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infections controll in ICU

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https://www.readbyqxmd.com/read/29229490/pseudomonas-aeruginosa-intensive-care-unit-outbreak-winnowing-of-transmissions-with-molecular-and-genomic-typing
#1
Benjamin J Parcell, Katarina Oravcova, Miguel Pinheiro, Matthew T G Holden, Gabby Phillips, Jane F Turton, Stephen H Gillespie
BACKGROUND: Pseudomonas aeruginosa healthcare outbreaks can be time consuming and difficult to investigate. Guidance does not specify which typing technique is most practical to base decisions on. AIM: We explore the usefulness of whole genome sequencing (WGS) in the investigation of a Pseudomonas aeruginosa outbreak describing how it compares with pulsed-field gel electrophoresis (PFGE) and variable number tandem repeat (VNTR) analysis. METHODS: Six patient isolates and six environmental samples from an Intensive Care Unit (ICU) positive for P...
December 8, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29215330/quantifying-hospital-acquired-carriage-of-extended-spectrum-beta-lactamase-producing-enterobacteriaceae-among-patients-in-dutch-hospitals
#2
Marjolein F Q Kluytmans-van den Bergh, Suzan P van Mens, Manon R Haverkate, Martin C J Bootsma, Jan A J W Kluytmans, Marc J M Bonten
BACKGROUND Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are emerging worldwide. Contact precautions are recommended for known ESBL-E carriers to control the spread of ESBL-E within hospitals. OBJECTIVE This study quantified the acquisition of ESBL-E rectal carriage among patients in Dutch hospitals, given the application of contact precautions. METHODS Data were used from 2 cluster-randomized studies on isolation strategies for ESBL-E: (1) the SoM study, performed in 14 Dutch hospitals from 2011 through 2014 and (2) the R-GNOSIS study, for which data were limited to those collected in a Dutch hospital in 2014...
December 7, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29214175/what-healthcare-workers-should-know-about-environmental-bacterial-contamination-in-the-intensive-care-unit
#3
REVIEW
Vincenzo Russotto, Andrea Cortegiani, Teresa Fasciana, Pasquale Iozzo, Santi Maurizio Raineri, Cesare Gregoretti, Anna Giammanco, Antonino Giarratano
Intensive care unit- (ICU-) acquired infections are a major health problem worldwide. Inanimate surfaces and equipment contamination may play a role in cross-transmission of pathogens and subsequent patient colonization or infection. Bacteria contaminate inanimate surfaces and equipment of the patient zone and healthcare area, generating a reservoir of potential pathogens, including multidrug resistant species. Traditional terminal cleaning methods have limitations. Indeed patients who receive a bed from prior patient carrying bacteria are exposed to an increased risk (odds ratio 2...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29208754/proactive-use-of-high-flow-nasal-cannula-with-critically-ill-subjects
#4
Keith D Lamb, Sarah K Spilman, Trevor W Oetting, Julie A Jackson, Matthew W Trump, Sheryl M Sahr
INTRODUCTION: It has been suggested that use of a high-flow nasal cannula (HFNC) could be a first-line therapy for patients with acute hypoxic respiratory failure. The purpose of this study was to determine if protocolized use of HFNC decreases unplanned intubation and adverse outcomes in an ICU population. METHODS: The study was a prospective evaluation of 2 cohorts who received HFNC per protocol. Control groups were retrospective selections of subjects who received HFNC in the pre-protocol period...
December 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29181195/survey-of-extent-of-translation-of-oral-healthcare-guidelines-for-icu-patients-into-clinical-practice-by-nursing-staff
#5
Vivek Agarwal, Rameshwari Singhal, Richa Khanna, Pavitra Rastogi, Avinash Agarwal, Shuchi Tripathi
Nosocomial infections in critically ill/ventilated patients result from bacterial load in oropharyngeal regions. Oral decontamination serves as the easiest effective means of controlling infections. Knowledge, attitude, and practices followed by healthcare personnel in intensive care settings need to be assessed to implement concrete measures in health-care. Survey questionnaire was constructed and implemented following its validation on seventy nursing and paramedical staff working in government and private intensive care units throughout Lucknow city...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29172401/management-of-carbapenem-resistant-acinetobacter-baumannii-epidemic-in-an-intensive-care-unit-using-multifaceted-intervention-strategy
#6
Jeongmin Hong, Ok Jeom Jang, Mi Hui Bak, Eun Hwa Baek, Ki-Ho Park, Sun In Hong, Oh-Hyun Cho, In-Gyu Bae
Background/Aims: We evaluated the effects of a multifaceted intervention for controlling a carbapenem-resistant Acinetobacter baumannii (CRAB) epidemic in an intensive care unit (ICU) with no restrictions on carbapenem use. Methods: This study was conducted in a medical ICU between April 2012 and June 2016. The baseline infection control programs included surveillance cultures, contact precautions, and environmental cleaning. However, increases in the detection of CRAB isolates beginning in May 2013 led to the implementation of a new protocol, consisting of universal glove and gown use with daily chlorhexidine bathing for all patients in combination with baseline programs...
November 27, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29169425/-establishment-of-acinetobacter-baumannii-induced-pneumonia-model-in-mice
#7
Yimin Zhang, Xuening Zhou, Hongfang Zhang, Cheng Huan, Zhengrong Ye
Objective To establish Acinetobacter baumannii (A. baumannii)-induced pneumonia models in C57BL/6 mice, and study the molecule mechanism of A. baumannii infection. Methods Eighty C57BL/6 mice were divided into normal control group, cyclophosphamide-treated group, A. baumannii infection group, and cyclophosphamide-pretreated A. baumannii infection group. Immunodeficient mice were prepared by injecting cyclophosphamide intraperitoneally. A. baumannii was isolated from intensive care unit (ICU) and fresh bacteria (1×10(8) CFU/mL) were prepared...
October 2017: Xi Bao Yu Fen Zi Mian Yi Xue za Zhi, Chinese Journal of Cellular and Molecular Immunology
https://www.readbyqxmd.com/read/29168046/procalcitonin-guided-antibiotic-therapy-in-intensive-care-unit-patients-a-systematic-review-and-meta-analysis
#8
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/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/29158918/challenges-with-surveillance-of-healthcare-associated-infections-in-intensive-care-units-in-south-africa
#10
Saajida Mahomed, Ozayr Mahomed, A Willem Sturm, Stephen Knight, Prashini Moodley
Background: The incidence of healthcare-associated infections (HAIs) in the public health sector in South Africa is not known due to the lack of a surveillance system. We report on the challenges experienced in the implementation of a surveillance system for HAIs in intensive care units (ICUs). Methods: A passive, paper-based surveillance system was piloted in eight ICUs to measure the incidence of ventilator-associated pneumonia, catheter-associated urinary tract infection, and central line-associated bloodstream infection...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29151417/-effect-of-early-use-of-different-doses-of-enteral-nutrition-on-prognosis-of-patients-with-acute-respiratory-failure
#11
Jianting Gao, Qiuyan Wang
OBJECTIVE: To observe the impact of initial low-dose (trophic type) enteral nutrition (EN) support on mechanical ventilation (MV) time, the incidence of complications and survival rate in patients with acute respiratory failure (ARF). METHODS: A prospective study was conducted. Forty-four patients with ARF undergoing MV admitted to Department of Critical Care Medicine of Hangzhou Traditional Chinese Medical Hospital from September 2015 to February 2017 were enrolled, and they were divided into a trophic feeding group (n = 23, study group) and a standard-dose feeding group (n = 21, control group)...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29143704/identification-of-clostridium-difficile-reservoirs-in-the-patient-environment-and-efficacy-of-aerial-hydrogen-peroxide-decontamination
#12
Samuel Yui, Shanom Ali, Monika Muzslay, Annette Jeanes, A Peter R Wilson
OBJECTIVE To identify, using a novel enhanced method of recovery, environmental sites where spores of Clostridium difficile persist despite cleaning and hydrogen peroxide aerial decontamination. DESIGN Cohort study. SETTING Tertiary referral center teaching hospital. METHODS In total, 16 sites representing high-frequency contact or difficult-to-clean surfaces in a single-isolation room or bed area in patient bed bays were sampled before and after terminal or hydrogen peroxide disinfection using a sponge swab...
November 16, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29140969/risk-factors-for-ventilator-associated-events-in-a-picu
#13
Raeley Guess, Jarin Vaewpanich, Jorge A Coss-Bu, Siriporn Phongjitsiri, Curtis Kennedy, Jeffrey Starke, Satid Thammasitboon
OBJECTIVE: The term ventilator-associated events includes ventilator-associated condition, infection-related ventilator-associated complication, and ventilator-associated pneumonia. We sought to identify potential new risk factors for ventilator-associated condition and infection-related ventilator-associated complication in the PICU population. DESIGN: Matched case control study. SETTING: Children's hospital at a tertiary care academic medical center...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29130231/-effect-of-postoperative-hyperglycemia-on-clinical-outcome-of-gastrointestinal-fistula-patients-undergoing-gastrointestinal-reconstruction
#14
Qiongyuan Hu, Jian'an Ren, Wenhao Tang, Jieshou Li
OBJECTIVE: To investigate the effect of hyperglycemia within postoperative 48 hours on gastrointestinal (GI) fistula patients without preoperative diagnosis of diabetes undergoing selective GI reconstruction. METHODS: Clinical data of GI fistula patients with age of 18 to 70 years and without diffuse peritonitis and systemic infection undergoing definitive GI reconstruction at Intestinal Fistula Center of Jinling Hospital from September 2012 to December 2015 were retrospectively analyzed...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29128300/enteral-versus-parenteral-early-nutrition-in-ventilated-adults-with-shock-a-randomised-controlled-multicentre-open-label-parallel-group-study-nutrirea-2
#15
Jean Reignier, Julie Boisramé-Helms, Laurent Brisard, Jean-Baptiste Lascarrou, Ali Ait Hssain, Nadia Anguel, Laurent Argaud, Karim Asehnoune, Pierre Asfar, Frédéric Bellec, Vlad Botoc, Anne Bretagnol, Hoang-Nam Bui, Emmanuel Canet, Daniel Da Silva, Michael Darmon, Vincent Das, Jérôme Devaquet, Michel Djibre, Frédérique Ganster, Maité Garrouste-Orgeas, Stéphane Gaudry, Olivier Gontier, Claude Guérin, Bertrand Guidet, Christophe Guitton, Jean-Etienne Herbrecht, Jean-Claude Lacherade, Philippe Letocart, Frédéric Martino, Virginie Maxime, Emmanuelle Mercier, Jean-Paul Mira, Saad Nseir, Gael Piton, Jean-Pierre Quenot, Jack Richecoeur, Jean-Philippe Rigaud, René Robert, Nathalie Rolin, Carole Schwebel, Michel Sirodot, François Tinturier, Didier Thévenin, Bruno Giraudeau, Amélie Le Gouge
BACKGROUND: Whether the route of early feeding affects outcomes of patients with severe critical illnesses is controversial. We hypothesised that outcomes were better with early first-line enteral nutrition than with early first-line parenteral nutrition. METHODS: In this randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2 trial) done at 44 French intensive-care units (ICUs), adults (18 years or older) receiving invasive mechanical ventilation and vasopressor support for shock were randomly assigned (1:1) to either parenteral nutrition or enteral nutrition, both targeting normocaloric goals (20-25 kcal/kg per day), within 24 h after intubation...
November 8, 2017: Lancet
https://www.readbyqxmd.com/read/29127842/budesonide-facilitates-weaning-from-mechanical-ventilation-in-difficult-to-wean-very-severe-copd-patients-association-with-inflammatory-mediators-and-cells
#16
Seyed Mohammadreza Hashemian, Esmaeil Mortaz, Hamidreza Jamaati, Leila Bagheri, Seyed Amir Mohajerani, Johan Garssen, Masoud Movassaghi, Peter J Barnes, Nicholas S Hill, Ian M Adcock
INTRODUCTION: Mechanical ventilatory support is life-saving therapy for patients with respiratory failure in intensive care units (ICU) but is linked to ventilator-associated pneumonia and other nosocomial infections. Interventions that improve the efficiency of weaning from mechanical ventilation may improve patient outcomes. OBJECTIVE: To determine whether inhaled budesonide decreases time-to-weaning in COPD stage 4 difficult-to-wean patients and reduces the release of pro-inflammatory cytokines in ICU patients...
October 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29126595/burn-patients-with-infection-related-ventilator-associated-complications-have-worse-outcomes-compared-to-those-without-ventilator-associated-events
#17
Duraid Younan, Russell Griffin, Ahmed Zaky, Jean-Francois Pittet, Bernard Camins
BACKGROUND: The Centers for Disease Control and Prevention (CDC) replaced its definition for ventilator-associated pneumonia (VAP) in 2013. The aim of the current study is to compare the outcome of burn patients with ventilator associated events (VAEs). METHODS: Burn patients with at least two days of ventilator support were identified from the registry between 2013 and 2016. Kruskal-Wallis and Fisher's exact tests were utilized for continuous and categorical variables, respectively...
October 31, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29123370/assessing-hand-hygiene-compliance-among-healthcare-workers-in-six-intensive-care-units
#18
REVIEW
M Musu, A Lai, N M Mereu, M Galletta, M Campagna, M Tidore, M F Piazza, L Spada, M V Massidda, S Colombo, P Mura, R C Coppola
Introduction: Healthcare associated infections (HAIs) are a cause of high morbidity, disability and reduced quality of life, as well as mortality and rising costs for health systems. Preventing the HAI risk by planning and implementing effective preventive strategies is important to safeguard patient health. Methods: The study aimed to evaluate the presence of procedures and protocols for infection control, to assess the adhesion to the different aspects of hand hygiene (HH) and hand washing technique by healthcare workers in six ICUs...
September 2017: Journal of Preventive Medicine and Hygiene
https://www.readbyqxmd.com/read/29122787/effect-of-daily-antiseptic-body-wash-with-octenidine-on-nosocomial-primary-bacteraemia-and-nosocomial-multidrug-resistant-organisms-in-intensive-care-units-design-of-a-multicentre-cluster-randomised-double-blind-cross-over-study
#19
Anne Meißner, Dirk Hasenclever, Oana Brosteanu, Iris Freya Chaberny
INTRODUCTION: Nosocomial infections are serious complications that increase morbidity, mortality and costs and could potentially be avoidable. Antiseptic body wash is an approach to reduce dermal micro-organisms as potential pathogens on the skin. Large-scale trials with chlorhexidine as the antiseptic agent suggest a reduction of nosocomial infection rates. Octenidine is a promising alternative agent which could be more effective against Gram-negative organisms. We hypothesise that daily antiseptic body wash with octenidine reduces the risk of intensive care unit (ICU)-acquired primary bacteraemia and ICU-acquired multidrug-resistant organisms (MDRO) in a standard care setting...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29113779/hospital-acquired-lower-respiratory-tract-infections-among-high-risk-hospitalized-patients-in-a-tertiary-care-teaching-hospital-in-china-an-economic-burden-analysis
#20
Tianyuan Yan, Yingxia Li, Yu Sun, Haiyan Wang, Jingna Wang, Weili Wang, Yunhong Liu, Xiaohui Wu, Shuhui Wang
BACKGROUND: Data on the economic burden of hospital-acquired lower respiratory tract infection (LRTI) among high risk hospitalized patients are lacking in China. This study aims to fill this knowledge gap. METHODS: We used a prospective matched cohort design, comparing patients with LRTIs and 1:1 matched patients without LRTIs. Study period was from January 2013 to December 2015 analyzing inpatients from high risk wards - intensive care unit (ICU), dialysis, hematology, etc...
November 4, 2017: Journal of Infection and Public Health
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