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antibiotics in icu patients

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https://www.readbyqxmd.com/read/28102514/carbapenemase-producing-klebsiella-pneumoniae-bloodstream-infection-in-critically-ill-patients-risk-factors-and-predictors-of-mortality
#1
M Papadimitriou-Olivgeris, F Fligou, C Bartzavali, A Zotou, A Spyropoulou, K Koutsileou, S Vamvakopoulou, N Sioulas, V Karamouzos, E D Anastassiou, I Spiliopoulou, M Christofidou, M Marangos
A significant increase in carbapenemase-producing Klebsiella pneumoniae (CP-Kp) bacteraemias has been observed worldwide. The objective of the present work was to study the risk factors and predictors of mortality of CP-Kp bacteraemias among critically ill patients. During a 4-year period (2012-3015), a matched 1:2 case-control study was conducted. Klebsiella pneumoniae was identified by Vitek 2 technology. Antibiotic susceptibility was performed by the agar disc diffusion method and Etest. The presence of the bla KPC, bla VIM and bla NDM genes was confirmed by polymerase chain reaction (PCR)...
January 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28100714/the-dynamics-of-the-pulmonary-microbiome-during-mechanical-ventilation-in-the-intensive-care-unit-and-the-association-with-occurrence-of-pneumonia
#2
Tetyana Zakharkina, Ignacio Martin-Loeches, Sébastien Matamoros, Pedro Povoa, Antoni Torres, Janine B Kastelijn, Jorrit J Hofstra, B de Wever, Menno de Jong, Marcus J Schultz, Peter J Sterk, Antonio Artigas, Lieuwe D J Bos
RATIONALE: Ventilator-associated pneumonia (VAP) is the most common nosocomial infections in patients admitted to the ICU. The adapted island model predicts several changes in the respiratory microbiome during intubation and mechanical ventilation. OBJECTIVES: We hypothesised that mechanical ventilation and antibiotic administration decrease the diversity of the respiratory microbiome and that these changes are more profound in patients who develop VAP. METHODS: Intubated and mechanically ventilated ICU-patients were included...
January 18, 2017: Thorax
https://www.readbyqxmd.com/read/28099636/use-of-reactive-hyperemia-peripheral-arterial-tonometry-and-circulating-biological-markers-to-predict-outcomes-in-sepsis
#3
Vandack Nobre, Thiago Bragança Ataíde, Luisa Caldeira Brant, Clara Rodrigues Oliveira, Lucas Vieira Rodrigues, Antonio Luiz Pinho Ribeiro, Fernanda Barbosa Lopes, Ivan Euclides Saraiva, Marcus Vinícius Andrade
Objective: To evaluate the usefulness and prognostic value of reactive hyperemia - peripheral arterial tonometry in patients with sepsis. Moreover, we investigated the association of reactive hyperemia - peripheral arterial tonometry results with serum levels of certain inflammatory molecules. Methods: Prospective study, conducted in an 18-bed mixed intensive care unit for adults. The exclusion criteria included severe immunosuppression or antibiotic therapy initiated more than 48 hours before assessment...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28096229/disseminated-melioidosis-in-the-head-and-neck
#4
Tze Ling Loh, Sergios Latis, Graeme Crossland, Hemi Patel
A 35-year-old man was admitted to an intensive care unit with unilateral facial swelling and septic shock after multiple presentations to the emergency department with non-specific unilateral pain over the parotid area. A CT scan of his neck showed diffuse right-sided facial soft tissue infection, mastoid effusion and temporal lobe cerebritis. The upper lobes of his lungs had cannonball lesions that were suggestive of septic lung metastases. Blood cultures and ear canal swabs were positive for Burkholderia pseudomallei The temporal lobe cerebritis eventually developed into an abscess, necessitating a cortical mastoidectomy, craniectomy and temporal lobectomy...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28092204/impact-of-combination-therapy-and-early-de-escalation-on-outcome-of-ventilator-associated-pneumonia-caused-by-pseudomonas-aeruginosa
#5
Laurène Deconinck, Agnès Meybeck, Pierre Patoz, Nicolas Van Grunderbeeck, Nicolas Boussekey, Arnaud Chiche, Pierre-Yves Delannoy, Hugues Georges, Olivier Leroy
BACKGROUND: Pseudomonas aeruginosa is a common cause of ventilator-associated pneumonia (VAP). Guidelines recommend dual coverage of P. aeruginosa, but the beneficial effect of combination therapy is controversial. We described antibiotic prescriptions and evaluated the clinical impact of initial combination antibiotic therapy and de-escalation strategy in patients with VAP caused by P. aeruginosa. METHODS: Between 1994 and 2014, all 100 patients with VAP caused by P...
January 16, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28091345/propofol-as-a-risk-factor-for-icu-acquired-weakness-in-septic-patients-with-acute-respiratory-failure
#6
Peter A Abdelmalik, Goran Rakocevic
BACKGROUND: Critical illness polyneuropathy (CIN) and critical illness myopathy (CIM), together "ICU-Acquired weakness (ICUAW)," occur frequently in septic patients. One of the proposed mechanisms for ICUAW includes prolonged inactivation of sodium channels. Propofol, used commonly in patients with acute respiratory failure (ARF), primarily acts via enhancement of GABAergic transmission but may also increase sodium channel inactivation, suggesting a potential interaction. METHODS: Electronic medical records and EMG reports of patients with ICUAW and a diagnosis of either sepsis, septicaemia, severe sepsis, or septic shock, concurrent with a diagnosis of acute respiratory failure (ARF), were retrospectively analyzed in a single center university hospital...
January 16, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28089672/isopropyl-alcohol-is-as-efficient-as-chlorhexidine-to-prevent-contamination-of-blood-cultures
#7
Jovanna Martínez, Juan H Macías, Virginia Arreguín, Jose A Álvarez, Alejandro E Macías, Juan L Mosqueda-Gómez
BACKGROUND: False-positive blood cultures can lead to unnecessary risks and misuse of antibiotics; to reduce rates of false-positives, it would be useful to determine whether use of an antiseptic with a prolonged effect is required. METHODS: Clinical study of efficacy (blinded and randomized) to compare the rate of blood culture contamination when skin antisepsis was performed with 70% isopropyl alcohol or 2% chlorhexidine gluconate in 70% isopropyl alcohol in 2 hospitals...
January 12, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28077045/association-of-time-to-antibiotics-and-clinical-outcomes-in-adult-hematologic-malignancy-patients-with-febrile-neutropenia
#8
Allison R Butts, Christina Carracedo Bachmeier, Emily V Dressler, Meng Liu, Ann Cowden, Jeff Talbert, Val R Adams
Objective The objective of this study was to determine the clinical impact of time to antibiotic administration in adult inpatients who have hematologic malignancies and develop febrile neutropenia. Methods A retrospective chart review was conducted to screen for all febrile neutropenia events amongst adult hematologic malignancy patients between 1 January 2010 and 1 September 2014. All included patients were admitted to the hospital at the time of fever onset, having been admitted for a diagnosis other than febrile neutropenia...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28076304/the-use-of-liquid-chromatography-tandem-mass-spectrometry-for-therapeutic-drug-monitoring-of-antibiotics-in-cancer-patients
#9
Nahed El-Najjar, Jonathan Jantsch, André Gessner
Cancer remains a leading cause of mortality and morbidity worldwide. In addition to organ failure, the most frequent reasons for admission of cancer patients to intensive care units (ICU) are: infections and sepsis. As critically ill, the complexity of the health situation of cancer patients renders the standard antimicrobial regimen more complex and even inadequate which results in increased mortality rates. This is due to pathophysiological changes in the volume of distribution, increased clearance, as well as to organ dysfunction...
January 11, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28068956/cost-effectiveness-of-antibiotic-treatment-strategies-for-community-acquired-pneumonia-results-from-a-cluster-randomized-cross-over-trial
#10
Cornelis H van Werkhoven, Douwe F Postma, Marie-Josee J Mangen, Jan Jelrik Oosterheert, Marc J M Bonten
BACKGROUND: To determine the cost-effectiveness of strategies of preferred antibiotic treatment with beta-lactam/macrolide combination or fluoroquinolone monotherapy compared to beta-lactam monotherapy. METHODS: Costs and effects were estimated using data from a cluster-randomized cross-over trial of antibiotic treatment strategies, primarily from the reduced third payer perspective (i.e. hospital admission costs). Cost-minimization analysis (CMA) and cost-effectiveness analysis (CEA) were performed using linear mixed models...
January 10, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28067569/optimizing-postoperative-handover-to-the-intensive-care-unit-at-a-tertiary-centre
#11
Shankar Kumar, Andrew R McKean, Andrew Ramwell, Carolyn Johnston, Susannah Leaver
BACKGROUND: Comprehensive handover of patients transferred from operating theatre to the intensive care unit is crucial in ensuring ongoing quality and safety of care. Handover in this setting poses unique challenges, yet few studies have considered or tested approaches to improve the process. A quality improvement project was undertaken to assess and improve the quality of information transfer during the handover of postoperative patients to the general intensive care unit at a tertiary centre...
January 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28064542/antibiotic-treatment-patterns-costs-and-resource-utilization-among-patients-with-community-acquired-pneumonia-a-us-cohort-study
#12
Christopher J Llop, Edward Tuttle, Glenn S Tillotson, Kerry LaPlante, Thomas M File
OBJECTIVES: The current treatment options for patients with community-acquired pneumonia (CAP) often present a trade-off between the potential for treatment failure and safety concerns. We set out to investigate real-world outcomes associated with the use of currently available antimicrobial treatment options for CAP in both the outpatient and inpatient (non-intensive care unit [ICU]) settings. METHODS: This claims-based retrospective study included adult patients diagnosed with CAP and treated with antibiotic therapies, including any oral fluoroquinolone, macrolide, or beta-lactam monotherapy in the outpatient setting, and intravenous (IV) levofloxacin or IV azithromycin/ceftriaxone in the inpatient setting...
January 18, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28062856/rapid-resistome-mapping-using-nanopore-sequencing
#13
Eric van der Helm, Lejla Imamovic, Mostafa M Hashim Ellabaan, Willem van Schaik, Anna Koza, Morten O A Sommer
The emergence of antibiotic resistance in human pathogens has become a major threat to modern medicine. The outcome of antibiotic treatment can be affected by the composition of the gut. Accordingly, knowledge of the gut resistome composition could enable more effective and individualized treatment of bacterial infections. Yet, rapid workflows for resistome characterization are lacking. To address this challenge we developed the poreFUME workflow that deploys functional metagenomic selections and nanopore sequencing to resistome mapping...
January 6, 2017: Nucleic Acids Research
https://www.readbyqxmd.com/read/28058720/an-observational-study-of-community-acquired-severe-sepsis-comparing-intensive-care-and-non-intensive-care-patients
#14
S T Nygård, S Skrede, N Langeland, H K Flaatten
BACKGROUND: Most studies of sepsis are from intensive care units (ICUs). We aimed to investigate community-acquired severe sepsis in a broader population, in order to compare patients treated in or outside an ICU . METHODS: We performed a 1-year prospective observational study with enrollment of patients from three units; a general ICU, a combined ICU/non-ICU and a medical ward with limited surveillance facilities. Hospital survivors were followed up for 5 years...
January 6, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28057985/the-efficacy-of-noble-metal-alloy-urinary-catheters-in-reducing-catheter-associated-urinary-tract-infection
#15
Alanood Ahmed Aljohi, Hanan Elkefafy Hassan, Rakesh Kumar Gupta
BACKGROUND: Catheter-associated urinary tract infection (CAUTI) is the most common device-related healthcare-acquired infection. CAUTI can be severe and lead to bacteremia, significant morbidity, prolonged hospital stay, and high antibiotic consumption. PATIENTS AND METHODS: In this study, we evaluated the CAUTI-reducing efficacy of noble metal alloy catheters in sixty patients (thirty per group) in the Intensive Care Unit (ICU) at the King Fahad Hospital in Saudi Arabia...
October 2016: Urology Annals
https://www.readbyqxmd.com/read/28054307/etiology-and-complications-of-thrombocytopenia-in-hospitalized-medical-patients
#16
Eric M Fountain, Gowthami M Arepally
To determine incidence, risk factors, hematologic complications, and prognostic significance of thrombocytopenia in the general medicine population, we performed a single-institutional, retrospective study of all adult patients admitted to a general medical ward from January 1st, 2014 to December 31st, 2014 with hospital-acquired thrombocytopenia. Those with moderate thrombocytopenia, defined as a platelet count nadir of <100 × 10^9/L and/or a >50% relative decline, were compared to those with less severe thrombocytopenia...
January 4, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28053969/pneumococcal-urinary-antigen-test-use-in-diagnosis-and-treatment-of-pneumonia-in-seven-utah-hospitals
#17
Devin M West, Lindsay M McCauley, Jeffrey S Sorensen, Al R Jephson, Nathan C Dean
The pneumocococcal urine antigen test increases specific microbiological diagnosis over conventional culture methods in pneumonia patients. Data are limited regarding its yield and effect on antibiotic prescribing among patients with community-onset pneumonia in clinical practice. We performed a secondary analysis of 2837 emergency department patients admitted to seven Utah hospitals over 2 years with international diagnostic codes version 9 codes and radiographic evidence of pneumonia. Mean age was 64.2 years, 47...
October 2016: ERJ Open Research
https://www.readbyqxmd.com/read/28049382/use-of-intracranial-pressure-monitoring-in-bacterial-meningitis-a-10-year-follow-up-on-outcome-and-intracranial-pressure-versus-head-ct-scans
#18
Lykke Larsen, Frantz R Poulsen, Troels H Nielsen, Carl-Henrik Nordström, Mette K Schulz, Åse B Andersen
BACKGROUND: The aim of this study was to evaluate the clinical outcome of patients with severe bacterial meningitis where intracranial pressure (ICP) monitoring has been performed. METHODS: A retrospective observational study including patients admitted 1st(.) January 2005 to 31st(.) December 2014. Thirty nine patients age 18-89 years were included. All the patients received intensive care with mechanical ventilation, ICP monitoring, sedation, antibiotics and corticosteroids according to current guidelines...
January 3, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28048964/variability-in-antibiotic-regimens-for-surgical-necrotizing-enterocolitis-highlights-the-need-for-new-guidelines
#19
Brian P Blackwood, Catherine J Hunter, Julia Grabowski
BACKGROUND: Necrotizing enterocolitis or NEC is the most common gastrointestinal emergency in the newborn. The etiology of NEC remains unknown, and treatment consists of antibiotic therapy and supportive care with the addition of surgical intervention as necessary. Unlike most surgical diseases, clear guidelines for the type and duration of peri-operative antibiotic therapy have not been established. Our aim was to review the antibiotic regimen(s) applied to surgical patients with NEC within a single neonatal intensive care unit (NICU) and to evaluate outcomes and help develop guidelines for antibiotic administration in this patient population...
January 3, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28044184/-outcome-predictors-for-copd-patients-hospitalized-for-acute-exacerbation
#20
M Spielmanns, F Axer, C Nell, A R Koczulla, T Boeselt, F Magnet, J H Storre, W Windisch
BACKGROUND: Prognostic factors for clinical failure of acute exacerbation in patients with COPD (AECOPD) are of special importance in order to choose an adequate therapy and resources during inpatient treatment. Our database was analyzed to identify predictors for a negative outcome. MATERIALS AND METHODS: In a retrospective analysis medical records of 616 patients (299 women; 317 men) hospitalized for AECOPD between January 2011 and January 2016 were analyzed in order to evaluate demographic and clinical parameters leading to adverse events...
January 2, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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