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https://www.readbyqxmd.com/read/29324651/incidence-microbiological-profile-and-risk-factors-of-healthcare-associated-infections-in-intensive-care-units-a-10-year-observation-in-a-provincial-hospital-in-southern-poland
#1
Małgorzata Kołpa, Marta Wałaszek, Agnieszka Gniadek, Zdzisław Wolak, Wiesław Dobroś
Healthcare-associated infections (HAIs) occurring in patients treated in an intensive care unit (ICU) are serious complications in the treatment process. Aetiological factors of these infections can have an impact on treatment effects, treatment duration and mortality. The aim of the study was to determine the prevalence and microbiological profile of HAIs in patients hospitalized in an ICU over a span of 10 years. The active surveillance method was used to detect HAIs in adult patients who spent over 48 h in a general ICU ward located in southern Poland between 2007 and 2016...
January 11, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29313312/influence-of-single-dose-antibiotic-prophylaxis-for-early-onset-pneumonia-in-high-risk-intubated-patients
#2
Timothy D Lewis, Kelly A Dehne, Kathryn Morbitzer, Denise H Rhoney, Casey Olm-Shipman, J Dedrick Jordan
BACKGROUND: Early-onset pneumonia (EOP) after endotracheal intubation is common among critically ill patients with a neurologic injury and is associated with worse clinical outcomes. METHODS: This retrospective cohort study observed outcomes pre- and post-implementation of an EOP prophylaxis protocol which involved the administration of a single dose of ceftriaxone 2 g around the time of intubation. The study included patients ≥ 18 years who were admitted to the University of North Carolina Medical Center (UNCMC) neuroscience intensive care unit (NSICU) between April 1, 2014, and October 26, 2016, and intubated for ≥ 72 h...
January 8, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29286009/efficacy-of-loading-dose-of-colistin-in-acinetobacter-baumannii-ventilator-associated-pneumonia
#3
Emine Alp, Esma Eren, Gülseren Elay, Fatma Cevahir, Aliye Esmaoğlu, Jordi Rello
Colistin loading dose (LD) has been postulated as an advance in therapy. The clinical, microbiological effectiveness and nephrotoxicity of adding an LD to systemic colistin in ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR) Acinetobacter baumannii remain unknown. In this quasi experimental study, the efficacy, outcomes and nephrotoxicity in 30 adults who received intravenous colistin with LD for MDR A. baumannii ventilator associated pneumonia were compared with 22 in absence of LD...
December 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/29285846/development-of-a-modified-swallowing-screening-tool-to-manage-post-extubation-dysphagia
#4
Martin Christensen, Michaela Trapl
Post-extubation dysphagia is a condition that is becoming a growing concern. The condition occurs in 3-62% of extubated patients and can be related to mixed aetiologies, such as neuromuscular impairment, critical illness and laryngeal damage. The risk factors for developing dysphagia in critically ill patients are under-diagnosed and perhaps underestimated. Recent studies recommend the implementation of a standardized swallowing screen to prevent aspiration and decrease pneumonia rate and mortality. The aim of this quality improvement initiative was the development of a bedside swallowing screening tool to assess effective swallowing post-endotracheal extubation...
December 28, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/29283957/early-tracheostomy-in-patients-with-traumatic-cervical-spinal-cord-injury-appears-safe-and-may-improve-outcomes
#5
Christopher Flanagan, Benjamin R Childs, Timothy A Moore, Heather A Vallier
STUDY DESIGN: Retrospective case series OBJECTIVE.: To characterize outcomes associated with tracheostomy timing following traumatic cervical spinal cord injury (CSCI). SUMMARY OF BACKGROUND DATA: The morbidity associated with cervical spine trauma is substantially increased in the setting of concomitant CSCI. Despite recent evidence, it remains uncertain if early tracheostomy following traumatic CSCI can improve outcomes. METHODS: From January 1, 2007, to December 31, 2015, retrospective chart review identified seventy (70) patients who presented to a single Level 1 trauma center with traumatic CSCI and received tracheostomy for management of respiratory compromise...
December 27, 2017: Spine
https://www.readbyqxmd.com/read/29246210/rates-and-risk-factors-associated-with-hospitalization-for-pneumonia-with-icu-admission-among-adults
#6
Aaron D Storms, Jufu Chen, Lisa A Jackson, James D Nordin, Allison L Naleway, Jason M Glanz, Steven J Jacobsen, Eric S Weintraub, Nicola P Klein, Paul M Gargiullo, Alicia M Fry
BACKGROUND: Pneumonia poses a significant burden to the U.S. health-care system. However, there are few data focusing on severe pneumonia, particularly cases of pneumonia associated with specialized care in intensive care units (ICU). METHODS: We used administrative and electronic medical record data from six integrated health care systems to estimate rates of pneumonia hospitalizations with ICU admissions among adults during 2006 through 2010. Pneumonia hospitalization was defined as either a primary discharge diagnosis of pneumonia or a primary discharge diagnosis of sepsis or respiratory failure with a secondary diagnosis of pneumonia in administrative data...
December 16, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29239151/an-observational-veneto-research-on-ventilator-associated-pneumonia-overvap-attributable-mortality-and-cumulative-incidence-of-ventilator-associated-pneumonia
#7
Armando Olivieri, Daniele Del Monte, Luca Benacchio, Daniele Bonvicini, Marco Baiocchi, Camilla Allegri, Luana Fornasier, Alessandra Carlot, Ioannis Psimadas, Alfeo Bonato, Mara Bernasconi, Andrea Medè, Andrea Bianchin, Mario Peta, Massimiliano Caravello, Roberta Rampazzo, Antonella Pedrini, Massimiliano Dalsasso, Debora Saggioro, Andrea Zennaro, Carlo Ori, Ernesto Pizzirani
BACKGROUND: The association between Ventilator-associated pneumonia (VAP) and mortality varies from study to study, and its entity is uncertain due a considerable variation in the attributable mortality. The aim of this study was to evaluate the relationship between VAP frequency and mortality in a cohort of mechanically ventilated patients. METHODS: A multicentre prospective observational study was conducted in 21 Intensive Care Units (ICU). The patients were recruited from 2008 to 2010 within randomly selected periods...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29222035/carriage-of-esbl-producing-enterobacteriaceae-in-french-hospitals-the-portablse-study
#8
B Pilmis, V Cattoir, D Lecointe, A Limelette, I Grall, A Mizrahi, G Marcade, I Poilane, T Guillard, N Bourgeois Nicolaos, J-R Zahar, A Le Monnier
BACKGROUND: Currently, contact precautions are recommended for patients colonized or infected with extended spectrum beta-lactamase producing enterobacteriaceae (ESBL-PE). Recent studies have challenged this strategy. This study aimed to assess the rate of ESBL-PE faecal carriage among hospitalized patients according to type of hospital ward, and to identify risk factors associated with carriage. METHODS: We conducted a point prevalence study in five different types of hospital wards (medical, surgical, intensive care unit (ICU), after care and rehabilitation and geriatric) in 8 French hospitals...
December 5, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29217880/renal-manifestation-in-scrub-typhus-during-a-major-outbreak-in-central-nepal
#9
A Sedhain, G R Bhattarai
Renal involvement and acute kidney injury (AKI) are common clinical manifestations seen in scrub typhus, a vector-borne tropical disease. There are no data on renal manifestation in scrub typhus in Nepal. We conducted a prospective study to analyze the incidence, urinary abnormalities, course, severity, outcome, and the predictors of AKI in patients with scrub typhus during a major outbreak in Central Nepal. Total 1398 patients admitted with acute febrile illness were subjected for Scrub Typhus Detect™ Immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) test, of which 502 (35...
November 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/29216940/-study-on-risk-factor-of-central-venous-catheter-infection-in-icu-1-160-patients-report
#10
Ming Zhang, Yongqing Xu, Zhiming Jiang, Junying Qian, Zhonghui Zhang, Nannan Sun, Jian Xie, Tao Li
OBJECTIVE: To analyze the etiology and risk factors of central venous catheter (CVCs) infections, and to explore the prophylaxis and treatment for catheter-related infections. METHODS: A retrospective study was conducted. The patients with CVCs admitted to intensive care unit (ICU) of Qianfoshan Hospital Affiliated to Shandong University from January 2000 to December 2016 were enrolled. The gender, age, catheter data and microorganism culture results of all patients were collected...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29206767/prevention-of-ventilator-associated-and-early-postoperative-pneumonia-through-tapered-endotracheal-tube-cuffs-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#11
Bert Maertens, Koen Blot, Stijn Blot
OBJECTIVE: Microaspiration of subglottic secretions is considered a major pathogenic mechanism of hospital-acquired pneumonia, either early postoperative or ventilator-associated pneumonia. Tapered endotracheal tube cuffs have been proposed to provide a better seal of the extraluminal airway, thereby preventing microaspiration and possibly hospital-acquired pneumonia. We performed a systematic review and meta-analysis to assess the value of endotracheal tubes with tapered cuffs in the prevention of hospital-acquired pneumonia...
December 4, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29189950/cost-assessment-of-a-new-oral-care-program-in-the-intensive-care-unit-to-prevent-ventilator-associated-pneumonia
#12
Jérôme Ory, Charline Mourgues, Evelyne Raybaud, Russell Chabanne, Jean Christophe Jourdy, Fabien Belard, Renaud Guérin, Bernard Cosserant, Jean Sébastien Faure, Laure Calvet, Bruno Pereira, Dominique Guelon, Ousmane Traore, Laurent Gerbaud
OBJECTIVES: Ventilator-associated pneumonia (VAP) is the most frequent hospital-acquired infections in intensive care units (ICU). In the bundle of care to prevent the VAP, the oral care is very important strategies, to decrease the oropharyngeal bacterial colonization and presence of causative bacteria of VAP. In view of the paucity of medical economics studies, our objective was to determine the cost of implementing this oral care program for preventing VAP. MATERIALS AND METHODS: In five ICUs, during period 1, caregivers used a foam stick for oral care and, during period 2, a stick and tooth brushing with aspiration...
November 30, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29186095/-intraoperative-fluid-therapy-during-esophagectomy-followed-by-repair
#13
V A Sizov, M B Raevskaya, N B Kovalerova, D V Ruchkin, V V Subbotin, V V Kazennov, S A Ilyin
AIM: To optimize fluid therapy in transhiatal eshophagectomy by using of goal-oriented infusion therapy based on stroke volume variation. MATERIAL AND METHODS: Our trial enrolled 30 patients who underwent transhiatal esophagectomy followed by repair for the period 2011-2014. Patients were divided into 2 groups. The first group (LT) included 16 patients with liberal fluid therapy. The second group (GDT) consisted of 14 patients in whom goal-oriented fluid therapy was performed...
2017: Khirurgiia
https://www.readbyqxmd.com/read/29181890/acute-kidney-injury-induced-by-concomitant-use-of-vancomycin-and-piperacillin-tazobactam-in-pediatrics
#14
Manal Abouelkheir, Sarah Alsubaie
BACKGROUND: Vancomycin is very commonly used in combination with piperacillin-tazobactam (PTZ) as an initial empiric therapy for moderate to severe infections, whenever coverage for both methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa is required. The combination of vancomycin and PTZ in adults has recently been reported to significantly increase the risk of developing acute kidney injury (AKI) relative to vancomycin monotherapy; such reports in pediatrics are sparse...
November 27, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29180888/association-between-serum-concentration-of-25-hydroxyvitamin-d-and-community-acquired-pneumonia-a-case-control-study
#15
Mojgan Mamani, Neda Muceli, Hamid Reza Ghasemi Basir, Maryam Vasheghani, Jalal Poorolajal
Background: Community-acquired pneumonia (CAP) is a common disease with significant morbidity and mortality. There is evidence that vitamin D deficiency can be associated with infectious diseases. The aim of this study was to compare the levels of vitamin D between patients with CAP and healthy controls. Methods: In a case-control study on 73 patients with CAP and 76 healthy controls, the serum concentration of 25-hydroxyvitamin D (25[OH]D) was measured. Severity and outcomes of disease and also duration of hospital stay were compared in patients with different levels of 25(OH)D...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/29180034/surgical-stabilization-of-rib-fractures-a-single-institution-experience
#16
Erica D Kane, Elan Jeremitsky, Katharine R Bittner, Susan Kartiko, Andrew R Doben
BACKGROUND: Utilization of surgical stabilization of rib fractures (SSRF) has increased. Despite compelling small studies, many centers still struggle with determining criteria for intervention. We investigate the benefit of SSRF in our patients compared to non-operative (NonOp) National Trauma Databank (NTDB) Controls, specifically in the older population. STUDY DESIGN: Retrospective comparison of trauma patients with ≥3 and >5 rib fractures who underwent SSRF at a tertiary care Level I trauma center to non-operatively managed (NonOp) National Trauma Databank (NTDB) controls from equivalent Level I centers between 2007-2014...
November 24, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29174858/visualized-evaluation-of-blood-flow-to-the-gastric-conduit-and-complications-in-esophageal-reconstruction
#17
Kazuhiro Noma, Yasuhiro Shirakawa, Nobuhiko Kanaya, Tsuyoshi Okada, Naoaki Maeda, Takayuki Ninomiya, Shunsuke Tanabe, Kazufumi Sakurama, Toshiyoshi Fujiwara
BACKGROUND: Evaluation of the blood supply to gastric conduits is critically important to avoid complications following esophagectomy. We commenced visualized evaluation of blood flow using indocyanine green (ICG) fluorescent imaging from July 2015, to reduce reconstructive complications. In this study, we aimed to statistically verify the efficacy of blood flow evaluation using our simplified ICG method. STUDY DESIGN: A total of 285 consecutive patients who underwent esophagectomy and gastric conduit reconstruction were reviewed and divided into two groups: before and after introduction of ICG evaluation...
November 22, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29167061/implementation-and-outcomes-of-hospital-wide-computerized-antimicrobial-approval-system-and-on-the-spot-education-in-a-traumatic-intensive-care-unit-in-taiwan
#18
Tsung-Yu Huang, Chien-Hui Hung, Li-Ju Lai, Hui-Ju Chuang, Chien-Chen Wang, Pei-Tzu Lin, Wei-Hsiu Hsu
BACKGROUND/PURPOSE: Inappropriate prescribing of antibiotics is a major health-care problem in intensive care units (ICUs). This study evaluates the impact of a direct hospital-wide computerized antimicrobial approval system (HCAAS) and on-the-spot education for practitioners in a neurosurgical ICU in Taiwan. METHODS: We retrospectively analyzed the medical records monthly of patients who were admitted to the neurosurgical ICU during a period of 7 years and 7 months...
November 11, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/29154953/correlation-between-cefepime-utilization-and-pseudomonas-aeruginosa-resistance-rate-to-beta-lactams-and-carbapenems-in-patients-with-healthcare-associated-infections
#19
Zorana M Djordjevic, Marko M Folic, Slobodan M Jankovic
OBJECTIVES: There is direct link between overutilization or abuse of antibiotics and P.aeruginosa resistance rate, but other factors could influence the resistance rate, too. The study aim was to observe changes of P.aeruginosa resistance rate in patients with hospital acquired infections (HAIs) after a period of cefepime unavailability in an intensive care unit (ICU). METHODS: The study was designed as retrospective observational analysis of trends in utilization of antibiotics and density of resistance to antibiotics...
November 14, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29153959/after-hours-respiratory-physiotherapy-for-intubated-and-mechanically-ventilated-patients-with-community-acquired-pneumonia-an-australian-perspective
#20
Lisa van der Lee, Anne-Marie Hill, Shane Patman
INTRODUCTION: Community acquired pneumonia (CAP) is a common reason for admission to an intensive care unit for intubation and mechanical ventilation, and results in high morbidity and mortality. The primary aim of the study was to investigate availability and provision of respiratory physiotherapy, outside of normal business hours, for intubated and mechanically ventilated adults with CAP in Australian hospitals. MATERIALS AND METHODS: A cross-sectional, mixed methods online survey was conducted...
November 15, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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