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Antibiotic emergency room sepsis

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https://www.readbyqxmd.com/read/29675402/poor-compliance-with-sepsis-guidelines-in-a-tertiary-care-children-s-hospital-emergency-room
#1
Benjamin Louis Moresco, Clinton Woosley, Morris Sauter, Utpal Bhalala
Objectives: This study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children's hospital. Methods: This was a retrospective, observational study of children (0-18 years old) in The Children's Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for "severe sepsis" and "shocks...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29673855/activation-of-a-code-sepsis-in-the-emergency-department-is-associated-with-a-decrease-in-mortality
#2
Neus Robert Boter, Josep Maria Mòdol Deltell, Irma Casas Garcia, Gemma Rocamora Blanch, Gemma Lladós Beltran, Anna Carreres Molas
OBJECTIVES: To evaluate the impact of a code sepsis (CS) activation, complying with recommendations, the evolution of patients with severe sepsis in the emergency room and determine independent factors associated to mortality. METHOD: All patients attending the emergency room with severe sepsis during a 6-month period were included. Complying with Surviving Sepsis Campaign recommendations, patients' average stay, intensive care admissions and 30-day mortality were assessed...
April 16, 2018: Medicina Clínica
https://www.readbyqxmd.com/read/29124121/patients-comorbidities-reduce-the-clinical-value-of-emergency-colonoscopy-results-of-a-retrospective-cohort-study
#3
Cristiano Cremone, Anouk Esch, Charlotte Gagniere, Alessandro Fugazza, Faria Mesli, Michael Levy, Aurelien Amiot, Alexis Laurent, Yann LeBaleur, Francois Hemery, Nicolas De'Angelis, Francesco Brunetti, Iradj Sobhani
Background and study aims:  Urgent endoscopy is often used to diagnose and sometimes treat acute upper gastrointestinal syndromes (hemorrhage, toxic ingestion, and occlusion). However, its suitability concerning the management of lower gastrointestinal conditions in emergency circumstances is controversial. Patients and methods:  We studied the role of emergency colonoscopy in diagnosis and treatment of all consecutive patients presenting with acute lower gastrointestinal symptoms referred to our hospital on an emergency basis...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28321299/successful-emergency-department-interventions-that-reduce-time-to-antibiotics-in-febrile-pediatric-cancer-patients
#4
Sandra Spencer, MIchele Nypaver, Katherine Hebert, Christopher Benner, Rachel Stanley, Daniel Cohen, Alexander Rogers, Jason Goldstick, Prashant Mahajan
Children with cancer and fever are at high risk for sepsis related death. Rapid antibiotic delivery (< 60 minutes) has been shown to reduce mortality. We compared patient outcomes and describe interventions from three separate quality improvement (QI) projects conducted in three United States (US) tertiary care pediatric emergency departments (EDs) with the shared aim to reduce time to antibiotic (TTA) to < 60 minutes in febrile pediatric oncology patients (Temperature > 38.0 C). A secondary objective was to identify interventions amenable to translation to other centers...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27824151/the-antimicrobial-susceptibility-of-klebsiella-pneumoniae-from-community-settings-in-taiwan-a-trend-analysis
#5
Wu-Pu Lin, Jann-Tay Wang, Shan-Chwen Chang, Feng-Yee Chang, Chang-Phone Fung, Yin-Ching Chuang, Yao-Shen Chen, Yih-Ru Shiau, Mei-Chen Tan, Hui-Ying Wang, Jui-Fen Lai, I-Wen Huang, Tsai-Ling Lauderdale
Drug-resistant Klebsiella pneumoniae, especially extended-spectrum β-lactamase (ESBL)- and/or AmpC β-lactamase-producing strains, is an emerging problem worldwide. However, few data focusing on drug susceptibility of K. pneumoniae from community is available. In this study, we analyzed 1016 K. pneumoniae isolates from outpatients or those visiting emergency rooms collected during 2002-2012 from Taiwan Surveillance of Antimicrobial Resistance program. Significantly decreased susceptibilities to 3(rd) generation cephalosporins and ciprofloxacin were found during the study period...
November 8, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27633708/necrotizing-fasciitis-of-the-breast-requiring-emergent-radical-mastectomy
#6
Nicholas D Ward, Jennifer W Harris, David A Sloan
Necrotizing fasciitis is a rare, aggressive, soft-tissue infection that results in necrosis of skin, subcutaneous tissue, and fascia. It spreads rapidly and may progress to sepsis, multi-organ failure, and death. Predisposing conditions include diabetes, chronic alcoholism, advanced age, vascular disease, and immunosuppression and many cases are preceded by an injury or invasive procedure. Necrotizing soft-tissue infection of the breast is uncommon, with only a few reported cases in the literature. We present a 53-year-old diabetic woman who presented to the emergency room with several weeks of worsening breast and shoulder pain, swelling, and erythema...
January 2017: Breast Journal
https://www.readbyqxmd.com/read/27557072/-patient-from-gambia-with-sonographic-white-kidneys
#7
Eva Aebert, Maike Büttner-Herold, Frederick Pfister, Thomas Mühlbacher, Christoph Berg, Martin Müller, Michael Haap, Ferruh Artunc
HISTORY AND ADMISSION FINDINGS: A 39-year-old male refugee from Gambia is admitted to the emergency room with fever, body aches and productive cough. INVESTIGATIONS: Laboratory, ultrasound and CT investigations show a sepsis due to Staphylcoccus aureus, a renal failure with the appearance of "snow-white" kidneys on ultrasound and a previously unknown acute HIV-infection. DIAGNOSIS, TREATMENT AND COURSE: Broad antibiotic treatment and an antiretroviral therapy (adapted to the impaired renal function) as well as hemodialysis are commenced...
August 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27501600/appropriateness-of-broad-spectrum-antibiotics-for-severe-sepsis-and-septic-shock-in-the-emergency-department
#8
Panita Worapratya, Jutharat Joraluck, Apisit Wanjaroenchaisuk, Prasit Wuthisuthimethawee
OBJECTIVE: Determine the appropriateness of broad-spectrum antibiotics applied in severe sepsis and septic shock in an emergency room and its impact on the survival rate. MATERIAL AND METHOD: This was a prospective observational study in an emergency room setting at a tertiary care facility where early goal-directed therapy (EGDT) was applied for resuscitation of severe septic and septic shock patients. The data recorded were the initial vital signs, SAP II score, time of EGDT goals achieved (ScvO₂> 70), time of antibiotics initiated, type of antibiotics used, organisms that were identified, source of infection, initial and final diagnosis, and outcome of treatment...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
https://www.readbyqxmd.com/read/27454386/are-early-antibiotics-important-for-everyone
#9
Yeh-Li Ho, Vivian Vieira Tenório Sales, Daniel Joelsons
Since the first edition of Surviving Sepsis Campaign Guidelines, the administration of intravenous antibiotics in the first hours of sepsis is recommend. However, in the last ten years, several studies around importance of early antibiotics in emergency room or in intensive care unit produced disparate results. Therefore, is early administration of antibiotics a life-salver? In this article, we explore studies around this theme and some questions about what does "early antibiotics" mean are addressed.
January 2017: Shock
https://www.readbyqxmd.com/read/27333027/a-broad-spectrum-infection-diagnostic-that-detects-pathogen-associated-molecular-patterns-pamps-in-whole-blood
#10
Mark Cartwright, Martin Rottman, Nathan I Shapiro, Benjamin Seiler, Patrick Lombardo, Nazita Gamini, Julie Tomolonis, Alexander L Watters, Anna Waterhouse, Dan Leslie, Dana Bolgen, Amanda Graveline, Joo H Kang, Tohid Didar, Nikolaos Dimitrakakis, David Cartwright, Michael Super, Donald E Ingber
BACKGROUND: Blood cultures, and molecular diagnostic tests that directly detect pathogen DNA in blood, fail to detect bloodstream infections in most infected patients. Thus, there is a need for a rapid test that can diagnose the presence of infection to triage patients, guide therapy, and decrease the incidence of sepsis. METHODS: An Enzyme-Linked Lectin-Sorbent Assay (ELLecSA) that uses magnetic microbeads coated with an engineered version of the human opsonin, Mannose Binding Lectin, containing the Fc immunoglobulin domain linked to its carbohydrate recognition domain (FcMBL) was developed to quantify pathogen-associated molecular patterns (PAMPs) in whole blood...
July 2016: EBioMedicine
https://www.readbyqxmd.com/read/26831896/neonatal-and-maternal-outcomes-following-midtrimester-preterm-premature-rupture-of-the-membranes-a-retrospective-cohort-study
#11
Laura Aoife Linehan, Jennifer Walsh, Aoife Morris, Louise Kenny, Keelin O'Donoghue, Eugene Dempsey, Noirin Russell
BACKGROUND: Preterm premature rupture of membranes (PPROM) complicates 1% of all pregnancies and occurs in one third of all preterm deliveries. Midtrimester PPROM is often followed by spontaneous miscarriage and elective termination of ongoing pregnancies is offered in many countries. The aim of this retrospective descriptive cohort study was to investigate the natural history of midtrimester PPROM in a jurisdiction where termination of pregnancy in the absence of maternal compromise is unavailable...
January 29, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/26474394/evaluation-of-the-broad-range-pcr-esi-ms-technology-in-blood-specimens-for-the-molecular-diagnosis-of-bloodstream-infections
#12
Elena Jordana-Lluch, Montserrat Giménez, M Dolores Quesada, Belén Rivaya, Clara Marcó, M Jesús Domínguez, Fernando Arméstar, Elisa Martró, Vicente Ausina
BACKGROUND: Rapid identification of the etiological agent in bloodstream infections is of vital importance for the early administration of the most appropriate antibiotic therapy. Molecular methods may offer an advantage to current culture-based microbiological diagnosis. The goal of this study was to evaluate the performance of IRIDICA, a platform based on universal genetic amplification followed by mass spectrometry (PCR/ESI-MS) for the molecular diagnosis of sepsis-related pathogens directly from the patient's blood...
2015: PloS One
https://www.readbyqxmd.com/read/26323739/current-concepts-on-hemodynamic-support-and-therapy-in-septic-shock
#13
REVIEW
Leonardo Lima Rocha, Camila Menezes Souza Pessoa, Thiago Domingos Corrêa, Adriano José Pereira, Murillo Santucci Cesar de Assunção, Eliézer Silva
Severe sepsis and septic shock represent a major healthcare challenge. Much of the improvement in mortality associated with septic shock is related to early recognition combined with timely fluid resuscitation and adequate antibiotics administration. The main goals of septic shock resuscitation include intravascular replenishment, maintenance of adequate perfusion pressure and oxygen delivery to tissues. To achieve those goals, fluid responsiveness evaluation and complementary interventions - i.e. vasopressors, inotropes and blood transfusion - may be necessary...
September 2015: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/26296982/-current-concepts-on-hemodynamic-support-and-therapy-in-septic-shock
#14
Leonardo Lima Rocha, Camila Menezes Souza Pessoa, Thiago Domingos Corrêa, Adriano José Pereira, Murillo Santucci Cesar de Assunção, Eliézer Silva
Severe sepsis and septic shock represent a major healthcare challenge. Much of the improvement in mortality associated with septic shock is related to early recognition combined with timely fluid resuscitation and adequate antibiotics administration. The main goals of septic shock resuscitation include intravascular replenishment, maintenance of adequate perfusion pressure and oxygen delivery to tissues. To achieve those goals, fluid responsiveness evaluation and complementary interventions - i.e. vasopressors, inotropes and blood transfusion - may be necessary...
September 2015: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/25840554/sepsis-in-standard-care-patients-characteristics-effectiveness-of-antimicrobial-therapy-and-patient-outcome-a-cohort-study
#15
Franz Ratzinger, Katharina Eichbichler, Michael Schuardt, Irene Tsirkinidou, Dieter Mitteregger, Helmuth Haslacher, Thomas Perkmann, Klaus G Schmetterer, Georg Doffner, Heinz Burgmann
PURPOSE: Fast diagnosis and initiation of appropriate antibiotic therapy is pivotal for the survival of sepsis patients. However, most studies on suspected sepsis patients are conducted in the intensive care unit or in the emergency room setting, neglecting the standard care setting. This study evaluated sepsis risk factors, microbiological accurateness of the initial empiric antimicrobial therapy and its effect on hospital mortality in standard care patients. METHODS: In this prospective observational cohort study, patients with clinically suspected sepsis meeting two or more SIRS criteria were screened on standard care wards...
June 2015: Infection
https://www.readbyqxmd.com/read/25627760/postoperative-burden-of-hospital-acquired-clostridium-difficile-infection
#16
Zaid M Abdelsattar, Greta Krapohl, Layan Alrahmani, Mousumi Banerjee, Robert W Krell, Sandra L Wong, Darrell A Campbell, David M Aronoff, Samantha Hendren
OBJECTIVE Clostridium difficile infection (CDI) is a common hospital-acquired infection. Previous reports on the incidence, risk factors, and impact of CDI on resources in the surgical population are limited. In this context, we study CDI across diverse surgical settings. METHODS We prospectively identified patients with laboratory-confirmed postoperative CDI after 40 different general, vascular, or gynecologic surgeries at 52 academic and community hospitals between July 2012 and September 2013. We used multivariable regression models to identify CDI risk factors and to determine the impact of CDI on resource utilization...
January 2015: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/25337488/bedside-abg-electrolytes-lactate-and-procalcitonin-in-emergency-pediatrics
#17
Prerna Batra, Ajeet Kumar Dwivedi, Neha Thakur
Point of care testing, is the term commonly applied to the bedside tests performed in sick patients. Common clinical conditions encountered in pediatric emergency rooms are respiratory, gastro-intestinal, infections and cardiac. Emergencies at most of the places, especially developing countries are overburdened. Availability of tests like arterial blood gas, lactate, electrolytes and procalcitonin, bedside tests or point of care tests can help identify sick patients quickly. Abnormalities like acid-base disturbances and dyselectrolytemias can be dealt with instantly, thus improving the overall prognosis...
July 2014: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/25256141/acinetobacter-baumannii-neonatal-mastitis-a-case-report
#18
Emma L Mohr, Abeba Berhane, John Gregory Zora, Parminder S Suchdev
INTRODUCTION: Neonatal mastitis is a rare infection. When it does occur, infants younger than 2 months of age are typically affected and the majority of cases are caused by Staphylococcus aureus. We present the first reported case of neonatal mastitis caused by Acinetobacter baumannii, an unusual organism for this type of infection. CASE PRESENTATION: A 15-day-old full-term Caucasian male neonate presented to our emergency room following fever at home and was admitted for routine neonatal sepsis evaluation...
2014: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/25208720/two-cases-and-a-review-of-streptococcus-pyogenes-endocarditis-in-children
#19
REVIEW
Danielle R Weidman, Hilal Al-Hashami, Shaun K Morris
BACKGROUND: Infective endocarditis is a rare diagnosis in pediatrics. Group A beta-hemolytic Streptococcus pyogenes is known to cause a range of type and severity of infections in childhood. However, S. pyogenes is a rarely described cause of endocarditis in children. This paper presents two cases of S. pyogenes endocarditis and the largest and most up-to-date review of cases previously reported in the literature. CASE PRESENTATION: Here we describe two pediatric cases of S...
September 10, 2014: BMC Pediatrics
https://www.readbyqxmd.com/read/24462421/presepsin-as-a-powerful-monitoring-tool-for-the-prognosis-and-treatment-of-sepsis-a-multicenter-prospective-study
#20
MULTICENTER STUDY
Shigeatsu Endo, Yasushi Suzuki, Gaku Takahashi, Tatsuyori Shozushima, Hiroyasu Ishikura, Akira Murai, Takeshi Nishida, Yuhei Irie, Masanao Miura, Hironobu Iguchi, Yasuo Fukui, Kimiaki Tanaka, Tsuyoshi Nojima, Yoshikazu Okamura
Presepsin is a protein whose levels increase specifically in the blood of patients with sepsis. It is proposed as a diagnostic and prognostic marker for assessing the degree of sepsis severity. The present multicenter prospective study compared the clinical utility of presepsin with other conventional sepsis biomarkers including procalcitonin, interleukin-6, and C-reactive protein for evaluating the severity of sepsis during follow-up. Patients with sepsis (n = 103) admitted to the emergency room or intensive care unit were enrolled in this study and classified into 3 diagnostic groups: sepsis, severe sepsis, and septic shock...
January 2014: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
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