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Time to antibiotic in sepsis

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https://www.readbyqxmd.com/read/28314653/assessment-of-risk-factors-for-candidemia-in-non-neutropenic-patients-hospitalized-in-internal-medicine-wards-a-multicenter-study
#1
M Falcone, G Tiseo, C Tascini, A Russo, E Sozio, G Raponi, C Rosin, P Pignatelli, P Carfagna, A Farcomeni, R Luzzati, F Violi, F Menichetti, M Venditti
BACKGROUND: An increasing prevalence of candidemia has been reported in Internal Medicine wards (IMWs). The aim of our study was to identify risk factors for candidemia among non-neutropenic patients hospitalized in IMWs. METHODS: A multicenter case-control study was performed in three hospitals in Italy. Patients developing candidemia (cases) were compared to patients without candidemia (controls) matched by age, time of admission and duration of hospitalization...
March 14, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28303104/mathematical-modeling-of-streptococcus-pneumoniae-colonization-invasive-infection-and-treatment
#2
Elisa Domínguez-Hüttinger, Neville J Boon, Thomas B Clarke, Reiko J Tanaka
Streptococcus pneumoniae (Sp) is a commensal bacterium that normally resides on the upper airway epithelium without causing infection. However, factors such as co-infection with influenza virus can impair the complex Sp-host interactions and the subsequent development of many life-threatening infectious and inflammatory diseases, including pneumonia, meningitis or even sepsis. With the increased threat of Sp infection due to the emergence of new antibiotic resistant Sp strains, there is an urgent need for better treatment strategies that effectively prevent progression of disease triggered by Sp infection, minimizing the use of antibiotics...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28276800/sepsis-alert-a-triage-model-that-reduces-time-to-antibiotics-and-length-of-hospital-stay
#3
Mari Rosenqvist, Emma Fagerstrand, Peter Lanbeck, Olle Melander, Per Åkesson
OBJECTIVE: To study if a modified triage system at an Emergency Department (ED) combined with educational efforts resulted in reduced time to antibiotics and decreased length of hospital stay (LOS) for patients with severe infection. METHODS: A retrospective, observational study comparing patients before and after the start of a new triage model at the ED of a University Hospital. After the implementation of the model, patients with fever and abnormal vital signs were triaged into a designated sepsis line (Sepsis Alert) for rapid evaluation by the attending physician supported by a infectious diseases (IDs) specialist...
February 28, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28272077/changing-trend-in-bacterial-etiology-and-antibiotic-resistance-in-sepsis-of-intramural-neonates-at-a-tertiary-care-hospital
#4
M P Roy, M Bhatt, V Maurya, S Arya, R Gaind, H K Chellani
BACKGROUND: Septicemia is an important cause of neonatal morbidity and mortality. However, organized data on causative organisms and their resistant pattern are scanty from developing countries. The changing trend in causative organisms and their antibiotic resistance is yet to be documented in India. The present study examines the trends in bacterial profile and antibiotic resistance of the organisms causing sepsis in hospitalized neonates. MATERIALS AND METHODS: A retrospective laboratory-based analysis of blood cultures obtained from Neonatal Intensive Care Unit of a tertiary care hospital in New Delhi was done for the period of 1999-2014, divided into five phases...
March 3, 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/28257335/serial-procalcitonin-predicts-mortality-in-severe-sepsis-patients-results-from-the-multicenter-procalcitonin-monitoring-sepsis-moses-study
#5
Philipp Schuetz, Robert Birkhahn, Robert Sherwin, Alan E Jones, Adam Singer, Jeffrey A Kline, Michael S Runyon, Wesley H Self, D Mark Courtney, Richard M Nowak, David F Gaieski, Stefan Ebmeyer, Sascha Johannes, Jan C Wiemer, Andrej Schwabe, Nathan I Shapiro
OBJECTIVES: To prospectively validate that the inability to decrease procalcitonin levels by more than 80% between baseline and day 4 is associated with increased 28-day all-cause mortality in a large sepsis patient population recruited across the United States. DESIGN: Blinded, prospective multicenter observational clinical trial following an Food and Drug Administration-approved protocol. SETTING: Thirteen U.S.-based emergency departments and ICUs...
March 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28240688/repeated-piperacillin-tazobactam-plasma-concentration-measurements-in-severely-obese-versus-nonobese-critically-ill-septic-patients-and-the-risk-of-under-and-overdosing
#6
Boris Jung, Martin Mahul, Dominique Breilh, Rachel Legeron, Jeremy Signe, Helene Jean-Pierre, Anne-Catrin Uhlemann, Nicolas Molinari, Samir Jaber
OBJECTIVE: Obesity and critical illness modify pharmacokinetics of antibiotics, but piperacillin-tazobactam continuous IV infusion pharmacokinetics has been poorly studied in obese critically ill patients. We aimed to compare pharmacokinetics of piperacillin in severely obese and nonobese patients with severe sepsis or septic shock. We hypothesized that plasma concentration variability would expose the critically ill to both piperacillin under and overdosing. METHODS: Prospective comparative study...
February 24, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28229030/retroperitoneal-necrotizing-fasciitis-masquerading-as-perianal-abscess-rare-and-perilous
#7
Anandhi Amaranathan, Ashok Kumar Sahoo, Deepak Barathi, Gomathi Shankar, Sarath Chandra Sistla
Necrotizing fasciitis is one of the uncommon presentations of a rapidly spreading subcutaneous tissue infection. Although the actual cause is unclear in many cases, most of them are due to the rapid proliferation of microorganisms. Retroperitoneal necrotizing fasciitis is extremely rare. It is a potentially lethal infection that requires immediate and aggressive surgical care. Early diagnosis is the key to a better prognosis. The possibility of retroperitoneal necrotizing fasciitis should be suspected in patients with symptoms of sepsis that are disproportionate to clinical findings...
January 17, 2017: Curēus
https://www.readbyqxmd.com/read/28226029/predictive-value-of-c-reactive-protein-in-critically-ill-patients-after-abdominal-surgery
#8
Frédéric Sapin, Patrick Biston, Michael Piagnerelli
OBJECTIVES: The development of sepsis after abdominal surgery is associated with high morbidity and mortality. Due to inflammation, it may be difficult to diagnose infection when it occurs, but measurement of C-reactive protein could facilitate this diagnosis. In the present study, we evaluated the predictive value and time course of C-reactive protein in relation to outcome in patients admitted to the intensive care unit (ICU) after abdominal surgery. METHODS: We included patients admitted to the ICU after abdominal surgery over a period of two years...
January 1, 2017: Clinics
https://www.readbyqxmd.com/read/28225634/journal-club-ultrasound-guided-breast-interventions-low-incidence-of-infectious-complications-with-use-of-an-uncovered-probe
#9
Chris Reisenauer, Robert T Fazzio, Gina Hesley
OBJECTIVE: The purpose of this study was to determine the incidence of infectious complications after ultrasound-guided breast interventions performed with an intermediate-level disinfection protocol without an ultrasound probe cover. MATERIALS AND METHODS: Two independent institutional databases were searched to identify breast infections in patients who underwent ultrasound-guided interventions between January 2005 and July 2013. The departments of radiology and infectious diseases independently maintained these databases...
February 22, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28219190/-efficacy-and-safety-of-procalcitonin-guidance-in-reducing-the-duration-of-antibiotic-treatment-of-sepsis-patients
#10
X L Xu, F D Yan, J Q Yu, Q H Chen, H Lin, R Q Zheng
Objective: To assesse the efficacy and safety of procalcitonin-guided antibiotic treatment of sepsis patients in intensive care units (ICU). Methods: A prospective, randomised, controlled trial was gone in ICU of Northern Jiangsu People's Hospital.Between January 2013 and December 2015.One hundred and fifty-six patients assessed for eligibility were randomly assigned to the procalcitonin-guided group (PCT group, 79) or to regular antibiotic group (RAT group, 77). Patients who received antibiotics for presumed infection according to principle of antimicrobial usage...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28193899/structure-of-a-lipid-a-phosphoethanolamine-transferase-suggests-how-conformational-changes-govern-substrate-binding
#11
Anandhi Anandan, Genevieve L Evans, Karmen Condic-Jurkic, Megan L O'Mara, Constance M John, Nancy J Phillips, Gary A Jarvis, Siobhan S Wills, Keith A Stubbs, Isabel Moraes, Charlene M Kahler, Alice Vrielink
Multidrug-resistant (MDR) gram-negative bacteria have increased the prevalence of fatal sepsis in modern times. Colistin is a cationic antimicrobial peptide (CAMP) antibiotic that permeabilizes the bacterial outer membrane (OM) and has been used to treat these infections. The OM outer leaflet is comprised of endotoxin containing lipid A, which can be modified to increase resistance to CAMPs and prevent clearance by the innate immune response. One type of lipid A modification involves the addition of phosphoethanolamine to the 1 and 4' headgroup positions by phosphoethanolamine transferases...
February 28, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28187059/clinical-and-microbiologic-characteristics-of-early-onset-sepsis-among-vlbw-infants-opportunities-for-antibiotic-stewardship
#12
Sagori Mukhopadhyay, Karen M Puopolo
BACKGROUND: Most very-low birth weight (birth weight <1500 grams, VLBW) infants receive empiric antibiotics for risk of early-onset sepsis (EOS). The objective of this study was to determine the characteristics of VLBW infants with culture-confirmed EOS at a single center during 25 years, to identify opportunities for antibiotic stewardship. METHODS: Retrospective cohort study including VLBW infants admitted from 1990-2015. EOS was defined as isolation of a pathogen in blood or cerebrospinal fluid culture obtained < 72 hours of age...
February 9, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28177854/risk-factors-for-30-day-hospital-re-admission-with-an-infectious-complication-after-lower-extremity-vascular-procedures
#13
Joseph C Melvin, Jamie B Smith, Robin L Kruse, Todd R Vogel
BACKGROUND: Lowering the 30-d re-admission rate after vascular surgery offers the potential to improve healthcare quality. This study evaluated re-admission associated with infections after open and endovascular lower extremity (LE) procedures for peripheral artery disease (PAD). METHODS: Patients admitted for elective LE procedures for PAD were selected from the Cerner Health Facts(®) database. Chi-square analysis evaluated the characteristics of the index admission associated with infection at 30-d re-admission...
February 8, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28155332/reducing-antibiotic-exposure-in-suspected-neonatal-sepsis
#14
Christopher Henry Grant, Andrew Arnott, Tim Brook, Alice Horne, William Hurst, Sarah Kelly, Christina Lang, Madeleine Payne, Hannah Pert, Sarah Sparrow, Pakaye Anne Dokubo, Natalie Bee, Ruth Gibbs, Julie-Clare Becher
Prolonged antibiotic therapy is associated with antimicrobial resistance and increased mortality in preterm infants. We evaluated the impact of an automatic stop order (ASO) and C-reactive protein (CRP) on the duration of antibiotics and level of intervention in infants screened for early-onset sepsis who had negative cultures. We introduced an ASO for low-risk infants, then, consequently, for all infants treated for suspected sepsis. We subsequently introduced a single CRP measurement at 36 hours. Between 2011 and 2014, 4 time periods were studied, at baseline and after each intervention...
January 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28153472/conservative-management-of-distal-leg-necrosis-in-lung-transplant-recipients
#15
F Aigner, M Husmann, L C Huber, C Benden, M M Schuurmans
Critical limb ischemia (CLI) with distal leg necrosis in lung transplant recipients (LTR) is associated with a high risk for systemic infection and sepsis. Optimal management of CLI has not been defined so far in LTR. In immunocompetent individuals with leg necrosis, surgical amputation would be indicated and standard care. We report on the outcome of four conservatively managed LTR with distal leg necrosis due to peripheral arterial disease (PAD) with medial calcification of the distal limb vessels. Time interval from lung transplantation to CLI ranged from four years (n = 1) to more than a decade (n = 3)...
January 28, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28141683/fever-in-the-emergency-department-predicts-survival-of-patients-with-severe-sepsis-and-septic-shock-admitted-to-the-icu
#16
Jonas Sundén-Cullberg, Rebecca Rylance, Jesper Svefors, Anna Norrby-Teglund, Jonas Björk, Malin Inghammar
OBJECTIVES: To study the prognostic value of fever in the emergency department in septic patients subsequently admitted to the ICU. DESIGN: Observational cohort study from the Swedish national quality register for sepsis. SETTING: Thirty ICU's in Sweden. PATIENTS: Two thousand two hundred twenty-five adults who were admitted to an ICU within 24 hours of hospital arrival with a diagnosis of severe sepsis or septic shock were included...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28135233/use-of-colistin-in-a-neonatal-intensive-care-unit-a-cohort-study-of-65-patients
#17
Eren Çağan, Evrim Kıray Baş, Hüseyin Selim Asker
BACKGROUND The emergence of infections related to multidrug-resistant Gram-negative bacilli (MDR-GNB) reintroduced the use of colistin, an antibiotic that was previously abandoned due to adverse effects. However, because of its limited use in neonatal intensive care units, there is very little data about the effectiveness and safety of colistin in children and newborns. In this study, which will be the largest case study in the literature, we aimed to evaluate the effectiveness and safety of colistin in full-term and preterm newborns...
January 30, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28134708/chorioamnionitis-time-for-a-new-approach
#18
Tara M Randis, Richard A Polin, George Saade
PURPOSE OF REVIEW: The association between maternal chorioamnionitis and early-onset sepsis in the newborn has long been recognized, and established guidelines recommend treating all exposed infants with broad-spectrum antibiotics until infection can be ruled out. However, recent data suggest that close observation of well appearing term and late-preterm newborns may be a preferable alternative. The present review addresses the evidence in favor of newly proposed changes to the diagnosis and management of women and newborns following a maternal diagnosis of chorioamnionitis...
April 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28131458/biomarkers-for-the-diagnosis-of-neonatal-sepsis-and-necrotizing-entercolitis-clinical-practice-guidelines
#19
Margaret Gilfillan, Vineet Bhandari
Sepsis and necrotizing enterocolitis are major contributors to morbidity and mortality in neonates, especially in those born preterm. While therapeutic interventions are available for both (for e.g. antibiotics), a major dilemma is early diagnosis so that these interventions can be done in a timely manner. As clinical evaluation alone is unreliable in identifying infants in the early stages of neonatal sepsis or necrotizing enterocolitis, there is a need to find specific biomarkers associated with these conditions to improve diagnostic capabilities...
January 25, 2017: Early Human Development
https://www.readbyqxmd.com/read/28126452/early-sepsis-bundle-compliance-for-non-hypotensive-patients-with-intermediate-versus-severe-hyperlactemia
#20
Daniel E Leisman, Jason A Zemmel D'Amore, Jeanie L Gribben, Mary Frances Ward, Kevin D Masick, Andrea R Bianculli, Kathryn H Bradburn, John K D'Angelo, Martin E Doerfler
OBJECTIVE: To compare the association of 3-h sepsis bundle compliance with hospital mortality in non-hypotensive sepsis patients with intermediate versus severe hyperlactemia. METHODS: This was a cohort study of all non-hypotensive, hyperlactemic sepsis patients captured in a prospective quality-improvement database, treated October 2014 to September 2015 at five tertiary-care centers. We defined sepsis as 1) infection, 2) ≥2 SIRS criteria, and 3) ≥1 organ dysfunction criterion...
January 15, 2017: American Journal of Emergency Medicine
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