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pneumonia associated ventilator

Gregory G Stone, Paul Newell, Leanne B Gasink, Helen Broadhurst, Angela Wardman, Katrina Yates, Zhangjing Chen, Jie Song, Joseph W Chow
Objectives: This analysis evaluated the clinical activity of ceftazidime/avibactam against MDR Enterobacteriaceae and Pseudomonas aeruginosa isolates pooled from the adult Phase III clinical trials in patients with complicated intra-abdominal infection (cIAI), complicated urinary tract infection (cUTI) or nosocomial pneumonia (NP) including ventilator-associated pneumonia (VAP). Methods: Baseline isolates from five Phase III randomized controlled trials of ceftazidime/avibactam versus predominantly carbapenem comparators in patients with cIAI (RECLAIM 1 and 2; NCT01499290 and RECLAIM 3; NCT01726023), cUTI (RECAPTURE 1 and 2; NCT01595438 and NCT01599806), NP including VAP (REPROVE; NCT01808092) and cIAI or cUTI caused by ceftazidime-non-susceptible Gram-negative pathogens (REPRISE; NCT01644643) were tested for MDR status and susceptibility to ceftazidime/avibactam and carbapenem-based comparators using CLSI broth microdilution methodology...
June 14, 2018: Journal of Antimicrobial Chemotherapy
Elem Kocaçal Güler, Gülengün Türk
The aim of this systematic review was to determine the effect of chlorhexidine at different concentration and frequency on ventilator-associated pneumonia and microbial colonization in mechanically ventilated patients. Relevant studies in English language were identified by searching data bases between January 2010 and December 2017. Ten studies met the inclusion criteria. Chlorhexidine with 0.2% concentration was found to be more effective than the control group (placebo dental gel and normal saline) in preventing the development of ventilator-associated pneumonia in three of the eight studies...
June 1, 2018: Western Journal of Nursing Research
Brittany N Burton, Jenny Q Hu, Aria Jafari, Richard D Urman, Ian F Dunn, W Linda Bi, Adam S DeConde, Rodney A Gabriel
OBJECTIVES: Updated multi-institutional database studies assessing perioperative risk factors on 30-day morbidity and mortality after skull base surgeries are limited. We aim to identify perioperative risk factors and report the incidence of 30-day morbidity and mortality in adult patients after skull base surgery. PATIENTS AND METHODS: We queried the 2007-2016 American College of Surgeons National Surgical Quality Improvement program database to identify patients who underwent anterior, middle, or posterior skull base surgery...
June 10, 2018: Clinical Neurology and Neurosurgery
Marina R Pulido, Verónica González-Galán, Felipe Fernández Cuenca, Álvaro Pascual, José Garnacho-Montero, Massimo Antonelli, George Dimopoulos, José A Lepe, Michael J McConnell, José Miguel Cisneros
OBJECTIVE: The objective of this study was to evaluate the ability of the BioFire FilmArray Blood Culture Identification (BCID) Panel to rapidly detect pathogens producing late-onset ventilator-associated pneumonia (VAP), a severe infection often produced by Gram negative bacteria. These microorganisms are frequently multidrug resistant (MDR) and typically require broad spectrum empiric treatment. METHODS: In this study, in the context of an international multicenter clinical trial (Magic Bullet), respiratory samples were collected at the time of suspicion of VAP from 165 patients in 32 participating hospitals in Spain, Greece and Italy...
June 12, 2018: Clinical Microbiology and Infection
Baptiste Chéhère, Valérie Bougault, Cécile Chenivesse, Jean-Marie Grosbois, Benoit Wallaert
BACKGROUND: Pulmonary rehabilitation (PR) improves performance in the 6-min walk test (6MWT) in a subset of patients with fibrotic idiopathic interstitial pneumonia (f-IIP); however, a large proportion of patients do not respond to PR. AIM: To investigate the effects of a PR program on cardiorespiratory responses during a 6MWT and to identify the characteristics of patients who do not show improved performance after PR. DESIGN: An observational study...
June 14, 2018: European Journal of Physical and Rehabilitation Medicine
Craig R Ainsworth, Jeffrey Dellavolpe, Kevin K Chung, Leopoldo C Cancio, Phillip Mason
INTRODUCTION: Recent reports on the use of extracorporeal membrane oxygenation (ECMO) in critically ill burn patients with Acute Respiratory Distress Syndrome (ARDS) recommended against the use of ECMO. The authors cited the high mortality rates associated with the use of ECMO in these patients with no appreciable benefit. Accumulating evidence from referral centers suggests improved survival in patients with ARDS receiving ECMO. We report our recent experience treating patients with severe ARDS with ECMO in a burn intensive care unit...
June 11, 2018: Burns: Journal of the International Society for Burn Injuries
Eleni Papakrivou, Demosthenes Makris, Efstratios Manoulakas, Marios Karvouniaris, Epaminondas Zakynthinos
BACKGROUND: Ventilator-associated pneumonia (VAP) might be increased in cases with intra-abdominal hypertension (IAH). However, despite animal experimentation and physiological studies on humans in favor of this hypothesis, there is no definitive clinical data that IAH is associated with VAP. We therefore aimed to study whether IAH is a risk factor for increased incidence of VAP in critical care patients. This 1-center prospective observational cohort study was conducted in the intensive care unit of the University Hospital of Larissa, Greece, during 2013 to 2015...
January 1, 2018: Journal of Intensive Care Medicine
Helio S Sader, Robert K Flamm, Glenn E Dale, Paul R Rhomberg, Mariana Castanheira
Background: Murepavadin (POL7080) represents the first member of a novel class of outer membrane protein-targeting antibiotics. Murepavadin acts by binding to LPS transport protein D and is being developed for the treatment of hospital-acquired and ventilator-associated pneumonia caused by Pseudomonas aeruginosa. Objectives: To evaluate the antimicrobial activity of murepavadin against XDR P. aeruginosa. Methods: A total of 785 clinical isolates of XDR P...
June 12, 2018: Journal of Antimicrobial Chemotherapy
Vasileios-Arsenios Lioutas, Sarah Marchina, Louis R Caplan, Magdy Selim, Joseph Tarsia, Luciana Catanese, Jonathan Edlow, Sandeep Kumar
BACKGROUND: Many patients with acute intracerebral hemorrhages (ICHs) undergo endotracheal intubation with subsequent mechanical ventilation (MV) for "airway protection" with the intent to prevent aspiration, pneumonias, and its related mortality. Conversely, these procedures may independently promote pneumonia, laryngeal trauma, dysphagia, and adversely affect patient outcomes. The net benefit of intubation and MV in this patient cohort has not been systematically investigated...
June 13, 2018: Cerebrovascular Diseases
Andrea Cortegiani, Fabiana Madotto, Cesare Gregoretti, Giacomo Bellani, John G Laffey, Tai Pham, Frank Van Haren, Antonino Giarratano, Massimo Antonelli, Antonio Pesenti, Giacomo Grasselli
BACKGROUND: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. METHODS: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents...
June 12, 2018: Critical Care: the Official Journal of the Critical Care Forum
Demet Demirkol, Umay Kavgacı, Burcu Babaoğlu, Serhan Tanju, Banu Oflaz Sözmen, Suda Tekin
BACKGROUND: The aim of this case report is to discuss diagnostic workup and clinical management of cytomegalovirus reactivation in a critically ill immunocompetent pediatric patient. CASE PRESENTATION: A 2-year-old white boy who had no medical history presented with respiratory distress and fever. His Pediatric Risk of Mortality and Pediatric Logistic Organ Dysfunction scores were 20 and 11, respectively. Our preliminary diagnosis was multiple organ dysfunction secondary to sepsis...
June 11, 2018: Journal of Medical Case Reports
Oluwasola Lawal, Hugo Knobel, Hans Weda, Lieuwe D Bos, Tamara M E Nijsen, Royston Goodacre, Stephen J Fowler
Bacteria are found ubiquitously within and on nearly every site within humans, including the airways. Microbes interact with airway epithelial cells in lung infections such as ventilator-associated pneumonia (VAP). Development of infection results in the production of oxidants such as hydrogen peroxide that may further damage the epithelium. VAP is difficult to diagnose and associated with significant mortality. Current methods are invasive and time consuming impacting on appropriate therapy, antimicrobial resistance and financial costs...
June 7, 2018: Analyst
Ayca Yildiz-Peköz, Ozlem Akbal, S Hande Tekarslan, A Olcay Sagirli, Lütfiye Mulazimoglu, Deniz Morina, Erdal Cevher
BACKGROUND: Pneumonia is a bacterial lower respiratory tract infection that has a high morbidity rate. The gram-negative pathogen Pseudomonas aeruginosa is a significant cause of nosocomial infections and ventilator-associated pneumonias and is mainly treated by carbapenems. Doripenem is a carbapenem drug, which has a broad-spectrum antibacterial activity. The aim of this study was to develop doripenem-loaded chitosan microparticles for pulmonary administration to provide more efficient treatment for pneumonia...
June 7, 2018: Journal of Aerosol Medicine and Pulmonary Drug Delivery
Matteo Bassetti, Antonio Vena, Antony Croxatto, Elda Righi, Benoit Guery
Infections with Pseudomonas aeruginosa have become a real concern in hospital-acquired infections, especially in critically ill and immunocompromised patients. The major problem leading to high mortality lies in the appearance of drug-resistant strains. Therefore, a vast number of approaches to develop novel anti-infectives is currently pursued. Diverse strategies range from killing (new antibiotics) to disarming (antivirulence) the pathogen. In this review, selected aspects of P. aeruginosa antimicrobial resistance and infection management will be addressed...
2018: Drugs in Context
Nguyen Viet Hung, Phan Thi Hang, Victor D Rosenthal, Le Thi Anh Thu, Le Thi Thu Nguyet, Ngo Quy Chau, Truong Anh Thu, Dinh Pham Phuong Anh, Tran Thi My Hanh, Tran Thi Thuy Hang, Dang Thi Van Trang, Nguyen Phuc Tien, Vo Thi Hong Thoa, Đao Quang Minh
OBJECTIVE: The aim of the study was to report the results of the International Nosocomial Infection Control Consortium (INICC) study conducted from May 2008 to March 2015. METHODS: A device-associated healthcare-acquired infection surveillance study in three adult intensive care units (ICUs) and 1 neonatal ICU from 4 hospitals in Vietnam using U.S. the Centers for Disease Control and Prevention's National Healthcare Safety Network (CDC/NHSN) definitions and criteria as well as INICC methods...
June 4, 2018: Journal of Patient Safety
Ingrid Toews, Aneesh Thomas George, John V Peter, Richard Kirubakaran, Luís Eduardo S Fontes, Jabez Paul Barnabas Ezekiel, Joerg J Meerpohl
BACKGROUND: Upper gastrointestinal (GI) bleeding due to stress ulcers contributes to increased morbidity and mortality in people admitted to intensive care units (ICUs). Stress ulceration refers to GI mucosal injury related to the stress of being critically ill. ICU patients with major bleeding as a result of stress ulceration might have mortality rates approaching 48.5% to 65%. However, the incidence of stress-induced GI bleeding in ICUs has decreased, and not all critically ill patients need prophylaxis...
June 4, 2018: Cochrane Database of Systematic Reviews
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
Ahmadreza Yazdannik, Vajihe Atashi, Somayeh Ghafari
Background: Failure to provide proper respiratory care leads to incidence of certain complications such as ventilator-associated pneumonia. Nurses have a crucial role in providing this care. The aim of this study is to assess the performance of ICU (Intensive Care Unit) nurses in providing respiratory care. Materials and Methods: The present descriptive cross-sectional study recruited 120 nurses working in selected hospitals affiliated to Isfahan University of Medical Sciences from March to August 2016...
May 2018: Iranian Journal of Nursing and Midwifery Research
Maria Chatzi, John Papanikolaou, Demosthenes Makris, Ioanna Papathanasiou, Aspasia Tsezou, Marios Karvouniaris, Epaminondas Zakynthinos
PURPOSE: To test the potential of four common Toll-like receptor (TLR) polymorphisms to predispose to specific intensive care unit (ICU)-acquired infections and affect outcomes in a Greek ICU. MATERIALS AND METHODS: The incidence of TLR2-Arg753Gln, TLR4-Asp299Gly, TLR4-Thr399Ile and TLR9-T1237C polymorphisms, and their association with ICU-acquired infections and patients' clinical outcomes were prospectively evaluated The examined genetic polymorphisms were assessed by real-time Polymerase-Chain-Reaction (PCR)...
May 25, 2018: Journal of Critical Care
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
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