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ICU pneumonia rate

James C Hurley
BACKGROUND: Acinetobacter species such as Acinetobacter baumanii are of increasing concern in association with ventilator associated pneumonia (VAP). In the ICU, Acinetobacter infections are known to be subject to seasonal variation but the extent of geographic variation is unclear. The objective here is to define the extent and possible reasons for geographic variation for Acinetobacter associated VAP whether or not these isolates are reported as Acinetobacter baumanii. METHODS: A meta-regression model of VAP associated Acinetobacter incidence within the published literature was undertaken using random effects methods...
October 18, 2016: BMC Infectious Diseases
Kelsey Chinnadurai, Lindy Fenlason, Brian Bridges, Mana Espahbodi, Sivakumar Chinnadurai, Jane Blood-Siegfried
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common nosocomial infection in pediatric intensive care units (ICUs). Ventilator-associated pneumonia protocols decrease the incidence of VAP; however, many components of these protocols are not feasible in all settings. This study was done in a large pediatric hospital in Nicaragua. OBJECTIVE: The aim of this study is to implement a sustainable evidence-based VAP protocol, in a different culture, for the purpose of decreasing VAP rates...
November 2016: Dimensions of Critical Care Nursing: DCCN
Víctor Daniel Rosenthal, Hail M Al-Abdely, Amani Ali El-Kholy, Safa A Aziz AlKhawaja, Hakan Leblebicioglu, Yatin Mehta, Vineya Rai, Nguyen Viet Hung, Souha Sami Kanj, Mona Foda Salama, Estuardo Salgado-Yepez, Naheed Elahi, Rayo Morfin Otero, Anucha Apisarnthanarak, Braulio Matias De Carvalho, Bat Erdene Ider, Dale Fisher, Maria Carmen S G Buenaflor, Michael M Petrov, Ana Marcela Quesada-Mora, Farid Zand, Vaidotas Gurskis, Tanja Anguseva, Aamer Ikram, Daisy Aguilar de Moros, Wieslawa Duszynska, Nepomuceno Mejia, Florin George Horhat, Vladislav Belskiy, Vesna Mioljevic, Gabriela Di Silvestre, Katarina Furova, Gloria Y Ramos-Ortiz, May Osman Gamar Elanbya, Hindra Irawan Satari, Umesh Gupta, Tarek Dendane, Lul Raka, Humberto Guanche-Garcell, Bijie Hu, Denis Padgett, Kushlani Jayatilleke, Najla Ben Jaballah, Eleni Apostolopoulou, Walter Enrique Prudencio Leon, Alejandra Sepulveda-Chavez, Hector Miguel Telechea, Andrew Trotter, Carlos Alvarez-Moreno, Luis Kushner-Davalos
BACKGROUND: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days...
October 11, 2016: American Journal of Infection Control
Benjamin W Teh, Simon J Harrison, Monica A Slavin, Leon J Worth
BACKGROUND: Bloodstream infections (BSIs) are a significant complication of treatment for multiple myeloma (MM). The objective of this study was to define the epidemiology of BSI with current era MM treatment regimens, including immunomodulatory drugs, proteasome inhibitors and autologous haematopoietic stem cell transplantation (ASCT). METHODS: Clinical and microbiology records of patients with MM diagnosed between 2008 and 2012 were reviewed using a standardised tool to capture patient demographics, myeloma characteristics and BSI characteristics (type, severity, outcomes)...
September 26, 2016: European Journal of Haematology
Jean-Francois Timsit, Elie Azoulay, Carole Schwebel, Pierre Emmanuel Charles, Muriel Cornet, Bertrand Souweine, Kada Klouche, Samir Jaber, Jean-Louis Trouillet, Fabrice Bruneel, Laurent Argaud, Joel Cousson, Ferhat Meziani, Didier Gruson, Adeline Paris, Michael Darmon, Maité Garrouste-Orgeas, Jean-Christophe Navellou, Arnaud Foucrier, Bernard Allaouchiche, Vincent Das, Jean-Pierre Gangneux, Stéphane Ruckly, Daniele Maubon, Vincent Jullien, Michel Wolff
Importance: Although frequently used in treating intensive care unit (ICU) patients with sepsis, empirical antifungal therapy, initiated for suspected fungal infection, has not been shown to improve outcome. Objective: To determine whether empirical micafungin reduces invasive fungal infection (IFI)-free survival at day 28. Design, Setting, and Participants: Multicenter double-blind placebo-controlled study of 260 nonneutropenic, nontransplanted, critically ill patients with ICU-acquired sepsis, multiple Candida colonization, multiple organ failure, exposed to broad-spectrum antibacterial agents, and enrolled between July 2012 and February 2015 in 19 French ICUs...
October 5, 2016: JAMA: the Journal of the American Medical Association
Fleur P Paling, Martin Wolkewitz, Lonneke G M Bode, Peter M C Klein Klouwenberg, David S Y Ong, Pieter Depuydt, Liesbet de Bus, Frangiscos Sifakis, Marc J M Bonten, Jan A J W Kluytmans
OBJECTIVE: To quantify the incidence of intensive care unit (ICU) acquired pneumonia caused by Staphylococcus aureus (S. aureus) and its association with S. aureus colonization at ICU admission. METHODS: This was a post-hoc analysis of two cohort studies in critically ill patients. The primary outcome was the incidence of microbiologically confirmed S. aureus ICU-acquired pneumonia. Incidences of S. aureus ICU pneumonia and associations with S. aureus colonization at ICU admission were determined using competing risks analyses...
September 29, 2016: Clinical Microbiology and Infection
Li Weng, Xu Huang, Lie Chen, Li-Qin Feng, Wei Jiang, Xiao-Yun Hu, Jin-Min Peng, Chun-Yao Wang, Qing-Yuan Zhan, Bin Du
BACKGROUND: Pneumocystis jiroveci pneumonia (PJP) in non-HIV patients is still a challenge for intensivists. The aim of our study was to evaluate mortality predictors of PJP patients requiring Intensive care unit (ICU) admission. METHODS: Retrospectively review medical records of patients with diagnosis of PJP admitted to four ICUs of two academic medical centers from October 2012 to October 2015. RESULTS: Eighty-two patients were enrolled in the study...
September 29, 2016: BMC Infectious Diseases
Lawrence A DeLuca, Paul Walsh, Donald D Davidson, Lisa R Stoneking, Laurel M Yang, Kristi J H Grall, M Jessica Gonzaga, Wanda J Larson, Uwe Stolz, Dylan M Sabb, Kurt R Denninghoff
BACKGROUND: Ventilator-associated pneumonia (VAP) has been linked to emergency department (ED) intubation and length of stay (LOS). We assessed VAP prevalence in ED intubated patients, feasibility of ED VAP prevention, and effect on VAP rates. METHODS: This was a quality improvement initiative using a pre/post design. Phase 1 (PRE1) comprised patients before intensive care unit (ICU) bundle deployment. Phase 2 (PRE2) occurred after ICU but before ED deployment. Phase 3 (POST) included patients received VAP prevention starting at ED intubation...
September 21, 2016: American Journal of Infection Control
Sofia Maraki, Elpis Mantadakis, Viktoria Eirini Mavromanolaki, Diamantis P Kofteridis, George Samonis
BACKGROUND: Acinetobacter baumannii has emerged as a major cause of nosocomial outbreaks. It is particularly associated with nosocomial pneumonia and bloodstream infections in immunocompromised and debilitated patients with serious underlying pathologies. Over the last two decades, a remarkable rise in the rates of multidrug resistance to most antimicrobial agents that are active against A. baumannii has been noted worldwide. We evaluated the rates of antimicrobial resistance and changes in resistance over a 5-year period (2010-2014) in A...
September 2016: Infection & Chemotherapy
Anne Maree Kelly, Anna Holdgate, Gerben Keijzers, Sharon Klim, Colin A Graham, Simon Craig, Win Sen Kuan, Peter Jones, Charles Lawoko, Said Laribi
BACKGROUND: This study aimed to determine epidemiology and outcome for patients presenting to emergency departments (ED) with shortness of breath who were transported by ambulance. METHODS: This was a planned sub-study of a prospective, interrupted time series cohort study conducted at three time points in 2014 and which included consecutive adult patients presenting to the ED with dyspnoea as a main symptom. For this sub-study, additional inclusion criteria were presentation to an ED in Australia or New Zealand and transport by ambulance...
September 22, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Ahmad Ghoochani Khorasani, Shahin Shadnia, Mohammad Mashayekhian, Mitra Rahimi, Abbas Aghabiklooei
Background. Ventilator-associated pneumonia (VAP) is the most common health care-associated infection. To prevent this complication, aspiration of subglottic secretions using Hi-Lo Evac endotracheal tube (Evac ETT) is a recommended intervention. However, there are some reports on Evac ETT dysfunction. We aimed to compare the incidence of VAP (per ventilated patients) in severely ill poisoned patients who were intubated using Evac ETT versus conventional endotracheal tubes (C-ETT) in our toxicology ICU. Materials and Methods...
2016: Scientifica
Mevlut Karatas, Sedat Saylan, Ugur Kostakoglu, Gurdal Yilmaz
OBJECTIVES: Ventilator-associated pneumonia (VAP) is a significant cause of hospital-related infections, one that must be prevented due to its high morbidity and mortality. The purpose of this study was to evaluate the incidence and risk factors in patients developing VAP in our intensive care units (ICUs). METHODS: This retrospective cohort study involved in mechanically ventilated patients hospitalized for more than 48 hours. VAP diagnosed patients were divided into two groups, those developing pneumonia (VAP(+)) and those not (VAP(-))...
July 2016: Pakistan Journal of Medical Sciences Quarterly
Y L Gong, Z C Yang, S P Yin, M X Liu, C Zhang, X Q Luo, Y Z Peng
Objective: To analyze the distribution and drug resistance of pathogen isolated from severely burned patients with bloodstream infection, so as to provide reference for the clinical treatment of these patients. Methods: Blood samples of 162 severely burned patients (including 120 patients with extremely severe burn) with bloodstream infection admitted into our burn ICU from January 2011 to December 2014 were collected. Pathogens were cultured by fully automatic blood culture system, and API bacteria identification panels were used to identify pathogen...
September 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Maryam Karkhane, Mohamad Amin Pourhosiengholi, Mohammad Reza Akbariyan Torkabad, Zahra Kimiia, Seyed Mehdi Mortazavi, Seyed Karim Hossieni Aghdam, Abdolrazagh Marzban, Mohammad Reza Zali
So far, too little attention has been paid to total burden of healthcare associated infections (HAIs) in Iran. In the present study, we aimed to assess the rate of HAIs, as well as economic burden of hospitalization and antibiotic related cost associated with HAIs in ICU at training Taleghani hospital in Iran and to compare our results with national nosocomial infections surveillance (NNIS) system. This research to date for the first time has tended to focus on the economic burden of HAIs rather than epidemiology of HAIs evaluation...
2016: Iranian Journal of Pharmaceutical Research: IJPR
Urshila Durani, Maria V Dioverti Prono, Pritish K Tosh, Mrinal Patnaik, Jason N Barreto, Aaron J Tande
While lymphopenia is a well-defined risk factor for severe influenza, the effect of neutropenia is unknown. This was a retrospective single centre study of adult patients with documented neutropenia and influenza between 2005 and 2013. Forty patients were included with a median follow-up of 2 years (IQR 0.8-4.0). Median ANC at influenza diagnosis was 0.3 × 10(9)/L (IQR 0.1-0.4 × 10(9)/L). Outcomes included hospitalization (N = 28, 70%), pneumonia (N = 9, 23%), ICU admission (N = 9, 23%) and mechanical ventilation (N = 7, 18%)...
September 16, 2016: Infectious Diseases
Shane P Selvanderan, Matthew J Summers, Mark E Finnis, Mark P Plummer, Yasmine Ali Abdelhamid, Michael B Anderson, Marianne J Chapman, Christopher K Rayner, Adam M Deane
OBJECTIVES: Pantoprazole is frequently administered to critically ill patients for prophylaxis against gastrointestinal bleeding. However, comparison to placebo has been inadequately evaluated, and pantoprazole has the potential to cause harm. Our objective was to evaluate benefit or harm associated with pantoprazole administration. DESIGN: Prospective randomized double-blind parallel-group study. SETTING: University-affiliated mixed medical-surgical ICU...
October 2016: Critical Care Medicine
Ashu Sara Mathai, Atul Phillips, Rajesh Isaac
BACKGROUND: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection acquired by patients in the Intensive Care Unit (ICU). However, there are scarce clinical data, particularly from Indian ICUs on the occurrence of this infection. AIMS: To collect data on the incidence, microbiological profile, and outcomes of patients with VAP. SETTINGS AND DESIGN: Tertiary level, medical-surgical ICU; prospective, observational study...
September 2016: Lung India: Official Organ of Indian Chest Society
Kathryn Booth, Josh Rivet, Richelle Flici, Ellen Harvey, Mark Hamill, Douglas Hundley, Katelyn Holland, Sandra Hubbard, Apurva Trivedi, Bryan Collier
The intensive care unit (ICU) trauma population is at high risk for complications associated with immobility. The purpose of this project was to compare ICU trauma patient outcomes before and after implementation of a structured progressive mobility (PM) protocol. Outcomes included hospital and ICU stays, ventilator days, falls, respiratory failure, pneumonia, or venous thromboembolism (VTE). In the preintervention cohort, physical therapy (PT) consults were placed 53% of the time. This rose to more than 90% during the postintervention period...
September 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Miklos Lipcsey, Ivan Subiakto, Jonathan Chiong, Melissa A Kaufman, Antoine G Schneider, Rinaldo Bellomo
OBJECTIVE: Fluid bolus therapy (FBT) is a common therapy for hypotensive sepsis, but no studies have compared primary FBT (in the first 6 hours after presentation to the emergency department [ED]) with secondary FBT (6-24 hours after presentation to the ED). We aimed to describe the patterns of use, physiological sequelae and outcomes of patients with hypotensive sepsis who were treated with primary FBT or combined primary and secondary FBT (secondary FBT). DESIGN, SETTING AND PATIENTS: A retrospective observational study of patients with hypotensive sepsis presenting to the ED of a tertiary hospital from 1 January to 31 December 2010...
September 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Muhammad W Sadiq, Elisabet I Nielsen, Dalia Khachman, Jean-Marie Conil, Bernard Georges, Georges Houin, Celine M Laffont, Mats O Karlsson, Lena E Friberg
The purpose of this study was to develop a whole-body physiologically based pharmacokinetic (WB-PBPK) model for ciprofloxacin for ICU patients, based on only plasma concentration data. In a next step, tissue and organ concentration time profiles in patients were predicted using the developed model. The WB-PBPK model was built using a non-linear mixed effects approach based on data from 102 adult intensive care unit patients. Tissue to plasma distribution coefficients (Kp) were available from the literature and used as informative priors...
August 30, 2016: Journal of Pharmacokinetics and Pharmacodynamics
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