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https://www.readbyqxmd.com/read/29207958/bloodstream-infections-at-a-tertiary-level-paediatric-hospital-in-south-africa
#1
Harsha Lochan, Vashini Pillay, Colleen Bamford, James Nuttall, Brian Eley
BACKGROUND: Bloodstream infection (BSI) in children causes significant morbidity and mortality. There are few studies describing the epidemiology of BSI in South African children. METHODS: A retrospective descriptive cohort study was conducted at a paediatric referral hospital in Cape Town, South Africa. The National Health Laboratory Service (NHLS) microbiology database was accessed to identify positive blood culture specimens during the period 2011-2012. Demographic and clinical details, antimicrobial management and patient outcome information were extracted from medical and laboratory records...
December 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29194916/the-impact-of-obesity-in-cirrhotic-patients-with-septic-shock-a-retrospective-cohort-study
#2
Beverley Kok, Constantine J Karvellas, Juan G Abraldes, Rajiv Jalan, Vinay Sundaram, David Gurka, Sean Keenan, Aseem Kumar, Greg Martinka, Brian Bookatz, Gordon Wood, Anand Kumar
BACKGROUND & AIMS: The prevalence of obesity in cirrhosis is rising. The impact of obesity in the critically-ill cirrhotic patient with sepsis/septic shock has not been evaluated. This study aimed to examine the relationship between obesity and mortality in cirrhotic patients admitted to the intensive care unit with septic shock. METHODS: A retrospective cohort study of all cirrhotic patients with septic shock (n=362) and a recorded body mass index (BMI) from an international, multicenter (CATTS) database (1996-2015) was performed...
December 1, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29189346/impact-of-quality-bundle-enforcement-by-a-critical-care-pharmacist-on-patient-outcome-and-costs
#3
Géraldine Leguelinel-Blache, Tri-Long Nguyen, Benjamin Louart, Hélène Poujol, Jean-Philippe Lavigne, Jason A Roberts, Laurent Muller, Jean-Marie Kinowski, Claire Roger, Jean-Yves Lefrant
OBJECTIVES: Surgical and medical ICU patients are at high risk of mortality and provide a significant cost to the healthcare system. The aim of this study is to describe the effect of pharmacist-led interventions on drug therapy and clinical strategies on ICU patient outcome and hospital costs. DESIGN: Before and after study in two French ICUs (16 and 10 beds). PATIENTS: ICU patients. INTERVENTION: From January 1, 2013, to June 30, 2015, a pharmacist observation period was compared with an intervention period in which a critical care pharmacist provided recommendations to clinicians regarding sedative drugs and doses, choice of mechanical ventilation mode and related settings, antimicrobial de-escalation, and central venous and urinary catheters removal...
November 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29186145/respective-impact-of-implementation-of-prevention-strategies-colonization-with-multiresistant-bacteria-and-antimicrobial-use-on-the-risk-of-early-and-late-onset-vap-an-analysis-of-the-outcomerea-network
#4
Wafa Ibn Saied, Bertrand Souweine, Maité Garrouste-Orgeas, Stéphane Ruckly, Michael Darmon, Sébastien Bailly, Yves Cohen, Elie Azoulay, Carole Schwebel, Aguila Radjou, Hatem Kallel, Christophe Adrie, Anne-Sylvie Dumenil, Laurent Argaud, Guillaume Marcotte, Samir Jamali, Laurent Papazian, Dany Goldgran-Toledano, Lila Bouadma, Jean-Francois Timsit
RATIONALE: The impact of prevention strategies and risk factors for early-onset (EOP) versus late-onset (LOP) ventilator-associated pneumonia (VAP) are still debated. OBJECTIVES: To evaluate, in a multicenter cohort, the risk factors for EOP and LOP, as the evolution of prevention strategies. METHODS: 7,784 patients with mechanical ventilation (MV) for at least 48 hours were selected into the multicenter prospective OUTCOMEREA database (1997-2016)...
2017: PloS One
https://www.readbyqxmd.com/read/29169012/methicillin-resistant-staphylococcus-aureus-isolated-from-an-intensive-care-unit-in-minas-gerais-brazil-over-a-six-year-period
#5
Thiago C Nascimento, Cláudio G Diniz, Vânia L Silva, Alessandra B Ferreira-Machado, Marina O Fajardo, Tamara Lopes R de Oliveira, Dennis de C Ferreira, Fernanda S Cavalcante, Kátia R Netto Dos Santos
To characterize methicillin-resistant Staphylococcus aureus (MRSA) isolates from an intensive care unit of a tertiary-care teaching hospital, between 2005 and 2010. A total of 45 MRSA isolates were recovered from patients admitted to the ICU in the study period. Resistance rates higher than 80% were found for clindamycin (100%), erythromycin (100%), levofloxacin (100%), azithromycin (97.7%), rifampin (88.8%), and gentamycin (86.6%). The SCCmec typing revealed that the isolates harbored the types III (66.7%), II (17...
November 20, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29168046/procalcitonin-guided-antibiotic-therapy-in-intensive-care-unit-patients-a-systematic-review-and-meta-analysis
#6
Hui-Bin Huang, Jin-Min Peng, Li Weng, Chun-Yao Wang, Wei Jiang, Bin Du
BACKGROUND: Serum procalcitonin (PCT) concentration is used to guide antibiotic decisions in choice, timing, and duration of anti-infection therapy to avoid antibiotic overuse. Thus, we performed a systematic review and meta-analysis to seek evidence of different PCT-guided antimicrobial strategies for critically ill patients in terms of predefined clinical outcomes. METHODS: We searched for relevant studies in PubMed, Embase, Web of Knowledge, and the Cochrane Library up to 25 February 2017...
November 22, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29167061/implementation-and-outcomes-of-hospital-wide-computerized-antimicrobial-approval-system-and-on-the-spot-education-in-a-traumatic-intensive-care-unit-in-taiwan
#7
Tsung-Yu Huang, Chien-Hui Hung, Li-Ju Lai, Hui-Ju Chuang, Chien-Chen Wang, Pei-Tzu Lin, Wei-Hsiu Hsu
BACKGROUND/PURPOSE: Inappropriate prescribing of antibiotics is a major health-care problem in intensive care units (ICUs). This study evaluates the impact of a direct hospital-wide computerized antimicrobial approval system (HCAAS) and on-the-spot education for practitioners in a neurosurgical ICU in Taiwan. METHODS: We retrospectively analyzed the medical records monthly of patients who were admitted to the neurosurgical ICU during a period of 7 years and 7 months...
November 11, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/29165152/detection-of-antibiotic-resistant-acinetobacter-baumannii-in-various-hospital-environments-potential-sources-for-transmission-of-acinetobacter-infections
#8
Zahra Shamsizadeh, Mahnaz Nikaeen, Bahram Nasr Esfahani, Seyed Hamed Mirhoseini, Maryam Hatamzadeh, Akbar Hassanzadeh
BACKGROUND: Antibiotic resistant Acinetobacter baumannii has emerged as one of the most problematic hospital acquired pathogens around the world. This study was designed to investigate the presence of antibiotic resistant A. baumannii in various hospital environments. METHODS: Air, water and inanimate surface samples were taken in different wards of four hospitals and analyzed for the presence of A. baumannii. Confirmed A. baumannii isolates were analyzed for antimicrobial susceptibility and also screened for the presence of three most common OXA- type carbapenemase-encoding genes...
May 8, 2017: Environmental Health and Preventive Medicine
https://www.readbyqxmd.com/read/29164489/antimicrobial-stewardship-opportunities-in-critically-ill-patients-with-gram-negative-lower-respiratory-tract-infections-a-multicenter-cross-sectional-analysis
#9
Kimberly C Claeys, Evan J Zasowski, Trang D Trinh, Abdalhamid M Lagnf, Susan L Davis, Michael J Rybak
INTRODUCTION: Lower respiratory tract infections (LRTIs) are a major cause of morbidity and death. Because of changes in how LRTIs are defined coupled with the increasing prevalence of drug resistance, there is a gap in knowledge regarding the current burden of antimicrobial use for Centers for Disease Control and Prevention (CDC)-defined LRTIs. We describe the infection characteristics, antibiotic consumption, and clinical and economic outcomes of patients with Gram-negative (GN) LRTIs treated in intensive care units (ICUs)...
November 21, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29162291/the-efficacy-of-self-disinfecting-bedrail-covers-in-an-intensive-care-unit
#10
Lisa M Esolen, Lokendra Thakur, Abraham J Layon, Thomas A Fuller, Deni-Jo Harrington, Kunal Jha, Subhashinie Kariyawasam
BACKGROUND: Hospital surfaces are considered important vectors in the spread of nosocomial pathogens. This study evaluated microbial counts on novel antimicrobial bedrail covers over a 2-week period in a critical care environment. METHODS: Disposable bedrail covers (Aionx Inc, Hershey, PA) made of a copper and silver polymer and capable of conducting an imperceptible surface potential, were installed in a case-control manner on a series of occupied intensive care unit beds...
November 19, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29153063/-investigation-of-various-virulence-factors-of-klebsiella-pneumoniae-strains-isolated-from-nosocomial-infections
#11
Halit Kuş, Uğur Arslan, Hatice Türk Dağı, Duygu Fındık
Klebsiella pneumoniae is an opportunistic pathogen that commonly affects immunosuppressed patients and causes nosocomial infections. K.pneumoniae has a variety of virulence factors, especially capsule polysaccharide, hypermucoviscosity (HV), fimbriae, toxins and determinants for iron acquisition. The aim of this study was to detect the virulence factors in K.pneumoniae strains isolated from nosocomial infections in two years. Fifty three K.pneumoniae strains isolated from the samples of patients with nosocomial infections in the Medical Microbiology Laboratory of Selcuk University Faculty of Medicine Hospital between 2011 and 2013 were included in the study...
October 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/29151996/co-occurrence-of-plasmid-mediated-ampc-%C3%AE-lactamase-activity-among-klebsiella-pneumoniae-and-escherichia-coli
#12
Abdulaziz Zorgani, Hiyam Daw, Najib Sufya, Abdullah Bashein, Omar Elahmer, Chedly Chouchani
Introduction: Extended-spectrum β-lactamases (ESBLs), including the AmpC type, are important mechanisms of resistance among Klebsiella pneumoniae and Escherichia coli isolates. Objective: The aim of the study was to investigate the occurrence of AmpC-type β-lactamase producers isolated from two hospitals in Tripoli, Libya. Methods: All clinical isolates (76 K. pneumoniae and 75 E. coli) collected over two years (2013-2014) were evaluated for susceptibility to a panel of antimicrobials and were analyzed phenotypically for the ESBL and AmpC phenotype using E-test and ESBL and AmpC screen disc test...
2017: Open Microbiology Journal
https://www.readbyqxmd.com/read/29145465/hospital-associated-methicillin-resistant-staphylococcus-aureus-a-cross-sectional-analysis-of-risk-factors-in-south-african-tertiary-public-hospitals
#13
Liliwe L Shuping, Lazarus Kuonza, Alfred Musekiwa, Samantha Iyaloo, Olga Perovic
INTRODUCTION: Hospital-associated methicillin-resistant S. aureus (HA-MRSA) remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa. METHODS: We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture...
2017: PloS One
https://www.readbyqxmd.com/read/29144958/isolation-of-blandm-producing-enterobacteriaceae-in-a-public-hospital-in-salvador-bahia-brazil
#14
Maria Goreth Barberino, Silvia de Araujo Cruvinel, Célio Faria, Marco Aurélio Salvino, Márcio Oliveira
Carbapenemases have great importance in the global epidemiological scenario since infections with carbapenemase-producing bacteria are associated with high mortality, especially in hospitalized patients in intensive care units. This study describes two microorganisms producers of the New Delhi Metallo-b-lactamase (NDM), Klebsiella pneumoniae and Citrobacter freundii, from two patients admitted to a public hospital in Salvador, Bahia. These are the first clinical cases of NDM described in microorganisms in the north and northeast Brazil...
November 13, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29134489/the-quick-loss-of-carbapenem-susceptibility-in-pseudomonas-aeruginosa-at-intensive-care-units
#15
Yamin Zou, Jiangping Lian, Ying Di, Haisheng You, Hongping Yao, Junhui Liu, Yalin Dong
Background Patients colonized with carbapenem-susceptible Pseudomonas aeruginosa (CSPA) strains upon admission to the intensive care unit (ICU) tend to be quickly followed by detected carbapenem-resistant P. aeruginosa strains after admission. Objective To assess the risk factors associated with the quick loss of carbapenem susceptibility and to identify time threshold of prior antimicrobial exposure for the loss during ICU stay. Setting A tertiary-care teaching hospital with 2560 beds located in the northwest region of China...
November 14, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29122697/early-administration-of-appropriate-antimicrobial-agent-to-improve-the-outcome-of-carbapenem-resistant-acinetobacter-baumannii-complex-bacteremic-pneumonia
#16
Seong Yeon Park, Eun Jung Lee, Tark Kim, Shi Nae Yu, Ki-Ho Park, Mi Suk Lee, Se Yoon Park, Min Hyok Jeon, Tae Hyong Kim, Eun Ju Choo
BACKGROUND: Carbapenem resistant Acinetobacter baumannii complex (CRABC) is an emerging pathogen that causes bloodstream infections and nosocomial pneumonia. This study aimed to describe the severe infection associated with CRABC bacteremic pneumonia and to investigate risk factors for 28-day mortality. METHODS: All patients ≥18 years of age with a CRABC bacteremic pneumonia were enrolled retrospectively at five teaching hospitals in South Korea. Empirical antimicrobial therapy was defined as appropriate if administration of at least one antimicrobial agent, to which the causative pathogen was susceptible, more than 48 hours, within 5 days of the onset of bacteremia...
November 6, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29108947/antibiotic-strategies-and-clinical-outcomes-in-critically-ill-patients-with-pneumonia-caused-by-carbapenem-resistant-acinetobacter-baumannii
#17
Chun-An Liang, Ying-Chi Lin, Po-Liang Lu, Huang-Chi Chen, Hsu-Liang Chang, Chau-Chyun Sheu
OBJECTIVES: This study aimed to investigate antibiotic prescribing patterns and effectiveness of different anti-carbapenem-resistant Acinetobacter baumannii (CRAB) strategies for CRAB pneumonia. METHODS: We conducted a multicenter, retrospective study in three hospitals. During 2010-2015, adult ICU patients with CRAB pneumonia treated with at least one antimicrobial agent covering the CRAB isolate in vitro for more than two days were included. We used multivariate logistic regression to analyze the associations of anti-CRAB strategies with ICU mortality and other clinical outcomes...
November 3, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29097104/characterization-of-microbial-community-composition-antimicrobial-resistance-and-biofilm-on-intensive-care-surfaces
#18
K Johani, D Abualsaud, D M Costa, H Hu, G Whiteley, A Deva, K Vickery
BACKGROUND: Organisms causing healthcare associated infections can be sourced from the inanimate environment around patients. Residing in a biofilm increases the chances of these organisms persisting in the environment. We aimed to characterise bacterial environmental contamination, genetically and physiologically, and relate this to general intensive care unit (ICU) cleanliness. METHODS: Cleanliness was determined by adenosine triphosphate (ATP) measurements of 95 high-touch objects...
October 30, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/29095722/pcr-based-tests-for-the-early-diagnosis-of-sepsis-where-do-we-stand
#19
Andrew N Ginn, Catriona L Halliday, Abby P Douglas, Sharon C-A Chen
PURPOSE OF REVIEW: Bloodstream infections are a major cause of hospital and ICU admission with high morbidity and mortality; however, early and targeted antimicrobial therapy reduces mortality in high-risk patients. This article focuses on the diagnosis of bloodstream infections by PCR-based approaches at an early stage to enable prompt treatment and prevent organ dysfunction. RECENT FINDINGS: PCR systems offering highly multiplexed targeting of bacterial and/or fungal pathogens (in whole blood) offer the best opportunity for clinical impact, as informed decisions can be made within 4-8 h of the blood draw...
December 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29081301/shortening-the-application-time-of-alcohol-based-hand-rubs-to-15-seconds-may-improve-the-frequency-of-hand-antisepsis-actions-in-a-neonatal-intensive-care-unit
#20
Axel Kramer, Didier Pittet, Romana Klasinc, Stefan Krebs, Torsten Koburger, Christoph Fusch, Ojan Assadian
BACKGROUND For alcohol-based hand rubs, the currently recommended application time of 30 seconds is longer than the actual time spent in clinical practice. We investigated whether a shorter application time of 15 seconds is microbiologically safe in neonatal intensive care and may positively influence compliance with the frequency of hand antisepsis actions. METHODS We conducted in vitro experiments to determine the antimicrobial efficacy of hand rubs within 15 seconds, followed by clinical observations to assess the effect of a shortened hand antisepsis procedure under clinical conditions in a neonatal intensive care unit (NICU)...
October 30, 2017: Infection Control and Hospital Epidemiology
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