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https://www.readbyqxmd.com/read/29891594/risk-factors-for-gastrointestinal-colonization-and-acquisition-of-carbapenem-resistant-gram-negative-bacteria-among-patients-in-intensive-care-units-in-thailand
#1
Anong Kiddee, Kanit Assawatheptawee, Anamai Na-Udom, Pornpit Treebupachatsakul, Apirath Wangteeraprasert, Timothy R Walsh, Pannika R Niumsup
This study was conducted to investigate the prevalence and risk factors for carbapenem-resistant Gram-negative Bacteria (CR-GNB) colonization and acquisition among patients admitted to Intensive Care Units (ICUs) in two tertiary care hospitals in Northern Thailand. Rectal swab screening for CR-GNB was performed on patients at ICU admission and discharge. Phenotypes and genotypes of all isolates were determined. Risk factors were analyzed by logistic regression analysis. Overall, carriage rates of CR-GNB at admission was 11...
June 11, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29886788/implementation-of-a-nurse-driven-protocol-for-catheter-removal-to-decrease-catheter-associated-urinary-tract-infection-rate-in-a-surgical-trauma-icu
#2
Anna F Tyson, Eileen F Campbell, Lacey R Spangler, Samuel W Ross, Caroline E Reinke, Catherine L Passaretti, Ronald F Sing
INTRODUCTION: Early removal of urinary catheters is an effective strategy for catheter-associated urinary tract infection (CAUTI) prevention. We hypothesized that a nurse-directed catheter removal protocol would result in decreased catheter utilization and CAUTI rates in a surgical trauma intensive care unit (STICU). METHODS: We performed a retrospective, cohort study following implementation of a multimodal CAUTI prevention bundle in the STICU of a large tertiary care center...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29884118/efficacy-of-introducing-a-checklist-to-reduce-central-venous-line-associated-bloodstream-infections-in-the-icu-caring-for-adult-patients
#3
Dominic Wichmann, Cristina E Belmar Campos, Stephan Ehrhardt, Timo Kock, Claudia Weber, Holger Rohde, Stefan Kluge
BACKGROUND: Central line-associated bloodstream infections (CLABSI) are a major source of sepsis in modern intensive care medicine. Some years ago bundle interventions have been introduced to reduce CLABSI. The use of checklists may be an additional tool to improve the effect of these bundles even in highly specialized institutions. In this study we investigate if the introduction of a checklist reduces the frequency of CLABSI. METHODS: During the study period from October 2011 to September 2012, we investigated the effect of implementing a checklist for the placement of central venous lines (CVL)...
June 8, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29870854/the-impact-of-supplemental-parenteral-nutrition-early-during-critical-illness-on-invasive-fungal-infections-a-secondary-analysis-of-the-epanic-randomised-controlled-trial
#4
Greet De Vlieger, Catherine Ingels, Pieter J Wouters, Yves Debaveye, Ilse Vanhorebeek, Joost Wauters, Alexander Wilmer, Michael P Casaer, Greet Van den Berghe
OBJECTIVE: In the EPaNIC RCT (N=4,640), postponing the administration of parenteral nutrition (PN) to beyond one week in the intensive care unit (ICU) (late-PN) reduced the number of ICU-acquired infections and the costs for antimicrobial drugs as compared with initiation of PN within 24-48h of admission (early-PN). In a secondary analysis, we hypothesise that late-PN reduces the odds to acquire an invasive fungal infection (IFI) in the ICU. METHODS: The impact of late-PN (N=2,328) versus early-PN (N=2,312) on acquired IFI and on the likelihood to acquire an IFI over time was assessed in univariable and multivariable analyses...
June 2, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29870516/multicenter-study-of-device-associated-infection-rates-bacterial-resistance-length-of-stay-and-mortality-in-intensive-care-units-of-2-cities-of-vietnam-international-nosocomial-infection-control-consortium-findings
#5
Nguyen Viet Hung, Phan Thi Hang, Victor D Rosenthal, Le Thi Anh Thu, Le Thi Thu Nguyet, Ngo Quy Chau, Truong Anh Thu, Dinh Pham Phuong Anh, Tran Thi My Hanh, Tran Thi Thuy Hang, Dang Thi Van Trang, Nguyen Phuc Tien, Vo Thi Hong Thoa, Đao Quang Minh
OBJECTIVE: The aim of the study was to report the results of the International Nosocomial Infection Control Consortium (INICC) study conducted from May 2008 to March 2015. METHODS: A device-associated healthcare-acquired infection surveillance study in three adult intensive care units (ICUs) and 1 neonatal ICU from 4 hospitals in Vietnam using U.S. the Centers for Disease Control and Prevention's National Healthcare Safety Network (CDC/NHSN) definitions and criteria as well as INICC methods...
June 4, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29851765/-acute-variceal-bleeding-causes-significant-morbidity
#6
Marta Carneiro de Moura, Shiyi Chen, Binita M Kamath, Vicky Lee Ng, Simon C Ling
BACKGROUND AND AIMS: The need for primary prophylaxis of variceal bleeding in children is unclear due to insufficient evidence of the efficacy of prophylactic therapy and the mortality and morbidity associated with the first bleeding event. Previous studies have provided estimates of mortality. We aimed to investigate the morbidity associated with acute variceal bleeding (AVB) in children and to identify contributing factors. METHODS: We retrospectively reviewed children with chronic liver disease or portal vein thrombosis admitted with acute upper gastrointestinal bleeding between 2000 and 2015...
May 30, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29851032/interventions-for-necrotizing-soft-tissue-infections-in-adults
#7
REVIEW
Camille Hua, Romain Bosc, Emilie Sbidian, Nicolas De Prost, Carolyn Hughes, Patricia Jabre, Olivier Chosidow, Laurence Le Cleach
BACKGROUND: Necrotizing soft tissue infections (NSTIs) are severe and rapidly spreading soft tissue infections of the subcutaneous tissue, fascia, or muscle, which are mostly caused by bacteria. Associated rates of mortality and morbidity are high, with the former estimated at around 23%, and disability, sequelae, and limb loss occurring in 15% of patients. Standard management includes intravenous empiric antimicrobial therapy, early surgical debridement of necrotic tissues, intensive care support, and adjuvant therapies such as intravenous immunoglobulin (IVIG)...
May 31, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29808971/single-versus-divided-administration-of-intravenous-immunoglobulin-for-sepsis-a-retrospective-and-historical-control-study
#8
Kensuke Nakamura, Ryota Inokuchi, Kazutaka Fukushima, Hiromu Naraba, Yuji Takahashi, Tomohiro Sonoo, Hideki Hashimoto, Kent Doi, Naoto Morimura
BACKGROUND: Intravenous immunoglobulin (IVIG) is regarded as effective, theoretically, for sepsis. The IVIG regimen for severe infection covered by Japanese health insurance is administration of 5 g per day for three days: an extremely low dosage. We investigated its effectiveness by comparison between divided dosage and single dosage of 15 g × one day. METHODS: Patients who were admitted to our hospital's Emergency Medical Center and treated with IVIG for sepsis were included and were analyzed retrospectively...
May 28, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29807859/impact-of-an-ultraviolet-air-sterilizer-on-cardiac-surgery-patients-a-randomized-clinical-trial
#9
María Heredia-Rodríguez, Elisa Álvarez-Fuente, Juan Bustamante-Munguira, Rodrigo Poves-Alvarez, Inmaculada Fierro, Esther Gómez-Sánchez, Estefanía Gómez-Pesquera, Mario Lorenzo-López, José María Eiros, Francisco Javier Álvarez, Eduardo Tamayo
BACKGROUND: Numerous studies have evaluated the use of ultraviolet-C devices for terminal disinfection in hospitals, however, to date there is little information about the device's final impact on patients. We investigated the effect of an ultraviolet air sterilizer (UVAS) on the clinical outcomes of cardiac surgery patients. MATERIALS AND METHODS: This random, prospective and non-interventional study included 1097 adult patients undergoing elective cardiac surgery: 522 stayed in an ICU room with UVAS (Medixair® ) and 575 patients ICU room without UVAS and were used as a control...
May 25, 2018: Medicina Clínica
https://www.readbyqxmd.com/read/29801591/device-associated-nosocomial-infection-in-general-hospitals-kingdom-of-saudi-arabia-2013-2016
#10
Eiman Gaid, Abdullah Assiri, Scott McNabb, Weam Banjar
Healthcare-associated infections (HAIs) including device-associated HAI (DA-HAI) are a serious patient safety issue in hospitals worldwide, affecting 5-10% of hospitalized patients and deadly for patients in intensive care units (ICUs). (Vincent, 2003; Al-Tawfiq et al., 2013; Hu et al., 2013). DA-HAIs account for up to 23% of HAIs in ICUs and about 40% of all hospital infections (i.e. central line-associated blood stream infections [CLABSI], ventilator-associated pneumonia [VAP], and catheter-associated urinary tract infections [CAUTI])...
March 2018: Journal of Epidemiology and Global Health
https://www.readbyqxmd.com/read/29799871/cost-effectiveness-analysis-of-chlorhexidine-alcohol-versus-povidone-iodine-alcohol-solution-in-the-prevention-of-intravascular-catheter-related-bloodstream-infections-in-france
#11
Franck Maunoury, Christian Farinetto, Stéphane Ruckly, Jeremy Guenezan, Jean-Christophe Lucet, Alain Lepape, Julien Pascal, Bertrand Souweine, Olivier Mimoz, Jean-François Timsit
OBJECTIVE: To perform a cost-effectiveness analysis of skin antiseptic solutions (chlorhexidine-alcohol (CHG) versus povidone iodine-alcohol solution (PVI)) for the prevention of intravascular-catheter-related bloodstream infections (CRBSI) in intensive care unit (ICU) in France based on an open-label, multicentre, randomised, controlled trial (CLEAN). DESIGN: A 100-day time semi-markovian model was performed to be fitted to longitudinal individual patient data from CLEAN database...
2018: PloS One
https://www.readbyqxmd.com/read/29782519/increased-circulating-microrna-122-is-a-biomarker-for-discrimination-and-risk-stratification-in-patients-defined-by-sepsis-3-criteria
#12
Tim Rahmel, Simon T Schäfer, Ulrich H Frey, Michael Adamzik, Jürgen Peters
BACKGROUND: Sepsis is now operationally defined as life-threatening organ dysfunction caused by an infection, identified by an acute change in SOFA-Score of at least two points, including clinical chemistry such as creatinine or bilirubin concentrations. However, little knowledge exists about organ-specific microRNAs as potentially new biomarkers. Accordingly, we tested the hypotheses that micro-RNA-122, the foremost liver-related micro-RNA (miR), 1) discriminates between sepsis and infection, 2) is an early predictor for mortality, and 3) improves the prognostic value of the SOFA-score...
2018: PloS One
https://www.readbyqxmd.com/read/29777534/is-it-necessary-to-have-a-dentist-within-an-intensive-care-unit-team-report-of-a-randomised-clinical-trial
#13
Wanessa Teixeira Bellissimo-Rodrigues, Mayra Gonçalves Menegueti, Gilberto Gambero Gaspar, Hayala Cristina Cavenague de Souza, Maria Auxiliadora-Martins, Anibal Basile-Filho, Roberto Martinez, Fernando Bellissimo-Rodrigues
OBJECTIVE: To evaluate the effectiveness of dental treatment in improving oral health in critical patients. METHODS: This randomised clinical trial was conducted in a general intensive care unit (ICU) at a tertiary care public facility from 1 January 2011 to 8 August 2013. Data from 254 adult patients staying in the ICU for 48 hours or more were analysed. The experimental group (n = 127) had access to dental treatment provided by a dentist four to five times a week, in addition to routine oral hygiene, whereas the control group (n = 127) had access only to routine oral hygiene, including topical application of chlorhexidine, provided by the ICU nursing staff...
May 18, 2018: International Dental Journal
https://www.readbyqxmd.com/read/29770752/ventilator-bundle-compliance-and-risk-of-ventilator-associated-events
#14
Bryan D Harris, Gale A Thomas, Matthew H Greene, Steven S Spires, Thomas R Talbot
OBJECTIVEVentilator bundles encompass practices that reduce the risk of ventilator complications, including ventilator-associated pneumonia. The impact of ventilator bundles on the risk of developing ventilator-associated events (VAEs) is unknown. We sought to determine whether decreased compliance to the ventilator bundle increases the risk for VAE development.DESIGNNested case-control study.SETTINGThis study was conducted at 6 adult intensive care units at an academic tertiary-care center in Tennessee.PATIENTSIn total, 273 patients with VAEs were randomly matched in a 1:4 ratio to controls by mechanical ventilation duration and ICU type...
June 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29763777/incorporation-of-point-of-care-ultrasound-into-morning-round-is-associated-with-improvement-in-clinical-outcomes-in-critically-ill-patients-with-sepsis
#15
Zhonghua Chen, Yucai Hong, Junru Dai, Lifeng Xing
OBJECTIVES: Point-of-care ultrasound (POCUS) has been widely used in the intensive care unit (ICU). However, it is largely unknown whether the use of POCUS is associated with improved patient-important outcomes. The study aimed to investigate whether incorporation of POCUS during morning round on a routine basis was able to improve clinical outcomes in critically ill patients with sepsis. DESIGN: It was a prospective observational study. SETTING: A tertiary care emergency intensive care unit...
May 11, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#16
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29751127/temporal-trends-and-patterns-in-antimicrobial-resistant-gram-negative-bacteria-implicated-in-intensive-care-unit-acquired-infections-a-cohort-based-surveillance-study-in-istanbul-turkey
#17
Bulent Durdu, Evangelos I Kritsotakis, Andrew C K Lee, Perihan Torun, Ismail N Hakyemez, Bilge Gultepe, Turan Aslan
OBJECTIVES: This study assessed trends and patterns in antimicrobial resistant intensive care unit (ICU)-acquired infections caused by Gram-negative bacteria (GNB) in Istanbul, Turkey. METHODS: Bacterial culture and antibiotic susceptibility data were collected for all GNB causing nosocomial infections in five adult ICUs of a large university hospital during 2012-2015. Multi-resistance patterns were categorised as multidrug (MDR), extensively-drug (XDR) and pandrug (PDR)-resistance...
May 8, 2018: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29735825/high-level-aminoglycoside-resistance-in-acinetobacter-baumannii-recovered-from-intensive-care-unit-patients-in-northeastern-india
#18
Supriya Upadhyay, Annie Bakorlin Khyriem, Prithwis Bhattacharya, Amitabha Bhattacharjee, Santa Ram Joshi
Background: Acinetobacter baumannii has emerged as an important nosocomial pathogen, its ability to acquire resistance to carbapenems and aminoglycosides, has complicated their treatment regimen. The present study investigates the prevalence and diversity of aminoglycoside-modifying enzymes and 16S methyltransferases in A. baumannii isolates recovered from patients admitted in Intensive Care Unit (ICU) of a tertiary referral hospital in Northeastern India. Materials and Methods: We investigated the high-level aminoglycoside-resistance (HLAR) (gentamicin and amikacin minimum inhibitory concentration ≥ 512 μg/ml) among 164 multidrug-resistant A...
January 2018: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29730473/the-intensive-care-unit-icu-course-and-outcome-in-acute-on-chronic-liver-failure-are-comparable-to-other-populations
#19
Philippe Meersseman, Lies Langouche, Johannie du Plessis, Hannelie Korf, Michaël Mekeirele, Wim Laleman, Frederik Nevens, Alexander Wilmer, Greet Van den Berghe, Schalk W van der Merwe
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation of cirrhosis, development of organ failure and high short term mortality. Whether the outcome in ACLF patients admitted to the ICU with organ failure differs from other ICU populations is unknown. We compared the clinical course and host response in ICU patients with or without ACLF, matched for baseline severity of illness scores and characteristics. METHODS: From the large prospective EPaNIC randomized control trial database (n=4640), 133 patients were identified with cirrhosis of whom 71 fulfilled the CLIF criteria for ACLF...
May 3, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29716584/clinicians-attitude-towards-a-placebo-controlled-randomised-clinical-trial-investigating-the-effect-of-neuraminidase-inhibitors-in-adults-hospitalised-with-influenza
#20
Naomi Bradbury, Jonathan Nguyen-Van-Tam, Wei Shen Lim
BACKGROUND: The value of neuraminidase inhibitors (NAIs) in reducing severe clinical outcomes from influenza is debated. A clinical trial to generate better evidence is desirable. However, it is unknown whether UK clinicians would support a placebo-controlled trial. A survey was conducted to determine the attitude of clinicians towards a clinical trial and their current practice in managing adults admitted to hospital with suspected influenza. METHODS: Senior clinicians (n = 50) across the UK actively involved in the care of patients hospitalised with severe respiratory infections and/or respiratory infection research were invited to participate in an on-line survey...
May 2, 2018: BMC Health Services Research
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