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Time to antibiotic in sepsis

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https://www.readbyqxmd.com/read/28818544/trends-in-antimicrobial-resistance-in-bloodstream-infection-isolates-at-a-large-urban-hospital-in-malawi-1998-2016-a-surveillance-study
#1
Patrick Musicha, Jennifer E Cornick, Naor Bar-Zeev, Neil French, Clemens Masesa, Brigitte Denis, Neil Kennedy, Jane Mallewa, Melita A Gordon, Chisomo L Msefula, Robert S Heyderman, Dean B Everett, Nicholas A Feasey
BACKGROUND: Bacterial bloodstream infection is a common cause of morbidity and mortality in sub-Saharan Africa, yet few facilities are able to maintain long-term surveillance. The Malawi-Liverpool-Wellcome Trust Clinical Research Programme has done sentinel surveillance of bacteraemia since 1998. We report long-term trends in bloodstream infection and antimicrobial resistance from this surveillance. METHODS: In this surveillance study, we analysed blood cultures that were routinely taken from adult and paediatric patients with fever or suspicion of sepsis admitted to Queen Elizabeth Central Hospital, Blantyre, Malawi from 1998 to 2016...
August 14, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28809612/a-retrospective-study-evaluating-the-efficacy-of-identification-and-management-of-sepsis-at-a-district-level-hospital-internal-medicine-department-in-the-western-cape-province-south-africa-in-comparison-with-the-guidelines-stipulated-in-the-2012-survivi
#2
Raisa Bhikoo, Sarah Versfeld, M M De V Basson, Almero H Oosthuizen
BACKGROUND: Currently there is little information on the identification, management and outcomes of patients with sepsis in developing countries. Simple cost-effective measures such as accurate identification of patients with sepsis and early antibiotic administration are achievable targets, within reach without having to make use of unsustainable protocols constructed in developed countries. OBJECTIVES: To assess the ability of clinicians at a district-level hospital to identify and manage sepsis, and to assess patient outcome in terms of in-hospital mortality and length of hospital stay given the above management...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28807042/incidence-prevalence-and-management-of-mrsa-bacteremia-across-patient-populations-a-review-of-recent-developments-in-mrsa-management-and-treatment
#3
REVIEW
Ali Hassoun, Peter K Linden, Bruce Friedman
Methicillin-resistant Staphylococcus aureus (MRSA) infection is still a major global healthcare problem. Of concern is S. aureus bacteremia, which exhibits high rates of morbidity and mortality and can cause metastatic or complicated infections such as infective endocarditis or sepsis. MRSA is responsible for most global S. aureus bacteremia cases, and compared with methicillin-sensitive S. aureus, MRSA infection is associated with poorer clinical outcomes. S. aureus virulence is affected by the unique combination of toxin and immune-modulatory gene products, which may differ by geographic location and healthcare- or community-associated acquisition...
August 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28797245/fungal-biomarker-discovery-by-integration-of-classifiers
#4
João Pedro Saraiva, Marcus Oswald, Antje Biering, Daniela Röll, Cora Assmann, Tilman Klassert, Markus Blaess, Kristin Czakai, Ralf Claus, Jürgen Löffler, Hortense Slevogt, Rainer König
BACKGROUND: The human immune system is responsible for protecting the host from infection. However, in immunocompromised individuals the risk of infection increases substantially with possible drastic consequences. In extreme, systemic infection can lead to sepsis which is responsible for innumerous deaths worldwide. Amongst its causes are infections by bacteria and fungi. To increase survival, it is mandatory to identify the type of infection rapidly. Discriminating between fungal and bacterial pathogens is key to determine if antifungals or antibiotics should be administered, respectively...
August 10, 2017: BMC Genomics
https://www.readbyqxmd.com/read/28796391/impact-of-carbapenem-resistant-klebsiella-pneumoniae-cr-kp-infections-in-kidney-transplantation
#5
Giovanni Varotti, Ferdinando Dodi, Alessia Terulla, Gregorio Santori, Gabriele Mariottini, Massimo Bertocchi, Anna Marchese, Iris Fontana
BACKGROUND: Carbapenem-resistant Klebsiella pneumoniae (CR-KP) infections in solid organ transplant patients are progressively increasing and are associated with worse outcomes, although potential risk factors and therapeutic strategies are still not well defined. METHODS: We conducted a retrospective matched-pair analysis in which we compared 26 recipients CR-KP-positive after kidney transplantation (KT) with 52 CR-KP-negative patients transplanted in the same period, during a CR-KP outbreak occurred in our hospital...
August 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28795679/-research-progress-of-presepsin-in-sepsis-diagnosis
#6
Hui Yu, Yuanlin Zeng, Congyang Zhou
Sepsis is a frequently met syndrome with complex clinical symptoms and high mortality in emergency department. Early diagnosis of sepsis and timely treatment can improve survival. In recent years, the application of biomarkers [such as procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6)] are commonly used in the early diagnosis of sepsis, but their specificity and sensitivity are limited because of the long lag of report time. Soluble leukocyte differentiation antigen 14 sub type (sCD14-ST, namely presepsin) is a kind of novel biomarkers...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28790011/management-of-septic-shock-in-an-intermediate-care-unit
#7
Eric Meaudre, Cédric Nguyen, Claire Contargyris, Ambroise Montcriol, Erwan d'Aranda, Pierre Esnault, Mourad Bensalah, Bertrand Prunet, Julien Bordes, Philippe Goutorbe
BACKGROUND: While guidelines advocate goal-directed resuscitation based on timed bundles, the management of SS outside an ICU setting has been poorly studied in intermediate care units (IMCU). PATIENTS AND METHOD: We reviewed all cases of septic shock patients admitted to our IMCU between January 2013 and June 2014. The characteristics of sepsis, compliance of bundles, and outcomes were collected. The IMCU population was compared with the SS patients admitted to the ICU during the same period...
August 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28754611/transdermal-delivery-of-gentamicin-using-dissolving-microneedle-arrays-for-potential-treatment-of-neonatal-sepsis
#8
Patricia González-Vázquez, Eneko Larrañeta, Maelíosa T C McCrudden, Courtney Jarrahian, Annie Rein-Weston, Manjari Quintanar-Solares, Darin Zehrung, Helen McCarthy, Aaron J Courtenay, Ryan F Donnelly
Neonatal infections are a leading cause of childhood mortality in low-resource settings. World Health Organization guidelines for outpatient treatment of possible serious bacterial infection (PSBI) in neonates and young infants when referral for hospital treatment is not feasible include intramuscular gentamicin (GEN) and oral amoxicillin. GEN is supplied as an aqueous solution of gentamicin sulphate in vials or ampoules and requires health care workers to be trained in dose calculation or selection of an appropriate dose based on the patient's weight band and to have access to safe injection supplies and appropriate sharps disposal...
July 25, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28745260/implementation-of-an-antimicrobial-stewardship-program-in-a-neonatal-intensive-care-unit
#9
Nneka I Nzegwu, Michelle R Rychalsky, Loren A Nallu, Xuemei Song, Yanhong Deng, Amber M Natusch, Robert S Baltimore, George R Paci, Matthew J Bizzarro
OBJECTIVE To evaluate antimicrobial utilization and prescription practices in a neonatal intensive care unit (NICU) after implementation of an antimicrobial stewardship program (ASP). DESIGN Quasi-experimental, interrupted time-series study. SETTING A 54-bed, level IV NICU in a regional academic and tertiary referral center. PATIENTS AND PARTICIPANTS All neonates prescribed antimicrobials from January 1, 2011, to June 30, 2016, were eligible for inclusion. INTERVENTION Implementation of a NICU-specific ASP beginning July 2012...
July 26, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28745253/-gastrointestinal-symptoms-with-meningococcal-infection-emergence-of-neisseria-meningitidis-serogroup-w
#10
H F Wunderink, I N Vlasveld, M J Knol, A van der Ende, E H R van Essen, E J Kuijper
BACKGROUND: Meningococcal disease usually presents as meningitis and/or septicaemia, but can also present as pneumonia or arthritis. Since 2000, a worldwide increase in meningococcal disease is reported which is caused by a new virulent clone of serogroup W (MenW:cc11). This subtype is more likely to give an atypical clinical presentation and results in high mortality rates. CASE DESCRIPTION: A 68-year-old woman with polymyalgia rheumatica, managed with prednisone, developed an acute gastrointestinal syndrome of nausea, diarrhoea, vomiting, fever and chills...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28739652/in-hospital-quality-of-care-measures-for-pediatric-sepsis-syndrome
#11
Folafoluwa O Odetola, Gary Freed, Caroline Shevrin, Brian Madden, Julie McCormick, Kevin Dombkowski
BACKGROUND AND OBJECTIVES: Sepsis syndrome, comprising sepsis, severe sepsis, and septic shock, is a leading cause of child mortality and morbidity, for which the delivery of time-sensitive care leads to improved survival. We aimed to describe the development and testing of quality measures for in-hospital care of pediatric sepsis syndrome. METHODS: Seven measures of quality of care for children hospitalized with sepsis syndrome were developed by using an iterative process including literature review, development of concepts and candidate measures, and selection of measures for feasibility and importance by 2 panels of experts...
July 24, 2017: Pediatrics
https://www.readbyqxmd.com/read/28734608/sequence-specific-dna-solid-phase-extraction-in-an-on-chip-monolith-towards-detection-of-antibiotic-resistance-genes
#12
Radim Knob, Daniel B Nelson, Richard A Robison, Adam T Woolley
Antibiotic resistance of bacteria is a growing problem and presents a challenge for prompt treatment in patients with sepsis. Currently used methods rely on culturing or amplification; however, these steps are either time consuming or suffer from interference issues. A microfluidic device was made from black polypropylene, with a monolithic column modified with a capture oligonucleotide for sequence selective solid-phase extraction of a complementary target from a lysate sample. Porous properties of the monolith allow flow and hybridization of a target complementary to the probe immobilized on the column surface...
July 10, 2017: Journal of Chromatography. A
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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