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antibiotic care

Bruno Viaggi, Daniele Poole, Omar Tujjar, Silvia Marchiani, Agostino Ognibene, Stefano Finazzi
Biomarkers are widely used to confirm the presence of infection. However, it would be of the greatest importance to predict in advance the occurrence or worsening of organ dysfunction in infected patients allowing timely antibiotic escalation. This study investigates the ability of procalcitonin (PCT) and MR-proADM to predict the transition to sepsis in infected patients. The study was conducted in a neurointensive care unit over a three-month period. We included both patients with and without infection to investigate the specificity of organ dysfunction prediction in infected patients...
2018: PloS One
Zeynep Ture, Emine Alp
Invasive candida infections are the most important causes of invasive nosocomial infections in intensive care units and in risky groups such as immunosuppressed patients. These infections lead to undesirable consequences such as increased morbidity and mortality in patients, prolongation of hospital stay, and increased hospital costs. In recent years, the incidence of non-albicans Candida spp.'s has increased. Unfortunately, some of these species are naturally resistant to first line antifungals. In addition, biofilm formation on the central venous catheter and invasive devices may cause treatment failure...
August 13, 2018: Hospital Practice (Minneapolis)
Ece Egilmezer, Gregory J Walker, Padmavathy Bakthavathsalam, Joshua R Peterson, J Justin Gooding, William Rawlinson, Sacha Stelzer-Braid
Acute respiratory tract infections are a major cause of morbidity and mortality and represent a significant burden on the health care system. Laboratory testing is required to definitively distinguish infecting influenza virus from other pathogens, resulting in prolonged emergency department (ED) visits and unnecessary antibiotic use. Recently available rapid point-of-care tests (POCT) may allow for appropriate use of antiviral and antibiotic treatments and decrease patient lengths of stay. We undertook a systematic review to assess the effect of POCT for influenza on three outcomes: (1) antiviral prescription, (2) antibiotic prescription, and (3) patient length of stay in the ED...
August 13, 2018: Reviews in Medical Virology
Anirban Hom Choudhuri, Priyanka Khurana, Partha Sarathi Biswas, Rajeev Uppal
Background and Aims: The critically ill patients with liver disease are vulnerable to infections in both community and hospital settings. The nosocomial infections are often caused by multidrug-resistant (MDR) bacteria. The present observational study was conducted to describe the epidemiology, course, and outcome of MDR bacterial infection and identify the risk factors of such infection in critically ill patients with liver disease. Materials and Methods: A retrospective observational study was conducted on 106 consecutive critically patients with liver disease admitted in the Intensive Care Unit between March 2015 and February 2017...
July 2018: Saudi Journal of Anaesthesia
Mariam Hassan, Machaon M Bonafede, Brendan L Limone, Paul Hodgkins, Gregory S Sawicki
Purpose: To conduct an analysis describing clinical characteristics, pulmonary exacerbation (PEx) events, and health care resource utilization among Medicaid-insured patients with cystic fibrosis (CF). Patients and methods: A retrospective analysis of the Truven Health MarketScan® Medicaid Multi-State administrative claims database (2010-2014) was undertaken. Patients aged ≥6 years with a CF diagnosis, continuously enrolled for 12 months, were identified. Demographics, comorbidities, PEx events, and health care resource utilization and costs over a 12-month enrollment period were analyzed for all patients and by age groups...
2018: ClinicoEconomics and Outcomes Research: CEOR
JoAnna K Leyenaar, Christine B Andrews, Emily R Tyksinski, Eric Biondi, Kavita Parikh, Shawn Ralston
BACKGROUND: Emergency medicine and paediatric hospital medicine physicians each provide a portion of the initial clinical care for the majority of hospitalised children in the USA. While these disciplines share goals to increase quality of care, there are scant data describing their collaboration. Our national, multihospital learning collaborative, which aimed to increase narrow-spectrum antibiotic prescribing for paediatric community-acquired pneumonia, provided an opportunity to examine factors influencing the success of quality improvement efforts across these two clinical departments...
August 12, 2018: BMJ Quality & Safety
Minghui Zhu, Xiaoyan Zhao, Qiang Zhu, Zhaorui Zhang, Yu Dai, Liangan Chen, Zhixin Liang
BACKGROUND: Ochrobactrum anthropi has become an emerging pathogen for bloodstream infection (BSI). METHODS: From January 1st 2010 to June 30th 2017, inpatients with one or more blood cultures positive for O. anthropi isolates at Chinese People's Liberation Army General Hospital in Beijing, China, were enrolled in this study. Clinical and laboratory data were collected by reviewing electronic records. RESULTS: A total of 11 patients with O...
August 9, 2018: Journal of Infection and Public Health
Jun-Jun Yeh, Cheng-Li Lin, Chia-Hung Kao
AIMS: To evaluate the relationship between cardiovascular diseases (CVDs) and pneumonia in the general population. METHODS: This retrospective observational study included two cohorts, namely CVD (n = 28,363) and non-CVD (n = 28,363) cohorts, which were matched by propensity score and examined for cases of pneumonia. Data were obtained from 2000 to 2011. In both cohorts, pneumonia risk was measured using multivariable Cox proportional hazard models. RESULTS: With the non-CVD cohort as reference, the corresponding adjusted hazard ratios (aHRs) [95% confidence intervals (CIs)] of pneumonia were 2...
August 8, 2018: European Journal of Internal Medicine
Juanita L Derouen
Perioperative care of the septic patient presents unique challenges for the nurse. Understanding the physiology of sepsis is important for the nurse to anticipate the physiologic changes associated with the disorder and to prioritize the patient's needs. Ensuring adequate intravenous access by peripheral or central venous access as well as anticipating potential invasive monitoring lines allows the nurse to quickly administer antibiotic therapy, initiate fluid resuscitation, and prepare for potential vasopressor use...
September 2018: Critical Care Nursing Clinics of North America
Desi M Newberry, Tracey Robertson Bell
BACKGROUND: Congenital tuberculosis (TB) is rare in the United States. Recent immigration patterns to the United States have made the diagnosis of congenital TB an important public health issue. PURPOSE: To explore the epidemiology, pathophysiology, diagnostic evaluation, treatment, and prognosis for congenital TB. The implications for exposed healthcare professionals in the neonatal intensive care unit (NICU) setting are also explored. METHODS/SEARCH STRATEGY: Relevant articles were accessed via PubMed, CINAHL, and Google Scholar...
August 9, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
H Ciesielczuk, M Wilks, S Castelain, M Choquet, M Morotti, E Pluquet, V Sambri, M Tassinari, S Zannoli, L Cavalié, H Dupont, H Guet-Revillet
Intra-abdominal infections (IAIs) are one of the most common type of infections in patients with sepsis and an important cause of death in intensive care units. Early detection and treatment are necessary to reduce patient complications and improve outcomes. The Unyvero IAI Application (Curetis GmbH) is the first automated assay to rapidly and simultaneously identify a large panel of bacteria, fungi, toxins, and antibiotic resistance markers directly from IAI-related samples. The assay was evaluated in four European clinical laboratories in comparison to routine microbiological practices...
August 10, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Anna Lucia Gallo, Mauro Pollini, Federica Paladini
Chronic wounds and related infections cause physical and psychological distress in patients, increased mortality, disability and high health care costs. The healing process can be delayed by several factors and in particular by the risk of infections, which can be further complicated by the increasing number of antibiotic-resistant microorganisms. New approaches in wounds management have been encouraged, aiming at preventing infections and improving wound healing. In this scenario, silver has emerged as an ideal antimicrobial agent due to its recognized efficacy against bacteria, viruses and fungi...
August 9, 2018: Journal of Materials Science. Materials in Medicine
G W Fuller, J N Rao
Descending mediastinitis is a rare, life-threatening condition caused by contiguous spread of oropharyngeal or cervical infection into the mediastinum. Infectious mononucleosis generally results in a self-limited illness characterized by fever, pharyngitis and lymphadenopathy. We present an exceptional case of an 18-year-old with infectious mononucleosis complicated by progressive bacterial superinfection and fulminant descending mediastinitis. After resuscitation, broad spectrum antibiotics, critical care support and definitive surgical management, they made a full recovery...
August 2018: Journal of Surgical Case Reports
Marta Bodro, Laura Linares, Diana Chiang, Asuncion Moreno, Carlos Cervera
Recurrent urinary tract infections are a common clinical problem in kidney transplant recipients. Due to the complex urological anatomy derived from the implantation of the kidney graft, the spectrum of the disease and the broad underlying pathophysiological mechanisms. Recurrent urinary infections worsen the quality of life, decrease the graft survival and increase the costs of kidney transplantation. Areas covered. In this review we describe the definitions, clinical characteristics, pathophysiological mechanisms and microbiology of recurrent urinary tract infections in kidney transplantations...
August 9, 2018: Expert Review of Anti-infective Therapy
Kevin Antoine Brown, Laura K MacDougall, Kim Valenta, Andrew Simor, Jennie Johnstone, Samira Mubareka, George Broukhanski, Gary Garber, Allison McGeer, Nick Daneman
OBJECTIVE: Clostridium difficile spores play an important role in transmission and can survive in the environment for several months. Optimal methods for measuring environmental C. difficile are unknown. We sought to determine whether increased sample surface area improved detection of C. difficile from environmental samples. SETTING: Samples were collected from 12 patient rooms in a tertiary-care hospital in Toronto, Canada. METHODS: Samples represented small surface-area and large surface-area floor and bedrail pairs from single-bed rooms of patients with low (without prior antibiotics), medium (with prior antibiotics), and high (C...
August 2018: Infection Control and Hospital Epidemiology
Gabriela Schmid-Mohler, Ann-Louise Caress, Rebecca Spirig, Christian Benden, Janelle Yorke
AIM AND OBJECTIVES: To explore the experience of pulmonary exacerbation from the perspective of adults with cystic fibrosis. BACKGROUND: While management of pulmonary exacerbations is a pillar of cystic fibrosis care, little is known of patients' perspectives. Understanding the patient's experience is essential for developing and evaluating interventions in support of patient self-management. DESIGN: Qualitative study with longitudinal study in a subsample...
August 9, 2018: Journal of Clinical Nursing
Ahmad Kaako
Introduction: Clostridium difficile infection (CDI) is a leading cause of hospital-associated gastrointestinal illness with high burden on the health-care system. Design: Observational, retrospective, prospective, pre- and post-intervention study on the incidence and prevalence rates of CDIs. The primary outcome is the healthcare-onset CDIs (HO-CDIs) incidence rate and proportion. Methods: Best practice alerts (BPAs) for CDI were developed in electronic medical records and released on July 13, 2016...
July 2018: Avicenna Journal of Medicine
S Shanmugapriya, T Saravanan, S Saranya Rajee, R Venkatrajan, Pinky Mariam Thomas
Purpose: Drug use prescribing indicators advocated by the World Health Organization (WHO) are important tools for assessing the degree of polypharmacy, use of generic medicines, and to evaluate if there is inappropriate use of antibiotics or parenteral medications besides estimating the adherence to the essential drugs list. This study aimed to assess the WHO prescribing indicators in prescriptions given at the medical outpatient department (OPD) in a private medical college hospital in South India...
July 2018: Perspectives in Clinical Research
Joseph Philip, Christian Kegg, Dalia Lopez-Colon, Brian J Kelly, Robert M Lawrence, Matthew A Robinson, Ravi S Samraj, Mark S Bleiweis
BACKGROUND: There is no consensus for the length of prophylactic antibiotics after delayed chest closure (DCC) postcardiac surgery in pediatrics. In September 2014, our institution's pediatric cardiac intensive care unit changed the policy on length of prophylactic antibiotics after DCC from 5 days (control) to 2 days (study group). The objective of the study was to determine whether a 2-day course of antibiotics is as effective as a 5-day course in preventing blood stream and sternal wound infections in pediatric DCC...
August 8, 2018: Journal of Intensive Care Medicine
Ofira Zloto, Irina S Barequet, Alon Weissman, Orit Ezra Nimni, Yoav Berger, Noa Avni-Zauberman
PURPOSE: To examine the clinical characteristics, treatments, and prognosis of all cases of infectious keratitis resistant to conventional therapy and treated by photo-activated chromophore for keratitis corneal cross-linking (PACK-CXL) in one institution between 2012 and 2016. METHODS: A database search of patients who underwent PACK-CXL (ultraviolet-A for 10 minutes for irradiance of 9 mW/cm2 ) for infectious keratitis unresponsive to medical treatment at a tertiary care hospital was conducted...
August 1, 2018: Journal of Refractive Surgery
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