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ICU pneumonia rate

Alessandro Russo, Simone Giuliano, Giancarlo Ceccarelli, Francesco Alessandri, Alessandra Giordano, Grazia Brunetti, Mario Venditti
Objectives: a significant cause of mortality in intensive care unit (ICU) is represented by multidrug-resistant (MDR) gram-negative bacteria, such as MDR Acinetobacter baumannii (MDR-AB) and Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-Kp). Aim of the present study was the comparison of clinical features, therapy and outcome of patients who developed septic shock due to either MDR-AB or KPC-Kp. Methods: were retrospectively analyzed patients admitted to the intensive care unit (ICU) of a teaching hospital, from November 2010 to December 2015, who developed septic shock due to MDR-AB or KPC-Kp infection...
March 19, 2018: Antimicrobial Agents and Chemotherapy
Nikhil Satchidanand, Timothy J Servoss, Ranjit Singh, Angela M Bosinski, Penny Tirpak, Linda L Horton, Bruce J Naughton
BACKGROUND: Early, data-driven discussion surrounding palliative care can improve care delivery and patient experience. OBJECTIVE: To develop a 30-day mortality prediction tool for older patients in intensive care unit (ICU) with pneumonia that will initiate palliative care earlier in hospital course. DESIGN: Retrospective Electronic Health Record (EHR) review. SETTING: Four urban and suburban hospitals in a Western New York hospital system...
January 1, 2018: American Journal of Hospice & Palliative Care
Grzegorz Ziółkowski, Iwona Pawłowska, Lech Krawczyk, Jadwiga Wojkowska-Mach
BACKGROUND: Acinetobacter baumannii strains are currently the most commonly isolated non-fermenting rods at Polish intensive care units (ICUs), and they are the dominant aetiological agents of pneumonia. This study aimed to evaluate the prevalence of A. baumannii isolated from patients who were hospitalised at Sosnowiec Hospital's ICU. We also investigated the drug sensitivity of A. baumannii in relation to antibiotic consumption expressed as the defined daily dose (DDD) and Clostridium difficile infection (CDI)...
March 13, 2018: Journal of Infection and Public Health
Selcuk Kayir, Hulya Ulusoy, Guvenc Dogan
Background/aims Sedation is one of the most important components of intensive care unit (ICU) in patients who are mechanically ventilated at intensive care conditions. As a result of sedation and analgesia in the intensive care unit, the patient is to be awakened a comfortable and easy process. The aim of the study is to demonstrate the effects of day-time sedation interruptions in intensive care patients. Material and methods We made a retrospective review of 100 patients who were monitored, mechanically ventilated and treated at our intensive care unit between January 2008 and January 2013...
January 13, 2018: Curēus
Demosthenes Makris, Efi Petinaki, Vasssiliki Tsolaki, Efstratios Manoulakas, Konstantinos Mantzarlis, Olimpia Apostolopoulou, Dimitrios Sfyras, Epaminondas Zakynthinos
Background: Retrospective studies have reported good clinical success rates using colistin as monotherapy to treat Acinetobacter baumannii ventilator-associated pneumonia (VAP), comparable to that obtained with colistin combined with other antibiotics. However, inadequate penetration into the pulmonary parenchyma for colistin has been shown in animal models. Aim: The aim of the study was to study prospectively the outcome, measured as clinical response and survival, of intravenously administered colistin versus colistin combined with high-dose ampicillin-sulbactam in Intensive Care Unit (ICU) patients with multiresistant A...
February 2018: Indian Journal of Critical Care Medicine
Robert M Van Haren, Reza J Mehran, Arlene M Correa, Mara B Antonoff, Carla M Baker, Ta Charra Woodard, Wayne L Hofstetter, Gabriel E Mena, Jack A Roth, Boris Sepesi, Stephen G Swisher, Ara A Vaporciyan, Garrett L Walsh, David C Rice
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways aim to improve postoperative recovery through evidence-based practices including early ambulation, multimodal opioid-sparing analgesia, and reduction of surgical stress. The purpose of this study was to evaluate outcomes following implementation of ERAS in patients undergoing resection for pulmonary malignancy. METHODS: A retrospective review compared outcomes for patients undergoing pulmonary resection for primary lung cancer...
March 9, 2018: Annals of Thoracic Surgery
Iolanda Alves Braga, Paola Amaral de Campos, Paulo Pinto Gontijo Filho, Rosineide Marques Ribas
BACKGROUND: Healthcare-associated infection (HAI) represents a major problem for patient safety worldwide. AIM: To provide an up-to-date picture of the extent, aetiology, risk factors and patterns of infections in intensive care units (ICUs) in 28 Brazilian hospitals of different sizes. METHODS: A one-day point prevalence survey in 2016 enrolled the ICU of hospitals from the 12 meso regions located in the State of Minas Gerais, Southeast region of Brazil...
March 6, 2018: Journal of Hospital Infection
X Huang, L Weng, L Yi, M Li, Y Y Feng, Y Tian, J G Xia, Q Y Zhan, B Du
Objective: To investigate the clinical manifestations and prognostic factors of hospital death in connective tissue disease patients with acute respiratory failure caused by pneumocystis pneumonia (PCP) admitted to two medical intensive care units(MICU). Methods: A retrospective review was conducted for all connective tissue disease (CTD) patients with acute respiratory failure from PCP in MICU of 2 academic medical centers between 2010 and 2015. The patients were divided into survivors and non-survivors. Demographic and clinical data, including laboratory, radiological and microbiological findings, as well as therapy, clinical course, mortality and prognostic factors of hospital mortality were included in the analysis...
March 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
Sebastien Tanaka, Claire Geneve, Gianpiero Tebano, Nathalie Grall, Pascal Piednoir, Régis Bronchard, Mathieu Godement, Enora Atchade, Pascal Augustin, Herve Mal, Yves Castier, Philippe Montravers, Mathieu Desmard
BACKGROUND: Bacterial respiratory infections (BRI) are major complications contributing to increased morbidity and mortality after lung transplantation (LT). This study analyzed epidemiology and outcome of 175 consecutive patients developing BRI in ICU after LT between 2006 and 2012. METHODS: Three situations were described: colonization determined in donors and recipients, pneumonia and tracheobronchitis during the first 28 postoperative days. Severity score, demographic, bacteriologic and outcome data were collected...
March 5, 2018: BMC Pulmonary Medicine
G Ortiz, M Garay, D Mendoza, P Cardinal-Fernández
INTRODUCTION: Acute respiratory distress syndrome (ARDS) is an inflammatory lung disorder, and its pathological hallmark is diffuse alveolar damage (DAD). Given that open lung biopsy (OLB) can sometimes result in severe side effects, it is rarely performed in patients with ARDS. AIM: The aims of this study were to describe: (a) the rate of treatment change associated with the histological result; and (b) the incidence of side effects induced by OLB. DESIGN AND PATIENTS: A retrospective, single-center, descriptive observational study was carried out in Hospital Santa Clara (Bogotá, Colombia) from February 2007 to January 2014...
February 28, 2018: Medicina Intensiva
Ali AlBarrak, Badriah Alotaibi, Yara Yassin, Abdulaziz Mushi, Fuad Maashi, Yassein Seedahmed, Mohamed Alshaer, Abdulaziz Altaweel, Husameddin Elshiekh, Abdulhafiz Turkistani, Tanaz Petigara, John Grabenstein, Saber Yezli
BACKGROUND: The Hajj mass gathering is a risk for pneumococcal disease. We evaluated the proportion of adult community-acquired pneumonia (CAP) cases attributable to Streptococcus pneumoniae among Hajj pilgrims in 2016. To add sensitivity to etiologic attribution, we used a urine-antigen test, in addition to culture-based methods METHODS: Adults hospitalized with x-ray confirmed CAP were prospectively enrolled from all general hospitals designated to treat Hajj pilgrims in the holy cities of Mecca and Medina...
February 20, 2018: International Journal of Infectious Diseases: IJID
Ting-Ting Geng, Xin Xu, Man Huang
Carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infection (BSI) has become increasingly frequent threat recently, especially in the intensive care unit (ICU). High-dose tigecycline (TGC) regimen is proposed due to the limitation of treatment options. We investigated the efficacy and safety of high-dose TGC combination regimens for treating CRKP BSI. Furthermore, the risk factors for mortality were also determined.This was a single center retrospective cohort study conducted from 2014 to 2016. A total of 40 patients with nosocomial CRKP BSI admitted to the ICU were included; they were classified into two groups according to the treatment regimens with high-dose TGC (HD group) or not (non-HD group)...
February 2018: Medicine (Baltimore)
Rajesh M Shetty, Antonio Bellini, Dhuleep S Wijayatilake, Mark A Hamilton, Rajesh Jain, Sunil Karanth, ArunKumar Namachivayam
BACKGROUND: Patients admitted to intensive care and on mechanical ventilation, are administered sedative and analgesic drugs to improve both their comfort and interaction with the ventilator. Optimizing sedation practice may reduce mortality, improve patient comfort and reduce cost. Current practice is to use scales or scores to assess depth of sedation based on clinical criteria such as consciousness, understanding and response to commands. However these are perceived as subjective assessment tools...
February 21, 2018: Cochrane Database of Systematic Reviews
Su Wang, Li-Zhong Han, Yu-Xing Ni, Yi-Bo Zhang, Qun Wang, Da-Ke Shi, Wen-Hui Li, Yi-Chen Wang, Chen-Rong Mi
Surveillances and interventions on antibiotics use have been suggested to improve serious drug-resistance worldwide. Since 2007, our hospital have proposed many measures for regulating surgical prophylactic antibiotics (carbapenems, third gen. cephalosporins, vancomycin, etc.) prescribing practices, like formulary restriction or replacement for surgical prophylactic antibiotics and timely feedback. To assess the impacts on drug-resistance after interventions, we enrolled infected patients in 2006 (pre-intervention period) and 2014 (post-intervention period) in a tertiary hospital in Shanghai...
February 12, 2018: Brazilian Journal of Microbiology: [publication of the Brazilian Society for Microbiology]
Rumbidzai Majangara, Muchabayiwa Francis Gidiri, Zvavahera Mike Chirenje
The objectives of this study were to determine the identity and antibacterial susceptibility profiles of bacteria colonising the female genital tract and blood stream and their association with clinical outcomes in women with puerperal sepsis. A prospective descriptive cohort study was conducted at two tertiary hospitals in Zimbabwe. Endocervical swabs and blood were collected for culture and susceptibility testing from 151 consecutive women who met the World Health Organisation criteria for puerperal sepsis...
February 15, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Adam S Walpert, Ian D Thomas, Merlin C Lowe, Michael D Seckeler
OBJECTIVE: The aim of this study was to compare inpatient outcomes and costs for children with respiratory syncytial virus and congenital heart disease before and after the change in management guidelines for respiratory syncytial virus prophylaxis. DESIGN: Hospital discharge data from the Vizient (formerly University HealthSystem Consortium) were queried from October 2012 to June 2014 (Era 1) and July 2014 to April 2016 (Era 2) for patients aged <24 months with an any International Classification of Disease (ICD)-9 or ICD-10 code for congenital heart disease (745-747...
February 13, 2018: Congenital Heart Disease
Jinnan Ou, Huaying Chen, Lezhi Li, Liping Zhao, Na Nie
OBJECTIVE:  To estimate the benefits of non-invasive ventilation (NIV) used immediately after planned postextubation in patients with chronic respiratory disorders. METHODS:  Cochrane Library, PubMed, the Chinese BioMedical Literature Database of clinical trials (CBD) and Embase were searched for pertinent studies by 2 trained investigators. Pooled odds ratios and 95% confidence intervals (CIs) were calculated by employing both fixed-effects and random-effects models...
February 2018: Saudi Medical Journal
Cédric Dananché, Philippe Vanhems, Anaïs Machut, Martine Aupée, Caroline Bervas, François L'Hériteau, Alain Lepape, Jean-Christophe Lucet, Vincent Stoeckel, Jean-François Timsit, Anne Berger-Carbonne, Anne Savey, Thomas Bénet
OBJECTIVES: To assess trends and risk factors of ventilator-associated pneumonia according to age, particularly in the elderly admitted to French ICUs between 2007 and 2014. DESIGN: Multicenter, prospective French national Healthcare-Associated Infection surveillance network of ICUs ("Réseau REA-Raisin"). SETTINGS: Two-hundred fifty six ICUs in 246 settings in France. PATIENTS: Included were all adult patients hospitalized greater than or equal to 48 hours in ICUs participating in the network...
February 9, 2018: Critical Care Medicine
Emine Alp, Tuğba Tok, Leylagül Kaynar, Fatma Cevahir, İsmail Hakkı Akbudak, Kürşat Gündoğan, Mustafa Çetin, Jordi Rello
BACKGROUND: Haematological cancer (HC) patients are increasingly requiring intensive care (ICUs). The aim of this study was to investigate the outcome of HC patients in our ICU and evaluate 5 days-full support as a breakpoint for patients' re-assessment for support. METHODS: Retrospective study enrolling 112 consecutive HC adults, requiring ICU in January-December 2015. Patients' data were collected from medical records and Infection Control Committee surveillance reports...
February 8, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Ramesh Venkataraman, Jigeeshu V Divatia, Nagarajan Ramakrishnan, Rajesh Chawla, Pravin Amin, Palepu Gopal, Dhruva Chaudhry, Kapil Zirpe, Babu Abraham
Background: There is limited data regarding the microbiology of Intensive Care Unit (ICU)-acquired infections, such as ventilator-associated pneumonia (VAP), catheter-associated urinary tract infections (CAUTI), and catheter-related bloodstream infections (CRBSI) from India. Objectives: To explore the microbiology and resistance patterns of ICU-acquired infections and evaluate their outcomes. Materials and Methods: This was a multicenter observational study, conducted by Indian Society of Critical Care Medicine (MOSER study) between August 2011 and October 2012...
January 2018: Indian Journal of Critical Care Medicine
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