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JOURNAL ARTICLE
Manasawee Wantanatavatod, Panuwat Wongkulab
BACKGROUND: Carbapenem-resistant A. baumannii (CRAB) hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) is now a therapeutic problem worldwide. METHOD: An open-label, randomized, superiority, single-blind trial was conducted in Rajavithi Hospital, a super-tertiary care facility in Bangkok, Thailand. CRAB HAP/VAP patients were randomly assigned to receive either sitafloxacin-colistin-meropenem or colistin-meropenem. Outcomes in the two groups were then assessed with respect to mortality, clinical response, and adverse effects...
January 30, 2024: Antibiotics
#22
JOURNAL ARTICLE
Thainah Bruna Santos Zambrano, Ximena Sayonara Guillén Vivas, Caísa Batista Santos, Viviane de Fátima Mestre, Naga Raju Maddela, Lucia Elena Galarza Santana, Ricardo Sergio Couto de Almeida
BACKGROUND: Patients admitted to the Intensive Care Unit (ICU) are at greater risk of developing nosocomial infections due to their investigations, treatment and changes in the immune system. One of the most prevalent nosocomial infections is respiratory tract infection, such as hospital acquired pneumonia and ventilator-associated pneumonia (VAP). The bacteria commonly found in the oral cavity in the hospital environment are Streptococcus viridians , Staphylococcus aureus , Pseudomonas aeruginosa , Enterococcus spp...
March 2024: Infection prevention in practice
#23
REVIEW
Jayesh Dhanani, Jason A Roberts, Antoine Monsel, Antoni Torres, Marin Kollef, Jean-Jacques Rouby
BACKGROUND: Nebulisation of antibiotics is a promising treatment for ventilator-associated pneumonia (VAP) caused by multidrug-resistant organisms. Ensuring effective antibiotic concentrations at the site of infection in the interstitial space fluid is crucial for clinical outcomes. Current assessment methods, such as epithelial lining fluid and tissue homogenates, have limitations in providing longitudinal pharmacokinetic data. MAIN BODY: Lung microdialysis, an invasive research technique predominantly used in animals, involves inserting probes into lung parenchyma to measure antibiotic concentrations in interstitial space fluid...
February 19, 2024: Critical Care: the Official Journal of the Critical Care Forum
#24
REVIEW
Karyne Rangel, Salvatore Giovanni De-Simone
Acinetobacter pneumonia is a significant healthcare-associated infection that poses a considerable challenge to clinicians due to its multidrug-resistant nature. Recent world events, such as the COVID-19 pandemic, have highlighted the need for effective treatment and management strategies for Acinetobacter pneumonia. In this review, we discuss lessons learned from recent world events, particularly the COVID-19 pandemic, in the context of the treatment and management of Acinetobacter pneumonia. We performed an extensive literature review to uncover studies and information pertinent to the topic...
2024: Infection and Drug Resistance
#25
MULTICENTER STUDY
Matthieu Petit, Frank Bidar, Quentin Fosse, Lucie Lefevre, Marine Paul, Tomas Urbina, Paul Masi, Florent Bavozet, Jérémie Lemarié, Etienne de Montmollin, Chloé Andriamifidy-Berti, Julien Dessajan, Benjamin Zuber, Lara Zafrani, Edwige Peju, Paris Meng, Liliane Charrier, Loic Le Guennec, Marie Simon, Charles-Edouard Luyt, Luc Haudebourg, Guillaume Geri
BACKGROUND: Ventilator associated pneumonia (VAP) due to wild-type AmpC-producing Enterobacterales (wtAE) is frequent in intensive care unit (ICU) patients. Despite a low level of evidence, definitive antimicrobial therapy (AMT) with third generation cephalosporins (3GCs) or piperacillin is discouraged. METHODS: Observational prospective study including consecutive wtAE VAP patients in 20 French ICUs. The primary objective was to assess the association of the choice of definitive AMT, i...
February 5, 2024: Critical Care: the Official Journal of the Critical Care Forum
#26
JOURNAL ARTICLE
Nicola E Symonds, Eric X M Meng, John Gordon Boyd, Tracy Boyd, Andrew Day, Hailey Hobbs, David M Maslove, Patrick A Norman, Joanna S Semrau, Stephanie Sibley, John Muscedere
BACKGROUND: Critically ill patients are at high risk of acquiring ventilator-associated pneumonia (VAP), which occurs in approximately 20% of mechanically ventilated patients. VAP results either from aspiration of pathogen-contaminated oropharyngeal secretions or contaminated biofilms that form on endotracheal tubes (ETTs) after intubation. VAP results in increased duration of mechanical ventilation, increased intensive care unit and hospital length of stay, increased risk of death and increased healthcare costs...
February 2, 2024: BMJ Open
#27
Valentin De Villiers De La Noue, Lucien Brasme, Odile Bajolet, Vincent Legros
Gardnerella vaginalis (G. vaginalis) is a bacterium rarely responsible for systemic infections and is exceptionally isolated from bronchopulmonary samples. Here, we report here two patients with trauma who were diagnosed with a G. vaginalis ventilatory acquired pneumonia (VAP) via mini bronchoalveolar lavage (mini-BAL). According to our observations, G. vaginalis was the only microorganism with a significant threshold and the identification was obtained by a reliable mean. There is no recommendation for antibiotic treatment for invasive G...
February 1, 2024: Diagnostic Microbiology and Infectious Disease
#28
JOURNAL ARTICLE
Fredrik Hammarskjöld, Sören Berg, Herjan Bavelaar, Anna J Henningson, Knut Taxbro
BACKGROUND: Patients with severe coronavirus disease 2019 (COVID) pneumonia and acute respiratory distress syndrome (C-ARDS) on invasive mechanical ventilation (IMV) have been found to be prone to having other microbial findings than severe acute respiratory syndrome coronavirus 2 (SARS-2)-CoV-19 in the bronchoalveolar lavage (BAL) fluid at intubation causing a superinfection. These BAL results could guide empirical antibiotic treatment in complex clinical situations. However, there are limited data on the relationship between microbial findings in the initial BAL at intubation and later ventilator-associated pneumonia (VAP) diagnoses...
January 28, 2024: Acta Anaesthesiologica Scandinavica
#29
REVIEW
Mark L Metersky, Andre C Kalil
Two recent major guidelines on diagnosis and treatment of ventilator-associated pneumonia (VAP) recommend consideration of local antibiotic resistance patterns and individual patient risks for resistant pathogens when formulating an initial empiric antibiotic regimen. One recommends against invasive diagnostic techniques with quantitative cultures to determine the cause of VAP; the other recommends either invasive or noninvasive techniques. Both guidelines recommend short-course therapy be used for most patients with VAP...
March 2024: Infectious Disease Clinics of North America
#30
JOURNAL ARTICLE
Ginger G Cabrera-Tejada, Pablo Chico-Sánchez, Paula Gras-Valentí, Francisco A Jaime-Sánchez, Maria Galiana-Ivars, Sonia Balboa-Esteve, Isel L Gómez-Sotero, José Sánchez-Payá, Elena Ronda-Pérez
Healthcare-associated infections (HAIs) present a global public health challenge, contributing to high morbidity and mortality and substantial economic burdens. Ventilator-associated pneumonia (VAP) ranks as the second most prevalent HAI in intensive care units (ICUs), emphasizing the need for economic analyses in this context. This retrospective cohort study, conducted at the General Hospital of Alicante from 2012 to 2019, aimed to assess additional costs related to VAP by comparing the extended length of stay for infected and non-infected ICU patients undergoing mechanical ventilation (MV) for more than 48 h...
December 19, 2023: Antibiotics
#31
JOURNAL ARTICLE
Yin Mo, Suchart Booraphun, Andrew Yunkai Li, Pornanan Domthong, Gyan Kayastha, Yie Hui Lau, Ploenchan Chetchotisakd, Direk Limmathurotsakul, Paul Anantharajah Tambyah, Ben S Cooper
BACKGROUND: Ventilator-associated pneumonia (VAP) is associated with increased mortality, prolonged hospitalisation, excessive antibiotic use and, consequently, increased antimicrobial resistance. In this phase 4, randomised trial, we aimed to establish whether a pragmatic, individualised, short-course antibiotic treatment strategy for VAP was non-inferior to usual care. METHODS: We did an individually randomised, open-label, hierarchical non-inferiority-superiority trial in 39 intensive care units in six hospitals in Nepal, Singapore, and Thailand...
January 22, 2024: Lancet Respiratory Medicine
#32
JOURNAL ARTICLE
Claire Dahyot-Fizelier, Sigismond Lasocki, Thomas Kerforne, Pierre-Francois Perrigault, Thomas Geeraerts, Karim Asehnoune, Raphaël Cinotti, Yoann Launey, Vincent Cottenceau, Marc Laffon, Thomas Gaillard, Matthieu Boisson, Camille Aleyrat, Denis Frasca, Olivier Mimoz
BACKGROUND: Patients with acute brain injury are at high risk of ventilator-associated pneumonia (VAP). The benefit of short-term antibiotic prophylaxis remains debated. We aimed to establish the effect of an early, single dose of the antibiotic ceftriaxone on the incidence of early VAP in patients with severe brain injury who required mechanical ventilation. METHODS: PROPHY-VAP was a multicentre, randomised, double-blind, placebo-controlled, assessor-masked, superiority trial conducted in nine intensive care units in eight French university hospitals...
January 19, 2024: Lancet Respiratory Medicine
#33
JOURNAL ARTICLE
Sabrina Haque, Akash Ahmed, Nazrul Islam, Fahim Kabir Monjurul Haque
Recent research has shown that antibiotic-resistant microorganisms are becoming more prevalent in intensive care units (ICUs) at an exponential rate. Patients in the ICU can get infected by pathogens due to invasive operation procedures and critical health conditions. This study primarily emphasized tracheal samples from ICU patients due to their reliance on ventilators, increasing their susceptibility to Ventilator-Associated Pneumonia (VAP). Moreover, the rise of multidrug-resistant (MDR) pathogens makes treatment strategies more challenging for these patients...
January 8, 2024: Antibiotics
#34
Stefania Mercadante, Costanza Tripiciano, Lorenza Romani, Matteo Di Nardo, Gabriella Bottari, Bianca Maria Goffredo, Raffaele Simeoli, Isabella Guzzo, Laura Lancella, Charalampos Antachopoulos, Maia De Luca
BACKGROUND: Infections caused by antimicrobial-resistant (AMR) pathogens are increasing worldwide, representing a serious global public health issue with high morbidity and mortality rates The treatment of Pseudomonas aeruginosa (PA) infections has become a significant challenge due to its ability to develop resistance to many of the currently available antibiotics, especially in intensive care unit (ICU) settings. Among the very few therapeutic lines available against extensively drug-resistant (XDR)-PA and/or with difficult-to-treat resistance (DTR)-PA, cefiderocol is an injectable siderophore cephalosporin not licensed for use in pediatric patients...
December 30, 2023: Antibiotics
#35
JOURNAL ARTICLE
Jefferson Antonio Buendía, Diana Guerrero Patiño, Andrés Felipe Zuluaga Salazar
INTRODUCTION: Ventilator-associated pneumonia (VAP) is a prominent cause of morbidity and mortality in intensive care unit (ICU) patients. Due to the increase in Methicillin resistant Staphylococcus aureus infection, it is important to consider other more effective and safer alternatives compared to vancomycin. This motivates evaluating whether the use of an apparently more expensive drug such as linezolid can be cost-effective in Colombia. METHODS: A decision tree was used to simulate the results in terms of the cost and proportion of cured patients...
January 18, 2024: BMC Infectious Diseases
#36
REVIEW
Hisayuki Shuto, Kosaku Komiya, Kazuya Tone, Hiroyuki Matsumoto, Hiroshi Moro, Nobuaki Shime
BACKGROUND: Carbapenem is recommended as one of the first-line regimens for ventilator-associated pneumonia (VAP), but no recent systematic review has fully investigated its efficacy. This systematic review aims to evaluate the efficacy of carbapenem compared with non-carbapenem for VAP treatment. METHODS: We performed a systematic review and meta-analysis of studies comparing the efficacy and the safety between carbapenem and non-carbapenem with activity to Pseudomonas aeruginosa in the treatment for VAP...
March 2024: Respiratory Investigation
#37
JOURNAL ARTICLE
Victor D Rosenthal, Ruijie Yin, Patricio Nercelles, Sara E Rivera-Molina, Somani Jyoti, Reshma Dongol, Daisy Aguilar-De-Moros, Nellie Tumu, Johana Alarcon-Rua, Juan P Stagnaro, Safaa Alkhawaja, Luisa F Jimenez-Alvarez, Yuliana A Cano-Medina, Sandra L Valderrama-Beltran, Claudia M Henao-Rodas, Maria A Zuniga-Chavarria, Amani El-Kholy, Hala Mounir Agha, Suneeta Sahu, Siksha O Anusandhan, Mahuya Bhattacharyya, Mohit Kharbanda, Aruna Poojary, Pravin K Nair, Sheila N Myatra, Rajesh Chawla, Kavita Sandhu, Yatin Mehta, Prasad Rajhans, Farid Zand, Mohammad Abdellatif-Daboor, Chian-Wern Tai, Chin S Gan, Mohd-Basri Mat Nor, Guadalupe Aguirre-Avalos, Blanca E Hernandez-Chena, Alejandro Sassoe-Gonzalez, Isabel Villegas-Mota, Mary C Aleman-Bocanegra, Ider Bat-Erdene, Nilton Y Carreazo, Alex Castaneda-Sabogal, Jarosław Janc, Vladislav Belskiy, Sona Hlinkova, Dincer Yildizdas, Merve Havan, Alper Koker, Hulya Sungurtekin, Ener C Dinleyici, Ertugrul Guclu, Lili Tao, Ziad A Memish, Zhilin Jin
BACKGROUND: Reporting on the International Nosocomial Infection Control Consortium study results from 2015 to 2020, conducted in 630 intensive care units across 123 cities in 45 countries spanning Africa, Asia, Eastern Europe, Latin America, and the Middle East. METHODS: Prospective intensive care unit patient data collected via International Nosocomial Infection Control Consortium Surveillance Online System. Centers for Disease Control and Prevention/National Health Care Safety Network definitions applied for device-associated health care-associated infections (DA-HAI)...
January 6, 2024: American Journal of Infection Control
#38
JOURNAL ARTICLE
Muhammad Ali, Muhammad Harris Shoaib, Shagufta Nesar, Muhammad Jamal, Sabiha Gul, Saira Shahnaz, Shoaib Nawaz, Quratulain Khan, Javaria Imran
BACKGROUND: Stroke is a neurological disease and a leading cause of mortality worldwide. Strokes mainly consist of two types: hemorrhage and ischemia. Stroke patients are being administered multiple drug therapy and are at risk of drug-related problems. AIM: To estimate drug-related problems (DRPs) and clinical end outcomes in hospitalized stroke patients. METHODS: Current study was a multicenter, cross-sectional prospective observational study including 250 stroke patients admitted to tertiary care hospitals in Karachi, Pakistan...
2024: PloS One
#39
JOURNAL ARTICLE
Owen R Albin, Jonathan P Troost, Louis Saravolatz, Michael P Thomas, Robert C Hyzy, Mark A Konkle, Andrew J Weirauch, Robert P Dickson, Krishna Rao, Keith S Kaye
OBJECTIVES: Diagnostic error in the use of respiratory cultures for ventilator-associated pneumonia (VAP) fuels misdiagnosis and antibiotic overuse within intensive care units. In this prospective quasi-experimental study (NCT05176353), we aimed to evaluate the safety, feasibility, and efficacy of a novel VAP-specific bundled diagnostic stewardship intervention (VAP-DSI) to mitigate VAP over-diagnosis/overtreatment. METHODS: We developed and implemented a VAP-DSI using an interruptive clinical decision support tool and modifications to clinical laboratory workflows...
December 30, 2023: Clinical Microbiology and Infection
#40
JOURNAL ARTICLE
Abhishek Kori, Nidhi Negi, Iva Chandola, Reshmi Roy, Shikha Gairola, Lipika Gaur
BACKGROUND AND OBJECTIVES: Despite progress in diagnosing and managing ventilator-associated pneumonia (VAP), ongoing monitoring of ventilator-associated events (VAE) is crucial due to VAP's persistent prominence as the primary cause of Hospital-Acquired Infection (HAI) among Intensive Care unit patients. This study was done to illuminate the prevalence of VAE and antibiogram of bacterial isolates of VAP in a tertiary care hospital of Uttarakhand. MATERIALS AND METHODS: This cross-sectional study focused on ICU patients...
December 2023: Iranian Journal of Microbiology
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