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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
#1
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
#2
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
#3
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
#4
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 beta-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 1 January 2009 to 30 June 2016 (7.5 years) with KP bacteraemia were included...
June 8, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28602108/pharmacotherapy-for-community-acquired-pneumonia-in-the-elderly
#5
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...
June 16, 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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28545484/timing-of-appropriate-empirical-antimicrobial-administration-and-outcome-of-adults-with-community-onset-bacteremia
#13
Ching-Chi Lee, Chung-Hsun Lee, Ming-Yuan Hong, Hung-Jen Tang, Wen-Chien Ko
BACKGROUND: Early administration of appropriate antimicrobials has been correlated with a better prognosis in patients with bacteremia, but the optimum timing of early antibiotic administration as one of the resuscitation strategies for severe bacterial infections remains unclear. METHODS: In a retrospective cohort study, adults with community-onset bacteremia at the emergency department (ED) were analyzed. Effects of different cutoffs of time to appropriate antibiotic (TtAa) administration after arrival at the ED on 28-day mortality were examined, after adjustment for independent predictors of mortality identified by multivariate regression analysis...
May 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28526309/antimicrobial-stewardship-for-hospitalized-patients-with-viral-respiratory-tract-infections
#14
Christopher F Lowe, Michael Payne, David Puddicombe, Allison Mah, Davie Wong, Allison Kirkwood, Mark W Hull, Victor Leung
BACKGROUND: The purpose of this study was to implement a targeted antimicrobial stewardship intervention for patients with a viral respiratory tract infection. METHODS: This was a quasi-experimental before and after audit and feedback intervention of adult inpatients with a positive polymerase chain reaction for a respiratory virus in 2 acute care hospitals in Vancouver, Canada. Audit and feedback was implemented based on 2 criteria: microbiology (no positive bacterial cultures) and chest imaging (absence of pneumonia or consolidation on radiology dictation)...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28526018/infection-mediated-asthma-etiology-mechanisms-and-treatment-options-with-focus-on-chlamydia-pneumoniae-and-macrolides
#15
REVIEW
Wilmore C Webley, David L Hahn
Asthma is a chronic respiratory disease characterized by reversible airway obstruction and airway hyperresponsiveness to non-specific bronchoconstriction agonists as the primary underlying pathophysiology. The worldwide incidence of asthma has increased dramatically in the last 40 years. According to World Health Organization (WHO) estimates, over 300 million children and adults worldwide currently suffer from this incurable disease and 255,000 die from the disease each year. It is now well accepted that asthma is a heterogeneous syndrome and many clinical subtypes have been described...
May 19, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28516200/respiratory-viral-infections-are-underdiagnosed-in-patients-with-suspected-sepsis
#16
L R Ljungström, G Jacobsson, B E B Claesson, R Andersson, H Enroth
The study aim was to investigate the prevalence and clinical relevance of viral findings by multiplex PCR from the nasopharynx of clinically septic patients during a winter season. During 11 weeks of the influenza epidemic period in January-March 2012, consecutive adult patients suspected to be septic (n = 432) were analyzed with cultures from blood and nasopharynx plus multiplex PCR for respiratory viruses on the nasopharyngeal specimen. The results were compared with those from microbiology analyses ordered as part of standard care...
May 17, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28503879/impact-of-an-antimicrobial-stewardship-intervention-on-appropriateness-of-prescribing-for-community-acquired-pneumonia-in-an-australian-regional-hospital
#17
Stuart E Bond, Craig S Boutlis, Wilfred W Yeo, Spiros Miyakis
Community-acquired pneumonia (CAP) is the second commonest indication for antibiotic use in Australian hospitals and is therefore a frequent target for antimicrobial stewardship. A single-centre prospective study was conducted in a regional referral hospital comparing management of adult patients with CAP before and after an educational intervention. We demonstrated a reduction in duration of therapy and reduced inappropriate use of ceftriaxone-based regimens for non-severe CAP.
May 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28486675/short-course-versus-long-course-oral-antibiotic-treatment-for-infections-treated-in-outpatient-settings-a-review-of-systematic-reviews
#18
Elizabeth E Dawson-Hahn, Sharon Mickan, Igho Onakpoya, Nia Roberts, Matthew Kronman, Chris C Butler, Matthew J Thompson
Purpose.: To summarize the evidence comparing the effectiveness of short and long courses of oral antibiotics for infections treated in outpatient settings. Methods.: We identified systematic reviews of randomized controlled trials for children and adults with bacterial infections treated in outpatient settings from Medline, Embase, CINAHL, Cochrane Database of Systematic Reviews and The Database of Review of Effects. Data were extracted on the primary outcome of clinical resolution and secondary outcomes...
May 9, 2017: Family Practice
https://www.readbyqxmd.com/read/28480285/influence-of-antibiotics-on-the-detection-of-bacteria-by-culture-based-and-culture-independent-diagnostic-tests-in-patients-hospitalized-with-community-acquired-pneumonia
#19
Aaron M Harris, Anna M Bramley, Seema Jain, Sandra R Arnold, Krow Ampofo, Wesley H Self, Derek J Williams, Evan J Anderson, Carlos G Grijalva, Jonathan A McCullers, Andrew T Pavia, Richard G Wunderink, Kathryn M Edwards, Jonas M Winchell, Lauri A Hicks
BACKGROUND: Specimens collected after antibiotic exposure may reduce culture-based bacterial detections. The impact on culture-independent diagnostic tests is unclear. We assessed the effect of antibiotic exposure on both of these test results among patients hospitalized with community-acquired pneumonia (CAP). METHODS: Culture-based bacterial testing included blood cultures and high-quality sputum or endotracheal tube (ET) aspirates; culture-independent testing included urinary antigen testing (adults) for Streptococcus pneumoniae and Legionella pneumophila and polymerase chain reaction (PCR) on nasopharyngeal and oropharyngeal (NP/OP) swabs for Mycoplasma pneumoniae and Chlamydia pneumoniae...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28480236/serial-procalcitonin-as-a-predictor-of-bacteremia-and-need-for-intensive-care-unit-care-in-adults-with-pneumonia-including-those-with-highest-severity-a-prospective-cohort-study
#20
Suzanne M McCluskey, Philipp Schuetz, Michael S Abers, Benjamin Bearnot, Maria E Morales, Debora Hoffman, Shreya Patel, Lauren Rosario, Victor Chiappa, Blair A Parry, Ryan T Callahan, Sheila A Bond, Kent Lewandrowski, William Binder, Michael R Filbin, Jatin M Vyas, Michael K Mansour
BACKGROUND: Procalcitonin (PCT) is a prohormone that rises in bacterial pneumonia and has promise in reducing antibiotic use. Despite these attributes, there are inconclusive data on its use for clinical prognostication. We hypothesize that serial PCT measurements can predict mortality, intensive care unit (ICU) admission, and bacteremia. METHODS: A prospective cohort study of inpatients diagnosed with pneumonia was performed at a large tertiary care center in Boston, Massachusetts...
2017: Open Forum Infectious Diseases
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