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Time to antibiotic in sepsis

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https://www.readbyqxmd.com/read/27908337/source-identification-and-source-control
#1
REVIEW
Zeke P Oliver, Jack Perkins
Identifying sources of infection and establishing source control is an essential component of the workup and treatment of sepsis. Investigation with history, physical examination, laboratory tests, and imaging can in identifying sources of infection. All organ systems have the potential to develop sources of infection. However, there are inherent difficulties presented by some that require additional diligence, namely, urinalysis, chest radiographs, and intraabdominal infections. Interventions include administration of antibiotics and may require surgical or other specialist intervention...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27895446/a-case-of-fatal-sepsis-due-to-multidrug-resistant-corynebacterium-striatum
#2
M Chatzopoulou, T Koufakis, I Voulgaridi, I Gabranis, M Tsiakalou
BACKGROUND: Although non-diphtheria corynebacteria have traditionally been regarded as avirulent members of human bacterial flora, their pathogenic potential is increasingly recognized in our time. Reasons for this include the prolonged survival of severely ill and immunocompromised patients, the development of more invasive diagnostic and therapeutic procedures and the sub-optimal use of antibiotics that disrupts normal microbial balance and favors superinfections. CASE REPORT: We present a rare case of sepsis due to multidrug-resistant Corynebacterium striatum in a 76-year-old host...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27895015/protective-effects-of-human-and-mouse-soluble-scavenger-like-cd6-lymphocyte-receptor-in-a-lethal-model-of-polymicrobial-sepsis
#3
Mario Martínez-Florensa, Marta Consuegra-Fernández, Fernando Aranda, Noelia Armiger-Borràs, Marianna Di Scala, Esther Carrasco, Jerónimo Pachón, Jordi Vila, Gloria González-Aseguinolaza, Francisco Lozano
Sepsis still constitutes an unmet clinical need, which could benefit from novel adjunctive strategies to conventional antibiotic therapy. The soluble form of the scavenger-like human CD6 lymphocyte receptor (shCD6) binds to key pathogenic components from Gram-positive and -negative bacteria, and shows time- and dose-dependent efficacy in mouse models of monobacterial sepsis. The objective of the present work was to demonstrate the effectiveness of infusing mouse and human sCD6 by different systemic routes, either alone or as adjunctive therapy to gold-standard antibiotics, in a lethal model of polymicrobial sepsis...
November 28, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27886531/coagulation-and-sepsis
#4
REVIEW
Marcel Levi, Tom van der Poll
Severe sepsis is almost invariably associated with systemic activation of coagulation. There is ample evidence that demonstrates a wide-ranging cross-talk between hemostasis and inflammation, which is probably implicated in the pathogenesis of organ dysfunction in patients with sepsis. Inflammation not only leads to initiation and propagation of coagulation activity, but coagulation also markedly influences inflammation. Molecular mechanisms that play a role in inflammation-induced effects on coagulation have been recognized in much detail...
November 19, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27879561/late-therapeutic-intervention-with-antibiotics-and-fluid-resuscitation-allows-for-a-prolonged-disease-course-with-high-survival-in-a-severe-murine-model-of-sepsis
#5
Allison M Steele, Marlene E Starr, Hiroshi Saito
Current animal models of sepsis often incorporate antibiotics to be consistent with clinical standards for treatment of patients in the ICU. However, such experimental intervention is commonly initiated very early after infectious insult, which likely blunts the progression of systemic inflammation and downstream pathology. The objective of this study was to establish an animal model of sepsis with delayed therapeutic intervention, allowing a longer disease course and downstream pathology, but still resulting in a high survival rate...
November 22, 2016: Shock
https://www.readbyqxmd.com/read/27869407/community-acquired-staphylococcus-aureus-bacteremia-in-children-a-cohort-study-for-2010-2014
#6
Guadalupe Pérez, Soledad Martiren, Vanesa Reijtman, Romina Romero, Alejandra Mastroianni, Lidia Casimir, Rosa Bologna
INTRODUCTION: Community-acquired methicillin-resistant Staphylococcus aureus infections are a common, serious problem in pediatrics. OBJETIVE: To describe antibiotic resistance in community-acquired Staphylococcus aureus (SA) bacteremias. To compare the characteristics of SA bacteremias in terms of methicillin resistance. MATERIALS AND METHODS: Prospective cohort enrolled between January 2010 and December 2014. Inclusion criteria: infants and children between 30 days old and 16 years old hospitalized at the Hospital de Pediatria J...
December 1, 2016: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/27857510/the-diagnostic-accuracy-of-serum-procalcitonin-for-bacteremia-in-critically-ill-children
#7
Marianne E Nellis, Steven Pon, Ashley E Giambrone, Nana E Coleman, Jonathan Reiss, Elizabeth Mauer, Bruce M Greenwald
BACKGROUND: Bacterial sepsis is frequently encountered in children admitted to the Pediatric Intensive Care Unit (PICU) and requires early recognition and treatment. Procalcitonin (PCT) is a serum biomarker with a high sensitivity to predict bacteremia in critically-ill adults. This study sought to evaluate the diagnostic accuracy of PCT for bacteremia in febrile children in the PICU. METHODS: This retrospective observational study used data from children admitted to the PICU from October 2010 to October 2012...
November 2016: Infectious Diseases in Clinical Practice: IDCP
https://www.readbyqxmd.com/read/27845340/plastic-vs-self-expandable-metal-stents-for-palliation-in-malignant-biliary-obstruction-a-series-of-meta-analyses
#8
Majid A Almadi, Alan Barkun, Myriam Martel
OBJECTIVES: Self-expandable metal stents (SEMS) are thought to have an advantage over plastic stents in achieving biliary drainage. METHODS: We performed a systematic search of MEDLINE, EMBASE, Scopus, CENTRAL, and ISI Web of knowledge databases, from January 1980 to September 2015, for randomized-controlled trials (RCTs) comparing SEMS vs. plastic stents in the palliation of malignant biliary obstruction. Primary outcomes were durations of stent patency, patient survival, and 30-day mortality...
November 15, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27807818/impact-of-a-high-loading-dose-of-amikacin-in-patients-with-severe-sepsis-or-septic-shock
#9
Nicolas Allou, Astrid Bouteau, Jérôme Allyn, Aurélie Snauwaert, Dorothée Valance, Julien Jabot, Bruno Bouchet, Richard Galliot, Laure Corradi, Philippe Montravers, Pascal Augustin
BACKGROUND: The therapeutic effect of aminoglycosides is highest and optimal when the peak plasma concentration (C max)/minimal inhibitory concentration (MIC) ratio is between 8 and 10. The French guidelines recommend to use high doses of aminoglycosides for empiric antibiotic therapy in patients suffering from severe sepsis or septic shock. In clinical practice, the recommended target is an amikacin C max between 60 and 80 mg/L, which corresponds to approximately 8 times the MIC breakpoint, as defined by the European Committee on Antimicrobial Susceptibility Testing...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27785569/-clostridium-difficile-infections-in-geriatric-patients
#10
R Simmerlein, A Basta, M Gosch
Clostridium difficile is the main cause of nosocomial antibiotic-associated diarrhea in adults in Europe and North America. Infections with C. difficile typically occur in elderly patients with comorbidities and prior antibiotic therapy. Other risk factors are proton pump inhibitors, which are taken by many elderly patients. The main virulence factors are toxins A and B. The clinical spectrum ranges from asymptomatic colonization to severe disease with abdominal complications and sepsis. The current diagnostic gold standard is anaerobic culture but is impractical in routine use due to the long duration...
October 26, 2016: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/27771187/optimising-meropenem-dosing-in-critically-ill-australian-indigenous-patients-with-severe-sepsis
#11
Danny Tsai, Penelope Stewart, Rajendra Goud, Stephen Gourley, Saliya Hewagama, Sushena Krishnaswamy, Steven C Wallis, Jeffrey Lipman, Jason A Roberts
Currently there are no pharmacokinetic (PK) data to guide antibiotic dosing in critically ill Australian Indigenous patients with severe sepsis. This study aimed to determine whether the population pharmacokinetics of meropenem were different between critically ill Australian Indigenous and critically ill Caucasian patients. Serial plasma and urine samples as well as clinical and demographic data were collected over two dosing intervals from critically ill Australian Indigenous patients. Plasma meropenem concentrations were assayed by validated chromatography...
September 29, 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27769193/maternal-near-miss-and-quality-of-care-in-a-rural-rwandan-hospital
#12
Richard Kalisa, Stephen Rulisa, Thomas van den Akker, Jos van Roosmalen
BACKGROUND: The WHO Maternal Near Miss (MNM) approach was developed to evaluate and improve quality of obstetric care worldwide. This study aimed to study the incidence of MNM and quality of care at a district hospital in rural Rwanda by applying this approach. METHODS: A facility based, prospective cohort study conducted at a district hospital in rural Rwanda between June 2013 and December 2014. Subjects were followed from time of admission to discharge or death...
October 21, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27763961/no-incidence-of-postoperative-knee-sepsis-with-suprapatellar-nailing-of-open-tibia-fractures
#13
Phillip M Mitchell, Benjamin M Weisenthal, Cory A Collinge
OBJECTIVE: To evaluate the incidence of knee sepsis following suprapatellar nailing of open tibia fractures. DESIGN: Retrospective SETTING:: ACS Level 1 trauma centerPatients/Participants: We reviewed 139 open tibia fractures that underwent suprapatellar nailing as definitive treatment over a five-year period (January 1, 2011 to January 1, 2016). The majority of patients (90%, n=126) underwent intramedullary nailing at the time of their initial surgery. We defined knee sepsis as intra-articular infection requiring operative debridement, either open or arthroscopically, within one month's time...
October 1, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27756063/rapid-identification-of-bacterial-antibiotic-resistance-by-qpcr-in-infants-with-gram-negative-septicaemia-a-proof-of-concept-study
#14
Hugh Simon Lam, Kathy Y Y Chan, Margaret Ip, Kam Tong Leung, Norman W S Lo, Raymond P O Wong, Karen Li, Pak Cheung Ng
BACKGROUND: Neonatal sepsis remains an important cause of neonatal morbidity and mortality. Tools to rapidly predict antibiotic resistance in neonatal sepsis would be extremely valuable. OBJECTIVES: To develop quantitative polymerase chain reaction (qPCR) primer/probe sets that can rapidly detect antibiotic resistance genes common to a neonatal unit, and to investigate the feasibility of direct detection of antibiotic resistance genes in whole blood of infants with Gram-negative septicaemia without first isolating the organism...
October 19, 2016: Neonatology
https://www.readbyqxmd.com/read/27752318/a-collaborative-improvement-project-by-an-nhs-emergency-department-and-scottish-ambulance-paramedics-to-improve-the-identification-and-delivery-of-sepsis-6
#15
Martin Carberry, John Harden
Early identification of patients with sepsis is key to the delivery of the sepsis 6 bundle including antibiotic therapy within an hour.[1-3] Demand versus capacity challenges in the Emergency Department (ED) led to delays in antibiotic and sepsis 6 delivery. An alerting tool was developed that provided criteria for Scottish Ambulance Service (SAS) Paramedics to alert the ED of potential sepsis patients. Data from patients presenting to the ED prior to the alerting process commencing (n=50) and during alerting (n=50) were analysed, a questionnaire was used to ascertain feedback from all staff groups; nurses doctors, and paramedics (n=38)...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27749512/2016-update-for-the-rogers-textbook-of-pediatric-intensive-care-recognition-and-initial-management-of-shock
#16
Julie C Fitzgerald, Scott L Weiss, Niranjan Kissoon
OBJECTIVE: To review important articles in the field of pediatric shock and pediatric septic shock published subsequent to the Fifth Edition of the Rogers' Textbook of Pediatric Intensive Care. DATA SOURCES: The U.S. National Library of Medicine PubMed (www.ncbi.nlm.nih.gov/pubmed) was searched for combination of the term "pediatric" and the following terms: "sepsis, septic shock, shock, antibiotics, extracorporeal membrane oxygenation, and steroid." The abstract lists generated by these searches were screened for potential inclusion...
November 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27737909/effect-of-antibiotic-use-on-antimicrobial-antibiotic-resistance-and-late-onset-neonatal-infections-over-25%C3%A2-years-in-an-australian-tertiary-neonatal-unit
#17
David Carr, Elizabeth Helen Barnes, Adrienne Gordon, David Isaacs
BACKGROUND: Antibiotic resistance is a worldwide problem. We describe 25 years of responsible antibiotic use in a tertiary neonatal unit. METHODS: Data on neonatal infections and antibiotic use were collected prospectively from 1990 to 2014 at a single tertiary Sydney neonatal intensive care unit attached to a maternity unit. There are approximately 5500 deliveries and 900 nursery admissions per year. RESULTS: The mean annual rate of late-onset sepsis was 1...
October 13, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27730778/antibiotic-lock-therapy-in-the-era-of-gram-negative-resistance
#18
Rajeev Soman, Neha Gupta, Mitesh Suthar, Jatin Kothari, Alan Almeida, Anjali Shetty, Camilla Rodrigues
BACKGROUND: Central-line-associated blood-stream infection (CLABSI) is a highly consequential nosocomial infection. The most effective management includes the removal of the infected catheter. Retention of the catheter and antibiotic lock therapy (ALT) along with systemic antibiotics may be attempted only if there are unusual extenuating circumstances. CLABSIs due to Gram-negative bacteria (GNB) is more common in our setting and the organisms are often highly resistant. Hence, there is a need to explore the use of novel antimicrobials for catheter lock solutions along with antibiofilm agents...
February 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27729010/significance-of-soluble-triggering-receptor-expressed-on-myeloid-cells-1-elevation-in-patients-admitted-to-the-intensive-care-unit-with-sepsis
#19
P E Charles, R Noel, F Massin, J Guy, P E Bollaert, J P Quenot, S Gibot
BACKGROUND: Among septic patients admitted to the intensive care unit (ICU), early recognition of those with the highest risk of death is of paramount importance. Since clinical judgment is sometimes uncertain biomarkers could provide additional information likely to guide critical illness management. We evaluated the prognostic value of soluble Triggering Receptor Expressed by Myeloid cells 1 (sTREM-1), procalcitonin (PCT) and leucocyte surface expression of CD64. METHODS: This was a prospective cohort study, which included 190 septic patient admitted to the ICU in two hospitals...
October 12, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27713888/current-understanding-in-source-control-management-in-septic-shock-patients-a-review
#20
Leonel Lagunes, Belen Encina, Sergio Ramirez-Estrada
Sepsis and septic shock is one of the leading causes of death worldwide. Antibiotics, fluid resuscitation support of vital organ function and source control are the cornerstones for the treatment of these patients. Source control measures include all those actions taken in the process of care to control the foci of infection and to restore optimal function of the site of infection. Source control represents the multidisciplinary team required in order to optimize critical care for septic shock patients. In the last decade an increase interest on fluids, vasopressors, antibiotics, and organ support techniques in all aspects whether time, dose and type of any of those have been described...
September 2016: Annals of Translational Medicine
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