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https://www.readbyqxmd.com/read/28199348/presentation-management-and-outcomes-of-sepsis-in-adults-and-children-admitted-to-a-rural-ugandan-hospital-a-prospective-observational-cohort-study
#1
Kristina E Rudd, Leonard K Tutaryebwa, T Eoin West
OBJECTIVES: Limited data are available on sepsis in low-resource settings, particularly outside of urban referral centers. We conducted a prospective observational single-center cohort study in May 2013 to assess the presentation, management and outcomes of adult and pediatric patients admitted with sepsis to a community hospital in rural Uganda. METHODS: We consecutively screened all patients admitted to medical wards who met sepsis criteria. We evaluated eligible patients within 24 hours of presentation and 24-48 hours after admission, and followed them until hospital discharge...
2017: PloS One
https://www.readbyqxmd.com/read/28187785/longevity-and-gender-as-the-risk-factors-of-methicillin-resistant-staphylococcus-aureus-infections-in-southern-poland
#2
Monika Pomorska-Wesołowska, Anna Różańska, Joanna Natkaniec, Barbara Gryglewska, Anna Szczypta, Mirosława Dzikowska, Agnieszka Chmielarczyk, Jadwiga Wójkowska-Mach
BACKGROUND: The proportion of older people among the general population has risen. Staphylococcus aureus (SA) constitutes a significant problem. Underlying disease and functional debility, predispose the older adult to staphylococcal carriage and infection, specially bloodstream infection and pneumonia. METHODS: This is a retrospective cohort study of older patients with SA infections. We analyzed a database containing the results of laboratory cultures from patients treated in 2013 for SA infections and selected 613 hospitalized and non-hospitalized people aged ≥60 years...
February 10, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28185802/infection-in-burn-patients-in-a-referral-center-in-colombia
#3
Carlos Enrique Ramirez-Blanco, Carlos Enrique Ramirez-Rivero, Luis Alfonso Diaz-Martinez, Luis Miguel Sosa-Avila
INTRODUCTION: Worldwide, burns are responsible for more than 300,000 deaths annually; infection is a major cause of morbidity and mortality in these patients. Early identification and treatment of infection improves outcome. Toward this end it's necessary to identify the institutions flora and organisms that most frequently produces infection. OBJECTIVES: To characterize infections developed by burn patients hospitalized at the University Hospital of Santander (HUS)...
February 6, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28139431/prevalence-risk-factors-outcomes-and-molecular-epidemiology-of-mcr-1-positive-enterobacteriaceae-in-patients-and-healthy-adults-from-china-an-epidemiological-and-clinical-study
#4
Yang Wang, Guo-Bao Tian, Rong Zhang, Yingbo Shen, Jonathan M Tyrrell, Xi Huang, Hongwei Zhou, Lei Lei, Hong-Yu Li, Yohei Doi, Ying Fang, Hongwei Ren, Lan-Lan Zhong, Zhangqi Shen, Kun-Jiao Zeng, Shaolin Wang, Jian-Hua Liu, Congming Wu, Timothy R Walsh, Jianzhong Shen
BACKGROUND: The mcr-1 gene confers transferable colistin resistance. mcr-1-positive Enterobacteriaceae (MCRPE) have attracted substantial medical, media, and political attention; however, so far studies have not addressed their clinical impact. Herein, we report the prevalence of MCRPE in human infections and carriage, clinical associations of mcr-1-positive Escherichia coli (MCRPEC) infection, and risk factors for MCRPEC carriage. METHODS: We undertook this study at two hospitals in Zhejiang and Guangdong, China...
January 27, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28137813/nasal-mrsa-pcr-testing-reduces-duration-of-mrsa-targeted-therapy-in-patients-with-suspected-mrsa-pneumonia
#5
Nidhu Baby, Andrew C Faust, Terri Smith, Lyndsay A Sheperd, Laura Knoll, Edward L Goodman
OBJECTIVE: To evaluate the impact of pharmacist-ordered MRSA PCR testing on the duration of empiric MRSA-targeted antibiotic therapy in patients with suspected pneumonia. METHODS: This is a retrospective analysis of patients who received vancomycin or linezolid for suspected pneumonia before and after the implementation of a pharmacist-driven protocol for nasal MRSA PCR testing. Patients were included if they were adults >18 years of age and initiated on vancomycin or linezolid for suspected MRSA pneumonia...
January 30, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28124027/bacterial-lysis-through-interference-with-peptidoglycan-synthesis-increases-biofilm-formation-by-nontypeable-haemophilus-influenzae
#6
Sara Marti, Carmen Puig, Alexandra Merlos, Miguel Viñas, Marien I de Jonge, Josefina Liñares, Carmen Ardanuy, Jeroen D Langereis
Nontypeable Haemophilus influenzae (NTHi) is an opportunistic pathogen that mainly causes otitis media in children and community-acquired pneumonia or exacerbations of chronic obstructive pulmonary disease in adults. A large variety of studies suggest that biofilm formation by NTHi may be an important step in the pathogenesis of this bacterium. However, the underlying mechanisms involved in this process are poorly elucidated. In this study, we used a transposon mutant library to identify bacterial genes involved in biofilm formation...
January 2017: MSphere
https://www.readbyqxmd.com/read/28122100/acute-bacterial-meningitis-caused-by-acute-otitis-media-in-adults-a-series-of-12-patients
#7
Daniel M Kaplan, Ofer Gluck, Mordechai Kraus, Youval Slovik, Hindy Juwad
We conducted a retrospective chart review to characterize the outcomes of 12 patients-9 men and 3 women, aged 21 to 79 years (mean: 49)-who had been treated at our tertiary care center for acute bacterial meningitis caused by acute otitis media (ABMAO). Fever was the most common presenting sign/symptom, observed in 8 patients, followed by otalgia, neck stiffness, headache, and confusion. An opaque and bulging tympanic membrane was observed in 8 patients. Cultures were positive for Streptococcus pneumoniae in the cerebrospinal fluid, ear, and blood in 7, 5, and 3 patients, respectively...
January 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28068928/newly-recognized-cerebral-infarctions-on-postmortem-imaging-a-report-of-three-cases-with-systemic-infectious-disease
#8
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
#9
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...
February 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28050072/klebsiella-oxytoca-an-emerging-pathogen
#10
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
#11
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...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/28042214/study-of-invasive-pneumococcal-infection-in-adults-with-reference-to-penicillin-resistance
#12
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
#13
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...
February 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28034888/ultra-short-course-antibiotics-for-patients-with-suspected-ventilator-associated-pneumonia-but-minimal-and-stable-ventilator-settings
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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