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Antibiotic intensive care unit

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https://www.readbyqxmd.com/read/28734630/management-of-an-acinetobacter-baumannii-outbreak-in-an-intensive-care-unit
#1
M Tanguy, A Kouatchet, B Tanguy, É Pichard, S Fanello, M-L Joly-Guillou
INTRODUCTION: Acinetobacter baumannii is a ubiquitous pathogen resistant to desiccation and responsible for healthcare-associated infections (HAI), especially in intensive care units (ICU) where it is responsible for 5-10% of HAIs. An A. baumannii outbreak occurred in the ICU of the University Hospital of Angers, France. OBJECTIVES: To describe the A. baumannii outbreak and to evaluate the control measures taken. The secondary objective was to evaluate the impact of the electronic alert system on the incidence of multidrug resistance to antibiotics...
July 19, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28733213/risk-factors-for-the-infection-and-or-colonization-of-extended-spectrum-beta-lactamase-producing-bacteria-in-a-neonatal-intensive-care-unit-a-meta-analysis
#2
REVIEW
Xuan Li, Xuan Xu, Xianxian Yang, Mei Luo, Pin Liu, Kewen Su, Ying Qing, Shuai Chen, Jingfu Qiu, Yingli Li
BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing bacteria are the important causes of healthcare associated infection in the neonatal intensive care unit (NICU). This study performed a meta-analysis to identify the risk factors associated with infection and/or colonization of ESBL-producing bacteria in the NICU. METHODS: Relevant studies in the literature published from January 1, 2000 to July 1, 2016 were searched in the electronic databases. The literature was screened and data were extracted according to the inclusion and exclusion criteria...
July 18, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28731836/mortality-rate-and-antibiotic-resistance-in-complicated-diverticulitis-report-of-272-consecutive-patients-worldwide-a-prospective-cohort-study
#3
Federico Coccolini, Mattia Trevisan, Giulia Montori, Massimo Sartelli, Fausto Catena, Marco Ceresoli, Antonio Costanzo, Arianna Heyer, Luca Ansaloni
BACKGROUND: Complicated diverticulitis (CD) is a common problem for surgeons. In treating it, as a general principle, every verified source of infection should be controlled. Supplementary antimicrobial management involves a delicate balance of optimizing empirical therapy while reducing unnecessary antibiotic use. The necessity to know the most frequent infecting pathogens and their spectra of resistance is becoming pivotal. The aim of this study was to determine the microbiologic profile of complicated intra-abdominal infections (IAIs) secondary to CD, to analyze the role of empirical antimicrobial therapy, and to describe the clinical aspects of CD worldwide...
July 21, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28729206/antimicrobial-resistance-patterns-of-gram-negative-bacteria-isolated-from-bloodstream-infections-in-an-iranian-referral-pediatric-hospital-a-six-year-study
#4
Shima Mahmoudi, Masoumeh Mahzari, Maryam Banar, Babak Pourakbari, Mohammad Taghi Haghi Ashtiani, Mohsen Mohammadi, Sepideh Keshavarz Valian, Setareh Mamishi
INTRODUCTION: Bloodstream infections (BSIs) are considered as a major cause of morbidity and mortality in children all over the world. The aim of this study was to describe the epidemiology and antimicrobial resistance patterns of Gram-negative bacteria (GNB) isolated from bloodstream infections (BSIs) in children admitted to the Children Medical Center Hospital (CMC), Tehran, Iran. METHODS: Clinical and microbiological data of the patients with positive blood cultures was collected from March 2011 to September 2016...
July 17, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28726037/can-a-collaborative-subspecialty-antimicrobial-stewardship-intervention-have-lasting-effects
#5
Kaushal B Shah, Ramzy H Rimawi, Mark A Mazer, Paul P Cook
OBJECTIVE: We previously demonstrated the benefit of direct, daily collaboration between infectious disease (ID) and critical care practitioners (CCP) on guideline adherence and antibiotic use in the medical intensive care unit (MICU). In this post-intervention review, we sought to establish whether the effect on antibiotic use and guideline adherence was sustainable. DESIGN: A retrospective review of 87 patients, admitted to the 24-bed MICU, was done 3 (n = 45) and 6 months (n = 42) after the intervention...
July 19, 2017: Infection
https://www.readbyqxmd.com/read/28720036/procalcitonin-to-detect-bacterial-infections-in-critically-ill-pediatric-patients
#6
David M Jacobs, Maya Holsen, Shirley Chen, Nicholas M Fusco, Amanda B Hassinger
The diagnostic power of procalcitonin (PCT) in the pediatric intensive care unit (PICU) is uncertain. This study aimed to determine the diagnostic ability of PCT to detect serious bacterial infections (SBI) in a heterogeneous PICU population. This was a retrospective cohort study of patients on whom a PCT level was obtained within 48 hours of admission to a PICU from 2013 to 2015. Discriminatory ability of PCT to predict SBI was examined by test and receiver operating characteristics (AUC [area under the curve]-ROC)...
August 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28716451/multidrug-resistant-pseudomonas-aeruginosa-lower-respiratory-tract-infections-in-the-intensive-care-unit-prevalence-and-risk-factors
#7
Trang D Trinh, Evan J Zasowski, Kimberly C Claeys, Abdalhamid M Lagnf, Shravya Kidambi, Susan L Davis, Michael J Rybak
Intensive care unit (ICU) admission is a risk for multidrug-resistant (MDR) Pseudomonas aeruginosa, but factors specific to critically ill pneumonia patients are not fully characterized. Objective was to determine risk factors associated with MDR P. aeruginosa pneumonia among ICU patients. This was a retrospective case-control study of P. aeruginosa pneumonia in the ICU; cystic fibrosis and colonizers were excluded. Risk factors included comorbid conditions and prior healthcare exposure (anti-pseudomonal antibiotics, hospitalizations, nursing home, P...
June 19, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28716359/predictors-of-polymyxin-b-treatment-failure-in-gram-negative-healthcare-associated-infections-among-critically-ill-patients
#8
Bahiah Ismail, Mohd Nazri Shafei, Azian Harun, Saedah Ali, Mahamarowi Omar, Zakuan Zainy Deris
BACKGROUND: With increasing prevalence and spread of multidrug resistant Gram-negative infections, parenteral polymyxins resurged in clinical practice. The primary aim of the study was to determine the predictors of treatment failure and in-hospital mortality among critically ill patients treated with polymyxin B. METHODS: Demographic data, underlying diseases, procedures and details on polymyxin B therapy were retrospectively analyzed in a cohort of 84 patients who received intravenous polymyxin B in an intensive care unit from 2010 to 2014...
June 29, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28712106/sensitivity-and-specificity-of-urinalysis-samples-in-critically-ill-patients
#9
Sean P Lee, Terrie Vasilopoulos, Thomas James Gallagher
BACKGROUND: Preemptive screening of urine for patients admitted to an intensive care unit can result in misinterpretation of data and over- or under-treatment of urinary tract infection. METHODS: Data were studied from 169 consecutive patients admitted to the neurologic or burn intensive care unit at Shands Hospital at the University of Florida. All patients had a urinary catheter in place at the time of admission. Urinalysis and urine culture were sent for analysis...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28712104/do-bacteria-isolated-from-icu-patients-eskape-antibiotic-treatment-in-vitro-susceptibility-of-the-enterobacteriaceae-family-to-tigecycline
#10
Katarzyna Talaga-Ćwiertnia, Paweł Krzyściak, Małgorzata Bulanda
BACKGROUND: Enterobacteriaceae are currently causing the majority of healthcare-associated infections (HAI) and simultaneously expressing increasing levels of antibiotic resistance. The purpose of this study is to assess the in vitro sensitivity of MDR strains from the family Enterobacteriaceae to tigecycline in relation to their origin from patients hospitalized in intensive care units (ICUs) and non-ICUs. METHODS: The study involved 156 clinically-significant strains of the Enterobacteriaceae family isolated from patients with cIAIs and/or cSSSIs hospitalized in ICUs and other surgical departments...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28711678/linezolid-in-liver-failure-exploring-the-value-of-the-maximal-liver-function-capacity-limax-test-in-a-pharmacokinetic-pilot-study
#11
Sebastian G Wicha, Otto R Frey, Anka C Roehr, Johann Pratschke, Martin Stockmann, Rawan Alraish, Tilo Wuensch, Magnus Kaffarnik
BACKGROUND: Patients in the intensive care unit frequently require antibiotic treatment. Liver impairment possesses substantial challenges for dose selection in these patients. The aim of the present pilot study was to assess the novel maximal liver function capacity (LiMAx test) in comparison to conventional liver function markers as covariates of drug clearance in liver failure using linezolid as model drug. METHODS: 28 patients with different degrees of liver failure were recruited and LiMAx test, plasma, dialysis and urine sampling was performed under linezolid steady-state therapy (600 mg BID)...
July 12, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28709439/enhanced-antimicrobial-de-escalation-for-pneumonia-in-mechanically-ventilated-patients-a-cross-over-study
#12
Tracy Trupka, Kristen Fisher, Scott T Micek, Paul Juang, Marin H Kollef
BACKGROUND: Antibiotics are commonly administered to hospitalized patients with infiltrates for possible bacterial pneumonia, often leading to unnecessary treatment and increasing the risk for resistance emergence. Therefore, we performed a study to determine if an enhanced antibiotic de-escalation practice could improve antibiotic utilization in mechanically ventilated patients with suspected pneumonia cared for in an academic closed intensive care unit (ICU). METHODS: This was a prospective cross-over trial comparing routine antibiotic management (RAM) and enhanced antimicrobial de-escalation (EAD) performed within two medical ICUs (total 34 beds) at Barnes-Jewish Hospital, an academic referral center...
July 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28706411/toxic-shock-syndrome-within-24-h-of-an-office-hysteroscopy
#13
Nanak Bhagat, Akilandeshwari Karthikeyan, Sanjaya Kalkur
Office hysteroscopy is now a common procedure performed to look at the endometrial cavity and is relatively free of serious complications. A 68-year-old lady, previously fit and well, presented with abdominal pain, rigors, sweats, and vomiting within 24 h of an outpatient hysteroscopy for postmenopausal bleeding. She was diagnosed with streptococcal toxic shock syndrome (STSS) due to Group A beta-hemolytic streptococci. She was managed in the Intensive Care Unit, with inotropic and antibiotic support. She recovered eventually and was discharged home with oral antibiotics...
April 2017: Journal of Mid-life Health
https://www.readbyqxmd.com/read/28706386/alarming-emergence-molecular-characterization-and-outcome-of-blandm-1-in-patients-infected-with-multidrug-resistant-gram-negative-bacilli-in-a-tertiary-care-hospital
#14
Huma Naim, Meher Rizvi, Mohd Azam, Richa Gupta, Neelam Taneja, Indu Shukla, Haris M Khan
INTRODUCTION: This study was conducted to assess the prevalence of metallo-beta-lactamases (MBLs) in general and blaNDM-1 in particular. It also aimed at evaluating clinical characteristics and outcome in patients infected with MBLs. MATERIALS AND METHODS: A total of 116 carbapenem-resistant Gram-negative bacilli (CRGNB) were evaluated in the study. These CRGNB were tested for MBL production both phenotypically for MBLs and genotypically for blaNDM-1 gene by polymerase chain reaction (PCR)...
July 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28705675/use-of-evidence-based-recommendations-in-an-antibiotic-care-bundle-for-the-intensive-care-unit
#15
Nico T Mutters, Giulia De Angelis, Giovanni Restuccia, Francesca Di Muzio, Jeroen Schouten, Marlies Hulscher, Massimo Antonelli, Evelina Tacconelli
PURPOSE: To drive decisions on antibiotic therapy in the intensive care unit (ICU), we developed an antibiotic care bundle (ABC-Bundle) with evidence-based recommendations (EBRs) for antibiotic prescriptions. METHODS: We conducted a 3-step prospective study. First, a systematic review of the literature reporting EBRs for antibiotic usage in the ICU was performed. Second, we developed an ABC-Bundle through a 2-round, RAND-modified Delphi method with an international expert panel, including the most relevant EBRs on a 9-point Likert scale...
July 10, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28705450/clinical-outcome-and-antimicrobial-therapeutic-drug-monitoring-for-the-treatment-of-infections-in-acute-burn-patients
#16
Anna Silva Machado, Maura S Oliveira, Cristina Sanches, Carlindo Vieira da Silva Junior, David S Gomez, Rolf Gemperli, Silvia Regina Cavani Jorge Santos, Anna S Levin
PURPOSE: In critical burn patients, the pharmacokinetic parameters (absorption, distribution, metabolism, and excretion) of many classes of drugs, including antibiotics, are altered. The aim of this study was to compare 2 groups of burn patients undergoing treatment for health care-associated infections with and without therapeutic drug monitoring. METHODS: A retrospective analysis of a clinical intervention (ie, a before/after study) was conducted with patients with health care-associated pneumonia, burn infection, bloodstream infection, and urinary tract infection in the burn intensive care unit of a tertiary care hospital...
July 10, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28702465/a-dynamic-transmission-model-to-evaluate-the-effectiveness-of-infection-control-strategies
#17
Karim Khader, Alun Thomas, W Charles Huskins, Molly Leecaster, Yue Zhang, Tom Greene, Andrew Redd, Matthew H Samore
BACKGROUND: The advancement of knowledge about control of antibiotic resistance depends on the rigorous evaluation of alternative intervention strategies. The STAR*ICU trial examined the effects of active surveillance and expanded barrier precautions on acquisition of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) in intensive care units. We report a reanalyses of the STAR*ICU trial using a Bayesian transmission modeling framework. METHODS: The data included admission and discharge times and surveillance test times and results...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28702334/an-uncommon-cause-of-pneumonia-the-golden-diagnosis
#18
Laura Fabbri, Roberto Tonelli, Alessandro Andreani, Ivana Castaniere, Riccardo Fantini, Alessandro Marchioni, Enrico M Clini
A 28-year-old sub-Saharan African Italian non-smoker male presented with signs and symptoms of pneumonia and respiratory failure. Despite antibiotic treatment he experienced a significant worsening of respiratory conditions and admission to intensive care unit. He thus underwent chest computed tomography followed by fiberopict bronchoscopy with bronchoalveolar lavage whose macroscopic examination led to the diagnosis of acute chest syndrome. A brief literature review was conducted to discuss the first manifestation of this disease...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28702304/oral-versus-intravenous-clarithromycin-in-moderate-to-severe-community-acquired-pneumonia-an-observational-study
#19
Nikolas Rae, Aran Singanayagam, Stuart Schembri, James D Chalmers
OBJECTIVES: British Thoracic Society guidelines recommend clarithromycin in addition to beta-lactam antibiotics for patients with community-acquired pneumonia and CURB-65 score 2-5. Intravenous therapy is commonly used but there are few data on whether oral therapy is equally effective. METHODS: This observational study used propensity matching to compare two groups of patients with moderate to severe community-acquired pneumonia (CURB-65 score 2-5) treated with oral (n = 226) or intravenous (n = 226) clarithromycin on admission...
2017: Pneumonia
https://www.readbyqxmd.com/read/28698756/treatment-of-decubitis-ulcer-stage-iv-in-the-patient-with-polytrauma-and-vertical-share-pelvic-fracture-diagnosed-entherocollitis-and-deep-wound-infection-with-clostridium-difficile-with-combined-negative-pressure-wound-therapy-npwt-and-faecal-management-system
#20
Slavcho Stojmenski, Igor Merdzanovski, Andrej Gavrilovski, Sofija Pejkova, Gjorge Dzokic, Smilja Tudzarova
AIM: The aim of this paper was to present a case with the successful treatment of decubitis ulcer stage IV in the patient with polytrauma and vertical share pelvic fracture and diagnosed entherocollitis combined with deep wound infection with Clostridium difficile treated with combined Negative Pressure Wound Therapy (NPWT) and faecal management system. CASE REPORT: Patient D.S.1967 treated on Traumatology Clinic after tentamen suicide on 9.2.2015 with diagnosis: brain contusion; contusion of thoracal space; vertical share pelvic fracture; open fracture type II of the right calcaneus; fracture of the left calcaneus; fracture on the typical place of the left radius; fracture of the right radius with dislocation...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
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