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antibiotics in icu patients

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https://www.readbyqxmd.com/read/27911257/individualized-antibiotic-therapy-in-patients-with-ventilator-associated-pneumonia
#1
Gurdal Yilmaz, Sedat Saylan, Firdevs Aksoy, Iftihar Koksal
The optimal duration of treatment of ventilator-associated pneumonia (VAP) is still the subject of debate. While 1-week treatment has been reported as possibly sufficient, patients generally receive antibiotic therapy for 10-14 days. The purpose of our study was to investigate whether length of treatment in patients with VAP can be reduced with an individualized therapeutic strategy. The study was performed prospectively with patients diagnosed with VAP in our hospital's intensive care units between 1 January and 31 December, 2015...
December 1, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27903458/cardiac-arrest-among-patients-with-infections-causes-clinical-practice-and-research-implications
#2
REVIEW
Davide Leoni, Jordi Rello
The incidence of sepsis is increasing, and the condition is now the leading cause of death in general intensive care units (ICUs). Our review failed to identify studies of the causes of cardiac arrest among infected patients, even though non-cardiac causes represent 15% of out-of-hospital cardiac arrests and though one-third of events have positive blood cultures. Sudden cardiac arrest is the result of local damage to the heart and of the impact of systemic and pulmonary conditions on cardiac performance, and its danger is underestimated...
November 26, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27889413/molecular-diagnosis-of-bloodstream-infections-in-onco-haematology-patients-with-pcr-esi-ms-technology
#3
Elena Jordana-Lluch, Belén Rivaya, Clara Marcó, Montserrat Giménez, Ma Dolores Quesada, Agustín Escobedo, Montserrat Batlle, Elisa Martró, Vicente Ausina
OBJECTIVES: Onco-haematological patients are prone to develop infections, and antibiotic prophylaxis may lead to negative blood cultures. Thus, the microbiological diagnosis and subsequent administration of a targeted antimicrobial therapy is often difficult. The goal of this study was to evaluate the usefulness of IRIDICA (PCR/ESI-MS technology) for the molecular diagnosis of bloodstream infections in this patient group. METHODS: A total of 463 whole blood specimens from different sepsis episodes in 429 patients were analysed using the PCR/ESI-MS platform, comparing the results with those of blood culture and other clinically relevant information...
November 23, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27887595/antimicrobial-stewardship-of-chinese-ministry-of-health-reduces-multidrug-resistant-organism-isolates-in-critically-ill-patients-a-pre-post-study-from-a-single-center
#4
Xudong Ma, Jianfeng Xie, Yi Yang, Fengmei Guo, Zhiwei Gao, Hua Shao, Yingzi Huang, Congshan Yang, Haibo Qiu
BACKGROUND: China's Ministry of Health (MOH) has established a policy about the antimicrobial stewardship. To date, the effects of this policy on multidrug-resistant organism (MDRO) in critically ill patients are unknown. METHODS: A pre-post study was conducted on intensive care unit (ICU) patients from June 2010 to May 2011 and from June 2012 to May 2013. Bacterial cultures were conducted at ICU admission and discharge. In June 2011, our hospital started to administer the antimicrobial stewardship program of Chinese MOH...
November 25, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27882253/candida-glabrata-pneumonia-in-a-patient-with-chronic-obstructive-pulmonary-disease
#5
Onur Yazici, Mustafa Cortuk, Hasan Casim, Erdogan Cetinkaya, Ali Mert, Ali Ramazan Benli
Pneumonia remains an important cause of morbidity and mortality among infectious diseases. Streptococcus pneumoniae and viruses are the most common cause of pneumonia. Candidiasis in such patients has been associated with haemodialysis, fungal colonization, exposure to broad-spectrum antibiotics, intensive care unit (ICU) hospitalization, and immunocompromised patients. The most common cause of infection is C. albicans. The case presented here is of a 66-year-old male patient diagnosed with C. glabrata. The patient suffered from chronic obstructive pulmonary disease...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27879561/late-therapeutic-intervention-with-antibiotics-and-fluid-resuscitation-allows-for-a-prolonged-disease-course-with-high-survival-in-a-severe-murine-model-of-sepsis
#6
Allison M Steele, Marlene E Starr, Hiroshi Saito
Current animal models of sepsis often incorporate antibiotics to be consistent with clinical standards for treatment of patients in the ICU. However, such experimental intervention is commonly initiated very early after infectious insult, which likely blunts the progression of systemic inflammation and downstream pathology. The objective of this study was to establish an animal model of sepsis with delayed therapeutic intervention, allowing a longer disease course and downstream pathology, but still resulting in a high survival rate...
November 22, 2016: Shock
https://www.readbyqxmd.com/read/27878781/successful-elimination-of-extended-spectrum-beta-lactamase-esbl-producing-nosocomial-bacteria-at-a-neonatal-intensive-care-unit
#7
Borbála Szél, Zsolt Reiger, Edit Urbán, Andrea Lázár, Krisztina Mader, Ivelina Damjanova, Kamilla Nagy, Gyula Tálosi
BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria are highly dangerous to neonates. At our Neonatal Intensive Care Unit (NICU), the presence of these bacteria became so threatening in 2011 that immediate intervention was required. METHODS: This study was conducted during a nearly two-year period consisting of three phases: retrospective (9 months), educational (3 months) and prospective (9 months). Based on retrospective data analysis, a complex management plan was devised involving the introduction of the INSURE protocol, changes to the antibiotic regimen, microbiological screening at short intervals, progressive feeding, a safer bathing protocol, staff hand hygiene training and continuous monitoring of the number of newly infected and newly colonized patients...
November 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27876693/a-case-of-septic-shock-due-to-serratia-marcescens-pyelonephritis-and-bacteremia-in-a-patient-receiving-empagliflozin
#8
Wesley D Kufel, Ali Scrimenti, Jeffrey M Steele
Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been associated with serious urinary tract infections (UTIs) including pyelonephritis and urosepsis. The Food and Drug Administration (FDA) issued a label change to include this warning in December 2015 due to a small number of cases (n = 19) reported to the FDA Adverse Event Reporting System. Details of these cases are limited and none involved empagliflozin. To date, there has been no published literature comprehensively describing serious UTIs attributed to empagliflozin...
November 21, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27875357/optimal-timing-of-endoscopic-retrograde-cholangiopancreatography-in-acute-cholangitis
#9
Linda A Hou, Loren Laine, Nima Motamedi, Ara Sahakian, Christianne Lane, James Buxbaum
OBJECTIVES: Acute cholangitis mandates resuscitation, antibiotic therapy, and biliary decompression. Our aim was to define the optimal timing of endoscopic retrograde cholangiopancreatography (ERCP) for patients with acute cholangitis. METHODS: Clinical data on all cases of cholangitis managed by ERCP were prospectively collected from September 2010 to July 2013. The clinical impact of the time to ERCP, defined as the time from presentation in the emergency department to the commencement of the ERCP, was determined...
November 21, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27871508/perineural-catheter-infection-a-systematic-review-of-the-literature
#10
REVIEW
Davide Nicolotti, Enrico Iotti, Guido Fanelli, Christian Compagnone
Perineural catheter infection is a rare but potentially dramatic complication of continuous peripheral nerve block. Different risk factors have been identified and the incidence of infection is increased in trauma victims, intensive care unit patients, immunodeficient individuals, and diabetic patients. Also, postoperative hyperglycemia, the absence of antibiotic prophylaxis, and catheter lasting more than 48 hours seem to be associated with a greater risk of infection. Skin disinfection and a strict aseptic technique during catheter placement are fundamental...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27869407/community-acquired-staphylococcus-aureus-bacteremia-in-children-a-cohort-study-for-2010-2014
#11
Guadalupe Pérez, Soledad Martiren, Vanesa Reijtman, Romina Romero, Alejandra Mastroianni, Lidia Casimir, Rosa Bologna
INTRODUCTION: Community-acquired methicillin-resistant Staphylococcus aureus infections are a common, serious problem in pediatrics. OBJETIVE: To describe antibiotic resistance in community-acquired Staphylococcus aureus (SA) bacteremias. To compare the characteristics of SA bacteremias in terms of methicillin resistance. MATERIALS AND METHODS: Prospective cohort enrolled between January 2010 and December 2014. Inclusion criteria: infants and children between 30 days old and 16 years old hospitalized at the Hospital de Pediatria J...
December 1, 2016: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/27866659/value-of-propensity-score-matching-for-equalizing-comparator-groups-in-observational-database-studies-a-case-study-in-anti-infectives
#12
C Daniel Mullins, Frank R Ernst, Michelle R Krukas, Joseph Solomkin, Christian Eckmann, Ahmed Shelbaya, Alvaro Quintana, Arlene Reisman
PURPOSE: Propensity score methodologies can reduce bias and confounding in nonrandomized studies, including pharmaceutical comparative effectiveness studies. An observational case study was developed to demonstrate the impact of propensity score adjustments on outcomes (ie, discharge status) of patients hospitalized for complicated intra-abdominal infections. METHODS: Two cohorts were examined: intensive care unit (ICU) (vs non-ICU) patients and tigecycline-treated patients (vs patients receiving other antibiotics)...
November 17, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27865895/intensive-care-unit-acquired-pneumonia-due-to-pseudomonas-aeruginosa-with-and-without-multidrug-resistance
#13
Laia Fernández-Barat, Miquel Ferrer, Francesca De Rosa, Albert Gabarrús, Mariano Esperatti, Silvia Terraneo, Mariano Rinaudo, Gianluigi Li Bassi, Antoni Torres
OBJECTIVE: Pseudomonas aeruginosa often presents multi-drug resistance (MDR) in intensive care unit (ICU)-acquired pneumonia (ICUAP), possibly resulting in inappropriate empiric treatment and worse outcomes. We aimed to identify patients with ICUAP at risk for these pathogens in order to improve treatment selection and outcomes. METHODS: We prospectively assessed 222 consecutive immunocompetent ICUAP patients confirmed microbiologically. We determined the characteristics, risk factors, systemic inflammatory response and outcomes of P...
November 16, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27862103/pharmacokinetics-of-imipenem-cilastatin-burn-intensive-care-unit-patients-undergoing-high-dose-continuous-venovenous-hemofiltation
#14
Bradley A Boucher, Joanna Q Hudson, David M Hill, Joseph M Swanson, G Christopher Wood, S Casey Laizure, Angela Arnold-Ross, Zhe-Yi Hu, William L Hickerson
STUDY OBJECTIVE: High dose continuous venovenous hemofiltration (CVVH) is a continuous renal replacement therapy (CRRT) used frequently inpatients with burns. However, antibiotic dosing is based on inference from studies assessing substantially different methods of CRRT. To address this knowledge gap for imipenem/cilastatin (I-C) we evaluated the systemic and extracorporeal clearances (CL) of I-C in patients with burns undergoing high dose CVVH. DESIGN: Prospective clinical pharmacokinetic study...
November 9, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27857510/the-diagnostic-accuracy-of-serum-procalcitonin-for-bacteremia-in-critically-ill-children
#15
Marianne E Nellis, Steven Pon, Ashley E Giambrone, Nana E Coleman, Jonathan Reiss, Elizabeth Mauer, Bruce M Greenwald
BACKGROUND: Bacterial sepsis is frequently encountered in children admitted to the Pediatric Intensive Care Unit (PICU) and requires early recognition and treatment. Procalcitonin (PCT) is a serum biomarker with a high sensitivity to predict bacteremia in critically-ill adults. This study sought to evaluate the diagnostic accuracy of PCT for bacteremia in febrile children in the PICU. METHODS: This retrospective observational study used data from children admitted to the PICU from October 2010 to October 2012...
November 2016: Infectious Diseases in Clinical Practice: IDCP
https://www.readbyqxmd.com/read/27854183/prognostic-factors-in-the-survival-of-patients-with-blood-disorders-recovering-from-septic-shock
#16
Anna Waszczuk-Gajda, Wieslaw Wiktor Jedrzejczak
BACKGROUND: Septic shock is one of the major direct causes of death in patients in hematology departments. OBJECTIVES: The knowledge about clinical outcomes and factors associated with negative outcome in these patients can be important and useful for physicians to identify the patients who are most likely to benefit from ICU therapy. METHODS: We retrospectively analyzed records of 214 episodes of septic shock in patients with different blood diseases hospitalized between 1998 and 2011 in the Department of Hematology, Oncology and Internal Medicine, the Medical University of Warsaw, Poland...
November 17, 2016: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/27852379/-investigation-of-molecular-epidemiology-of-methicillin-resistant-staphylococcus-aureus-in-department-of-critical-care-medicine
#17
Y X Qin, Q D Li, X Y Wan, L Y Bi, J Wang
Objective: To investigate the feature of antimicrobial resistance, homology and other molecular epidemiology of methicillin-resistant staphylococcus aureus(MRSA) in Department of Critical Care Medicine(ICU). Methods: From October 2010 to December 2011, 149 strains of MRSA were collected and identified through sputum culture of patients from 10 ICUs of 10 teaching hospitals distributed in 9 chinese central city of China. Susceptibility testing to 18 kinds of antibiotic was performed, the method of pulsed field gel electrophoresis (PFGE) was used to analyze the homology, and the technique of multilocus sequencing typing (MLST) was used to identify the sequence type (ST)...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27849733/53-influence-of-macrolide-antibiotics-on-outcomes-in-icu-patients-with-acute-exacerbations-of-copd
#18
Tyree Kiser, Marc Moss, Ellen Burnham, Michael Ho, R Vandivier
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849331/-fournier-s-gangrene-after-anorectal-surgery-in-infant-two-case-reports
#19
Murat Sütçü, Güntulu Duran Şık, Feryal Gün, Ayper Somer, Nuran Salman
Necrotizing fasciitis is a life-threatening soft tissue infection characterized by progressive necrosis of the skin, subcutaneous tissues and fascia. Fournier's gangrene (FG) is a serious and aggressive form of infective necrotizing fasciitis involving perineal region and genitalia. Presently described are 2 pediatric cases of FG with widespread necrosis of surrounding tissue following anorectal surgery, causing severe septic shock. Case 1: Six-month-old female patient with anal stenosis and duplication presented at emergency clinic with fever, somnolence, irritability, and feeding difficulty...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27843965/a-new-approach-to-vancomycin-utilization-evaluation-a-cross-sectional-study-in-intensive-care-unit
#20
Atefeh Mahmoodian, Saeed Abbasi, Shadi Farsaei
OBJECTIVE: The risk of methicillin-resistant Staphylococcus aureus infections in Intensive Care Unit (ICU) is increasing in recent years with high rate of morbidity and mortality. Therefore, in this study, we aimed to evaluate the rationale use of vancomycin in ICU patients. METHODS: A total of 200 patients who received at least 48 h intravenous vancomycin were randomly selected from ICU wards, during 9 months. Vancomycin administration and related clinical and laboratory data were gathered from patients' charts and health information system to evaluate the appropriateness of different aspects of vancomycin use during all days which vancomycin were ordered...
October 2016: Journal of Research in Pharmacy Practice
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