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Hospital Acquired Pneumonia

Melanie Roch, Maria Celeste Varela, Agustina Taglialegna, Warren E Rose, Adriana E Rosato
Methicillin-resistant Staphylococcus aureus (MRSA) acquisition in cystic fibrosis (CF) patients confers a worse clinical outcome with increased rate of declined lung function. Telavancin, an approved lipoglycopeptide used to treat infections due to S. aureus has a dual mode of action causing inhibition of the peptidoglycan synthesis and membrane depolarization. CF-associated MRSA infections remain an important problem with no foreseeable decline in prevalence rates. Although telavancin is currently in clinical use for complicated skin infections and hospital-acquired pneumonia, the activity against CF- associated S...
June 18, 2018: Antimicrobial Agents and Chemotherapy
Raymond Farah, Rola Khamisy-Farah, Nicola Makhoul
BACKGROUND: Accurate diagnosis of community acquired pneumonia (CAP) is crucial to its proper management and to combating antibiotic resistance. Levels of C-reactive protein (CRP) have been shown to distinguish pneumonia from other pathological conditions and can be used to control the severity of infection during admission. OBJECTIVES: To investigate an association between consecutive measurements of CRP and the severity of CAP in hospitalized patients. METHODS: A total of 500 patients with CAP were admitted to the hospital...
June 2018: Israel Medical Association Journal: IMAJ
Vladislav Dolgachev, Sreehari Panicker, Sanjay Balijepalli, Lane Kelly McCandless, Yue Yin, Samantha Swamy, M V Suresh, Matthew J Delano, Mark R Hemmila, Krishnan Raghavendran, David Machado-Aranda
Previously, we reported that electroporation-mediated (EP) delivery of the FER gene improved survival in a combined trauma-pneumonia model. The mechanism of this protective effect is unknown. In this paper, we performed a pneumonia model in C57/BL6 mice with 500 CFU of Klebsiella pneumoniae. After inoculation, a plasmid encoding human FER was delivered by EP into the lung (PNA/pFER-EP). Survival of FER-treated vs. controls (PNA; PNA/EP-pcDNA) was recorded. In parallel cohorts, bronchial alveolar lavage (BAL) and lung were harvested at 24 and 72 h with markers of infection measured...
June 15, 2018: Gene Therapy
Husam A AlTahan, Roaa R Amer, Areej A Madani, Eman A Bakhsh
BACKGROUND Epidural venous plexus (EVP) engorgement occurs due to many conditions, so it can be easily misdiagnosed. This becomes problematic when the diagnosis requires prompt treatment for a good outcome, especially when it results in cauda equina syndrome (CES). We report a case of extensive iliocaval thrombosis leading to epidural venous plexus and ascending lumbar vein engorgement as an outcome of deep venous thrombosis (DVT) due to probable adverse effects of oral combined contraceptive pills (OCCP). CASE REPORT A 42-year-old woman presented to a rural medical facility with bilateral lower-limb swelling and skin darkening for 2 days...
June 15, 2018: American Journal of Case Reports
Helio S Sader, Robert K Flamm, Glenn E Dale, Paul R Rhomberg, Mariana Castanheira
Background: Murepavadin (POL7080) represents the first member of a novel class of outer membrane protein-targeting antibiotics. Murepavadin acts by binding to LPS transport protein D and is being developed for the treatment of hospital-acquired and ventilator-associated pneumonia caused by Pseudomonas aeruginosa. Objectives: To evaluate the antimicrobial activity of murepavadin against XDR P. aeruginosa. Methods: A total of 785 clinical isolates of XDR P...
June 12, 2018: Journal of Antimicrobial Chemotherapy
Vasileios-Arsenios Lioutas, Sarah Marchina, Louis R Caplan, Magdy Selim, Joseph Tarsia, Luciana Catanese, Jonathan Edlow, Sandeep Kumar
BACKGROUND: Many patients with acute intracerebral hemorrhages (ICHs) undergo endotracheal intubation with subsequent mechanical ventilation (MV) for "airway protection" with the intent to prevent aspiration, pneumonias, and its related mortality. Conversely, these procedures may independently promote pneumonia, laryngeal trauma, dysphagia, and adversely affect patient outcomes. The net benefit of intubation and MV in this patient cohort has not been systematically investigated...
June 13, 2018: Cerebrovascular Diseases
Mario Tumbarello, Enrico Maria Trecarichi, Alberto Corona, Francesco Giuseppe De Rosa, Matteo Bassetti, Cristina Mussini, Francesco Menichetti, Claudio Viscoli, Caterina Campoli, Mario Venditti, Andrea De Gasperi, Alessandra Mularoni, Carlo Tascini, Giustino Parruti, Carlo Pallotto, Simona Sica, Ercole Concia, Rosario Cultrera, Gennaro De Pascale, Alessandro Capone, Spinello Antinori, Silvia Corcione, Elda Righi, Angela Raffaella Losito, Margherita Digaetano, Francesco Amadori, Daniele Roberto Giacobbe, Giancarlo Ceccarelli, Ernestina Mazza, Francesca Raffaelli, Teresa Spanu, Roberto Cauda, Pierluigi Viale
Background: Ceftazidime-avibactam (CAZ-AVI) has been approved in Europe for the treatment of complicated intra-abdominal and urinary-tract infections, as well as hospital-acquired pneumonia, and for Gram-negative infections with limited treatment options. CAZ-AVI displays in vitro activity against KPC-enzyme producers, but clinical-trial data on its efficacy in this setting are lacking. Methods: We retrospectively reviewed 138 cases of infections caused by Klebsiella pneumoniae carbapenemase-producing (KPC-Kp) in adults who received CAZ-AVI in compassionate-use programs in Italy...
June 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Alvaro J Ruiz, Giancarlo Buitrago, Nelcy Rodríguez, Gabriel Gómez, Suela Sulo, Carlos Gómez, Jamie Partridge, Juan Misas, Rodolfo Dennis, Magda Jeannette Alba, Walter Chaves-Santiago, Carolina Araque
BACKGROUND & AIMS: Hospitalized patients show a high rate of malnutrition, which is associated with poor patient outcomes and high healthcare costs. However, relatively few studies have investigated the association between clinical and economic outcomes and malnutrition in hospitalized patients, particularly those with cardiac and pulmonary conditions. METHODS: This multicenter prospective observational cohort study included 800 patients hospitalized at four Colombian hospitals with a diagnosis of congestive heart failure, acute myocardial infarction, community-acquired pneumonia, or chronic obstructive pulmonary disease...
June 1, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Jin-Young Min, Hye-Jin Kim, Chungsik Yoon, Kiyoung Lee, Myoungsouk Yeo, Kyoung-Bok Min
Background: Hospital-acquired pneumonia (HAP) is an inflammatory condition of the lung that develops at least 48⁻72 h after admission. HAP is contracted by both intensive care unit (ICU) and non-ICU patients, but no studies have examined the risk of HAP in patients admitted to the emergency department (ED). This study investigated the risk of developing HAP in ED patients and compared the occurrence of HAP 3⁻10 days after the first day of hospitalization in patients hospitalized via ED with those hospitalized via outpatient clinics...
June 5, 2018: International Journal of Environmental Research and Public Health
Matteo Bassetti, Antonio Vena, Antony Croxatto, Elda Righi, Benoit Guery
Infections with Pseudomonas aeruginosa have become a real concern in hospital-acquired infections, especially in critically ill and immunocompromised patients. The major problem leading to high mortality lies in the appearance of drug-resistant strains. Therefore, a vast number of approaches to develop novel anti-infectives is currently pursued. Diverse strategies range from killing (new antibiotics) to disarming (antivirulence) the pathogen. In this review, selected aspects of P. aeruginosa antimicrobial resistance and infection management will be addressed...
2018: Drugs in Context
Kirsten Koehorst-Ter Huurne, Catharina Gm Groothuis-Oudshoorn, Paul Dlpm vanderValk, Kris Ll Movig, Job van der Palen, Marjolein Brusse-Keizer
Aim: The aim of this study was to analyze the association between therapy adherence to inhaled corticosteroids (ICSs) and tiotropium on the one hand and morbidity and mortality in COPD on the other hand. Methods: Therapy adherence to ICSs and tiotropium over a 3-year period of, respectively, 635 and 505 patients was collected from pharmacy records. It was expressed as percentage and deemed optimal at ≥75-≤125%, suboptimal at ≥50%-<75%, and poor at <50% (underuse) or >125% (overuse)...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Marco Fiorentino, Fadi A Tohme, Shu Wang, Raghavan Murugan, Derek C Angus, John A Kellum
BACKGROUND: Several studies have shown that long-term survival after acute kidney injury (AKI) is reduced even if there is clinical recovery. However, we recently reported that in septic shock patients those that recover from AKI have survival similar to patients without AKI. Here, we studied a cohort with less severe sepsis to examine the effects of AKI on longer-term survival as a function of recovery by discharge. METHODS: We analyzed patients with community-acquired pneumonia from the Genetic and Inflammatory Markers of Sepsis (GenIMS) cohort...
2018: PloS One
Nguyen Viet Hung, Phan Thi Hang, Victor D Rosenthal, Le Thi Anh Thu, Le Thi Thu Nguyet, Ngo Quy Chau, Truong Anh Thu, Dinh Pham Phuong Anh, Tran Thi My Hanh, Tran Thi Thuy Hang, Dang Thi Van Trang, Nguyen Phuc Tien, Vo Thi Hong Thoa, Đao Quang Minh
OBJECTIVE: The aim of the study was to report the results of the International Nosocomial Infection Control Consortium (INICC) study conducted from May 2008 to March 2015. METHODS: A device-associated healthcare-acquired infection surveillance study in three adult intensive care units (ICUs) and 1 neonatal ICU from 4 hospitals in Vietnam using U.S. the Centers for Disease Control and Prevention's National Healthcare Safety Network (CDC/NHSN) definitions and criteria as well as INICC methods...
June 4, 2018: Journal of Patient Safety
Bradford D Gessner, Qin Jiang, Cornelis H Van Werkhoven, Heather L Sings, Chris Webber, Daniel Scott, Kathleen M Neuzil, Katherine L O'Brien, Richard G Wunderink, Diederick E Grobbee, Marc J M Bonten, Luis Jodar
BACKGROUND: We conducted a post-hoc analysis of a double blind, randomized, placebo-controlled trial of 13-valent pneumococcal conjugate vaccine (PCV13) among adults aged 65 years or older to assess public health impact. METHODS: For all outcomes, we included all randomized subjects, using a modified intention-to-treat (mITT) approach to determine vaccine efficacy (VE), vaccine preventable disease incidence (VPDI) defined as control minus vaccinated group incidence, and numbers needed to vaccinate (NNV) (based on a five-year duration of protection)...
May 31, 2018: Vaccine
Grant W Waterer, Wesley H Self, D Mark Courtney, Carlos G Grijalva, Robert A Balk, Timothy D Girard, Sherene S Fakhran, Christopher Trabue, Paul McNabb, Evan J Anderson, Derek J Williams, Anna M Bramley, Seema Jain, Kathryn M Edwards, Richard G Wunderink
INTRODUCTION: Adults hospitalized with community-acquired pneumonia are at high risk for short-term mortality. However, it is unclear whether improvements in in-hospital pneumonia care could substantially lower this risk. We extensively reviewed all in-hospital deaths in a large prospective CAP study to assess the cause of each death and assess the extent of potentially preventable mortality. METHODS: We enrolled adults hospitalized with CAP at five tertiary-care hospitals in the United States...
May 30, 2018: Chest
Nyambura Moremi, Heike Claus, Levina Rutta, Matthias Frosch, Ulrich Vogel, Stephen E Mshana
INTRODUCTION: Despite the reported high rates of surgical site infections (SSI) caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (EPE) in low-income countries, including Tanzania, the role of EPE carriage to subsequent occurrence of SSI is not known. This study investigated the magnitude of EPE carriage among surgical patients at the time of admission and discharge, and linked the carried EPE genotypes to those from SSI. METHODS: EPE were confirmed among isolates from rectal and wound/pus swabs using VITEK-2...
May 28, 2018: Journal of Hospital Infection
Oscar Daniel Ayala, Catherine Wakeman, Isaac J Pence, Eric P Skaar, Anita Mahadevan-Jansen
Staphylococcus aureus is a leading cause of hospital-acquired infections, such as bacteremia, pneumonia, and endocarditis. Treatment of these infections can be challenging since strains of S. aureus, such as methicillin-resistant S. aureus (MRSA), have evolved resistance to antimicrobials. Current methods to identify infectious agents in hospital environments often rely on time-consuming, multi-step culturing techniques to distinguish problematic strains (i.e. antimicrobial resistant variants) of a particular bacterial species...
May 30, 2018: ACS Infectious Diseases
C Olivier, H Kunneke, N O'Connell, E Von Delft, M Wates, A Dramowski
BACKGROUND: Healthcare-associated infections (HAIs) cause substantial morbidity, mortality and healthcare costs. The prevalence of neonatal/paediatric HAI at South African (SA) district and regional hospitals is unknown. OBJECTIVES: To document HAI rates, antimicrobial use for HAI, infection prevention staffing, hand hygiene (HH) provisions and HH compliance rates in neonatal and paediatric wards in two district and two regional hospitals in the Western Cape Province, SA...
April 25, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Shahina Rahman, Maja von Cube, Martin Schumacher, Martin Wolkewitz
BACKGROUND: In many studies the information of patients who are dying in the hospital is censored when examining the change in length of hospital stay (cLOS) due to hospital-acquired infections (HIs). While appropriate estimators of cLOS are available in literature, the existence of the bias due to censoring of deaths was neither mentioned nor discussed by the according authors. METHODS: Using multi-state models, we systematically evaluate the bias when estimating cLOS in such a way...
May 30, 2018: BMC Medical Research Methodology
B Tu, S X Liu, D Wu, X Zhang, L Shi, Y X Xie, P Zhao, E Q Qin
Objective: o investigate the features of pathogenic bacteria for community-acquired bloodstream infection due to Gram-negative bacilli in patients with liver cirrhosis and optimal therapeutic strategy. Methods: A retrospective analysis was performed for the clinical data of patients with liver cirrhosis who were admitted to 302 Hospital of PLA due to community-acquired bloodstream infection from January 2010 to December 2015, and a statistical analysis was performed for their clinical features, pathogenic bacteria, and results of drug sensitivity test...
January 20, 2018: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
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