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Time to antibiotic in sepsis

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https://www.readbyqxmd.com/read/28727802/diagnostic-accuracy-of-procalcitonin-neutrophil-lymphocyte-count-ratio-c-reactive-protein-and-lactate-in-patients-with-suspected-bacterial-sepsis
#1
Lars Ljungström, Anna-Karin Pernestig, Gunnar Jacobsson, Rune Andersson, Barbara Usener, Diana Tilevik
BACKGROUND: Early recognition is a key factor to achieve improved outcomes for septic patients. Combinations of biomarkers, as opposed to single ones, may improve timely diagnosis and survival. We investigated the performance characteristics of sepsis biomarkers, alone and in combination, for diagnosis of verified bacterial sepsis using Sepsis-2 and Sepsis-3 criteria, respectively. METHODS: Procalcitonin (PCT), neutrophil-lymphocyte count ratio (NLCR), C-reactive protein (CRP), and lactate were determined in a total of 1,572 episodes of adult patients admitted to the emergency department on suspicion of sepsis...
2017: PloS One
https://www.readbyqxmd.com/read/28717548/infective-complications-in-patients-after-transrectal-ultrasound-guided-prostate-biopsy-and-the-role-of-ciprofloxacin-resistant-escherichia-coli-colonization-in-rectal-flora
#2
Mustafa Bilal Hamarat, Fatih Tarhan, Rahim Horuz, Gülfem Akengin Öcal, Mehmet Kutlu Demirkol, Alper Kafkaslı, Özgür Yazıcı
OBJECTIVE: In the present study, we aimed to invastigate the ciprofloxacin resistance in rectal flora of the patients undergoing prostate biopsy in our department. Additionally, the possible effects of the presence of ciprofloxacin resistant bacteria in faecal flora on the risk of infective complications after the procedure as well as the effect of antibiotic prophylaxis on such infectious complications have been evaluated. MATERIAL AND METHODS: A total of 142 patients undergoing transrectal ultrasound-guided prostate biopsy were included into the study program...
June 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/28696672/magnetic-extraction-of-acinetobacter-baumannii-using-colistin-functionalized-%C3%AE-fe2o3-au-core-shell-composite-nanoclusters
#3
Charleson S Bell, Raquel Mejias, Sinead Miller, Jasmine Greer, Mark McClain, Timothy L Cover, Todd D Giorgio
Acinetobacter baumannii is a gram-negative bacterium of increasing concern due to its virulence and persistence in combat and healthcare environments. The incidence of both community-acquired and nosocomial A. baumannii infections is on the rise in foreign and domestic healthcare facilities. Treatment options are limited due to the acquisition of multi-drug resistance to the few effective antibiotics. Currently, the most effective pharmaceutically-based treatment for multi-drug-resistant A. baumannii infections is the antibiotic colistin (polymyxin E)...
July 11, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28693558/zinc-as-an-adjunct-treatment-for-reducing-case-fatality-due-to-clinical-severe-infection-in-young-infants-study-protocol-for-a-randomized-controlled-trial
#4
Nitya Wadhwa, Sudha Basnet, Uma Chandra Mouli Natchu, Laxman P Shrestha, Shinjini Bhatnagar, Halvor Sommerfelt, Tor A Strand, Siddarth Ramji, K C Aggarwal, Harish Chellani, Anuradha Govil, Mamta Jajoo, N B Mathur, Meenakshi Bhatt, Anup Mohta, Imran Ansari, Srijana Basnet, Ram H Chapagain, Ganesh P Shah, Binod M Shrestha
BACKGROUND: An estimated 2.7 of the 5.9 million deaths in children under 5 years of age occur in the neonatal period. Severe infections contribute to almost a quarter of these deaths. Mortality due to severe infections in developing country settings is substantial despite antibiotic therapy. Effective interventions that can be added to standard therapy for severe infections are required to reduce case fatality. METHODS/DESIGN: This is a double-blind randomized placebo-controlled parallel group superiority trial to investigate the effect of zinc administered orally as an adjunct to standard therapy to infants aged 3 days up to 2 months (59 days) hospitalized with clinical severe infection, that will be undertaken in seven hospitals in Delhi, India and Kathmandu, Nepal...
July 10, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28669679/a-novel-one-step-real-time-multiplex-pcr-assay-to-detect-streptococcus-agalactiae-presence-and-serotypes-ia-ib-and-iii
#5
Lucy L Furfaro, Barbara J Chang, Matthew S Payne
Streptococcus agalactiae is the leading cause of early-onset neonatal sepsis. Culture-based screening methods lack the sensitivity of molecular assays and do not indicate serotype; a potentially important virulence marker. We aimed to develop a multiplex PCR to detect S. agalactiae while simultaneously identifying serotypes Ia, Ib, and III; commonly associated with infant disease. Primers were designed to target S. agalactiae serotype-specific cps genes and the dltS gene. The assay was validated with 512 vaginal specimens from pregnant women...
June 16, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28663673/spontaneous-bacterial-peritonitis-by-burkholderia-cepacia-complex-a-rare-difficult-to-treat-infection-in-decompensated-cirrhotic-patients
#6
Sunil Taneja, Pramod Kumar, Vikas Gautam, Ajay Duseja, Virendra Singh, Radha K Dhiman, Yogesh Chawla
INTRODUCTION: Burkholderia cepacia complex (Bcc) is non-fermenting Gram-negative bacillus and has been rarely reported to cause spontaneous bacterial peritonitis (SBP) in decompensated cirrhosis. OBJECTIVE: This study was done to evaluate the clinical presentation of cirrhotic patients with SBP due to Bcc and to determine its impact on clinical outcome. METHODS: This is a retrospective, observational study conducted during the period from 1st January 2013 through 31st March 2015...
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28655352/evaluation-of-early-antimicrobial-therapy-adaptation-guided-by-the-betalacta%C3%A2-test-a-case-control-study
#7
Marc Garnier, Sacha Rozencwajg, Tài Pham, Sophie Vimont, Clarisse Blayau, Mehdi Hafiani, Jean-Pierre Fulgencio, Francis Bonnet, Jean-Luc Mainardi, Guillaume Arlet, Muriel Fartoukh, Salah Gallah, Christophe Quesnel
BACKGROUND: Rapid diagnostic tests detecting microbial resistance are needed for limiting the duration of inappropriateness of empirical antimicrobial therapy (EAT) in intensive care unit patients, besides reducing the use of broad-spectrum antibiotics. We hypothesized that the betaLACTA® test (BLT) could lead to early increase in the adequacy of antimicrobial therapy. METHODS: This was a case-control study. Sixty-one patients with BLT-guided adaptation of EAT were prospectively included, and then matched with 61 "controls" having similar infection characteristics (community or hospital-acquired, and source of infection), in whom EAT was conventionally adapted to antibiogram results...
June 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28646964/global-advocacy-needed-for-sepsis-in-children
#8
Sagar Dugani, Niranjan Kissoon
Sepsis in children is a complex syndrome that develops from various infections and results in 15-30% mortality in high-income countries and up to 50% or higher in low-income countries. Worldwide, this represents an annual burden of 30 million cases resulting in 8 million deaths. Not surprisingly, there is a significantly higher burden in low-income countries with children there being 18 times more likely to die before the age of 5 years compared to high-income countries. Factors such as commercial air travel, climate change, and unchecked population growth have contributed to the growing burden of infectious diseases and ensuing sepsis...
June 2017: Journal of Infection
https://www.readbyqxmd.com/read/28628607/host-gene-expression-analysis-in-sri-lankan-melioidosis-patients
#9
Shivankari Krishnananthasivam, Nimanthi Jayathilaka, Harindra Darshana Sathkumara, Enoka Corea, Mohan Natesan, Aruna Dharshan De Silva
BACKGROUND: Melioidosis is a life threatening infectious disease caused by the gram-negative bacillus Burkholderia pseudomallei predominantly found in southeast Asia and northern Australia. Studying the host transcription profiles in response to infection is crucial for understanding disease pathogenesis and correlates of disease severity, which may help improve therapeutic intervention and survival. The aim of this study was to analyze gene expression levels of human host factors in melioidosis patients and establish useful correlation with disease biomarkers, compared to healthy individuals and patients with sepsis caused by other pathogens...
June 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28602274/impact-of-an-electronic-sepsis-initiative-on-antibiotic-use-and-health-care-facility-onset-clostridium-difficile-infection-rates
#10
Robert Hiensch, Jashvant Poeran, Patricia Saunders-Hao, Victoria Adams, Charles A Powell, Allison Glasser, Madhu Mazumdar, Gopi Patel
BACKGROUND: Although integrated, electronic sepsis screening and treatment protocols are thought to improve patient outcomes, less is known about their unintended consequences. We aimed to determine if the introduction of a sepsis initiative coincided with increases in broad-spectrum antibiotic use and health care facility-onset (HCFO) Clostridium difficile infection (CDI) rates. METHODS: We used interrupted time series data from a large, tertiary, urban academic medical center including all adult inpatients on 4 medicine wards (June 2011-July 2014)...
June 8, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28591678/treatment-outcomes-after-implementation-of-an-adapted-who-protocol-for-severe-sepsis-and-septic-shock-in-haiti
#11
Alfred Papali, T Eoin West, Avelino C Verceles, Marc E Augustin, L Nathalie Colas, Carl H Jean-Francois, Devang M Patel, Nevins W Todd, Michael T McCurdy
PURPOSE: The World Health Organization (WHO) has developed a simplified algorithm specific to resource-limited settings for the treatment of severe sepsis emphasizing early fluids and antibiotics. However, this protocol's clinical effectiveness is unknown. We describe patient outcomes before and after implementation of an adapted WHO severe sepsis protocol at a community hospital in Haiti. MATERIALS AND METHODS: Using a before-and-after study design, we retrospectively enrolled 99 adult Emergency Department patients with severe sepsis from January through March 2012...
May 27, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28578440/adherence-to-surviving-sepsis-guidelines-among-pediatric-intensivists-a-national-survey
#12
Farah C Thabet, Jihad N Zahraa, May S Chehab
To assess the compliance with the 2006 American College of Critical Care-Pediatric Advanced Life Support (ACCM-PALS) guidelines for sepsis management, and the 2012 surviving sepsis campaign (SSC), for the management of pediatric patients with sepsis and to identify the main barriers to adherence to these guidelines. Methods: In November 2015, a prospective cohort study in which a web based electronic survey using a case scenario to explore the usual management of a child with severe sepsis was designed and sent to all consultant pediatric intensivists practicing in Kingdom of Saudi Arabia (KSA)...
June 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28572520/clinical-management-of-sepsis
#13
S M Lam, A Cw Lau, R Pk Lam, W W Yan
Sepsis is a common cause of hospital admission worldwide and contributes significantly to morbidity and mortality. The definition of sepsis has evolved from the 1991 American College of Chest Physicians/Society of Critical Care Medicine definition based on the criteria of systemic inflammatory response syndrome, to the 2016 Sepsis-3 definition that incorporates the Sequential Organ Failure Assessment score. The landmark trial on protocolised early goal-directed therapy was published in 2001, but three subsequent multicentre randomised controlled trials (ProCESS, ARISE, and ProMISe) in 2014-2015 did not confirm a survival benefit with protocolised care...
June 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28560472/prevalence-clonality-and-pathogenicity-of-staphylococcus-epidermidis-isolates-in-newborn-feces
#14
S Fill Malfertheiner, S Wendt, F Layer, M Weigl, B Seelbach-Göbel, W König, B König
Coagulase-negative staphylococci (CoNS) are the most prevalent pathogens causing late-onset sepsis in neonates. The question is whether neonates acquire endemic hospital-adapted clones or incidentally occurring CoNS strains after birth during their hospital stay. Therefore, a prospective study was performed on the prevalence of CoNS in the stool of babies (born vaginally or by cesarean section) during their first days of life. Their clonal relatedness and potential to induce invasive disease were characterized...
May 30, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28550443/timing-to-antibiotic-therapy-in-septic-oncologic-patients-presenting-without-hypotension
#15
Kathleen Morneau, Gary B Chisholm, Frank Tverdek, Jeffrey Bruno, Katy M Toale
PURPOSE: Sepsis accounts for only 2% of the hospitalizations worldwide but more than 17% of total in-hospital mortality. Inappropriate antimicrobial selection and delays in appropriate therapy have been associated with reduced survival in severe sepsis and septic shock. No studies to date have exclusively targeted septic oncologic patients without hypotension. METHODS: This study was a retrospective chart review of 100 adult cancer patients presenting to the emergency department with sepsis without hypotension...
May 26, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28542614/evaluation-of-the-sepsis-flow-chip-assay-for-the-diagnosis-of-blood-infections
#16
Antonio Galiana, Javier Coy, Adelina Gimeno, Noemi Marco Guzman, Francisco Rosales, Esperanza Merino, Gloria Royo, Juan Carlos Rodríguez
BACKGROUND: Blood infections are serious complex conditions that generally require rapid diagnosis and treatment. The big challenge is to reduce the time necessary to make a diagnosis with current clinical microbiological methods so as to improve the treatment given to patients. METHODS: In this study, we assess for the first time the Sepsis Flow Chip assay, which is a novel diagnostic assay for simultaneous rapid-detection of the vast majority of bloodstream pathogens, including Gram-positive and Gram-negative bacteria and fungi, in the same assay, and for the detection of most common antibiotic resistance genes...
2017: PloS One
https://www.readbyqxmd.com/read/28538018/low-serum-angiopoietin-1-high-serum-angiopoietin-2-and-high-ang-2-ang-1-protein-ratio-are-associated-with-early-onset-sepsis-in-surinamese-newborns
#17
Rens Zonneveld, Rianne Jongman, Amadu Juliana, Wilco Zijlmans, Frans Plötz, Grietje Molema, Matijs van Meurs
PURPOSE: Vascular inflammation and leakage in sepsis is mediated by Angiopoietin-1 (Ang-1) and -2 (Ang-2) and their phosphorylation of the endothelial Tie-2 receptor. Levels of Ang-2 change in adults and children during sepsis, which is associated with severity of sepsis. This study investigates levels of Ang-1 and Ang-2 in newborns to gain insight in the vascular pathophysiology of early onset sepsis (EOS) within 72 hours after birth. METHODS: A prospective cohort study was performed amongst 71 Surinamese newborns treated with antibiotics for suspected EOS and 20 control newborns...
May 22, 2017: Shock
https://www.readbyqxmd.com/read/28528569/time-to-treatment-and-mortality-during-mandated-emergency-care-for-sepsis
#18
Christopher W Seymour, Foster Gesten, Hallie C Prescott, Marcus E Friedrich, Theodore J Iwashyna, Gary S Phillips, Stanley Lemeshow, Tiffany Osborn, Kathleen M Terry, Mitchell M Levy
BACKGROUND: In 2013, New York began requiring hospitals to follow protocols for the early identification and treatment of sepsis. However, there is controversy about whether more rapid treatment of sepsis improves outcomes in patients. METHODS: We studied data from patients with sepsis and septic shock that were reported to the New York State Department of Health from April 1, 2014, to June 30, 2016. Patients had a sepsis protocol initiated within 6 hours after arrival in the emergency department and had all items in a 3-hour bundle of care for patients with sepsis (i...
June 8, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28513809/oral-gentamicin-therapy-for-carbapenem-resistant-klebsiella-pneumoniae-gut-colonization-in-hematologic-patients-a-single-center-experience
#19
Paola Lambelet, Carlo Tascini, Simona Fortunato, Alessandro Stefanelli, Federico Simonetti, Chiara Vettori, Alessandro Leonildi, Francesco Menichetti
The mortality for carbapenem-resistant Klebsiella pneumoniae (KPC-Kp) infection ranges from 18 to 48% depending on the type of therapy. Mortality rates in hematologic patients are even higher, up to 85%. Gut decontamination with oral gentamicin might be an option to avoid a subsequent KPC-Kp infection in colonized patients. We treated 14 hematologic patients with oral gentamicin, 80 mg four times daily, for 7 to 25 days in order to eradicate KPC-Kp from the gut, starting oral gentamicin therapy when possible after the discontinuation of systemic antibiotic therapy...
May 17, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28494476/effect-of-the-shorter-stays-in-emergency-departments-time-target-policy-on-key-indicators-of-quality-of-care
#20
MULTICENTER STUDY
Peter Jones, James Le Fevre, Alana Harper, Susan Wells, Joanna Stewart, Elana Curtis, Papaarangi Reid, Shanthi Ameratunga
AIM: To determine whether implementation of a national health target called Shorter Stays in Emergency Departments impacted on clinical markers of quality of care. METHOD: A retrospective pre- and post-intervention study from 2006 to 2012 examined quality of care metrics for five different indicators at different sites in relation to the implementation of the target using a general linear model for times to treatment. Explanatory variables included period (pre- or post-target), ethnicity, age, deprivation and severity of condition...
May 12, 2017: New Zealand Medical Journal
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