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https://www.readbyqxmd.com/read/27917737/a-pediatric-approach-to-ventilator-associated-events-surveillance
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/27895901/prevention-of-hospital-acquired-pneumonia-in-non-ventilated-adult-patients-a-narrative-review
#5
REVIEW
Leonor Pássaro, Stephan Harbarth, Caroline Landelle
BACKGROUND: Pneumonia is one of the leading hospital-acquired infections worldwide and has an important impact. Although preventive measures for ventilator-associated pneumonia (VAP) are well known, less is known about appropriate measures for prevention of hospital-acquired pneumonia (HAP). AIM: The purpose of this narrative review is to provide an overview of the current standards for preventing HAP in non-ventilated adult patients. METHODS: A search of the literature up to May 2015 was conducted using Medline for guidelines published by national professional societies or professional medical associations...
2016: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/27888989/burden-and-risk-factors-of-ambulatory-or-hospitalized-cap-a%C3%A2-population-based-cohort-study
#6
Martin Kolditz, Falko Tesch, Luise Mocke, Gert Höffken, Santiago Ewig, Jochen Schmitt
BACKGROUND: Data on incidence, risk factors and outcome of community-acquired pneumonia (CAP) including outpatients is sparse. METHODS: We conducted a cohort study on 1.837.080 adults insured by a German statutory health insurance in 2010-2011. CAP was identified via ICD-10-GM codes, ambulatory cases were validated by antibiotic prescription within 7 days. Primary outcomes were incidence, hospitalisation and 30-day all-cause mortality. Evaluated risk factors included age, sex and comorbidities...
December 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27861340/prognostic-factors-associated-with-mortality-and-major-in-hospital-complications-in-patients-with-bacteremic-pneumococcal-pneumonia-population-based-study
#7
Jessica A Beatty, Sumit R Majumdar, Gregory J Tyrrell, Thomas J Marrie, Dean T Eurich
Bacteremic pneumococcal pneumonia (BPP) causes considerable mortality and morbidity. We aimed to identify prognostic factors associated with mortality and major in-hospital complications in BPP.A prospective, population-based clinical registry of 1636 hospitalized adult patients (≥18 years) with BPP was established between 2000 and 2010 in Northern Alberta, Canada. Prognostic factors for mortality and major in-hospital complications (e.g., cardiac events, mechanical ventilation, aspiration) were evaluated using multivariable logistic regression...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27850332/693-de-escalation-of-antibiotics-in-culture-positive-critically-ill-adults-with-pneumonia
#8
Peter Zepke, Jeffrey Fish
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27798219/impact-of-antibiotic-de-escalation-on-clinical-outcomes-in-community-acquired-pneumococcal-pneumonia
#9
Diego Viasus, Antonella F Simonetti, Carolina Garcia-Vidal, Jordi Niubó, Jordi Dorca, Jordi Carratalà
BACKGROUND: Although antibiotic de-escalation is regarded as a measure that reduces selection pressure, adverse drug effects and costs, evidence supporting this practice in community-acquired pneumococcal pneumonia (CAPP) is lacking. METHODS: We carried out a retrospective analysis of prospectively collected data of a cohort of hospitalized adults with CAPP. Pneumococcal aetiology was established in patients with one or more positive cultures for Streptococcus pneumoniae obtained from blood, sterile fluids or sputum, and/or a positive urinary antigen test...
October 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27790429/act-fast-as-time-is-less-high-faecal-carriage-of-carbapenem-resistant-enterobacteriaceae-in-critical-care-patients
#10
Sanjith Saseedharan, Manisa Sahu, Edwin Joseph Pathrose, Sarita Shivdas
INTRODUCTION: Carbapenem-resistant Enterobacteriaceae (CRE) are drug-resistant Gram-negative bacteria that are present in the community as well as in hospitals. Their infection and colonisation puts critically ill patients at high risk due to the drug-resistant nature of the strains and possible spreading of these organisms, even in a hospital environment. AIM: To examine the presence and types of Enterobacteriaceae species in patients admitted directly from the community...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27784524/adult-manifestation-of-henoch-sch%C3%A3-nlein-purpura
#11
Daria Marley Kemp, James Studdiford, Katie Osley, Joya Sahu
A 51-year-old man initially presented to the hospital with a 2-week history of constipation, intermittently diffuse abdominal pain, nausea, vomiting, and productive cough. Results from chest x-ray and obstruction series appreciated a right lower lobe opacity and small right pleural effusion. The patient met sepsis criteria and was empirically covered for community-acquired pneumonia with vancomycin, piperacillin-tazobactam, moxifloxacin, and tobramycin. His hospital course was complicated by oliguria, acute kidney injury with a normal renal ultrasound, and transaminitis with a negative hepatitis panel...
2016: Skinmed
https://www.readbyqxmd.com/read/27778318/oral-hygiene-care-for-critically-ill-patients-to-prevent-ventilator-associated-pneumonia
#12
REVIEW
Fang Hua, Huixu Xie, Helen V Worthington, Susan Furness, Qi Zhang, Chunjie Li
BACKGROUND: Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in people who have received mechanical ventilation for at least 48 hours. VAP is a potentially serious complication in these patients who are already critically ill. Oral hygiene care (OHC), using either a mouthrinse, gel, toothbrush, or combination, together with aspiration of secretions, may reduce the risk of VAP in these patients. OBJECTIVES: To assess the effects of oral hygiene care on incidence of ventilator-associated pneumonia in critically ill patients receiving mechanical ventilation in hospital intensive care units (ICUs)...
October 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27765474/amoxicillin-clavulanic-acid-prescriptions-at-the-greater-paris-university-hospitals-ap-hp
#13
I Fusier, O Parent de Curzon, S Touratier, L Escaut, M Lafaurie, S Fournier, M Sinègre, P Lechat, D Vittecoq
OBJECTIVE: We aimed to document amoxicillin-clavulanic acid prescription to improve the proper use of antibiotics in hospital settings. We used three criteria: quality of medical charts, adequacy of indications, and adequacy of treatment duration. METHOD: This study was designed as a one-day point prevalence survey carried out by antibiotic lead specialists. RESULTS: We included 387 prescriptions from 32 hospitals. Immunodeficiency was recorded as a risk factor in 30% of patients...
October 17, 2016: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/27763732/antibiotics-for-ventilator-associated-pneumonia
#14
REVIEW
Lauren E Arthur, Russell S Kizor, Adrian G Selim, Mieke L van Driel, Leonardo Seoane
BACKGROUND: Ventilator-associated pneumonia (VAP) is a significant cause of morbidity and mortality, complicating the medical course of approximately 10% of mechanically-ventilated patients, with an estimated attributable mortality of 13%. To treat VAP empirically, the American Thoracic Society currently recommends antibiotic therapy based on the patients' risk of colonisation by an organism with multidrug resistance. The selection of initial antibiotic therapy in VAP is important, as inappropriate initial antimicrobial treatment is associated with higher mortality and longer hospital stay in intensive care unit (ICU) patients...
October 20, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27760779/the-role-of-serum-mycoplasma-pneumoniae-iga-igm-and-igg-for-the-diagnosis-of-mycoplasma-pneumonia-related-pneumonia-in-school-age-children-and-adolescents
#15
Wei-Ju Lee, Eng-Yen Huang, Chih-Min Tsai, Kuang-Che Kuo, Yi-Chuan Huang, Kai-Sheng Hsieh, Chen-Kuang Niu, Hong-Ren Yu
Mycoplasma pneumoniae (M. pneumoniae) is an important causative pathogen of community-acquired pneumonia in children. Rapid and reliable laboratory diagnosis of M. pneumoniae infection is important so that appropriate antibiotic treatment can be initiated to reduce the misuse of drugs and resistance rates. Anti-M. pneumoniae immunoglobulin M (IgM) is an indicator of recent primary infection, but can persist for several months after initial infection. It has been suggested that anti-M. pneumoniae immunoglobulin A (IgA) can be a reliable indicator for recent M...
October 19, 2016: Clinical and Vaccine Immunology: CVI
https://www.readbyqxmd.com/read/27737908/point-of-care-crp-testing-in-the-diagnosis-of-pneumonia-in-adults
#16
(no author information available yet)
Respiratory tract infections (RTI) are among the most common acute conditions leading to GP consultations and to antibiotic prescribing in primary care, even though 70% are viral, and many others are minor self-limiting bacterial infections.(1-4) Between 0.5% and 1.1% of adults have community-acquired pneumonia every year in the UK, most of whom are managed in primary care.(4,5) The decision to prescribe antibiotics for an acute RTI in primary care is often based on clinical symptoms, which have low sensitivity and specificity, and high inter-observer variability...
October 2016: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/27734780/-is-procalcitonin-measurement-useful-in-managing-respiratory-tract-infections
#17
J M Prins, T van der Poll
Better use of current antibiotics is warranted to curb increasing antimicrobial resistance rates. Procalcitonin guidance can safely reduce antibiotic usage when used to initiate or discontinue antibiotics in adult patients with a respiratory tract infection. However, the claimed reductions in antibiotic usage are mainly achieved in patients with acute bronchitis and exacerbations of COPD, conditions for which guidelines already discourage antibiotic treatment. Sequential procalcitonin measurements can also reduce the treatment duration of community-acquired pneumonia from 10-12 to 5-7 days, which is, however, already the recommended treatment duration for in- and outpatients under the current Dutch guidelines...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27714594/rapid-diagnostic-test-and-use-of-antibiotic-against-methicillin-resistant-staphylococcus-aureus-in-adult-intensive-care-unit
#18
A-F Dureau, G Duclos, F Antonini, D Boumaza, N Cassir, J Alingrin, C Vigne, E Hammad, L Zieleskiewicz, M Leone
Ventilator-associated pneumonia (VAP) due to methicillin-resistant Staphylococcus aureus (MRSA) is associated with excess mortality and costs. Molecular biology test allows rapid identification of MRSA in sputum with high negative predictive value. We hypothesized that use of a rapid diagnostic test in patients with suspected VAP was associated with reduced use of antibiotics directed against MRSA. This retrospective, observational study was conducted in a polyvalent intensive care unit (ICU) of a university hospital...
October 7, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27703671/epidemiology-virulence-factors-and-management-of-the-pneumococcus
#19
Charles Feldman, Ronald Anderson
Pneumococcal infections continue to cause significant morbidity and mortality in patients throughout the world. This microorganism remains the most common bacterial cause of community-acquired pneumonia and is associated with a considerable burden of disease and health-care costs in both developed and developing countries. Emerging antibiotic resistance has been a concern because of its potential negative impact on the outcome of patients who receive standard antibiotic therapy. However, there have been substantial changes in the epidemiology of this pathogen in recent years, not least of which has been due to the use of pneumococcal conjugate vaccines in children, with subsequent herd protection in unvaccinated adults and children...
2016: F1000Research
https://www.readbyqxmd.com/read/27690519/broad-versus-narrow-spectrum-oral-antibiotic-transition-and-outcomes-in-healthcare-associated-pneumonia
#20
Whitney R Buckel, Edward Stenehjem, Jeff Sorensen, Nathan Dean, Brandon Webb
RATIONALE: Guidelines recommend a switch from intravenous to oral antibiotics once patients who are hospitalized with pneumonia achieve clinical stability. However, little evidence guides the selection of an oral antibiotic for patients with healthcare-associated pneumonia, especially where no microbiological diagnosis is made. OBJECTIVES: To compare outcomes between patients who were transitioned to broad vs narrow spectrum oral antibiotics after initially receiving broad-spectrum intravenous antibiotic coverage...
October 3, 2016: Annals of the American Thoracic Society
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