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Critical care infections

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https://www.readbyqxmd.com/read/29338730/factors-associated-with-hiv-positive-sero-status-among-exposed-infants-attending-care-at-health-facilities-a-cross-sectional-study-in-rural-uganda
#1
Methuselah Muhindo Kahungu, Julius Kiwanuka, Frank Kaharuza, Rhoda K Wanyenze
BACKGROUND: East and South Africa contributes 59% of all pediatric HIV infections globally. In Uganda, HIV prevalence among HIV exposed infants was estimated at 5.3% in 2014. Understanding the remaining bottlenecks to elimination of mother-to-child transmission (eMTCT) is critical to accelerating efforts towards eMTCT. This study determined factors associated with HIV positive sero-status among exposed infants attending mother-baby care clinics in rural Kasese so as to inform enhancement of interventions to further reduce MTCT...
January 16, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29337839/serum-admission-25-hydroxyvitamin-d-levels-and-outcomes-in-initially-non-septic-critically-ill-patients
#2
Alice G Vassiliou, Edison Jahaj, Zafeiria Mastora, Eleni Stagaki, Stylianos E Orfanos, Anastasia Kotanidou
INTRODUCTION: To examine whether very low levels of 25-hydroxyvitamin D {25(OH)D} upon admission to the intensive care unit (ICU) are associated with worse outcomes. METHODS: Retrospective observational cohort study of critically-ill patients treated in a multidisciplinary ICU. Two hundred and twenty seven initially non-septic, critically-ill patients, in whom 25-hydroxyvitamin D was measured at ICU admission. An additional group of 192 healthy subjects was also used...
January 15, 2018: Shock
https://www.readbyqxmd.com/read/29335014/cost-effectiveness-study-of-early-versus-late-parenteral-nutrition-in-critically-ill-children-pepanic-preplanned-secondary-analysis-of-a-multicentre-randomised-controlled-trial
#3
Esther van Puffelen, Suzanne Polinder, Ilse Vanhorebeek, Pieter Jozef Wouters, Niek Bossche, Guido Peers, Sören Verstraete, Koen Felix Maria Joosten, Greet Van den Berghe, Sascha Cornelis Antonius Theodorus Verbruggen, Dieter Mesotten
BACKGROUND: The multicentre randomised controlled PEPaNIC trial showed that withholding parenteral nutrition (PN) during the first week of critical illness in children was clinically superior to providing early PN. This study describes the cost-effectiveness of this new nutritional strategy. METHODS: Direct medical costs were calculated with use of a micro-costing approach. We compared the costs of late versus early initiation of PN (n = 673 versus n = 670 patients) in the Belgian and Dutch study populations from a hospital perspective, using Student's t test with bootstrapping...
January 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29334496/oxygen-in-the-critically-ill-friend-or-foe
#4
Elisa Damiani, Abele Donati, Massimo Girardis
PURPOSE OF REVIEW: To examine the potential harmful effects of hyperoxia and summarize the results of most recent clinical studies evaluating oxygen therapy in critically ill patients. RECENT FINDINGS: Excessive oxygen supplementation may have detrimental pulmonary and systemic effects because of enhanced oxidative stress and inflammation. Hyperoxia-induced lung injury includes altered surfactant protein composition, reduced mucociliary clearance and histological damage, resulting in atelectasis, reduced lung compliance and increased risk of infections...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29331944/liver-sampling-a-vital-window-into-hbv-pathogenesis-on-the-path-to-functional-cure
#5
REVIEW
Upkar S Gill, Laura J Pallett, Patrick T F Kennedy, Mala K Maini
In order to optimally refine the multiple emerging drug targets for hepatitis B virus (HBV), it is vital to evaluate virological and immunological changes at the site of infection. Traditionally liver biopsy has been the mainstay of HBV disease assessment, but with the emergence of non-invasive markers of liver fibrosis, there has been a move away from tissue sampling. Here we argue that liver biopsy remains an important tool, not only for the clinical assessment of HBV but also for research progress and evaluation of novel agents...
January 13, 2018: Gut
https://www.readbyqxmd.com/read/29331796/determination-of-meropenem-in-endotracheal-tubes-by-in-tube-solid-phase-microextraction-coupled-to-capillary-liquid-chromatography-with-diode-array-detection
#6
L Hakobyan, J Pla Tolos, Y Moliner-Martinez, C Molins-Legua, Jesús Ruiz Ramos, M Gordon, Paula Ramirez-Galleymore, P Campins-Falco
Meropenem is a widely used antimicrobial for the treatment of infections associated with the use of invasive medical devices in intensive care unit patients. These treatments are not always effective, in fact, in-vitro studies have demonstrated the difficulty of antimicrobials to penetrate into the biofilm, however in-vivo studies of the effect of these compounds is a trend, mostly because of the complexity of pulmonary samples extracted from ETTs. Therefore, the objective of this study was to evaluate in-tube solid phase microextraction (in-tube SPME) coupled to capillary liquid chromatography (CapLC) with DAD to determine meropenem in ETTs in order to estimate the penetration capability into the biofilm...
January 8, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29329922/a-multistate-investigation-of-health-care-associated-burkholderia-cepacia-complex-infections-related-to-liquid-docusate-sodium-contamination-january-october-2016
#7
Janet Glowicz, Matthew Crist, Carolyn Gould, Heather Moulton-Meissner, Judith Noble-Wang, Tom J B de Man, K Allison Perry, Zachary Miller, William C Yang, Stephen Langille, Jessica Ross, Bobbiejean Garcia, Janice Kim, Erin Epson, Stephanie Black, Massimo Pacilli, John J LiPuma, Ryan Fagan
BACKGROUND: Outbreaks of health care-associated infections (HAIs) caused by Burkholderia cepacia complex (Bcc) have been associated with medical devices and water-based products. Water is the most common raw ingredient in nonsterile liquid drugs, and the significance of organisms recovered from microbiologic testing during manufacturing is assessed using a risk-based approach. This incident demonstrates that lapses in manufacturing practices and quality control of nonsterile liquid drugs can have serious unintended consequences...
January 9, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29329124/septic-arthritis-of-the-wrist
#8
John D Jennings, Asif M Ilyas
Septic arthritis of the wrist is an uncommon condition, but one that can result in substantial morbidity. Timely identification and treatment is critical to patient care. No serum laboratory values have been shown to consistently confirm wrist joint infection. Thus, diagnosis is made based mainly on a thorough patient history, physical examination, and joint aspiration. When infection is suspected, aspiration of the wrist should be performed to confirm the diagnosis. Broad-spectrum antibiotics and joint aspiration or surgery are required to manage the infection and prevent sequelae...
January 11, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#9
Mary Beth Flynn Makic, Elizabeth Bridges
Recent updates emphasize early recognition and prompt intervention. ABSTRACT: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence...
January 11, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29324838/canine-visceral-leishmaniasis-diagnosis-and-management-of-the-reservoir-living-among-us
#10
REVIEW
Bruno L Travi, Anabela Cordeiro-da-Silva, Filipe Dantas-Torres, Guadalupe Miró
This article reviews essential topics of canine visceral leishmaniasis (CVL) due to Leishmania infantum infection. It focuses on the current serological and molecular diagnostic methods used in epidemiological research and veterinary clinics to diagnose CVL and includes new point-of-care (POC) tests under development. The efficacy of different treatment regimens on the clinical improvement and infectiousness of dogs is also addressed. In the last section, the review provides a critical appraisal of the effectiveness of different control measures that have been implemented to curb disease transmission...
January 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29324733/antibiotics-dispensed-to-privately-insured-pregnant-women-with-urinary-tract-infections-united-states-2014
#11
Elizabeth C Ailes, April D Summers, Emmy L Tran, Suzanne M Gilboa, Kathryn E Arnold, Dana Meaney-Delman, Jennita Reefhuis
Urinary tract infections (UTIs) occur in about 8% of pregnant women, and untreated UTIs can have serious consequences, including pyelonephritis, preterm labor, low birth weight, and sepsis (1). Pregnant women are typically screened for UTIs during early pregnancy, and those with bacteriuria are treated with antibiotics (1,2). Antibiotic stewardship is critical to improving patient safety and to combating antibiotic resistance. Because of the potential risk for birth defects, including anencephaly, heart defects, and orofacial clefts, associated with use of sulfonamides and nitrofurantoin during pregnancy (3), a 2011 committee opinion from the American College of Obstetricians and Gynecologists (ACOG) recommended that sulfonamides and nitrofurantoin may be prescribed in the first trimester of pregnancy only when other antimicrobial therapies are deemed clinically inappropriate (4)...
January 12, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29319654/trauma-and-intensive-care-nursing-knowledge-and-attitude-of-foley-catheter-insertion-and-maintenance
#12
Brenda Shaver, Stephanie A Eyerly-Webb, Zoe Gibney, Linda Silverman, Candace Pineda, Rachele J Solomon
In the acute care setting, the majority of urinary tract infections are associated with indwelling urinary catheters. Despite guidelines for proper use, catheter-associated urinary tract infections (CAUTIs) continue to occur in critically ill/injured patients. There is a paucity of data on the translation between CAUTI prevention education and behavioral change. This project evaluated nurse's clinical knowledge and attitude toward Foley catheter insertion and maintenance to determine the benefits of addressing gaps in knowledge and inconsistencies in attitude through education...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29319481/a-critical-review-of-recent-clinical-practice-guidelines-for-pediatric-urinary-tract-infection
#13
Michael Chua, Jessica Ming, Shang-Jen Chang, Joana Dos Santos, Niraj Mistry, Jan Michael Silangcruz, Mark Bayley, Martin Koyle
INTRODUCTION: Concerns regarding the quality, credibility, and applicability of recently published pediatric urinary tract infection (UTI) clinical practice guidelines have been raised due to the inconsistencies of recommendations between them. We aimed to determine the quality of the recent clinical practice guidelines on pediatric UTI by using the Appraisal of Guidelines Research and Evaluation (AGREE II) instrument, and summarize the standard of care in diagnosis and management of pediatric UTI from the top three clinical practice guidelines...
December 22, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29319247/infection-associated-secondary-hemophagocytic-lymphohistiocytosis-in-sepsis-syndromes-a-tip-of-an-iceberg
#14
Arun Agarwal, Aakanksha Agarwal
Background: Hemophagocytic lymphohistiocytosis (HLH) is a rare, underdiagnosed, fatal and devastating hyperinflammatory syndrome that has gained increasing recognition over the past decade. Patients with HLH present with clinical and laboratory evidence of uncontrolled inflammation. Delay in diagnosis and management inevitably leads to a rapidly progressive and fatal course. In this case series, we present 7 cases of secondary HLH (sHLH) in adults with their presentation, course, and outcomes...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29315320/association-of-day-4-cumulative-fluid-balance-with-mortality-in-critically-ill-patients-with-influenza-a-multicenter-retrospective-cohort-study-in-taiwan
#15
Wen-Cheng Chao, Chien-Hua Tseng, Ying-Chun Chien, Chau-Chyun Sheu, Ming-Ju Tsai, Wen-Feng Fang, Yu-Mu Chen, Kuo-Chin Kao, Han-Chung Hu, Wann-Cherng Perng, Kuang-Yao Yang, Wei-Chih Chen, Shinn-Jye Liang, Chieh-Liang Wu, Hao-Chien Wang, Ming-Cheng Chan
BACKGROUND: Fluid balance is a fundamental management of patients with sepsis, and this study aimed to investigate the impact of cumulative fluid balance on critically ill patients with influenza admitted to an intensive care unit (ICU). METHODS: This multicenter retrospective cohort study was conducted by the Taiwan Severe Influenza Research Consortium (TSIRC) which includes eight medical centers. Patients with virology-proven influenza infection admitted to ICUs between October 2015 and March 2016 were included for analysis...
2018: PloS One
https://www.readbyqxmd.com/read/29313072/-antibiotic-stewardship-measures-for-optimizing-prescription-of-anti-infective-agents
#16
REVIEW
C Lanckohr, H Bracht
Antibiotic stewardship (ABS) comprises a bundle of different interventions to improve anti-infective treatment in a hospital setting. An important component of ABS interventions is the interdisciplinary approach to infection management. Besides improving infrastructural aspects on a hospital level, including surveillance of the use of anti-infective agents and nosocomial infections, collation and interpretation of statistics on resistance and formulation of local treatment guidelines, ABS teams go to the wards and advise treating physicians on antibiotic therapy...
January 8, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29310974/sepsis-in-tropical-regions-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#17
Steven McGloughlin, Guy A Richards, Mohd Basri Mat Nor, Shirish Prayag, Tim Baker, Pravin Amin
Sepsis and septic shock in the tropics are caused by a wide array of organisms. These infections are encountered mainly in low and middle-income countries (LMIC) where a lack of infrastructure and medical facilities contribute to the high morbidity and mortality. Published sepsis guidelines are based on studies primarily performed in high income countries and as such recommendations may or may not be relevant to practice in the tropics. Failure to adhere to guidelines, particularly among non-intensive care specialists even in high-income countries, is an area of concern for sepsis management...
December 30, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29307965/evaluation-of-quality-indicators-in-an-indian-intensive-care-unit-using-chitra-database
#18
Kiran Kumar Gudivada, Bhuvana Krishna, Sampath Sriram
Background: Quality indicators (QIs) are essential for maintaining quality of care in the critically ill. The Indian Society of Critical Care Medicine proposed benchmarks and enabled Indian Intensive Care Units (ICUs) to capture data in an electronic database: Customized Health in Intensive Care Trainable Research and Analysis (CHITRA) tool. The purpose of this study is to report QIs in an Indian ICU using this database. Materials and Methods: Data from patients admitted to ICU between October 2015 and January 2017 were entered into CHITRA...
December 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29307960/tropical-fevers-in-indian-intensive-care-units-a-prospective-multicenter-study
#19
Sunit Singhi, Narendra Rungta, Karthi Nallasamy, Ashish Bhalla, J V Peter, Dhruva Chaudhary, Rajesh Mishra, Prakash Shastri, Rajesh Bhagchandani, T D Chugh
Background and Aims: Infections in tropics often present as undifferentiated fevers with organ failures. We conducted this nationwide study to identify the prevalence, profile, resource utilization, and outcome of tropical fevers in Indian Intensive Care Units (ICUs). Materials and Methods: This was a multicenter prospective observational study done in 34 ICUs across India (July 2013-September 2014). Critically ill adults and children with nonlocalizing fever >48 h and onset < 14 days with any of the following: thrombocytopenia/rash, respiratory distress, renal failure, encephalopathy, jaundice, or multiorgan failure were enrolled consecutively...
December 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29305954/clinical-use-of-the-polymyxins-the-tale-of-the-fox-and-the-cat
#20
Eric Wenzler, Kristen L Bunnell, Larry H Danziger
BACKGROUND: There is a need to identify practice patterns of polymyxin use, quantify gaps in knowledge, and recognize areas of persistent confusion. METHODS: A structured electronic survey was distributed to physicians, pharmacists, and microbiologists. Demographic information was obtained along with data regarding the availability, stewardship principles, therapeutic usage, dosing, microbiological testing, and knowledge, attitudes, and beliefs regarding the polymyxins...
January 3, 2018: International Journal of Antimicrobial Agents
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