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https://www.readbyqxmd.com/read/28698042/propensity-matched-analysis-of-the-impact-of-extended-spectrum-%C3%AE-lactamase-production-on-adults-with-community-onset-escherichia-coli-klebsiella-species-and-proteus-mirabilis-bacteremia
#1
Ching-Chi Lee, Chung-Hsun Lee, Ming-Yuan Hong, Chih-Chia Hsieh, Hung-Jen Tang, Wen-Chien Ko
BACKGROUND: The presence of extended-spectrum β-lactamase (ESBL) in Escherichia coli, Klebsiella species, and Proteus mirabilis (EKP) is of great microbiological and clinical importance. The study dealing with the direct impact of ESBL producers on the outcome of patients with community-onset bacteremia is lacking. METHODS: Adults with community-onset EKP bacteremia were recruited retrospectively during a 6-year period. ESBL producers were determined according to ESBL phenotype...
June 29, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28694251/advances-in-the-causes-and-management-of-community-acquired-pneumonia-in-adults
#2
REVIEW
Richard G Wunderink, Grant Waterer
Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant Staphylococcus aureus and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia...
July 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28694234/effectiveness-of-and-obstacles-to-antibiotic-streamlining-to-amoxicillin-monotherapy-in-bacteremic-pneumococcal-pneumonia
#3
Mathieu Blot, Diane Pivot, Abderrahmane Bourredjem, Arnaud Salmon-Rousseau, Claire de Curraize, Delphine Croisier, Pascal Chavanet, Christine Binquet, Lionel Piroth
BACKGROUND: Antibiotic streamlining is pivotal to reduce the emergence of resistant bacteria. However, whether streamlining is frequently performed and safe in difficult situations, such as bacteremic pneumococcal pneumonia (BPP), has still to be assessed. METHODS: All adult patients admitted to Dijon Hospital (France) from 2005 to 2013 who had BPP without complications, and were alive on the third day were enrolled. Clinical, biological, radiological, microbiological and therapeutic data were recorded...
July 7, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28680421/an-emm5-group-a-streptococcal-outbreak-among-workers-in-a-factory-manufacturing-telephone-accessories
#4
Mingliang Chen, Wenqing Wang, Lihong Tu, Yaxu Zheng, Hao Pan, Gangyi Wang, Yanxin Chen, Xi Zhang, Linying Zhu, Jian Chen, Min Chen
Ranked among the top10 infectious causes of death worldwide, group A Streptococcus (GAS) causes small- and large-scale outbreaks, depending on the trigger as transmission of a GAS strain or expansion of predominant clones. In China, GAS infections other than scarlet fever are not notifiable. In Shanghai, an epidemiological investigation was initiated after two successive severe pneumonia cases with one death in a digital factory, from where outbreaks are less widely reported. The investigation was performed using emm typing, pulsed-field gel electrophoresis (PFGE) typing, superantigen profiling, and genome analysis...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28671150/emerging-trends-of-nosocomial-pneumonia-in-intensive-care-unit-of-a-tertiary-care-public-teaching-hospital-in-western-india
#5
Rakesh Bhadade, Minal Harde, Rosemarie deSouza, Ashwini More, Ramesh Bharmal
BACKGROUND: Nosocomial pneumonia poses great challenge to an intensivist. Detailed information about hospital-acquired pneumonia (HAP) and ventilator-acquired pneumonia (VAP) is crucial for prevention and optimal management, thus improving quality Intensive Care Unit (ICU) care. Hence, we aimed to study the current trend of nosocomial pneumonia in ICU. MATERIALS AND METHODS: It was a prospective observational cohort study, conducted in the ICU of a tertiary care teaching public hospital over a period of 18 months...
July 2017: Annals of African Medicine
https://www.readbyqxmd.com/read/28666965/individualizing-duration-of-antibiotic-therapy-in-community-acquired-pneumonia
#6
Stefano Aliberti, Julio Ramirez, Fabio Giuliani, Timothy Wiemken, Giovanni Sotgiu, Sara Tedeschi, Manuela Carugati, Vincenzo Valenti, Marco Marchioni, Marco Camera, Roberto Piro, Manuela Del Forno, Giuseppe Milani, Paola Faverio, Luca Richeldi, Martina Deotto, Massimiliano Villani, Antonio Voza, Eleonora Tobaldini, Mauro Bernardi, Andrea Bellone, Matteo Bassetti, Francesco Blasi
International experts suggest tailoring antibiotic duration in community-acquired pneumonia (CAP) according to patients' characteristics. We aimed to assess the effectiveness of an individualized approach to antibiotic duration based on time in which CAP patients reach clinical stability during hospitalization. In a multicenter, non-inferiority, randomized, controlled trial hospitalized adult patients with CAP reaching clinical stability within 5 days after hospitalization were randomized to a standard vs. individualized antibiotic duration...
June 27, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28665084/an-audit-of-empiric-antibiotic-choice-in-the-inpatient-management-of-community-acquired-pneumonia
#7
F Delaney, A Jackson
Adherence to antimicrobial guidelines for empiric antibiotic prescribing in community-acquired pneumonia (CAP) has been reported to be worryingly low. We conducted a review of empiric antibiotic prescribing for sixty consecutive adult patients admitted to the Mercy University Hospital with a diagnosis of CAP. When analysed against local antimicrobial guidelines, guideline concordant empiric antibiotics were given in only 48% of cases, lower than the average rate in comparable studies. Concordance was 100% in cases where the CURB-65 pneumonia severity assessment score, on which the guidelines are based, was documented in the medical notes...
April 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28652113/early-versus-late-diagnosis-in-community-acquired-bacterial-meningitis-a-retrospective-cohort-study
#8
Jacob Bodilsen, Christian Thomas Brandt, Andrew Sharew, Michael Dalager-Pedersen, Thomas Benfield, Henrik Carl Schønheyder, Henrik Nielsen
OBJECTIVES: To examine clinical characteristics and outcome of patients with late diagnosis of community-acquired bacterial meningitis (CABM). METHODS: We conducted a chart review of all adults with proven CABM in three centres in Denmark from 1998 through 2014. Patients were categorised as 1) early diagnosis of CABM immediately on admission or 2) late diagnosis if CABM was not listed in referral or admission records and neither lumbar puncture nor antibiotic therapy for meningitis was considered immediately on admission...
June 23, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28624864/the-clinical-significance-of-pneumonia-in-patients-with-respiratory-specimens-harbouring-multidrug-resistant-pseudomonas-aeruginosa-a-5-year-retrospective-study-following-5667-patients-in-four-general-icus
#9
B Borgatta, S Gattarello, C A Mazo, A T Imbiscuso, M N Larrosa, M Lujàn, J Rello
Pseudomonas aeruginosa is the leading cause of pneumonia in intensive care units (ICUs), with multidrug-resistant (MDR) strains posing a serious threat. The aim of this study was to assess the clinical relevance of MDR Pseudomonas isolates in respiratory clinical specimens. A 5-year retrospective observational study in four medical-surgical ICUs from a referral hospital was carried out. Of 5667 adults admitted to the ICU, 69 had MDR-PA in respiratory samples: 31 were identified as having pneumonia (HAP/VAP): 21 ventilator-associated pneumonia (VAP) and ten hospital-acquired pneumonia (HAP)...
June 17, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28615012/moxifloxacin-monotherapy-versus-combination-therapy-in-patients-with-severe-community-acquired-pneumonia-evoked-ards
#10
Tim Rahmel, Sven Asmussen, Jan Karlik, Jörg Steinmann, Michael Adamzik, Jürgen Peters
BACKGROUND: We tested the hypothesis that moxifloxacin monotherapy is equally effective and safe as a betalactam antibiotic based combination therapy in patients with acute respiratory distress syndrome (ARDS) evoked by severe community acquired pneumonia (CAP). METHODS: In a retrospective chart review study of 229 patients with adult respiratory distress syndrome (ARDS) admitted to our intensive care unit between 2001 and 2011, 169 well-characterized patients were identified to suffer from severe CAP...
June 14, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28614669/severe-pneumococcal-pneumonia-causes-acute-cardiac-toxicity-and-subsequent-cardiac-remodeling
#11
Luis F Reyes, Marcos I Restrepo, Cecilia A Hinojosa, Nilam J Soni, Antonio Anzueto, Bettina L Babu, Norberto Gonzalez-Juarbe, Alejandro H Rodriguez, Alejandro Jimenez, James D Chalmers, Stefano Aliberti, Oriol Sibila, Vicki T Winter, Jacqueline J Coalson, Luis D Giavedoni, Charles S Dela Cruz, Grant W Waterer, Martin Witzenrath, Norbert Suttorp, Peter H Dube, Carlos J Orihuela
RATIONALE: Up to one-third of the patients hospitalized with pneumococcal pneumonia experience major adverse cardiac events (MACE) during or after pneumonia. In mice, Streptococcus pneumoniae can invade the myocardium, induce cardiomyocyte death, and disrupt cardiac function following bacteremia, but it is unknown whether the same occurs in humans with severe pneumonia. OBJECTIVE: We sought to determine whether S. pneumoniae can 1) translocate the heart, 2) induce cardiomyocyte death, 3) cause MACE, and 4) induce cardiac scar formation post-antibiotic treatment during severe pneumonia using a non-human primates (NHP) model...
June 14, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28602703/clinical-predictors-and-outcomes-of-klebsiella-pneumoniae-bacteraemia-in-a-regional-hospital-in-hong-kong
#12
M Y Man, H P Shum, Y H Chan, K C Chan, W W Yan, R A Lee, S K P Lau
BACKGROUND: Klebsiella pneumoniae (KP) infection is associated with high morbidity and mortality. Multidrug resistance, especially extended-spectrum β-lactamase (ESBL) production, in KP is endemic worldwide. Our study aimed to evaluate the clinical characteristics and outcomes of patients with KP bacteraemia in critical care and general ward settings. METHODS: Adult patients admitted to a regional hospital in Hong Kong from January 1(st), 2009 to June 30(th), 2016 (7...
June 9, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28602108/pharmacotherapy-for-community-acquired-pneumonia-in-the-elderly
#13
Diego Viasus, José A Núñez-Ramos, Samir A Viloria, Jordi Carratalà
Community-acquired pneumonia (CAP) is an increasing problem in the elderly that is associated with elevated morbidity and mortality. Given the expected increased life expectancy, this problem is only likely to worsen, so it has been considered that treatment effects must be examined separately in elderly adults with CAP. Areas covered: In this narrative review, we give an update of the available data of antibiotics for elderly patients with CAP. Clinical features, drug pharmacokinetics and pharmacodynamics, adverse effects, and outcomes differ in CAP depending on patient age...
July 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28599867/macrolide-therapy-for-community-acquired-pneumonia-due-to-atypical-pathogens-outcomes-assessment-at-an-early-time-point
#14
Thomas M File, Paul B Eckburg, George H Talbot, Lily Llorens, H David Friedland
BACKGROUND: Therapy directed against atypical pathogens in patients with community-acquired pneumonia (CAP) is often recommended. This post-hoc analysis evaluated the effect of addition of a macrolide to ceftaroline fosamil or ceftriaxone treatment in atypical CAP. METHODS: Two phase 3, double-blind, comparative safety and efficacy studies of ceftaroline fosamil vs. ceftriaxone, FOCUS 1 and FOCUS 2, enrolled adults with CAP. Only FOCUS 1 included 24-h adjunctive clarithromycin therapy for all patients on day 1...
June 6, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28596927/necrotizing-pseudomonas-aeruginosa-community-acquired-pneumonia-a-case-report-and-review-of-the-literature
#15
Satish Maharaj, Carmen Isache, Karan Seegobin, Simone Chang, Grant Nelson
Lung cavities are not typically associated with community-acquired pneumonia (CAP). CAP due to P. aeruginosa is rare and even less commonly causes necrotizing pneumonia. We report a case of P. aeruginosa CAP that progressed to necrotizing pneumonia and was eventually fatal. Procalcitonin (PCT) has been well investigated in guiding antibiotic therapy (especially CAP) in adults. In this case, PCT at presentation and sequentially was negative. We discuss this caveat and present hypotheses as to the sensitivity and specificity of PCT and C-reactive protein (CRP) in these patients...
2017: Case Reports in Infectious Diseases
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
#16
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/28575362/the-diagnostic-utility-of-induced-sputum-microscopy-and-culture-in-childhood-pneumonia
#17
David R Murdoch, Susan C Morpeth, Laura L Hammitt, Amanda J Driscoll, Nora L Watson, Henry C Baggett, W Abdullah Brooks, Maria Deloria Knoll, Daniel R Feikin, Karen L Kotloff, Orin S Levine, Shabir A Madhi, Katherine L O'Brien, J Anthony G Scott, Donald M Thea, Peter V Adrian, Dilruba Ahmed, Muntasir Alam, Juliet O Awori, Andrea N DeLuca, Melissa M Higdon, Ruth A Karron, Geoffrey Kwenda, Eunice M Machuka, Sirirat Makprasert, Jessica McLellan, David P Moore, John Mwaba, Salim Mwarumba, Daniel E Park, Christine Prosperi, Ornuma Sangwichian, Seydou Sissoko, Milagritos D Tapia, Scott L Zeger, Stephen R C Howie
Background.: Sputum microscopy and culture are commonly used for diagnosing the cause of pneumonia in adults but are rarely performed in children due to difficulties in obtaining specimens. Induced sputum is occasionally used to investigate lower respiratory infections in children but has not been widely used in pneumonia etiology studies. Methods.: We evaluated the diagnostic utility of induced sputum microscopy and culture in patients enrolled in the Pneumonia Etiology Research for Child Health (PERCH) study, a large study of community-acquired pneumonia in children aged 1-59 months...
June 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28567543/risk-factors-for-recurrent-carbapenem-resistant-klebsiella-pneumoniae-bloodstream-infection-a-prospective-cohort-study
#18
Maddalena Giannella, Elena Graziano, Lorenzo Marconi, Nicolo Girometti, Michele Bartoletti, Sara Tedeschi, Fabio Tumietto, Francesco Cristini, Simone Ambretti, Andrea Berlingeri, Russell E Lewis, Pierluigi Viale
To assess risk factors for recurrent carbapenem-resistant Klebsiella pneumoniae bloodstream-infection (CR-KP BSI), we performed a prospective observational cohort study of all consecutive adult patients cured of a CR-KP BSI at our hospital over a six-year period (June 2010 to June 2016). Maximum follow-up per patient was 180 days from the index blood cultures (BCs). Recurrent CR-KP BSI was defined as new evidence of positive BCs in patients with documented clinical response after completing a course of anti-CR-KP therapy...
June 1, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28566592/a-prospective-study-of-the-efficacy-safety-and-pharmacokinetics-of-enteral-moxifloxacin-in-the-treatment-of-hemodialysis-patients-with-pneumonia
#19
Issei Tokimatsu, Katsumi Shigemura, Tomohiro Kotaki, Hiroki Yoshikawa, Fukashi Yamamichi, Tadashi Tomo, Soichi Arakawa, Masato Fujisawa, Jun-Ichi Kadota
Objectives To investigate the efficacy of oral moxifloxacin (MFLX) as a treatment for pneumonia in hemodialysis (HD) patients and the pharmacokinetic (PK) profile of MFLX after oral administration. Methods Thirteen adult patients who required HD due to chronic renal failure were enrolled in the present study, which was performed to investigate the treatment of community-acquired pneumonia in HD patients. A standard dose of MFLX (400 mg, once daily) was administered. The therapy was continued, discontinued, or switched to another antibiotic depending on the response of the pneumonia to MFLX...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28555419/assessing-guideline-concordant-prescribing-for-community-acquired-pneumonia
#20
Kaci Thiessen, Ann E Lloyd, Michael J Miller, Juell Homco, Brooke Gildon, Katherine S O'Neal
Background Current reports of outpatient antimicrobial prescribing practices may overestimate guideline concordance since they address only drug selection. Appropriate stewardship should consider all prescribing criteria (i.e., dose, frequency, duration, and route of administration) to fully assess guideline concordance. Objective Using a community-acquired pneumonia (CAP) example, the aims of this pilot study were to estimate guideline concordance in adult patients 18 years or older when all prescribing criteria are considered, and provide recommendations to optimize treatment...
May 29, 2017: International Journal of Clinical Pharmacy
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