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https://www.readbyqxmd.com/read/28068928/newly-recognized-cerebral-infarctions-on-postmortem-imaging-a-report-of-three-cases-with-systemic-infectious-disease
#1
Sakon Noriki, Kazuyuki Kinoshita, Kunihiro Inai, Toyohiko Sakai, Hirohiko Kimura, Takahiro Yamauchi, Masayuki Iwano, Hironobu Naiki
BACKGROUND: Postmortem imaging (PMI) refers to the imaging of cadavers by computed tomography (CT) and/or magnetic resonance imaging (MRI). Three cases of cerebral infarctions that were not found during life but were newly recognized on PMI and were associated with severe systemic infections are presented. CASE PRESENTATIONS: An 81-year-old woman with a pacemaker and slightly impaired liver function presented with fever. Imaging suggested interstitial pneumonia and an iliopsoas abscess, and blood tests showed liver dysfunction and disseminated intravascular coagulation (DIC)...
January 10, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28064542/antibiotic-treatment-patterns-costs-and-resource-utilization-among-patients-with-community-acquired-pneumonia-a-us-cohort-study
#2
Christopher J Llop, Edward Tuttle, Glenn S Tillotson, Kerry LaPlante, Thomas M File
OBJECTIVES: The current treatment options for patients with community-acquired pneumonia (CAP) often present a trade-off between the potential for treatment failure and safety concerns. We set out to investigate real-world outcomes associated with the use of currently available antimicrobial treatment options for CAP in both the outpatient and inpatient (non-intensive care unit [ICU]) settings. METHODS: This claims-based retrospective study included adult patients diagnosed with CAP and treated with antibiotic therapies, including any oral fluoroquinolone, macrolide, or beta-lactam monotherapy in the outpatient setting, and intravenous (IV) levofloxacin or IV azithromycin/ceftriaxone in the inpatient setting...
January 18, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28050072/klebsiella-oxytoca-an-emerging-pathogen
#3
Lavan Singh, M P Cariappa, Mandeep Kaur
Klebsiella oxytoca is emerging as an important bacterial isolate causing hospital-acquired infection in adults and having multiple drug resistance to commonly used antibiotics. We analysed our data to observe the current pattern of drug resistance among K. oxytoca isolated from various samples during the period from January 2012 to March 2014 at a tertiary care hospital. A total of 17,335 samples were processed at the hospital laboratory during this period. Klebsiella was isolated from 654 of these clinical samples...
December 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28049113/update-on-pediatric-overuse
#4
Eric R Coon, Paul C Young, Ricardo A Quinonez, Daniel J Morgan, Sanket S Dhruva, Alan R Schroeder
As concerns over health care-related harms and costs continue to mount, efforts to identify and combat medical overuse are needed. Although much of the recent attention has focused on health care for adults, children are also harmed by overuse. Using a structured PubMed search and manual tables of contents review, we identified important articles on pediatric overuse published in 2015. These articles were evaluated according to the quality of the methods, the magnitude of clinical effect, and the number of patients potentially affected and were categorized into overdiagnosis, overtreatment, and overutilization...
January 3, 2017: Pediatrics
https://www.readbyqxmd.com/read/28042214/study-of-invasive-pneumococcal-infection-in-adults-with-reference-to-penicillin-resistance
#5
Vrishali Avinash Muley, Dnyaneshwari Purushottam Ghadage, Gauri Eknath Yadav, Arvind Vamanrao Bhore
BACKGROUND: Invasive pneumococcal infections often prove rapidly fatal, even where good medical treatment is readily available. In developed countries, up to 20% of people who contract pneumococcal meningitis die; however, in developing world, mortality is closer to 50%, even among hospitalized patients. The World Health Organization estimated 600,000-800,000 adult deaths each year from pneumococcal pneumonia, meningitis, and sepsis. AIMS: This study aims to estimate isolation rate of invasive pneumococcal infection in adults, to determine the antimicrobial susceptibility profile of Streptococcus pneumoniae isolates and to study the associated risk factors...
January 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28035692/application-of-a-risk-score-to-identify-older-adults-with-community-onset-pneumonia-most-likely-to-benefit-from-empiric-pseudomonas-therapy
#6
Christopher R Frei, Sylvie Rehani, Grace C Lee, Natalie K Boyd, Erene Attia, Ashley Pechal, Rachel S Britt, Eric M Mortensen
STUDY OBJECTIVE: To assess the impact of empiric Pseudomonas pharmacotherapy on 30-day mortality in hospitalized patients with community-onset pneumonia stratified according to their risk (low, medium, or high) of drug-resistant pathogens. DESIGN: Retrospective cohort study. DATA SOURCE: Veterans Health Administration database. PATIENTS: A total of 50,119 patients who were at least 65 years of age, hospitalized with pneumonia, and received antibiotics within 48 hours of admission between fiscal years 2002 and 2007; patients were stratified into empiric Pseudomonas therapy (31,027 patients) and no Pseudomonas therapy (19,092 patients) groups based on antibiotics received during their first 48 hours of admission...
December 30, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/28034888/ultra-short-course-antibiotics-for-patients-with-suspected-ventilator-associated-pneumonia-but-minimal-and-stable-ventilator-settings
#7
Michael Klompas, Lingling Li, John T Menchaca, Susan Gruber
PURPOSE: Many patients started on antibiotics for possible ventilator-associated pneumonia (VAP) do not have pneumonia. Patients with minimal and stable ventilator settings may be suitable candidates for early antibiotic discontinuation. We compared outcomes amongst patients with suspected VAP but minimal and stable ventilator settings treated with 1-3 versus >3 days of antibiotics. METHODS: We identified consecutive adult patients started on antibiotics for possible VAP with daily minimum PEEPs ≤5cm H2O and FiO2s ≤40% for at least 3 days within a large tertiary care hospital between 2006-2014...
December 29, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28006650/rise-of-multidrug-resistant-non-vaccine-serotype-15a-streptococcus-pneumoniae-in-the-united-kingdom-2001-to-2014
#8
Carmen Sheppard, Norman K Fry, Shazad Mushtaq, Neil Woodford, Rosy Reynolds, Regina Janes, Rachel Pike, Robert Hill, Maimuna Kimuli, Peter Staves, Michel Doumith, Timothy Harrison, David M Livermore
Conjugate vaccines have reduced pneumococcal disease in vaccinated children and unvaccinated adults, but non-vaccine serotypes are of concern, particularly if antibiotic resistant. We reviewed Streptococcus pneumoniae collected via: (i) the British Society for Antimicrobial Chemotherapy (BSAC) surveillances from 2001-2014; (ii) Public Health England's (PHE) invasive isolate surveillance from 2005-2014 and (iii) referral to PHE for resistance investigation from 2005-2014. Serotype 15A increased in all series, with many representatives showing triple resistance to macrolides, tetracyclines and penicillin...
December 15, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/28000028/demonstration-of-the-herd-effect-in-adults-after-the-implementation-of-pneumococcal-vaccination-with-pcv13-in-children
#9
C Hays, Q Vermee, A Agathine, A Dupuis, E Varon, C Poyart, M-C Ploy, J Raymond
The purpose of this investigation was to describe the evolution of serotypes and antibiotic susceptibility of Streptococcus pneumoniae strains isolated from both adults and children from the same population area with invasive pneumococcal disease (IPD) or acute otitis media (AOM), 5 years after the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13). From 2009 to 2015, 839 strains of S. pneumoniae strains were collected (481 from adults and 358 from children). Serotyping by latex antisera and molecular methods was performed...
December 20, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27999052/trimethoprim-sulfamethoxazole-versus-vancomycin-in-the-treatment-of-healthcare-ventilator-associated-mrsa-pneumonia-a-case-control-study
#10
Noa Eliakim-Raz, Moran Hellerman, Dafna Yahav, Jonathan Cohen, Ili Margalit, Sharon Fisher, Oren Zusman, Hila Shaked, Jihad Bishara
OBJECTIVES: Therapeutic options available to treat MRSA pneumonia are limited. Trimethoprim/sulfamethoxazole is an attractive treatment because of its bactericidal anti-MRSA activity, oral and parenteral formulations and good penetration to the lung tissue. We aimed to compare the efficacy and safety of trimethoprim/sulfamethoxazole with vancomycin in the treatment of healthcare/ventilator-associated MRSA pneumonia. METHODS: We carried out a retrospective case-control study of all consecutive hospitalized adult patients diagnosed with MRSA pneumonia at Beilinson Hospital during 2010-15 and treated with either vancomycin or trimethoprim/sulfamethoxazole...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27992528/colistin-dosage-without-loading-dose-is-efficacious-when-treating-carbapenem-resistant-acinetobacter-baumannii-ventilator-associated-pneumonia-caused-by-strains-with-high-susceptibility-to-colistin
#11
Rocío Álvarez-Marín, Rafael López-Rojas, Juan Antonio Márquez, María José Gómez, José Molina, José Miguel Cisneros, Carlos Ortiz-Leyba, Javier Aznar, José Garnacho-Montero, Jerónimo Pachón
OBJECTIVES: This study aims to analyze the mortality and the length of ICU stay (LOS) of A. baumannii VAP compared to respiratory colonization in patients with mechanical ventilation (MV). METHODS: A prospective cohort study was performed in an ICU of adult patients (February 2010-June 2011). One hundred patients on MV with A. baumannii in lower respiratory airways were recruited, and classified as VAP or airways colonization according to CPIS criteria, with a punctuation ≥6...
2016: PloS One
https://www.readbyqxmd.com/read/27988829/cost-effectiveness-of-pneumococcal-urinary-antigen-in-emergency-department-a-pragmatic-real-life-study
#12
Aurélien Dinh, Clara Duran, Benjamin Davido, Aurore Lagrange, Valérie Sivadon-Tardy, Frédérique Bouchand, Alain Beauchet, Jean-Louis Gaillard, Sébastien Beaune, Jérôme Salomon, Julie Grenet
Community-acquired pneumonia (CAP) is frequent and can be life-threatening. Streptococcus pneumoniae is the main bacteria involved, and is susceptible to penicillin A. Rapid microbiological diagnosis could then help reduce the antimicrobial spectrum. The pneumococcal urinary antigen (PUA) test is fast and easy to perform, but its impact on antimicrobial prescription and cost-effectiveness in emergency departments (ED) is not well known. We performed a pragmatic real life retrospective study in an adult ED to assess its usefulness: proportion of positive results, impact on antimicrobial prescriptions and cost-effectiveness...
December 17, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27983998/plasma-levels-of-soluble-intercellular-adhesion-molecule-1-as-a-biomarker-for-disease-severity-of-patients-with-community-acquired-pneumonia
#13
Pin-Yu Chang, Shih-Ming Tsao, Jer-Hwa Chang, Ming-Hsien Chien, Wen-Yueh Hung, Yi-Wen Huang, Shun-Fa Yang
BACKGROUND: Community-acquired pneumonia (CAP) is characterized as an acute inflammation of the lung associated with the activation of macrophages and neutrophils. Intercellular adhesion molecule-1 (ICAM-1) is an essential adhesion molecule involved in immune cell recruitment in lung inflammation. We investigated whether ICAM-1 is a useful biomarker for assessing the disease severity of hospitalized adult patients with CAP. METHODS: Plasma soluble ICAM-1 (sICAM-1) levels were measured in 78 patients with CAP and 69 healthy controls by using a commercial enzyme-linked immunosorbent assay...
October 28, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/27970750/zinforo-ceftaroline-fosamil-versus-other-empiric-antibiotics-for-moderate-to-severe-community-acquired-pneumonia-cap-in-adults-a-network-meta-analysis
#14
N Rao, E Gibson, R W Lawson, J J Goodall
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27958389/a-novel-pleuromutilin-antibacterial-compound-its-binding-mode-and-selectivity-mechanism
#15
Zohar Eyal, Donna Matzov, Miri Krupkin, Susanne Paukner, Rosemarie Riedl, Haim Rozenberg, Ella Zimmerman, Anat Bashan, Ada Yonath
The increasing appearance of pathogenic bacteria with antibiotic resistance is a global threat. Consequently, clinically available potent antibiotics that are active against multidrug resistant pathogens are becoming exceedingly scarce. Ribosomes are a main target for antibiotics, and hence are an objective for novel drug development. Lefamulin, a semi-synthetic pleuromutilin compound highly active against multi-resistant pathogens, is a promising antibiotic currently in phase III trials for the treatment of community-acquired bacterial pneumonia in adults...
December 13, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27929242/community-acquired-pneumonia-in-adults-diagnosis-and-management
#16
Alexander Kaysin, Anthony J Viera
Community-acquired pneumonia is a leading cause of death. Risk factors include older age and medical comorbidities. Diagnosis is suggested by a history of cough, dyspnea, pleuritic pain, or acute functional or cognitive decline, with abnormal vital signs (e.g., fever, tachycardia) and lung examination findings. Diagnosis should be confirmed by chest radiography or ultrasonography. Validated prediction scores for pneumonia severity can guide the decision between outpatient and inpatient therapy. Using procalcitonin as a biomarker for severe infection may further assist with risk stratification...
November 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27917737/a-pediatric-approach-to-ventilator-associated-events-surveillance
#17
Noelle M Cocoros, Gregory P Priebe, Latania K Logan, Susan Coffin, Gitte Larsen, Philip Toltzis, Thomas J Sandora, Marvin Harper, Julia S Sammons, James E Gray, Donald Goldmann, Kelly Horan, Michael Burton, Paul A Checchia, Matthew Lakoma, Shannon Sims, Michael Klompas, Grace M Lee
OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27912925/cardiac-arrest-in-pediatric-patients-receiving-azithromycin
#18
Santiago O Valdés, Jeffrey J Kim, Mary C Niu, Caridad M de la Uz, Christina Y Miyake, Brady S Moffett
OBJECTIVE: To compare outcomes of pediatric patients treated with azithromycin compared with penicillin or cephalosporin. We hypothesized that azithromycin use would not be associated with increased cardiac mortality in the pediatric population. STUDY DESIGN: Retrospective cohort study from the Pediatric Health Information System database between 2008 and 2012. Patients <19 years of age with a principal diagnosis of community-acquired pneumonia who received an antibiotic were included...
November 29, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27911391/a-murine-model-of-group-b-streptococcus-vaginal-colonization
#19
Kathryn A Patras, Kelly S Doran
Streptococcus agalactiae (group B Streptococcus, GBS), is a Gram-positive, asymptomatic colonizer of the human gastrointestinal tract and vaginal tract of 10 - 30% of adults. In immune-compromised individuals, including neonates, pregnant women, and the elderly, GBS may switch to an invasive pathogen causing sepsis, arthritis, pneumonia, and meningitis. Because GBS is a leading bacterial pathogen of neonates, current prophylaxis is comprised of late gestation screening for GBS vaginal colonization and subsequent peripartum antibiotic treatment of GBS-positive mothers...
November 16, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27899697/sudden-death-of-a-child-due-to-pyogenic-bacterial-myocarditis
#20
Asit K Sikary, Asit R Mridha, Chittaranjan Behera
Bacterial myocarditis is an uncommon condition and only a few fatal cases in adults are reported in the scientific literature. Death from acute bacterial myocarditis in children is extremely rare. We report an unusual case of fatal bacterial myocarditis in a seven-year-old girl, who had a history of cough for a month and fever for two days. She was given symptomatic treatment by a local physician without suspecting her clinical condition. Her condition rapidly deteriorated and she was brought in dead to the hospital...
November 28, 2016: Medico-legal Journal
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