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antimicrobial in icu

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https://www.readbyqxmd.com/read/29029170/use-of-a-structured-panel-process-to-define-antimicrobial-prescribing-appropriateness-in-critical-care
#1
Linda D Dresser, Chaim M Bell, Marilyn Steinberg, Niall D Ferguson, Stephen Lapinsky, Neil Lazar, Patricia Murphy, Jeffrey M Singh, Andrew M Morris
Background: Antimicrobial prescribing is frequently reported as appropriate or inappropriate, particularly in the ICU. However, the definitions used are non-standardized and lack validity and reliability. Objectives: To develop standardized definitions of appropriateness for antimicrobial prescribing in the critical care setting. Methods: We used consensus-based modified Delphi and RAND appropriateness methodology to develop criteria to define appropriateness of antimicrobial prescribing...
September 26, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29026472/clinical-features-and-antimicrobial-resistance-of-bacterial-agents-of-ventilator-associated-tracheobronchitis-in-hamedan-iran
#2
Seyyed Hamid Hashemi, Naeimeh Hashemi, Farzaneh Esna-Ashari, Abbas Taher, Arash Dehghan
OBJECTIVES: Ventilator-associated tracheobronchitis (VAT) is a common cause of mortality and morbidity in patients admitted to intensive care units (ICUs). This study was conducted to evaluate the clinical course, etiology, and antimicrobial resistance of bacterial agents of VAT in ICUs in Hamedan, Iran. METHODS: During a 12-month period, all patients with VAT in a medical and a surgical ICU were included. The criteria for the diagnosis of VAT were fever, mucus production, a positive culture of tracheal secretions, and the absence of lung infiltration...
September 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29021787/integron-digestive-carriage-in-human-and-cattle-a-one-health-cultivation-independent-approach
#3
Delphine Chainier, Olivier Barraud, Geoffrey Masson, Elodie Couve-Deacon, Bruno François, Claude-Yves Couquet, Marie-Cécile Ploy
Objectives: Dissemination of antimicrobial resistance (AMR) is a global issue that requires the adoption of a "One-Health" approach promoting integration of human and animal health. Besides culture-dependent techniques frequently used for AMR surveillance, cultivation-independent methods can give additional insights into the diversity and reservoir of AMR genetic determinants. Integrons are molecular markers that can provide overall and reliable estimation of AMR dissemination. In this study, considering the "One-Health" approach, we have analyzed the integron digestive carriage from stools of humans and cattle living in a same area and exposed to different antibiotic selection pressures...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29020364/antimicrobial-resistance-in-gram-negative-rods-causing-bacteremia-in-hematopoietic-stem-cell-transplant-patients-intercontinental-prospective-study-of-infectious-diseases-working-party-of-the-european-bone-marrow-transplantation-group
#4
Diana Averbuch, Gloria Tridello, Jennifer Hoek, Malgorzata Mikulska, Hamdi Akan, Lucrecia Yanez San Segundo, Thomas Pabst, Tülay Özçelik, Galina Klyasova, Irene Donnini, Depei Wu, Zafer Gülbas, Tsila Zuckerman, Aida Botelho de Sousa, Yves Beguin, Aliénor Xhaard, Emmanuel Bachy, Per Ljungman, Rafael de la Camara, Jelena Rascon, Isabel Ruiz Camps, Antonin Vitek, Francesca Patriarca, Laura Cudillo, Radovan Vrhovac, Peter J Shaw, Tom Wolfs, Tracey O'Brien, Batia Avni, Gerda Silling, Firas Al Sabty, Stelios Graphakos, Marja Sankelo, Henrik Sengeloev, Srinivas Pillai, Susanne Matthes, Frederiki Melanthiou, Simona Iacobelli, Jan Styczynski, Dan Engelhard, Simone Cesaro
Background: This intercontinental study aimed to study Gram-negative rods (GNR) resistance in hematopoietic stem cell transplantation (HSCT). Methods: GNR bacteremias occurring during six months post-HSCT (February/2014-May/2015) were prospectively collected, and analysed for rates and risk factors for resistance to fluoroquinolones, non-carbapenem anti-Pseudomonas beta-lactams (non-carbapenems), carbapenems and multidrug-resistance (MDR). Results: Sixty-five HSCT centers from 25 countries (Europe, Australia, Asia) reported data on 655 GNR episodes/704 pathogens in 591 patients (Enterobacteriaceae, 73%; non-fermentatives, 24% and 3% others)...
July 26, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28993173/role-of-mexab-oprm-and-mexxy-oprm-efflux-pumps-and-class-1-integrons-in-resistance-to-antibiotics-in-burn-and-intensive-care-unit-isolates-of-pseudomonas-aeruginosa
#5
Hamid Reza Goli, Mohammad Reza Nahaei, Mohammad Ahangarzadeh Rezaee, Alka Hasani, Hossein Samadi Kafil, Mohammad Aghazadeh, Mojtaba Nikbakht, Younes Khalili
BACKGROUND: The overexpression of efflux pumps and existence of class 1 integrons are the most important mechanisms that contribute to antimicrobial resistance in Pseudomonas aeruginosa especially in burn and Intensive Care Units (ICUs). The present study evaluated the role of MexAB-OprM and MexXY-OprM efflux pumps and class 1 integrons in resistance to antibiotics in burn and ICU isolates of P. aeruginosa. METHODS: Fifteen burn and forty-two ICU isolates were obtained from four hospitals in Northwest Iran...
October 6, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28993134/sepsis-caused-by-bloodstream-infection-in-patients-in-the-intensive-care-unit-the-impact-of-inactive-empiric-antimicrobial-therapy-on-outcome
#6
Daniel Brooks, Padmaja Polubothu, D Young, M G Booth, A Smith
BACKGROUND: Sepsis is one of the leading causes of death in the UK. AIMS: The aims of this study were to identify the rate of inactive antimicrobial therapy (AMT) in the ICU and whether inactive AMT had an effect on in hospital mortality, ICU mortality, 90-day mortality and length of hospital stay. Additionally, we wanted to identify risk factors for receiving inactive AMT. METHODS: This was a retrospective observational study conducted at Glasgow Royal Infirmary ICU between January 2010 and December 2013, with 12,000 blood cultures taken over this time period, of which n=127 were deemed clinically significant...
October 6, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28965794/health-care-associated-infections-in-pre-transplant-liver-intensive-care-unit-perspectives-and-challenges
#7
Elham A Hassan, Nahla M Elsherbiny, Abeer S Abd El-Rehim, Asmaa M A Soliman, Asmaa O Ahmed
BACKGROUND: Health care-associated infections (HAIs) threaten patient's safety worldwide especially in the intensive care units (ICU). In end-stage liver disease (ESLD), the condition is much more complicated. Data regarding HAIs among ESLD patients is lacking. We aimed to assess the incidence of HAIs, risk factors, causative micro-organisms, antimicrobial susceptibilities and mortality rates among patients with end-stage liver disease (ESLD) admitted to pre-transplant liver intensive care unit (LICU)...
September 28, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28964884/a-cross-sectional-point-prevalence-survey-to-study-the-environmental-contamination-of-nosocomial-pathogens-in-intensive-care-units-under-real-life-conditions
#8
I Wille, A Mayr, P Kreidl, C Brühwasser, G Hinterberger, A Fritz, W Posch, S Fuchs, A Obwegeser, D Orth-Höller, C Lass-Flörl
BACKGROUND: In intensive care units (ICUs) inanimate surfaces and equipment may be contaminated by nosocomial pathogens, including multi-drug resistant microorganisms. AIMS: To assess the degree of patients' close and distant environmental contamination including healthcare workers' (HCWs) hands with nosocomial pathogens under real life situations and to investigate potential transmission events. METHODS: For the course of three weeks agar contact samples were taken close and distant to the patient area and from HCWs' hands in eight ICUs of a tertiary care hospital in Innsbruck, Austria...
September 27, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28961733/impact-of-carbapenem-restriction-on-the-antimicrobial-susceptibility-pattern-of-pseudomonas-aeruginosa-isolates-in-the-icu
#9
Mohammad Abdallah, Mohammad Badawi, Mohammad Faisal Amirah, Akram Rasheed, Ahmed F Mady, Mohammed Alodat, Abdurahman Alharthy
Background: Rates of carbapenem-resistant Pseudomonas aeruginosa are increasing. Aggressive prevention strategies, including instituting antimicrobial stewardship programmes, are essential for combating antimicrobial resistance. Objectives: We conducted this study to compare the antimicrobial susceptibility pattern of P. aeruginosa before and after carbapenem restriction. Methods: We conducted a two-phase retrospective study in an adult ICU...
August 4, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28959441/clonal-diversity-and-detection-of-carbapenem-resistance-encoding-genes-among-multidrug-resistant-acinetobacter-baumannii-isolates-recovered-from-patients-and-environment-in-two-intensive-care-units-in-a-moroccan-hospital
#10
Jean Uwingabiye, Abdelhay Lemnouer, Ignasi Roca, Tarek Alouane, Mohammed Frikh, Bouchra Belefquih, Fatna Bssaibis, Adil Maleb, Yassine Benlahlou, Jalal Kassouati, Nawfal Doghmi, Abdelouahed Bait, Charki Haimeur, Lhoussain Louzi, Azeddine Ibrahimi, Jordi Vila, Mostafa Elouennass
BACKGROUND: Carbapenem-resistant Acinetobacter baumannii has recently been defined by the World Health Organization as a critical pathogen. The aim of this study was to compare clonal diversity and carbapenemase-encoding genes of A. baumannii isolates collected from colonized or infected patients and hospital environment in two intensive care units (ICUs) in Morocco. METHODS: The patient and environmental sampling was carried out in the medical and surgical ICUs of Mohammed V Military teaching hospital from March to August 2015...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28946125/a-simple-ultra-high-performance-liquid-chromatography-high-resolution-mass-spectrometry-assay-for-the-simultaneous-quantification-of-15-antibiotics-in-plasma
#11
S Lefeuvre, J Bois-Maublanc, L Hocqueloux, L Bret, T Francia, C Eleout-Da Violante, E M Billaud, F Barbier, L Got
Antibiotic (ATB) treatment of critically ill patients with pathophysiological injuries remains a challenge due to the constant increase in antimicrobial resistance. Therapeutic drug monitoring (TDM) is advised for ATB dose adjustments to avoid suboptimal concentrations and dose-related adverse effects. Therefore, a single and reliable analytical method for a broad selection of ATBs was developed using a high-resolution mass spectrometry (HRMS) platform for frequent use in intensive care units. An UHPLC assay coupled to high resolution accurate mass acquisition has been developed for the quantification of penicillins (amoxicillin, oxacillin, piperacillin, and ticarcillin), cephalosporines (cefepime, cefotaxime, ceftazidime, and ceftriaxone), carbapenems (ertapenem, imipenem, and meropenem), lincosamide (clindamycin), quinolones (ofloxacin and ciprofloxacin) and tazobactam...
September 11, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28943144/the-epidemiology-antibiograms-and-predictors-of-mortality-among-critically-ill-patients-with-central-line-associated-bloodstream-infections
#12
Shin-Huei Kuo, Wei-Ru Lin, Jun-You Lin, Chung-Hao Huang, Ya-Ting Jao, Pei-Wen Yang, Jong-Rung Tsai, Wen-Hung Wang, Yen-Hsu Chen, Ching-Tzu Hung, Po-Liang Lu
BACKGROUND/PURPOSE: For high risk of central line-associated bloodstream infections (CLABSIs) in patients of intensive care units (ICUs) and scarcely epidemiology and therapeutic recommendations in Asia, we aimed to evaluate the annual change in epidemiology, antibiogram, and risk factors for 14-day mortality. METHODS: A retrospective study of ICUs patients with CLABSIs at a medical center in Taiwan (2010-2016), where central line care bundle implemented since 2014, by reviewing clinical data, pathogens, and the antibiogram...
September 6, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28926966/augmented-renal-clearance-in-critical-illness-an-important-consideration-in-drug-dosing
#13
REVIEW
Sherif Hanafy Mahmoud, Chen Shen
Augmented renal clearance (ARC) is a manifestation of enhanced renal function seen in critically ill patients. The use of regular unadjusted doses of renally eliminated drugs in patients with ARC might lead to therapy failure. The purpose of this scoping review was to provide and up-to-date summary of the available evidence pertaining to the phenomenon of ARC. A literature search of databases of available evidence in humans, with no language restriction, was conducted. Databases searched were MEDLINE (1946 to April 2017), EMBASE (1974 to April 2017) and the Cochrane Library (1999 to April 2017)...
September 16, 2017: Pharmaceutics
https://www.readbyqxmd.com/read/28923865/an-in-vitro-comparison-of-ceftolozane-tazobactam-compared-to-traditional-beta-lactams-as-an-alternative-to-combination-antimicrobial-therapy-for-pseudomonas-aeruginosa
#14
Kellie J Goodlet, David P Nicolau, Michael D Nailor
Background: Guidelines for sepsis, febrile neutropenia, and hospital-acquired pneumonia include empiric regimens incorporating two antibiotics from different classes with activity against Pseudomonas aeruginosa for select at-risk patients to increase the likelihood of susceptibility to at least one agent.Objectives: The activity and cross-resistance rates of ceftolozane/tazobactam were compared to β-lactam comparators cefepime, ceftazidime, piperacillin/tazobactam, and meropenem alone and cumulatively with ciprofloxacin or tobramycin against P...
September 18, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28910379/a-one-year-prospective-study-of-colonization-with-antimicrobial-resistant-organisms-on-admission-to-a-vietnamese-intensive-care-unit
#15
Duong Bich Thuy, James Campbell, Nguyen Van Minh Hoang, Truong Thi Thuy Trinh, Ha Thi Hai Duong, Nguyen Chi Hieu, Nguyen Hoang Anh Duy, Nguyen Van Hao, Stephen Baker, Guy E Thwaites, Nguyen Van Vinh Chau, C Louise Thwaites
There is a paucity of data regarding initial bacterial colonization on admission to Intensive Care Units (ICUs) in low and middle-income countries (LMICs). Patients admitted to ICUs in LMICs are at high-risk of subsequent infection with antimicrobial-resistant organisms (AROs). We conducted a prospective, observational study at the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam from November 2014 to January 2016 to assess the colonization and antimicrobial susceptibility of Staphylococcus aureus, Escherichia coli, Klebsiella spp...
2017: PloS One
https://www.readbyqxmd.com/read/28903803/a-blueprint-for-targeted-antimicrobial-stewardship-in-neonatal-intensive-care-units
#16
Candace L Johnson, Lisa Saiman
No abstract text is available yet for this article.
October 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28903514/impact-of-an-antimicrobial-stewardship-program-on-antibiotic-use-at-a-nonfreestanding-children-s-hospital
#17
R Brigg Turner, Elena Valcarlos, Ann M Loeffler, Michael Gilbert, Dominic Chan
Background: Pediatric stewardship programs have been successful at reducing unnecessary antibiotic use. Data from nonfreestanding children's hospitals are currently limited. This study is an analysis of antibiotic use after implementation of an antimicrobial stewardship program at a community nonfreestanding children's hospital. Methods: In April 2013, an antimicrobial stewardship program that consisted of physician-group engagement and pharmacist prospective auditing and feedback was initiated...
September 1, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28902923/molecular-microbiological-and-clinical-characterization-of-clostridium-difficile-isolates-from-tertiary-care-hospitals-in-colombia
#18
Clara Lina Salazar, Catalina Reyes, Santiago Atehortua, Patricia Sierra, Margarita María Correa, Daniel Paredes-Sabja, Emma Best, Warren N Fawley, Mark Wilcox, Ángel González
In Colombia, the epidemiology and circulating genotypes of Clostridium difficile have not yet been described. Therefore, we molecularly characterized clinical isolates of C.difficile from patients with suspicion of C.difficile infection (CDI) in three tertiary care hospitals. C.difficile was isolated from stool samples by culture, the presence of A/B toxins were detected by enzyme immunoassay, cytotoxicity was tested by cell culture and the antimicrobial susceptibility determined. After DNA extraction, tcdA, tcdB and binary toxin (CDTa/CDTb) genes were detected by PCR, and PCR-ribotyping performed...
2017: PloS One
https://www.readbyqxmd.com/read/28900697/principles-of-antimicrobial-stewardship-for-bacterial-and-fungal-infections-in-icu
#19
EDITORIAL
Matteo Bassetti, Marin H Kollef, Garyphallia Poulakou
No abstract text is available yet for this article.
September 12, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28893354/similar-virulence-properties-of-infection-and-colonization-associated-pseudomonas-aeruginosa
#20
Aditi, Malini Shariff, Sunil K Chhabra, Mujeeb-Ur Rahman
PURPOSE: Pseudomonas aeruginosa is one of the agents that are commonly implicated in nosocomial infections. However, it is also present as a commensal in various body sites of healthy persons, making the diagnosis of infection by culture difficult. A number of virulence factors expressed by the organism have been implicated in its pathogenicity. We undertook this study to identify the host and organism factors associated with infection. METHODOLOGY: Pathogenic, colonizing and environmental isolates were tested for apr, lasB, the T3SS effector exoenzymes (exoS, exoT, exoU and exoY) and toxA genes, biofilm production and antimicrobial susceptibility...
September 12, 2017: Journal of Medical Microbiology
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