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antibiotics in icu patients

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https://www.readbyqxmd.com/read/29050887/antibiotic-stewardship-in-the-newborn-surgical-patient-a%C3%A2-quality-improvement-project-in-the-neonatal-intensive-care-unit
#1
Sarah Walker, Ankur Datta, Roxanne L Massoumi, Erica R Gross, Michael Uhing, Marjorie J Arca
BACKGROUND: There is significant diversity in the utilization of antibiotics for neonates undergoing surgical procedures. Our institution standardized antibiotic administration for surgical neonates, in which no empiric antibiotics were given to infants with surgical conditions postnatally, and antibiotics are given no more than 72 hours perioperatively. METHODS: We compared the time periods before and after implementation of antibiotic protocol in an institution review board-approved, retrospective review of neonates with congenital surgical conditions who underwent surgical correction within 30 days after birth...
October 16, 2017: Surgery
https://www.readbyqxmd.com/read/29050167/-serum-procalcitonin-in-patients-with-pulmonary-infection-and-central-nervous-system-injury
#2
J C Li, L Y Wang, Y F Wang, M H Mei, L Shi, M L Yao, X D Guan, B Ouyang
Objective: To evaluate the influence of serum procalcitonin in the diagnosis and treatment of pulmonary infection in patients with central nervous system injury. Methods: From October 2014 to February 2017, a retrospective study was performed. A total of 1 852 patients were screened in Department of Intensive Care Unite, First Affiliated Hospital of Sun Yat-sen University.Among them, 173 patients were identified with different kinds of infection. Finally, a total of 42 patients with pulmonary infection were enrolled...
October 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29045957/-clinical-characteristics-of-neonatal-fungal-sepsis-in-neonatal-intensive-care-unit
#3
X Zhang, X F Ru, Y Wang, X Li, T Sang, Q Feng
OBJECTIVE: To study the characteristics of neonatal fungal sepsis and the difference between bacterial sepsis and fungal sepsis. To improve the understanding of neonatal fungal sepsis. METHODS: Clinical data of neonatal fungal sepsis in neonatal intensive care unit (NICU) were collected from 2011 to 2016 in Peking University first Hospital. The clinical characteristics were analyzed retrospectively. The difference between neonatal fungal sepsis and bacterial sepsis was also analyzed...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29044014/-anaphylaxis-and-allergic-reactions-during-surgery-and-medical-procedures
#4
Blas J Larrauri, María Gabriela Torre, Eloísa Malbrán, María Cecilia Juri, Diego S Fernández Romero, Alejandro Malbrán
Anaphylaxis during anesthesia is an unpredictable, severe, and rare reaction. It has an incidence of 1/10 000 to 1/20 000 surgeries. In most series, the responsible drugs include neuromuscular blocking agents, latex, or antibiotics. The frequency and etiology of systemic allergic reactions in other medical procedures are largely unknown. The identification of responsible drugs of anaphylaxis is a complex task, requiring testing of all medications and substances used during surgery. We describe our experience in a retrospective study of 15 patients...
2017: Medicina
https://www.readbyqxmd.com/read/29044002/irrational-antibiotic-prescribing-practice-among-children-in-critical-care-of-tertiary-hospitals
#5
Mirza Tasawer Baig, Ali Akbar Sial, Ambreen Huma, Maryam Ahmed, Uzma Shahid, Nayel Syed
This study assessed the prescribing pattern of irrational use of antibiotic among children under age of 12 years in public and private sector hospitals in Pakistan. The prospective clinical evaluation of drug utilization pattern of antimicrobials from Patient Bedside File (PBF) of in-patients and Culture Sensitivity Test (CST) reports were evaluated to determine the antibiotic resistance. Two indicators recorded to assess antibiotic prescribing were; dose of prescribed antibiotic (low-dose, rational and high -dose) and Indication (valid or invalid)...
July 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29040243/toxic-shock-syndrome-still-a-timely-diagnosis
#6
Kira L Gossack-Keenan, April J Kam
BACKGROUND: Toxic shock syndrome (TSS) is an acute, severe, toxin-mediated disease, characterized by fever, hypotension, and multiorgan system involvement. Toxic shock syndrome has made headlines because of its high associated morbidity and mortality rate in previously healthy young females. Incidence peaked in the early 1980s owing to increased usage of ultra-absorbent tampons. After improved patient education and tampon labeling, the incidence of menstrual TSS has declined. CASE: A previously healthy 14-year-old girl presented to an urgent care center with a 2-day history of fever, erythematous maculopapular rash, vomiting, diarrhea, and malaise...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29039613/staphylococcus-aureus-colonisation-in-patients-from-a-primary-regional-hospital
#7
Anca Ungureanu, Ovidiu Zlatian, George Mitroi, Andrei Drocaş, Tiberiu Ţîrcă, Daniela Călina, Cristina Dehelean, Anca Oana Docea, Boris N Izotov, Valerii N Rakitskii, Ramona Cioboată, Demetrios A Spandidos, Aristides M Tsatsakis, Alice Găman
Staphylococcus aureus (SA or S. aureus) is a common pathogen that leads to local and systemic infections in communitarian and hospitalised patients. Staphylococcus colonizing nasal or pharyngeal sites can become virulent and cause severe infections. In this study, we collected 322 pharyngeal exudates and 142 nasal exudates from hospitalised and outpatients for screening purposes. The carriage rates in the pharynx were 27.06% for S. aureus, 11.55% for methicillin‑resistant S. aureus (MRSA) and 5.61% for methicillin‑oxacillin resistant S...
October 10, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29033819/an-unusual-presentation-of-pyoderma-gangrenosum-leading-to-systemic-inflammatory-response-syndrome
#8
Ali Didan, Alan Donnelly, Hock Chua
This is a report of an atypical presentation of pyoderma gangrenosum (PG) in a 26-year-old male who had a negative septic screen. The patient had a life-threatening presentation requiring an intensive care unit (ICU) admission for vasopressor support. It was thought that the likely cause of circulatory collapse was an overwhelming cytokine reaction or systemic inflammatory response syndrome (SIRS) secondary to extensive PG lesions rather than septic shock. The patient presented with multiple large ulcers, the largest being 4 cm in diameter on the central chest...
September 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/29033730/intentional-intra-arterial-injection-of-midazolam-in-a-patient-with-status-epilepticus-in-the-intensive-care-unit
#9
Muhammad Asghar Ali, Muhammad Yahya
Fundamental medical care includes intravenous (IV) access which provides prompt resuscitation and reliable delivery of analgesics, antibiotics, and vasoactive medication. Difficult access populations, especially in critical area, continue to challenge providers to consider and utilize alternative means to provide IV access. Potential options under such circumstances include intramuscular, intraosseous, and intratracheal drug administration, but in extreme cases where no other options are available, intra-arterial route might be considered...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033075/multi-drug-resistant-organism-infections-in-a-medical-icu-association-to-clinical-features-and-impact-upon-outcome
#10
E E Magira, S Islam, M S Niederman
OBJECTIVE: To define clinical features associated with Intensive Care Unit (ICU) infections caused by multi-drug resistant organisms (MDRO) and their impact on patient outcome. DESIGN: A single-center, retrospective case-control study was carried out between January 2010 and May 2010. SETTING: A medical ICU (MICU) in the United States. PATIENTS: The study included a total of 127 MDRO-positive patients and 186 MDRO-negative patients...
October 12, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29029802/early-life-environmental-exposures-interact-with-genetic-susceptibility-variants-in-pediatric-patients-with-eosinophilic-esophagitis
#11
Elizabeth T Jensen, Jonathan T Kuhl, Lisa J Martin, Carl D Langefeld, Evan S Dellon, Marc E Rothenberg
BACKGROUND: Although eosinophilic esophagitis (EoE) is associated with certain gene variants, the rapidly increasing incidence of EoE suggests that environmental factors contribute to disease development. OBJECTIVE: We tested for gene-environment interaction between EoE-predisposing polymorphisms (within TSLP, LOC283710/KLF13, CAPN14, CCL26, and TGFB) and implicated early-life factors (antibiotic use in infancy, cesarean delivery, breast-feeding, neonatal intensive care unit [NICU] admission, and absence of pets in the home)...
September 12, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29028461/antibiotic-impregnated-central-venous-catheters-do-not-change-antibiotic-resistance-patterns
#12
Isaiah R Turnbull, Sara A Buckman, Christopher B Horn, Grant V Bochicchio, John E Mazuski
BACKGROUND: Antibiotic-impregnated central venous catheters (CVCs) decrease the incidence of infection in high-risk patients. However, use of these catheters carries the hypothetical risk of inducing antibiotic resistance. We hypothesized that routine use of minocycline and rifampin-impregnated catheters (MR-CVC) in a single intensive care unit (ICU) would change the resistance profile for Staphylococcus aureus. METHODS: We reviewed antibiotic susceptibilities of S...
October 13, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29027654/pharmacokinetic-drug-drug-interactions-in-the-intensive-care-unit-single-centre-experience-and-literature-review
#13
Piotr Łój, Aleksanda Olender, Weronika Ślęzak, Łukasz J Krzych
BACKGROUND: Drug-drug interactions constitute a serious health hazard in everyday clinical practice in critically ill patients. Drug-drug interactions may be pharmacokinetic or pharmacodynamic in their nature. We aimed to investigate the quantity and quality of possible drug-drug interactions, and their possible side effects in intensive care unit patients in a 12-month period. METHODS: This retrospective study covered data on pharmacological treatment of 43 consecutive patients (11 females, 32 males) aged 62 ± 15 years, hospitalized between January 2015 and February 2016...
October 13, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29026472/clinical-features-and-antimicrobial-resistance-of-bacterial-agents-of-ventilator-associated-tracheobronchitis-in-hamedan-iran
#14
Seyyed Hamid Hashemi, Naeimeh Hashemi, Farzaneh Esna-Ashari, Abbas Taher, Arash Dehghan
OBJECTIVES: Ventilator-associated tracheobronchitis (VAT) is a common cause of mortality and morbidity in patients admitted to intensive care units (ICUs). This study was conducted to evaluate the clinical course, etiology, and antimicrobial resistance of bacterial agents of VAT in ICUs in Hamedan, Iran. METHODS: During a 12-month period, all patients with VAT in a medical and a surgical ICU were included. The criteria for the diagnosis of VAT were fever, mucus production, a positive culture of tracheal secretions, and the absence of lung infiltration...
September 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29025194/procalcitonin-to-initiate-or-discontinue-antibiotics-in-acute-respiratory-tract-infections
#15
REVIEW
Philipp Schuetz, Yannick Wirz, Ramon Sager, Mirjam Christ-Crain, Daiana Stolz, Michael Tamm, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Kristina B Kristoffersen, Olaf Burkhardt, Tobias Welte, Stefan Schroeder, Vandack Nobre, Long Wei, Heiner C Bucher, Neera Bhatnagar, Djillali Annane, Konrad Reinhart, Angela Branche, Pierre Damas, Maarten Nijsten, Dylan W de Lange, Rodrigo O Deliberato, Stella Ss Lima, Vera Maravić-Stojković, Alessia Verduri, Bin Cao, Yahya Shehabi, Albertus Beishuizen, Jens-Ulrik S Jensen, Caspar Corti, Jos A Van Oers, Ann R Falsey, Evelien de Jong, Carolina F Oliveira, Bianca Beghe, Matthias Briel, Beat Mueller
BACKGROUND: Acute respiratory infections (ARIs) comprise of a large and heterogeneous group of infections including bacterial, viral, and other aetiologies. In recent years, procalcitonin (PCT), a blood marker for bacterial infections, has emerged as a promising tool to improve decisions about antibiotic therapy (PCT-guided antibiotic therapy). Several randomised controlled trials (RCTs) have demonstrated the feasibility of using procalcitonin for starting and stopping antibiotics in different patient populations with ARIs and different settings ranging from primary care settings to emergency departments, hospital wards, and intensive care units...
October 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29023567/carbapenem-resistant-enterobacteriaceae-colonization-cre-and-subsequent-risk-of-infection-and-90-day-mortality-in-critically-ill-patients-an-observational-study
#16
Thomas Howe McConville, Sean Berger Sullivan, Angela Gomez-Simmonds, Susan Whittier, Anne-Catrin Uhlemann
BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) have emerged as an urgent public health threat. Intestinal colonization with CRE has been identified as a risk factor for the development of systemic CRE infection, but has not been compared to colonization with third and/or fourth generation cephalosporin-resistant (Ceph-R) Enterobacteriaceae. Moreover, the risk conferred by colonization on adverse outcomes is less clear, particularly in critically ill patients admitted to the intensive care unit (ICU)...
2017: PloS One
https://www.readbyqxmd.com/read/29021787/integron-digestive-carriage-in-human-and-cattle-a-one-health-cultivation-independent-approach
#17
Delphine Chainier, Olivier Barraud, Geoffrey Masson, Elodie Couve-Deacon, Bruno François, Claude-Yves Couquet, Marie-Cécile Ploy
Objectives: Dissemination of antimicrobial resistance (AMR) is a global issue that requires the adoption of a "One-Health" approach promoting integration of human and animal health. Besides culture-dependent techniques frequently used for AMR surveillance, cultivation-independent methods can give additional insights into the diversity and reservoir of AMR genetic determinants. Integrons are molecular markers that can provide overall and reliable estimation of AMR dissemination. In this study, considering the "One-Health" approach, we have analyzed the integron digestive carriage from stools of humans and cattle living in a same area and exposed to different antibiotic selection pressures...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29020364/antimicrobial-resistance-in-gram-negative-rods-causing-bacteremia-in-hematopoietic-stem-cell-transplant-patients-intercontinental-prospective-study-of-infectious-diseases-working-party-of-the-european-bone-marrow-transplantation-group
#18
Diana Averbuch, Gloria Tridello, Jennifer Hoek, Malgorzata Mikulska, Hamdi Akan, Lucrecia Yanez San Segundo, Thomas Pabst, Tülay Özçelik, Galina Klyasova, Irene Donnini, Depei Wu, Zafer Gülbas, Tsila Zuckerman, Aida Botelho de Sousa, Yves Beguin, Aliénor Xhaard, Emmanuel Bachy, Per Ljungman, Rafael de la Camara, Jelena Rascon, Isabel Ruiz Camps, Antonin Vitek, Francesca Patriarca, Laura Cudillo, Radovan Vrhovac, Peter J Shaw, Tom Wolfs, Tracey O'Brien, Batia Avni, Gerda Silling, Firas Al Sabty, Stelios Graphakos, Marja Sankelo, Henrik Sengeloev, Srinivas Pillai, Susanne Matthes, Frederiki Melanthiou, Simona Iacobelli, Jan Styczynski, Dan Engelhard, Simone Cesaro
Background: This intercontinental study aimed to study Gram-negative rods (GNR) resistance in hematopoietic stem cell transplantation (HSCT). Methods: GNR bacteremias occurring during six months post-HSCT (February/2014-May/2015) were prospectively collected, and analysed for rates and risk factors for resistance to fluoroquinolones, non-carbapenem anti-Pseudomonas beta-lactams (non-carbapenems), carbapenems and multidrug-resistance (MDR). Results: Sixty-five HSCT centers from 25 countries (Europe, Australia, Asia) reported data on 655 GNR episodes/704 pathogens in 591 patients (Enterobacteriaceae, 73%; non-fermentatives, 24% and 3% others)...
July 26, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29020307/follow-up-blood-cultures-in-gram-negative-bacteremia-are-they-needed
#19
Christina N Canzoneri, Bobak J Akhavan, Zehra Tosur, Pedro E Alcedo Andrade, Gabriel M Aisenberg
Background: Bloodstream infections remain a major cause of morbidity and mortality. Gram-negative bacilli (GNB) bacteremia is typically transient and usually resolves rapidly after the initiation of appropriate antibiotic therapy and source control. The optimal duration of treatment and utility of follow-up blood cultures (FUBC) have not been studied in detail. Currently, the management of Gram-negative bacteremia is determined by clinical judgment. To investigate the value of repeat blood cultures, we analyzed 500 episodes of bacteremia to determine frequency of FUBC and identify risk factors for persistent bacteremia...
July 26, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29020273/the-transmissibility-of-antibiotic-resistant-enterobacteriaceae-in-intensive-care-units
#20
Tanya Gurieva, Mirjam J D Dautzenberg, Marek Gniadkowski, Lennie P G Derde, Marc J M Bonten, Martin C J Bootsma
Background: The global emergence of infections caused by Enterobacteriaceae resistant to expanded-spectrum cephalosporins (ESCs) in intensive care units (ICUs) is, at least partly, driven by cross-transmission. Yet, individual transmission capacities of bacterial species have not been quantified. Methods: In this post-hoc analysis of a multicenter study in 13 European ICUs prospective surveillance data and a mathematical model were used to estimate transmission capacities and single admission reproduction numbers (RA) of Escherichia coli and non-E...
September 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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