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antibiotics in icu patients

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https://www.readbyqxmd.com/read/28434629/does-appropriate-empiric-antibiotic-therapy-modify-intensive-care-unit-acquired-enterobacteriaceae-bacteraemia-mortality-and-discharge
#1
K B Pouwels, E Van Kleef, S Vansteelandt, R Batra, J D Edgeworth, T Smieszek, J V Robotham
BACKGROUND: Conflicting results have been found regarding outcomes of intensive care unit (ICU)-acquired Enterobacteriaceae bacteraemia and the potentially modifying effect of appropriate empiric antibiotic therapy. AIM: To evaluate these associations while adjusting for potential time-varying confounding using methods from the causal inference literature. METHODS: Patients who stayed more than two days in two general ICUs in England between 2002 and 2006 were included in this cohort study...
March 16, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28432539/early-onset-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-incidence-risk-factors-and-consequences-in-cerebral-oxygenation-and-outcome
#2
Pierre Esnault, Cédric Nguyen, Julien Bordes, Erwan D'Aranda, Ambroise Montcriol, Claire Contargyris, Jean Cotte, Philippe Goutorbe, Christophe Joubert, Arnaud Dagain, Henry Boret, Eric Meaudre
BACKGROUND: Early-onset ventilator-associated pneumonia (EOVAP) occurs frequently in severe traumatic brain-injured patients, but potential consequences on cerebral oxygenation and outcome have been poorly studied. The objective of this study was to describe the incidence, risk factors for, and consequences on cerebral oxygenation and outcome of EOVAP after severe traumatic brain injury (TBI). METHODS: We conducted a retrospective, observational study including all intubated TBI admitted in the trauma center...
April 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#3
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28423968/penetrating-brain-injury-with-a-metal-bar-and-a-knife-report-of-two-interesting-cases
#4
Alireza Tabibkhooei, Morteza Taheri, Sadra Rohani, Iran Chanideh, Hessam Rahatlou
Introduction Penetrating brain injury (PBI) is uncommon among the civilian population. Here, we report two interesting cases of PBI. Case presentation The first patient was a 20-year-old male who sustained a penetrating head injury with a metal bar during an accident at work. The patient underwent early surgical intervention, and related meningitis was treated with antibiotics. The patient was discharged 45 days later with no deficit. The second patient was a 34-year-old male who was the victim of a violence attack and was admitted to hospital...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28421191/prospective-multicentre-study-on-the-epidemiology-and-current-therapeutic-management-of-severe-bronchiolitis-in-spain
#5
Jose C Flores-González, Juan Mayordomo-Colunga, Iolanda Jordan, Alicia Miras-Veiga, Cristina Montero-Valladares, Marta Olmedilla-Jodar, Andrés J Alcaraz-Romero, Miren Eizmendi-Bereciartua, Francisco Fernández-Carrión, Carmen Santiago-Gutierrez, Esther Aleo-Luján, Sonia Pérez-Quesada, Cristina Yun-Castilla, Carmen Martín, Álvaro Navarro-Mingorance, Concha Goñi-Orayen
Objective. To determine the epidemiology and therapeutic management of patients with severe acute bronchiolitis (AB) admitted to paediatric intensive care units (PICUs) in Spain. Design. Descriptive, prospective, multicentre study. Setting. Sixteen Spanish PICUs. Patients. Patients with severe AB who required admission to any of the participating PICUs over 1 year. Interventions. Both epidemiological variables and medical treatment received were recorded. Results. A total of 262 patients were recruited; 143 were male (54...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28420262/impact-of-an-educational-intervention-to-improve-physician-adherence-to-bronchiolitis-clinical-practice-guidelines-a-pre-post-intervention-study
#6
Marquita C Genies, Julia M Kim, Kristina Pyclik, Suzanne Rossi, Natalie Spicyn, Janet R Serwint
Bronchiolitis is the leading cause of infant hospitalizations in the United States. Despite clinical practice guidelines discouraging the utilization of non-evidence-based therapies, there continues to be wide variation in care and resource utilization. A pre-post physician focused educational intervention was conducted with the aims to reduce the use of non-evidence-based medical therapies, including bronchodilators, among patients admitted for bronchiolitis. Among patients meeting inclusion criteria (pre: n = 45; post: n = 47), bronchodilator use decreased by 50% ( P < ...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28416961/predictive-factors-of-methicillin-resistant-staphylococcus-aureus-infection-in-elderly-patients-with-community-onset-pneumonia
#7
Hyeyoung Jwa, Jong Wook Beom, Jong Hoo Lee
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a severe and life-threatening disease in patients with community-onset (CO) pneumonia. However, the current guidelines lack specificity for a screening test for MRSA infection. METHODS: This study was retrospectively conducted in elderly patients aged ≥65 years, who had contracted CO-pneumonia during hospitalization at the Jeju National University Hospital, between January 2012 and December 2014...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28415969/carbapenem-resistance-inappropriate-empiric-treatment-and-outcomes-among-patients-hospitalized-with-enterobacteriaceae-urinary-tract-infection-pneumonia-and-sepsis
#8
Marya D Zilberberg, Brian H Nathanson, Kate Sulham, Weihong Fan, Andrew F Shorr
BACKGROUND: Drug resistance among gram-negative pathogens is a risk factor for inappropriate empiric treatment (IET), which in turn increases the risk for mortality. We explored the impact of carbapenem-resistant Enterobacteriaceae (CRE) on the risk of IET and of IET on outcomes in patients with Enterobacteriaceae infections. METHODS: We conducted a retrospective cohort study in Premier Perspective database (2009-2013) of 175 US hospitals. We included all adult patients with community-onset culture-positive urinary tract infection (UTI), pneumonia, or sepsis as a principal diagnosis, or as a secondary diagnosis in the setting of respiratory failure, treated with antibiotics within 2 days of admission...
April 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28414686/severe-sepsis-and-septic-shock-cases-meeting-guidelines-among-patients-in-a-university-hospital-setting
#9
J A Charrier, C L Steen, E Borrero
BACKGROUND: A diagnosis of severe sepsis or septic shock has been shown to significantly increase mortality rate independent of other factors. Research has revealed all cause hospital case fatality rates have declined yet the percentage of severe sepsis cases continues to increase and age-adjusted mortality rates from severe sepsis and septic shock has significantly increased during the same time period. Patients with severe sepsis demonstrate ongoing mortality rate increases for up to 2 years following hospitalization when compared to aged matched controls of nonseptic patients...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413520/prognosis-of-patients-with-acinetobacter-baumannii-infection-in-the-intensive-care-unit-a-retrospective-analysis
#10
Dong Xiao, Lu Wang, Daquan Zhang, Dongming Xiang, Qi Liu, Xuezhong Xing
The present retrospective study aimed to investigate the prognostic factors for critically ill patients with an Acinetobacter baumannii (A. baumannii) infection. A total of 37 patients from the intensive care unit (ICU) were enrolled in the study. Data was collected from patients, including age, gender, ethnicity, A. baumannii infection status, concurrent infection status, prescribed antibiotics, Acute Physiology and Chronic Health Evaluation II (APACHE II) and sepsis-related organ failure assessment (SOFA) scores, procalcitonin level, site of infection, shock, sepsis and renal replacement therapy status...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28412677/differential-analysis-of-clinical-efficacy-on-patients-with-serious-infection-in-icu-by-different-meropenem-regimens
#11
Wei-Min Wang, Xu-Sheng An, Xiang-Cheng Zhang, Liang-Liang Hui, Shi-Guang Guo, Bei-Bei Chen, Kui Zang, Fu-Tai Shang, Long-Chuan Wu
To investigate the difference in clinical efficacy and safety of different meropenem regimens on patients with serious infection in ICU. Then, 228 patients with serious infection in ICU were divided by random into control group (intermittent administration in 1000mg/30min single dose) and research group (continuous administration in 200mg/10min +800mg/180min), respectively. The blood concentration of meropenem were recorded in two groups at different time points, and difference in treatment effectiveness, iconographic effectiveness, bacterial eradication rate, 28-day survival rate and many other clinical scoring indices (SOFA, APACHEII, CPIS, and SIRS) were compared between two groups...
November 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28412131/screening-nasal-swabs-for-methicillin-resistant-staphylococcus-aureus-a-regional-burn-center-s-experience
#12
Shawn Tejiram, Laura S Johnson, Mihriye Mete, Sameer Desale, Kimberly Johnson, Jenny Zhang, Lauren T Moffatt, Jeffrey W Shupp
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen that can result in substantial morbidity and mortality. Early detection of MRSA colonization by screening nasal swabs may be important in the management of burn-injured patients. However, studies examining its use in this population are limited. The aim of this study was to study the utility of admission MRSA screening nasal swabs and determine if being positive for MRSA on admission impacted outcomes. MATERIALS AND METHODS: A retrospective review was conducted of burn patients who presented to a single regional burn center between June 2012 and December 2014...
April 12, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28409531/procalcitonin-levels-in-sepsis-and-its-association-with-clinical-outcome-in-southern-india
#13
Alex Rebello, Molly Mary Thabah, Tarun Kumar Dutta, Zachariah Bobby, B N Harish, Vadivelan Mehalingam
Procalcitonin has been found to be a good marker for the diagnosis of sepsis. However, data on procalcitonin levels to predict the clinical outcome in patients with sepsis are limited. The aim of our study was to estimate serum procalcitonin levels in patients with sepsis and to identify its relationship with the clinical outcome. This was a prospective observational study conducted on 112 patients with sepsis admitted to the medical wards and medical intensive care unit of a tertiary care teaching hospital...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/28408938/bacteraemia-in-intensive-care-unit-clinical-bacteriological-and-prognostic-prospective-study
#14
Zineb Lachhab, Mohammed Frikh, Adil Maleb, Jalal Kasouati, Nouafal Doghmi, Yassine Ben Lahlou, Bouchra Belefquih, Abdelhay Lemnouer, Mostafa Elouennass
Objectives. We conducted a one-year observational study from December 2012 to November 2013 to describe the epidemiology of bacteraemia in intensive care units (ICU) of Mohammed V Military Teaching Hospital of Rabat (Morocco). Methods. The study consisted of monitoring all blood cultures coming from intensive care units and studying the bacteriological profile of positive blood cultures as well as their clinical significance. Results. During this period, a total of 46 episodes of bacteraemia occurred, which corresponds to a rate of 15,4/1000 patients...
2017: Canadian Journal of Infectious Diseases & Medical Microbiology
https://www.readbyqxmd.com/read/28400693/ludwig-s-angina-a-nightmare-worsened-by-adverse-drug-reaction-to-antibiotics
#15
Mohamed Hisham, Mundilipalayam N Sivakumar, R S Senthil Kumar, P Nandakumar
A 52-year-old obese gentleman presented to the hospital with complaints of fever and shortness of breath for 10 days. He was admitted in the ward and treated for acute exacerbation of asthma. He was shifted to the Intensive Care Unit (ICU) for persistent fever, neck swelling, airway obstruction and desaturation. Ludwig's angina was suspected and computed tomography of neck confirmed it. A difficult airway was anticipated and preceded with surgical tracheostomy. The patient had hypersensitivity reactions to piperacillin/tazobactam; hence, he was treated with clindamycin and metronidazole...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28400686/convergence-of-minds-for-better-patient-outcome-in-intensive-care-unit-infections
#16
Chand Wattal, Yash Javeri, Neeraj Goel, Debashish Dhar, Sonal Saxena, Sarman Singh, Jaswinder Kaur Oberoi, B K Rao, Purva Mathur, Vikas Manchanda, Vivek Nangia, Arti Kapil, Ashok Rattan, Supradip Ghosh, Omender Singh, Vinod Singh, Iqbal Kaur, Sanghamitra Datta, Sharmila Sen Gupta
BACKGROUND: There is emergence of resistance to the last-line antibiotics such as carbapenems in Intensive Care Units (ICUs), leaving little effective therapeutic options. Since there are no more newer antibiotics in the armamentarium in the near future, it has become imperative that we harness the interdisciplinary knowledge for the best clinical outcome of the patient. AIMS: The aim of the conference was to utilize the synergies between the clinical microbiologists and critical care specialists for better patient care and clinical outcome...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28384858/antimicrobial-resistance-surveillance-among-intensive-care-units-of-a-tertiary-care-hospital-in-southern-india
#17
Kailash Moolchandani, Apurba Sankar Sastry, R Deepashree, Sujatha Sistla, B N Harish, Jharna Mandal
INTRODUCTION: Hospital Acquired Infections (HAIs) are the rising threat in the health care facilities across the globe. As most Intesive Care Unit (ICU) patients are frequently on broad spectrum antimicrobials, this induces selective antibiotic pressure which leads to development of Antimicrobial Resistance (AMR) among the microorganisms of ICUs. AIM: To study the occurrence of different types of HAIs in patients admitted to various ICUs of JIPMER and the AMR pattern of the bacterial pathogens isolated from them...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28381601/a-novel-multiplex-pcr-assay-for-the-detection-of-chlorhexidine-quaternary-ammonium-mupirocin-and-methicillin-resistance-genes-with-simultaneous-discrimination-of-staphylococcus-aureus-from-coagulase-negative-staphylococci
#18
Jo-Ann McClure, Johanna Zaal DeLongchamp, John M Conly, Kunyan Zhang
Methicillin-resistant Staphylococcus aureus (MRSA) is a clinically significant pathogen resistant to a wide variety of antibiotics and responsible for a large number of nosocomial infections worldwide. The Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention recently recommended to adopt universal mupirocin/chlorhexidine decolonization of all admitted intensive care unit patients, rather than MRSA screening with targeted treatments, which raises the serious concern about the selection of resistance to mupirocin and chlorhexidine in strains of staphylococci...
April 5, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28378244/ventilator-associated-pneumonia-by-methicillin-susceptible-staphylococcus-aureus-do-minimum-inhibitory-concentrations-to-vancomycin-and-daptomycin-matter
#19
J Ruiz-Ramos, P Vidal-Cortés, A Díaz-Lamas, R Reig-Valero, F Roche-Campo, M Del Valle-Ortiz, X Nuvials-Casals, M Ortiz-Piquer, D Andaluz-Ojeda, L Tamayo-Lomas, M A Blasco-Navalpotro, M Rodriguez-Aguirregabiria, J Aguado, P Ramirez
The use of vancomycin minimum inhibitory concentration (MIC) as an outcome predictor in patients with methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia has become an important topic for debate in the last few years. Given these previous results, we decided to investigate whether MICs to vancomycin or daptomycin had any effect on the evolution of patients with ventilator-associated pneumonia (VAP) due to MSSA. An observational, retrospective, multicenter study was conducted among patients with MSSA VAP...
April 4, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28376885/citrobacter-braakii-bacteremia-induced-septic-shock-after-colonoscopy-preparation-with-polyethylene-glycol-in-a-critically-ill-patient-a-case-report
#20
Tetsuya Yumoto, Yoshiyasu Kono, Seiji Kawano, Chihiro Kamoi, Atsuyoshi Iida, Motoko Nose, Keiji Sato, Toyomu Ugawa, Hiroyuki Okada, Yoshihito Ujike, Atsunori Nakao
BACKGROUND: Polyethylene glycol (PEG) is widely used for bowel cleaning in preparation for colonoscopy because of its safety. Septic shock after PEG preparation is an extremely rare complication. Herein, we describe a case of septic shock that occurred immediately after colonoscopy preparation with PEG. CASE PRESENTATION: A 75-year-old Japanese male who had previously developed diabetes after total pancreatectomy received PEG in preparation for colonoscopy. He had been admitted to the emergency intensive care unit 4 days earlier due to hematochezia presenting with shock...
April 4, 2017: Annals of Clinical Microbiology and Antimicrobials
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