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https://www.readbyqxmd.com/read/28288860/epidemiology-of-multidrug-resistant-gram-negative-pathogens-isolated-from-ventilator-associated-pneumonia-in-icu-patients
#1
Richa Gupta, Abida Malik, Meher Rizvi, Moied Ahmed, Anuradha Singh
OBJECTIVES: Antibiotic resistance among Gram-negative pathogens isolated from ventilator-associated pneumonia (VAP) poses a grave threat in intensive care unit (ICU) patients. The aim of this study was to assess the prevalence of pathogens in ICU patients and their drug resistance profile. The prevalence of extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases and metallo-β-lactamases (MBLs) was also assessed. METHODS: Tracheal aspirates were collected aseptically from 87 ICU patients between May 2012 and January 2014...
March 10, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28286833/ventilator-associated-pneumonia-and-its-responsible-germs-an-epidemiological-study
#2
Rama Bozorgmehr, Vanousheh Bahrani, Alireza Fatemi
INTRODUCTION: Ventilator-associated pneumonia (VAP) is one of the most common hospital infections and a side effect of lengthy stay in intensive care unit (ICU). Considering the ever-changing pattern of common pathogens in infectious diseases and the raise in prevalence of hospital infections, the present study was designed aiming to determine the prevalence of VAP and its bacterial causes. METHODS: In this cross-sectional study, the medical profiles of all the patients under mechanical ventilation, who had no symptoms of pneumonia at the time of intubation and developed new infiltration in chest radiography after 48 hours under mechanical ventilation along with at least 2 of the symptoms including fever, hypothermia, leukocytosis, leukopenia, or purulent discharge from the lungs, were evaluated...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28275224/aggressive-versus-conservative-antibiotic-use-to-prevent-and-treat-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-comparison-of-two-case-series
#3
Arturo Chieregato, Paolo Malacarne, Francesco Cocciolo, Maurizio Ravaldini, Emanuele Russo, Bruno Viaggi, Michele Giardino, Carlotta Rossi, Bruno Simini, Guido Bertolini
BACKGROUND: In patients with traumatic brain injury (TBI), ventilator-associated pneumonia (VAP) is considered a dangerous complication, prompting early aggressive antibiotic treatment and prophylaxis. While this approach increases the selection of multidrug-resistant bacteria (MDR), its clinical benefit has not been demonstrated. METHODS: One-year incidence of VAP in severe TBI patients (ICU stay >48 hours, with either Glasgow Coma Scale 8 or receiving intracranial pressure monitoring, or having undergone emergency surgery) and the prevalence of MDR among those who eventually developed it, were compared in two Italian intensive care units (ICUs) adopting different antibiotic approaches...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28273989/healthcare-associated-infections-in-a-resource-limited-setting
#4
Chanaveerappa Bammigatti, Saikumar Doradla, Harish Narasimha Belgode, Harichandra Kumar, Rathinam Palamalai Swaminathan
INTRODUCTION: Health Care associated Infections (HAI) are the most common complications affecting the hospitalized patients. HAI are more common in developing and under developed countries. However, there are no systematic surveillance programs in these countries. AIM: To find out the burden, predisposing factors and multidrug resistant organisms causing HAI in a resource limited setting. MATERIALS AND METHODS: This prospective observational study was done at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28257317/pulmonary-infections-in-critical-intensive-care-rapid-diagnosis-and-optimizing-antimicrobial-usage
#5
Ivor S Douglas
PURPOSE OF REVIEW: Diagnosis of pulmonary infection, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in the critically ill patient remains a common and therapeutically challenging diagnosis with significant attributable morbidity, mortality, and cost. Current clinical approaches to surveillance, early detection and, conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of HAP and VAP and the impact of these novel approaches on rational antimicrobial selection and stewardship are the focus of recent studies reviewed here...
March 2, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28246441/molecular-characterization-of-rhodococcus-equi-isolates-in-equines
#6
Rabyia Javed, A K Taku, R K Sharma, Gulzaar Ahmed Badroo
AIM: The aim was to determine the occurrence of Rhodococcus equi in equines and their environment in Jammu (R.S. Pura, Katra), molecular characterization and to determine the antibiotic resistance pattern of R. equi. MATERIALS AND METHODS: A total of 96 nasopharyngeal swab samples were collected from equines. The organism was isolated on Columbia nalidixic acid agar containing 5% sheep blood as well as on sheep blood agar and was later confirmed by cultural characteristics and biochemical tests...
January 2017: Veterinary World
https://www.readbyqxmd.com/read/28208857/emergence-of-hospital-acquired-carbapenem-resistant-non-fermenters-in-teaching-institute
#7
Hariom Sharan, Neeraj Katare, Aparna Pandey, Ganesh Shivmurti Bhatambare, Trupti Bajpai
INTRODUCTION: Non-Fermenting Gram Negative Bacilli (NFGNB) are emerging now-a-days because of their tendency to colonize various surfaces and inherent resistance to commonly used disinfectants. They are responsible for multi-drug resistant hospital acquired infections. Detection of carbapenem resistance mechanisms is essential for treatment and infection control purpose as can spread to other organisms causing hospital outbreaks. AIM: To characterize non-fermenters from various clinical samples and to detect different carbapenem resistance mechanisms in meropenem resistant isolates...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28198727/new-guidelines-for-nosocomial-pneumonia
#8
Mark L Metersky, Andre C Kalil
PURPOSE OF REVIEW: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) remain important causes of morbidity and mortality in hospitalized patients. New evidence-based guidelines for the diagnosis and treatment of these entities were released by the Infectious Diseases Society of America and the American Thoracic Society in 2016. This review summarizes the recommendations contained within these guidelines and their supporting rationale. RECENT FINDINGS: With respect to diagnosis of HAP and VAP, the guidelines suggest using semiquantitative cultures of noninvasively obtained respiratory samples instead of quantitative cultures of invasively obtained samples...
February 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28181665/multidrug-resistant-bacteria-among-patients-with-ventilatorassociated-pneumonia-in-an-emergency-intensive-care-unit-egypt
#9
Magda M Azzab, Rehab H El-Sokkary, Mohamed M Tawfeek, Manar G Gebriel
Ventilator-associated pneumonia (VAP) is the most common hospital-acquired infection among mechanically ventilated patients. Our objectives were to determine the incidence of VAP, isolate multidrug-resistant bacteria, identify the most prevalent resistant strains and identify their antibiotic susceptibility pattern. The VAP rate was calculated. The isolated microbes were identified and tested for antibiotic susceptibilities. The minimum inhibitory concentrations were determined of imipenem, meropenem and ertapenem for Klebsiella isolates...
February 1, 2017: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
https://www.readbyqxmd.com/read/28163887/central-venous-access-related-adverse-events-after-trabectedin-infusions-in-soft-tissue-sarcoma-patients-experience-and-management-in-a-nationwide-multi-center-study
#10
Michiel C Verboom, Jan Ouwerkerk, Neeltje Steeghs, Jacob Lutjeboer, J Martijn Kerst, Winette T A van der Graaf, Anna K L Reyners, Stefan Sleijfer, Hans Gelderblom
BACKGROUND: Trabectedin has shown efficacy against soft tissue sarcomas (STS) and has manageable toxicity. Trabectedin is administered through central venous access devices (VAD), such as subcutaneous ports with tunneled catheters, Hickman catheters and PICC lines. Venous access related adverse events are common, but have not yet been reported in detail. METHODS: A retrospective analysis of patient files of STS patients receiving trabectedin monotherapy between 1999 and 2014 was performed in all five STS referral centers in the Netherlands...
2017: Clinical Sarcoma Research
https://www.readbyqxmd.com/read/28158521/prevention-of-s-aureus-vap-conventional-antibiotics-won-t-cut-it
#11
Jason P Burnham, Marin H Kollef
No abstract text is available yet for this article.
February 4, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28149576/duration-of-antibiotic-therapy-in-the-intensive-care-unit
#12
REVIEW
Gabor Zilahi, Mary Aisling McMahon, Pedro Povoa, Ignacio Martin-Loeches
There are certain well defined clinical situations where prolonged therapy is beneficial, but prolonged duration of antibiotic therapy is associated with increased resistance, medicalising effects, high costs and adverse drug reactions. The best way to decrease antibiotic duration is both to stop antibiotics when not needed (sterile invasive cultures with clinical improvement), not to start antibiotics when not indicated (treating colonization) and keep the antibiotic course as short as possible. The optimal duration of antimicrobial treatment for ventilator-associated pneumonia (VAP) is unknown, however, there is a growing evidence that reduction in the length of antibiotic courses to 7-8 days can minimize the consequences of antibiotic overuse in critical care, including antibiotic resistance, adverse effects, collateral damage and costs...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28149487/clinical-response-and-outcome-of-pneumonia-due-to-multi-drug-resistant-acinetobacter-baumannii-in-critically-ill-patients
#13
Lida Shojaei, Mostafa Mohammadi, Mohammad-Taghi Beigmohammadi, Mahsa Doomanlou, Alireza Abdollahi, Mohammad Mehdi Feizabadi, Hossein Khalili
BACKGROUND AND OBJECTIVES: The frequency of multi-drug resistant Acinetobacter spp. infections is increasing in Iran. Considering availability of limited therapeutic options, clinical response and outcome of ventilator-associated pneumonia due to multi-drug resistant A.baumannii were evaluated in critically ill patients. MATERIALS AND METHODS: In this prospective study, 29 patients with carbapenem resistance A. baumannii ventilator-associated pneumonia were enrolled...
October 2016: Iranian Journal of Microbiology
https://www.readbyqxmd.com/read/28139543/antibiotic-resistance-pathogen-profile-in-ventilator-associated-pneumonia-in-a-tertiary-care-hospital-in-india
#14
Abhijit Chaudhury, A Shobha Rani, Usha Kalawat, Sachin Sumant, Anju Verma, B Venkataramana
BACKGROUND & OBJECTIVES: Ventilator-associated pneumonia (VAP) is an important hospital-acquired infection with substantial mortality. Only a few studies are available from India addressing the microbiological aspects of VAP, which have been done with small study populations. This study was carried out in the intensive care units (ICUs) of a tertiary care hospital to assess the profile of pathogens and to determine the pattern of antimicrobial resistance. METHODS: This was a retrospective study of clinically suspected cases of VAP...
September 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28118221/prevention-of-ventilator-associated-pneumonia
#15
Gianluigi Li Bassi, Tarek Senussi, Eli Aguilera Xiol
PURPOSE OF REVIEW: Ventilator-associated pneumonia (VAP) is an iatrogenic disease. Here we appraise recent advancements in the development and testing of strategies to prevent VAP. We also provide recommendations on the most promising interventions that should be applied. RECENT FINDINGS: In the last year, preventive bundles have consistently let to a reduction of VAP. A few trials on endotracheal tubes (ETTs) with novel cuffs failed to translate positive bench findings into clinical settings...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28114979/impact-of-the-duration-of-antibiotics-on-clinical-events-in-patients-with-pseudomonas-aeruginosa-ventilator-associated-pneumonia-study-protocol-for-a-randomized-controlled-study
#16
Adrien Bouglé, Arnaud Foucrier, Hervé Dupont, Philippe Montravers, Alexandre Ouattara, Pierre Kalfon, Pierre Squara, Tabassome Simon, Julien Amour
BACKGROUND: Ventilator-associated pneumonia (VAP) accounts for 25% of infections in intensive care units. Compared to a long duration (LD) of antibiotic therapy, a short duration (SD) has a comparable clinical efficacy with less antibiotic use and less multidrug-resistant (MDR) pathogen emergence, with the exception of documented VAP of non-fermenting Gram-negative bacilli (NF-GNB), including Pseudomonas aeruginosa (PA). These results have led the American Thoracic Society to recommend SD therapy for VAP, except for PA-VAP...
January 23, 2017: Trials
https://www.readbyqxmd.com/read/28114348/polymicrobial-ventilator-associated-pneumonia-fighting-in-vitro-candida-albicans-pseudomonas-aeruginosa-biofilms-with-antifungal-antibacterial-combination-therapy
#17
Maria E Rodrigues, Susana P Lopes, Cláudia R Pereira, Nuno F Azevedo, Anália Lourenço, Mariana Henriques, Maria O Pereira
The polymicrobial nature of ventilator-associated pneumonia (VAP) is now evident, with mixed bacterial-fungal biofilms colonizing the VAP endotracheal tube (ETT) surface. The microbial interplay within this infection may contribute for enhanced pathogenesis and exert impact towards antimicrobial therapy. Consequently, the high mortality/morbidity rates associated to VAP and the worldwide increase in antibiotic resistance has promoted the search for novel therapeutic strategies to fight VAP polymicrobial infections...
2017: PloS One
https://www.readbyqxmd.com/read/28100714/the-dynamics-of-the-pulmonary-microbiome-during-mechanical-ventilation-in-the-intensive-care-unit-and-the-association-with-occurrence-of-pneumonia
#18
Tetyana Zakharkina, Ignacio Martin-Loeches, Sébastien Matamoros, Pedro Povoa, Antoni Torres, Janine B Kastelijn, Jorrit J Hofstra, B de Wever, Menno de Jong, Marcus J Schultz, Peter J Sterk, Antonio Artigas, Lieuwe D J Bos
RATIONALE: Ventilator-associated pneumonia (VAP) is the most common nosocomial infections in patients admitted to the ICU. The adapted island model predicts several changes in the respiratory microbiome during intubation and mechanical ventilation. OBJECTIVES: We hypothesised that mechanical ventilation and antibiotic administration decrease the diversity of the respiratory microbiome and that these changes are more profound in patients who develop VAP. METHODS: Intubated and mechanically ventilated ICU-patients were included...
January 18, 2017: Thorax
https://www.readbyqxmd.com/read/28092204/impact-of-combination-therapy-and-early-de-escalation-on-outcome-of-ventilator-associated-pneumonia-caused-by-pseudomonas-aeruginosa
#19
Laurène Deconinck, Agnès Meybeck, Pierre Patoz, Nicolas Van Grunderbeeck, Nicolas Boussekey, Arnaud Chiche, Pierre-Yves Delannoy, Hugues Georges, Olivier Leroy
BACKGROUND: Pseudomonas aeruginosa is a common cause of ventilator-associated pneumonia (VAP). Guidelines recommend dual coverage of P. aeruginosa, but the beneficial effect of combination therapy is controversial. We described antibiotic prescriptions and evaluated the clinical impact of initial combination antibiotic therapy and de-escalation strategy in patients with VAP caused by P. aeruginosa. METHODS: Between 1994 and 2014, all 100 patients with VAP caused by P...
May 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28034888/ultra-short-course-antibiotics-for-patients-with-suspected-ventilator-associated-pneumonia-but-minimal-and-stable-ventilator-settings
#20
Michael Klompas, Lingling Li, John T Menchaca, Susan Gruber
PURPOSE: Many patients started on antibiotics for possible ventilator-associated pneumonia (VAP) do not have pneumonia. Patients with minimal and stable ventilator settings may be suitable candidates for early antibiotic discontinuation. We compared outcomes amongst patients with suspected VAP but minimal and stable ventilator settings treated with 1-3 versus >3 days of antibiotics. METHODS: We identified consecutive adult patients started on antibiotics for possible VAP with daily minimum PEEPs ≤5cm H2O and FiO2s ≤40% for at least 3 days within a large tertiary care hospital between 2006-2014...
December 29, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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