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https://www.readbyqxmd.com/read/29861799/sequential-measurements-of-pentraxin-3-serum-levels-in-patients-with-ventilator-associated-pneumonia-a-nested-case-control-study
#1
Huseyin Bilgin, Murat Haliloglu, Ali Yaman, Pinar Ay, Beliz Bilgili, Mustafa Kemal Arslantas, Filiz Ture Ozdemir, Goncagul Haklar, Ismail Cinel, Lutfiye Mulazimoglu
Purpose: The main purpose of this study was to investigate the dynamics of pentraxin 3 (PTX3) compared with procalcitonin (PCT) and C-reactive protein (CRP) in patients with suspicion of ventilator-associated pneumonia (VAP). Materials and Methods: We designed a nested case-control study. This study was performed in the Surgical Intensive Care Unit of a tertiary care academic university and teaching hospital. Ninety-one adults who were mechanically ventilated for >48 hours were enrolled in the study...
2018: Canadian Journal of Infectious Diseases & Medical Microbiology
https://www.readbyqxmd.com/read/29843808/long-term-use-of-selective-digestive-decontamination-in-an-icu-highly-endemic-for-bacterial-resistance
#2
Catalina Sánchez-Ramírez, Silvia Hípola-Escalada, Miriam Cabrera-Santana, María Adela Hernández-Viera, Liliana Caipe-Balcázar, Pedro Saavedra, Fernando Artiles-Campelo, Nayra Sangil-Monroy, Carlos Federico Lübbe-Vázquez, Sergio Ruiz-Santana
BACKGROUND: We examined whether long-term use of selective digestive tract decontamination (SDD) was effective in reducing intensive care unit (ICU)-acquired infection and antibiotic consumption while decreasing colistin-, tobramycin-, and most of the antibiotic-resistant colonization rates in a mixed ICU with a high endemic level of multidrug-resistant bacteria (MDRB). METHODS: In this cohort study, which was conducted in a 30-bed medical-surgical ICU, clinical outcomes before (1 year, non-SDD group) and after (4 years) implementation of SDD were compared...
May 30, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29784844/incidences-of-pseudomonas-associated-ventilator-associated-pneumonia-within-studies-of-respiratory-tract-applications-of-polymyxin-testing-the-stoutenbeek-concurrency-postulates
#3
James C Hurley
Regimens containing topical polymyxin appear highly effective at preventing Ventilator-associated pneumonia (VAP) overall and more-so, gram negative VAP. However, Soutenbeek's postulates, that VAP incidences within studies of topical antibiotics would depend on the context of whether the component (control and intervention) groups of each study were concurrent versus non-concurrent, remain untested.The literature was searched for concurrent control (CC) versus non-concurrent control (NCC) designed studies of respiratory tract applications of topical polymyxin to mechanically ventilated (MV) patients that reported Pseudomonas associated Ventilator-associated pneumonia (PsVAP) incidences...
May 21, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29769151/real-time-automated-detection-of-ventilator-associated-events-avoiding-missed-detections-misclassifications-and-false-detections-due-to-human-error
#4
Erica S Shenoy, Eric S Rosenthal, Yu-Ping Shao, Siddharth Biswal, Manohar Ghanta, Erin E Ryan, Dolores Suslak, Nancy Swanson, Valdery Moura Junior, David C Hooper, M Brandon Westover
OBJECTIVETo validate a system to detect ventilator associated events (VAEs) autonomously and in real time.DESIGNRetrospective review of ventilated patients using a secure informatics platform to identify VAEs (ie, automated surveillance) compared to surveillance by infection control (IC) staff (ie, manual surveillance), including development and validation cohorts.SETTINGThe Massachusetts General Hospital, a tertiary-care academic health center, during January-March 2015 (development cohort) and January-March 2016 (validation cohort)...
May 17, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29741076/monitoring-of-hospital-acquired-pneumonia-in-patients-with-severe-brain-injury-on-first-access-to-intensive-neurological-rehabilitation-first-year-of-observation
#5
Gianfranco Beghi, Antonio De Tanti, Paolo Serafini, Chiara Bertolino, Antonietta Celentano, Graziella Taormina
Nosocomial or hospital acquired pneumonia (HAP) is an illness contracted during a hospital stay, generally with onset 48 hours or more after admission to hospital, or within 14 days of discharge from hospital. HAP is divided into subgroups: Ventilator-associated pneumonia (VAP), accounting for 86% of hospital acquired pneumonia, and stroke-associated pneumonia (SAP). The incidence of SAP in neurological intensive care units (NICUs) is 4.1-56.6%, in medical intensive care units (MICUs) it is 17-50%, in stroke units it is 3...
May 9, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29722334/antibiotics-de-escalation-in-the-treatment-of-ventilator-associated-pneumonia-in-trauma-patients-a-retrospective-study-on-propensity-score-matching-method
#6
Hu Li, Chun-Hui Yang, Li-Ou Huang, Yu-Hui Cui, Dan Xu, Chun-Rong Wu, Jian-Guo Tang
Background: Antimicrobial de-escalation refers to starting the antimicrobial treatment with broad-spectrum antibiotics, followed by narrowing the drug spectrum according to culture results. The present study evaluated the effect of de-escalation on ventilator-associated pneumonia (VAP) in trauma patients. Methods: This retrospective study was conducted on trauma patients with VAP, who received de-escalation therapy (de-escalation group) or non-de-escalation therapy (non-de-escalation group)...
May 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29722052/the-methodological-quality-of-guidelines-for-hospital-acquired-pneumonia-and-ventilator-associated-pneumonia-a-systematic-review
#7
REVIEW
R Ambaras Khan, Z Aziz
WHAT IS KNOWN AND OBJECTIVES: Clinical practice guidelines serve as a framework for physicians to make decisions and to support best practice for optimizing patient care. However, if the guidelines do not address all the important components of optimal care sufficiently, the quality and validity of the guidelines can be reduced. The objectives of this study were to systematically review current guidelines for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), evaluate their methodological quality and highlight the similarities and differences in their recommendations for empirical antibiotic and antibiotic de-escalation strategies...
May 2, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29664891/reinventing-the-wheel-impact-of-prolonged-antibiotic-exposure-on-multi-drug-resistant-ventilator-associated-pneumonia-in-trauma-patients
#8
Richard H Lewis, John P Sharpe, Joseph M Swanson, Timothy C Fabian, Martin A Croce, Louis J Magnotti
INTRODUCTION: Multi-drug resistant (MDR) strains of both Acinetobacter baumannii (AB) and Pseudomonas aeruginosa (PA) as causative VAP pathogens are becoming increasingly common. Still, the risk factors associated with this increased resistance have yet to be elucidated. The purpose of this study was to examine the changing sensitivity patterns of these pathogens over time and determine which risk factors predict MDR in trauma patients with VAP. METHODS: Patients with either AB or PA VAP over 10 years were stratified by pathogen sensitivity (sensitive (SEN) and MDR), age, severity of shock and injury severity...
April 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29659359/-pneumonia-associated-with-mechanical-ventilation-update-and-recommendations-inter-societies-sadi-sati
#9
Wanda Cornistein, Ángel M Colque, María Inés Staneloni, María Monserrat Lloria, Mónica Lares, Ana Laura González, Alejandro Fernández Garcés, Edith Carbone
Representatives of the Argentine Society of Infectious Diseases (SADI) and the Argentine Society of Intensive Therapy (SATI) worked together on the development of specific recommendations for the diagnosis, treatment and prevention of ventilator-associated pneumonia (VAP). The methodology used was the analysis of the literature published in the last 15 years, complemented with the opinion of experts and local data. This document aims to offer basic tools to optimize diagnosis based on clinical and microbiological criteria, orientation in empirical and targeted antibiotic schemes, news on posology and administration of antibiotics in critical patients and to promote effective measures to reduce the risk of VAP...
2018: Medicina
https://www.readbyqxmd.com/read/29652913/ventilator-associated-pneumonia-in-patients-assisted-by-veno-arterial-extracorporeal-membrane-oxygenation-support-epidemiology-and-risk-factors-of-treatment-failure
#10
Adrien Bouglé, Camille Bombled, Dimitri Margetis, Guillaume Lebreton, Charles Vidal, Marine Coroir, David Hajage, Julien Amour
INTRODUCTION: Ventilator-associated pneumonia (VAP) is frequent in Intensive Care Unit (ICU) patients. In the specific case of patients treated with Veno-Arterial Extracorporeal Membrane Oxygenation Support (VA-ECMO), VAP treatment failures (VAP-TF) have been incompletely investigated. METHODS: To investigate the risk factors of treatment failure (VAP-TF) in a large cohort of ICU patients treated with VA-ECMO, we conducted a retrospective study in a Surgical ICU about patients assisted with VA-ECMO between January 1, 2013, and December 31, 2014...
2018: PloS One
https://www.readbyqxmd.com/read/29628347/impact-of-selective-digestive-decontamination-without-systemic-antibiotics-in-a-major-heart-surgery-intensive-care-unit
#11
María Jesús Pérez-Granda, José M Barrio, Javier Hortal, Almudena Burillo, Patricia Muñoz, Emilio Bouza
PURPOSE: The incidence density of ventilator-associated pneumonia (VAP) is higher in patients undergoing major heart surgery than in other populations, despite the introduction of bundles of preventive measures, because many risk factors are not amenable to intervention. Selective digestive decontamination (SDD) has been shown to be efficacious for decreasing the frequency of VAP, although it has not been incorporated into the routine of most intensive care units. The objective of our study was to evaluate the efficacy of SDD without parenteral antibiotics for preventing VAP in a major heart surgery intensive care unit...
March 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29615093/continuous-versus-intermittent-endotracheal-cuff-pressure-control-for-the-prevention-of-ventilator-associated-respiratory-infections-in-vietnam-study-protocol-for-a-randomised-controlled-trial
#12
Vu Quoc Dat, Ronald B Geskus, Marcel Wolbers, Huynh Thi Loan, Lam Minh Yen, Nguyen Thien Binh, Le Thanh Chien, Nguyen Thi Hoang Mai, Nguyen Hoan Phu, Nguyen Phu Huong Lan, Nguyen Van Hao, Hoang Bao Long, Tran Phuong Thuy, Nguyen Van Kinh, Nguyen Vu Trung, Vu Dinh Phu, Nguyen Trung Cap, Dao Tuyet Trinh, James Campbell, Evelyne Kestelyn, Heiman F L Wertheim, Duncan Wyncoll, Guy Edward Thwaites, H Rogier van Doorn, C Louise Thwaites, Behzad Nadjm
BACKGROUND: Ventilator-associated respiratory infection (VARI) comprises ventilator-associated pneumonia (VAP) and ventilator-associated tracheobronchitis (VAT). Although their diagnostic criteria vary, together these are the most common hospital-acquired infections in intensive care units (ICUs) worldwide, responsible for a large proportion of antibiotic use within ICUs. Evidence-based strategies for the prevention of VARI in resource-limited settings are lacking. Preventing the leakage of oropharyngeal secretions into the lung using continuous endotracheal cuff pressure control is a promising strategy...
April 4, 2018: Trials
https://www.readbyqxmd.com/read/29614915/preliminary-experience-of-tigecycline-treatment-in-critically-ill-children-with-ventilator-associated-pneumonia
#13
Shupeng Lin, Lingfang Liang, Chenmei Zhang, Sheng Ye
Objective Ventilator-associated pneumonia (VAP) is a life-threatening complication for children who are treated in a paediatric intensive care unit. Tigecycline treatment of children with VAP has not been well studied. This study aimed to describe tigecycline use in children with VAP in a tertiary care hospital. Methods We conducted a retrospective chart review in a tertiary hospital from May 1, 2012 to May 1, 2017. Results Twenty-four children (20 girls) with median age of 8 months (range, 27 days to 6 years and 9 months) were treated with tigecycline...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29531445/colistin-versus-colistin-combined-with-ampicillin-sulbactam-for-multiresistant-acinetobacter-baumannii-ventilator-associated-pneumonia-treatment-an-open-label-prospective-study
#14
Demosthenes Makris, Efi Petinaki, Vasssiliki Tsolaki, Efstratios Manoulakas, Konstantinos Mantzarlis, Olimpia Apostolopoulou, Dimitrios Sfyras, Epaminondas Zakynthinos
Background: Retrospective studies have reported good clinical success rates using colistin as monotherapy to treat Acinetobacter baumannii ventilator-associated pneumonia (VAP), comparable to that obtained with colistin combined with other antibiotics. However, inadequate penetration into the pulmonary parenchyma for colistin has been shown in animal models. Aim: The aim of the study was to study prospectively the outcome, measured as clinical response and survival, of intravenously administered colistin versus colistin combined with high-dose ampicillin-sulbactam in Intensive Care Unit (ICU) patients with multiresistant A...
February 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29511909/resistance-trends-and-treatment-options-in-gram-negative-ventilator-associated-pneumonia
#15
REVIEW
Nathaniel J Rhodes, Caroline E Cruce, J Nicholas O'Donnell, Richard G Wunderink, Alan R Hauser
PURPOSE OF REVIEW: Hospital-acquired and ventilator-associated pneumonia (VAP) are frequent causes of infection among critically ill patients. VAP is the most common hospital-acquired bacterial infection among mechanically ventilated patients. Unfortunately, many of the nosocomial Gram-negative bacteria that cause VAP are increasingly difficult to treat. Additionally, the evolution and dissemination of multi- and pan-drug resistant strains leave clinicians with few treatment options. VAP patients represent a dynamic population at risk for antibiotic failure and under-dosing due to altered antibiotic pharmacokinetic parameters...
March 6, 2018: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/29506460/clinical-pulmonary-infection-score-and-a-spot-serum-procalcitonin-level-to-guide-discontinuation-of-antibiotics-in-ventilator-associated-pneumonia-a-study-in-a-single-institution-with-high-prevalence-of-nonfermentative-gram-negative-bacilli-infection
#16
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
https://www.readbyqxmd.com/read/29416463/effect-of-extended-infusion-of-meropenem-and-nebulized-amikacin-on-gram-negative-multidrug-resistant-ventilator-associated-pneumonia
#17
Mona Ahmed Ammar, Waleed Abdalla
Background: Ventilator-associated pneumonia (VAP) due to multidrug-resistant organisms (MDROs) is associated with a significant mortality in the Intensive Care Unit (ICU). The aim of this study was to compare the efficacy and safety of extended infusion of meropenem and nebulized amikacin on VAP caused by Gram-negative MDRO versus intravenous (IV) meropenem and amikacin alone. Methodology: A randomized nonblinded controlled trial was performed on ninety patients with VAP...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29340593/the-clinical-utility-of-methicillin-resistant-staphylococcus-aureus-mrsa-nasal-screening-to-rule-out-mrsa-pneumonia-a-diagnostic-meta-analysis-with-antimicrobial-stewardship-implications
#18
Diane M Parente, Cheston B Cunha, Eleftherios Mylonakis, Tristan T Timbrook
Background: Recent literature has highlighted MRSA nasal screening as a possible antimicrobial stewardship program (ASP) tool for avoiding unnecessary empiric MRSA therapy for pneumonia, yet current guidelines recommend MRSA therapy based on risk factors. The objective of this meta-analysis was to evaluate the diagnostic value of MRSA nasal screening in MRSA pneumonia. Methods: Pubmed and EMBASE were searched from inception to November 2016 for English studies evaluating MRSA nasal screening and development of MRSA pneumonia...
January 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29337703/new-antibiotics-for-ventilator-associated-pneumonia
#19
Matteo Bassetti, Antionio Vena, Nadia Castaldo, Elda Righi, Maddalena Peghin
PURPOSE OF REVIEW: Ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR) bacteria represents a global emerging problem. Delayed prescription of an adequate treatment for VAP has been associated with higher morbidity and mortality. New molecules have been developed to face the need of compounds that are active against resistant Gram-positive and Gram-negative pathogens. The aim of this review is to summarize the current scenario of new therapeutic options for the treatment of VAP...
April 2018: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29317840/an-antibiotic-stewardship-exercise-in-the-icu-building-a-treatment-algorithm-for-the-management-of-ventilator-associated-pneumonia-based-on-local-epidemiology-and-the-2016-infectious-diseases-society-of-america-american-thoracic-society-guidelines
#20
Lyn S Awad, Dania I Abdallah, Anas M Mugharbil, Tamima H Jisr, Nabila S Droubi, Nabila A El-Rajab, Rima A Moghnieh
Introduction: Management of ventilator-associated pneumonia (VAP), the most common infection in patients on mechanical ventilation, should be tailored to local microbiological data. The aim of this study was to determine susceptibility patterns of organisms causing VAP to develop a treatment algorithm based on these findings and evidence from the literature. Materials and methods: This is a retrospective analysis of the microbiological etiology of VAP in the intensive care unit (ICU) of a Lebanese tertiary care hospital from July 2015 to July 2016...
2018: Infection and Drug Resistance
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