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https://www.readbyqxmd.com/read/28101656/off-label-use-of-antimicrobials-in-neonates-in-a-tertiary-children-s-hospital
#1
Niina Laine, Ann Marie Kaukonen, Kalle Hoppu, Marja Airaksinen, Harri Saxen
PURPOSE: Off-label (OL) use of drugs for hospitalized children is very common. OL use occurs especially in the youngest patients, neonates. This study focused on the OL use of antimicrobials in neonates. To our knowledge, only few studies have focused on the prevalence of OL use of antimicrobials in neonates. METHODS: We investigated the OL use of antimicrobials in neonates in a tertiary children's hospital. First, we investigated what were the most consumed OL antimicrobials in defined daily doses according to hospital's registry data from neonatal intensive care unit (NICU) during 2009-2014...
January 18, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28099689/effectiveness-and-safety-of-procalcitonin-evaluation-for-reducing-mortality-in-adults-with-sepsis-severe-sepsis-or-septic-shock
#2
REVIEW
Brenda Ng Andriolo, Regis B Andriolo, Reinaldo Salomão, Álvaro N Atallah
BACKGROUND: Serum procalcitonin (PCT) evaluation has been proposed for early diagnosis and accurate staging and to guide decisions regarding patients with sepsis, severe sepsis and septic shock, with possible reduction in mortality. OBJECTIVES: To assess the effectiveness and safety of serum PCT evaluation for reducing mortality and duration of antimicrobial therapy in adults with sepsis, severe sepsis or septic shock. SEARCH METHODS: We searched the Central Register of Controlled Trials (CENTRAL; 2015, Issue 7); MEDLINE (1950 to July 2015); Embase (Ovid SP, 1980 to July 2015); Latin American Caribbean Health Sciences Literature (LILACS via BIREME, 1982 to July 2015); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO host, 1982 to July 2015), and trial registers (ISRCTN registry, ClinicalTrials...
January 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28096975/a-prospective-survey-of-pseudomonas-aeruginosa-colonization-and-infection-in-the-intensive-care-unit
#3
Regev Cohen, Frida Babushkin, Shoshana Cohen, Marina Afraimov, Maurice Shapiro, Martina Uda, Efrat Khabra, Amos Adler, Ronen Ben Ami, Svetlana Paikin
BACKGROUND: Pseudomonas aeruginosa (PA) surveillance may improve empiric antimicrobial therapy, since colonizing strains frequently cause infections. This colonization may be 'endogenous' or 'exogenous', and the source determines infection control measures. We prospectively investigated the sources of PA, the clinical impact of PA colonization upon admission and the dynamics of colonization at different body sites throughout the intensive care unit stay. METHODS: Intensive care patients were screened on admission and weekly from the pharynx, endotracheal aspirate, rectum and urine...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28096015/association-of-medication-errors-with-drug-classifications-clinical-units-and-consequence-of-errors-are-they-related
#4
Maki Muroi, Jay J Shen, Alona Angosta
Registered nurses (RNs) play an important role in safe medication administration and patient safety. This study examined a total of 1276 medication error (ME) incident reports made by RNs in hospital inpatient settings in the southwestern region of the United States. The most common drug class associated with MEs was cardiovascular drugs (24.7%). Among this class, anticoagulants had the most errors (11.3%). The antimicrobials was the second most common drug class associated with errors (19.1%) and vancomycin was the most common antimicrobial that caused errors in this category (6...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28093229/antimicrobial-activity-and-mechanism-of-pdc213-an-endogenous-peptide-from-human-milk
#5
Yazhou Sun, Yahui Zhou, Xiao Liu, Fan Zhang, Linping Yan, Ling Chen, Xing Wang, Hongjie Ruan, Chenbo Ji, Xianwei Cui, Jiaqin Wang
Human milk has always been considered an ideal source of elemental nutrients to both preterm and full term infants in order to optimally develop the infant's tissues and organs. Recently, hundreds of endogenous milk peptides were identified in human milk. These peptides exhibited angiotensin-converting enzyme inhibition, immunomodulation, or antimicrobial activity. Here, we report the antimicrobial activity and mechanism of a novel type of human antimicrobial peptide (AMP), termed PDC213 (peptide derived from β-Casein 213-226 aa)...
January 16, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28076304/the-use-of-liquid-chromatography-tandem-mass-spectrometry-for-therapeutic-drug-monitoring-of-antibiotics-in-cancer-patients
#6
Nahed El-Najjar, Jonathan Jantsch, André Gessner
Cancer remains a leading cause of mortality and morbidity worldwide. In addition to organ failure, the most frequent reasons for admission of cancer patients to intensive care units (ICU) are: infections and sepsis. As critically ill, the complexity of the health situation of cancer patients renders the standard antimicrobial regimen more complex and even inadequate which results in increased mortality rates. This is due to pathophysiological changes in the volume of distribution, increased clearance, as well as to organ dysfunction...
January 11, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28072933/altered-blood-levels-of-vitamin-d-cathelicidin-and-parathyroid-hormone-in-patients-with-sepsis-a-pilot-study
#7
T Greulich, W Regner, M Branscheidt, C Herr, A R Koczulla, C F Vogelmeier, R Bals
It has been recognised that vitamin D (VitD) has a potential role in the regulation of inflammation and protection from infection. In a prospective clinical observational pilot study, we investigated the serum levels of 25-hydroxyvitamin-D3 (25(OH)D3), 1,25-hydroxyvitamin-D3 (1,25(OH)2D3), parathyroid hormone (PTH), and cathelicidin in intensive care unit (ICU) patients with or without systemic inflammatory response syndrome (SIRS). We included 32 patients with SIRS (septic patients), 16 ICU patients without SIRS, and 16 healthy controls...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28064542/antibiotic-treatment-patterns-costs-and-resource-utilization-among-patients-with-community-acquired-pneumonia-a-us-cohort-study
#8
Christopher J Llop, Edward Tuttle, Glenn S Tillotson, Kerry LaPlante, Thomas M File
OBJECTIVES: The current treatment options for patients with community-acquired pneumonia (CAP) often present a trade-off between the potential for treatment failure and safety concerns. We set out to investigate real-world outcomes associated with the use of currently available antimicrobial treatment options for CAP in both the outpatient and inpatient (non-intensive care unit [ICU]) settings. METHODS: This claims-based retrospective study included adult patients diagnosed with CAP and treated with antibiotic therapies, including any oral fluoroquinolone, macrolide, or beta-lactam monotherapy in the outpatient setting, and intravenous (IV) levofloxacin or IV azithromycin/ceftriaxone in the inpatient setting...
January 18, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28056822/the-first-occurrence-of-a-ctx-m-esbl-producing-escherichia-coli-outbreak-mediated-by-mother-to-neonate-transmission-in-an-irish-neonatal-intensive-care-unit
#9
Ciara O'Connor, Roy K Philip, John Kelleher, James Powell, Alan O'Gorman, Barbara Slevin, Neil Woodford, Jane F Turton, Elaine McGrath, Cathriona Finnegan, Lorraine Power, Nuala H O'Connell, Colum P Dunne
BACKGROUND: Escherichia coli (E. coli) comprise part of the normal vaginal microflora. Transfer from mother to neonate can occur during delivery resulting, sometimes, in neonatal bacterial disease. Here, we aim to report the first outbreak of CTX-M ESBL-producing E. coli with evidence of mother-to-neonate transmission in an Irish neonatal intensive care unit (NICU) followed by patient-to-patient transmission. METHODS: Investigation including molecular typing was conducted...
January 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28051826/-vap-and-oral-hygiene-a-systematic-review
#10
F Guerra, F De Martino, M Capocci, F Rinaldo, A Mannocci, A De Biase, L Ottolenghi, G La Torre
Ventilator associated pneumonia (VAP) is a common nosocomial infection in intensive care units. International literature showed how the use of professional oral hygiene protocols provide an essential support in VAP prevention. The aim of this study is to provide a systematic and narrative updated review, to further demonstrate that a proper protocol of oral hygiene, in special needs patients, can reduce risk of developing VAP. In this study were analyzed 10 narrative and 3 systematic reviews. Systematic reviews were evaluated with AMSTAR checklist, INSA tool was used to analyze narrative reviews...
November 2016: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28050070/report-on-the-newly-emerging-nosocomial-burkholderia-cepacia-in-a-tertiary-hospital
#11
Shoba Srinivasan, N C Arora, Kavita Sahai
BACKGROUND: Burkholderia cepacia is an aerobic, motile, opportunistic Gram negative bacillus that can survive in certain disinfectants. This is a report of the emerging infection with the bacteria B. cepacia in our hospital. The awareness of this emerging bacterium is important, as it is known to cause nosocomial infection in hospitals, especially in the Intensive Care Unit (ICU) setting. setting. B. cepacia, although known to be multidrug resistant, shows sensitivity to some antibiotics that can be used to treat infection caused by it...
December 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28036311/etiological-profile-of-early-neonatal-bacterial-sepsis-by-multiplex-qpcr
#12
Walter P Silva-Junior, Almir S Martins, Paula C N Xavier, Kelly L A Appel, Silvio A Oliveira Junior, Durval B Palhares
INTRODUCTION: Given the major impact in terms of morbidity and mortality that episodes of early neonatal sepsis (ENS) have on both newborns and health systems, this study aimed to identify the etiological profile of early neonatal bacterial sepsis by a multiplex quantitative real-time polymerase chain reaction (qPCR). METHODOLOGY: Blood samples from newborns diagnosed with clinical ENS and hospitalized in neonatal intensive care units (NICUs) were collected and analyzed using the multiplex qPCR method to detect Streptococcus agalactiae, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter sp...
December 30, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/28018869/pathogens-and-antimicrobial-susceptibility-profiles-in-critically-ill-patients-with-bloodstream-infections-a-descriptive-study
#13
Rachel D Savage, Robert A Fowler, Asgar H Rishu, Sean M Bagshaw, Deborah Cook, Peter Dodek, Richard Hall, Anand Kumar, François Lamontagne, François Lauzier, John Marshall, Claudio M Martin, Lauralyn McIntyre, John Muscedere, Steven Reynolds, Henry T Stelfox, Nick Daneman
BACKGROUND: Surveillance of antimicrobial resistance is vital to guiding empirical treatment of infections. Collating and reporting routine data on clinical isolate testing may offer more timely information about resistance patterns than traditional surveillance network methods. METHODS: Using routine microbiology testing data collected from the Bacteremia Antibiotic Length Actually Needed for Clinical Effectiveness retrospective cohort study, we conducted a descriptive secondary analysis among critically ill patients in whom bloodstream infections had been diagnosed in 14 intensive care units (ICUs) in Canada...
October 2016: CMAJ Open
https://www.readbyqxmd.com/read/28018320/single-molecule-sequencing-pacbio-of-the-staphylococcus-capitis-nrcs-a-clone-reveals-the-basis-of-multidrug-resistance-and-adaptation-to-the-neonatal-intensive-care-unit-environment
#14
Patrícia Martins Simões, Hajar Lemriss, Yann Dumont, Sanâa Lemriss, Jean-Philippe Rasigade, Sophie Assant-Trouillet, Azeddine Ibrahimi, Saâd El Kabbaj, Marine Butin, Frédéric Laurent
The multi-resistant Staphylococcus capitis clone NRCS-A has recently been described as a major pathogen causing nosocomial, late-onset sepsis (LOS) in preterm neonates worldwide. NRCS-A representatives exhibit an atypical antibiotic resistance profile. Here, the complete closed genome (chromosomal and plasmid sequences) of NRCS-A prototype strain CR01 and the draft genomes of three other clinical NRCS-A strains from Australia, Belgium and the United Kingdom are annotated and compared to available non-NRCS-A S...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28004983/methicillin-resistant-staphylococcus-aureus-pneumonia-in-critically-ill-trauma-and-burn-patients-a-retrospective-cohort-study
#15
Kristen L Bunnell, Andrew R Zullo, Christine Collins, Charles A Adams
BACKGROUND: The timing and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia in trauma patients are not well characterized. This information is critical for the selection of appropriate empiric antibiotics. The objective of this study was to determine the incidence of MRSA pneumonia in early-onset and late-onset pneumonia and to identify risk factors for MRSA in the trauma-burn intensive care unit (ICU). PATIENTS AND METHODS: We conducted a retrospective cohort study from January 2012 to March 2015 of patients in the trauma and burn ICU with clinical and microbiologic evidence of pneumonia...
December 22, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27997675/compliance-with-procalcitonin-algorithm-antibiotic-recommendations-for-patients-in-medical-intensive-care-unit
#16
Abdalla A Ammar, Simon W Lam, Abhijit Duggal, Elizabeth A Neuner, Stephanie N Bass, Jorge A Guzman, Xiao-Feng Wang, Xiaozhen Han, Seth R Bauer
STUDY OBJECTIVES: To describe compliance with antibiotic recommendations based on a previously published procalcitonin (PCT)-guided algorithm in clinical practice, to compare PCT algorithm compliance rates between PCT assays ordered in the antibiotic initiation setting (PCT concentration measured < 24 hours after antibiotic initiation or prior to antibiotic initiation) with those in the antibiotic continuation setting (PCT concentration measured ≥ 24 hours after antibiotic initiation), and to evaluate patient- and PCT-related factors independently associated with algorithm compliance in patients in the medical intensive care unit...
December 20, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27997332/delivering-on-antimicrobial-resistance-agenda-not-possible-without-improving-fungal-diagnostic-capabilities
#17
David W Denning, David S Perlin, Eavan G Muldoon, Arnaldo Lopes Colombo, Arunaloke Chakrabarti, Malcolm D Richardson, Tania C Sorrell
Antimicrobial resistance, a major public health concern, largely arises from excess use of antibiotic and antifungal drugs. Lack of routine diagnostic testing for fungal diseases exacerbates the problem of antimicrobial drug empiricism, both antibiotic and antifungal. In support of this contention, we cite 4 common clinical situations that illustrate this problem: 1) inaccurate diagnosis of fungal sepsis in hospitals and intensive care units, resulting in inappropriate use of broad-spectrum antibacterial drugs in patients with invasive candidiasis; 2) failure to diagnose chronic pulmonary aspergillosis in patients with smear-negative pulmonary tuberculosis; 3) misdiagnosis of fungal asthma, resulting in unnecessary treatment with antibacterial drugs instead of antifungal drugs and missed diagnoses of life-threatening invasive aspergillosis in patients with chronic obstructive pulmonary disease; and 4) overtreatment and undertreatment of Pneumocystis pneumonia in HIV-positive patients...
February 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/27992494/application-of-bacteriophage-containing-aerosol-against-nosocomial-transmission-of-carbapenem-resistant-acinetobacter-baumannii-in-an-intensive-care-unit
#18
Yu-Huai Ho, Chun-Chieh Tseng, Lih-Shinn Wang, Yi-Ting Chen, Guan-Jin Ho, Teng-Yi Lin, Ling-Yi Wang, Li-Kuang Chen
BACKGROUND: Carbapenem-resistant Acinetobacter baumannii (CRAB) is associated with nosocomial infections worldwide. Here, we used phage as a potential agent to evaluate the efficacy of daily cleaning practices combined with a bacteriophage-containing aerosol against CRAB. METHODS: A two-phase prospective intervention study was performed at a 945-bed public teaching hospital. From March to December 2013, we performed terminal cleaning using standard procedures plus an aerosol with active bacteriophage in the intensive care units to evaluate the impact on nosocomial incidence density, carbapenem-resistance rates and antimicrobial drug consumption amounts...
2016: PloS One
https://www.readbyqxmd.com/read/27986734/how-to-measure-the-impacts-of-antibiotic-resistance-and-antibiotic-development-on-empiric-therapy-new-composite-indices
#19
Josie S Hughes, Amy Hurford, Rita L Finley, David M Patrick, Jianhong Wu, Andrew M Morris
OBJECTIVES: We aimed to construct widely useable summary measures of the net impact of antibiotic resistance on empiric therapy. Summary measures are needed to communicate the importance of resistance, plan and evaluate interventions, and direct policy and investment. DESIGN, SETTING AND PARTICIPANTS: As an example, we retrospectively summarised the 2011 cumulative antibiogram from a Toronto academic intensive care unit. OUTCOME MEASURES: We developed two complementary indices to summarise the clinical impact of antibiotic resistance and drug availability on empiric therapy...
December 16, 2016: BMJ Open
https://www.readbyqxmd.com/read/27980377/temporal-trends-of-healthcare-associated-infections-and-antimicrobial-use-in-2011-2013-observed-with-annual-point-prevalence-surveys-in-ferrara-university-hospital-italy
#20
REVIEW
P Antonioli, M C Manzalini, A Stefanati, B Bonato, A Verzola, A Formaglio, G Gabutti
INTRODUCTION: Healthcare associated infections (HAIs) and misuse of antimicrobials (AMs) represent a growing public health problem. The Point Prevalence Surveys (PPSs) find available information to be used for specific targeted interventions and evaluate their effects. The objective of this study was to estimate the prevalence of HAIs and AM use, to describe types of infections, causative pathogens and to compare data collected through three PPSs in Ferrara University Hospital (FUH), repeated in 3 different years (2011-2013)...
September 2016: Journal of Preventive Medicine and Hygiene
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