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antimicrobial in icu

Lauren E Arthur, Russell S Kizor, Adrian G Selim, Mieke L van Driel, Leonardo Seoane
BACKGROUND: Ventilator-associated pneumonia (VAP) is a significant cause of morbidity and mortality, complicating the medical course of approximately 10% of mechanically-ventilated patients, with an estimated attributable mortality of 13%. To treat VAP empirically, the American Thoracic Society currently recommends antibiotic therapy based on the patients' risk of colonisation by an organism with multidrug resistance. The selection of initial antibiotic therapy in VAP is important, as inappropriate initial antimicrobial treatment is associated with higher mortality and longer hospital stay in intensive care unit (ICU) patients...
October 20, 2016: Cochrane Database of Systematic Reviews
Pallavi Surase, Gita Nataraj, Sunil Kuyare, Preeti Mehta
OBJECTIVES: The study was carried out to determine the extent and type of contamination of the hands and accessories of staff from different settings and also to determine the phenotypic similarity between the isolates recovered from the same staff. DESIGN: Prospective cross-sectional study. SETTING: Tertiary care center. PARTICIPANTS: Health care workers (HCWs') and administrative staff. METHODS: Samples were collected and processed for bacteriology from the dominant hand, mobiles, aprons, stethoscopes and computer keyboards of 280 staff working in different settings after consent...
August 2016: Journal of the Association of Physicians of India
Athanasios Tselebonis, Evangelia Nena, Christos Nikolaidis, Theocharis Konstantinidis, Christos Kontogiorgis, Maria Panopoulou, Theodore C Constantinidis
OBJECTIVE: To monitor microbes, focusing on drug resistance, on the hands of the personnel of four departments of a tertiary hospital (ICU, neonatal unit, internal medicine ward and surgical ward) and explore differences between departments, professions and genders. MATERIALS AND METHODS: Hand sampling from 125 healthcare employees was conducted followed by isolation, identification and antibiotic resistance profiling of different microbial species. RESULTS: Staphylococcus spp was the most prevalent microbe (76/125, 60...
September 1, 2016: Folia Medica
Ana Flores-Carrero, Indira Labrador, Alberto Paniz-Mondolfi, David R Peaper, Dana Towle, María Araque
Enterobacter spp. have emerged as an important group of pathogens linked to outbreaks in neonatal intensive care units (NICUs), usually involving strains expressing extended-spectrum β-lactamases (ESBLs). The aim of this study was to describe the first nosocomial bloodstream infection outbreak caused by Enterobacter ludwigii co-harbouring CTX-M-8, SHV-12 and TEM-15 in a NICU in a Venezuelan hospital. Initial bacterial identification was achieved by VITEK(®)2 system and matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (VITEK(®) MS) and was subsequently confirmed by nucleotide sequencing of the 16S rDNA gene and hsp60 genotyping...
October 7, 2016: Journal of Global Antimicrobial Resistance
A Deny, C Loiez, V Deken, S Putman, A Duhamel, J Girard, G Pasquier, C Chantelot, E Senneville, H Migaud
: Factors that predict the occurrence of a surgical site infection due to methicillin-resistant Staphylococcus aureus (MRSA) are not well known; however this information could be used to modify the recommended antimicrobial prophylaxis. We carried out a retrospective study of S. aureus infections on orthopedic implants to determine: (1) whether epidemiological factors can be identified that predict a MRSA infection, (2) the impact of these factors as evidenced by the odds ratio (OR). HYPOTHESIS: Risk factors for a MRSA infection can be identified from a cohort of patients with S...
October 12, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
David Carr, Elizabeth Helen Barnes, Adrienne Gordon, David Isaacs
BACKGROUND: Antibiotic resistance is a worldwide problem. We describe 25 years of responsible antibiotic use in a tertiary neonatal unit. METHODS: Data on neonatal infections and antibiotic use were collected prospectively from 1990 to 2014 at a single tertiary Sydney neonatal intensive care unit attached to a maternity unit. There are approximately 5500 deliveries and 900 nursery admissions per year. RESULTS: The mean annual rate of late-onset sepsis was 1...
October 13, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Tayfur Demiray, Mehmet Köroğlu, Ahmet Özbek, Taner Hafizoğlu, Mustafa Altındiş
Raoultella terrigena, formerly known as Klebsiella terrigena is Gram-negative, non-motile, facultative anaerobic, encapsulated bacilli and is a very rare cause of infections in humans. Until now, only two cases of actual clinical infection caused by R. terrigena were reported in adults. This report is the first case of neonatal infection with this microorganism, which was isolated from the urinary tract of a premature newborn followed in Neonatal Intensive Care Unit. Vitek 2® automated system had identified the bacteria as R...
November 2015: Turkish Journal of Pediatrics
Angeliki Mavroidi, Maria Katsiari, Eleftheria Palla, Sofia Likousi, Zoi Roussou, Charikleia Nikolaou, Evangelia D Platsouka
A rapid increase was observed in the incidence of extensively drug-resistant Acinetobacter baumannii (XDR Aba) isolates in a Greek hospital during 2014. To investigate the causes of this rise, the antimicrobial resistance profiles of all carbapenem-resistant (CARB-R) Aba isolates recovered during 2014-2015 were determined. Selected XDR Aba isolates (n = 13) were characterized by molecular methods. XDR Aba (48 isolates) represented 21.4% of the 224 CARB-R Aba recovered during the study period. The 13 selected XDR Aba isolates were positive for the blaOXA-23, the intrinsic blaOXA-51, and the adeB gene of the AdeABC efflux pump, and all belonged to the 3LST ST101, corresponding to the international clone II...
October 11, 2016: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Esther van Kleef, Sarah R Deeny, Mark Jit, Barry Cookson, Simon D Goldenberg, W John Edmunds, Julie V Robotham
BACKGROUND: Early clinical trials of a Clostridium difficile toxoid vaccine show efficacy in preventing C. difficile infection (CDI). The optimal patient group to target for vaccination programmes remains unexplored. This study performed a model-based evaluation of the effectiveness of different CDI vaccination strategies, within the context of existing infection prevention and control strategies such as antimicrobial stewardship. METHODS: An individual-based transmission model of CDI in a high-risk hospital setting was developed...
October 7, 2016: Vaccine
Sarah E Petite, Seth R Bauer, Jessica E Bollinger, Christine L Ahrens, Lisa M Harinstein
STUDY OBJECTIVE: It is unknown if beta-lactam monotherapy is sufficient for complicated intra-abdominal infections or if broader coverage is required, such as with vancomycin. This study sought to determine the clinical outcomes of piperacillin/tazobactam monotherapy compared to combination therapy with vancomycin and piperacillin/tazobactam for complicated intra-abdominal infections among patients within a surgical intensive care unit. DESIGN: Retrospective cohort study...
October 11, 2016: Pharmacotherapy
A Dramowski, A Whitelaw, M F Cotton
BACKGROUND: In most African countries the prevalence and effects of paediatric healthcare-associated infection (HCAI) and human immunodeficiency virus (HIV) infection are unknown. AIM: To investigate the burden, spectrum, risk factors, and impact of paediatric HCAI by prospective clinical surveillance at a South African referral hospital. METHODS: Continuous prospective clinical and laboratory HCAI surveillance using Centers for Disease Control and Prevention (CDC)/National Healthcare Safety Network (NHSN) definitions was conducted at Tygerberg Children's Hospital, South Africa, from May 1(st) to October 31(st) in 2014 and 2015...
September 1, 2016: Journal of Hospital Infection
Emine Alp
Septic shock is still a lethal disease in intensive care units (ICU). The mortality can exceed 40% even with therapeutic management. The high mortality is clearly associated with the delay of appropriate antimicrobial therapy. Early diagnosis and identification of infectious source is the mainstay of optimal therapeutic management. On the other hand, source control and optimize antibiotic dosing according to pharmacokinetics (PK)/pharmacodynamics (PD) properties of antibiotics and organ dysfunction of patients are required to get the best clinical outcome...
September 2016: Annals of Translational Medicine
Irena Klavs, Jana Kolman, Tatjana Lejko Zupanc, Božena Kotnik Kevorkijan, Aleš Korošec, Mojca Serdt
INTRODUCTION: In the second Slovenian national healthcare-associated infections (HAIs) prevalence survey, conducted within the European point prevalence survey of HAIs and antimicrobial use in acute-care hospitals, we estimated the prevalence of all types of HAIs and identified risk factors. METHODS: Patients from acute-care hospitals were enrolled into a one-day cross-sectional study in October 2011. Descriptive analyses were performed to describe the characteristics of patients, their exposure to invasive procedures and the prevalence of different types of HAIs...
December 1, 2016: Zdravstveno Varstvo
Jason P Burnham, John P Kirby, Marin H Kollef
PURPOSE: To review the salient features of the diagnosis and management of the most common skin and soft tissue infections (SSTI). This review focuses on severe SSTIs that require care in an intensive care unit (ICU), including toxic shock syndrome, myonecrosis/gas gangrene, and necrotizing fasciitis. METHODS: Guidelines, expert opinion, and local institutional policies were reviewed. RESULTS: Severe SSTIs are common and their management complex due to regional variation in predominant pathogens and antimicrobial resistance patterns, as well as variations in host immune responses...
October 3, 2016: Intensive Care Medicine
Duo Yang, Zeqiang Xie, Xuli Xin, Wenying Xue, Man Zhang
Mortality associated with infections due to carbapenem-resistant Klebsiella pneumoniae (CR-KP) is high and the infections need to be predicted early. The risk factors for CR-KP infection are heterogeneous. The aim of the present study was to construct a model allowing for the early prediction of CR-KP infection. Nosocomial infections due to K. pneumoniae were evaluated retrospectively over a 2-year period. The case cohort consisted of 370 inpatients with CR-KP infection. For each case enrolled, two matched controls with no CR-KP infection during their hospitalization were randomly selected...
October 2016: Biomedical Reports
Thomas Desautels, Jacob Calvert, Jana Hoffman, Melissa Jay, Yaniv Kerem, Lisa Shieh, David Shimabukuro, Uli Chettipally, Mitchell D Feldman, Chris Barton, David J Wales, Ritankar Das
BACKGROUND: Sepsis is one of the leading causes of mortality in hospitalized patients. Despite this fact, a reliable means of predicting sepsis onset remains elusive. Early and accurate sepsis onset predictions could allow more aggressive and targeted therapy while maintaining antimicrobial stewardship. Existing detection methods suffer from low performance and often require time-consuming laboratory test results. OBJECTIVE: To study and validate a sepsis prediction method, InSight, for the new Sepsis-3 definitions in retrospective data, make predictions using a minimal set of variables from within the electronic health record data, compare the performance of this approach with existing scoring systems, and investigate the effects of data sparsity on InSight performance...
September 30, 2016: JMIR Medical Informatics
Ozgun Cuvas Apan, Teoman Zafer Apan, Alparslan Apan
STUDY OBJECTIVE: Microbial contamination during preparation of the infusion drugs is an important issue in intensive care units. Objective of this study was to investigate in vitro antimicrobial properties of commonly used vasoactive drugs. DESIGN: Prospective study. SETTING: Clinical microbiology laboratory of a university hospital. MEASUREMENTS: Growth of the microorganisms Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans in saline dilutions of adrenaline at 1, 10, and 100 μg/mL; noradrenaline at 1, 10, and 100 μg/mL; and dopamine at 0...
November 2016: Journal of Clinical Anesthesia
Dominique D Benoit, Gordon Doig, Jean-Francois Timsit
No abstract text is available yet for this article.
September 29, 2016: Intensive Care Medicine
Lillian J Juttukonda, Walter J Chazin, Eric P Skaar
: During infection, bacterial pathogens must adapt to a nutrient metal-limited environment that is imposed by the host. The innate immune protein calprotectin inhibits bacterial growth in vitro by chelating the divalent metal ions zinc (Zn(2+), Zn) and manganese (Mn(2+), Mn), but pathogenic bacteria are able to cause disease in the presence of this antimicrobial protein in vivo. One such pathogen is Acinetobacter baumannii, a Gram-negative bacterium that causes pneumonia and bloodstream infections that can be complicated by resistance to multiple antibiotics...
2016: MBio
G Kampf
Chlorhexidine digluconate (CHG) is an antimicrobial agent used for different types of applications in hand hygiene, skin antisepsis, oral care, and patient washing. Increasing use raises concern regarding development of acquired bacterial resistance. Published data from clinical isolates with CHG minimum inhibitory concentrations (MICs) were reviewed and compared to epidemiological cut-off values to determine resistance. CHG resistance is rarely found in Escherichia coli, Salmonella spp., Staphylococcus aureus or coagulase-negative staphylococci...
August 26, 2016: Journal of Hospital Infection
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