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Vancomycin AND outcome AND Mortality

Tobias Siegfried Kramer, Cornelius Remschmidt, Sven Werner, Michael Behnke, Frank Schwab, Guido Werner, Petra Gastmeier, Rasmus Leistner
Background: Infections caused by vancomycin-resistant enterococci (VRE) are on the rise worldwide. Few studies have tried to estimate the mortality burden as well as the financial burden of those infections and found that VRE are associated with increased mortality and higher hospital costs. However, it is unclear whether these worse outcomes are attributable to vancomycin resistance only or whether the enterococcal species ( Enterococcus faecium or Enterococcus faecalis ) play an important role...
2018: Antimicrobial Resistance and Infection Control
Mini Kamboj, Nina Cohen, Yao-Ting Huang, Marina Kerpelev, Ann Jakubowski, Kent A Sepkowitz, Genovefa A Papanicolaou, Susan K Seo
In recent years, vancomycin-resistant Enterococcus (VRE) colonization is increasingly being encountered among transplant populations, and VRE has become one of the leading causes of bacteremia early after allogeneic hematopoietic stem cell transplantation (allo-HSCT). There are sparse data regarding the effect of empiric VRE therapy for febrile, neutropenic allo-HSCT recipients colonized with VRE. All allo-HSCT patients aged 18 years and older who developed VRE bacteremia (VREB) between 2005-2014 were identified and categorized as to whether they received empiric versus (vs) directed VRE therapy...
November 15, 2018: Biology of Blood and Marrow Transplantation
John J Lewin, Aaron M Cook, Cynthia Gonzales, David Merola, Ron Neyens, William J Peppard, Gretchen M Brophy, Lisa Kurczewski, Melissa Giarratano, Jason Makii, A Shaun Rowe, Eljim P Tesoro, Amber Zaniewski, Sarah Clark, Wendy C Ziai
BACKGROUND: Central nervous system (CNS) infections are particularly prevalent in the adult neurocritical care patient population and are associated with significant morbidity and mortality. Factors relevant to the nature of CNS infections pose significant challenges to clinicians treating afflicted patients. Intraventricular (IVT) administration of antibiotics may offer several benefits over systemic therapy; however, the outcomes and current practices of such treatments are poorly described in the literature...
November 16, 2018: Neurocritical Care
Larissa de Souza Constantino, Tatiana da Rosa Guimarães, Simone Quintana de Oliveira, Éverson Miguel Bianco, Luiza Gabriela de Souza Pessoa, Monique Michels, Eloir Paulo Schenkel, Felipe Dal Pizzol, Flávio Henrique Reginatto
BACKGROUND AND PURPOSE: Antibiotic resistance is now a worldwide public health problem. A potential alternative source in the search for new antibiotics is the bioactive molecules obtained from marine products, as the halistanol trisulfate, obtained from Petromica citrina, and herein investigated from its antimicrobial and anti-inflammatory properties. EXPERIMENTAL APPROACH: The antimicrobial activity of the fractionation products (TSH fraction, halistanol sulfate (HS) and halistanol sulfate C (HS-C)) of the marine sponge Petromica citrina was evaluated against twenty bacteria and two fungi strains by the disk diffusion and microdilution methods...
December 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Gurpreet S Bhalla, Muqtadir Malik, Manbeer S Sarao, Kuntal Bandyopadhyay, Pratiksha Singh, Satish Tadepalli, Lavan Singh
Meningitis is a common and life-threatening infection of the central nervous system (CNS) in infants with long-term and disabling sequelae like hydrocephalus. Hydrocephalus is treated by diverting cerebrospinal fluid (CSF) either to another body cavity (via CSF shunt) or externally (via CSF drain) which are prone to infection. Though rare, Candida parapsilosis ( C. parapsilosis ) is a known pathogen in device-associated CNS infections and has been reported in both, infants and adults. A six-month-old male infant was brought to the hospital with disproportionate head enlargement of three months duration...
August 14, 2018: Curēus
Meg Jardine, Robert Commons, Janak de Zoysa, Muh Geot Wong, Nicole Gilroy, Julianne Green, Belinda Henderson, Rhonda Stuart, David Tunnicliffe, Carolyn van Eps, Eugene Athan
AIM: There is no national consensus on infection control in haemodialysis units in Australia and New Zealand. The primary aim of this guideline was to provide recommendations on screening for blood-borne viruses and multi-resistant organisms for dialysis units based on the available evidence. METHODS: The KHA-CARI overall approach to guideline development follows the GRADE framework. A facilitated workshop was conducted to ensure that patient and caregiver concerns were considered...
October 16, 2018: Nephrology
Mohammad Abdallah, Mohammad Al-Saafin
Vancomycin-resistant enterococci (VRE) are Gram-positive bacteria that are resistant to vancomycin. Infections caused by VRE are associated with adverse outcomes such as extended length of hospital stay, increased cost, and high mortality rate. Clinical and surveillance VRE isolates have been reported from Saudi Arabia. In this review, prevalence, characteristics, risk factors, resistance, and virulence of VRE isolates associated with infection and colonization in Saudi Arabia are described.
October 16, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Stanley Cho, Elizabeth Spencer, Robert Hirten, Ari Grinspan, Marla C Dubinsky
OBJECTIVES: Recurrent Clostridium difficile infection (RCDI) increases morbidity and mortality in patients with inflammatory bowel disease (IBD). Fecal microbiota transplant (FMT) is known to be very effective for RCDI in non-IBD patients with cure rates up to 91%. The same success rates of FMT have not been reported in IBD patients with RCDI, and the data in pediatrics is limited. We aimed to determine the effectiveness of FMT for RCDI in established pediatric IBD patients. METHODS: We performed a retrospective chart review of pediatric patients with IBD and RCDI (≥3 episodes) who underwent FMT via colonoscopy at a tertiary care IBD center...
October 12, 2018: Journal of Pediatric Gastroenterology and Nutrition
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...
December 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 Carreno, Tori Smiraglia, Christopher Hunter, Ellis Tobin, Ben Lomaestro
Combination therapy with vancomycin and piperacillin/tazobactam (TZP) has been associated with increased risk of acute kidney injury (AKI) compared with monotherapy with either agent. This retrospective, matched cohort study was conducted to assess the comparative incidence of AKI due to combination therapy in patients receiving vancomycin and TZP in combination or as monotherapy. Patients aged ≥18 years admitted to Albany Medical Center (Albany, NY) between September 2013 and August 2014 who had received therapy for at least two consecutive days were included...
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
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