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Culture-negative sepsis

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https://www.readbyqxmd.com/read/29792103/prolonged-use-of-antibiotics-after-birth-is-associated-with-increased-morbidity-in-preterm-infants-with-negative-cultures
#1
C Fajardo, B Alshaikh, A Harabor
BACKGROUND: Most preterm infants are exposed to a variable duration of antibiotic therapy after birth despite negative cultures. Data is emerging about the risks of prolonged antibiotics. We sought to assess the association between length of initial antibiotic course and neonatal outcomes in a cohort from a single large perinatal centre. METHODS: Retrospective cohort study of prospectively collected data on all infants with a birth weight of less than 1250 g hospitalized in our NICU in a 4-year window and who had negative blood and CSF cultures in the first 2 days of life...
May 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29791315/incidence-of-early-onset-sepsis-in-infants-born-to-women-with-clinical-chorioamnionitis
#2
Tara M Randis, Madeline Murguia Rice, Leslie Myatt, Alan T N Tita, Kenneth J Leveno, Uma M Reddy, Michael W Varner, John M Thorp, Brian M Mercer, Mara J Dinsmoor, Susan M Ramin, Marshall W Carpenter, Philip Samuels, Anthony Sciscione, Jorge E Tolosa, George Saade, Yoram Sorokin
OBJECTIVE: To determine the frequency of sepsis and other adverse neonatal outcomes in women with a clinical diagnosis of chorioamnionitis. METHODS: We performed a secondary analysis of a multi-center placebo-controlled trial of vitamins C/E to prevent preeclampsia in low risk nulliparous women. Clinical chorioamnionitis was defined as either the "clinical diagnosis" of chorioamnionitis or antibiotic administration during labor because of an elevated temperature or uterine tenderness in the absence of another cause...
May 23, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29786145/pilot-study-demonstrates-that-placental-histology-can-provide-an-additional-tool-for-diagnosing-early-onset-neonatal-sepsis
#3
J M A Ykema, E J D'Haens, M Havenith, J van Eyck, R A van Lingen, M A C Hemels
AIM: We explored whether placental histology could help to diagnose early-onset neonatal sepsis (EONS), guide clinical decision-making 48 hours after birth and reduce antibiotic use. METHODS: This study comprised 109 infants born at less than 32 weeks of gestation, who were admitted to the neonatal intensive care unit of Isala, Zwolle, The Netherlands, between January 2013 and December 2013. EONS was defined as clinical symptoms plus raised serial C-reactive protein >10 mg/L and a positive (proven EONS) or a negative (suspected EONS) blood culture...
May 22, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29771353/predictors-for-identifying-burn-sepsis-and-performance-versus-existing-criteria
#4
David M Hill, Matthew D Percy, Sai R Velamuri, Julio Lanfranco, Ivan Romero Legro, Scott E Sinclair, William L Hickerson
Sepsis is the largest cause of mortality in thermally injured patients. Traditional SIRS criteria do not aid diagnosis of sepsis in burn centers. Studies have attempted identification of the best indicators of sepsis in the thermal injured patient, but predictive variables are inconsistent across the various studies. Currently, consensus guidelines lack evidential support as to which patients will benefit most from prompt antimicrobial therapy. The purpose of our study was to evaluate novel diagnostic parameters for thermal injured patients with known sepsis and compare these parameters with existing diagnostic criteria...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29764503/bacteriological-profile-of-neonatal-sepsis-and-antibiotic-susceptibility-pattern-of-isolates-admitted-at-kanti-children-s-hospital-kathmandu-nepal
#5
Nikita Singh Yadav, Saroj Sharma, Dhiraj Kumar Chaudhary, Prabhat Panthi, Pankaj Pokhrel, Anil Shrestha, Pappu Kumar Mandal
OBJECTIVE: Neonatal sepsis is a major cause of morbidity and mortality of newborns (< 1 month of age). Septicemia and drug resistance is a predominant issue for neonatal death in Nepal. This study is intended to find bacteriological profile of neonatal sepsis and antibiotic susceptibility pattern of the isolates from neonates at Kanti Children's Hospital, Kathmandu, Nepal. RESULTS: Out of 350 suspected cases of neonatal sepsis, 59 (16.9%) cases showed positive blood culture...
May 15, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29756072/managing-antibiotics-wisely-a-quality-improvement-programme-in-a-tertiary-neonatal-unit-in-the-uk
#6
Vasiliki Makri, Gemma Davies, Stephanie Cannell, Katherine Willson, Lucy Winterson, Joanna Webb, Amit Kandhari, Maha Mansour, Joanne Thomas, Geraint Morris, Jean Matthes, Sujoy Banerjee
Microbial resistance to antibiotics is a serious global health problem compounded by antibiotic overuse and limited investment in new antibiotic research. Inappropriate perinatal antibiotic exposure is increasingly linked to lifelong adverse outcomes through its impact on the developing microbiome. Antibiotic stewardship may be the only effective preventative strategy currently available. As the first tertiary neonatal unit in the UK to collaborate in an international quality improvement programme (QIP) with Vermont Oxford Network (VON), we present the results of our antibiotic stewardship initiative...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29753321/influence-of-pathogen-and-focus-of-infection-on-procalcitonin-values-in-sepsis-patients-with-bacteremia-or-candidemia
#7
Daniel O Thomas-Rüddel, Bernhard Poidinger, Matthias Kott, Manfred Weiss, Konrad Reinhart, Frank Bloos
BACKGROUND: This study aimed to evaluate the accuracy of procalcitonin (PCT) serum concentrations to diagnose Gram-negative bacteremia and the association of PCT serum concentrations with more specific pathogens and the focus of infection. METHODS: Secondary analysis of the prospectively collected patient-level dataset from a cluster randomized quality improvement trial was performed. The trial included sepsis patients with organ dysfunction treated in the participating intensive care units from 2011 to 2015...
May 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29742943/comparison-between-presepsin-and-procalcitonin-in-early-diagnosis-of-neonatal-sepsis
#8
Agustin Iskandar, Maimun Z Arthamin, Kristin Indriana, Muhammad Anshory, Mina Hur, Salvatore Di Somma
BACKGROUND: Neonatal sepsis remains worldwide one of the leading causes of morbidity and mortality in both term and preterm infants. Lower mortality rates are related to timely diagnostic evaluation and prompt initiation of empiric antibiotic therapy. Blood culture, as gold standard examination for sepsis, has several limitations for early diagnosis, so that sepsis biomarkers could play an important role in this regard. This study was aimed to compare the value of the two biomarkers presepsin and procalcitonin in early diagnosis of neonatal sepsis...
May 9, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29733508/fast-rapid-determinations-of-antibiotic-susceptibility-phenotypes-using-label-free-cytometry
#9
Tzu-Hsueh Huang, Yih-Ling Tzeng, Robert M Dickson
Sepsis, a life-threatening immune response to blood infections (bacteremia), has a ∼30% mortality rate and is the 10th leading cause of US hospital deaths. The typical bacterial loads in adult septic patients are ≤100 bacterial cells (colony forming units, CFU) per ml blood, while pediatric patients exhibit only ∼1000 CFU/ml. Due to the low numbers, bacteria must be propagated through ∼24-hours blood cultures to generate sufficient CFUs for diagnosis and further analyses. Herein, we demonstrate that, unlike other rapid post-blood culture antibiotic susceptibility tests (ASTs), our phenotypic approach can drastically accelerate ASTs for the most common sepsis-causing gram-negative pathogens by circumventing long blood culture-based amplification...
May 7, 2018: Cytometry. Part A: the Journal of the International Society for Analytical Cytology
https://www.readbyqxmd.com/read/29721398/myoclonus-from-antibiotic-therapy-ceftazidime-induced-neurotoxicity-a-case-report-and-review
#10
Chong Yau Ong, Yan Qin
A 78-year-old Chinese man with a history of end-stage renal disease (ESRD) presented with fever of one-day duration. He was treated for catheter-related sepsis with intravenous piperacillin and tazobactam, which was later switched to vancomycin and ceftazidime secondary to persistent fever with negative cultures. On the fifth day of treatment with vancomycin and ceftazidime, he developed new-onset upper limb myoclonus which progressed to bilateral upper limb ataxia. A provisional diagnosis of myoclonus and ataxia secondary to neurotoxicity related to ceftazidime was made and the ceftazidime was ceased...
March 1, 2018: Curēus
https://www.readbyqxmd.com/read/29706365/clinical-epidemiology-of-carbapenem-resistant-gram-negative-sepsis-among-hospitalized-patients-shifting-burden-of-disease
#11
Nicholas S Britt, David J Ritchie, Marin H Kollef, Carey-Ann D Burnham, Michael J Durkin, Nicholas B Hampton, Scott T Micek
BACKGROUND: Infections caused by carbapenem-resistant gram-negative bacilli are an emerging public health threat. However, there is a paucity of data examining comparative incidence rates, risk factors, and outcomes in this population. METHODS: This single-center retrospective cohort study was conducted at an urban tertiary-care academic medical center. We included patients admitted from 2012 to 2015 who met the following criteria: i) age ≥ 18 years; and ii) culture positive for carbapenem-resistant Enterobacteriaceae (CRE) or carbapenem-resistant non-Enterobacteriaceae (CRNE) from any site...
April 26, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29700761/development-and-first-evaluation-of-a-novel-multiplex-real-time-pcr-on-whole-blood-samples-for-rapid-pathogen-identification-in-critically-ill-patients-with-sepsis
#12
Kirsten van de Groep, Martine P Bos, Paul H M Savelkoul, Anna Rubenjan, Christel Gazenbeek, Willem J G Melchers, Tom van der Poll, Nicole P Juffermans, David S Y Ong, Marc J M Bonten, Olaf L Cremer
Molecular tests may enable early adjustment of antimicrobial therapy and be complementary to blood culture (BC) which has imperfect sensitivity in critically ill patients. We evaluated a novel multiplex real-time PCR assay to diagnose bloodstream pathogens directly in whole blood samples (BSI-PCR). BSI-PCR included 11 species- and four genus-specific PCRs, a molecular Gram-stain PCR, and two antibiotic resistance markers. We collected 5 mL blood from critically ill patients simultaneously with clinically indicated BC...
April 26, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29698291/csa-90-promotes-bone-formation-and-mitigates-methicillin-resistant-staphylococcus-aureus-infection-in-a-rat-open-fracture-model
#13
Rebecca Mills, Tegan L Cheng, Kathy Mikulec, Lauren Peacock, David Isaacs, Carl Genberg, Paul B Savage, David G Little, Aaron Schindeler
BACKGROUND: Infection of open fractures remains a significant cause of morbidity and mortality to patients worldwide. Early administration of prophylactic antibiotics is known to improve outcomes; however, increasing concern regarding antimicrobial resistance makes finding new compounds for use in such cases a pressing area for further research. CSA-90, a synthetic peptidomimetic compound, has previously demonstrated promising antimicrobial action against Staphylococcus aureus in rat open fractures...
April 24, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29695000/new-diagnostic-possibilities-for-neonatal-sepsis
#14
Chryssoula Tzialla, Paolo Manzoni, Cristian Achille, Lina Bollani, Mauro Stronati, Alessandro Borghesi
Progress in neonatal care has decrease morbidity and mortality due to neonatal sepsis (NS). Although diagnosis of sepsis continues to rely on blood culture, this method is too slow and limited by false-negative results. There are numerous sepsis biomarkers that have been evaluated for the early diagnosis of NS, but, to date, there is no single ideal biomarker, though novel biomarkers are becoming more sophisticated and specific in their clinical applications. This review provides an overview of the current diagnostic approaches available or under development for diagnosing NS...
May 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29691444/adaptive-response-of-neonatal-sepsis-derived-group-b-streptococcus-to-bilirubin
#15
Richard Hansen, Sophie Gibson, Eduardo De Paiva Alves, Mark Goddard, Andrew MacLaren, Anne Marie Karcher, Susan Berry, Elaina S R Collie-Duguid, Emad El-Omar, Mike Munro, Georgina L Hold
Hyperbilirubinemia is so common in newborns as to be termed physiological. The most common bacteria involved in early-onset neonatal sepsis are Streptococcus agalactiae, commonly called Group B Streptococcus (GBS). Whilst previous studies show bilirubin has antioxidant properties and is beneficial in endotoxic shock, little thought has been given to whether bilirubin might have antibacterial properties. In this study, we performed a transcriptomic and proteomic assessment of GBS cultured in the presence/absence of bilirubin...
April 24, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29690929/gonococcal-sepsis-in-a-32-year-old-female-a-case-report
#16
Michael Owusu, Kwadwo Sarfo Marfo, Godfred Acheampong, Abednego Arthur, Nimako Sarpong, Justin Im, Ondari D Mogeni, Augustina Annan, Hsin-Ying Chiang, Chih-Horng Kuo, Se Eun Park, Florian Marks, Ellis Owusu-Dabo, Yaw Adu-Sarkodie
BACKGROUND: Neisseria gonorrhoeae is a Gram-negative bacterium which affects the urethra, throat, rectum and cervix of patients and often associated with sexually transmitted infections. The global epidemiology of the disease is not well characterised especially in resource constraint countries due to poor diagnostic capacity and inefficient reporting systems. Although important, little is known about the propensity of this bacterium to cause sepsis in immunocompetent individuals. CASE PRESENTATION: A 32-year-old female presented with fever and generalised malaise to a rural hospital in Ghana...
April 24, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29689386/identification-and-antimicrobial-resistance-of-pathogens-for-neonatal-septicemia-in-china-a-meta-analysis
#17
Jing-Yang Li, Shang-Qin Chen, Yan-Yan Yan, Ying-Ying Hu, Jia Wei, Qiu-Ping Wu, Zhen-Lang Lin, Jing Lin
OBJECTIVES: The purpose of the study is to analyze the distribution and antimicrobial resistance of common bacterial pathogens causing neonatal septicemia based on a systematic review of the published studies in China. METHODS: Articles about neonatal sepsis published in the Chinese literature from 2009 to 2014 were identified according to the inclusion and exclusion criteria. Data were extracted and analyzed using Comprehensive Meta-Analysis software. RESULTS: A total of 71 studies were included in which a total of 8080 bacterial species were isolated from culture positive blood samples...
April 21, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29686548/evaluating-predictors-of-invasive-candidiasis-in-patients-with-and-without-candidemia-on-micafungin
#18
Amy Carr, Peter Colley, Mezgebe Berhe, Hoa L Nguyen
Numerous risk factors have been linked to invasive candidiasis; however, they are nonspecific and often trigger empiric antifungal therapy in a large number of patients. Identification of more precise predictors could promote judicious use of empiric echinocandins. In this retrospective review, 127 patients with blood cultures positive for Candida spp. were compared to a randomly selected cohort of 134 patients on empiric micafungin for ≥3 days and with blood cultures negative for Candida spp. Factors associated with candidemia included total parenteral nutrition (TPN; 26...
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29686180/chromobacterium-violaceum-the-deadly-sepsis
#19
Guntur Darmawan, R N Yasmin Kusumawardhani, Bachti Alisjahbana, Trinugroho Heri Fadjari
Chromobacterium violaceum is a Gram-negative facultatively anaerobic, oxidase-positive bacterium producing a dark violet antioxidant pigment called violacein. It is an opportunistic pathogen and has an ubiquitous distribution, mainly resides in water and soil of tropical and subtropical regions.An-18-year-old man referred to the emergency room with a 5-day history of progressively worsening swelling of the right cheek. He sought consult and hospitalized at another institution for three days prior this admission; however, his condition deteriorated...
January 2018: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/29684391/a-randomized-control-trial-of-preoperative-prophylactic-antibiotics-prior-to-percutaneous-nephrolithotomy-in-low-infectious-risk-population-a-report-from-the-edge-consortium
#20
Ben H Chew, Nicole L Miller, Joel E Abbott, Dirk Lange, Mitchell R Humphreys, Vernon M Pais, Manoj Monga, Amy E Krambeck, Roger L Sur
INTRODUCTION: Single institution studies suggest a benefit of a week of preoperative antibiotics prior to percutaneous nephrolithotomy (PCNL). These studies are limited by lower quality methodology such as the inclusion of heterogeneous populations or the use of non-standard definitions of sepsis. The American Urological Association (AUA) Best Practice Statement recommends <24 hours of IV antibiotics, but no other data exist about the duration/benefit of preoperative antibiotics. We sought to perform a rigorous (using CONSORT guidelines), multi-institutional trial to assess preoperative antibiotics in PCNL patients at low risk of developing infections...
April 20, 2018: Journal of Urology
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