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Nikos Ulrich, Petra Gastmeier, Ralf-Peter Vonberg
Background: Identifying the source of an outbreak is the most crucial aspect of any outbreak investigation. In this review, we address the frequently discussed question of whether (rectal) screening of health care workers (HCWs) should be carried out when dealing with outbreaks caused by gram negative bacteria (GNB).A systematic search of the medical literature was performed, including the Worldwide Outbreak Database and PubMed. Outbreaks got included if a HCW was the source of the outbreak and the causative pathogen was an Escherichia coli , Klebsiella spp ...
2018: Antimicrobial Resistance and Infection Control
I-Ling Chen, Chen-Hsiang Lee, Shih-Wen Ting, Lily Yu-Chin Wang
Objectives: The increasing number of reports on infections due to carbapenem-resistant Gram-negative bacilli (GNB) has raised concerns, because they have complicated empiric or guided antibiotic therapy for critically ill patients. We aimed to develop a scoring system to predict nosocomial imipenem-resistant GNB (IR-GNB) septicemia among the critically ill patients. Materials and methods: The study included critically ill adult patients with nosocomial GNB septicemia at Kaohsiung Chang Gung Memorial Hospital (CGMH) in 2013-2015, and the scoring system for predicting IR-GNB septicemia was developed, followed by prospective validation conducted among patients at Linkou CGMH and Kaohsiung CGMH between January and June, 2016...
2018: Infection and Drug Resistance
Bo Zhang, Uyen Tran, Oliver Wessely
The development of the kidney relies on the establishment and maintenance of a precise tubular diameter of its functional units, the nephrons. This process is disrupted in Polycystic Kidney Disease (PKD) resulting in dilations of the nephron and renal cyst formation. In the course of exploring G-protein coupled signaling in the Xenopus pronephric kidney we discovered that loss of the G-protein alpha subunit Gnas results in a PKD phenotype. Polycystin-1, one of the genes mutated in human PKD, encodes for a protein resembling a G-protein coupled receptor...
March 12, 2018: Development
Aliana Meneses Ferreira, Frederico Moreira, Thais Guimaraes, Fernanda Spadão, Jessica Fernandes Ramos, Marjorie Vieira Batista, Jayr Schmidt Filho, Silvia Figueiredo Costa, Vanderson Rocha
BACKGROUND: Bloodstream infections (BSI) are a major complication in the early phase of a hematopoietic stem cell transplant (HSCT). AIM: To describe the incidence and risk factors for BSI occurring in the pre-engraftment phase of HSCT and its impact on mortality. METHODS: We retrospectively analysed clinical variables of 232 HSCT patients between 2014 and 2015. Univariate Cox regression analyses were performed to test the association between each covariate and the outcome...
March 9, 2018: Journal of Hospital Infection
Peter M Hawkey, Roderic E Warren, David M Livermore, Cliodna A M McNulty, David A Enoch, Jonathan A Otter, A Peter R Wilson
The Working Party makes more than 100 tabulated recommendations in antimicrobial prescribing for the treatment of infections caused by multidrug-resistant (MDR) Gram-negative bacteria (GNB) and suggest further research, and algorithms for hospital and community antimicrobial usage in urinary infection. The international definition of MDR is complex, unsatisfactory and hinders the setting and monitoring of improvement programmes. We give a new definition of multiresistance. The background information on the mechanisms, global spread and UK prevalence of antibiotic prescribing and resistance has been systematically reviewed...
March 1, 2018: Journal of Antimicrobial Chemotherapy
Phunsup Wongsurakiat, Sirapat Tulatamakit
Background We wanted to determine the impact of combined Clinical Pulmonary Infection Score (CPIS) and a spot serum procalcitonin (PCT)-guided protocol to shorten the duration of antibiotic treatment in patients with ventilator-associated pneumonia (VAP), mainly caused by nonfermentative gram-negative bacilli (NF-GNB). Methods Patients with VAP who received appropriate antibiotics for 7 days, temperature ⩽ 37.8°C, without shock, and CPIS ⩽ 6 were allocated to the PCT group or conventional group according to the treating physicians' decisions...
January 2018: Therapeutic Advances in Respiratory Disease
Alessandra Forcina, Francesca Lorentino, Vincenzo Marasco, Chiara Oltolini, Magda Marcatti, Raffaella Greco, Maria Teresa Lupo-Stanghellini, Matteo Carrabba, Massimo Bernardi, Jacopo Peccatori, Consuelo Corti, Fabio Ciceri
Multidrug-resistant Gram-negative bacteria (MDR-GNB) are an emerging cause of morbidity and mortality after hematopoietic stem cell transplantation (HSCT). Three-hundred-forty-eight consecutive patients transplanted at our hospital from July 2012 to January 2016 were screened for a pre-transplant MDR-GNB colonization and evaluated for clinical outcomes. A pre-transplant MDR-GNB colonization was found in 16.9% of allo-HSCT and in 9.6% of auto-HSCT recipients. Both in auto- and in allo-HSCT, carriers of a MDR-GNB showed no significant differences in overall survival (OS), transplant-related mortality (TRM) nor infection-related mortality (IRM) compared to non-carriers...
March 1, 2018: Biology of Blood and Marrow Transplantation
Matthias Guggenmos, Philipp Sterzer, Radoslaw Martin Cichy
Multivariate pattern analysis (MVPA) methods such as decoding and representational similarity analysis (RSA) are growing rapidly in popularity for the analysis of magnetoencephalography (MEG) data. However, little is known about the relative performance and characteristics of the specific dissimilarity measures used to describe differences between evoked activation patterns. Here we used a multisession MEG data set to qualitatively characterize a range of dissimilarity measures and to quantitatively compare them with respect to decoding accuracy (for decoding) and between-session reliability of representational dissimilarity matrices (for RSA)...
February 27, 2018: NeuroImage
Jade E McLellan, Joshua I Pitcher, Susan A Ballard, Elizabeth A Grabsch, Jan M Bell, Mary Barton, M Lindsay Grayson
Background: Antibiotic misuse in food-producing animals is potentially associated with human acquisition of multidrug-resistant (MDR; resistance to ≥ 3 drug classes) bacteria via the food chain. We aimed to determine if MDR Gram-negative (GNB) organisms are present in fresh Australian chicken and pork products. Methods: We sampled raw, chicken drumsticks (CD) and pork ribs (PR) from 30 local supermarkets/butchers across Melbourne on two occasions. Specimens were sub-cultured onto selective media for third-generation cephalosporin-resistant (3GCR) GNBs, with species identification and antibiotic susceptibility determined for all unique colonies...
2018: Antimicrobial Resistance and Infection Control
Nese Saltoglu, Onder Ergonul, Necla Tulek, Mucahit Yemisen, Ayten Kadanali, Gul Karagoz, Ayse Batirel, Oznur Ak, Cagla Sonmezer, Haluk Eraksoy, Atahan Cagatay, Serkan Surme, Salih A Nemli, Tuna Demirdal, Omer Coskun, Derya Ozturk, Nurgul Ceran, Filiz Pehlivanoglu, Gonul Sengoz, Turan Aslan, Yasemin Akkoyunlu, Oral Oncul, Hakan Ay, Lutfiye Mulazımoglu, Buket Erturk, Fatma Yilmaz, Gulsen Yoruk, Nuray Uzun, Funda Simsek, Taner Yildirmak, Kadriye Kart Yaşar, Meral Sonmezoglu, Yasar Küçükardali, Nazan Tuna, Oguz Karabay, Nail Ozgunes, Fatma Sargın
OBJECTIVES: We described the clinical outcome of the diabetic patients who had foot infections with multidrug resistant organisms. METHODS: We included the patients with diabetic foot infections (DFI) from 19 centers, between May 2011 and December 2015. Infection was defined according to IDSA DFI guidelines. Patients with severe infection, complicated moderate infection were hospitalized. The patients were followed-up for 6 months after discharge. RESULTS: In total, 791 patients with DFI were included, 531(67%) was male, median age was 62 (19-90)...
February 21, 2018: International Journal of Infectious Diseases: IJID
Alix Pantel, Julien Monier, Jean-Philippe Lavigne
Objectives: To evaluate the performance of the Accelerate Pheno™ system for the identification and antimicrobial susceptibility testing (AST) of a panel of Gram-negative bacilli (GNB) with different resistance profiles (e.g. penicillinases, ESBLs, cephalosporinase overproduction, carbapenemases, impermeability) directly from positive blood cultures in <7 h. Methods: A panel of 105 clinical strains previously characterized for the presence of β-lactamase-encoding genes was tested...
February 20, 2018: Journal of Antimicrobial Chemotherapy
Shuxian Wen, Donghua Feng, Zerong Lu, Junyan Liu, Brian M Peters, Hailing Tang, Danhong Su, Yong-Ping Lin, Ling Yang, Zhenbo Xu, Mark E Shirtliff, Dingqiang Chen
BACKGROUND: Carbapenem-resistant Gram-negative bacilli (GNB) have become an important cause of nosocomial infections of hospitalized patients. METHODS: To investigate the microbial infection patterns and molecular epidemiology characteristics of the carbapenem-resistant GNB isolates from a long-term hospitalized patient, antimicrobial susceptibility testing, phenotypic screening test for carbapenemase production, PCR screening and DNA sequencing of carbapenemase genes, repetitive extragenic palindromic sequence-based PCR (REP-PCR), multilocus sequencing typing (MLST) and genetic environment analysis were performed...
February 13, 2018: Microbial Pathogenesis
John Rene Labib, Sally K Ibrahim, Marwa Rashad Salem, Meray Rene L Youssef, Basant Meligy
BACKGROUND: Patients in pediatric intensive care units (PICUs) are susceptible to infections with gram-negative bacteria (GNB). METHODS: A prospective observational study was conducted in 2 PICUs at Cairo University Hospitals to determine the incidence and outcome of GNB infections over 1 year. Variables of interest included age, gender, isolated organism, susceptibility to antibiotics, and final outcome. RESULTS: During the study period, 1420 patients were admitted to the PICU; of these, 291 developed GNB infections...
February 9, 2018: American Journal of Infection Control
Marco Falcone, Giusy Tiseo, Francesco Dentali, Micaela La Regina, Emanuela Foglia, Maurizia Gambacorta, Elisabetta Garagiola, Giorgio Bonardi, Pierangelo Clerici, Fabrizio Colombo, Alessio Farcomeni, Ercole Concia, Salvatore Corrao, Mauro Campanini, Antonino Mazzone
OBJECTIVE: To develop a risk-scoring tool to predict multidrug-resistant (MDR) etiology in patients with bloodstream infections (BSI) caused by Gram-negative bacilli (GNB). METHODS: A prospective multicenter study analyzed patients with BSI hospitalized in 31 Internal Medicine wards in Italy from March 2012 to December 2012. Patients with BSI caused by MDR-GNB (non-susceptible to at least one agent in three antimicrobial categories) were compared to those with BSI due to susceptible GNB...
February 6, 2018: European Journal of Internal Medicine
Marco Falcone, Giusy Tiseo, Emanuele Durante-Mangoni, Veronica Ravasio, Francesco Barbaro, Maria Paola Ursi, Maria Bruna Pasticci, Matteo Bassetti, Paolo Grossi, Mario Venditti, Marco Rizzi
Objective: To investigate predisposing factors and outcomes of non-HACEK Gram-negative bacilli (GNB) infective endocarditis (IE) in a multicenter, contemporary cohort. Patients and Methods: Patients with IE due to GNB prospectively observed in 26 Italian centers from 2004 to 2011 were analyzed. Using a case-control design, each case was compared to three controls with IE by other etiologies matched for age and sex. Logistic regression was performed to identify risk factors for GNB IE. Factors associated with early and late mortality were assessed by Cox regression analysis...
January 29, 2018: Antimicrobial Agents and Chemotherapy
Marco Falcone, Pierluigi Viale, Giusy Tiseo, Manjunath Pai
Ceftazidime-avibactam (CAZ-AVI) is a combination of a third-generation cephalosporin and a non-β-lactam, β-lactamase inhibitor, recently approved for urinary tract infections and complicated abdominal infections. Moreover, it represents a treatment option for patients with hospital acquired pneumonia (HAP), especially when caused by multidrug-resistant (MDR) bacteria. Areas covered: The review focuses on the pharmacokinetics (PK) of CAZ-AVI in HAP and on preclinical and clinical studies evaluating PK/pharmacodynamics (PD) in this field...
January 31, 2018: Expert Opinion on Drug Metabolism & Toxicology
Natasha Alexander, Katie Sullivan, Furqan Shaikh, Meredith S Irwin
BACKGROUND: Ganglioneuromas (GNs) usually demonstrate favorable histological and clinical features. Surgery is often performed due to clinical symptoms and/or theoretical concerns that GN may transform into neuroblastoma (NB); however, several studies have identified significant GN-surgical morbidities. OBJECTIVES: We compared the natural history, biological and clinical features of GN and ganglioneuroblastoma-intermixed (GNB-I) managed by surgery or observation to inform management and surveillance...
January 25, 2018: Pediatric Blood & Cancer
Alba Ribera, Laura Soldevila, Raul Rigo-Bonnin, Fe Tubau, Ariadna Padullés, Joan Gómez-Junyent, Javier Ariza, Oscar Murillo
Continuous infusion (CI) of beta-lactams could optimize their pharmacokinetic/pharmacodynamic indices, especially in difficult-to-treat infections. PURPOSE: To validate an easy-to-use method to guide beta-lactams dosage in CI (formula). METHODS: A retrospective analysis was conducted of a prospectively collected cohort (n = 24 patients) with osteoarticular infections caused by Gram-negative bacilli (GNB) managed with beta-lactams in CI. Beta-lactams dose was calculated using a described formula (daily dose = 24 h × beta-lactam clearance × target "steady-state" concentration) to achieve concentrations above the MIC...
January 23, 2018: Infection
Doo-Hwan Kim, Seong-Soo Choi, Syn-Hae Yoon, So-Hee Lee, Dong-Kyun Seo, In-Gyu Lee, Woo-Jong Choi, Jin-Woo Shin
BACKGROUND: Recently, several studies suggested that radiofrequency (RF) ablation of the genicular nerves is a safe and effective therapeutic procedure for intractable pain associated with chronic knee osteoarthritis (OA). Diagnostic genicular nerve block (GNB) with local anesthetic has been generally conducted before making decisions regarding RF ablation. Although GNB has been recently performed together with corticosteroid, the analgesic effects of corticosteroids for treating chronic pain remain controversial...
January 2018: Pain Physician
Mark L Metersky, Timothy R Aksamit, Alan Barker, Radmila Choate, Charles L Daley, Leigh A Daniels, Angela DiMango, Edward Eden, David Griffith, Margaret Johnson, Michael Knowles, Anne E O'Donnell, Kenneth Olivier, Matthias Salathe, Byron Thomashow, Gregory Tino, Gerard Turino, Kevin L Winthrop, David Mannino
RATIONALE: Staphylococcus aureus is commonly cultured from the sputum of patients with bronchiectasis, however little is known about the prevalence of the organism in these patients, the characteristics of patients who have grown the organism or its implications. OBJECTIVES: Determine the relationship between S. aureus and pulmonary function, frequency of exacerbations and frequency of hospitalization in patients with bronchiectasis Methods: The Bronchiectasis Research Registry is a database of adults with non-cystic fibrosis bronchiectasis identified from 13 sites within the United States...
January 18, 2018: Annals of the American Thoracic Society
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