamically stable surgical patients suspected of having an intensive care unit-acquired infection. This study demonstrated that aggressive initiation of antimicrobial therapy was associated with increased 30-day deaths...
May 30, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28556289/influence-of-regular-reporting-on-local-pseudomonas-aeruginosa-and-acinetobacter-spp-sensitivity-to-antibiotics-on-consumption-of-antibiotics-and-resistance-patterns
#14
Z M Djordjevic, M M Folic, S M Jankovic
WHAT IS KNOWN AND OBJECTIVE: Regular surveillance of antimicrobial resistance is an important component of multifaceted interventions directed at the problem with resistance of bacteria causing healthcare-associated infections (HAIs) in intensive care units (ICUs). Our aim was to analyse antimicrobial consumption and resistance among isolates of Pseudomonas aeruginosa and Acinetobacter spp. causing HAIs, before and after the introduction of mandatory reporting of resistance patterns to prescribers...
May 27, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28549778/stepwise-introduction-of-the-best-care-always-central-line-associated-bloodstream-infection-prevention-bundle-in-a-network-of-south-african-hospitals
#15
G A Richards, A J Brink, A P Messina, C Feldman, K Swart, D van den Bergh
BACKGROUND: Healthcare-associated infection (HCAI) remains a major international problem. AIM: The 'Best Care Always!' (BCA) campaign was launched in South Africa to reduce preventable HCAI, including central-line-associated bloodstream infection (CLABSI). METHODS: The intervention took place in 43 Netcare Private Hospitals, increasing later to 49 with 958 intensive care units (ICUs) and 439 high-care (HC) beds and 1207 ICUs and 493 HC beds, respectively...
May 24, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28545831/pre-post-evaluation-of-effects-of-a-titanium-dioxide-coating-on-environmental-contamination-of-an-intensive-care-unit-the-titanic-study
#16
B de Jong, A M Meeder, K W A C Koekkoek, M A Schouten, P Westers, A R H van Zanten
BACKGROUND: Among patients admitted to European hospitals or intensive care units (ICUs), 5.7% and 19.5% will encounter healthcare-associated infections (HAIs), respectively, and antimicrobial resistance is emerging. As hospital surfaces are contaminated with potentially pathogenic bacteria, environmental cleanliness is an essential aspect to reduce HAIs. AIM: To address the efficacy of a titanium dioxide coating in reducing the microbial colonization of environmental surfaces in an ICU...
April 15, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28538851/-antimicrobial-sensitivity-of-the-environmental-microbiota-in-the-intensive-care-units-of-a-peruvian-hospital
#17
José Díaz-Tello, Jesús Rojas-Jaimes, Jimmy Ibarra-Trujillo, Delza Tárraga-Gonzales
The objective was to detect Gram-negative bacilli and Gram-positive cocci isolated from the environmental microbiota of the Intensive Care Unit (ICU) departments of Neonatology, Pediatrics, and Transplants (kidney, liver, and general) in a Lima hospital and determine their antimicrobial sensitivity. Eighty samples were obtained from inanimate surfaces using a wet swab. A total of 61 bacterial strains were identified, including Staphylococcus epidermis (46.0%), Alcaligenes sp. (21.3%), Pseudomonas aeruginosa (16...
January 2017: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28535790/clonal-replacement-of-epidemic-kpc-producing-klebsiella-pneumoniae-in-a-hospital-in-china
#18
Yuying Liang, Xiuyun Yin, Lijun Zeng, Shuiping Chen
BACKGROUND: Klebsiella pneumoniae is a frequent nosocomial pathogen causing difficult-to-treat infections worldwide. The prevalence of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-KP) is increasing in China. The aim of this study was to investigate the molecular epidemiology of KPC-KP in a nosocomial outbreak. METHODS: Fifty-four KPC-KP isolates were consecutively collected between November 2013 and August 2014 during a KPC-KP outbreak in a tertiary care hospital in Beijing, China...
May 23, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28532467/antimicrobial-consumption-costs-and-resistance-patterns-a-two-year-prospective-study-in-a-romanian-intensive-care-unit
#19
Carmen Axente, Monica Licker, Roxana Moldovan, Elena Hogea, Delia Muntean, Florin Horhat, Ovidiu Bedreag, Dorel Sandesc, Marius Papurica, Dorina Dugaesescu, Mirela Voicu, Luminita Baditoiu
BACKGROUND: Due to the vulnerable nature of its patients, the wide use of invasive devices and broad-spectrum antimicrobials used, the intensive care unit (ICU) is often called the epicentre of infections. In the present study, we quantified the burden of hospital acquired pathology in a Romanian university hospital ICU, represented by antimicrobial agents consumption, costs and local resistance patterns, in order to identify multimodal interventional strategies. METHODS: Between 1(st) January 2012 and 31(st) December 2013, a prospective study was conducted in the largest ICU of Western Romania...
May 22, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28526309/antimicrobial-stewardship-for-hospitalized-patients-with-viral-respiratory-tract-infections
#20
Christopher F Lowe, Michael Payne, David Puddicombe, Allison Mah, Davie Wong, Allison Kirkwood, Mark W Hull, Victor Leung
BACKGROUND: The purpose of this study was to implement a targeted antimicrobial stewardship intervention for patients with a viral respiratory tract infection. METHODS: This was a quasi-experimental before and after audit and feedback intervention of adult inpatients with a positive polymerase chain reaction for a respiratory virus in 2 acute care hospitals in Vancouver, Canada. Audit and feedback was implemented based on 2 criteria: microbiology (no positive bacterial cultures) and chest imaging (absence of pneumonia or consolidation on radiology dictation)...
May 16, 2017: American Journal of Infection Control
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