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Antibiotic intensive care unit

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https://www.readbyqxmd.com/read/28206733/end-of-life-decisions-in-34-slovene-intensive-care-units-a-nationwide-prospective-clinical-study
#1
Miha Orazem, Urh Groselj, Manca Stojan, Neza Majdic, Gaj Vidmar, Stefan Grosek
BACKGROUND: To determine how end-of-life decisions (EOLD) on limitations of life- sustaining treatment (LST) are made in three different types of intensive care units (ICUs) in Slovenia. METHODS: A national multicenter prospective study among 31 adult and three pediatric/neonatal ICUs (PICUs). The questionnaire form on EOLD was designed to assess the clinical practice. Data were collected between January 1, 2013, and March 31, 2013. For statistical analysis we used IBM® SPSS® Statistics 20 software package...
February 15, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28206705/erysipelothrix-rhusiopathiae-bloodstream-infection-a-22-year-experience-at-mayo-clinic-minnesota
#2
E M Tan, J R Marcelin, N Adeel, R J Lewis, M J Enzler, P K Tosh
Erysipelothrix rhusiopathiae is a facultatively anaerobic Gram-positive bacillus found mostly in swine, fish and sheep. E. rhusiopathiae classically causes cutaneous eruptions in butchers, fish handlers and veterinarians. Based solely on case reports, 90% of E. rhusiopathiae bloodstream infections (BSI) have been associated with infective endocarditis (IE). To assess the true frequency of IE in E. rhusiopathiae BSI as well as other clinical associations, we performed a retrospective cohort analysis of E...
February 16, 2017: Zoonoses and Public Health
https://www.readbyqxmd.com/read/28203255/the-influencing-factors-on-procalcitonin-values-in-newborns-with-noninfectious-conditions-during-the-first-week-of-life
#3
Jueseong Lee, Yong Hyeon Bang, Eun Hee Lee, Byung Min Choi, Young Sook Hong
PURPOSE: Although procalcitonin (PCT) level is useful for the diagnosis of neonatal sepsis, PCT reliability is inconsistent because of the varied conditions encountered in neonatal intensive care units. This study aimed to investigate PCT levels and factors influencing increased PCT levelin newborns without bacterial infection during the first week of life. METHODS: In newborns hospitalized between March 2013 and October 2015, PCT levels were measured on the first, third, and seventh days after birth...
January 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28197738/vaccines-for-staphylococcus-aureus-and-target-populations
#4
Clarissa Pozzi, Reuben Olaniyi, Lassi Liljeroos, Ilaria Galgani, Rino Rappuoli, Fabio Bagnoli
Staphylococcus aureus is a leading pathogen in surgical site, intensive care unit, and skin infections, as well as healthcare-associated pneumonias. These infections are associated with an enormous burden of morbidity, mortality, and increase of hospital length of stay and patient cost. S. aureus is impressively fast in acquiring antibiotic resistance, and multidrug-resistant strains are a serious threat to human health. Due to resistance or insufficient effectiveness, antibiotics and bundle measures leave a tremendous unmet medical need worldwide...
February 15, 2017: Current Topics in Microbiology and Immunology
https://www.readbyqxmd.com/read/28197051/benefits-of-and-untoward-events-during-intrahospital-transport-of-pediatric-intensive-care-unit-patients
#5
M M Harish, Suhail Sarwar Siddiqui, Natesh R Prabu, Harish K Chaudhari, Jigeeshu V Divatia, Atul Prabhakar Kulkarni
BACKGROUND AND AIMS: The transport of critically ill patients for procedures or imaging outside the Intensive Care Unit (ICU) is potentially hazardous; hence, the transport process must be organized and efficient. The literature about benefits of and untoward events (UEs) during intrahospital transport of pediatric critically ill patient is scarce. We, therefore, audited the UEs during and benefits of intrahospital transport of critically ill pediatric patients in our ICU. SUBJECTS AND METHODS: Eighty critically ill pediatric (<18 years) cancer patients, transported from the ICU for either diagnostic or therapeutic procedure over a period of 6 months, were included in the study...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28195096/genotyping-of-clinical-and-environmental-multidrug-resistant-enterococcus-faecium-strains
#6
Leili Shokoohizadeh, Ashraf Mohabati Mobarez, Masoud Alebouyeh, Mohammad Reza Zali, Reza Ranjbar
CONTEXT: Multidrug resistant (MDR) Enterococcus faecium is a nosocomial pathogen and clonal complex 17 (CC17) is the main genetic subpopulation of E. faecium in hospitals worldwide. AIMS: There has thus far been no report of major E. faecium clones in Iranian hospitals. SUBJECTS AND METHODS: The present study analyzed strains of MDR E. faecium obtained from patients and the Intensive Care Unit environments using pulsed field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) to determine the antibiotic resistance patterns and genetic features of the dominant...
January 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28193661/determining-the-clinical-utility-of-an-absolute-procalcitonin-value-for-predicting-a-positive-culture-result
#7
Erica M Caffarini, Joshua DeMott, Gourang Patel, Ishaq Lat
Various procalcitonin ranges have been established to guide antimicrobial therapy; however, there are no data that establish whether the initial procalcitonin value will determine the likelihood of a positive culture result. This study aims to establish if the initial procalcitonin value on clinical presentation can provide positive predictive value of any positive culture result.This was a retrospective study of 813 medical intensive care unit patients. Data points collected included patient demographics, procalcitonin assays, source of infection, culture results, and length of stay...
February 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28191382/inadvertent-skipping-of-steroids-in-septic-shock-leads-to-a-diagnosis-of-adult-onset-still-s-disease
#8
Vinoth K Sethuraman, Kavitha Balasubramanian, Stalin Viswanathan, Rajeswari Aghoram
Adult onset Still's disease is uncommon in middle-aged and elderly individuals and can rarely present with shock; shock is usually associated with disseminated intravascular coagulation, multiorgan dysfunction syndrome or acute respiratory distress syndrome. We report a post-menopausal woman with arthritis, fever, pneumonitis and hypotension which was managed as septic shock. Steroids were inadvertently missed during the second day of hospitalization in the intensive care unit. Persistence of hypotension on inotropes, with normal renal, hepatic and neurological function and recurrence of fever when steroids were skipped, led to suspicion of an inflammatory disorder...
January 14, 2017: Curēus
https://www.readbyqxmd.com/read/28187812/family-discussions-on-life-sustaining-interventions-in-neurocritical-care
#9
M M Adil, D Larriviere
Approximately 20% of all deaths in the USA occur in the intensive care unit (ICU) and the majority of ICU deaths involves decision of de-escalation of life-sustaining interventions. Life-sustaining interventions may include intubation and mechanical ventilation, artificial nutrition and hydration, antibiotic treatment, brain surgery, or vasoactive support. Decision making about goals of care can be defined as an end-of-life communication and the decision-making process between a clinician and a patient (or a surrogate decision maker if the patient is incapable) in an institutional setting to establish a plan of care...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187809/management-of-bacterial-central-nervous-system-infections
#10
M C Brouwer, D van de Beek
Bacterial infections of the central nervous system present as a medical emergency, thus requiring rapid diagnosis and immediate treatment. The most prevalent bacterial infections seen in the intensive care unit can be summarized as acute bacterial meningitis, subdural empyema, intracerebral abscess, and ventriculitis, which all commonly involve the brain parenchyma. The infections can either be community-acquired or hospital-acquired, e.g., after neurosurgical intervention, as a complication of severe neurotrauma or related to indwelling cerebrospinal fluid drains...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28181665/multidrug-resistant-bacteria-among-patients-with-ventilatorassociated-pneumonia-in-an-emergency-intensive-care-unit-egypt
#11
Magda M Azzab, Rehab H El-Sokkary, Mohamed M Tawfeek, Manar G Gebriel
Ventilator-associated pneumonia (VAP) is the most common hospital-acquired infection among mechanically ventilated patients. Our objectives were to determine the incidence of VAP, isolate multidrug-resistant bacteria, identify the most prevalent resistant strains and identify their antibiotic susceptibility pattern. The VAP rate was calculated. The isolated microbes were identified and tested for antibiotic susceptibilities. The minimum inhibitory concentrations were determined of imipenem, meropenem and ertapenem for Klebsiella isolates...
February 1, 2017: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
https://www.readbyqxmd.com/read/28181033/clinical-and-microbiological-determinants-of-severe-and-fatal-outcomes-in-patients-infected-with-enterobacteriaceae-producing-extended-spectrum-%C3%AE-lactamase
#12
L Surgers, A Boyd, P-Y Boelle, V Lalande, P-A Jolivot, P-M Girard, G Arlet, C Cambier, A Homor, D Decre, J-L Meynard
Although extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae have become a worldwide public health concern, little is known regarding the clinical course of colonized or infected individuals. Our objective was to characterize the determinants of fatal outcomes related to ESBL-producing microorganisms at a large hospital in Paris, France. In 2012-2013, all consecutive patients with clinical samples testing positive for ESBL-producing Enterobacteriaceae at Saint-Antoine Hospital were identified...
February 8, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28169101/-patient-safety-in-antibiotics-administration-risk-assessment
#13
REVIEW
M Maqueda Palau, E Pérez Juan
OBJECTIVE: To determine the level of risk in the preparation and administration of antibiotics frequently used in the Intensive Care Unit using a risk matrix. MATERIAL AND METHOD: A study was conducted using situation analysis and literature review of databases, protocols and good practice guidelines on intravenous therapy, drugs, and their administration routes. The most used antibiotics in the ICU registered in the ENVIN-HELICS program from 1 April to 30 June 2015 were selected...
February 3, 2017: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/28167592/patient-characteristics-management-and-predictors-of-outcome-from-severe-community-onset-staphylococcal-sepsis-in-northeast-thailand-a-prospective-multicenter-study
#14
T Eoin West, Chanthiwa Wikraiphat, Sarunporn Tandhavanant, Pitchayanant Ariyaprasert, Pornpan Suntornsut, Shawna Okamoto, Weera Mahavanakul, Pramot Srisamang, Sunchai Phiphitaporn, Jirasak Anukunananchai, Ploenchan Chetchotisakd, Sharon J Peacock, Narisara Chantratita
Staphylococcus aureus infection is a persistent threat in resource-restricted settings in southeast Asia but informative data about this disease remain limited. We analyzed characteristics, management, and predictors of outcome in severely septic patients with community-onset S. aureus infection in northeast Thailand. We performed a prospective, multicenter observational cohort study of community-onset S. aureus sepsis in four referral hospitals recruiting patients at least 14 years of age admitted between March 2010 and December 2013...
February 6, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28167543/carbapenem-minimal-inhibitory-concentrations-in-escherichia-coli-and-klebsiella-species-producing-extended-spectrum-beta-lactamases-esbls-in-critical-care-patients-from-2001-2009
#15
J Kristie Johnson, Gwen L Robinson, Lisa L Pineles, Adebola O Ajao, LiCheng Zhao, Jennifer S Albrecht, Anthony D Harris, Kerri A Thom, Jon P Furuno
Extended spectrum β-lactamase (ESBL) -producing Enterobacteriaceae are increasing in prevalence worldwide. Carbapenem antibiotics are used as a first line of therapy against ESBL-producing Enterobacteriaceae. We examined gastrointestinal colonization of carbapenem-resistant-ESBLs (CR-ESBL) among a cohort of critical care patients. In this cohort of patients, we cultured for ESBL-producing Klebsiella spp. and Escherichia coli and then performed MIC susceptibility testing for imipenem, doripenem, meropenem, and ertapenem on the patient's first isolate...
February 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28165033/micheliolide-provides-protection-of-mice-against-staphylococcus-aureus-and-mrsa-infection-by-down-regulating-inflammatory-response
#16
Xinru Jiang, Yuli Wang, Yifei Qin, Weigang He, Adel Benlahrech, Qingwen Zhang, Xin Jiang, Zhenhui Lu, Guang Ji, Yuejuan Zheng
A major obstacle to therapy in intensive care units is sepsis caused by severe infection. In recent years gram-positive (G(+)) bacteria, most commonly staphylococci, are thought to be the main pathogens. Micheliolide (MCL) was demonstrated to provide a therapeutic role in rheumatoid arthritis, inflammatory intestinal disease, colitis-associated cancer, and lipopolysaccharide (LPS, the main component of G(-) bacterial cell wall) induced septic shock. We proved here that MCL played an anti-inflammatory role in Staphylococcus aureus (S...
February 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28160952/antibiotic-trends-amid-multidrug-resistant-gram-negative-infections-in-intensive-care-units
#17
REVIEW
Leanne H Fowler, Susan Lee
Isolates from ICUs most commonly find multidrug-resistant (MDR) gram-negative bacteria. The purpose of this article is to discuss the significant impact MDR gram-negative infections are having on ICUs, the threat on health and mortality, and effective and new approaches aimed to combat MDR gram-negative infections in critically ill populations. Inappropriate antibiotic therapies for suspected or documented infections are the leading cause of the emergence of bacterial resistance. A variety of strategies are aimed at combatting this international burden via antibiotic stewardship programs...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28160023/the-intensive-care-medicine-research-agenda-on-multidrug-resistant-bacteria-antibiotics-and-stewardship
#18
REVIEW
Marin H Kollef, Matteo Bassetti, Bruno Francois, Jason Burnham, George Dimopoulos, Jose Garnacho-Montero, Jeffrey Lipman, Charles-Edouard Luyt, David P Nicolau, Maarten J Postma, Antonio Torres, Tobias Welte, Richard G Wunderink
PURPOSE: To concisely describe the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to the management of multidrug-resistant (MDR) bacteria, antibiotic use, and antimicrobial stewardship in the intensive care unit (ICU) setting. METHODS: Narrative review based on a systematic analysis of the medical literature, national and international guidelines, and expert opinion...
February 4, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28156198/a-multicenter-record-review-of-in-hospital-adverse-drug-events-requiring-a-higher-level-of-care
#19
Kristel Marquet, Neree Claes, Elke De Troy, Gaby Kox, Martijn Droogmans, Arthur Vleugels
OBJECTIVE: Adverse drug events (ADEs) are a worldwide concern, particularly when leading to a higher level of care. This study defines a higher level of care as an unplanned (re)admission to an intensive care unit or an intervention by a Medical Emergency Team. The objectives are to describe the incidence and preventability of ADEs leading to a higher level of care, to assess the types of drug involved, and to identify the risk factors. METHODS: A three-stage retrospective review was performed in six Belgian hospitals...
February 3, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28156021/loss-of-cutaneous-microbial-diversity-during-first-three-weeks-of-life-in-very-low-birth-weight-infants
#20
A Salava, V Aho, E Lybeck, P Pereira, L Paulin, I Nupponen, A Ranki, P Auvinen, S Andersson, A Lauerma
Neonatal sepsis (NS) is a frequent problem in neonatal intensive care, especially in preterm and very low birth weight (VLBW) infants. The objective of the study was to characterize the cutaneous bacterial microbiome in VLBW infants treated in the neonatal intensive care unit (NICU). Non-invasive skin microbiome specimens were taken repeatedly from 12 VLBW infants during treatment in NICU starting on the first day of life. All infants received benzylpenicillin and netilmicin during the first 1-5 postnatal days...
February 3, 2017: Experimental Dermatology
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