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https://www.readbyqxmd.com/read/29649586/nephrotoxicity-of-piperacillin-tazobactam-combined-with-vancomycin-should-it-be-a-concern
#1
Cafer Balcı, Ömrüm Uzun, Mustafa Arıcı, Sibel Aşçıoğlu Hayran, Deniz Yüce, Serhat Ünal
The combination of piperacillin-tazobactam (pip-tazo) and vancomycin provides a wide spectrum of activity against many pathogens acquired in the health-care setting. However, there have been reports of increased potential for nephrotoxicity with this combination. The aim of this study was to evaluate the nephrotoxic effect of pip-tazo plus vancomycin and compare it with that of pip-tazo and vancomycin alone, and meropenem plus vancomycin, another broad-spectrum combination. A total of 402 patients receiving either antimicrobial regimen for more than 48 hours were evaluated retrospectively in a two-year period...
April 9, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29623443/pharmacokinetic-and-pharmacodynamic-considerations-of-antibiotics-of-last-resort-in-treating-gram-negative-infections-in-adult-critically-ill-patients
#2
REVIEW
Mojdeh S Heavner, Kimberly C Claeys, Anne M Masich, Jeffrey P Gonzales
PURPOSE OF REVIEW: We provide an overview of antimicrobials that are considered last resort for the treatment of resistant gram-negative infections in adult critically ill patients. The role in therapy, pharmacodynamic (PD) goals, and pharmacokinetic (PK) changes in critical illness for aminoglycosides, polymyxins, tigecycline, fosfomycin, and fluoroquinolones are summarized. RECENT FINDINGS: Altered PK in septic patients in the intensive care unit (ICU) is observed with many of our agents of last resort...
April 5, 2018: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/29619807/-recommendations-for-the-care-of-patients-with-community-acquired-pneumonia-in-the-emergency-department
#3
A Julián-Jiménez, I Adán Valero, A Beteta López, L M Cano Martín, O Fernández Rodríguez, R Rubio Díaz, M A Sepúlveda Berrocal, J González Del Castillo, F J Candel González
The incidence of community-acquired pneumonia (CAP) ranges from 2-15 cases / 1,000 inhabitants / year, being higher in those older than 65 years and in patients with high co-morbidity. Around 75% of all CAP diagnosed are treated in the Emergency Department (ED). The CAP represents the main cause for sepsis and septic shock in ED, and the most frequent cause of death and admission to the Intensive Care Unit (ICU) due to infectious disease. Overall mortality is 10-14% according to age and associated risk factors...
April 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29615167/pseudomonas-aeruginosa-evaluation-of-pathogen-burden-and-drug-resistance-trends-in-a-tertiary-care-hospital
#4
Muhammad Saeed, Farhan Rasheed, Raja Kamran Afzal, Shahida Hussain, Saba Riaz, Adeel Ahmad
OBJECTIVE: To evaluate the pathogen burden and antibiotic-resistance trends of Pseudomonas aeruginosa among hospitalised patients at a tertiary care hospital. STUDY DESIGN: Retrospective, hospital record-based, cross-sectional study. PLACE AND DURATION OF STUDY: Microbiology Laboratory, Allama Iqbal Medical College/Jinnah Hospital, Lahore, from January 2014 to December 2016. METHODOLOGY: A total of 5,960 samples were collected from clinically suspected cases of bacterial infections, admitted to the hospital...
April 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29614247/pseudomonas-aeruginosa-adapts-to-octenidine-in-the-laboratory-and-a-simulated-clinical-setting-leading-to-increased-tolerance-to-chlorhexidine-and-other-biocides
#5
Matthew J Shepherd, Ginny Moore, Matthew E Wand, J Mark Sutton, Lucy J Bock
BACKGROUND: Octenidine is frequently used for infection prevention in neonatal and burn intensive care units, where Pseudomonas aeruginosa has caused nosocomial outbreaks. AIM: To investigate the efficacy and impact of using octenidine against P. aeruginosa. METHODS: Seven clinical isolates of P. aeruginosa were exposed to increasing concentrations of octenidine over several days. Fitness, minimum bactericidal concentrations after 1 minute, 5 minutes and 24 hours, and minimum inhibitory concentrations of a variety of antimicrobials were measured for the parental and octenidine-adapted P...
March 31, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29608958/point-prevalence-surveys-of-antimicrobial-use-among-eight-neonatal-intensive
#6
Sumanth Gandra, Gerardo Alvarez-Uria, Srinivas Murki, Sanjeev K Singh, Ravishankar Kanithi, Dasaratha R Jinka, Ashok K Chikkappa, Sreeram Subramanian, Anita Sharma, Dhanya Dharmapalan, Hemasree Kandraju, Anil Kumar Vasudevan, Onkaraiah Tunga, Akhila Akula, Yingfen Hsia, Mike Sharland, Ramanan Laxminarayan
BACKGROUND: Information about antimicrobial use is scarce and poorly understood among neonatal intensive care units (NICUs) in India. In this study, we describe antimicrobial use in eight NICUs using four point prevalence surveys (PPSs). METHODS: As part of the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children (GARPEC) study, one-day, cross-sectional, hospital-based PPSs were conducted four times between 1 February 2016 and 28 February 2017 in eight NICUs...
March 30, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29596216/reduction-of-inappropriate-antimicrobial-prescriptions-in-a-tertiary-neonatal-intensive-care-unit-following-antimicrobial-stewardship-care-bundle-implementation
#7
Joseph Y Ting, Vanessa Paquette, Karen Ng, Sarka Lisonkova, Valoria Hait, Sandesh Shivanada, Peter Tilley, Osiovich Horacio, Ashley Roberts
BACKGROUND: Our objective was to evaluate the appropriateness of antibiotic prescriptions in the neonatal intensive care unit (NICU) using standardised criteria and determine the effects of an antimicrobial stewardship programme (ASP) on patterns of antibiotic usage. METHODS: A retrospective audit of antibiotic use from July 2010-June 2013 was conducted, focusing on prescriptions of vancomycin, cefotaxime, meropenem and linezolid for >3 calendar days. We evaluated the appropriateness of each course of antibiotic treatment based on the Centers for Disease Control and Prevention (CDC) 12-Step Guidelines to Prevent Antimicrobial Resistance (Steps 4, 6 and 9)...
March 24, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29588851/vancomycin-resistant-enterococcus-faecium-sequence-type-796-rapid-international-dissemination-of-a-new-epidemic-clone
#8
Andrew A Mahony, Andrew H Buultjens, Susan A Ballard, Elizabeth A Grabsch, Shirley Xie, Torsten Seemann, Rhonda L Stuart, Despina Kotsanas, Allen Cheng, Helen Heffernan, Sally A Roberts, Geoffrey W Coombs, Narin Bak, John K Ferguson, Glen C Carter, Benjamin P Howden, Timothy P Stinear, Paul D R Johnson
Background: Vancomycin-resistant Enterococcus faecium (VRE) is a leading cause of hospital-acquired infections. New, presumably better-adapted strains of VRE appear unpredictably; it is uncertain how they spread despite improved infection control. We aimed to investigate the relatedness of a novel sequence type (ST) of vanB E. faecium - ST796 - very near its time of origin from hospitals in three Australian states and New Zealand. Methods: Following near-simultaneous outbreaks of ST796 in multiple institutions, we gathered then tested colonization and bloodstream infection isolates' antimicrobial resistance (AMR) phenotypes, and phylogenomic relationships using whole genome sequencing (WGS)...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29575345/risk-factors-for-multidrug-resistant-gram-negative-bacteria-infection-in-intensive-care-units-a-meta-analysis
#9
Hui Ang, Xuan Sun
AIMS: To identify the risk factors for multidrug-resistant Gram-negative bacteria systematically and provide suggestions and an evidence-base for clinical measures. BACKGROUND: With the increase in the social population, changes in human behaviour and ecosystems, as well as economic development, bacteria have gradually produced drug resistance genes. These have swept through intensive care units causing high mortality. METHODS: Relevant literature which included case-control and cohort studies published from January 1999 to March 2017 were searched in the Cochrane Library, PubMed, Web of Science, and Medline...
March 25, 2018: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/29564870/-nosocomial-infections-caused-by-multiresistant-pseudomonas-aeruginosa-carbapenems-included-predictive-and-prognostic-factors-a-prospective-study-2016-2017
#10
A Hernández, G Yagüe, E García Vázquez, M Simón, L Moreno Parrado, M Canteras, J Gómez
OBJECTIVE: Pseudomonas aeruginosa is one of the major pathogens causing hospital-acquired infections. In recent years, antimicrobial resistance is increasing and multidrug resistant (MDR) and extremely drug resistant (XDR) isolates have been associated with an increase of mortality. The aim of this study is to assess the clinical significance and analyze predictors and prognostic factors. METHODS: Prospective case-control non-paired study involving 64 patients with P...
March 21, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29564246/antimicrobial-resistance-and-putative-virulence-genes-of-pseudomonas-aeruginosa-isolates-from-patients-with-respiratory-tract-infection
#11
Heba Y Al Dawodeyah, Nathir Obeidat, Luay F Abu-Qatouseh, Asem A Shehabi
Introduction: Pseudomonas aeruginosa is a common agent causing community acquired and nosocomial respiratory tract infections, with particularly life-threatening manifestations in patients who are immunocompromised of who have cystic fibrosis. This study investigated the occurrence of extended-spectrum β-lactamases (ESBLs) and metallo β-lactamase (MBL) in association with important putative virulence genes and genotypes variation among P. aeruginosa isolates from respiratory tract infection of Jordanian patients...
March 2018: Germs
https://www.readbyqxmd.com/read/29555630/comparison-of-septic-shock-due-to-mdr-acinetobacter-baumannii-or-klebsiella-pneumoniae-carbapenemase-producing-k-pneumoniae-in-icu-patients
#12
Alessandro Russo, Simone Giuliano, Giancarlo Ceccarelli, Francesco Alessandri, Alessandra Giordano, Grazia Brunetti, Mario Venditti
Objectives: a significant cause of mortality in intensive care unit (ICU) is represented by multidrug-resistant (MDR) gram-negative bacteria, such as MDR Acinetobacter baumannii (MDR-AB) and Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-Kp). Aim of the present study was the comparison of clinical features, therapy and outcome of patients who developed septic shock due to either MDR-AB or KPC-Kp. Methods: were retrospectively analyzed patients admitted to the intensive care unit (ICU) of a teaching hospital, from November 2010 to December 2015, who developed septic shock due to MDR-AB or KPC-Kp infection...
March 19, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29555392/emergence-and-characterization-of-nosocomial-multidrug-resistant-and-extensively-drug-resistant-acinetobacter-baumannii-isolates-in-tehran-iran
#13
Bahare Salehi, Hossein Goudarzi, Bahram Nikmanesh, Hamidreza Houri, Mostafa Alavi-Moghaddam, Zohreh Ghalavand
RATIONALE: Acinetobacter baumannii is one of the antibiotic-resistant superbugs that threatens hospitalized patients. Emergence and spread of the multidrug-resistant (MDR) and extensively drug-resistant (XDR) clones cause erratic outbreaks following environmental contamination of hospital settings. OBJECTIVE: The present study intended to characterize the antimicrobial resistant profiles and the genotypes of clinical and environmental isolates of A. baumannii as a result of dissemination of resistant strains...
March 16, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29544449/development-and-validation-of-a-diagnostic-model-for-early-differentiation-of-sepsis-and-non-infectious-sirs-in-critically-ill-children-a-data-driven-approach-using-machine-learning-algorithms
#14
Florian Lamping, Thomas Jack, Nicole Rübsamen, Michael Sasse, Philipp Beerbaum, Rafael T Mikolajczyk, Martin Boehne, André Karch
BACKGROUND: Since early antimicrobial therapy is mandatory in septic patients, immediate diagnosis and distinction from non-infectious SIRS is essential but hampered by the similarity of symptoms between both entities. We aimed to develop a diagnostic model for differentiation of sepsis and non-infectious SIRS in critically ill children based on routinely available parameters (baseline characteristics, clinical/laboratory parameters, technical/medical support). METHODS: This is a secondary analysis of a randomized controlled trial conducted at a German tertiary-care pediatric intensive care unit (PICU)...
March 15, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29534630/antibiotic-use-in-the-intensive-care-unit-optimization-and-de-escalation
#15
Maureen Campion, Gail Scully
Appropriate antimicrobial therapy is essential to ensuring positive patient outcomes. Inappropriate or suboptimal utilization of antibiotics can lead to increased length of stay, multidrug-resistant infections, and mortality. Critically ill intensive care patients, particularly those with severe sepsis and septic shock, are at risk of antibiotic failure and secondary infections associated with incorrect antibiotic use. Through the initiation of active empiric antibiotic therapy based upon local susceptibilities, daily evaluation of signs and symptoms of infection and narrowing of antibiotic therapy when feasible, providers can streamline the treatment of common intensive care unit (ICU) infections...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29523910/tracking-multidrug-resistant-klebsiella-pneumoniae-from-an-italian-hospital-molecular-epidemiology-and-surveillance-by-pfge-rapd-and-pcr-based-resistance-genes-prevalence
#16
Giancarlo Ripabelli, Manuela Tamburro, Giuliana Guerrizio, Incoronata Fanelli, Romeo Flocco, Massimiliano Scutellà, Michela L Sammarco
Antimicrobial-resistant Klebsiella pneumoniae represent a global public health concern. K. pneumoniae strains isolated during 2010 and 2014-2016 within a single hospital of Molise Region, Central Italy, were analyzed testing antimicrobial susceptibility, clonality by pulsed-field gel electrophoresis (PFGE) and random amplified polymorphic DNA (RAPD)-PCR, and prevalence of carbapenem resistance genes by PCR. Forty isolates (23 wild-type in 2010 and 17 non-wild-type in 2014-2016) were collected from hospitalized patients (65...
March 9, 2018: Current Microbiology
https://www.readbyqxmd.com/read/29522784/multi-hospital-point-prevalence-study-of-healthcare-associated-infections-in-28-adult-intensive-care-units-in-brazil
#17
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
https://www.readbyqxmd.com/read/29518198/molecular-epidemiology-of-ndm-1-and-oxa-48-producing-klebsiella-pneumoniae-in-an-iranian-hospital-clonal-dissemination-of-st11-and-st893
#18
Hamid Solgi, Farzad Badmasti, Christian G Giske, Shadi Aghamohammad, Fereshteh Shahcheraghi
Objectives: Despite the fact that the blaOXA-48 and blaNDM-1 genes have successfully disseminated among Klebsiella pneumoniae isolates worldwide, outbreaks remain unidentified in Iran. Here we examined the molecular epidemiology of 96 carbapenem-resistant K. pneumoniae recovered from an Iranian hospital. Methods: A total of 96 non-replicate carbapenem-resistant K. pneumoniae were recovered from clinical specimens in a university hospital. Detection of ESBLs and carbapenemases produced by studied strains was performed using PCR and DNA sequencing...
March 6, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29509314/the-use-of-antimicrobial-photodynamic-therapy-in-oral-injuries-of-a-pediatric-patient-with-myelodysplastic-syndrome-case-report
#19
Maria Cecília Freire de Melo, Thuanny Silva de Macedo, Julianelly Alves Biserra, Karina Luz Cavalcanti Rodrigues, Mônica Cruz, Aurora Karla de Lacerda Vidal
AIM: To report a case of a pediatric patient carrier of myelodysplastic syndrome (MDS) with severe oral infectious disease, in which antimicrobial photodynamic therapy (aPDT) was used as a therapeutic choice to support systemic treatment. METHODS AND RESULTS: This case report refers to a 1-year-old male patient with MDS and hospitalized for investigation and treatment of complications at a Pediatric Oncology and Hematology Center in Recife/PE, Brazil. The intraoral examination revealed a violaceous lesion surrounding the lower incisor teeth, which progressed with alteration of color to milky yellowish white, compromising the entire lower gingival border, leading to tooth mobility and consequent loss of teeth 71 and 81...
March 6, 2018: Special Care in Dentistry
https://www.readbyqxmd.com/read/29501285/impact-and-safety-of-open-lung-biopsy-in-patients-with-acute-respiratory-distress-syndrome-ards
#20
G Ortiz, M Garay, D Mendoza, P Cardinal-Fernández
INTRODUCTION: Acute respiratory distress syndrome (ARDS) is an inflammatory lung disorder, and its pathological hallmark is diffuse alveolar damage (DAD). Given that open lung biopsy (OLB) can sometimes result in severe side effects, it is rarely performed in patients with ARDS. AIM: The aims of this study were to describe: (a) the rate of treatment change associated with the histological result; and (b) the incidence of side effects induced by OLB. DESIGN AND PATIENTS: A retrospective, single-center, descriptive observational study was carried out in Hospital Santa Clara (Bogotá, Colombia) from February 2007 to January 2014...
February 28, 2018: Medicina Intensiva
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