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hospital acquired pneumonia guidelines

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https://www.readbyqxmd.com/read/28576117/clinical-failure-with-and-without-empiric-atypical-bacteria-coverage-in-hospitalized-adults-with-community-acquired-pneumonia-a-systematic-review-and-meta-analysis
#1
Khalid Eljaaly, Samah Alshehri, Ahmed Aljabri, Ivo Abraham, Mayar Al Mohajer, Andre C Kalil, David E Nix
BACKGROUND: Both typical and atypical bacteria can cause community-acquired pneumonia (CAP); however, the need for empiric atypical coverage remains controversial. Our objective was to evaluate the impact of antibiotic regimens with atypical coverage (a fluoroquinolone or combination of a macrolide/doxycycline with a β-lactam) to a regimen without atypical antibiotic coverage (β-lactam monotherapy) on rates of clinical failure (primary endpoint), mortality, bacteriologic failure, and adverse events, (secondary endpoints)...
June 2, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28566116/adherence-to-local-antimicrobial-guidelines-for-initial-treatment-of-community-acquired-infections
#2
Trine Langfeldt Hagen, Mathias Amdi Hertz, Gábor Balázs Uhrin, Michael Dalager-Pedersen, Henrik Carl Schønheyder, Henrik Nielsen
INTRODUCTION: Adherence to antimicrobial guidelines is key to ensuring a correct treatment of severe infections and to lessening misuse of broad-spectrum antimicrobials. We conducted a retrospective cross-sectional study at the Emergency Department of Aalborg University Hospital, North Denmark Region. Our aim was to examine adherence to local antimicrobial guidelines in the empirical treatment of community-acquired infections and to identity any predictors of guideline non-adherence. METHODS: We identified 1,555 patients who had blood cultures performed and were admitted to the medical emergency department in 2016...
June 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28562556/low-utility-of-blood-culture-in-pediatric-community-acquired-pneumonia-an-observational-study-on-2705-patients-admitted-to-the-emergency-department
#3
Jae Hyun Kwon, Jung Heon Kim, Jeong-Yong Lee, Youn-Jung Kim, Chang Hwan Sohn, Kyoung Soo Lim, Won Young Kim
To investigate the utility of blood cultures performed on previously healthy children and adolescents with community-acquired pneumonia (CAP) at a tertiary care hospital emergency department (ED).We reviewed 3235 patients with CAP aged 6 months to 18 years who underwent blood cultures at the ED from 2009 through 2016. CAP was defined according to the International Classification of Diseases, 10th Revision codes for pneumonia and the requirement of antibiotic treatment plus any of the following: radiologically confirmed, hospitalized, or moderate to severe disease...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28559001/characterizing-non-linear-effects-of-hospitalization-duration-on-antimicrobial-resistance-in-respiratory-isolates-a-retrospective-analysis-of-a-prospective-nationwide-surveillance-system
#4
Rami Sommerstein, Andrew Atkinson, Elia F Lo Priore, Andreas O Kronenberg, Jonas Marschall
OBJECTIVES: Our objective was to systematically study the influence of length of hospital stay on bacterial resistance in relevant respiratory tract isolates. METHODS: Using prospective epidemiological data from the National Swiss Antibiotic Resistance Surveillance System, susceptibility testing results of respiratory isolates retrospectively retrieved from patients hospitalized between 2008-2014 were compiled. Generalized additive models were used to illustrate resistance rates relative to hospitalization duration and to adjust for co-variables...
May 27, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28549532/a-drop-system-for-prognostication-of-nhcap-inpatients
#5
Takeshi Koizumi, Hiroki Tsukada, Kazuhiko Ito, Satoshi Shibata, Satoshi Hokari, Takafumi Tetsuka, Nobumasa Aoki, Hiroshi Moro, Yoshinari Tanabe, Toshiaki Kikuchi
Nursing and healthcare-associated pneumonia (NHCAP) is a category of healthcare-associated pneumonia that was modified for the healthcare system of Japan. The NHCAP guidelines stated the difficulty in assessing the severity classifications, for instance, A-DROP. We compared the usefulness of different severity classifications (A-DROP, CURB-65, PSI, and I-ROAD) in predicting the prognosis of nursing and healthcare-associated pneumonia. We conducted a retrospective analysis on 303 adult patients hospitalized for nursing healthcare-associated pneumonia and community-acquired pneumonia, which were diagnosed at the Department of Respiratory Medicine of Niigata General City Hospital between January 2012 and December 2014...
May 23, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28528008/-role-of-therapeutic-drug-monitoring-in-pulmonary-infections
#6
REVIEW
C Padoin
Pulmonary infections are common and caused by a wide range of viruses, bacteria, parasites and fungi. They consist of lower respiratory tract infections with community and hospital acquired acute pneumonia, bronchitis, lung abscess, fungal infections and tuberculosis. The management of these infections should be based on guidelines that take into account the microorganisms most frequently involved as a basis for empirical treatment, with identification of causative microorganisms allowing targeted treatments...
May 17, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28524255/enablers-and-barriers-to-the-use-of-antibiotic-guidelines-in-the-assessment-and-treatment-of-community-acquired-pneumonia-a-qualitative-study-of-clinicians-perspectives
#7
Antoine Sedrak, Mahesan Anpalahan, Karen Luetsch
BACKGROUND: Community-acquired pneumonia (CAP) is a common condition and a number of guidelines have been developed for its assessment and treatment. Adherence to guidelines by clinicians varies and particularly the prescribing of antibiotics often remains suboptimal. OBJECTIVE: The aim of this study was to elucidate potential barriers and enablers to the adherence to antibiotic guidelines by clinicians treating CAP in an Australian hospital. METHODS: Semi-structured interviews were conducted with purposively recruited senior prescribers who regularly treat CAP in an Australian hospital...
June 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28511383/study-on-mics-of-tigecycline-in-clinical-isolates-of-carbapenem-resistant-enterobacteriaceae-cre-at-a-tertiary-care-centre-in-north-india
#8
Vineeta Khare, Prashant Gupta, Fareya Haider, Rehana Begum
INTRODUCTION: Members of family Enterobacteriaceae are the most common Gram-negative bacteria isolated from clinical samples. Those Enterobacteriaceae which have acquired resistance to all β-lactams antibiotics including the carbapenems are considered as Carbapenem Resistant Enterobacteriaceae (CRE). These CRE isolates are often resistant to most other classes of antimicrobials as well, making their treatment a great challenge. Tigecycline is one of the last resort antimicrobials against such multidrug resistant bacteria...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28501761/improving-the-quality-of-the-intensive-care-follow-up-of-ventilated-patients-during-a-national-registration-program
#9
P Reper, D Dicker, P Damas, L Huyghens, M Haelterman
OBJECTIVES: The Belgian Public Health Organization is concerned with rates of hospital-acquired infections like ventilator-associated pneumonia (VAP). Implementing best practice guidelines for these nosocomial infections has variable success in the literature. This retrospective study was undertaken to see whether implementation of the evidence-based practices as a bundle was feasible, would influence compliance, and could reduce the rates of VAP. STUDY DESIGN: We utilized easily collectable data about regular care to rapidly assess whether interventions already in place were effectively successfully applied...
July 2017: Public Health
https://www.readbyqxmd.com/read/28455128/burden-of-adult-community-acquired-healthcare-associated-hospital-acquired-and-ventilator-associated-pneumonia-new-york-city-2010-2014
#10
Rachel E Corrado, David Lee, David E Lucero, Jay K Varma, Neil M Vora
BACKGROUND: Although pneumonia is a leading cause of death in New York City (NYC), limited data exist about the settings in which pneumonia is acquired across NYC. Pneumonia acquired in community settings are more likely to be preventable with vaccines and treatable with first-line antibiotics than those acquired in non-community settings. Our objective was to estimate the burden of hospitalizations associated with community-acquired (CAP)-, healthcare-associated (HCAP)-, hospital-acquired (HAP)-, and ventilator-associated (VAP) pneumonia during 2010-2014...
April 25, 2017: Chest
https://www.readbyqxmd.com/read/28427381/penicillin-treatment-for-patients-with-community-acquired-pneumonia-in-denmark-a-retrospective-cohort-study
#11
Gertrud Baunbæk Egelund, Andreas Vestergaard Jensen, Stine Bang Andersen, Pelle Trier Petersen, Bjarne Ørskov Lindhardt, Christian von Plessen, Gernot Rohde, Pernille Ravn
BACKGROUND: Community-acquired pneumonia (CAP) is a severe infection, with high mortality. Antibiotic strategies for CAP differ across Europe. The objective of the study was to describe the epidemiology of CAP in Denmark and evaluate the prognosis of patients empirically treated with penicillin-G/V monotherapy. METHODS: Retrospective cohort study including hospitalized patients with x-ray confirmed CAP. We calculated the population-based incidence, reviewed types of empiric antibiotics and duration of antibiotic treatment...
April 20, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28416961/predictive-factors-of-methicillin-resistant-staphylococcus-aureus-infection-in-elderly-patients-with-community-onset-pneumonia
#12
Hyeyoung Jwa, Jong Wook Beom, Jong Hoo Lee
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a severe and life-threatening disease in patients with community-onset (CO) pneumonia. However, the current guidelines lack specificity for a screening test for MRSA infection. METHODS: This study was retrospectively conducted in elderly patients aged ≥65 years, who had contracted CO-pneumonia during hospitalization at the Jeju National University Hospital, between January 2012 and December 2014...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28407054/procalcitonin-as-a-marker-of-etiology-in-adults-hospitalized-with-community-acquired-pneumonia
#13
Wesley H Self, Robert A Balk, Carlos G Grijalva, Derek J Williams, Yuwei Zhu, Evan J Anderson, Grant W Waterer, D Mark Courtney, Anna M Bramley, Christopher Trabue, Sherene Fakhran, Anne J Blaschke, Seema Jain, Kathryn M Edwards, Richard G Wunderink
Background: Recent trials suggest procalcitonin-based guidelines can reduce antibiotic use for respiratory infections. However, the accuracy of procalcitonin to discriminate between viral and bacterial pneumonia requires further dissection. Methods: We evaluated the association between serum procalcitonin concentration at hospital admission with pathogens detected in a multicenter prospective surveillance study of adults hospitalized with community-acquired pneumonia...
April 12, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28397171/pediatric-antibiotic-stewardship-successful-interventions-to-reduce-broad-spectrum-antibiotic-use-on-general-pediatric-wards
#14
Katharina Kreitmeyr, Ulrich von Both, Alenka Pecar, Johannes P Borde, Rafael Mikolajczyk, Johannes Huebner
PURPOSE: Antibiotic stewardship programs (ASP) optimize antibiotic usage and combat antibiotic resistance of bacteria. The objective of this study was to assess the impact of specific ASP interventions on antibiotic consumption in general pediatric wards. METHODS: We conducted a prospective study to compare a pre-intervention (Sept.-Dec. 2014) and post-intervention (Sept.-Dec. 2015) period. An ASP bundle was established including (1) infectious diseases (ID) ward rounds (prospective-audit-with-feedback), (2) ID consultation service, (3) internal guidelines on empiric antibiotic therapy...
April 10, 2017: Infection
https://www.readbyqxmd.com/read/28382951/nosocomial-and-community-acquired-spontaneous-bacterial-peritonitis-in-patients-with-liver-cirrhosis-in-china-comparative-microbiology-and-therapeutic-implications
#15
Lei Shi, Dan Wu, Lei Wei, Suxia Liu, Peng Zhao, Bo Tu, Yangxin Xie, Yanan Liu, Xinhua Wang, Liying Liu, Xin Zhang, Zhe Xu, Fusheng Wang, Enqiang Qin
Spontaneous bacterial peritonitis (SBP) is a common complication of liver cirrhosis. This study was performed to compare the microbiological characteristics of nosocomial and community-acquired episodes of bacterial peritonitis in China. Five hundred and seventy-five strains were isolated from the ascitic fluid of cirrhotic patients from the Beijing 302 Hospital from January 2014 to December 2014. The patients in the community-acquired SBP (n = 311) and the nosocomial SBP (n = 264) groups exhibited significant differences in clinical symptoms (P < 0...
April 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28369192/telavancin-in-the-recent-hospital-acquired-and-ventilator-associated-pneumonia-hap-vap-2016-guidelines
#16
Ali Hassoun, Bruce Friedman, Louis D Saravolatz
No abstract text is available yet for this article.
June 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28281915/burden-of-community-acquired-pneumonia-in-adults-over-18%C3%A2-y-of-age
#17
Filiz Kosar, Devrim Emel Alici, Basak Hacibedel, Burcu Arpınar Yigitbas, Pejman Golabi, Caglar Cuhadaroglu
This study aimed to determine the economic burden and affecting factors in adult community-acquired pneumonia (CAP) patients (≥ 18 years) by retrospectively evaluating the data of 2 centers in Istanbul province, Turkey. Data of outpatients and inpatients with CAP from January 2013 through June 2014 were evaluated. The numbers of laboratory analyses, imaging, hospitalization days, and specialist visits were multiplied by the relevant unit costs and the costs of the relevant items per patient were obtained...
March 10, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28257317/pulmonary-infections-in-critical-intensive-care-rapid-diagnosis-and-optimizing-antimicrobial-usage
#18
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...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28198727/new-guidelines-for-nosocomial-pneumonia
#19
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...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28198726/community-acquired-pneumonia-requiring-hospitalization-rational-decision-making-and-interpretation-of-guidelines
#20
Douwe F Postma, Cornelis H van Werkhoven, Jan Jelrik Oosterheert
PURPOSE OF REVIEW: This review focuses on the evidence base for guideline recommendations on the diagnosis, the optimal choice, timing and duration of empirical antibiotic therapy, and the use of microbiological tests for patients hospitalized with community-acquired pneumonia (CAP): issues for which guidelines are frequently used as a quick reference. Furthermore, we will discuss possibilities for future research in these topics. RECENT FINDINGS: Many national and international guideline recommendations, even on critical elements of CAP management, are based on low-to-moderate quality evidence...
May 2017: Current Opinion in Pulmonary Medicine
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