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https://www.readbyqxmd.com/read/29344356/risk-factors-and-outcomes-for-multidrug-resistant-gram-negative-bacilli-bacteremia
#1
Swati Patolia, Getahun Abate, Nirav Patel, Setu Patolia, Sharon Frey
Background: The incidence of multidrug-resistant (MDR) organisms is increasing along with mortality. Identifying risk factors for the development of MDR Gram-negative bacilli (GNB) bacteremia could greatly impact patient care and management. Methods: Data from the electronic health record of patients with GNB over 13-month period were collected at a single university medical center. Baseline demographic data, risk factor, microbiological data, recurrence of bacteremia, and mortality were recorded...
January 2018: Therapeutic Advances in Infectious Disease
https://www.readbyqxmd.com/read/29343141/novel-%C3%AE-lactam-%C3%AE-lactamase-inhibitors-versus-alternative-antibiotics-for-the-treatment-of-complicated-intra-abdominal-infection-and-complicated-urinary-tract-infection-a-meta-analysis-of-randomized-controlled-trials
#2
Mengmeng Chen, Minjie Zhang, Peixian Huang, Qiongyu Lin, Cheng Sun, Hongke Zeng, Yiyu Deng
OBJECTIVES: The aim of this study is to compare the efficacy and safety of novel BL/BLIs with alternative antibiotics for the treatment of Complicated intra-abdominal infection (cIAI) and complicated urinary tract infection (cUTI). METHODS: We performed a systematic review and meta-analysis of all randomized controlled trials comparing novel β-lactam/β-lactamase inhibitors (BL/BLIs) with other antibiotics for the treatment of cIAI and cUTI. The primary outcome included clinical and microbiological treatment success...
January 18, 2018: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29341844/empiric-antibiotics-for-sepsis
#3
Sara A Buckman, Isaiah R Turnbull, John E Mazuski
BACKGROUND: Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Early recognition and treatment are the cornerstones of management. METHODS: Review of the English-language literature. RESULTS: For both sepsis and septic shock "antimicrobials [should be] be initiated as soon as possible and within one hour" (Surviving Sepsis Campaign). The risk of progression from severe sepsis to septic shock increases 8% for each hour before antibiotics are started...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29339423/immune-protection-against-lethal-fungal-bacterial-intra-abdominal-infections
#4
Elizabeth A Lilly, Melanie Ikeh, Evelyn E Nash, Paul L Fidel, Mairi C Noverr
Polymicrobial intra-abdominal infections (IAIs) are clinically prevalent and cause significant morbidity and mortality, especially those involving fungi. Our laboratory developed a mouse model of IAI and demonstrated that intraperitoneal inoculation with Candida albicans or other virulent non-albicans Candida (NAC) species plus Staphylococcus aureus resulted in 70 to 80% mortality in 48 to 72 h due to robust local and systemic inflammation (sepsis). Surprisingly, inoculation with Candida dubliniensis or Candida glabrata with S...
January 16, 2018: MBio
https://www.readbyqxmd.com/read/29330724/a-novel-nomogram-for-predicting-postsurgical-intra-abdominal-infection-in-gastric-cancer-patients-a-prospective-study
#5
Chen-Chen Mao, Xiao-Dong Chen, Ji Lin, Wei-Shan Zhu-Ge, Zhong-Dong Xie, Xi-Yi Chen, Feng-Min Zhang, Rui-Sen Wu, Wei-Teng Zhang, Neng Lou, Li Shi, Guan-Bao Zhu, Xian Shen
BACKGROUND: This study aimed to determine the relationship between intra-abdominal infection (IAI) and sarcopenia prospectively and to construct a nomogram to identify patients at a high risk of IAI. METHODS: We conducted a prospective study of 682 consecutive patients with gastric cancer who underwent radical gastrectomy. The sarcopenia elements, including lumbar skeletal muscle index, handgrip strength, and gait speed, were measured before surgery. Factors contributing to IAI were determined through univariate and multivariate analysis...
January 12, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29321120/evaluating-vancomycin-and-piperacillin-tazobactam-in-emergency-department-patients-with-severe-sepsis-and-septic-shock
#6
Christina Le, Frank Chu, Ronald Dunlay, Julian Villar, Peter Fedullo, Gabriel Wardi
STUDY OBJECTIVE: To determine the frequency and cause of inadequate initial antibiotic therapy with vancomycin and piperacillin-tazobactam in patients with severe sepsis and septic shock in the emergency department (ED), characterize its impact on patient outcomes, and identify patients who would benefit from an alternative initial empiric regimen. METHODS: Retrospective cohort study conducted between 2012 and 2015 in which 342 patients with culture-positive severe sepsis or septic shock who received initial vancomycin and piperacillin-tazobactam were reviewed to determine appropriateness of antimicrobial therapy, risk factors for inappropriate use, and outcome data...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29307962/monotherapy-versus-combination-therapy-against-nonbacteremic-carbapenem-resistant-gram-negative-infections-a-retrospective-observational-study
#7
Abdul Ghafur, Vidyalakshmi Devarajan, T Raja, Jose Easow, M A Raja, Sankar Sreenivas, Balasubramaniam Ramakrishnan, S G Raman, Dedeepiya Devaprasad, Balaji Venkatachalam, Ramesh Nimmagadda
Background: Superiority of colistin-carbapenem combination therapy (CCCT) over colistin monotherapy (CMT) against carbapenem-resistant Gram-negative bacterial (CRGNB) infections is not conclusively proven. Aim: The aim of the current study was to analyze the effectiveness of both strategies against CRGNB nonbacteremic infections. Design: This was a retrospective observational cohort study. Subjects and Methods: Case record analysis of patients who had CRGNB nonbacteremic infections identified over a period of 4 years (January 2012-December 2015) was done by medical record review at a tertiary care center in India...
December 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29305753/systematic-review-and-meta-analysis-of-the-use-of-serum-procalcitonin-levels-to-predict-intra-abdominal-infections-after-colorectal-surgery
#8
Winson Jianhong Tan, Wan Qi Ng, Rehena Sultana, Nurun Nisa de Souza, Min Hoe Chew, Fung Joon Foo, Choong Leong Tang, Wah Siew Tan
PURPOSE: There has been much recent interest in the use of procalcitonin (PCT) as a marker of intra-abdominal infection (IAI) following colorectal surgery. However, the literature remains divided on the value of PCT in this setting. This meta-analysis aims to evaluate the value of PCT in predicting IAI after colorectal surgery. METHODS: Systemic literature search was performed using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews to identify studies evaluating the diagnostic accuracy of PCT as a predictor for detecting IAI on postoperative days (POD) 3 to 5 following colorectal surgery...
January 5, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29305368/treatment-of-a-complex-orthopaedic-infection-due-to-extensively-drug-resistant-pseudomonas-aeruginosa
#9
Sidra Hassan, Mani D Kahn, Nidhi Saraiya, Priya Nori
According to the Centers for Disease Control and Prevention (CDC), approximately 51 000 healthcare-associated infections caused by Pseudomonas aeruginosa occur annually in the USA, more than 6000 of which (13%) are caused by multidrug resistant (MDR) strains. Ceftolozane/tazobactam (TOL/TAZ) (Zerbaxa) was approved by the US Food and Drug Administration (FDA) in December 2014 for the treatment of complicated intra-abdominal and urinary tract infections. At this time, clinical data on the role of TOL/TAZ treatment outside of FDA-approved indications is limited...
January 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29303687/effect-of-the-abdominal-fascial-closure-with-triclosan-coated-sutures-in-fecal-peritonitis-on-surgical-site-infection-and-evisceration-a-retrospective-multi-center-study
#10
Jaime Ruiz-Tovar, Natalia Alonso, Aina Ochagavía, Antonio Arroyo, Carolina Llavero
BACKGROUND: Surgical site infection (SSI) is a frequent complication in dirty surgery, reaching rates of up to 40%. The incidence of SSI might be influenced by the suture used for closure of the abdominal fascia. Sutures coated with antibacterial substances may reduce the bacterial load in the incision. PATIENTS AND METHODS: A retrospective study of patients with intra-operative diagnosis of fecal peritonitis undergoing a laparotomy in three Spanish hospitals was performed...
January 2018: Surgical Infections
https://www.readbyqxmd.com/read/29303686/microbiologic-analysis-of-complicated-and-uncomplicated-acute-appendicitis
#11
Andrés García-Marín, Mercedes Pérez-López, Elena Martínez-Guerrero, Lorena Rodríguez-Cazalla, Antonio Compañ-Rosique
BACKGROUND: Microbiologic studies suggest that complicated (CAA) and uncomplicated (UAA) acute appendicitis are different entities. Routine peritoneal fluid cultures continue to be controversially related to a low positive rate, found mainly in UAA; to isolation of typical micro-organisms with expected susceptibilities; and to a community-acquired intra-abdominal infection. The aim of this study was to describe microbiologic isolates in CAA and UAA and the usefulness of peritoneal fluid cultures to determine the susceptibilities to our antibiotic therapy guidelines...
January 2018: Surgical Infections
https://www.readbyqxmd.com/read/29298133/epidemiology-and-risk-factors-for-isolation-of-multi-drug-resistant-organisms-in-patients-with-complicated-intra-abdominal-infections
#12
Francesco M Labricciosa, Massimo Sartelli, Lilian M Abbo, Pamela Barbadoro, Luca Ansaloni, Federico Coccolini, Fausto Catena
BACKGROUND: Patients with complicated intra-abdominal infections (cIAIs) caused by multi-drug-resistant organisms (MDROs) have been identified as being at increased risk for adverse outcomes. Prompt identification and stratification of these patients is essential in the clinical management, allowing the physician timely optimization of empiric antimicrobial therapy while awaiting results of intra-operative cultures to streamline antibiotic treatment. METHODS: The study is a secondary analysis from two prospective multi-center color surveillance studies...
January 3, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29290909/influence-of-proton-pump-inhibitors-in-the-development-of-spontaneous-bacterial-peritonitis
#13
Suelen A S Miozzo, Jorge A John, Marcelo C Appel-da-Silva, Isabella A Dossin, Cristiane V Tovo, Angelo A Mattos
AIM: To investigate whether the use of proton pump inhibitors (PPIs) increases the incidence of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and ascites. METHODS: An historical cohort study was carried out in cirrhotic outpatients with ascites followed in a specialized clinic at a tertiary hospital in Southern Brazil. Patient charts were reviewed to collect information on the variables of interest as the use of PPIs. Primary outcome was defined as development of SBP during the study period...
December 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29290237/antibiotic-pharmacokinetic-and-pharmacodynamic-parameters-in-pediatric-clinical-practice
#14
R Cohen, E Grimprel
Progress in the knowledge of antibiotic mechanisms of action allows to determine the pharmacodynamics/pharmacokinetic (PK/PD) parameters predictive of antibiotic efficacy in bacterial infections. According to the antibiotic compound, the bacterial species implicated, the location of the infection, and the severity of the disease, these parameters may vary. The PK/PD parameters described in this paper, focus only on blood compartments. These PK/PD parameters best predict efficacy in the most frequent infections (e...
December 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29280704/reversible-pneumatosis-cystoides-intestinalis-after-liver-transplantation
#15
M Telegrafo, A A Stabile Ianora, G Angelelli, M Moschetta
Pneumatosis cystoides intestinalis (PCI) is a rare disease characterized by the presence of multiple gas-filled cysts within the submucosa or subserosa of the intestinal wall. We report a case of PCI in a 54-yearold man 4 weeks after liver transplantation due to hepatitis B virus (HBV)-associated liver cirrhosis presenting with illness, diarrhea and abdominal pain. CT scans revealed normal shape of the abdominal parenchymal organs and no intra-hepatic complication due to liver transplantation. Main abdominal venous and arterial vessels resulted patent...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29277527/high-excess-costs-of-infections-caused-by-carbapenem-resistant-gram-negative-bacilli-in-an-endemic-region
#16
Carlos Andrés Vargas-Alzate, Luis Felipe Higuita-Gutiérrez, Lucelly López López, Astrid Vanessa Cienfuegos Gallet, Judy Natalia Jiménez Quiceno
BACKGROUND: The financial burden of antibiotic resistance is a serious concern worldwide. The aim of this study is to describe the excess costs associated with pneumonia, bacteremia, surgical site infections and intra-abdominal infections caused by carbapenem-resistant gram-negative bacilli in Medellín, Colombia, an endemic region for carbapenem resistance. METHODS: A cohort study was conducted in a third level hospital from 2014 to 2015. All patients with carbapenem-resistant and carbapenem-susceptible gram-negative bacteria infections were included...
December 22, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29260135/laparoscopic-surgery-in-distal-pancreatic-tumors
#17
Fatma Ümit Malya, Hüseyin Kazım Bektaşoğlu, Mustafa Hasbahçeci, Yunus Taşçı, Enver Kunduz, Oğuzhan Karatepe, Kemal Dolay
Objective: Laparoscopic distal pancreatectomy is increasingly being used in the surgical treatment of corpus and distal pancreatic tumors. In this study, patients who underwent laparoscopic or open distal pancreatectomy for benign or malignant causes were evaluated in terms of tumor characteristics and perioperative outcomes. Material and Methods: We retrospectively reviewed data from a total of 27 distal pancreatectomy cases performed for benign or malignant causes in the General Surgery Department between January 2013 and December 2015...
2017: Turkish Journal of Surgery
https://www.readbyqxmd.com/read/29232537/laparoscopic-versus-conventional-open-surgery-in-intersphincteric-resection-for-low-rectal-cancer-a-systematic-review-and-meta-analysis
#18
Xubing Zhang, Qingbin Wu, Tao Hu, Chaoyang Gu, Liang Bi, Ziqiang Wang
AIM: This meta-analysis aims at comparing laparoscopic intersphincteric resection (LISR) with conventional open ISR (OISR) for low rectal cancer (LRC) in terms of intraoperative, postoperative, pathological, and survival outcomes. MATERIALS AND METHODS: A systematic literature search with no limits was performed in PubMed and Ovid. The last search was performed on May 27, 2017. The outcomes of interests included intraoperative outcomes: operative time and blood loss; postoperative outcomes: hospital day, postoperative hospital day, time to first flatus, time to normal diet, ileus, intra-abdominal abscess, anastomotic leakage, anastomotic stricture, wound infection, pneumonia, urinary complication, morbidity, and mortality; pathological outcomes: lymph node harvested, R0 resection rate, distance of proximal resection margin, distal resection margin and circumferential resection margin (CRM), and positive CRM; survival outcomes: 3-year overall survival (OS), 3-year disease-free survival (DFS), 5-year OS, and 5-year DFS...
December 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29230684/imipenem-relebactam-and-meropenem-vaborbactam-two-novel-carbapenem-%C3%AE-lactamase-inhibitor-combinations
#19
REVIEW
George G Zhanel, Courtney K Lawrence, Heather Adam, Frank Schweizer, Sheryl Zelenitsky, Michael Zhanel, Philippe R S Lagacé-Wiens, Andrew Walkty, Andrew Denisuik, Alyssa Golden, Alfred S Gin, Daryl J Hoban, Joseph P Lynch, James A Karlowsky
Relebactam (formerly known as MK-7655) is a non-β-lactam, bicyclic diazabicyclooctane, β-lactamase inhibitor that is structurally related to avibactam, differing by the addition of a piperidine ring to the 2-position carbonyl group. Vaborbactam (formerly known as RPX7009) is a non-β-lactam, cyclic, boronic acid-based, β-lactamase inhibitor. The structure of vaborbactam is unlike any other currently marketed β-lactamase inhibitor. Both inhibitors display activity against Ambler class A [including extended-spectrum β-lactamases (ESBLs), Klebsiella pneumoniae carbapenemases (KPCs)] and class C β-lactamases (AmpC)...
December 12, 2017: Drugs
https://www.readbyqxmd.com/read/29229171/special-considerations-in-pediatric-kidney-transplantation
#20
REVIEW
Sean A Hebert, Rita D Swinford, David R Hall, Jason K Au, John S Bynon
Universally accepted as the treatment of choice for children needing renal replacement therapy, kidney transplantation affords children the opportunity for an improved quality of life over dialysis therapy. Immunologic and surgical advances over the last 15 years have improved the pediatric patient and kidney graft survival. Unique to pediatrics, congenital genitourinary anomalies are the most common primary diseases leading to kidney failure, many with urological issues. Early urological evaluation for post-transplant bladder dysfunction and emphasis on immunization adherence are the mainstays of pediatric pretransplant and post-transplant evaluations...
November 2017: Advances in Chronic Kidney Disease
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