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Time to antibiotic in sepsis

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https://www.readbyqxmd.com/read/28077047/extended-infusion-compared-to-standard-infusion-cefepime-as-empiric-treatment-of-febrile-neutropenia
#1
Rebekah H Wrenn, David Cluck, LeAnne Kennedy, Christopher Ohl, John C Williamson
Background Extended infusion (EI) dosing provides a longer time above the minimum inhibitory concentration, which is important for the clinical success of β-lactam antibiotics, especially for patients with impaired immunity. The aim of this study was to determine the feasibility and clinical impact of administering cefepime by EI as treatment of febrile neutropenia. Methods This was a prospective, randomized, comparative pilot study. All patients received cefepime 2 g IV every 8 h, with the first dose administered using a 30-min infusion...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28071947/presacral-abscess-as-a-rare-complication-of-sacral-nerve-stimulator-implantation
#2
A Gumber, S Ayyar, H Varia, S Pettit
A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28071865/the-impact-of-evidence-based-sepsis-guidelines-on-emergency-department-clinical-practice-a-pre-post-medical-record-audit
#3
Bernadine Romero, Margaret Fry, Michael Roche
AIMS AND OBJECTIVES: The aim of this study was to explore the number of patients presenting with sepsis before and after guideline implementation; the impact of sepsis guidelines on triage assessment, Emergency Department management and time to antibiotics. BACKGROUND: Sepsis remains one of the leading causes of mortality and morbidity within hospitals. Globally, strategies have been implemented to reduce morbidity and mortality rates, which rely on the early recognition and management of sepsis...
January 10, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28067711/early-goal-directed-therapy-for-sepsis-a-novel-solution-for-discordant-survival-outcomes-in-clinical-trials
#4
Andre C Kalil, Daniel W Johnson, Steven J Lisco, Junfeng Sun
OBJECTIVES: Early goal-directed therapy has shown discordant survival outcomes in sepsis studies. We aim to find the reasons for this discordance. DESIGN: Random-effects and Bayesian hierarchical analyses. SETTING: Studies that evaluated early goal-directed therapy. SUBJECTS: Patients with severe sepsis and/or septic shock. INTERVENTIONS: Early goal-directed therapy. MEASUREMENTS AND MAIN RESULTS: A total of 19,998 patients were included in the main analysis: 31 observational (n = 15,656) and six randomized (n = 4,342) studies...
January 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28063000/evaluation-of-loop-mediated-isothermal-amplification-for-the-rapid-identification-of-bacteria-and-resistance-determinants-in-positive-blood-cultures
#5
J Rödel, J A Bohnert, S Stoll, L Wassill, B Edel, M Karrasch, B Löffler, W Pfister
The use of molecular assays to rapidly identify pathogens and resistance genes directly from positive blood cultures (BCs) contribute to shortening the time required for the diagnosis of bloodstream infections. In this work, loop-mediated isothermal amplification (LAMP) assays have been examined for their potential use in BC diagnosis. Three different assays were applied. The commercially available eazyplex® MRSA test detects Staphylococcus aureus, S. epidermidis, mecA, and mecC. Two in-house assays [Gram-positive (GP) and Gram-negative (GN)] have been developed for the detection of streptococci, enterococci, vanA, vanB, Pseudomonas spp...
January 6, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28062114/effect-of-immediate-administration-of-antibiotics-in-patients-with-sepsis-in-tertiary-care-a-systematic-review-and-meta-analysis
#6
REVIEW
Amy N B Johnston, Joon Park, Suhail A Doi, Vicki Sharman, Justin Clark, Jemma Robinson, Julia Crilly
PURPOSE: The goal of this review was to synthesize existing evidence regarding outcomes (mortality) for patients who present to the emergency department, are administered antibiotics immediately (within 1 hour) or later (>1 hour), and are diagnosed with sepsis. METHODS: A search of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL, using the MeSH descriptors "sepsis," "systemic inflammatory response syndrome," "mortality," "emergency," and "antibiotics," was performed to identify studies reporting time to antibiotic administration and mortality outcome in patients with sepsis...
January 3, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28061799/ralstonia-picketti-neonatal-sepsis-a-case-report
#7
Deepak Sharma, Pradeep Sharma, Priyanka Soni, Basudev Gupta
BACKGROUND: Ralstonia genus are gram negative bacillus and includes four bacteria namely Ralstonia picketti, Ralstonia Solanacearum, Ralstonia insidiosa and Ralstonia mannitolilytica. These are opportunistic pathogens and cause infections in immunocompromised host. The sources of infection are usually contaminated solutions and water. The majority of the reported cases are caused by R. picketti. It is very rare cause of neonatal sepsis with less than twenty cases reported in literature till date...
January 7, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28058720/an-observational-study-of-community-acquired-severe-sepsis-comparing-intensive-care-and-non-intensive-care-patients
#8
S T Nygård, S Skrede, N Langeland, H K Flaatten
BACKGROUND: Most studies of sepsis are from intensive care units (ICUs). We aimed to investigate community-acquired severe sepsis in a broader population, in order to compare patients treated in or outside an ICU . METHODS: We performed a 1-year prospective observational study with enrollment of patients from three units; a general ICU, a combined ICU/non-ICU and a medical ward with limited surveillance facilities. Hospital survivors were followed up for 5 years...
January 6, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28050900/planned-early-birth-versus-expectant-management-waiting-for-prelabour-rupture-of-membranes-at-term-37-weeks-or-more
#9
REVIEW
Philippa Middleton, Emily Shepherd, Vicki Flenady, Rosemary D McBain, Caroline A Crowther
BACKGROUND: Prelabour rupture of membranes (PROM) at term is managed expectantly or by planned early birth. It is not clear if waiting for birth to occur spontaneously is better than intervening, e.g. by inducing labour. OBJECTIVES: The objective of this review is to assess the effects of planned early birth (immediate intervention or intervention within 24 hours) when compared with expectant management (no planned intervention within 24 hours) for women with term PROM on maternal, fetal and neonatal outcomes...
January 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28036311/etiological-profile-of-early-neonatal-bacterial-sepsis-by-multiplex-qpcr
#10
Walter P Silva-Junior, Almir S Martins, Paula C N Xavier, Kelly L A Appel, Silvio A Oliveira Junior, Durval B Palhares
INTRODUCTION: Given the major impact in terms of morbidity and mortality that episodes of early neonatal sepsis (ENS) have on both newborns and health systems, this study aimed to identify the etiological profile of early neonatal bacterial sepsis by a multiplex quantitative real-time polymerase chain reaction (qPCR). METHODOLOGY: Blood samples from newborns diagnosed with clinical ENS and hospitalized in neonatal intensive care units (NICUs) were collected and analyzed using the multiplex qPCR method to detect Streptococcus agalactiae, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter sp...
December 30, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/27994922/diagnostic-and-prognostic-value-of-presepsin-for-subclinical-chorioamnionitis-in-pregnancies-between-23-28-week-with-preterm-premature-rupture-of-the-membranes
#11
Erbil Çakar, Şule Eren Çakar, Habibe Ayvacı Taşan, Deniz Karçaaltıncaba, Mehmet Baki Şentürk, Nermin Koç, Ramazan Uluhan
BACKGROUND: Presepsin is an inflammatory marker released from monocytes and macrophages as an acute reaction to microbial infection. We hypothesized that it may be useful in pregnancies with preterm premature rupture of the membranes (PPROM) for early diagnosis of subclinical chorioamnionitis. AIMS: To determine whether the plasma presepsin level has any diagnostic or prognostic value for subclinical chorioamnionitis in pregnancies complicated with PPROM. STUDY DESIGN: Prospective cohort study...
November 2016: Balkan Medical Journal
https://www.readbyqxmd.com/read/27994476/a-novel-combination-approach-of-human-polyclonal-ivig-and-antibiotics-against-multidrug-resistant-gram-positive-bacteria
#12
Mariam Madkour Sallam, Khaled Abou-Aisha, Mohamed El-Azizi
BACKGROUND: Gram-positive bacteria, especially methicillin-resistant Staphylococcus aureus (MRSA) and enterococci, have shown a remarkable ability to develop resistance to antimicrobial agents. OBJECTIVE: We aimed to assess possible enhancement of the antimicrobial activity of vancomycin, amoxicillin, clarithromycin, and azithromycin by human polyclonal intravenous immunoglobulin G (IVIG) against 34 multidrug-resistant (MDR) bacterial isolates, including MRSA, Enterococcus faecium, and Enterococcus faecalis...
2016: Infection and Drug Resistance
https://www.readbyqxmd.com/read/27978817/evaluation-of-galleria-mellonella-larvae-for-studying-the-virulence-of-streptococcus-suis
#13
Nadya Velikova, Kevin Kavanagh, Jerry M Wells
BACKGROUND: Streptococcus suis is an encapsulated Gram-positive bacterium and the leading cause of sepsis and meningitis in young pigs, resulting in considerable economic losses in the porcine industry. S. suis is considered an emerging zoonotic agent with increasing numbers of human cases over the last years. In the environment, both avirulent and virulent strains occur in pigs, with no evidence for consistent adapatation of virulent strains to the human host. Currently, there is an urgent need for a convenient, reliable and standardised animal model to rapidly assess S...
December 15, 2016: BMC Microbiology
https://www.readbyqxmd.com/read/27974860/a-novel-microfluidic-assay-for-rapid-phenotypic-antibiotic-susceptibility-testing-of-bacteria-detected-in-clinical-blood-cultures
#14
Christer Malmberg, Pikkei Yuen, Johanna Spaak, Otto Cars, Thomas Tängdén, Pernilla Lagerbäck
BACKGROUND: Appropriate antibiotic therapy is critical in the management of severe sepsis and septic shock to reduce mortality, morbidity and health costs. New methods for rapid antibiotic susceptibility testing are needed because of increasing resistance rates to standard treatment. AIMS: The purpose of this study was to evaluate the performance of a novel microfluidic method and the potential to directly apply this method on positive blood cultures. METHODS: Minimum inhibitory concentrations (MICs) of ciprofloxacin, ceftazidime, tigecycline and/or vancomycin for Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus were determined using a linear antibiotic concentration gradient in a microfluidic assay...
2016: PloS One
https://www.readbyqxmd.com/read/27957598/clinical-and-microbiological-features-of-actinotignum-bacteremia-a-retrospective-observational-study-of-57-cases
#15
H Pedersen, E Senneby, M Rasmussen
The purpose of this study was to investigate the incidence, clinical presentation, and prognosis of Actinotignum bacteremia in southern Sweden. Actinotignum isolates in blood cultures were identified retrospectively between 1st January 2012 and 31st March 2016 through searches in the clinical microbiology laboratory database. The population covered by this laboratory is approximately 1.3 million. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was used for species determination...
December 12, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27956267/intravenous-fosfomycin-back-to-the-future-systematic-review-and-meta-analysis-of-the-clinical-literature
#16
REVIEW
B Grabein, W Graninger, J Rodríguez Baño, A Dinh, D B Liesenfeld
OBJECTIVES: We conducted a systematic review and meta-analysis to summarise the clinical evidence and usage patterns of intravenous fosfomycin from its development to the present time. METHODS: PubMed, the Cochrane Library and local journals were searched for relevant studies reporting aggregated data of intravenous fosfomycin use in adults and children, with no restrictions regarding study design. Single case reports were excluded. Data were systematically abstracted for all included studies...
December 9, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27941371/survival-benefit-and-cost-savings-from-compliance-with-a-simplified-3-hour-sepsis-bundle-in-a-series-of-prospective-multisite-observational-cohorts
#17
Daniel E Leisman, Martin E Doerfler, Mary Frances Ward, Kevin D Masick, Benjamin J Wie, Jeanie L Gribben, Eric Hamilton, Zachary Klein, Andrea R Bianculli, Meredith B Akerman, John K D'Angelo, Jason A D'Amore
OBJECTIVES: To determine mortality and costs associated with adherence to an aggressive, 3-hour sepsis bundle versus noncompliance with greater than or equal to one bundle element for severe sepsis and septic shock patients. DESIGN: Prospective, multisite, observational study following three sequential, independent cohorts, from a single U.S. health system, through their hospitalization. SETTING: Cohort 1: five tertiary and six community hospitals...
December 9, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27940455/sepsis-for-the-anaesthetist
#18
M E Nunnally
Sepsis is as a dysregulated systemic response to infection. Morbidity and mortality of the syndrome are very high worldwide. Recent definitions have redefined criteria for sepsis. The new definition (Sepsis-3) classifies sepsis as infection with organ dysfunction (the old 'severe sepsis'). Septic patients are at risk for secondary injuries, thus aggressive source control, resuscitation, and antibiotic therapy are the mainstays of management. Central to sepsis physiology is vasodilated shock. Many patients respond to i...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27927508/kyphectomy-in-children-with-severe-myelomeningocele-related-kyphosis
#19
R N Dunn, L N Bomela
STUDY DESIGN: Retrospective review of prospectively maintained database. OBJECTIVES: To review myelomeningocele patients with severe kyphosis undergoing kyphectomy surgery in terms of complications and clinical and radiographic outcomes. SUMMARY OF BACKGROUND DATA: Because of posterior element abnormality in myelomeningocele, the extensor muscles act as perverted flexors, driving progressive kyphosis that resulted in sitting, respiratory, and skin breakdown problems...
May 2016: Spine Deformity
https://www.readbyqxmd.com/read/27924169/hospital-acquired-infections-after-cardiac-surgery-and-current-physician-practices-a-retrospective-cohort-study
#20
Scott O'Keefe, Kenneth Williams, Jean-Francois Legare
BACKGROUND: The management of hospital-acquired infections (HAIs) with respect to physician practices remains largely unexplored despite increasing efforts to standardize care. In the present study, we report findings from a 2-month audit of all patients that have undergone cardiac surgery at a large referral center in Atlantic Canada. METHODS: All patients who underwent cardiac surgical procedures during May and June 2013 at the Queen Elizabeth II Health Sciences Center in Halifax, Nova Scotia were identified...
January 2017: Journal of Clinical Medicine Research
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