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Healthcare associated pneumonia

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https://www.readbyqxmd.com/read/28717120/new-delhi-metallo-beta-lactamase-ndm-1-producing-klebsiella-pneumoniae-isolated-from-a-burned-patient
#1
Santiago Petersen-Morfin, Paola Bocanegra-Ibarias, Rayo Morfin-Otero, Elvira Garza-González, Hector Raul Perez-Gomez, Esteban González-Diaz, Sergio Esparza-Ahumada, Gerardo León-Garnica, Gabriel Amezcua-Salazar, Eduardo Rodriguez-Noriega
BACKGROUND Infections affecting burn patients are frequently caused by Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacteriaceae species. Infections with these pathogens have become increasingly difficult to treat due to evolving antibiotic resistance mechanisms, including the production of carbapenemases. CASE REPORT The present case report describes the evolution of a burn patient with polymicrobial healthcare-associated burn infections, including a bloodstream infection due to an emergent multidrug-resistant New Delhi metallo-beta-lactamase (NDM-1)-producing Klebsiella pneumoniae...
July 18, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28716451/multidrug-resistant-pseudomonas-aeruginosa-lower-respiratory-tract-infections-in-the-intensive-care-unit-prevalence-and-risk-factors
#2
Trang D Trinh, Evan J Zasowski, Kimberly C Claeys, Abdalhamid M Lagnf, Shravya Kidambi, Susan L Davis, Michael J Rybak
Intensive care unit (ICU) admission is a risk for multidrug-resistant (MDR) Pseudomonas aeruginosa, but factors specific to critically ill pneumonia patients are not fully characterized. Objective was to determine risk factors associated with MDR P. aeruginosa pneumonia among ICU patients. This was a retrospective case-control study of P. aeruginosa pneumonia in the ICU; cystic fibrosis and colonizers were excluded. Risk factors included comorbid conditions and prior healthcare exposure (anti-pseudomonal antibiotics, hospitalizations, nursing home, P...
June 19, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28716359/predictors-of-polymyxin-b-treatment-failure-in-gram-negative-healthcare-associated-infections-among-critically-ill-patients
#3
Bahiah Ismail, Mohd Nazri Shafei, Azian Harun, Saedah Ali, Mahamarowi Omar, Zakuan Zainy Deris
BACKGROUND: With increasing prevalence and spread of multidrug resistant Gram-negative infections, parenteral polymyxins resurged in clinical practice. The primary aim of the study was to determine the predictors of treatment failure and in-hospital mortality among critically ill patients treated with polymyxin B. METHODS: Demographic data, underlying diseases, procedures and details on polymyxin B therapy were retrospectively analyzed in a cohort of 84 patients who received intravenous polymyxin B in an intensive care unit from 2010 to 2014...
June 29, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28712104/do-bacteria-isolated-from-icu-patients-eskape-antibiotic-treatment-in-vitro-susceptibility-of-the-enterobacteriaceae-family-to-tigecycline
#4
Katarzyna Talaga-Ćwiertnia, Paweł Krzyściak, Małgorzata Bulanda
BACKGROUND: Enterobacteriaceae are currently causing the majority of healthcare-associated infections (HAI) and simultaneously expressing increasing levels of antibiotic resistance. The purpose of this study is to assess the in vitro sensitivity of MDR strains from the family Enterobacteriaceae to tigecycline in relation to their origin from patients hospitalized in intensive care units (ICUs) and non-ICUs. METHODS: The study involved 156 clinically-significant strains of the Enterobacteriaceae family isolated from patients with cIAIs and/or cSSSIs hospitalized in ICUs and other surgical departments...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28705150/economic-burden-of-varicella-in-children-1-12%C3%A2-years-of-age-in-hungary-2011-2015
#5
Z Meszner, Z Molnar, E Rampakakis, H K Yang, B J Kuter, Lara J Wolfson
BACKGROUND: Although live-attenuated varicella-zoster virus (VZV) vaccines have been proven to be safe and effective in preventing varicella and real-word evidence shows routine childhood immunization programs are effective in dramatically reducing varicella associated morbidity and mortality, varicella vaccine is not included in the National Immunization Program (NIP) in Hungary. The purpose of this study was to evaluate the clinical and economic burden associated with varicella in Hungary...
July 14, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28695492/patterns-of-acute-poisoning-with-pesticides-in-the-paediatric-age-group
#6
Kavinda Chandimal Dayasiri, Shaluka F Jayamanne, Chamilka Y Jayasinghe
BACKGROUND: Pesticides are identified as one of the dangerous poisons globally in children and are associated with increased short- and long-term morbidity. Pesticide poisoning is the most common method of self-poisoning among adults in rural Sri Lanka, and the clinical management is associated with significant healthcare costs to the country. There is however little data published on acute pesticide poisoning among children in rural Sri Lanka. The current study aimed to comprehensively evaluate clinical profiles, harmful first aid measures, emergency clinical management, complications and outcomes related to acute pesticide poisoning among children in the rural community of Sri Lanka...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28694251/advances-in-the-causes-and-management-of-community-acquired-pneumonia-in-adults
#7
REVIEW
Richard G Wunderink, Grant Waterer
Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant Staphylococcus aureus and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia...
July 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28688757/-description-and-role-of-bacteriological-techniques-in-the-management-of-lung-infections
#8
REVIEW
S Dahyot, L Lemee, M Pestel-Caron
Acute pneumonias occur in a variety of clinical settings and accurate identification of bacterial causes is extremely important. No microbiological tool is either 100 % sensitive or 100 % specific, and despite investigations, aetiology remains unanswered in more than 30 % of pneumonia. No sample may be necessary for patients treated as outpatients, non invasive respiratory specimens are preferred in hospitalised individuals (community or healthcare associated), while invasive specimens are used as second line for community acquired pneumonia (CAP) in intensive care, and in the first line where pneumonia occurs in immunosuppressed patients...
July 5, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28677255/anaerobic-antibiotic-usage-for-pneumonia-in-the-medical-intensive-care-unit
#9
Mutsumi J Kioka, Bruno DiGiovine, Mohamed Rezik, Jeffrey H Jennings
BACKGROUND AND OBJECTIVE: Pneumonia is a common admitting diagnosis in the intensive care unit (ICU). When aspiration is suspected, antibiotics to cover anaerobes are frequently used, but in the absence of clear risk factors, current guidelines have questioned their role. It is unknown how frequently these guidelines are followed. METHODS: We conducted a single-centre observational study on practice patterns of anaerobic antibiotic use in consecutive patients admitted to the ICU with aspiration pneumonia (Asp), community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP)...
July 4, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28669365/incidence-of-pneumonia-in-nursing-home-residents-with-dementia-in-the-netherlands-an-estimation-based-on-three-differently-designed-studies
#10
T P Zomer, T VAN DER Maaden, A B VAN Gageldonk-Lafeber, S C DE Greeff, J T VAN DER Steen, L Verhoef
Pneumonia leads to considerable morbidity and mortality in nursing home residents with dementia. We assessed pneumonia incidence based on data from three different studies: (1) real-time national surveillance of healthcare-associated infections in nursing home residents in 2009-2015; (2) a randomized controlled trial in 2012-2015 to assess effects of a practical guideline in nursing home residents with dementia and pneumonia; and (3) a study in 2007-2010 to assess quality of dying in newly admitted nursing home residents with dementia...
July 3, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28668656/epidemiology-management-and-outcome-of-carbapenem-resistant-klebsiella-pneumoniae-bloodstream-infections-in-hospitals-within-the-same-endemic-metropolitan-area
#11
Maria Luisa Cristina, Cristiano Alicino, Marina Sartini, Valeria Faccio, Anna Maria Spagnolo, Valerio Del Bono, Giovanni Cassola, Anna Maria De Mite, Maria Paola Crisalli, Gianluca Ottria, Elisa Schinca, Giuliano Lo Pinto, Luigi Carlo Bottaro, Claudio Viscoli, Andrea Orsi, Daniele Roberto Giacobbe, Giancarlo Icardi
In the last decade, carbapenem-resistant Klebsiella pneumoniae (CR-Kp) has become endemic in several countries, including Italy. In the present study, we assessed the differences in epidemiology, management, and mortality of CR-Kp bloodstream infection (BSI) in the three main adult acute-care hospitals of the metropolitan area of Genoa, Italy. From January 2013 to December 2014, all patients with CR-Kp BSI were identified through the computerized microbiology laboratory databases of the three hospitals. The primary endpoints of the study were incidence and characteristics of CR-Kp BSI in hospitals within the same endemic metropolitan area...
June 28, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28658101/propensity-score-matched-analysis-comparing-the-clinical-outcome-of-klebsiella-pneumoniae-and-escherichia-coli-causing-community-onset-monomicrobial-bacteremia
#12
COMPARATIVE STUDY
Tsung-Hang Kuo, Chao-Yung Yang, Chung-Hsun Lee, Chih-Chia Hsieh, Wen-Chien Ko, Ching-Chi Lee
Bacteremia is a life-threatening condition that is associated with substantial healthcare costs. Escherichia coli and Klebsiella pneumoniae are the leading causes of community-onset gram-negative bacteremia. However, a comprehensive comparison between these pathogens involved in bacteremia episodes has yet to be reported.In this retrospective cohort study, adults with community-onset monomicrobial bacteremia caused by E coli or K pneumoniae were recruited in the emergency department of a medical center during a 6-year period, and the clinical variables were collected retrospectively from medical records...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28656006/clinical-characteristics-of-influenza-associated-pneumonia-of-adults-clinical-features-and-factors-contributing-to-severity-and-mortality
#13
Takashi Ishiguro, Naho Kagiyama, Ryuji Uozumi, Kyuto Odashima, Yotaro Takaku, Kazuyoshi Kurashima, Satoshi Morita, Noboru Takayanagi
Background: Pneumonia is a major complication of influenza that contributes to mortality. Clinical characteristics and factors of influenza virus contributing to the severity and mortality of pneumonia have not been fully elucidated. Objective: The objective was to clarify clinical characteristics and factors contributing to the severity and mortality of influenza-associated pneumonia (flu-p). Methods: We retrospectively analyzed patients with flu-p. Results: From December 1999 to March 2016, 210 patients with a median age of 69 (range, 17 to 92) years with flu-p based on positive rapid antigen tests, increased antibody titers of paired sera, or positive results of reverse transcription polymerase chain reaction were admitted to our institution...
June 2017: Yale Journal of Biology and Medicine
https://www.readbyqxmd.com/read/28643188/impact-of-appropriateness-of-empiric-therapy-on-outcomes-in-community-onset-bacteremia-by-extended-spectrum-%C3%AE-lactamase-producing-escherichia-coli-and-klebisella-pneumoniae-definitively-treated-with-carbapenems
#14
E-J Joo, D A Park, N R Lee, S-Y Moon, J-K Choi, J-H Ko, K R Peck
Despite a significant increase of bloodstream infection caused by extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae in the community-setting, information regarding clinical outcomes of inappropriate empiric therapy (IAT) in patients with those infections is limited. A multicenter-retrospective cohort study was conducted in four hospitals. A total of 249 adults were identified to have community-onset bacteremia caused by ESBL-producing Escherichia coli and Klebsiella pneumoniae, and definitively treated with carbapenems...
June 23, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28638594/high-burden-of-antimicrobial-resistance-among-gram-negative-bacteria-causing-healthcare-associated-infections-in-a-critical-care-unit-of-nepal
#15
Narayan Prasad Parajuli, Subhash Prasad Acharya, Shyam Kumar Mishra, Keshab Parajuli, Basista Prasad Rijal, Bharat Mani Pokhrel
BACKGROUND: Healthcare associated infections (HCAI) and antimicrobial resistance are principal threats to the patients of intensive care units and are the major determining factors for patient outcome. They are associated with increased morbidity, mortality, excess hospitalization and financial costs. The present study is an attempt to investigate the spectrum and antimicrobial resistance of bacterial isolates involved in healthcare associated infections (HCAI) in the patients of a critical care unit at a tertiary care university hospital in Kathmandu, Nepal...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28633678/variation-in-empiric-coverage-versus-detection-of-methicillin-resistant-staphylococcus-aureus-and-pseudomonas-aeruginosa-in-hospitalizations-for-community-onset-pneumonia-across-128-us-veterans-affairs-medical-centers
#16
Barbara E Jones, Kevin Antoine Brown, Makoto M Jones, Benedikt D Huttner, Tom Greene, Brian C Sauer, Karl Madaras-Kelly, Michael A Rubin, Matthew Bidwell Goetz, Matthew H Samore
OBJECTIVE To examine variation in antibiotic coverage and detection of resistant pathogens in community-onset pneumonia. DESIGN Cross-sectional study. SETTING A total of 128 hospitals in the Veterans Affairs health system. PARTICIPANTS Hospitalizations with a principal diagnosis of pneumonia from 2009 through 2010. METHODS We examined proportions of hospitalizations with empiric antibiotic coverage for methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PAER) and with initial detection in blood or respiratory cultures...
June 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28633665/optimizing-bronchodilation-in-the-prevention-of-copd-exacerbations
#17
REVIEW
Marc Miravitlles, Antonio Anzueto, José R Jardim
The natural disease course of chronic obstructive pulmonary disease (COPD) is often punctuated by exacerbations: acute events of symptom worsening associated with significant morbidity and healthcare resource utilization; reduced quality of life; and increased risk of hospitalization and death. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommend that patients at risk of exacerbations (GOLD Groups C and D) receive a long-acting muscarinic antagonist (LAMA) or a long-acting β2-agonist (LABA)/LAMA combination, respectively, as preferred initial treatments...
June 20, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28629753/active-identification-of-patients-who-are-methicillin-resistant-staphylococcus-aureus-colonized-is-not-associated-with-longer-duration-of-vancomycin-therapy
#18
Carlos Acuna-Villaorduna, Westyn Branch-Elliman, Judith Strymish, Kalpana Gupta
BACKGROUND: Excessive prescribing of vancomycin among patients admitted to inpatient wards is a challenge for antimicrobial stewardship programs, especially in the setting of expanded screening programs for methicillin-resistant Staphylococcus aureus (MRSA). Studies examining factors associated with longer duration of vancomycin use are limited. METHODS: We conducted a retrospective cohort study to assess the impact of universal MRSA admission screening on duration of vancomycin use at the VA Boston Healthcare System during the period from January 2013-November 2015...
June 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28617860/increasing-prevalence-of-infectious-diseases-in-asylum-seekers-at-a-tertiary-care-hospital-in-switzerland
#19
Constantine Bloch-Infanger, Veronika Bättig, Jürg Kremo, Andreas F Widmer, Adrian Egli, Roland Bingisser, Manuel Battegay, Stefan Erb
OBJECTIVE: The increasing number of refugees seeking asylum in Europe in recent years poses new challenges for the healthcare systems in the destination countries. The goal of the study was to describe the evolution of medical problems of asylum seekers at a tertiary care centre in Switzerland. METHODS: At the University Hospital Basel, we compared all asylum seekers during two 1-year time periods in 2004/05 and 2014/15 concerning demographic characteristics and reasons for referrals and hospitalizations...
2017: PloS One
https://www.readbyqxmd.com/read/28614140/a-comparison-of-clinical-characteristics-and-outcomes-of-ventilator-associated-pneumonias-among-burn-patients-by-diagnostic-criteria-set
#20
Duraid Younan, Russell Griffin, Thomas Swain, Eric Schinnerer, Jean-Francois Pittet, Bernard Camins
OBJECTIVES: The National Healthcare Safety Network (NHSN) replaced its old definition for ventilator associated pneumonia (VAP) with ventilator associated events (VAEs) in 2013. Little data is available comparing the two definitions in burn patients. METHODS: Data from 2011-2014 were collected on burn patients mechanically ventilated for at least two days. VAP was determined using two methods: (1) pneumonia as defined by the previous more clinical CDC (NHSN) definition captured in the burn registry; (2) pneumonia as defined by the recent CDC (NHSN) standard of Ventilator-Associated Events where patients meeting the criteria for possible VAP (PVAP) were considered having a pneumonia...
June 13, 2017: Shock
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