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antibiotics in icu patients

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https://www.readbyqxmd.com/read/28648477/time-to-antibiotics-administration-and-outcome-in-community-acquired-pneumonia-secondary-analysis-of-a-randomized-controlled-trial
#1
Christophe Marti, Gregor John, Daniel Genné, Virginie Prendki, Olivier T Rutschmann, Jérôme Stirnemann, Nicolas Garin
BACKGROUND: The association between early antibiotic administration and outcomes remains controversial in patients hospitalized for community-acquired pneumonia. METHODS: We performed a secondary analysis of a randomized controlled trial comparing two antibiotic treatment strategies for patients hospitalized for moderately severe CAP. The univariate and multivariate associations between time to antibiotic administration (TTA) and time to clinical stability were assessed using a Cox proportional hazard model...
June 22, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28644310/predictors-of-mortality-in-cirrhosis-inpatients-with-clostridium-difficile-infection
#2
Elliot Z Smith, Patrick G Northup, Curtis K Argo
BACKGROUND: Clostridium difficile is a bacterial pathogen associated with significant morbidity and mortality in patients with cirrhosis. GOALS: Our primary aim is to identify variables that are predictive of poor outcomes in cirrhosis patients with C. difficile infection (CDI). We also aim to further characterize the risk factors for developing CDI and risk of mortality in this patient population. STUDY: A total of 200 subjects with a diagnosis of cirrhosis and CDI were matched to 200 cirrhosis inpatients without CDI...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28643112/a-retrospective-study-of-antibiotic-de-escalation-in-patients-with-ventilator-associated-pneumonia-in-malaysia
#3
Rahela Ambaras Khan, Zoriah Aziz
Background Antibiotic de-escalation is an important strategy to conserve the effectiveness of broad-spectrum antibiotics. However, the outcome of this strategy for the treatment of ventilator-associated pneumonia (VAP) has not been widely studied in developing countries. Objectives To evaluate the outcome on intensive care unit (ICU) mortality, 28 days mortality, and length of ICU stay among VAP patients who receive de-escalation therapy. Setting This study was conducted in an ICU of a Malaysian public hospital...
June 22, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28640662/using-probiotics-in-clinical-practice-where-are-we-now-a-review-of-existing-meta-analyses
#4
Mariangela Rondanelli, Milena Anna Faliva, Simone Perna, Attilio Giacosa, Gabriella Peroni, Anna Maria Castellazzi
The scientific literature has demonstrated that probiotics have a broad spectrum of activity, although often the results are contradictory. This study provides a critical overview of the current meta-analyses that have evaluated the efficacy of probiotics in physiological and pathological conditions, such as metabolic disease, antibiotic-associated and Clostridium difficile-associated diarrhea, IBS, constipation, IBD, chemotherapy-associated diarrhea, respiratory tract infection, ventilator-associated pneumonia, NAFLD, liver encephalopathy, periodontitis, depression, vaginosis, urinary tract infections, pancreatitis, incidence of ventilator-associated pneumonia, hospital infection and stay in ICU, mortality of post-trauma patients, necrotising enterocolitis in premature infants...
June 22, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28639165/molecular-characterization-of-intestinal-carriage-of-carbapenem-resistant-enterobacteriaceae-among-inpatients-at-two-iranian-university-hospitals-first-report-of-co-production-of-bla-ndm-7-and-bla-oxa-48
#5
H Solgi, F Badmasti, Z Aminzadeh, C G Giske, M Pourahmad, F Vaziri, S A Havaei, F Shahcheraghi
Gastrointestinal colonization of carbapenem-resistant Enterobacteriaceae (CRE) could serve as a reservoir for the transmission of these pathogens in the clinical setting. The aim of this study was to investigate the intestinal carriage of CRE and to analyze risk factors for CRE carriage. Rectal swabs were collected from 95 patients at two Iranian university hospitals. CRE screening was performed using selective media (CHROMagar and MacConkey agar). Polymerase chain reaction (PCR) was used to detect carbapenemase-encoding genes...
June 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28638248/evaluation-of-microorganisms-causing-ventilator-associated-pneumonia-in-a-pediatric-intensive-care-unit
#6
Ayse Betul Ergul, Serife Cetin, Yasemin Ay Altintop, Sefika Elmas Bozdemir, Alper Ozcan, Umit Altug, Hasan Samsa, Yasemin Altuner Torun
OBJECTIVE: The aim of this study was to identify microorganisms causing ventilator-associated pneumonia (VAP) and also study the antibiotic resistance/susceptibility. MATERIALS AND METHODS: We retrospectively assessed microorganisms isolated from patients diagnosed with VAP in a pediatric intensive care unit between January 1, 2014, and June 30, 2016. RESULTS: We included 44 patients diagnosed with VAP. The prevalence thereof was 8.6 patients per 1,000 ventilator days...
June 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28635201/hamman-rich-syndrome-a-forgotten-entity
#7
William Newmarch, Angelica Puopolo, Madina Weiler, Brian Casserly
The following report outlines the case of a 76-year-old gentleman who presented to the hospital with acute interstitial pneumonitis, a rare and rapidly progressive type of idiopathic interstitial pneumonia. The patient initially presented with a three-week history of progressive shortness of breath and cough which was diagnosed as community acquired pneumonia. Treatment with oral antibiotics was unsuccessful resulting in re-presentation the following week with type one respiratory failure. Investigations revealed widespread inflammatory changes consistent with an acute inflammatory process...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28633626/age-related-differences-in-management-and-outcomes-in-hospitalized-healthy-and-well-functioning-bacteremic-pneumococcal-pneumonia-patients-a-cohort-study
#8
Luis A Ruiz, Pedro P España, Ainhoa Gómez, Amaia Bilbao, Carmen Jaca, Amaia Arámburu, Alberto Capelastegui, Marcos I Restrepo, Rafael Zalacain
BACKGROUND: Limited data are available regarding fit and healthy patients with pneumonia at different ages. We evaluated the association of age with clinical presentation, serotype and outcomes among healthy and well-functioning patients hospitalized for bacteremic pneumococcal community-acquired pneumonia. METHODS: We performed a prospective cohort study of consecutive healthy and well-functioning patients hospitalized for this type of pneumonia. Patients were stratified into younger (18 to 64 years) and older (≥65 years) groups...
June 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28632822/-strategies-to-reduce-infections-and-antibiotic-use-and-its-effects-in-a-neonatal-care-unit
#9
Soledad Urzúa, Marcela Ferrés, Patricia García, Amparo Sánchez, Matías Luco
INTRODUCTION: Late onset sepsis (LOS) remains an important cause of morbidity and mortality in neonatal intensive care units (NICU). The empirical use of vancomycin and other broad spectrum antibiotics is very frequent and is associated with the emergence of resistant agents, infection by gram-negative bacilli (GNB), fungal infections and increased morbidity and mortality. OBJECTIVE: To evaluate the impact of 5 intervention protocols designed to reduce infections and promote the rational use of antibiotics (AB) in a single NICU...
April 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28632783/transient-effects-of-transfusion-and-feeding-advances-volumetric-and-caloric-on-necrotizing-enterocolitis-development-a-case-crossover-study
#10
Vi T Le, Mark A Klebanoff, Maria M Talavera, Jonathan L Slaughter
OBJECTIVE: To evaluate the short-term effects of feed fortification, feed volume increase, and PRBC transfusion on the odds of developing NEC. STUDY DESIGN: Case-crossover study of neonatal intensive care infants born at ≤ 32 weeks' gestation who were admitted to 5 central Ohio intensive care units from January 2012-July 2016 and developed NEC Bell Stage ≥2. Each patient served as their own control, with exposure during the 48-hour period just prior to NEC onset (hazard period) being compared to a preceding 48-hour control period, thus eliminating confounding by patient factors fixed between both intervals...
2017: PloS One
https://www.readbyqxmd.com/read/28631639/prevalence-of-clostridium-difficile-infection-among-the-patients-attending-a-tertiary-care-teaching-hospital
#11
Lavanya Segar, Joshy M Easow, Sreenivasan Srirangaraj, Mohammad Hanifah, Noyal M Joseph, K S Seetha
BACKGROUND: Clostridium difficile, a most important nosocomial enteric pathogen, is recognized globally as responsible for antibiotic-associated diarrhea and colitis. It is associated with considerable morbidity and mortality due to widespread use of antibiotics. AIMS: The study was done to determine the prevalence of C. difficile infection (CDI) among the patients attending a tertiary care teaching hospital in Puducherry. SETTINGS AND DESIGN: We performed a prospective cohort study in Mahatma Gandhi Medical College and Research Institute...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28630246/ominous-triad-triggered-by-high-dose-glucocorticosteroid-therapy
#12
Sarah Bär, Fritz Daudel, Thomas Zueger
Glucocorticosteroids (CS) play a key role in the treatment of numerous diseases. Nonetheless, they can be accompanied by several adverse effects. We present the case of a 51-year-old woman who was treated with high-dose CS for a relapse of her multiple sclerosis. After 5 days of treatment, the patient developed severe diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis-a potentially life-threatening triad which has previously been described, in our case, however, for the first time as a complication of CS therapy...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28629754/improving-compliance-with-surgical-antibiotic-prophylaxis-guidelines-a-multicenter-evaluation
#13
Cristiane Schmitt, Rubia Aparecida Lacerda, Ruth Natalia Teresa Turrini, Maria Clara Padoveze
BACKGROUND: Improving surgical antibiotic prophylaxis (SAP) use is an important element in the control of antimicrobial resistance. However, compliance with SAP guidelines is unsatisfactory. This study investigated the level of compliance with SAP guidelines in neurosurgery, and institutional characteristics associated with compliance. METHODS: This study assessed surgeries in 9 Brazilian hospitals. Medical record reviews and a structured questionnaire were used to assess compliance and to describe institutional characteristics...
June 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28624864/the-clinical-significance-of-pneumonia-in-patients-with-respiratory-specimens-harbouring-multidrug-resistant-pseudomonas-aeruginosa-a-5-year-retrospective-study-following-5667-patients-in-four-general-icus
#14
B Borgatta, S Gattarello, C A Mazo, A T Imbiscuso, M N Larrosa, M Lujàn, J Rello
Pseudomonas aeruginosa is the leading cause of pneumonia in intensive care units (ICUs), with multidrug-resistant (MDR) strains posing a serious threat. The aim of this study was to assess the clinical relevance of MDR Pseudomonas isolates in respiratory clinical specimens. A 5-year retrospective observational study in four medical-surgical ICUs from a referral hospital was carried out. Of 5667 adults admitted to the ICU, 69 had MDR-PA in respiratory samples: 31 were identified as having pneumonia (HAP/VAP): 21 ventilator-associated pneumonia (VAP) and ten hospital-acquired pneumonia (HAP)...
June 17, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28620893/systemic-antibiotics-for-preventing-ventilator-associated-pneumonia-in-comatose-patients-a-systematic-review-and-meta-analysis
#15
Cássia Righy, Pedro Emmanuel Americano do Brasil, Jordi Vallés, Fernando A Bozza, Ignacio Martin-Loeches
BACKGROUND: Early-onset ventilator-associated pneumonia (EO-VAP) is the leading cause of morbidity and mortality in comatose patients. However, VAP prevention bundles focus mainly on late-onset VAP and may be less effective in preventing EO-VAP in comatose patients. Systemic antibiotic administration at the time of intubation may have a role in preventing EO-VAP. Therefore, we evaluated the effectiveness of systemic antibiotic administration in VAP prevention in comatose patients through a systematic review and meta-analysis...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28620491/pseudo-thrombotic-thrombocytopenic-purpura-presenting-as-multi-organ-dysfunction-syndrome-a-rare-complication-of-pernicious-anemia
#16
Saroj Kandel, Nibash Budhathoki, Shanta Pandey, Bikash Bhattarai, Aam Baqui, Ramesh Pandey, Divya Salhan, Danilo Enriquez, Joseph Quist, Frances M Schmidt
OBJECTIVE: We present a rare case of pernicious anemia presented as multi-organ dysfunction syndrome, later found to have pseudo-thrombotic thrombocytopenic purpura. METHODS: An 86-year-old female presented with respiratory distress, altered mental status, acute renal failure and was intubated in emergency room. She was found to have severe anemia, thrombocytopenia, high lactate, high lactate dehydrogenase and low haptoglobin. Peripheral smear revealed multilobulated neutrophils with schistocytes, poikilocytes and anisocytes...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28618727/analysis-of-epidemiology-and-risk-factors-for-mortality-in-ventilator-associated-pneumonia-attacks-in-intensive-care-unit-patients
#17
Ayşe But, Meltem Arzu Yetkin, Dilek Kanyilmaz, Halide Aslaner, Aliye Baştuğ, Adalet Aypak, Pınar Öngürü, Esragül Akinci, Nevzat Mehmet Mutlu, Hürrem Bodur
BACKGROUND/AIM: The aim of this study was to investigate the epidemiologic characteristics, the causative microorganisms and their antimicrobial susceptibility patterns, and the prognostic risk factors for mortality in critically ill patients with ventilator-associated pneumonia (VAP). MATERIALS AND METHODS: In this retrospective observational study, all the critically ill patients with VAP hospitalized in a medical/surgical intensive care unit (ICU) between January 2010 and June 2015 were evaluated...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28617807/treatment-with-macrolides-and-glucocorticosteroids-in-severe-community-acquired-pneumonia-a-post-hoc-exploratory-analysis-of-a-randomized-controlled-trial
#18
Adrian Ceccato, Catia Cilloniz, Otavio T Ranzani, Rosario Menendez, Carles Agusti, Albert Gabarrus, Miquel Ferrer, Oriol Sibila, Michael S Niederman, Antoni Torres
BACKGROUND: Systemic corticosteroids have anti-inflammatory effects, whereas macrolides also have immunomodulatory activity in addition to their primary antimicrobial actions. We aimed to evaluate the potential interaction effect between corticosteroids and macrolides on the systemic inflammatory response in patients with severe community-acquired pneumonia to determine if combining these two immunomodulating agents was harmful, or possibly beneficial. METHODS: We performed a post-hoc exploratory analysis of a randomized clinical trial conducted in three tertiary hospitals in Spain...
2017: PloS One
https://www.readbyqxmd.com/read/28615012/moxifloxacin-monotherapy-versus-combination-therapy-in-patients-with-severe-community-acquired-pneumonia-evoked-ards
#19
Tim Rahmel, Sven Asmussen, Jan Karlik, Jörg Steinmann, Michael Adamzik, Jürgen Peters
BACKGROUND: We tested the hypothesis that moxifloxacin monotherapy is equally effective and safe as a betalactam antibiotic based combination therapy in patients with acute respiratory distress syndrome (ARDS) evoked by severe community acquired pneumonia (CAP). METHODS: In a retrospective chart review study of 229 patients with adult respiratory distress syndrome (ARDS) admitted to our intensive care unit between 2001 and 2011, 169 well-characterized patients were identified to suffer from severe CAP...
June 14, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28614442/skin-and-soft-tissue-infections-in-the-intensive-care-unit-a-retrospective-study-in-a-tertiary-care-center
#20
Luís Filipe Malheiro, Rita Magano, Alcina Ferreira, António Sarmento, Lurdes Santos
Objective: To identify factors that may influence outcomes in patients with severe skin and soft tissue infections in the intensive care unit. Methods: A retrospective observational study was conducted in a cohort of 1,123 critically ill patients admitted to an intensive care unit with a primary or secondary diagnosis of severe skin and soft tissues infection between January 2006 and December 2014. Results: Thirty patients were included, 20 (66...
June 12, 2017: Revista Brasileira de Terapia Intensiva
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