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Pneumonia and antimicrobial stewardship

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https://www.readbyqxmd.com/read/29277527/high-excess-costs-of-infections-caused-by-carbapenem-resistant-gram-negative-bacilli-in-an-endemic-region
#1
Carlos Andrés Vargas-Alzate, Luis Felipe Higuita-Gutiérrez, Lucelly López López, Astrid Vanessa Cienfuegos Gallet, Judy Natalia Jiménez Quiceno
BACKGROUND: The financial burden of antibiotic resistance is a serious concern worldwide. The aim of this study is to describe the excess costs associated with pneumonia, bacteremia, surgical site infections and intra-abdominal infections caused by carbapenem-resistant gram-negative bacilli in Medellín, Colombia, an endemic region for carbapenem resistance. METHODS: A cohort study was conducted in a third level hospital from 2014 to 2015. All patients with carbapenem-resistant and carbapenem-susceptible gram-negative bacteria infections were included...
December 22, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29249216/pathogen-distribution-and-antimicrobial-resistance-among-pediatric-healthcare-associated-infections-reported-to-the-national-healthcare-safety-network-2011-2014
#2
Jason G Lake, Lindsey M Weiner, Aaron M Milstone, Lisa Saiman, Shelley S Magill, Isaac See
OBJECTIVE To describe pathogen distribution and antimicrobial resistance patterns for healthcare-associated infections (HAIs) reported to the National Healthcare Safety Network (NHSN) from pediatric locations during 2011-2014. METHODS Device-associated infection data were analyzed for central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP), and surgical site infection (SSI). Pooled mean percentage resistance was calculated for a variety of pathogen-antimicrobial resistance pattern combinations and was stratified by location for device-associated infections (neonatal intensive care units [NICUs], pediatric intensive care units [PICUs], pediatric oncology and pediatric wards) and by surgery type for SSIs...
December 18, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29238934/treatment-outcome-of-non-carbapenemase-producing-carbapenem-resistant-klebsiella-pneumoniae-infections-a-multicenter-study-in-taiwan
#3
Chin-Fang Su, Chien Chuang, Yi-Tsung Lin, Yu-Jiun Chan, Jung-Chung Lin, Po-Liang Lu, Ching-Tai Huang, Jann-Tay Wang, Yin-Ching Chuang, L Kristopher Siu, Chang-Phone Fung
Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections are associated with high mortality, and experiences with its treatment are usually based on carbapenemase-producing strains. Non-carbapenemase-producing CRKP is of clinical significance, but relevant studies are lacking. This nationwide study aimed to evaluate the outcome of antimicrobial therapy in patients with non-carbapenemase-producing CRKP infections. Patients with non-carbapenemase-producing CRKP infections were enrolled from 16 hospitals during January 2013 to December 2014 in Taiwan...
December 14, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29237206/-piperacillin-tazobactam-shortage-central-restriction-and-alternative-recommendations-as-effective-antibiotic-stewardship-intervention-at-a-maximal-care-hospital
#4
Johanna Kessel, Barbara Dolff, Thomas Wichelhaus, Nils Keiner, Michael Hogardt, Claudia Reinheimer, Imke Wieters, Sebastian Harder, Volkhard A J Kempf, Christoph Stephan
Background Drug supply bottleneck is a worldwide challenge, e. g. the antibiotics Piperacillin/Tazobactam shortage in 2016/2017. The efficacy of an appropriate replacement management was evaluated at the University Hospital Frankfurt (UHF). Methods The Antibiotic-Stewardship (ABS)-Team at UHF decreed a restriction of PIP/TAZ and provided alternative antibiotic therapy recommendations during the shortage period. Consequences of this intervention on antibiotic consumption and overall costs were investigated...
December 13, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29189614/acquired-infection-and-antimicrobial-utilization-during-initial-nicu-hospitalization-in-infants-with-congenital-diaphragmatic-hernia
#5
Sarah Keene, Karna Murthy, Eugenia Pallotto, Beverly Brozanski, Jason Gien, Isabella Zaniletti, Cheryl Hulbert, Ruth Seabrook, Natalie Rintoul, Louis Chicoine, Nicolas Porta, Theresa R Grover
BACKGROUND: In addition to substantial medical and surgical intervention, neonates with congenital diaphragmatic hernia (CDH) often have concurrent concerns for acquired infection. However, few studies focus on infection and corresponding antimicrobial utilization in this population. METHODS: The Children's Hospital Neonatal Database was queried for CDH infants hospitalized from Jan 2010- Feb 2016. Patient charts were linked to the Pediatric Health Information Systems (PHIS) database...
November 16, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29177489/disease-based-antimicrobial-stewardship-a-review-of-active-and-passive-approaches-to-patient-management
#6
Farnaz Foolad, Jerod L Nagel, Gregory Eschenauer, Twisha S Patel, Cynthia T Nguyen
Although new antimicrobial stewardship programmes (ASPs) often begin by targeting the reduction of antimicrobial use, an increasing focus of ASPs is to improve the management of specific infectious diseases. Disease-based antimicrobial stewardship emphasizes improving patient outcomes by optimizing antimicrobial use and increasing compliance with performance measures. Directing efforts towards the comprehensive management of specific infections allows ASPs to promote the shift in healthcare towards improving quality, safety and patient outcome metrics for specific diseases...
December 1, 2017: Journal of Antimicrobial Chemotherapy
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
#7
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/29152678/first-year-results-of-an-antibiotic-stewardship-program-in-a-greek-tertiary-care-hospital
#8
K Chrysou, O Zarkotou, S Kalofolia, P Papagiannakopoulou, G Chrysos, K Themeli-Digalaki, A Tsakris, S Pournaras
The aim of this study was to investigate the effect of the implementation of an antibiotic stewardship program (ASP) on antibiotic consumption in our 428-bed hospital. The Infection Control Committee implemented an ASP beginning in January 2016, aiming to reduce inappropriate antibiotic use through improved prescribing practices. The ASP included both pre-authorization and prospective audit and feedback strategies. We collected pharmacy and hospital data for the years 2015 (pre-intervention) and 2016 (post-intervention)...
November 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29150897/determining-best-outcomes-from-community-acquired-pneumonia-and-how-to-achieve-them
#9
REVIEW
Jane Hadfield, Lesley Bennett
Community-acquired pneumonia (CAP) is a common acute medical illness with a standard, effective treatment that was introduced before the evidenced-based medicine era. Mortality rates have improved in recent decades but improvements have been minimal when compared to other conditions such as acute coronary syndromes. The standardized approach to treatment makes CAP a target for comparative performance and outcome measures. While easy to collect, simplistic outcomes such as mortality, readmission and length of stay are difficult to interpret as they can be affected by subjective choices and health care resources...
November 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29149338/multiplex-respiratory-virus-testing-for-antimicrobial-stewardship-a-prospective-assessment-of-antimicrobial-use-and-clinical-outcomes-among-hospitalized-adults
#10
Makeda Semret, Ian Schiller, Barbara Ann Jardin, Charles Frenette, Vivian G Loo, Jesse Papenburg, Shelly A McNeil, Nandini Dendukuri
Background: Respiratory tract infections are frequent causes of hospitalization and initiation of empirical antimicrobial therapy. Testing for a broad panel of respiratory viruses has been advocated as a useful tool for antibiotic stewardship. We conducted a prospective observational study to assess the impact of rapid viral test results on antimicrobial prescriptions and clinical outcomes among hospitalized adults. Methods: Eight hundred patients admitted with respiratory symptoms were tested by a 12-virus respiratory panel (RVP) during 3 consecutive winters in Montreal, Canada...
November 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29017750/trends-and-relationship-between-antimicrobial-resistance-and-antibiotic-use-in-xinjiang-uyghur-autonomous-region-china-based-on-a-3-year-surveillance-data-2014-2016
#11
Haishaerjiang Wushouer, Zhao-Xia Zhang, Jian-Hua Wang, Ping Ji, Qing-Fang Zhu, Renagu Aishan, Lu-Wen Shi
PURPOSES: The objective of the study was to identify the trends and relations between antimicrobial resistance (AMR) and antibiotic use in the Xinjiang Uyghur Autonomous Region in Western China from 2014 to 2016. METHODS: A retrospective, descriptive analysis of AMR prevalence, and trends and relations between AMR and antibiotic use during the 3-year period was performed. RESULTS: Third-generation cephalosporin-resistant Escherichia coli was the most prevalent resistant pathogen in terms of both resistance density and resistance proportion...
October 7, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28882006/update-in-infectious-diseases-2017
#12
REVIEW
F J Candel, M Peñuelas, C Lejárraga, T Emilov, C Rico, I Díaz, C Lázaro, J M Viñuela-Prieto, M Matesanz
Antimicrobial resistance in complex models of continuous infection is a current issue. The update 2017 course addresses about microbiological, epidemiological and clinical aspects useful for a current approach to infectious disease. During the last year, nosocomial pneumonia approach guides, recommendations for management of yeast and filamentous fungal infections, review papers on the empirical approach to peritonitis and extensive guidelines on stewardship have been published. HIV infection is being treated before and more intensively...
September 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28880805/a-prospective-one-year-microbiologic-survey-of-combined-pneumonia-and-respiratory-failure
#13
Kristen Fisher, Tracy Trupka, Scott T Micek, Paul Juang, Marin H Kollef
BACKGROUND: Pneumonia and respiratory failure are common problems in the intensive care unit (ICU) setting, often occurring together. The relative prevalence of pneumonia types (community acquired, hospital acquired, ventilator associated) and causative pathogens is not well described in patients with respiratory failure. METHODS: This was a prospective observational cohort study conducted in the medical ICU (34 beds) of Barnes-Jewish Hospital, an academic referral center of 1,300 beds from January 2016-December 2016...
October 2017: Surgical Infections
https://www.readbyqxmd.com/read/28856589/impact-of-a-mixed-educational-and-semi-restrictive-antimicrobial-stewardship-project-in-a-large-teaching-hospital-in-northern-italy
#14
Daniele Roberto Giacobbe, Valerio Del Bono, Malgorzata Mikulska, Giulia Gustinetti, Anna Marchese, Federica Mina, Alessio Signori, Andrea Orsi, Fulvio Rudello, Cristiano Alicino, Beatrice Bonalumi, Alessandra Morando, Giancarlo Icardi, Sabrina Beltramini, Claudio Viscoli
BACKGROUND: The overuse of antimicrobials favors the dissemination of antimicrobial resistance, as well as invasive fungal diseases and Clostridium difficile infections (CDI). In this study, we assessed the impact of a mixed educational and semi-restrictive antimicrobial stewardship (AMS) project in a large teaching hospital in Italy. METHODS: The AMS project was conducted from May 2014 to April 2016. It consisted of two initiatives in two consecutive periods: (1) educational activities; (2) semi-restrictive control of antimicrobial prescribing through a computerized software...
December 2017: Infection
https://www.readbyqxmd.com/read/28844378/nasal-methicillin-resistant-staphylococcus-aureus-screening-in-patients-with-pneumonia-a-powerful-antimicrobial-stewardship-tool
#15
Ethan A Smith, Howard S Gold, Monica V Mahoney, Elizabeth B Hirsch, Stephanie E Giancola, Graham M Snyder, Gregory Marks, Hai Tran, Angela Hirai-Yang, Christopher McCoy
No abstract text is available yet for this article.
November 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28820112/prevalence-study-of-plasmid-mediated-ampc-%C3%AE-lactamases-in-enterobacteriaceae-lacking-inducible-ampc-from-saudi-hospitals
#16
Baha Abdalhamid, Samar Albunayan, Alaa Shaikh, Nasreldin Elhadi, Reem Aljindan
PURPOSE: Enterobacteriaceae encoding plasmid-mediated AmpC (pAmpC) β-lactamases confer resistance to the third generation cephalosporins. pAmpC association with extended spectrum β-lactamases (ESBLs), plasmid-mediated quinolone resistance (PMQR) and aminoglycoside modifying enzymes (AMEs) is well documented. There are limited data regarding the epidemiology and clinical significance of pAmpC in Saudi Arabia. This study aimed to determine the prevalence of pAmpC and its coexistence with ESBLs, PMQR and AMEs in Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis isolates in Saudi hospitals from January to December 2015...
September 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28815897/multidrug-resistant-enterobacteriaceae-pseudomonas-aeruginosa-and-vancomycin-resistant-enterococcus-three-major-threats-to-hematopoietic-stem-cell-transplant-recipients
#17
REVIEW
Michael J Satlin, Thomas J Walsh
Hematopoietic stem cell transplant (HSCT) recipients are uniquely threatened by the emergence of multidrug-resistant (MDR) bacteria because these patients rely on immediate active antimicrobial therapy to combat bacterial infections. This review describes the epidemiology and treatment considerations for three challenging MDR bacterial pathogens in HSCT recipients: MDR Enterobacteriaceae, including extended-spectrum β-lactamase (ESBL)-producing and carbapenem-resistant Enterobacteriaceae (CRE), Pseudomonas aeruginosa, and vancomycin-resistant Enterococcus (VRE)...
August 16, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28814443/antibiotic-use-by-pediatric-residents-identifying-opportunities-and-strategies-for-antimicrobial-stewardship
#18
Prateek J Shukla, Maria Behnam-Terneus, Beatriz Cunill-De Sautu, Geovanny F Perez
OBJECTIVES: To determine the antibiotic prescribing practices of pediatric residents and assess how they acquire knowledge leading to prescribing behaviors. METHODS: We performed a cross-sectional electronic survey of all pediatric residents at the Children's National Medical Center and Nicklaus Children's Hospital, assessing antibiotic prescribing patterns for common pediatric infections, use of antibiograms, and factors influencing antibiotic choice. RESULTS: Eighty-five surveys (45%) were returned complete and included in the analysis...
September 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28754148/nosocomial-bacterial-infections-and-their-antimicrobial-susceptibility-patterns-among-patients-in-ugandan-intensive-care-units-a-cross-sectional-study
#19
Peter Agaba, Janat Tumukunde, J V B Tindimwebwa, Arthur Kwizera
BACKGROUND: The intensive care unit (ICU) admits critically ill patients requiring advanced airway, respiratory, cardiac and renal support. Despite the highly-specialized interventions, the mortality and morbidity is still high due to a number of reasons including nosocomial infections, which are the most likely complications in hospitalized patients with the rates being highest among ICU patients. METHODS: In this cross-sectional study of 111 adult patients admitted to 2 of the ICUs in Uganda, we set out to describe the commonest bacterial infections, their antimicrobial susceptibility patterns and factors associated with development of a nosocomial infection...
July 28, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28743946/identification-of-the-eskape-pathogens-by-mass-spectrometric-analysis-of-microbial-membrane-glycolipids
#20
Lisa M Leung, William E Fondrie, Yohei Doi, J Kristie Johnson, Dudley K Strickland, Robert K Ernst, David R Goodlett
Rapid diagnostics that enable identification of infectious agents improve patient outcomes, antimicrobial stewardship, and length of hospital stay. Current methods for pathogen detection in the clinical laboratory include biological culture, nucleic acid amplification, ribosomal protein characterization, and genome sequencing. Pathogen identification from single colonies by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) analysis of high abundance proteins is gaining popularity in clinical laboratories...
July 25, 2017: Scientific Reports
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