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https://www.readbyqxmd.com/read/28213808/genotyping-and-antifungal-susceptibility-of-dipodascus-capitatus-isolated-in-a-neonatal-intensive-care-unit-of-a-sicilian-hospital
#1
Teresa Fasciana, Mario Giuffrè, Cinzia Calà, Ingrid Anne Mandy Schierz, Giuseppe Aquilina, Giuseppa Pinello, Giuseppina Capra, Dario Lipari, Giovanni Corsello, Anna Giammanco
In August 2015, Dipodascus capitatus was isolated from two patients admitted to the neonatal intensive care unit. Nosocomial acquisition of the fungus was suspected and epidemiological studies were undertaken. The patients were simultaneously hospitalized, and the comparison of the two isolates by two independent molecular typing methods have confirmed clonal dissemination of a single strain of D. capitatus. Antimicrobial susceptibility testing was useful for identifying the appropriated antifungal therapy in micafungin...
February 18, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28198956/evaluating-pharmaceutical-waste-disposal-in-pediatric-units
#2
Maria Angélica Randoli de Almeida, Ana Maria Miranda Martins Wilson, Maria Angélica Sorgini Peterlini
OBJECTIVE: To verify the disposal of pharmaceutical waste performed in pediatric units. METHOD: A descriptive and observational study conducted in a university hospital. The convenience sample consisted of pharmaceuticals discarded during the study period. Handling and disposal during preparation and administration were observed. Data collection took place at pre-established times and was performed using a pre-validated instrument. RESULTS: 356 drugs disposals were identified (35...
November 2016: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28193661/determining-the-clinical-utility-of-an-absolute-procalcitonin-value-for-predicting-a-positive-culture-result
#3
Erica M Caffarini, Joshua DeMott, Gourang Patel, Ishaq Lat
Various procalcitonin ranges have been established to guide antimicrobial therapy; however, there are no data that establish whether the initial procalcitonin value will determine the likelihood of a positive culture result. This study aims to establish if the initial procalcitonin value on clinical presentation can provide positive predictive value of any positive culture result.This was a retrospective study of 813 medical intensive care unit patients. Data points collected included patient demographics, procalcitonin assays, source of infection, culture results, and length of stay...
February 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28182774/benefits-and-unintended-consequences-of-antimicrobial-de-escalation-implications-for-stewardship-programs
#4
Josie Hughes, Xi Huo, Lindsey Falk, Amy Hurford, Kunquan Lan, Bryan Coburn, Andrew Morris, Jianhong Wu
Sequential antimicrobial de-escalation aims to minimize resistance to high-value broad-spectrum empiric antimicrobials by switching to alternative drugs when testing confirms susceptibility. Though widely practiced, the effects de-escalation are not well understood. Definitions of interventions and outcomes differ among studies. We use mathematical models of the transmission and evolution of Pseudomonas aeruginosa in an intensive care unit to assess the effect of de-escalation on a broad range of outcomes, and clarify expectations...
2017: PloS One
https://www.readbyqxmd.com/read/28178922/risk-factors-for-excessively-prolonged-meropenem-use-in-the-intensive-care-setting-a-case-contol-study
#5
Juri Katchanov, Benno Kreuels, Florian P Maurer, Kai Wöstmann, Johannes Jochum, Christina König, Kariem Seoudy, Holger Rohde, Ansgar W Lohse, Dominic Wichmann, Michael Baehr, Camilla Rothe, Stefan Kluge
BACKGROUND: Inappropriate use of broad-spectrum antimicrobials affects adversely both the individual patient and the general public. The aim of the study was to identify patients at risk for excessively prolonged carbapenem treatment in the ICU as a target for antimicrobial stewardship interventions. METHODS: Case-control study in a network of 11 ICUs of a university hospital. Patients with uninterrupted meropenem therapy (MT) > 4 weeks were compared to controls...
February 8, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28173962/prevalence-of-healthcare-associated-infections-in-polish-adult-intensive-care-units-summary-data-from-the-ecdc-european-point-prevalence-survey-of-hospital-associated-infections-and-antimicrobial-use-in-poland-2012-2014
#6
A Deptuła, E Trejnowska, G Dubiel, M Żukowski, A Misiewska-Kaczur, T Ozorowski, W Hryniewicz
BACKGROUND: Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. Local epidemiological studies need to be conducted to set the priorities for surveillance and prevention programmes. AIM: To investigate the epidemiology of hospital-acquired infections (HAIs) among patients admitted to Polish adult ICUs over a three-year period. METHODS: Data were collected according to the European Centre for Disease Prevention and Control (ECDC) European Union Point Prevalence Survey of Healthcare-associated Infections and Antimicrobial Use in European Acute Care Hospitals (EU-PPS HAI & AU) protocol for 39,318 patients within 160 acute care hospitals...
January 4, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28169858/central-nervous-system-infections-in-immunocompromised-patients
#7
Romain Sonneville, Eric Magalhaes, Geert Meyfroidt
PURPOSE OF REVIEW: Although rare, central nervous system (CNS) infections are increasingly being recognized in immunocompromised patients. The goal of the present review is to provide a practical diagnostic approach for the intensivist, and to briefly discuss some of the most prevalent conditions. RECENT FINDINGS: Immunocompromised patients presenting with new neurological symptoms should always be suspected of a CNS infection. These infections carry a poor prognosis, especially if intracranial hypertension, severely altered mental status or seizures are present...
February 4, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28169101/-patient-safety-in-antibiotics-administration-risk-assessment
#8
REVIEW
M Maqueda Palau, E Pérez Juan
OBJECTIVE: To determine the level of risk in the preparation and administration of antibiotics frequently used in the Intensive Care Unit using a risk matrix. MATERIAL AND METHOD: A study was conducted using situation analysis and literature review of databases, protocols and good practice guidelines on intravenous therapy, drugs, and their administration routes. The most used antibiotics in the ICU registered in the ENVIN-HELICS program from 1 April to 30 June 2015 were selected...
February 3, 2017: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/28167547/bacteremia-due-to-carbapenem-resistant-enterobacteriaceae-cre-a-multicenter-clinical-and-molecular-epidemiologic-analysis-in-the-nation-s-epicenter-for-cre
#9
Michael J Satlin, Liang Chen, Gopi Patel, Angela Gomez-Simmonds, Gregory Weston, Angela C Kim, Susan K Seo, Marnie E Rosenthal, Steven J Sperber, Stephen G Jenkins, Camille L Hamula, Anne-Catrin Uhlemann, Michael H Levi, Bettina C Fries, Yi-Wei Tang, Stefan Juretschko, Albert D Rojtman, Tao Hong, Barun Mathema, Michael R Jacobs, Thomas J Walsh, Robert A Bonomo, Barry N Kreiswirth
Although the New York/New Jersey (NY/NJ) area is an epicenter for carbapenem-resistant Enterobacteriaceae (CRE), there are few multicenter studies of CRE from this region. We characterized patients with CRE bacteremia in 2013 at eight NY/NJ medical centers and determined the prevalence of carbapenem resistance among Enterobacteriaceae bloodstream isolates and CRE resistance mechanisms, genetic backgrounds, capsular types (cps), and antimicrobial susceptibilities. Of 121 patients with CRE bacteremia, 50% had cancer or transplantation...
February 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28160023/the-intensive-care-medicine-research-agenda-on-multidrug-resistant-bacteria-antibiotics-and-stewardship
#10
REVIEW
Marin H Kollef, Matteo Bassetti, Bruno Francois, Jason Burnham, George Dimopoulos, Jose Garnacho-Montero, Jeffrey Lipman, Charles-Edouard Luyt, David P Nicolau, Maarten J Postma, Antonio Torres, Tobias Welte, Richard G Wunderink
PURPOSE: To concisely describe the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to the management of multidrug-resistant (MDR) bacteria, antibiotic use, and antimicrobial stewardship in the intensive care unit (ICU) setting. METHODS: Narrative review based on a systematic analysis of the medical literature, national and international guidelines, and expert opinion...
February 4, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28155050/relation-between-presence-of-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-in-systematic-rectal-swabs-and-respiratory-tract-specimens-in-icu-patients
#11
Hélène Carbonne, Matthieu Le Dorze, Anne-Sophie Bourrel, Hélène Poupet, Claire Poyart, Emmanuelle Cambau, Jean-Paul Mira, Julien Charpentier, Rishma Amarsy
BACKGROUND: The choice of empirical antimicrobial therapy for pneumonia in intensive care unit (ICU) is a challenge, since pneumonia is often related to multidrug-resistant pathogens, particularly extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E). To prevent the overuse of broad-spectrum antimicrobial therapy, the main objective of this study was to test the performance of digestive colonization surveillance as a predictor of ESBL-E presence or absence in respiratory samples performed in ICU and to evaluate the impact of time sampling (≤5 days or >5 days) on such prediction...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28153582/changing-trends-in-antimicrobial-susceptibility-pattern-of-bacterial-isolates-in-a-burn-unit
#12
Narendra Pal Singh, Mayuri Rani, Kavita Gupta, Tanu Sagar, Iqbal Rajinder Kaur
INTRODUCTION: Emerging antimicrobial resistance in nosocomial bacterial isolates, limits the available treatment options for burn wound infections, among them multi-drug resistant Gram negative bacteria and methicillin-resistant Staphylococcus aureus (MRSA) are major contributors to the increase in morbidity and mortality rates. MATERIAL AND METHODS: A retrospective cross-sectional study was done in the Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi...
January 30, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28149576/duration-of-antibiotic-therapy-in-the-intensive-care-unit
#13
REVIEW
Gabor Zilahi, Mary Aisling McMahon, Pedro Povoa, Ignacio Martin-Loeches
There are certain well defined clinical situations where prolonged therapy is beneficial, but prolonged duration of antibiotic therapy is associated with increased resistance, medicalising effects, high costs and adverse drug reactions. The best way to decrease antibiotic duration is both to stop antibiotics when not needed (sterile invasive cultures with clinical improvement), not to start antibiotics when not indicated (treating colonization) and keep the antibiotic course as short as possible. The optimal duration of antimicrobial treatment for ventilator-associated pneumonia (VAP) is unknown, however, there is a growing evidence that reduction in the length of antibiotic courses to 7-8 days can minimize the consequences of antibiotic overuse in critical care, including antibiotic resistance, adverse effects, collateral damage and costs...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28149487/clinical-response-and-outcome-of-pneumonia-due-to-multi-drug-resistant-acinetobacter-baumannii-in-critically-ill-patients
#14
Lida Shojaei, Mostafa Mohammadi, Mohammad-Taghi Beigmohammadi, Mahsa Doomanlou, Alireza Abdollahi, Mohammad Mehdi Feizabadi, Hossein Khalili
BACKGROUND AND OBJECTIVES: The frequency of multi-drug resistant Acinetobacter spp. infections is increasing in Iran. Considering availability of limited therapeutic options, clinical response and outcome of ventilator-associated pneumonia due to multi-drug resistant A.baumannii were evaluated in critically ill patients. MATERIALS AND METHODS: In this prospective study, 29 patients with carbapenem resistance A. baumannii ventilator-associated pneumonia were enrolled...
October 2016: Iranian Journal of Microbiology
https://www.readbyqxmd.com/read/28147429/-outbreak-of-sarg-in-a-neonatal-intensive-care-unit
#15
Lenka Hobzová, Miroslav Špliňo, Roman Chlíbek, Helena Žemličková, Lenka Ryšková
The article provides information on an outbreak of infection with a strain of Staphylococcus aureus resistant to gentamicin (SARG) and a hyperproducer of enterotoxins A and D at a neonatal intensive care unit of the University Hospital in Hradec Králové. A retrospective investigation was carried out that provided an overview of the presence of the SARG strain in the patients, staff and hospital environment. Subsequently, strict infection precautions were implemented and the importance of rational antimicrobial therapy was emphasized...
December 2016: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28139543/antibiotic-resistance-pathogen-profile-in-ventilator-associated-pneumonia-in-a-tertiary-care-hospital-in-india
#16
Abhijit Chaudhury, A Shobha Rani, Usha Kalawat, Sachin Sumant, Anju Verma, B Venkataramana
BACKGROUND & OBJECTIVES: Ventilator-associated pneumonia (VAP) is an important hospital-acquired infection with substantial mortality. Only a few studies are available from India addressing the microbiological aspects of VAP, which have been done with small study populations. This study was carried out in the intensive care units (ICUs) of a tertiary care hospital to assess the profile of pathogens and to determine the pattern of antimicrobial resistance. METHODS: This was a retrospective study of clinically suspected cases of VAP...
September 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28129261/identifying-augmented-renal-clearance-in-trauma-patients-validation-of-the-augmented-renal-clearance-in-trauma-intensive-care-arctic-scoring-system
#17
Jeffrey F Barletta, Alicia J Mangram, Marilyn Byrne, Joseph F Sucher, Alexzandra K Hollingworth, Francis R Ali-Osman, Gina R Shirah, Michael Haley, James K Dzandu
BACKGROUND: Augmented renal clearance (ARC) is common in trauma patients and associated with subtherapeutic antimicrobial concentrations. This study reported the incidence of ARC, identified ARC risk factors and described a model to predict ARC (i.e.,ARCTIC) that is specific to trauma patients. METHODS: Consecutive trauma patients who were admitted to the ICU between March 2015 and January 2016 and had a measured creatinine clearance (CrCl) were considered for inclusion...
January 26, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28124965/-bacteremia-caused-by-ciprofloxacin-resistant-salmonella-serotype-kentucky-a-case-report-and-the-review-of-literature
#18
Tuba Müderris, Fatma Yekta Ürkmez, Şeref Alp Küçüker, Muhammet Fethi Sağlam, Gül Ruhsar Yılmaz, Rahmet Güner, Revasiye Güleşen, Ziya Cibali Açıkgöz
Salmonella infections can be seen in four clinical types, namely gastroenteritis, bacteremia/sepsis, enteric fever and carriage. These infections can result in uncomplicated diarrhea in most cases, but can lead to invasive disease requiring antimicrobial therapy and can be life-threatening in elderly or immunocomprimised patients. Broad-spectrum cephalosporins and fluoroquinolones are crucial options in the treatment of the invasive infections. Ciprofloxacin resistance is rarely seen in non-typhoid Salmonella enterica isolates, and only in S...
October 2016: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28124422/survival-of-two-dogs-with-pyothorax-secondary-to-perforating-oesophageal-foreign-body
#19
C Boyd, M Claus, G Hosgood, L Smart
CASE REPORT: Two dogs with an oesophageal foreign body (FB) were diagnosed with secondary pyothorax at the time of presentation. One dog was managed with surgical FB removal, pleural lavage and thoracostomy tube placement. Following surgery, it was admitted to the intensive care unit for oxygen therapy, antimicrobial and analgesic administration, fluid therapy, thoracic drainage and enteral nutrition. The other dog was managed with endoscopic FB removal, thoracostomy tube placement with continuous suction, and similar aftercare in the intensive care unit...
January 2017: Australian Veterinary Journal
https://www.readbyqxmd.com/read/28122913/epidemiology-and-susceptibility-of-pathogens-from-smart-2011-12-turkey-evaluation-of-hospital-acquired-versus-community-acquired-urinary-tract-infections-and-icu-versus-non-icu-associated-intra-abdominal-infections
#20
Iftihar Koksal, Gurdal Yilmaz, Serhat Unal, Pinar Zarakolu, Volkan Korten, Lutfiye Mulazimoglu, Fehmi Tabak, Birgul Mete, Vildan Avkan Oguz, Zeynep Gulay, Emine Alp, Robert Badal, Sibylle Lob
OBJECTIVES: To describe the epidemiology and susceptibility of pathogens (including ESBL producers) from hospital-acquired (HA) versus community-acquired (CA) urinary tract infections (UTIs) and ICU- versus non-ICU-associated intra-abdominal infections (IAIs) in Turkey as a part of the SMART study. METHODS: For this report, Gram-negative pathogens (363 from UTIs and 458 from IAIs) were collected in 2011 and 2012 at six hospitals in Turkey. HA versus CA UTIs and ICU- versus non-ICU-associated IAIs were compared for the species isolated, percentage of ESBL-positive isolates by species and susceptibility for overall and individual Gram-negative species...
January 25, 2017: Journal of Antimicrobial Chemotherapy
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