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https://www.readbyqxmd.com/read/29457583/financial-incentives-to-reduce-hospital-acquired-infections-under-alternative-payment-arrangements
#1
Catherine Crawford Cohen, Jianfang Liu, Bevin Cohen, Elaine L Larson, Sherry Glied
OBJECTIVE The financial incentives for hospitals to improve care may be weaker if higher insurer payments for adverse conditions offset a portion of hospital costs. The purpose of this study was to simulate incentives for reducing hospital-acquired infections under various payment configurations by Medicare, Medicaid, and private payers. DESIGN Matched case-control study. SETTING A large, urban hospital system with 1 community hospital and 2 tertiary-care hospitals. PATIENTS All patients discharged in 2013 and 2014...
February 19, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29456727/risk-factors-and-coping-strategies-of-severe-community-acquired-pneumonia-in-chemotherapy-induction-period-of-acute-leukemia
#2
Ning Li, Qingcheng Duan, Weidan Zhang
The risk factors and coping strategies of severe community-acquired pneumonia (SCAP) in chemotherapy induction period of acute leukemia were investigated. Eighty-six patients with CAP in chemotherapy induction period of acute leukemia in Dezhou Hospital from March 2014 to February 2017 were selected and divided into observation group (SCAP group, n=45) and control group (non-SCAP group, n=41) according to the acute physiology and chronic health evolution II (APACHE II) score. The blood, sputum, nasopharyngeal secretion and pleural effusion samples were collected from patients in both groups, and the samples were detected for pathogens, followed by the analysis of relevant factors...
March 2018: Oncology Letters
https://www.readbyqxmd.com/read/29456043/colistin-alone-versus-colistin-plus-meropenem-for-treatment-of-severe-infections-caused-by-carbapenem-resistant-gram-negative-bacteria-an-open-label-randomised-controlled-trial
#3
Mical Paul, George L Daikos, Emanuele Durante-Mangoni, Dafna Yahav, Yehuda Carmeli, Yael Dishon Benattar, Anna Skiada, Roberto Andini, Noa Eliakim-Raz, Amir Nutman, Oren Zusman, Anastasia Antoniadou, Pia Clara Pafundi, Amos Adler, Yaakov Dickstein, Ioannis Pavleas, Rosa Zampino, Vered Daitch, Roni Bitterman, Hiba Zayyad, Fidi Koppel, Inbar Levi, Tanya Babich, Lena E Friberg, Johan W Mouton, Ursula Theuretzbacher, Leonard Leibovici
BACKGROUND: Colistin-carbapenem combinations are synergistic in vitro against carbapenem-resistant Gram-negative bacteria. We aimed to test whether combination therapy improves clinical outcomes for adults with infections caused by carbapenem-resistant or carbapenemase-producing Gram-negative bacteria. METHODS: A randomised controlled superiority trial was done in six hospitals in Israel, Greece, and Italy. We included adults with bacteraemia, ventilator-associated pneumonia, hospital-acquired pneumonia, or urosepsis caused by carbapenem-non-susceptible Gram-negative bacteria...
February 15, 2018: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29455172/transmission-of-esbl-producing-enterobacteriaceae-and-their-mobile-genetic-elements-identification-of-sources-by-whole-genome-sequencing-study-protocol-for-an-observational-study-in-switzerland
#4
Tanja Stadler, Dominik Meinel, Lisandra Aguilar-Bultet, Jana S Huisman, Ruth Schindler, Adrian Egli, Helena M B Seth-Smith, Lucas Eichenberger, Peter Brodmann, Philipp Hübner, Claudia Bagutti, Sarah Tschudin-Sutter
INTRODUCTION: Extended-spectrum beta-lactamases (ESBL)-producing Enterobacteriaceae were first described in relation with hospital-acquired infections. In the 2000s, the epidemiology of ESBL-producing organisms changed as especially ESBL-producing Escherichia coli was increasingly described as an important cause of community-acquired infections, supporting the hypothesis that in more recent years ESBL-producing Enterobacteriaceae have probably been imported into hospitals rather than vice versa...
February 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29455061/relationship-between-nurse-staffing-level-and-adult-nursing-sensitive-outcomes-in-tertiary-hospitals-of-korea-retrospective-observational-study
#5
Chul-Gyu Kim, Kyun-Seop Bae
BACKGROUND: Nurse staffing level is an important factor on nursing sensitive outcome. The relationships of nurse staffing level with nursing sensitive outcomes such as mortality, upper gastrointestinal bleeding and pressure ulcer have been explored in the United States, Canada, Australia, and New Zealand. Lower level of hospital nurse staffing seems associated with more adverse outcomes, especially mortality. However, there is insufficient evidence of the nurse staffing level-outcome relationship in other indicators...
January 2, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29455059/the-impact-of-infection-on-mortality-in-octogenarians-who-were-admitted-due-to-acute-coronary-syndrome
#6
Kudret Keskin, Gökhan Çetinkal, Serhat Sığırcı, Süleyman Sezai Yıldız, Şükrü Çetin, Ahmet Gürdal, Betül Balaban Kocaş, Kadriye Orta Kılıçkesmez
BACKGROUND: The prevalence of coronary artery disease is on the rise as the life expectancy of the population increases. However, treatment of acute coronary syndrome in the elderly patients has its own problems that have not been thoroughly addressed in the clinical trials. Since these patients are generally fragile and have multiple co-morbidities, the course of acute coronary syndrome can frequently be complicated. Infection, which co-exists either at the initial presentation or is acquired during the hospital stay, is a condition about which there is little published data...
February 10, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29454906/risk-factors-for-pseudomonas-aeruginosa-infections-consequences-of-inappropriate-initial-antimicrobial-therapy-a-systematic-literature-review-meta-analysis
#7
REVIEW
Sanjay Merchant, Emma M Proudfoot, Hafsa N Quadri, Heather J McElroy, William R Wright, Ankur Gupta, Eric M Sarpong
Treating infections of Gram-negative pathogens, in particular Pseudomonas aeruginosa, is a challenge for clinicians in the Asia-Pacific region due to inherent and acquired resistance to antimicrobials. This systematic review and meta-analysis provides updated information of the risk factors for P. aeruginosa infections in Asia-Pacific, and consequences (e.g., mortality, costs) of initial inappropriate antimicrobial therapy (IIAT). EMBASE and MEDLINE databases were searched for Asia-Pacific studies reporting the consequences of IIAT versus initial appropriate antimicrobial therapy (IAAT) in Gram-negative infections, and risk factors for serious P...
February 15, 2018: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29454592/effective-antimicrobial-stewardship-strategies-for-cost-effective-utilization-of-telavancin-for-the-treatment-of-patients-with-hospital-acquired-bacterial-pneumonia-caused-by-staphylococcus-aureus
#8
James A McKinnell, Shelby Corman, Dipen Patel, Grace H Leung, Lynne M Gordon, Thomas P Lodise
PURPOSE: Clinicians and stewardship programs are challenged with positioning of novel, higher priced antibiotic agents for the treatment of clinical infections. We developed a decision-analytic model to describe costs, including drug, total treatment costs, and health care outcomes, associated with telavancin (TLV) compared with vancomycin (VAN) for patients with Staphylococcus aureus (SA) hospital-acquired bacterial pneumonia (HABP). METHODS: This decision-analytic model assessed the treatment of SA-HABP with TLV versus VAN...
February 14, 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29454181/brainstem-dysfunction-heralding-disseminated-cryptococcosis
#9
Prachaya Srivanitchapoom, Yuvadee Pitakpatapee, Panitta Sitthinamsuwan, Sith Sathornsumetee
Cryptococcal meningoencephalitis is one of the most common central nervous system infections affecting immunocompromised patients. However, brainstem involvement is extremely rare and may represent a diagnostic challenge to clinicians. We report a non-HIV infected, chronically immunosuppressed, patient with fatal disseminated cryptococcosis presented with subcutaneous masses at both thighs and progressive brainstem dysfunction. Magnetic resonance imaging demonstrated multiple brainstem infarcts likely derived from small vessel vasculopathy...
February 12, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29449294/disease-characteristics-and-management-of-hospitalised-adolescents-and-adults-with-community-acquired-pneumonia-in-china-a-retrospective-multicentre-survey
#10
Liang Chen, Fei Zhou, Hui Li, Xiqian Xing, Xiudi Han, Yiming Wang, Chunxiao Zhang, Lijun Suo, Jingxiang Wang, Guohua Yu, Guangqiang Wang, Xuexin Yao, Hongxia Yu, Lei Wang, Meng Liu, Chunxue Xue, Bo Liu, Xiaoli Zhu, Yanli Li, Ying Xiao, Xiaojing Cui, Lijuan Li, Timothy M Uyeki, Chen Wang, Bin Cao
OBJECTIVES: To describe the clinical characteristics and management of patients hospitalised with community-acquired pneumonia (CAP) in China. DESIGN: This was a multicentre, retrospective, observational study. SETTING: 13 teaching hospitals in northern, central and southern China from 1 January 2014 to 31 December 2014 PARTICIPANTS: Information on hospitalised patients aged ≥14 years with radiographically confirmed pneumonia with illness onset in the community was collected using standard case report forms...
February 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29447449/prognostic-and-pathogenic-role-of-angiopoietin-1-and-2-in-pneumonia
#11
Birgitt Gutbier, Anne-Kathrin Neuhauß, Katrin Reppe, Carolin Ehrler, Ansgar Santel, Jörg Kaufmann, Markus Scholz, Norbert Weissmann, Lars Morawietz, Timothy J Mitchell, Stefano Aliberti, Stefan Hippenstiel, Norbert Suttorp, Martin Witzenrath
RATIONALE: During pneumonia, pathogen-host interaction evokes inflammation and lung barrier dysfunction. Tie2-activation by Angiopoietin-1 reduces, while Tie2-blockade by Angiopoietin-2 increases inflammation and permeability during sepsis. The role of Angiopoietin-1/-2 in pneumonia remains unidentified. OBJECTIVES: To investigate the prognostic and pathogenetic impact of Angiopoietins in regulating pulmonary vascular barrier function and inflammation in bacterial pneumonia...
February 15, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29447369/mandatory-change-from-surgical-skull-caps-to-bouffant-caps-among-operating-room-personnel-does-not-reduce-surgical-site-infections-in-class-i-surgical-cases-a-single-center-experience-with-more-than-15-000-patients
#12
Hussain Shallwani, Hakeem J Shakir, Ashley M Aldridge, Maureen T Donovan, Elad I Levy, Kevin J Gibbons
BACKGROUND: Surgical site infections (SSIs) are noteworthy and costly complications. New recommendations from a national organization have urged the elimination of traditional surgeon's caps (surgical skull caps) and mandated the use of bouffant caps to prevent SSIs. OBJECTIVE: To report SSI rates for >15 000 class I (clean) surgical procedures 13 mo before and 13 mo after surgical skull caps were banned at a single site with 25 operating rooms. METHODS: SSI data were acquired from hospital infection control monthly summary reports from January 2014 to March 2016...
May 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29447204/comparison-of-viral-infection-in-healthcare-associated-pneumonia-hcap-and-community-acquired-pneumonia-cap
#13
Eun Sun Kim, Kyoung Un Park, Sang Hoon Lee, Yeon Joo Lee, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Choon-Taek Lee, Jae Ho Lee
BACKGROUND: Although viruses are known to be the second most common etiological factor in community-acquired pneumonia (CAP), the respiratory viral profile of the patients with healthcare-associated pneumonia (HCAP) has not yet been elucidated. We investigated the prevalence and the clinical impact of respiratory virus infection in adult patients with HCAP. METHODS: Patients admitted with HCAP or CAP, between January and December 2016, to a tertiary referral hospital in Korea, were prospectively enrolled, and virus identification was performed using reverse-transcription polymerase chain reaction (RT-PCR)...
2018: PloS One
https://www.readbyqxmd.com/read/29447024/microbiology-and-clinical-outcomes-of-puerperal-sepsis-a-prospective-cohort-study
#14
Rumbidzai Majangara, Muchabayiwa Francis Gidiri, Zvavahera Mike Chirenje
The objectives of this study were to determine the identity and antibacterial susceptibility profiles of bacteria colonising the female genital tract and blood stream and their association with clinical outcomes in women with puerperal sepsis. A prospective descriptive cohort study was conducted at two tertiary hospitals in Zimbabwe. Endocervical swabs and blood were collected for culture and susceptibility testing from 151 consecutive women who met the World Health Organisation criteria for puerperal sepsis...
February 15, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29445826/genome-based-comparison-of-clostridioides-difficile-average-amino-acid-identity-analysis-of-core-genomes
#15
Adriana Cabal, Se-Ran Jun, Piroon Jenjaroenpun, Visanu Wanchai, Intawat Nookaew, Thidathip Wongsurawat, Mary J Burgess, Atul Kothari, Trudy M Wassenaar, David W Ussery
Infections due to Clostridioides difficile (previously known as Clostridium difficile) are a major problem in hospitals, where cases can be caused by community-acquired strains as well as by nosocomial spread. Whole genome sequences from clinical samples contain a lot of information but that needs to be analyzed and compared in such a way that the outcome is useful for clinicians or epidemiologists. Here, we compare 663 public available complete genome sequences of C. difficile using average amino acid identity (AAI) scores...
February 14, 2018: Microbial Ecology
https://www.readbyqxmd.com/read/29444837/whole-genome-sequence-analysis-of-streptococcus-pneumoniae-strains-that-cause-hospital-acquired-pneumonia-infections
#16
Bin Chang, Masatomo Morita, Ken-Ichi Lee, Makoto Ohnishi
Streptococcus pneumoniae colonizes the nasopharyngeal mucus in healthy individuals and can cause otitis media, pneumonia, and invasive pneumococcal diseases. In this study, we analyzed the S. pneumoniae strains that caused 19 pneumonia episodes in long-term inpatients with severe underlying disease in a hospital during a period of 14 months (from January 2014 to February 2015). Serotyping and whole genome sequencing analyses revealed that 18 of the 19 pneumonia cases were caused by S. pneumoniae strains belonging to 3 genetically distinct groups: clonal complex (CC) 9999, sequence type (ST) 282, and ST166...
February 14, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29440952/antibiotic-treatment-in-childhood-community-acquired-pneumonia-clinical-practice-versus-guidelines-results-from-two-university-hospitals
#17
Sorin Claudiu Man, Valentina Sas, Cristina Schnell, Camelia Florea, Adelina Ţuţu, Ariana Szilágyi, Sergiu Belenes, Amalia Hebriştean, Anca Bonaţ, Claudia Cladovan, Cornel Aldea
Background and aims: Community-acquired pneumonia (CAP) is a both common and serious childhood infection. Antibiotic treatment guidelines help to reduce inadequate antibiotics prescriptions. Methods: We conducted a retrospective study at the Clinical Emergency Hospital for Children, 3rd Pediatric Clinic, Cluj-Napoca and Dr. Gavril Curteanu Clinical City Hospital, in Oradea. All patients discharged with a diagnosis of CAP between December 1, 2014 and February 28, 2015, were included in the study...
2018: Clujul Medical (1957)
https://www.readbyqxmd.com/read/29439654/prospective-study-on-human-fecal-carriage-of-enterobacteriaceae-possessing-mcr-1-and-mcr-2-genes-in-a-regional-hospital-in-hong-kong
#18
Wai-Sing Chan, Chun-Hang Au, Dona N Ho, Tsun-Leung Chan, Edmond Shiu-Kwan Ma, Bone Siu-Fai Tang
BACKGROUND: Human fecal carriage of Enterobacteriaceae possessing mobilized colistin resistance genes (mcr-1 and mcr-2) remains obscure in Hong Kong. As part of routine surveillance on emerging antibiotic resistance, we conducted a prospective study on this topic in a regional hospital in Hong Kong. METHODS: From October 31 to November 25, 2016, all fecal specimens submitted for routine analysis were included in this surveillance study. These comprised 672 consecutive routine fecal specimens collected from 616 individuals...
February 13, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29438727/is-cohorting-the-only-solution-to-control-carbapenemase-producing-enterobacteriaceae-outbreaks-a-single-centre-experience
#19
Legeay Clément, Thépot-Seegers Valérie, Pailhoriès Hélène, Hilliquin Delphine, Zahar Jean-Ralph
BACKGROUND: Carbapenemase producing Enterobacteriaceae (CPE) area a major issue. Cohorting can help controlling spread of CPEs in hospitals, but is expensive and hard to implement. AIM: To identify ward variables associated with CPE in-hospital transmission in a hospital where cohorting was never implemented. METHODS: Cohort prospective study, where we compared fourteen consecutive days period regarding in-hospital transmission. Each period met the 2 following conditions: 1) CPE carriers/infected admitted for at least 48h, 2) 80% of relative contact patients were screened at least twice...
February 10, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29438479/novel-tn916-like-elements-confer-aminoglycoside-macrolide-co-resistance-in-clinical-isolates-of-streptococcus-gallolyticus-ssp-gallolyticus
#20
Stanimir Kambarev, Frédéric Pecorari, Stéphane Corvec
Background: Streptococcus gallolyticus ssp. gallolyticus (Sgg) is a commensal bacterium and an opportunistic pathogen. In humans it has been clinically associated with the incidence of colorectal cancer (CRC) and epidemiologically recognized as an emerging cause of infective endocarditis (IE). The standard therapy of Sgg includes the administration of a penicillin in combination with an aminoglycoside. Even though penicillin-resistant isolates have still not been reported, epidemiological studies have shown that this microbe is a reservoir of multiple acquired genes, conferring resistance to tetracyclines, aminoglycosides, macrolides and glycopeptides...
February 9, 2018: Journal of Antimicrobial Chemotherapy
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