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Time to antibiotic in sepsis

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https://www.readbyqxmd.com/read/28542614/evaluation-of-the-sepsis-flow-chip-assay-for-the-diagnosis-of-blood-infections
#1
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
#2
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
#3
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...
May 21, 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
#4
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
#5
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
https://www.readbyqxmd.com/read/28492525/neonatal-sepsis-in-rural-india-timing-microbiology-and-antibiotic-resistance-in-a-population-based-prospective-study-in-the-community-setting
#6
P Panigrahi, D S Chandel, N I Hansen, N Sharma, S Kandefer, S Parida, R Satpathy, L Pradhan, A Mohapatra, S S Mohapatra, P R Misra, N Banaji, J A Johnson, J G Morris, I H Gewolb, R Chaudhry
OBJECTIVE: To examine the timing and microbiology of neonatal sepsis in a population-based surveillance in the Indian community setting. STUDY DESIGN: All live born infants in 223 villages of Odisha state were followed at home for 60 days. Suspect sepsis cases were referred to study hospitals for further evaluation including blood culture. RESULTS: Of 12 622 births, 842 were admitted with suspected sepsis of whom 95% were 4 to 60 days old...
May 11, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28485627/reply-to-the-timing-of-early-antibiotics-and-hospital-mortality-in-sepsis-playing-devil-s-advocate
#7
Vincent Liu, Vikram Fielding-Singh, Theodore J Iwashyna, Jay Bhattacharya, Gabriel Escobar
No abstract text is available yet for this article.
May 9, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28469892/chasing-the-golden-hour-lessons-learned-from-improving-initial-neutropenic-sepsis-management
#8
Caroline Forde, Paula Scullin
Neutropenic sepsis remains a time critical and potentially fatal complication of systemic anti-cancer therapy. A target 'door to needle' time of one hour for first dose empirical intravenous antibiotics continues to be promoted nationally. A baseline audit (June 2011) highlighted shortfalls in care in the Belfast Trust, with only 15% of patients receiving antibiotics within sixty minutes. A multi-professional group within the Trust was established to try and initiate the improvements in neutropenic sepsis recognition and initial management that were urgently required...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28466151/effect-of-a-multifaceted-educational-intervention-for-anti-infectious-measures-on-sepsis-mortality-a-cluster-randomized-trial
#9
Frank Bloos, Hendrik Rüddel, Daniel Thomas-Rüddel, Daniel Schwarzkopf, Christine Pausch, Stephan Harbarth, Torsten Schreiber, Matthias Gründling, John Marshall, Philipp Simon, Mitchell M Levy, Manfred Weiss, Andreas Weyland, Herwig Gerlach, Tobias Schürholz, Christoph Engel, Claudia Matthäus-Krämer, Christian Scheer, Friedhelm Bach, Reimer Riessen, Bernhard Poidinger, Karin Dey, Norbert Weiler, Andreas Meier-Hellmann, Helene H Häberle, Gabriele Wöbker, Udo X Kaisers, Konrad Reinhart
PURPOSE: Guidelines recommend administering antibiotics within 1 h of sepsis recognition but this recommendation remains untested by randomized trials. This trial was set up to investigate whether survival is improved by reducing the time before initiation of antimicrobial therapy by means of a multifaceted intervention in compliance with guideline recommendations. METHODS: The MEDUSA study, a prospective multicenter cluster-randomized trial, was conducted from July 2011 to July 2013 in 40 German hospitals...
May 2, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28444845/preoperative-sepsis-is-an-independent-risk-factor-for-major-complications-after-lower-extremity-amputation-in-patients-with-diabetic-end-stage-renal-disease
#10
Young Hwan Park, Jong Hyub Song, Gi Won Choi, Hak Jun Kim
AIM: Patients with diabetic end-stage renal disease (ESRD) are at increased risk of lower extremity amputation (LEA) and postoperative complications compared to those without diabetic ESRD. This study sought to determine the factors that influence complications following LEA in patients with diabetic ESRD. METHODS: A total of 41 patients with diabetic ESRD (total of 46 amputations) who underwent LEA were enrolled in this study. The electronic medical records were retrospectively reviewed to identify the predictors of postoperative complications...
April 26, 2017: Nephrology
https://www.readbyqxmd.com/read/28441217/an-unusual-case-of-sepsis-and-petechial-rash
#11
Christina Gardner
This article describes a man who presented to the ED in acute distress with signs and symptoms of sepsis, pneumonia, and a new petechial rash on his chest. He was eventually diagnosed with Rocky Mountain spotted fever. Aggressive treatment of sepsis and timely administration of empiric antibiotics were lifesaving in this situation.
May 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28440737/heart-rate-variability-depression-in-porcine-peritonitis-induced-sepsis-without-organ-failure
#12
Dagmar Jarkovska, Lenka Valesova, Jiri Chvojka, Jan Benes, Vojtech Danihel, Jitka Sviglerova, Lukas Nalos, Martin Matejovic, Milan Stengl
Depression of heart-rate variability (HRV) in conditions of systemic inflammation has been shown in both patients and experimental animal models and HRV has been suggested as an early indicator of sepsis. The sensitivity of HRV-derived parameters to the severity of sepsis, however, remains unclear. In this study we modified the clinically relevant porcine model of peritonitis-induced sepsis in order to avoid the development of organ failure and to test the sensitivity of HRV to such non-severe conditions. In 11 anesthetized, mechanically ventilated and instrumented domestic pigs of both sexes, sepsis was induced by fecal peritonitis...
May 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28439133/importance-of-pharmacy-involvement-in-the-treatment-of-sepsis
#13
Joseph B Cavanaugh, Jesse B Sullivan, Nicole East, Jessica N Nodzon
Purpose: A review of the impact of pharmacists on appropriate medication selection, timing of administration, and as members of a multidisciplinary sepsis response team. Summary: Early goal-directed therapy (EGDT), currently recommended by the 2013 Surviving Sepsis Campaign guidelines for the management of patients with sepsis, includes the administration of appropriate antibiotics in patients with septic shock within the first hour. Multidisciplinary teams containing pharmacists have been shown to decrease time to antibiotic delivery, time to antibiotic administration, and patient mortality...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28435890/gene-expression-profile-of-human-cytokines-in-response-to-burkholderia-pseudomallei-infection
#14
Shivankari Krishnananthasivam, Harindra Darshana Sathkumara, Enoka Corea, Mohan Natesan, Aruna Dharshan De Silva
Melioidosis is an underreported infectious disease, caused by the Gram-negative bacterium Burkholderia pseudomallei. Understanding the disease susceptibility and pathogenesis is crucial for developing newer diagnostic and therapeutic strategies for this life-threatening infection. In this study, we aimed to analyze the gene expression levels of important cytokines in melioidosis patients and establish useful correlates with disease biomarkers compared to cases of sepsis infection caused by other pathogens and healthy individuals...
March 2017: MSphere
https://www.readbyqxmd.com/read/28427133/-effects-of-application-of-vancomycin-in-the-early-stage-of-patients-with-extremely-severe-burn
#15
Z Zhu, G W Cao, J J Bao, Z H Hu, Z Shen, H Tao, B Cao, F Xu
Objective: To evaluate the effects of application of vancomycin in the early stage of patients with extremely severe burn, in order to provide reference to drug for anti-infection treatment in the early stage of patients with extremely severe burn. Methods: Data of 15 patients of Kunshan explosion on August 2nd, 2014, admitted to the Department of Intensive Care in our hospital were retrospectively analyzed. The clinical efficacy of continuously intravenous dripping of vancomycin (combined with imipenem) in the early stage of burns (before and on post burn day 14) was analyzed...
April 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28426384/a-2-year-old-boy-with-circulatory-failure-owing-to-streptococcal-toxic-shock-syndrome-case-report
#16
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28422970/the-gut-microbiota-as-a-modulator-of-innate-immunity-during-melioidosis
#17
Jacqueline M Lankelma, Emma Birnie, Tassili A F Weehuizen, Brendon P Scicluna, Clara Belzer, Riekelt H Houtkooper, Joris J T H Roelofs, Alex F de Vos, Tom van der Poll, Andries E Budding, W Joost Wiersinga
BACKGROUND: Melioidosis, caused by the Gram-negative bacterium Burkholderia pseudomallei, is an emerging cause of pneumonia-derived sepsis in the tropics. The gut microbiota supports local mucosal immunity and is increasingly recognized as a protective mediator in host defenses against systemic infection. Here, we aimed to characterize the composition and function of the intestinal microbiota during experimental melioidosis. METHODOLOGY/PRINCIPAL FINDINGS: C57BL/6 mice were infected intranasally with B...
April 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28419265/validation-of-the-sepsis-metascore-for-diagnosis-of-neonatal-sepsis
#18
Timothy E Sweeney, James L Wynn, María Cernada, Eva Serna, Hector R Wong, Henry V Baker, Máximo Vento, Purvesh Khatri
What’s Known on This Subject.: Neonates are at increased risk for developing sepsis, but this population often exhibits ambiguous clinical signs that complicate the diagnosis of infection. No biomarker has yet shown enough diagnostic accuracy to rule out sepsis at the time of clinical suspicion. What This Study Adds.: We show that a gene-expression-based signature is an accurate objective measure of the risk of sepsis in a neonate or preterm infant, and it substantially improves diagnostic accuracy over that of commonly used laboratory-based testing...
April 13, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28414686/severe-sepsis-and-septic-shock-cases-meeting-guidelines-among-patients-in-a-university-hospital-setting
#19
J A Charrier, C L Steen, E Borrero
BACKGROUND: A diagnosis of severe sepsis or septic shock has been shown to significantly increase mortality rate independent of other factors. Research has revealed all cause hospital case fatality rates have declined yet the percentage of severe sepsis cases continues to increase and age-adjusted mortality rates from severe sepsis and septic shock has significantly increased during the same time period. Patients with severe sepsis demonstrate ongoing mortality rate increases for up to 2 years following hospitalization when compared to aged matched controls of nonseptic patients...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28411298/detecting-sepsis-are-two-opinions-better-than-one
#20
Poushali Bhattacharjee, Matthew M Churpek, Ashley Snyder, Michael D Howell, Dana P Edelson
The diagnosis of sepsis requires that objective criteria be met with a corresponding subjective suspicion of infection. We conducted a study to characterize the agreement between different providers' suspicion of infection and the correlation with patient outcomes using prospective data from a general medicine ward. Registered nurse (RN) suspicion of infection was collected every 12 hours and compared with medical doctor or advanced practice professional (MD/APP) suspicion, defined as an existing order for antibiotics or a new order for blood or urine cultures within the 12 hours before nursing screen time...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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