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https://www.readbyqxmd.com/read/28813492/point-prevalence-survey-of-healthcare-facility-onset-healthcare-associated-clostridium-difficile-infection-in-greek-hospitals-outside-the-intensive-care-unit-the-c-define-study
#1
Athanasios Skoutelis, Angelos Pefanis, Sotirios Tsiodras, Nikolaos V Sipsas, Moyssis Lelekis, Marios C Lazanas, Panagiotis Gargalianos, George N Dalekos, Emmanuel Roilides, George Samonis, Efstratios Maltezos, Dimitrios Hatzigeorgiou, Malvina Lada, Symeon Metallidis, Athena Stoupis, Georgios Chrysos, Lazaros Karnesis, Styliani Symbardi, Chariclia V Loupa, Helen Giamarellou, Ioannis Kioumis, Helen Sambatakou, Epameinondas Tsianos, Maria Kotsopoulou, Areti Georgopali, Klairi Liakou, Stavroula Perlorentzou, Stamatina Levidiotou, Marina Giotsa-Toutouza, Helen Tsorlini-Christoforidou, Ilias Karaiskos, Georgia Kouppari, Eleftheria Trikka-Graphakos, Maria-Anna Ntrivala, Kate Themeli-Digalaki, Anastasia Pangalis, Melina Kachrimanidou, Maria Martsoukou, Stergios Karapsias, Maria Panopoulou, Sofia Maraki, Anagnostina Orfanou, Efthymia Petinaki, Maria Orfanidou, Vasiliki Baka, Antonios Stylianakis, Iris Spiliopoulou, Stavroula Smilakou, Loukia Zerva, Evangelos Vogiatzakis, Eleni Belesiotou, Charalambos A Gogos
BACKGROUND: The correlation of Clostridium difficile infection (CDI) with in-hospital morbidity is important in hospital settings where broad-spectrum antimicrobial agents are routinely used, such as in Greece. The C. DEFINE study aimed to assess point-prevalence of CDI in Greece during two study periods in 2013. METHODS: There were two study periods consisting of a single day in March and another in October 2013. Stool samples from all patients hospitalized outside the ICU aged ≥18 years old with diarrhea on each day in 21 and 25 hospitals, respectively, were tested for CDI...
2017: PloS One
https://www.readbyqxmd.com/read/28807914/amplification-of-antimicrobial-resistance-in-gut-flora-of-patients-treated-with-ceftriaxone
#2
J Meletiadis, A Turlej-Rogacka, A Lerner, A Adler, E Taconelli, J W Mouton
Although antibacterial therapy has an impact on human intestinal flora and emergence of resistant bacteria, its role on amplification of antimicrobial resistance and the quantitative exposure-effect relationship is not clear. An observational prospective study was conducted to determine whether and how ceftriaxone exposure is related to amplification of resistance in non- ICU patients.Serial stool samples from 122 ESBL(+) hospitalized patients were analyzed with quantitative real-time PCR to quantify the resistant gene blaCTX-M Drug exposure was calculated for each patient using a population pharmacokinetic model...
August 14, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28807835/the-role-of-antimicrobial-stewardship-programmes-in-children-a-systematic-review
#3
REVIEW
André Ricardo Araujo da Silva, Déborah Cardoso Albernaz de Almeida Dias, Amanda Fáris Marques, Clara Biscaia di Biase, Indah K Murni, Angela Dramowski, Mike Sharland, Johanes Huebner, Walter Zingg
The United Nations and the World Health Organization have designated antimicrobial resistance (AMR) as a major health priority and developed action plans to reduce AMR in all healthcare settings. Establishment of institutional antimicrobial stewardship programmes (ASPs) is advocated as a key intervention to reduce antibiotic consumption in hospitals and address high rates of multi-drug resistant (MDR) bacteria. We searched PUBMED and the Cochrane database of systematic reviews (1/2007-3/2017) to identify studies reporting about the effectiveness of ASPs in general paediatric wards and paediatric intensive care units (PICU), on reducing antibiotic consumption, on using broad spectrum/restricted antibiotics, and on antibiotic resistance and healthcare-associated infections (HAIs)...
August 11, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28803549/comparative-gut-microbiota-and-resistome-profiling-of-intensive-care-patients-receiving-selective-digestive-tract-decontamination-and-healthy-subjects
#4
Elena Buelow, Teresita D J Bello González, Susana Fuentes, Wouter A A de Steenhuijsen Piters, Leo Lahti, Jumamurat R Bayjanov, Eline A M Majoor, Johanna C Braat, Maaike S M van Mourik, Evelien A N Oostdijk, Rob J L Willems, Marc J M Bonten, Mark W J van Passel, Hauke Smidt, Willem van Schaik
BACKGROUND: The gut microbiota is a reservoir of opportunistic pathogens that can cause life-threatening infections in critically ill patients during their stay in an intensive care unit (ICU). To suppress gut colonization with opportunistic pathogens, a prophylactic antibiotic regimen, termed "selective decontamination of the digestive tract" (SDD), is used in some countries where it improves clinical outcome in ICU patients. Yet, the impact of ICU hospitalization and SDD on the gut microbiota remains largely unknown...
August 14, 2017: Microbiome
https://www.readbyqxmd.com/read/28803496/management-of-multidrug-resistant-pseudomonas-aeruginosa-in-the-intensive-care-unit-state-of-the-art
#5
Alberto Enrico Maraolo, Marco Cascella, Silvia Corcione, Arturo Cuomo, Salvatore Nappa, Guglielmo Borgia, Francesco Giuseppe De Rosa, Ivan Gentile
Pseudomonas aeruginosa (PA) is one of the most important causes of healthcare-related infections among Gram-negative bacteria. The best therapeutic approach is controversial, especially for multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains as well as in the setting of most severe patients, such as in the intensive care unit (ICU). Areas covered: This article addresses several points. First, the main microbiological aspects of PA, focusing on its wide array of resistance mechanisms. Second, risk factors and the worse outcome linked to MDR-PA infection...
August 14, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28800896/antimicrobial-susceptibility-of-clostridium-difficile-isolates-from-icu-colonized-patients-revealed-alert-to-st-37-rt-017-isolates
#6
Jingyu Yang, Xiaoxia Zhang, Xiaohua Liu, Lin Cai, Ping Feng, Xiaohui Wang, Zhiyong Zong
Seventy Clostridium difficile isolates from ICU colonized patients were tested for antimicrobial susceptibility and screened for resistance determinants. We found that multilocus sequence type 37 (ribotype 017) toxin A-negative/B-positive isolates were more likely resistant to moxifloxacin than toxin A-positive/B-positive isolates (41.7% versus 9.3%) with major variations in both GyrA (Thr82Ile) and GyrB (Ser366Ala), suggesting that the use of quinolone should be more strictly regulated.
July 1, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28800866/five-year-trends-of-critical-care-practice-and-outcomes
#7
Craig M Lilly, Sunil Swami, Xinggang Liu, Richard R Riker, Omar Badawi
BACKGROUND: Longitudinal analyses of large detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. METHODS: Data representing 991,571 consecutive critical care visits to160 United States adult ICUs during 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28782646/%C3%AE-lacta-%C3%A2-test-performance-for-detection-of-extended-spectrum-%C3%AE-lactamase-producing-gram-negative-bacilli-directly-on-bronchial-aspirates-samples-a-validation-study
#8
Salah Gallah, Yahia Benzarara, Jacques Tankovic, Paul-Louis Woerther, Hayat Bensekri, Jean-Luc Mainardi, Guillaume Arlet, Sophie Vimont, Marc Garnier
OBJECTIVES: Incidence of Extended Spectrum β-Lactamase-producing Gram Negative Bacilli (ESBL-P-GNB)-related infections is worryingly increasing worldwide. ESBL-P-GNB detection directly on bronchial aspirate samples (BAS) performed for suspected pneumonia may help save empirical carbapenems. Our objectives were to optimize β-LACTA(®) test (BLT) realization and evaluate BLT performance for ESBL-P-GNB detection directly on BAS. METHODS: 1) BLT technical optimization using BAS of different matrix types spiked with increasing concentrations of CTX-M-15-producing Klebsiella pneumoniae; 2) in vitro validation of BLT diagnostic performance on 17 ESBL enzymes, belonging to CTX-M, SHV, TEM, OXA, GES, VEB, and PER groups; 3) clinical validation of BLT performance on 126 BAS prospectively collected from 7 Intensive Care Units...
August 3, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28780198/antimicrobial-resistance-of-3-types-of-gram-negative-bacteria-isolated-from-hospital-surfaces-and-the-hands-of-health-care-workers
#9
Hui-Ping Wang, Hong-Jiang Zhang, Jie Liu, Qi Dong, Shan Duan, Jun-Qi Ge, Zhong-Hua Wang, Zheng Zhang
BACKGROUND: There has been an increased focus in recent years on antimicrobial resistance of bacteria isolated from clinical samples. However, resistance of bacteria from hospital environments has been less frequently investigated. METHODS: According to hygienic standard for disinfection in hospitals, samples were collected from hospital inanimate surfaces and the hands of health care workers after daily cleaning. An automatic microorganism analyzer was used to identify bacteria and test for antimicrobial susceptibility...
August 2, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28779830/role-of-procalcitonin-in-the-management-of-infected-patients-in-the-intensive-care-unit
#10
REVIEW
David N Gilbert
The combination of molecular pathogen diagnostics and the biomarker procalcitonin (PCT) are changing the use of antimicrobials in patients admitted to critical care units with severe community-acquired pneumonia, possible septic shock, or other clinical syndromes. An elevated serum PCT level is good supportive evidence of a bacterial pneumonia, whereas a low serum PCT level virtually eliminates an etiologic role for bacteria even if the culture for a potential bacterial pathogen is positive. Serum PCT levels can be increased in any shocklike state; a low PCT level eliminates invasive bacterial infection as an etiology in more than 90% of patients...
September 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28776434/pneumonia-in-mechanically-ventilated-patients-no-diagnostic-and-prognostic-value-of-different-quantitative-tracheal-aspirates-thresholds
#11
J Garnacho-Montero, A Gutiérrez-Pizarraya, I Lopez-García, J C Miranda, V González-Galán, Y Corcia-Palomo, I Alonso-Araujo, L Martín-Villén, J Aznar-Martín, R Amaya-Villar
BACKGROUND: Diagnosis of pneumonia in ventilated patients is challenging due to the lack of specific and definitive clinical symptoms, laboratory data or radiological abnormalities. METHODS: Based on quantitative tracheal aspirate (QTA) results, three groups of patients were compared: <10(5) cfu/ml, ≥10(5) cfu/ml and <10(6) cfu/ml, and ≥10(6) cfu/ml. We recorded demographic variables, underlying diseases and severity of illness at ICU admission...
August 4, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28774865/shifts-in-antimicrobial-consumption-and-infection-rates-before-and-during-a-piperacillin-tazobactam-shortage
#12
S Travis King, Katie E Barber, Jason J Parham, Kayla R Stover
BACKGROUND: Anti-infective shortages represent a growing threat to the optimal management of the infected patient and alter the institutional selective pressure against hospital-acquired infections. The objective of this analysis was to assess the impact that a shortage of piperacillin-tazobactam had on the overall antibacterial use and HAI rates at an academic institution. METHODS: Antimicrobial use and infection data were extracted from TheraDoc Clinical Surveillance Software (Premier, Inc...
July 31, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28757818/procalcitonin-assisted-antibiotic-strategy-in-sepsis
#13
Domonkos Trásy, Zsolt Molnár
Sepsis is one of the biggest challenges in critical care nowadays. Defining sepsis is a difficult task on its own and its diagnosis and treatment requires well trained, devoted personnel with interdisciplinary collaboration in order to provide the patients the best chance for survival. Immediate resuscitation, early adequate antimicrobial therapy, source control and highly sophisticated organ support on the intensive care units are all inevitable necessities for successful recovery. To help fast and accurate diagnosis biomarkers have been measured for decades...
May 2017: EJIFCC
https://www.readbyqxmd.com/read/28754148/nosocomial-bacterial-infections-and-their-antimicrobial-susceptibility-patterns-among-patients-in-ugandan-intensive-care-units-a-cross-sectional-study
#14
Peter Agaba, Janat Tumukunde, J V B Tindimwebwa, Arthur Kwizera
BACKGROUND: The intensive care unit (ICU) admits critically ill patients requiring advanced airway, respiratory, cardiac and renal support. Despite the highly-specialized interventions, the mortality and morbidity is still high due to a number of reasons including nosocomial infections, which are the most likely complications in hospitalized patients with the rates being highest among ICU patients. METHODS: In this cross-sectional study of 111 adult patients admitted to 2 of the ICUs in Uganda, we set out to describe the commonest bacterial infections, their antimicrobial susceptibility patterns and factors associated with development of a nosocomial infection...
July 28, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28750921/the-methodology-of-surveillance-for-antimicrobial-resistance-and-healthcare-associated-infections-in-europe-suspire-a-systematic-review-of-publicly-available-information
#15
REVIEW
María Núñez-Núñez, María Dolores Navarro, Virginia Palomo, Nithya Babu Rajendran, María Dolores Del Toro, Andreas Voss, Mike Sharland, Frangiscos Sifakis, Evelina Tacconelli, Jesús Rodríguez-Baño
OBJECTIVES: Surveillance is a key component of any control strategy for health-care associated infections (HAIs) and antimicrobial resistance (AMR), and public availability of methodological aspects is crucial for the interpretation of the data. We sought to systematically review publicly available information for HAIs and/or AMR surveillance systems organised by public institutions or scientific societies in European countries. METHODS: A systematic review of scientific and grey literature following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was performed...
July 24, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28745260/implementation-of-an-antimicrobial-stewardship-program-in-a-neonatal-intensive-care-unit
#16
Nneka I Nzegwu, Michelle R Rychalsky, Loren A Nallu, Xuemei Song, Yanhong Deng, Amber M Natusch, Robert S Baltimore, George R Paci, Matthew J Bizzarro
OBJECTIVE To evaluate antimicrobial utilization and prescription practices in a neonatal intensive care unit (NICU) after implementation of an antimicrobial stewardship program (ASP). DESIGN Quasi-experimental, interrupted time-series study. SETTING A 54-bed, level IV NICU in a regional academic and tertiary referral center. PATIENTS AND PARTICIPANTS All neonates prescribed antimicrobials from January 1, 2011, to June 30, 2016, were eligible for inclusion. INTERVENTION Implementation of a NICU-specific ASP beginning July 2012...
July 26, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28740102/niosomes-a-strategy-toward-prevention-of-clinically-significant-drug-incompatibilities
#17
Hebatallah B Mohamed, Sohair M El-Shanawany, Mostafa A Hamad, Mahmoud Elsabahy
Drug incompatibilities are considered as one of the most critical problems in intensive care units. In the current study, the ability of nanomaterials to prevent drug incompatibilities in clinical settings has been investigated. As a proof-of-concept, the ability of niosomes to prevent physical and chemical incompatibilities that occur upon mixing acyclovir and vancomycin during management of acute meningitis has been explored. Nanosized spherical particles loaded separately with either vancomycin or acyclovir, with high entrapment efficiency (ca...
July 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28739223/decreased-mortality-in-patients-prescribed-vancomycin-after-implementation-of-antimicrobial-stewardship-program
#18
Erin L Conway, John A Sellick, Amy Horey, Kristen Fodero, Michael C Ott, Michael P Krajewski, Kari A Mergenhagen
BACKGROUND: The impact of an antimicrobial stewardship program (ASP) on 30-day mortality rates was evaluated in patients prescribed vancomycin in a Veterans Affairs hospital. METHODS: A retrospective chart review of patients receiving a minimum of 48 hours of vancomycin during October 2006-July 2014. A multivariate logistic regression analysis was used to determine predictors of mortality. Interventions of the ASP consist of appropriate antibiotic selection, dosing, microbiology, and treatment duration...
July 21, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28733718/antimicrobial-resistance-in-the-next-30%C3%A2-years-humankind-bugs-and-drugs-a-visionary-approach
#19
REVIEW
Matteo Bassetti, Garyphallia Poulakou, Etienne Ruppe, Emilio Bouza, Sebastian J Van Hal, Adrian Brink
PURPOSE: To describe the current standards of care and major recent advances with regard to antimicrobial resistance (AMR) and to give a prospective overview for the next 30 years in this field. METHODS: Review of medical literature and expert opinion were used in the development of this review. RESULTS: There is undoubtedly a large clinical and public health burden associated with AMR in ICU, but it is challenging to quantify the associated excess morbidity and mortality...
July 21, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28731836/mortality-rate-and-antibiotic-resistance-in-complicated-diverticulitis-report-of-272-consecutive-patients-worldwide-a-prospective-cohort-study
#20
Federico Coccolini, Mattia Trevisan, Giulia Montori, Massimo Sartelli, Fausto Catena, Marco Ceresoli, Antonio Costanzo, Arianna Heyer, Luca Ansaloni
BACKGROUND: Complicated diverticulitis (CD) is a common problem for surgeons. In treating it, as a general principle, every verified source of infection should be controlled. Supplementary antimicrobial management involves a delicate balance of optimizing empirical therapy while reducing unnecessary antibiotic use. The necessity to know the most frequent infecting pathogens and their spectra of resistance is becoming pivotal. The aim of this study was to determine the microbiologic profile of complicated intra-abdominal infections (IAIs) secondary to CD, to analyze the role of empirical antimicrobial therapy, and to describe the clinical aspects of CD worldwide...
July 21, 2017: Surgical Infections
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