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Vancomycin AND outcome AND Mortality

Brady S Moffett, Jennifer Morris, Charissa Kam, Marianne Galati, Ankhi Dutta, Ayse Akcan-Arikan
INTRODUCTION: Vancomycin associated acute kidney injury (vAKI) is a well known complication in pediatric patients. Identification and characterization of the incidence and risk factors for vAKI in the pediatric population would assist clinicians in potentially preventing or mitigating vAKI. METHODS AND MATERIALS: A 6 year retrospective cohort study was designed. Patients were included if they were < 19 years of age, received vancomycin as inpatients, and had a baseline SCr and one other SCr drawn during and up to 72 hours after the discontinuation of vancomycin...
2018: PloS One
Haim Ben-Zvi, Genady Drozdinsky, Shiri Kushnir, Tomer Avni, Oded Scheuerman, Jihad Bisahra, Dafna Yahav
Use of GeneXpert MRSA/SA in diagnostic algorithms of Staphylococcus aureus bacteremia may influence both patients' clinical outcomes and antibiotic stewardship. We evaluated these outcomes in a retrospective cohort before (1/6/2015-31/5/2016) and after (1/6/2016-31/8/2017) the introduction of the test in adult patients with Gram-positive cocci in clusters in blood cultures. We included 254 patients (125 preintervention, 129 postintervention). No significant difference in 30-day mortality or clinical success was demonstrated between periods...
August 29, 2018: Diagnostic Microbiology and Infectious Disease
Kerry Anne Rambaran, Saeed K Alzghari, Charles F Seifert
Vascular access infection is one of the major contributors to hemodialysis (HD) patient morbidity and mortality. There is a paucity of consensus guidelines on vancomycin use in the HD population. The primary objective of this study was to determine if vancomycin serum concentrations were associated with positive outcomes in HD patients with Gram-positive bacteremia. A retrospective cohort study conducted at a 443-bed tertiary teaching county hospital from January 1, 2010 to January 1, 2016 was performed. Patients aged 18-89, with chronic renal failure on hemodialysis who presented with positive blood cultures with Gram-positive bacteria and received intravenous vancomycin for at least 24 hours were evaluated...
July 3, 2018: Curēus
Mitchell S Buckley, Nicole C Hartsock, Andrew J Berry, Dale S Bikin, Emily C Richards, Melanie J Yerondopoulos, Emir Kobic, Laura M Wicks, Drayton A Hammond
PURPOSE: The objective of this study was to evaluate AKI incidence with concomitant vancomycin and piperacillin/tazobactam (PTZ) compared to vancomycin and cefepime (FEP) in critically ill patients. MATERIALS AND METHODS: A retrospective, cohort study was conducted in adult critically ill patients from January 1, 2014 to December 31, 2017. The primary aim was to compare the incidence of AKI during concomitant therapy or until hospital discharge. Secondary analyses included AKI severity, time to AKI as well as recovery, and clinical outcomes...
August 11, 2018: Journal of Critical Care
M L Hung, H T Liao, W S Chen, M H Chen, C C Lai, C Y Tsai, D M Chang
Objective The objective of this paper is to analyze the clinical features, outcomes, mortality risk factors, and all-cause mortalities of invasive aspergillosis (IA) in patients with systemic lupus erythematosus (SLE). Methods Medical records were reviewed to identify SLE patients with IA from January 2006 to June 2017, at Taipei Veterans General Hospital, Taiwan. A total of 6714 SLE patients were included. Clinical/laboratory parameters and treatment outcomes were analyzed. Results Four patients (19.0%) had definite and 17 had probable (81...
August 29, 2018: Lupus
Daniela Weber, Andreas Hiergeist, Markus Weber, Katja Dettmer, Daniel Wolff, Joachim Hahn, Wolfgang Herr, André Gessner, Ernst Holler
Background: Maintaining gastrointestinal (GI) microbiome diversity plays a key role during allogeneic stem cell transplantation (ASCT) and loss of diversity correlates with acute GI Graft-versus-Host Disease (GvHD) and outcome. Methods: In this retrospective analysis of 161 ASCT patients we used serial analyses of urinary 3-indoxyl sulfate (3-IS) levels and GI microbiome parameters within the first 10 days after ASCT to identify potential commensal microbiota sparing antibiotics...
August 17, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Nobuaki Shime, Nobuyuki Saito, Miya Bokui, Naoki Sakane, Mitsuhiro Kamimura, Tsutomu Shinohara, Tadashi Kosaka, Hisashi Ishikura, Atsuko Kobayashi
Objective: To evaluate the clinical outcomes associated with anti-methicillin-resistant Staphylococcus aureus (MRSA) antimicrobials. Methods: We reviewed a prospective database of 247 consecutive patients with clinically and microbiologically confirmed MRSA infections, hospitalized in 7 Japanese hospitals between April 2014 and March 2015, and treated with anti-MRSA pharmaceuticals. Survival was measured at 30 days. We examined the relationships between initial antimicrobial administered and survival and organ toxicity...
2018: Infection and Drug Resistance
Min Huang, Hao Wu, Jing Zhou, Min Xu, Suming Zhou
BACKGROUND: Vancomycin is widely used for infections caused by gram-positive bacteria, but little attention has been paid to vancomycin in the treatment of critically ill patients aged ≥80 years. The aim of the current study was to investigate the efficacy of vancomycin and risk factors associated with nephrotoxicity of vancomycin in elderly critically ill patients. METHODS: A retrospective study was performed in a 14-bed medical-surgical geriatric ICU between January 2007 and June 2014...
August 1, 2018: Archives of Iranian Medicine
Joseph J Carreno, Tori Smiraglia, Christopher Hunter, Ellis Tobin, Ben Lomaestro
INTRODUCTION: Combination therapy with vancomycin and piperacillin-tazobactam has been associated with increased risk of acute kidney injury (AKI) as compared to monotherapy. This study was conducted to assess the comparative incidence of AKI due to combination therapy in patients receiving vancomycin and piperacillin-tazobactam in combination or as monotherapy. METHODS: Retrospective, matched, cohort study of patients receiving vancomycin and piperacillin-tazobactam in combination or as monotherapy...
August 10, 2018: International Journal of Antimicrobial Agents
Minghuan Jiang, Nok-Hang Leung, Margaret Ip, Joyce H S You
BACKGROUND: Clostridium difficile infection (CDI) caused by ribotype 002 strain is associated with poor outcomes in Chinese patients. Fecal microbiota transplantation (FMT) is an effective but costly treatment for CDI. We aimed to examine potential cost-effectiveness of ribotype-guided FMT in Chinese patients with severe CDI. METHODS: A decision-analytic model was designed to simulate outcomes of ribotype 002-guided FMT versus vancomycin treatment in Chinese patients with severe CDI in the hospital setting...
2018: PloS One
Josephine V Seale, Richard A Hutchinson, Paul F Fleming, Ajay Sinha, Stephen T Kempley, Shahid M Husain, Michael R Millar
BACKGROUND: Necrotising enterocolitis (NEC) is a significant cause of infant morbidity and mortality, disproportionately affecting those of extreme prematurity and/or very low birth weight. A number of risk factors have been identified, including an association between the use of antibiotics, and the subsequent development of NEC. AIM: This review sought to address whether the choice of antibiotic(s) used to treat infants with suspected late-onset sepsis (LOS) influences the risk of developing NEC...
August 2018: Early Human Development
Steven C Lin, Carolyn D Alonso, Alan C Moss
Clostridium difficile, an anaerobic gram-positive, spore-forming bacillus, has become the most common cause of nosocomial infectious diarrhea, and is associated with increased mortality in all populations. Patients who have received solid organ transplants (SOT) are at increased risk of Clostridium difficile infection (CDI) and CDI recurrence (rCDI). This may be related to chronic immunosuppression, frequent antibiotic exposure, and increased or prolonged hospitalizations. Increased morbidity and mortality from CDI is well-described in SOT patients...
July 16, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Jun Jie Benjamin Seng, Mei Hui Amanda Yong, Zi Xin Peh, Jie Lin Soong, Mooi Heong Tan
Background Vancomycin therapeutic drug monitoring (TDM) is commonly performed to ensure safe and effective use of the antibiotic. Aim of Study To evaluate appropriateness of vancomycin TDM and its outcomes in Singapore General Hospital. Method A retrospective, cross-sectional study was conducted between 1 January 2014 and 28 February 2014 involving patients who received ≥ 1 dose of intravenous vancomycin with TDM. Patient demographics and relevant vancomycin TDM data were collected from medical records...
June 12, 2018: International Journal of Clinical Pharmacy
Kevin C Katz, George R Golding, Kelly Baekyung Choi, Linda Pelude, Kanchana R Amaratunga, Monica Taljaard, Stephanie Alexandre, Jun Chen Collet, Ian Davis, Tim Du, Gerald A Evans, Charles Frenette, Denise Gravel, Susy Hota, Pamela Kibsey, Joanne M Langley, Bonita E Lee, Camille Lemieux, Yves Longtin, Dominik Mertz, Lorraine Maze Dit Mieusement, Jessica Minion, Dorothy L Moore, Michael R Mulvey, Susan Richardson, Michelle Science, Andrew E Simor, Paula Stagg, Kathryn N Suh, Geoffrey Taylor, Alice Wong, Nisha Thampi
BACKGROUND: The clinical and molecular epidemiology of health care-associated Clostridium difficile infection in nonepidemic settings across Canada has evolved since the first report of the virulent North American pulsed-field gel electrophoresis type 1 (NAP1) strain more than 15 years ago. The objective of this national, multicentre study was to describe the evolving epidemiology and molecular characteristics of health care-associated C. difficile infection in Canada during a post-NAP1-epidemic period, particularly patient outcomes associated with the NAP1 strain...
June 25, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Patrícia Guedes Garcia, Liliana Andrade Chebli, Tarsila Campanha da Rocha Ribeiro, Pedro Duarte Gaburri, Fabio Heleno de Lima Pace, Kátia Valéria Bastos Dias Barbosa, Lívia Almeida Costa, William de Almeida Cruz, Isabelle Carvalho de Assis, Bernardo Rodriguez Mendes Moraes, Alexandre Zanini, Julio Maria Fonseca Chebli
PURPOSE: The prospective assessment of Clostridium difficile infection (CDI) impact in inflammatory bowel disease (IBD) flare in outpatient setting has been poorly investigated. We aimed to evaluate the prevalence and the associated factors with CDI in IBD outpatients presenting colitis flares as well as the outcomes following treatment. METHODS: In this prospective cohort study, conducted from October, 2014, to July, 2016, 120 IBD patients (55% presenting colitis flare) and 40 non-IBD controls were assessed for CDI...
June 21, 2018: International Journal of Colorectal Disease
Fatma Ben Abid, Mohammed Abukhattab, Hafedh Ghazouani, Obada Khalil, Ahmed Gohar, Hussam Al Soub, Muna Al Maslamani, Abdullatif Al Khal, Eman Al Masalamani, Said Al Dhahry, Samar Hashim, Faraj Howadi, Adeel A Butt
BACKGROUND: Central nervous system (CNS) viral infections are an important cause of morbidity and mortality. No data are available regarding their epidemiology in Qatar. DESIGN: We retrospectively evaluated all cerebrospinal fluid findings from January 2011-March 2015 at Hamad Medical Corporation. Those with abnormal CSF finding were included in our study. We excluded those with missing medical records, no clinical evidence of viral CNS infection, or proven bacterial, fungal or tuberculosis CNS infection...
August 2018: International Journal of Infectious Diseases: IJID
Kazuhiko Nakaharai, Kojiro Morita, Taisuke Jo, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
OBJECTIVES: Previous studies evaluating the clinical benefits of prophylactic antibiotics for severe acute pancreatitis (SAP) have generated inconsistent results due to heterogeneities among the study settings. We determined if early prophylactic antibiotics improved the outcomes of SAP patients using a study designed to overcome these previous methodological weaknesses. METHODS: We conducted a retrospective cohort study of SAP patients discharged between July 2010 and March 2016, using a Japanese nationwide inpatient database...
September 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Adrienne G Randolph, Ruifei Xu, Tanya Novak, Margaret M Newhams, Juliane Bubeck Wardenburg, Scott L Weiss, Ronald C Sanders, Neal J Thomas, Mark W Hall, Keiko M Tarquinio, Natalie Cvijanovich, Rainer G Gedeit, Edward J Truemper, Barry Markovitz, Mary E Hartman, Kate G Ackerman, John S Giuliano, Steven L Shein, Kristin Moffitt
Background: Respiratory coinfection with influenza virus and methicillin-resistant Staphylococcus aureus (MRSA) causes life-threatening necrotizing pneumonia in children. Sporadic incidence precludes evaluation of antimicrobial efficacy. We assessed the clinical characteristics and outcomes of critically ill children with influenza-MRSA respiratory coinfection and evaluated antibiotic use. Methods: We prospectively enrolled children (<18 years) with influenza infection and acute respiratory failure across 34 pediatric intensive care units Nov 2008 to May 2016...
June 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Ying Dong, Kirsten Glaser, Christian P Speer
Methicillin-resistant Staphylococcus aureus (MRSA) is a ubiquitous human inhabitant and one of the important pathogens of neonatal infections. MRSA is associated with significant mortality and morbidity, especially in very immature preterm neonates. Moreover, MRSA may be implicated in adverse long-term neonatal outcomes, posing a substantial disease burden. Recent advances in molecular microbiology have shed light on the evolution of MRSA population structure and virulence factors, which may contribute to MRSA epidemic waves worldwide...
2018: Neonatology
Chien-Chang Yang, Cheng-Len Sy, Yhu-Chering Huang, Shian-Sen Shie, Jwu-Ching Shu, Pang-Hsin Hsieh, Ching-Hsi Hsiao, Chih-Jung Chen
Bacteremia caused by MRSA with reduced vancomycin susceptibility (MRSA-RVS) frequently resulted in treatment failure and mortality. The relation of bacterial factors and unfavorable outcomes remains controversial. We retrospectively reviewed clinical data of patients with bacteremia caused by MRSA with vancomycin MIC = 2 mg/L from 2009 to 2012. The significance of bacterial genotypes, agr function and heterogeneous vancomycin-intermediate S. aureus (hIVSA) phenotype in predicting outcomes were determined after clinical covariates adjustment with multivariate analysis...
May 18, 2018: Scientific Reports
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