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Antibiotic intensive care unit

Florian Lamping, Thomas Jack, Nicole Rübsamen, Michael Sasse, Philipp Beerbaum, Rafael T Mikolajczyk, Martin Boehne, André Karch
BACKGROUND: Since early antimicrobial therapy is mandatory in septic patients, immediate diagnosis and distinction from non-infectious SIRS is essential but hampered by the similarity of symptoms between both entities. We aimed to develop a diagnostic model for differentiation of sepsis and non-infectious SIRS in critically ill children based on routinely available parameters (baseline characteristics, clinical/laboratory parameters, technical/medical support). METHODS: This is a secondary analysis of a randomized controlled trial conducted at a German tertiary-care pediatric intensive care unit (PICU)...
March 15, 2018: BMC Pediatrics
Farouq Muhammad Dayyab, Garba Iliyasu, Aliyu Aminu, Zaiyad Garba Habib, Abdulwasiu Bolaji Tiamiyu, Sirajo Haliru Tambuwal, Muhammad Musa Borodo, Abdulrazaq Garba Habib
Background: Hospital-acquired infections (HAIs) are an important cause of morbidity and mortality. This study examined the epidemiology, clinical outcomes and microbiological profile of HAIs. Methods: This prospective study was carried out on patients identified to have developed HAIs while admitted to the medical wards, surgical wards, dialysis unit and intensive care unit (ICU) of the hospital. Patients were recruited consecutively until the target study population was reached...
March 12, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
Maureen Campion, Gail Scully
Appropriate antimicrobial therapy is essential to ensuring positive patient outcomes. Inappropriate or suboptimal utilization of antibiotics can lead to increased length of stay, multidrug-resistant infections, and mortality. Critically ill intensive care patients, particularly those with severe sepsis and septic shock, are at risk of antibiotic failure and secondary infections associated with incorrect antibiotic use. Through the initiation of active empiric antibiotic therapy based upon local susceptibilities, daily evaluation of signs and symptoms of infection and narrowing of antibiotic therapy when feasible, providers can streamline the treatment of common intensive care unit (ICU) infections...
January 1, 2018: Journal of Intensive Care Medicine
Agnieszka Chmielarczyk, Monika Pobiega, Grzegorz Ziółkowski, Monika Pomorska-Wesołowska, Dorota Romaniszyn, Lech Krawczyk, Jadwiga Wójkowska-Mach
BACKGROUND: The impact of multidrug-resistant organisms (MDROs), including non-fermentative bacilli (NFBs), is rising and underestimated, especially in intensive care units (ICUs). The growing prevalence of multidrug resistance (MDR) and extensive drug resistance (XDR) is challenging for clinicians, as the treatment options are limited. OBJECTIVES: The purpose of this study was to analyze the extent of the epidemiological problem of multidrugresistant, extensively drug-resistant and pandrug-resistant (PDR) non-fermentative bacilli isolated from pneumonia and bloodstream infections (BSIs) in patients hospitalized in southern Poland...
March 13, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
John Pham, Talal Asif, Majdi S Hamarshi
Methicillin-resistant S taphylococcus aureus (MRSA) was previously considered a purely nosocomial pathogen. However, community-acquired MRSA has recently emerged as an important cause of severe necrotizing community-acquired pneumonia (CA-MRSA) in previously healthy individuals. This new pathogen exhibits antibiotic resistance and is linked to extended hospital stay and higher mortality. CA-MRSA has presented new therapeutic challenges due to high vancomycin treatment failure and lack of specificity of clinical findings...
January 3, 2018: Curēus
Man-Yee Man, Hoi-Ping Shum, Wing-Wa Yan, Susanna K P Lau
We report a 21-year-old young male with Lemierre's syndrome presented as tonsillitis and Fusobacterium septicemia with respiratory failure and required intensive care. Lemierre's syndrome is the septic embolic complication of recent pharyngeal illness. Fusobacterium spp. accounts for the majority of cases. High index of suspicion is needed and prolonged antibiotic is advised. It is seldom seen in intensive care but should never be forgotten.
February 2018: Indian Journal of Critical Care Medicine
Prabahs Prasun Giri, Joydeb Roy, Agnisekhar Saha
Aim of the Study: Scrub typhus has been globally recognized as an emerging infectious disease contributing significantly to pyrexia of unknown origin (PUO) and a potential cause of multiorgan dysfunction syndrome (MODS). We studied the incidence of scrub typhus as a cause of pediatric intensive care unit (PICU) admission and MODS in our hospital and its clinical and laboratory characteristics to measure the incidence of MODS caused by scrub typhus. Materials and Methods: This study was done in a pediatric teaching hospital in Kolkata, India...
February 2018: Indian Journal of Critical Care Medicine
Richa Aggarwal, Neha Rastogi, Purva Mathur, Kapil Dev Soni, Subodh Kumar, Amit Gupta, Sushma Sagar
Introduction: There have been isolated case reports and reports of outbreak of colistin-resistant Klebsiella from various parts of the world but only two from India and that too from oncology centers. We report cluster of colistin-resistant Klebsiella pneumonia bloodstream infection cases from our surgical trauma Intensive Care Unit. Methodology: The study was carried out in surgical ICU of Level-I trauma center. Retrospective analysis of all the five patients with CRK was done...
February 2018: Indian Journal of Critical Care Medicine
Demosthenes Makris, Efi Petinaki, Vasssiliki Tsolaki, Efstratios Manoulakas, Konstantinos Mantzarlis, Olimpia Apostolopoulou, Dimitrios Sfyras, Epaminondas Zakynthinos
Background: Retrospective studies have reported good clinical success rates using colistin as monotherapy to treat Acinetobacter baumannii ventilator-associated pneumonia (VAP), comparable to that obtained with colistin combined with other antibiotics. However, inadequate penetration into the pulmonary parenchyma for colistin has been shown in animal models. Aim: The aim of the study was to study prospectively the outcome, measured as clinical response and survival, of intravenously administered colistin versus colistin combined with high-dose ampicillin-sulbactam in Intensive Care Unit (ICU) patients with multiresistant A...
February 2018: Indian Journal of Critical Care Medicine
Natalie Yu Yi Ng, Hannah Hui En Ang, Jacqueline Chieh Ling Tan, Weng Hoe Ho, Win Sen Kuan, Mui Teng Chua
PURPOSE: We aim to determine whether the combination of regional tissue oxygen saturation (StO2 ) measurement using near-infrared spectroscopy (NIRS), inferior vena cava (IVC) collapsibility and ejection fraction (EF) is able to detect occult sepsis. METHODS: We included adult patients in the emergency department with at least one of the following: fever; any one component of the quick sepsis-related organ function assessment (SOFA) score; heart rate≥100 beats per minute; or white cell count <4...
February 27, 2018: American Journal of Emergency Medicine
Rachael K Ross, Luke Keele, Sherri Kubis, Andrew J Lautz, Adam C Dziorny, Adam R Denson, Kathleen A O'Connor, Marianne R Chilutti, Scott L Weiss, Jeffrey S Gerber
We retrospectively studied the effect of introducing procalcitonin into clinical practice on antibiotic use within a large academic pediatric intensive care unit. In the absence of a standardized algorithm, availability of the procalcitonin assay did not reduce the frequency of antibiotic initiations or the continuation of antibiotics for greater than 72 hours.
February 8, 2018: Journal of the Pediatric Infectious Diseases Society
Miry Shim, Sara Yang, Catherine R Messina, Jonathan P Mintzer
PURPOSE: To compare discharge breastmilk feeding rates among asymptomatic term newborns receiving 48-hour versus >48-hour antibiotics in the neonatal intensive care unit (NICU) and a cohort of well-baby nursery (WBN) newborns. MATERIALS AND METHODS: This retrospective review included asymptomatic term neonates admitted to the NICU due to maternal chorioamnionitis and a comparison group of WBN neonates between January 2012 and December 2015. Demographic, birth, feeding, and lactation consultant visit data were analyzed in univariate and multivariate models...
March 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
Giancarlo Ripabelli, Manuela Tamburro, Giuliana Guerrizio, Incoronata Fanelli, Romeo Flocco, Massimiliano Scutellà, Michela L Sammarco
Antimicrobial-resistant Klebsiella pneumoniae represent a global public health concern. K. pneumoniae strains isolated during 2010 and 2014-2016 within a single hospital of Molise Region, Central Italy, were analyzed testing antimicrobial susceptibility, clonality by pulsed-field gel electrophoresis (PFGE) and random amplified polymorphic DNA (RAPD)-PCR, and prevalence of carbapenem resistance genes by PCR. Forty isolates (23 wild-type in 2010 and 17 non-wild-type in 2014-2016) were collected from hospitalized patients (65...
March 9, 2018: Current Microbiology
S Hoang, A Georget, J Asselineau, A-G Venier, C Leroyer, A M Rogues, R Thiébaut
OBJECTIVE: To assess the role of environment, medical care and individual risks factors for P. aeruginosa colonization and infection. STUDY DESIGN AND SETTING: A French multicentric prospective study involved ten ICUs for a five months period. Every adult patient newly hospitalized in ICUs with no P. aeruginosa carriage up to 48 hours after admission was included and weekly screened before discharge or death. Screening swabs were either rectal, sputum or oropharyngeal samples...
2018: PloS One
Vita Boyar
PURPOSE: The purpose of this study was to report on our experience with a portable, single-use negative pressure wound therapy device used in combination with activated active Leptospermum honey (ALH) in the treatment of colonized or infected, dehisced, thoracic wounds in neonates with complex congenital heart disease. DESIGN: Retrospective, descriptive study. SUBJECTS AND SETTING: We reviewed medical records of 18 neonates and reported on findings from 11; the remaining 7 were not included secondary to incomplete records, transfer to a different institution prior to wound healing, or death...
March 2018: Journal of Wound, Ostomy, and Continence Nursing
Lingchen Kong, Jianzhong Li, Peng Wu, Jianhua Xu, Honglei Li, Haifei Long, Pan Liu, Fangfang Wei, Wenhong Peng
OBJECTIVE: To investigate the curative effect of lateral position ventilation combined with vibration sputum drainage on the patients with acute respiratory distress syndrome (ARDS). METHODS: A prospective randomized controlled trial was conducted. The patients with ARDS undergoing mechanical ventilation (MV) admitted to intensive care unit (ICU) of Linyi Central Hospital from January 2013 to June 2017 were enrolled, and they were divided into simple ventilation group and combined treatment group according to random number table...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Praneeth Moka, Pooja Goswami, Arti Kapil, Immaculata Xess, Vishnubhatla Sreenivas, Anoop Saraya
OBJECTIVES: The knowledge about pathogens and their antibiotic susceptibility patterns is essential to select an appropriate antibiotic. METHODS: We investigated the microbiological profile in pancreatic and extrapancreatic infections, and antibiotic sensitivity pattern in patients with acute pancreatitis. RESULTS: Of 556 patients with acute pancreatitis, only 189 developed bacterial infection; however, bacteremia was present in 42 patients (7...
April 2018: Pancreas
Nusrat Shafiq, Vikas Gautam, Avaneesh Kumar Pandey, Navjot Kaur, Shubha Garg, Harish Negi, Sharonjeet Kaur, Pallab Ray, Samir Malhotra
Background & objectives: Development of antibacterial resistance and its association with antibiotic overuse makes it necessary to identify a specific and sensitive biomarker for the diagnosis of bacterial infection and guiding antibiotic therapy. Procalcitonin (PCT), as a sepsis biomarker, may play a role in guiding antibiotics treatment in hospital settings. The aim of the current meta-analysis was to analyze the utility of PCT on various outcomes of interest in inpatients. Methods: Different databases were searched for randomized controlled trials comparing PCT-guided therapy with standard therapy in admitted patients with bacterial infections...
November 2017: Indian Journal of Medical Research
Pieter J Colin, Stijn Jonckheere, Michel M R F Struys
OBJECTIVES: In this in-silico study, we investigate the clinical utility of target-controlled infusion for antibiotic dosing in an intensive care unit setting using vancomycin as a model compound. We compared target-controlled infusion and adaptive target-controlled infusion, which combines target-controlled infusion with data from therapeutic drug monitoring, with conventional (therapeutic drug monitoring-based) vancomycin dosing strategies. METHODS: A clinical trial simulation was conducted...
March 6, 2018: Clinical Pharmacokinetics
Phillip D Levin, Matan J Cohen, Eden Ohev-Zion, Samer Tannus, Sheldon Stohl, Alexander Avidan, Ronit Cohen-Poraduso, Allon E Moses, Charles L Sprung, Shmuel Benenson
Procalcitonin (PCT) measurement has been proposed to direct antibiotic use. We examined whether repeated PCT measurements (0, 6, and/or 12 hours) versus the initial measurement only (time 0) increased the sensitivity and specificity of PCT for diagnosing infection in intensive care unit patients. Infection was identified in 67/176 (38%) patients. The sensitivity of repeated versus the initial PCT measurement (with a cutoff value 0.5 ng/mL) was 52/67 (77%; 95% confidence interval [CI], 66%-87%) vs 46/67 (69%; 95% CI, 56%-79%; P = ...
March 1, 2018: Anesthesia and Analgesia
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