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https://www.readbyqxmd.com/read/30515424/an-outbreak-of-serratia-marcescens-in-a-moroccan-neonatal-intensive-care-unit
#1
Abdellatif Daoudi, Fatiha Benaoui, Nadia El Idrissi Slitine, Nabila Soraa, Fadl Mrabih Rabou Maoulainine
Serratia marcescens ( S. marcescens ) is an Enterobacteriaceae microorganism that is widespread in the environment, which may be the source of nosocomial infections, rare in the newborn but severe, and often in the form of outbreaks. The aim of our study is to report our experience, during an outbreak of S. marcescens , to show the severity of this germ, with review of the literature. Our study was retrospective, including 8 newborns with S. marcescens nosocomial infection, collected in the neonatal intensive care unit of Mohammed VI University Medical Hospital, during the epidemic period, over a period of 2 months (July and August 2016)...
2018: Advances in Medicine
https://www.readbyqxmd.com/read/30510640/incidence-and-risk-factors-for-potentially-suboptimal-serum-concentrations-of-vancomycin-during-cardiac-surgery
#2
Paolo Cotogni, Cristina Barbero, Mauro Rinaldi
AIM: To investigate the incidence and risk factors for vancomycin concentrations less than 10 mg/L during cardiac surgery. METHODS: In this prospective study, patients undergoing cardiac surgery received a single dose of 1000 mg of vancomycin. Multiple arterial samples were drawn during surgery. Exclusion criteria were hepatic dysfunction; renal dysfunction; ongoing infectious diseases; solid or hematologic tumors; severe insulin-dependent diabetes; body mass index of < 17 or > 40 kg/m2 ; pregnancy or lactation; antibiotic, corticosteroid, or other immunosuppressive therapy; vancomycin or nonsteroidal anti-inflammatory drug therapy in the previous 2 wk; chemotherapy or radiation therapy in the previous 6 mo; allergy to vancomycin or cefazolin; drug abuse; cardiac surgery in the previous 6 mo; previous or scheduled organ transplantation; preoperative stay in the intensive care unit for more than 24 h; emergency procedure or lack of adequate preparation for surgery; and participation in another trial...
November 26, 2018: World Journal of Cardiology
https://www.readbyqxmd.com/read/30506852/duration-of-exposure-to-antipseudomonal-%C3%AE-lactam-antibiotics-in-the-critically-ill-and-development-of-new-resistance
#3
Besu F Teshome, Scott Martin Vouri, Nicholas Hampton, Marin H Kollef, Scott T Micek
STUDY OBJECTIVE: Minimizing the duration of broad-spectrum antimicrobial exposure in the critically ill is a commonly used strategy aimed at preventing resistance. Our objective was to correlate the duration of exposure to antipseudomonal β-lactam antibiotics with the development of new resistance in critically ill patients. DESIGN: Single-center, retrospective cohort study. SETTING: A large, academic, tertiary care hospital. PATIENTS: A total of 7118 adults with a discharge diagnosis of severe sepsis or septic shock who received at least 1 dose of cefepime, meropenem, or piperacillin-tazobactam during their hospitalization between 2010 and 2015...
December 3, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/30472293/fecal-microbiota-transplantation-shortens-the-colonization-period-and-allows-the-re-entry-of-patients-carrying-carbapenamase-producing-bacteria-into-medical-care-facilities
#4
Nadia Saïdani, Jean-Christophe Lagier, Nadim Cassir, Matthieu Million, Sophie Baron, Grégory Dubourg, Carole Eldin, Jad Kerbaj, Camille Valles, Didier Raoult, Philippe Brouqui
BACKGROUND: Colonization with carbapenemase producing Enterobacteriaceae or Acinetobacter (CPE/A) is associated with complex medical care requiring implementation of specific isolation policies and limitation of patient discharge to other medical facilities. Fecal Microbiota Transplantation (FMT) has been proposed in order to reduce the duration of gut colonization. OBJECTIVES: We investigated whether a dedicated protocol of FMT could reduce the negativation time of CPE/A intestinal carriage in patients whose medical care has been delayed due to such colonization...
November 22, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/30448010/-medico-legal-risk-in-urology-analysis-of-a-portfolio-of-insured-persons-by-a-french-insurance-company-between-2009-and-2018
#5
F Papillon, L Cormier, D Legeais
OBJECTIVE: Presentation of data collected on urology claims from the register of a French insurance company. MATERIAL AND METHOD: Compensation claims involving urologists covering the period 2009-2018 were identified and analyzed. RESULTS: A total of 37 files were found. Oncological and functional surgical interventions accounts for 78% of repair claims. Postoperative complications represent 76% of the cases. The most represented acts are total prostatectomy (5) and promonto-fixation (4)...
November 14, 2018: Progrès en Urologie
https://www.readbyqxmd.com/read/30429391/incidence-epidemiology-and-control-of-clostridium-difficile-infection-in-a-tertiary-care-private-hospital-in-india
#6
Tanu Singhal, Sweta Shah, Reshma Tejam, Pooja Thakkar
Purpose: Clostridium difficile infection (CDI) is a serious healthcare-associated infection (HAI) now being increasingly reported from hospitals across India. However, there is a paucity of data on the incidence of and impact of control measures on CDI in India. Materials and Methods: This is a retrospective study conducted at a tertiary care hospital in Mumbai from January 2016 to December 2017. All patients with healthcare-onset diarrhoea were tested for C. difficile by glutamate dehydrogenase (GDH)/toxin assay or nucleic acid amplification test (NAAT)...
July 2018: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/30416942/antibiotic-elution-and-mechanical-strength-of-pmma-bone-cement-loaded-with-borate-bioactive-glass
#7
Grahmm A Funk, Jonathan C Burkes, Kimberly A Cole, Mohamed N Rahaman, Terence E McIff
Introduction: Local delivery of antibiotics using bone cement as the delivery vehicle is an established method of managing implant-associated orthopedic infections. Various fillers have been added to cement to increase antibiotic elution, but they often do so at the expense of strength. This study evaluated the effect of adding a borate bioactive glass, previously shown to promote bone formation, on vancomycin elution from PMMA bone cement. Methods: Five cement composites were made: three loaded with borate bioactive glass along with 0, 1, and 5 grams of vancomycin and two without any glass but with 1 and 5 grams vancomycin to serve as controls...
2018: Journal of Bone and Joint Infection
https://www.readbyqxmd.com/read/30406316/importance-of-compliance-audits-for-a-pediatric-complicated-appendicitis-clinical-practice-guideline
#8
Mehul V Raval, Alan B Kwan, Curtis D Travers, Kurt F Heiss
Clinical practice guidelines (CPG) have been shown to decrease practice variation, reduce resource use, and improve patient outcomes. The purpose of this study was to audit compliance of a pediatric complicated appendicitis CPG to identify areas for continued improvement. A comprehensive complicated appendicitis CPG was implemented in a children's hospital system. Outcomes were compared for 48 months pre- (01/2012 to 12/2015) and 28 months post-implementation (01/2016 to 04/2018). A detailed compliance audit was nested within the post-implementation period in 60 consecutive patients from 11/2017 to 03/2018...
November 7, 2018: Journal of Medical Systems
https://www.readbyqxmd.com/read/30402412/subcutaneous-emphysema-related-to-dental-procedures
#9
Cheol-Hee Jeong, Seungkyu Yoon, Seung-Won Chung, Jae-Young Kim, Kwang-Ho Park, Jong-Ki Huh
Objectives: The objective of this study was to analyze 11 cases of subcutaneous emphysema associated with dental procedures from a single hospital and discuss approaches for accurate diagnosis and treatment of the condition. Materials and Methods: The medical records of 11 patients who were treated for subcutaneous emphysema related to dental procedures between January 2009 and April 2017 were analyzed retrospectively. Patients with subcutaneous emphysema within the facial area or that spread to the neck and beyond, including the facial region, were assigned to two groups and compared in terms of age, sex, and durations of antibiotic use, hospitalization, and follow-up until improvement...
October 2018: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/30374510/appropriateness-of-perioperative-antibiotic-prophylaxis-in-two-italian-hospitals-a-pilot-study
#10
A Quattrocchi, M Barchitta, A Maugeri, G Basile, A R Mattaliano, R Palermo, A Grandi, R Canino, L Faccini, A Agodi, C Pasquarella
BACKGROUND: Appropriate perioperative antibiotic prophylaxis has been shown to be an effective measure for preventing surgical site infections and to avoid complications including increased antimicrobial resistance. The objective of the present study was to evaluate the appropriateness of perioperative antibiotic prophylaxis in two Italian hospitals. STUDY DESIGN: In 2016 a survey was prospectively carried out at two hospitals (identified as A and B) and all patients who underwent a surgical operation were enrolled...
September 2018: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/30367313/meropenem-antimicrobial-stewardship-program-clinical-economic-and-antibiotic-resistance-impact
#11
J F García-Rodríguez, B Bardán-García, M F Peña-Rodríguez, H Álvarez-Díaz, A Mariño-Callejo
There are few prospective studies with sufficient duration in time to evaluate clinical and antibiotic resistance impact of antibiotic stewardship programs (ASP). This is a descriptive study between January 2012 and December 2017, pre-post intervention. A meropenem ASP was initiated in January 2015; in patients who started treatment with meropenem, an infectious disease physician performed treatment recommendations to prescribers. Prospective information was collected to evaluate adequacy of meropenem prescription to local guidelines and to compare results between cases with accepted or rejected intervention...
October 26, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/30366645/application-of-a-ventilator-associated-pneumonia-prevention-guideline-and-outcomes-a-quasi-experimental-study
#12
Ana Sabrina Sousa, Cândida Ferrito, José Artur Paiva
OBJECTIVE: Ventilator associated pneumonia is the most frequent health-care-associated infection in Intensive Care Units, causing increased antibiotic consumption and resistance, length of stay, plus multiple health and economic costs. The aim of the study was to assess whether a customised guideline implementation would improve ventilator-associated pneumonia incidence and associated intensive care outcomes. DESIGN: This was a quasi-experimental, before-after study consisting of pre-intervention, intervention and post-intervention periods...
October 23, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/30356258/duration-of-travel-associated-faecal-colonisation-with-esbl-producing-enterobacteriaceae-a-one-year-follow-up-study
#13
Åse ÖstholmBalkhed, Maria Tärnberg, Maud Nilsson, Lennart E Nilsson, Håkan Hanberger, Anita Hällgren
BACKGROUND: In a previous study, we found that 30% of individuals travelling outside Scandinavia acquired extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) in their faecal flora. The aim of this study was to determine the duration of travel-associated faecal colonisation with ESBL-PE, to assess risk factors for prolonged colonisation and to detect changes in antibiotic susceptibility during prolonged colonisation. METHODS: Individuals with travel-associated colonisation with ESBL-PE submitted faecal samples every 3rd month over a one-year period...
2018: PloS One
https://www.readbyqxmd.com/read/30351268/staphylococcus-aureus-osteoarticular-infections-in-children-an-8-year-review-of-molecular-microbiology-antibiotic-resistance-and-clinical-characteristics
#14
Dimitrios Bouras, Anastassios Doudoulakakis, Maria Tsolia, Ilia Vaki, Nikolaos Giormezis, Niki Petropoulou, Evangelia Lebessi, Vasiliki Gennimata, Athanasios Tsakris, Iris Spiliopoulou, Athanasios Michos
PURPOSE: To investigate the clinical, phenotypic and genotypic characteristics of Staphylococcus aureus strains causing osteoarticular infections in a large paediatric series. METHODOLOGY: Medical records of children who were hospitalized with the diagnosis of community-associated S. aureus (CA-SA) osteomyelitis and/or septic arthritis in the two major tertiary paediatric hospitals of Athens during an 8-year period (2007-2015) were reviewed, and S. aureus isolates were analysed regarding antimicrobial resistance, detection of pathogenicity genes and genotyping using SCCmec, agr typing, PFGE and MLST...
October 23, 2018: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/30344855/-epidemio-clinical-features-of-genital-tuberculosis-among-tunisian-women-a-series-of-47-cases
#15
Souheil Zayet, Aida Berriche, Lamia Ammari, Mariem Razgallah, Rim Abdelmalek, Mohamed Khrouf, Badreddine Kilani, Hanène Tiouiri Benaissa
This study aimed to identify the epidemio-clinic, diagnostic, therapeutic and evolutionary features of genital tuberculosis (GT) among Tunisian women. We conducted a retrospective, descriptive study in the Department of Infectious Diseases at the La Rabta Hospital, Tunisia, over a period of 15 and a half years (January 2000 - June 2014). All patients hospitalized for genital TB were included in the study. The study focused on 47 cases. The average age of patients was 42.2 years. Eighteen women were from rural areas...
2018: Pan African Medical Journal
https://www.readbyqxmd.com/read/30343312/impact-of-a-multifaceted-prevention-program-on-ventilator-associated-pneumonia-including-selective-oropharyngeal-decontamination
#16
C Landelle, V Nocquet Boyer, M Abbas, E Genevois, N Abidi, S Naimo, R Raulais, L Bouchoud, F Boroli, H Terrisse, J-L Bosson, S Harbarth, J Pugin
PURPOSE: We describe the impact of a multifaceted program for decreasing ventilator-associated pneumonia (VAP) after implementing nine preventive measures, including selective oropharyngeal decontamination (SOD). METHODS: We compared VAP rates during an 8-month pre-intervention period, a 12-month intervention period, and an 11-month post-intervention period in a cohort of patients who received mechanical ventilation (MV) for > 48 h. The primary objective was to assess the effect on first VAP occurrence, using a Cox cause-specific proportional hazards model...
November 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/30341117/protocol-for-faecal-microbiota-transplantation-in-ulcerative-colitis-fmtuc-a-randomised-feasibility-study
#17
Maki Jitsumura, Andrew Laurence Cunningham, Matthew David Hitchings, Saiful Islam, Angharad P Davies, Paula E Row, Andrew D Riddell, James Kinross, Tom S Wilkinson, G J Jenkins, John G Williams, Dean Anthony Harris
BACKGROUND: The interaction of the gut microbiota with the human host is implicated in the pathogenesis of inflammatory and immunological diseases including ulcerative colitis (UC). Faecal microbiota transplantation (FMT) as a method of restoring gut microbial diversity is of increasing interest as a therapeutic approach in the management of UC. The current literature lacks consensus about the dose of FMT, route of administration and duration of response. METHODS AND ANALYSIS: This single-blinded randomised trial will explore the feasibility of FMT in 30 treatment-naïve patients with histologically confirmed distal UC limited to the recto-sigmoid region (up to 40 cm from the anal verge)...
October 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/30332675/predictors-of-outcomes-in-patients-with-prolonged-weaning-with-focus-on-respiratory-tract-pathogens-and-infection
#18
Catharina Hommelsheim, Mathias Sichau, Roland Heipel, Eckhard Müller, Sören Gatermann, Michael Pfeifer, Santiago Ewig
BACKGROUND: The impact of respiratory tract pathogens and infection on outcomes in patients with prolonged weaning is largely unknown. OBJECTIVE: We studied predictors of weaning outcomes (death and failure to achieve spontaneous ventilation) in a population treated during a 3.5-year period in a specialized and certified weaning centre. METHODS: Patient data were retrieved retrospectively from the clinical charts. Complete datasets were available in 173 patients...
October 17, 2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/30325991/association-of-the-duration-of-antibiotic-therapy-with-major-surgical-site-infection-in-cochlear-implantation
#19
Achraf Sayed-Hassan, Ruben Hermann, Frédéric Chidiac, Eric Truy, Nicolas Guevara, Sonanda Bailleux, Olivier Deguine, Blandine Baladi, Yohan Gallois, Alexis Bozorg-Grayeli, Yannick Lerosey, Benoit Godey, Cécile Parietti-Winkler, Bruno Pereira, Thierry Mom
Importance: Infection after cochlear implantation is a rare but serious event that can lead to meningitis. There is no consensus on prevention of infection in these patients, and each center applies its own strategy. Objective: To describe the rates of major surgical site infection for patients undergoing cochlear implantation who receive prolonged antibiotic treatment compared with those who receive a single perioperative dose of antibiotic prophylaxis. Design, Setting, and Participants: Retrospective cohort study of patients who underwent cochlear implantation between January 1, 2011, and July 8, 2015, with a postoperative follow-up of 1 to 3 years...
October 11, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/30325676/impact-on-mortality-of-adherence-to-evidence-based-interventions-in-patients-with-catheter-related-bloodstream-infection-due-to-methicillin-sensitive-staphylococcus-aureus
#20
Alejandra Morales-Cartagena, Mario Fernández-Ruiz, Antonio Lalueza, Jaime Lora-Tamayo, Rafael San Juan, Francisco López-Medrano, Julia Origüen, Fernando Chaves, José María Aguado
BACKGROUND: Recent studies have demonstrated improved survival when the management of Staphylococcus aureus bloodstream infection (BSI) is compliant with evidence-based therapeutic interventions. Whether this effect extends to low-risk sources, such as catheter-related BSI, remains unclear. METHODS: We retrospectively included 225 episodes of methicillin-sensitive S. aureus catheter-related BSI diagnosed in our centre during two non-consecutive periods: 2002-2004 (first period (101 episodes)) and 2009-2013 (second period (124 episodes))...
October 16, 2018: Infectious Diseases
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