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Antibiotic intensive care unit

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https://www.readbyqxmd.com/read/29777985/liquid-chromatography-tandem-mass-spectrometry-for-the-quantification-of-moxifloxacin-ciprofloxacin-daptomycin-caspofungin-and-isavuconazole-in-human-plasma
#1
Julian Hösl, André Gessner, Nahed El-Najjar
A simple and precise ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed for the simultaneous analysis of five anti-infective agents used to treat severe infections [three antibiotics (daptomycin, moxifloxacin, ciprofloxacin) and two antifungals (isavuconazole, caspofungin)] in human plasma. Sample preparation was based on protein precipitation with ice cold methanol. All five agents were analyzed with the corresponding isotopically labeled internal standards. All analytes were detected in multiple reactions monitoring (MRM) using API 4000 triple-quadrupole mass spectrometer with electrospray (ESI) source operating in positive mode...
May 12, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29772393/unexpected-mechanisms-of-resistance-in-dutch-pseudomonas-aeruginosa-isolates-collected-during-fourteen-years-of-surveillance
#2
P D Croughs, C H W Klaassen, J van Rosmalen, D M Maghdid, S A Boers, J P Hays, W H F Goessens
Pseudomonas aeruginosa is one of the most important causes of infection in the intensive care unit. It is intrinsically resistant to many antibiotics and easily acquires additional resistance genes via horizontal gene transfer of mobile genetic elements. In the present study, 1,528 P. aeruginosa isolates, obtained from a Dutch national surveillance program between the years 1998 and 2011, were analyzed for the presence of Extended Spectrum β-Lactamase (ESBL) genes blaCTX-M , blaSHV , blaTEM , blaBEL , blaPER , blaVEB , blaOXA-10 and metallo-β-Lactamase (MBL) genes blaIMP , blaVIM and blaNDM ...
May 14, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29771684/antibiotic-treatment-induced-secondary-iga-deficiency-enhances-susceptibility-to-pseudomonas-aeruginosa-pneumonia
#3
Oliver H Robak, Markus M Heimesaat, Andrey A Kruglov, Sandra Prepens, Justus Ninnemann, Birgitt Gutbier, Katrin Reppe, Hubertus Hochrein, Mark Suter, Carsten J Kirschning, Veena Marathe, Jan Buer, Mathias W Hornef, Markus Schnare, Pascal Schneider, Martin Witzenrath, Stefan Bereswill, Ulrich Steinhoff, Norbert Suttorp, Leif E Sander, Catherine Chaput, Bastian Opitz
Broad-spectrum antibiotics are widely used in patients on intensive care units (ICU), many of which develop hospital-acquired infections with Pseudomonas aeruginosa. Although preceding antimicrobial therapy is known as a major risk factor for P. aeruginosa-induced pneumonia, the underlying mechanisms remain incompletely understood. Here we demonstrate that depletion of the resident microbiota by broad-spectrum antibiotic treatment inhibited TLR-dependent production of a proliferation inducing ligand (APRIL), resulting in a secondary IgA deficiency in the lung in mice and human ICU patients...
May 17, 2018: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29769151/real-time-automated-detection-of-ventilator-associated-events-avoiding-missed-detections-misclassifications-and-false-detections-due-to-human-error
#4
Erica S Shenoy, Eric S Rosenthal, Yu-Ping Shao, Siddharth Biswal, Manohar Ghanta, Erin E Ryan, Dolores Suslak, Nancy Swanson, Valdery Moura Junior, David C Hooper, M Brandon Westover
OBJECTIVETo validate a system to detect ventilator associated events (VAEs) autonomously and in real time.DESIGNRetrospective review of ventilated patients using a secure informatics platform to identify VAEs (ie, automated surveillance) compared to surveillance by infection control (IC) staff (ie, manual surveillance), including development and validation cohorts.SETTINGThe Massachusetts General Hospital, a tertiary-care academic health center, during January-March 2015 (development cohort) and January-March 2016 (validation cohort)...
May 17, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29754841/-risks-associated-with-the-use-of-non-steroidal-anti-inflammatory-drugs-during-pneumonia
#5
REVIEW
G Voiriot, M Chalumeau, J Messika, D Basille, B Philippe, J-D Ricard, C Andrejak, V Jounieaux, O Sanchez, M Fartoukh
INTRODUCTION: Outpatient treatment of community-acquired pneumonia (CAP) patients with non-steroidal anti-inflammatory drugs (NSAIDs) is frequent, although this is not based on clinical recommendations and there is no scientific evidence supporting better symptom relief in comparison to acetaminophen. STATE OF THE ART: Experimental data suggest that NSAIDs alter the intrinsic functions of neutrophils, limit their locoregional recruitment, alter bacterial clearance and delay the resolution of inflammatory processes during acute bacterial pulmonary challenge...
May 10, 2018: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#6
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29751127/temporal-trends-and-patterns-in-antimicrobial-resistant-gram-negative-bacteria-implicated-in-intensive-care-unit-acquired-infections-a-cohort-based-surveillance-study-in-istanbul-turkey
#7
Bulent Durdu, Evangelos I Kritsotakis, Andrew C K Lee, Perihan Torun, Ismail N Hakyemez, Bilge Gultepe, Turan Aslan
OBJECTIVES: This study assessed trends and patterns in antimicrobial resistant intensive care unit (ICU)-acquired infections caused by Gram-negative bacteria (GNB) in Istanbul, Turkey. METHODS: Bacterial culture and antibiotic susceptibility data were collected for all GNB causing nosocomial infections in five adult ICUs of a large university hospital during 2012-2015. Multi-resistance patterns were categorised as multidrug (MDR), extensively-drug (XDR) and pandrug (PDR)-resistance...
May 8, 2018: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29750043/analysis-of-acinetobacter-baumannii-hospital-infections-in-patients-treated-at-the-intensive-care-unit-of-the-university-hospital-wroclaw-poland-a-6-year-single-center-retrospective-study
#8
Wieslawa Duszynska, Agnieszka Litwin, Stanislaw Rojek, Aleksander Szczesny, Alfonso Ciasullo, Waldemar Gozdzik
Background: Acinetobacter baumannii (AB) is one of the most frequently isolated strains of bacteria in intensive care unit (ICU) patients, which provides huge therapeutic problems due to its multidrug resistance (MDR). Patients and methods: The overall purpose of the study was analysis of health care- associated infections in terms of the incidence of AB strain infections and the changing susceptibility of this strain within a 6-year observation (2011-2016). The study was carried out in an ICU of the University Hospital in Wroclaw (Poland)...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29744794/evaluation-of-risk-factors-for-vancomycin-induced-nephrotoxicity
#9
So Jin Park, Na Ri Lim, Hyo Jung Park, Jae Wook Yang, Min-Ji Kim, Kyunga Kim, Yong Won In, Young Mee Lee
Background Vancomycin is a glycopeptide antibiotic of choice for the treatment of serious infections caused by multi-resistant Gram-positive bacteria. However, vancomycin-associated nephrotoxicity (VAN) often limits its use. Previous data suggested a few risk factors of VAN, including higher mean vancomycin trough level, higher daily doses, old age, long duration of vancomycin therapy, and concomitant nephrotoxins. Objective To evaluate the incidence and risk factors of VAN and determine whether higher vancomycin trough concentrations were associated with a greater risk for VAN...
May 9, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29742212/accidental-strangulation-in-children-by-the-automatic-closing-of-a-car-window
#10
Kailene Serena, Jefferson Pedro Piva, Cinara Andreolio, Paulo Roberto Antonacci Carvalho, Tais Sica da Rocha
Among the main causes of death in our country are car accidents, drowning and accidental burns. Strangulation is a potentially fatal injury and an important cause of homicide and suicide among adults and adolescents. In children, its occurrence is usually accidental. However, in recent years, several cases of accidental strangulation in children around the world have been reported. A 2-year-old male patient was strangled in a car window. The patient was admitted to the pediatric intensive care unit with a Glasgow Coma Scale score of 8 and presented with progressive worsening of respiratory dysfunction and torpor...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29741076/monitoring-of-hospital-acquired-pneumonia-in-patients-with-severe-brain-injury-on-first-access-to-intensive-neurological-rehabilitation-first-year-of-observation
#11
Gianfranco Beghi, Antonio De Tanti, Paolo Serafini, Chiara Bertolino, Antonietta Celentano, Graziella Taormina
Nosocomial or hospital acquired pneumonia (HAP) is an illness contracted during a hospital stay, generally with onset 48 hours or more after admission to hospital, or within 14 days of discharge from hospital. HAP is divided into subgroups: Ventilator-associated pneumonia (VAP), accounting for 86% of hospital acquired pneumonia, and stroke-associated pneumonia (SAP). The incidence of SAP in neurological intensive care units (NICUs) is 4.1-56.6%, in medical intensive care units (MICUs) it is 17-50%, in stroke units it is 3...
May 9, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29738784/m-grabowski-et-al-characterizations-of-handwashing-sink-activities-in-a-single-hospital-medical-intensive-care-unit
#12
M Grabowski, J M Lobo, B Gunnell, K Enfield, R Carpenter, L Barnes, A Mathers
BACKGROUND: Handwashing sink drains are increasingly implicated as a potential reservoir of antibiotic-resistant bacteria in hospital outbreaks; however, usage patterns that may promote this source remain unknown. AIM: To understand behaviours in the intensive care unit (ICU) that may facilitate establishment and nosocomial transmission of multidrug-resistant Gram negatives from a sink-trap reservoir to a patient. METHODS: Motion-sensitive cameras captured anonymized activity paired with periodic in-person observations during a quality investigation from four ICU sinks (two patient rooms and two patient bathrooms) in a university hospital...
May 5, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29735833/echinocandins-their-role-in-the-management-of-candida-biofilms
#13
Subramanian Swaminathan, Shweta Kamat, Nalini Adele Pinto
The importance of antifungal agents and their clinical implications has received little attention in comparison to antibiotics, particularly in the health-care setting. However, apart from bacterial infections rising in hospitals, the incidences of fungal infections are growing with the development of resistance to conventional antifungal agents. Newer antifungal agents such as echinocandins (ECs) have been extensively studied over the past decade and are recognised as a superior treatment compared with prior antifungals as a first line of therapy in tertiary institutions...
January 2018: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29734941/infective-endocarditis-due-to-burkholderia-cepacia-in-a-neonate-a-case-report
#14
Emir Yonas, Vito Damay, Raymond Pranata, Nuvi Nusarintowati
BACKGROUND: Burkholderia is a pathogen that is rarely seen in clinical cases. However, this organism is being found more commonly in hospitals. CASE PRESENTATION: A female Indonesian newborn was referred to our neonatal intensive care unit because of respiratory distress. The newborn had been delivered the previous night via cesarean section. A physical examination revealed intercostal retractions and weak cry. The newborn's gestational history was preterm, small for gestational age, and preterm premature ruptured membrane for 14 hours...
May 8, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29733352/adaptation-of-a-hospital-electronic-referral-system-for-antimicrobial-stewardship-prospective-audit-and-feedback-rounds
#15
Matthew D M Rawlins, Edward Raby, Frank M Sanfilippo, Rae Douglass, Jonathan Chambers, Duncan McLellan, John R Dyer
Objective: To evaluate the impact of the adaptation of an existing electronic referral application for use in antimicrobial stewardship prospective audit and feedback rounds (antimicrobial rounds). Design: Retrospective, single-centre observational study between March 2015 and February 2016. Setting: A new quaternary referral centre. Study Participants: Adults referred for antimicrobial rounds outside of the intensive care and haematology units...
May 4, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29732182/drugs-pharmacokinetics-during-veno-venous-extracorporeal-membrane-oxygenation-in-pediatrics
#16
REVIEW
Matteo Di Nardo, Enno Diederick Wildschut
Data evaluating pharmacokinetic/pharmacodynamic (PK/PD) aspect in the pediatric population are scarce especially regarding the pediatric intensive care unit. Dosing of frequently used drugs (sedatives, analgesics, antibiotics and cardiovascular drugs) are mainly based on non "pediatric intensive care unit (PICU)" patients, and sometimes are translated from adult patients. Among PICU patients, the most complex patients are the ones who are critically ill and are receiving mechanical circulatory/respiratory support for cardiac and/or respiratory failure...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29728100/raoultella-planticola-bacteremia-induced-fatal-septic-shock-following-burn-injury
#17
Tetsuya Yumoto, Hiromichi Naito, Hiromi Ihoriya, Kohei Tsukahara, Tomoyuki Ota, Toshiyuki Watanabe, Atsunori Nakao
BACKGROUND: Raoultella planticola, a Gram-negative, aerobic bacillus commonly isolated from soil and water, rarely causes invasive infections in humans. Septic shock from R. planticola after burn injury has not been previously reported. CASE PRESENTATION: A 79-year-old male was admitted to the emergency intensive care unit after extensive flame burn injury. He accidently caught fire while burning trash and plunged into a nearby tank filled with contaminated rainwater to extinguish the fire...
May 4, 2018: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/29726670/-clinical-significance-and-risk-factors-for-multidrug-resistant-enterobacteriaceae-colonization
#18
A Padilla-Serrano, J J Serrano-Castañeda, R Carranza-González, M P García-Bonillo
OBJECTIVE: To identify the main risk factors of rectal colonization by multidrug resistant Enterobacteriaceae (MRE), and their clinical impact. METHODS: An observational, prospective cohort study was carried out, between April 2016 and June 2017, where every Monday of each week rectal samples were taken from all the patients admitted at that moment in the Intensive Care Unit. We performed a descriptive analysis of all the variables collected during the study and a multivariate logistic regression analysis to determine the independent association of carriers of MRE against non-carriers and several possible risk factors...
May 4, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29722334/antibiotics-de-escalation-in-the-treatment-of-ventilator-associated-pneumonia-in-trauma-patients-a-retrospective-study-on-propensity-score-matching-method
#19
Hu Li, Chun-Hui Yang, Li-Ou Huang, Yu-Hui Cui, Dan Xu, Chun-Rong Wu, Jian-Guo Tang
Background: Antimicrobial de-escalation refers to starting the antimicrobial treatment with broad-spectrum antibiotics, followed by narrowing the drug spectrum according to culture results. The present study evaluated the effect of de-escalation on ventilator-associated pneumonia (VAP) in trauma patients. Methods: This retrospective study was conducted on trauma patients with VAP, who received de-escalation therapy (de-escalation group) or non-de-escalation therapy (non-de-escalation group)...
May 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29709574/detection-of-bla-oxa-48-and-clonal-relationship-in-carbapenem-resistant-k-pneumoniae-isolates-at-a-tertiary-care-center-in-western-turkey
#20
Gulfem Ece, Emine Tunc, Baris Otlu, Deniz Aslan, Cem Ece
BACKGROUND: Klebsiella pneumoniae is an important nosocomial pathogen that can lead to high morbidity and mortality. ESBL and carbapenamase producing strains may cause epidemic situations. The aim of our study was to investigate the molecular epidemiology and clonal relationship between carbapenem resistant K. pneumoniae strains isolated from our hospital during a three month period. METHODS: Fourteen carbapenem resistant K. pneumoniae strains isolated during April 1st-June 30th 2013 were included...
April 27, 2018: Journal of Infection and Public Health
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