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https://www.readbyqxmd.com/read/29458065/nosocomial-ventriculitis-caused-by-a-meticillin-and-linezolid-resistant-clone-of-staphylococcus-epidermidis-in-neurosurgical-patients
#1
Carlos Rodríguez-Lucas, Javier Fernández, José Antonio Boga, Lucia López-Amor, Lorena Forcelledo, Eva Lázaro-López, M Rosario Rodicio
BACKGROUND: Post-neurosurgical ventriculitis is mainly caused by coagulase-negative staphylococci. The rate of linezolid resistant S. epidermidis (LRSE) is increasing worldwide. AIMS: To report clinical and microbiological data from a series of ventriculitis cases caused by LRSE in a Spanish hospital between 2013 and 2016. METHODS: LRSE ventriculitis cases were retrospectively reviewed in a Spanish hospital during a four-year period. Clinical/epidemiological data of the infected patients were reviewed, the isolates involved were typed by PFGE and MLST, and the molecular basis of linezolid resistance was determined...
February 16, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29454824/candida-albicans-biology-molecular-characterization-pathogenicity-and-advances-in-diagnosis-and-control-an-update
#2
REVIEW
Maryam Dadar, Ruchi Tiwari, Kumaragurubaran Karthik, Sandip Chakraborty, Youcef Shahali, Kuldeep Dhama
Candida albicans is an emerging multidrug-resistant fungal pathogen representing an important source of invasive disease in humans and generating high healthcare costs worldwide. This fungus is frequently found in different anatomical sites of healthy persons and could induce systemic and superficial infections under optimal environmental conditions. Invasive candidiasis (IC) is an important nosocomial infection with high morbidity and mortality rates in hospitalized children. It represents a major source of prolonged infections in intensive care unit (ICU), particularly in immunosuppressed or elderly patients...
February 15, 2018: Microbial Pathogenesis
https://www.readbyqxmd.com/read/29449171/changes-in-antimicrobial-susceptibility-of-commonly-clinically-significant-isolates-before-and-after-the-interventions-on-surgical-prophylactic-antibiotics-spas-in-shanghai
#3
Su Wang, Li-Zhong Han, Yu-Xing Ni, Yi-Bo Zhang, Qun Wang, Da-Ke Shi, Wen-Hui Li, Yi-Chen Wang, Chen-Rong Mi
Surveillances and interventions on antibiotics use have been suggested to improve serious drug-resistance worldwide. Since 2007, our hospital have proposed many measures for regulating surgical prophylactic antibiotics (carbapenems, third gen. cephalosporins, vancomycin, etc.) prescribing practices, like formulary restriction or replacement for surgical prophylactic antibiotics and timely feedback. To assess the impacts on drug-resistance after interventions, we enrolled infected patients in 2006 (pre-intervention period) and 2014 (post-intervention period) in a tertiary hospital in Shanghai...
February 12, 2018: Brazilian Journal of Microbiology: [publication of the Brazilian Society for Microbiology]
https://www.readbyqxmd.com/read/29447024/microbiology-and-clinical-outcomes-of-puerperal-sepsis-a-prospective-cohort-study
#4
Rumbidzai Majangara, Muchabayiwa Francis Gidiri, Zvavahera Mike Chirenje
The objectives of this study were to determine the identity and antibacterial susceptibility profiles of bacteria colonising the female genital tract and blood stream and their association with clinical outcomes in women with puerperal sepsis. A prospective descriptive cohort study was conducted at two tertiary hospitals in Zimbabwe. Endocervical swabs and blood were collected for culture and susceptibility testing from 151 consecutive women who met the World Health Organisation criteria for puerperal sepsis...
February 15, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29438544/emergence-and-control-of-linezolid-resistant-staphylococcus-epidermidis-in-an-icu-of-a-german-hospital
#5
Christina Weßels, Birgit Strommenger, Ingo Klare, Jennifer Bender, Sabine Messler, Frauke Mattner, Michael Krakau, Guido Werner, Franziska Layer
Objectives: To investigate an outbreak of linezolid-resistant Staphylococcus epidermidis (LRSE) in an interdisciplinary ICU, linezolid consumption and infection control measures taken. Methods: Routine surveillance of nosocomial infections revealed colonization and infection with LRSE affecting 14 patients during a 15 month period. LRSE isolates were analysed with respect to their clonal relatedness, antimicrobial susceptibility, the presence of cfr and/or mutations in the 23S rRNA, rplC, rplD and rplV genes...
February 9, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29432350/an-exploratory-reanalysis-of-the-randomized-trial-on-efficacy-of-corticosteroids-as-rescue-therapy-for-the-late-phase-of-acute-respiratory-distress-syndrome
#6
G Umberto Meduri, Lisa Bridges, Reed A C Siemieniuk, Mehmet Kocak
OBJECTIVES: In the Acute Respiratory Distress Syndrome Network randomized controlled trial, methylprednisolone treatment was associated with increased return to mechanical ventilation with partial loss of early improvements. We hypothesize a causal relationship between protocol-driven rapid discontinuation of methylprednisolone post extubation and return to mechanical ventilation. To explore this possibility, we investigated the timing that events occurred in each treatment arm during active treatment intervention (efficacy) and after stopping therapy...
February 9, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29429570/outcomes-for-haematological-cancer-patients-admitted-to-an-intensive-care-unit-in-a-university-hospital
#7
Emine Alp, Tuğba Tok, Leylagül Kaynar, Fatma Cevahir, İsmail Hakkı Akbudak, Kürşat Gündoğan, Mustafa Çetin, Jordi Rello
BACKGROUND: Haematological cancer (HC) patients are increasingly requiring intensive care (ICUs). The aim of this study was to investigate the outcome of HC patients in our ICU and evaluate 5 days-full support as a breakpoint for patients' re-assessment for support. METHODS: Retrospective study enrolling 112 consecutive HC adults, requiring ICU in January-December 2015. Patients' data were collected from medical records and Infection Control Committee surveillance reports...
February 8, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29427997/impact-of-the-international-nosocomial-infection-control-consortium-inicc-s-multidimensional-approach-on-rates-of-central-line-associated-bloodstream-infection-in-14-intensive-care-units-in-11-hospitals-of-5-cities-in-argentina
#8
Victor Daniel Rosenthal, Javier Desse, Diego Marcelo Maurizi, Gustavo Jorge Chaparro, Pablo Wenceslao Orellano, Viviana Chediack, Rafael Cabrera, Daniel Golschmid, Cristina Graciela Silva, Julio Cesar Vimercati, Juan Pablo Stagnaro, Ivanna Perez, María Laura Spadaro, Adriana Miriam Montanini, Dina Pedersen, Teresa Laura Paniccia, Ana María Ríos Aguilera, Raul Cermesoni, Juan Ignacio Mele, Ernesto Alda, Analía Edith Paldoro, Agustín Román Ortta, Bettina Cooke, María Cecilia García, Mora Nair Obed, Cecilia Verónica Domínguez, Pablo Alejandro Saúl, María Cecilia Rodríguez Del Valle, Alberto Claudio Bianchi, Gustavo Alvarez, Ricardo Pérez, Carolina Oyola
OBJECTIVE To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and the INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in 14 intensive care units (ICUs) in Argentina from January 2014 to April 2017. DESIGN This prospective, pre-post surveillance study of 3,940 ICU patients was conducted in 11 hospitals in 5 cities in Argentina. During our baseline evaluation, we performed outcome and process surveillance of CLABSI applying Centers for Disease Control and Prevention/National Health Safety Network (CDC/NHSN) definitions...
February 12, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29426705/is-a-project-needed-to-prevent-urinary-tract-infection-in-patients-admitted-to-spanish-icus
#9
F Álvarez Lerma, P Olaechea Astigarraga, X Nuvials, R Gimeno, M Catalán, M P Gracia Arnillas, I Seijas Betolaza, M Palomar Martínez
OBJECTIVE: To analyze epidemiological data of catheter-associated urinary tract infection (CAUTI) in critically ill patients admitted to Spanish ICUs in order to assess the need of implementing a nationwide intervention program to reduce these infections. DESIGN: Non-intervention retrospective annual period prevalence analysis. SETTING: Participating ICUs in the ENVIN-UCI multicenter registry between the years 2007-2016. PATIENTS: Critically ill patients admitted to the ICU with catheter-associated urinary tract infection (CAUTI)...
February 6, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29425465/excess-mucin-impairs-subglottic-epithelial-host-defense-in-mechanically-ventilated-patients
#10
Jason Powell, James Garnett, Michael W Mather, Faye A H Cooles, Andrew Nelson, Bernard Verdon, Jon Scott, Kasim Jiwa, Marie-Hélène Ruchaud-Sparagano, Stephen P Cummings, John D Perry, Stephen E Wright, Janet A Wilson, Jeffrey Pearson, Chris Ward, A John Simpson
RATIONALE: Aspiration of infective subglottic secretions causes ventilator-associated pneumonia (VAP) in mechanically ventilated patients. Mechanisms underlying subglottic colonization in critical illness have not been defined, limiting strategies for targeted prevention of VAP. OBJECTIVES: To characterize subglottic host defense dysfunction in mechanically ventilated patients in the intensive care unit (ICU). To determine whether subglottic mucin contributes to neutrophil phagocytic impairment and bacterial growth...
February 9, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29422729/outcome-of-patients-admitted-to-a-tertiary-referral-intensive-care-unit-with-urosepsis-needing-source-control
#11
Chaitra C Rao, Pradeep Rangappa, Karthik Rao, Ipe Jacob
Introduction: Urosepsis is one of the common causes of admission to the Intensive Care Unit (ICU). It has traditionally been treated with antibiotics, but surgical management with Double J [DJ] ureteral stents is gaining popularity. This study compares patients with complicated urosepsis who underwent surgical source control by ureteral stenting with those managed medically. Materials and Methods: The study enrolled patients admitted to a tertiary adult ICU with a diagnosis of urosepsis over a period of 2 years...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29422171/strict-versus-liberal-insulin-therapy-in-the-cardiac-surgery-patient-an-evidence-based-practice-development-implementation-and-evaluation-project
#12
Jacqueline M Gordon, Lori S Lauver, Harleah G Buck
BACKGROUND: Hyperglycemia post-cardiac surgery is associated with poor clinical outcomes. Recent studies suggest maintaining liberal glycemic control (<180mg/dL) using a continuous insulin infusion (CII) versus strict control achieves optimal outcomes and prevents hypoglycemia. PURPOSE: To develop, implement and evaluate a nurse managed liberal CII protocol. METHODS: Retrospective review of 144 strict CII patient records and 147 liberal CII patient records...
February 2018: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29410029/sustained-multimodal-antimicrobial-stewardship-in-an-australian-tertiary-intensive-care-unit-from-2008-2015-an-interrupted-time-series-analysis
#13
Suman Adhikari, Michael Piza, Peter Taylor, Kush Deshpande, Doris Lam, Pam Konecny
The long term outcomes and sustainability of antimicrobial stewardship (AMS) in the intensive care unit (ICU) require evaluation. This study analysed the effect of a multimodal ICU AMS introduced in a 15-bed medical-surgical tertiary Australian adult ICU in November, 2008, with interrupted time-series analysis of antibiotic usage, resistance and cost from November 2005-October 2015, including national ICU average usage as a control. Overall ICU mortality, 30-day blood stream infection (BSI) mortality and length of stay (LOS) were compared over the same period...
January 30, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29409518/performance-of-the-quick-sequential-sepsis-related-organ-failure-assessment-score-as-a-prognostic-tool-in-infected-patients-outside-the-intensive-care-unit-a-systematic-review-and-meta-analysis
#14
Jae-Uk Song, Cheol Kyung Sin, Hye Kyeong Park, Sung Ryul Shim, Jonghoo Lee
BACKGROUND: The usefulness of the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) score in providing bedside criteria for early prediction of poor outcomes in patients with suspected infection remains controversial. We investigated the prognostic performance of a positive qSOFA score outside the intensive care unit (ICU) compared with positive systemic inflammatory response syndrome (SIRS) criteria. METHODS: A systematic literature search was performed using MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials...
February 6, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29402370/-impact-of-permissive-underfeeding-versus-standard-enteral-feeding-on-outcomes-in-critical-patients-requiring-mechanical-ventilation-a-prospective-randomized-controlled-study
#15
Nianbin Ma, Mingfu Shen, Zhen Wan, Sijun Pan, Xian Liu, Zhongxiang Yao
OBJECTIVE: To compare the impact of permissive underfeeding versus standard enteral feeding on outcomes in critical patients requiring mechanical ventilation (MV). METHODS: A prospective randomized controlled study was conducted. Eighty-two patients requiring MV admitted to intensive care unit (ICU) of Anji People's Hospital from January 2015 to March 2017 were enrolled, and they were randomly divided into the permissive underfeeding group (n = 40, non-protein heat was 52...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29388048/pharmacogenomic-biomarkers-do-not-predict-response-to-drotrecogin-alfa-in-patients-with-severe-sepsis
#16
Djillali Annane, Jean-Paul Mira, Lorraine B Ware, Anthony C Gordon, Charles J Hinds, David C Christiani, Jonathan Sevransky, Kathleen Barnes, Timothy G Buchman, Patrick J Heagerty, Robert Balshaw, Nadia Lesnikova, Karen de Nobrega, Hugh F Wellman, Mauricio Neira, Alexandra D J Mancini, Keith R Walley, James A Russell
PURPOSE: To explore potential design for pharmacogenomics trials in sepsis, we investigate the interaction between pharmacogenomic biomarkers and response to drotrecogin alfa (activated) (DrotAA). This trial was designed to validate whether previously identified improved response polymorphisms (IRPs A and B) were associated with an improved response to DrotAA in severe sepsis. METHODS: Patients with severe sepsis at high risk of death, who received DrotAA or not, with DNA available were included and matched to controls adjusting for age, APACHE II or SAPS II, organ dysfunction, ventilation, medical/surgical status, infection site, and propensity score (probability that a patient would have received DrotAA given their baseline characteristics)...
January 31, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29387343/multi-drug-resistant-acinetobacter-species-a-seven-year-experience-from-a-tertiary-care-center-in-lebanon
#17
Zeina A Kanafani, Nada Zahreddine, Ralph Tayyar, Jad Sfeir, George F Araj, Ghassan M Matar, Souha S Kanj
Background: Acinetobacter species have become increasingly common in the intensive care units (ICU) over the past two decades, causing serious infections. At the American University of Beirut Medical Center, the incidence of multi-drug resistant Acinetobacter baumannii (MDR-Ab) infections in the ICU increased sharply in 2007 by around 120%, and these infections have continued to cause a serious problem to this day. Methods: We conducted a seven-year prospective cohort study between 2007 and 2014 in the ICU...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29382400/comparative-antimicrobial-efficacy-of-two-hand-sanitizers-in-intensive-care-units-common-areas-a-randomized-controlled-trial
#18
Abhishek Deshpande, Jacqueline Fox, Ken Koon Wong, Jennifer L Cadnum, Thriveen Sankar, Annette Jencson, Sarah Schramm, Thomas G Fraser, Curtis J Donskey, Steven Gordon
OBJECTIVE Contaminated hands of healthcare workers (HCWs) are an important source of transmission of healthcare-associated infections. Alcohol-based hand sanitizers, while effective, do not provide sustained antimicrobial activity. The objective of this study was to compare the immediate and persistent activity of 2 hand hygiene products (ethanol [61% w/v] plus chlorhexidine gluconate [CHG; 1.0% solution] and ethanol only [70% v/v]) when used in an intensive care unit (ICU). DESIGN Prospective, randomized, double-blinded, crossover study SETTING Three ICUs at a large teaching hospital PARTICIPANTS In total, 51 HCWs involved in direct patient care were enrolled in and completed the study...
January 31, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29374504/the-role-of-negative-methicillin-resistant-staphylococcus-aureus-nasal-surveillance-swabs-in-predicting-the-need-for-empiric-vancomycin-therapy-in-intensive-care-unit-patients
#19
Darunee Chotiprasitsakul, Pranita D Tamma, Avinash Gadala, Sara E Cosgrove
OBJECTIVES The role of methicillin-resistant Staphylococcus aureus (MRSA) nasal surveillance swabs (nasal swabs) in guiding decisions about prescribing vancomycin is unclear. We aimed to determine the likelihood that patients with negative MRSA nasal swabs develop subsequent MRSA infections; to assess avoidable vancomycin days for patients with negative nasal swabs; and to identify risk factors for having a negative nasal swab and developing a MRSA infection during the intensive care unit (ICU) stay. METHODS This retrospective cohort study was conducted in 6 ICUs at a tertiary-care hospital from December 2013 through June 2015...
January 28, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29374489/stress-ulcer-prophylaxis-in-intensive-care-unit-patients-receiving-enteral-nutrition-a-systematic-review-and-meta-analysis
#20
Hui-Bin Huang, Wei Jiang, Chun-Yao Wang, Han-Yu Qin, Bin Du
BACKGROUND: Pharmacologic stress ulcer prophylaxis (SUP) is recommended in critically ill patients with high risk of stress-related gastrointestinal (GI) bleeding. However, as to patients receiving enteral feeding, the preventive effect of SUP is not well-known. Therefore, we performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of pharmacologic SUP in enterally fed patients on stress-related GI bleeding and other clinical outcomes. METHODS: We searched PubMed, Embase, and the Cochrane database from inception through 30 Sep 2017...
January 28, 2018: Critical Care: the Official Journal of the Critical Care Forum
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