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antibiotics in icu patients

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https://www.readbyqxmd.com/read/28231518/early-bronchoalveolar-lavage-for-intubated-trauma-patients-with-tbi-or-chest-trauma
#1
Tyler J Loftus, Stephen J Lemon, Linda L Nguyen, Stacy A Voils, Scott C Brakenridge, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Frederick A Moore, Philip A Efron, Alicia M Mohr
PURPOSE: To evaluate the efficacy of an early bronchoalveolar lavage (E-BAL) protocol. BAL was performed within 48 h for intubated patients with traumatic brain injury or chest trauma. We hypothesized that E-BAL would decrease antibiotic use and improve outcomes compared to late BAL (L-BAL) triggered by clinical signs of pneumonia. METHODS: Retrospective cohort analysis of 132 patients with quantitative BAL and ≥1 risk factor: head Abbreviated Injury Score ≥2, ≥3 rib fractures, or radiographic signs of aspiration or pulmonary contusion...
February 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28226029/predictive-value-of-c-reactive-protein-in-critically-ill-patients-after-abdominal-surgery
#2
Frédéric Sapin, Patrick Biston, Michael Piagnerelli
OBJECTIVES: The development of sepsis after abdominal surgery is associated with high morbidity and mortality. Due to inflammation, it may be difficult to diagnose infection when it occurs, but measurement of C-reactive protein could facilitate this diagnosis. In the present study, we evaluated the predictive value and time course of C-reactive protein in relation to outcome in patients admitted to the intensive care unit (ICU) after abdominal surgery. METHODS: We included patients admitted to the ICU after abdominal surgery over a period of two years...
January 1, 2017: Clinics
https://www.readbyqxmd.com/read/28225903/sphygmomanometers-and-thermometers-as-potential-fomites-of-staphylococcus-haemolyticus-biofilm-formation-in-the-presence-of-antibiotics
#3
Bruna Pinto Ribeiro Sued, Paula Marcele Afonso Pereira, Yuri Vieira Faria, Juliana Nunes Ramos, Vanessa Batista Binatti, Kátia Regina Netto Dos Santos, Sérgio Henrique Seabra, Raphael Hirata, Verônica Viana Vieira, Ana Luíza Mattos-Guaraldi, José Augusto Adler Pereira
BACKGROUND: The association between Staphylococcus haemolyticus and severe nosocomial infections is increasing. However, the extent to which fomites contribute to the dissemination of this pathogen through patients and hospital wards remains unknown. OBJECTIVES: In the present study, sphygmomanometers and thermometers were evaluated as potential fomites of oxacillin-resistant S. haemolyticus (ORSH). The influence of oxacillin and vancomycin on biofilm formation by ORSH strains isolated from fomites was also investigated...
March 2017: Memórias do Instituto Oswaldo Cruz
https://www.readbyqxmd.com/read/28225897/sphygmomanometers-and-thermometers-as-potential-fomites-of-staphylococcus-haemolyticus-biofilm-formation-in-the-presence-of-antibiotics
#4
Bruna Pinto Ribeiro Sued, Paula Marcele Afonso Pereira, Yuri Vieira Faria, Juliana Nunes Ramos, Vanessa Batista Binatti, Kátia Regina Netto Dos Santos, Sérgio Henrique Seabra, Raphael Hirata, Verônica Viana Vieira, Ana Luíza Mattos-Guaraldi, José Augusto Adler Pereira
BACKGROUND: The association between Staphylococcus haemolyticus and severe nosocomial infections is increasing. However, the extent to which fomites contribute to the dissemination of this pathogen through patients and hospital wards remains unknown. OBJECTIVES: In the present study, sphygmomanometers and thermometers were evaluated as potential fomites of oxacillin-resistant S. haemolyticus (ORSH). The influence of oxacillin and vancomycin on biofilm formation by ORSH strains isolated from fomites was also investigated...
February 16, 2017: Memórias do Instituto Oswaldo Cruz
https://www.readbyqxmd.com/read/28224093/pediatric-asthma-severity-score-is-associated-with-critical-care-interventions
#5
Danielle K Maue, Nadia Krupp, Courtney M Rowan
AIM: To determine if a standardized asthma severity scoring system (PASS) was associated with the time spent on continuous albuterol and length of stay in the pediatric intensive care unit (PICU). METHODS: This is a single center, retrospective chart review study at a major children's hospital in an urban location. To qualify for this study, participants must have been admitted to the PICU with a diagnosis of status asthmaticus. There were a total of 188 participants between the ages of two and nineteen, excluding patients receiving antibiotics for pneumonia...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28222699/suspicion-of-respiratory-tract-infection-with-multidrug-resistant-enterobacteriaceae-epidemiology-and-risk-factors-from-a-paediatric-intensive-care-unit
#6
Hanna Renk, Lenja Stoll, Felix Neunhoeffer, Florian Hölzl, Matthias Kumpf, Michael Hofbeck, Dominik Hartl
BACKGROUND: Multidrug-resistant (MDR) infections are a serious concern for children admitted to the Paediatric Intensive Care Unit (PICU). Tracheal colonization with MDR Enterobacteriaceae predisposes to respiratory infection, but underlying risk factors are poorly understood. This study aims to determine the incidence of children with suspected infection during mechanical ventilation and analyses risk factors for the finding of MDR Enterobacteriaceae in tracheal aspirates. METHODS: A retrospective single-centre analysis of Enterobacteriaceae isolates from the lower respiratory tract of ventilated PICU patients from 2005 to 2014 was performed...
February 21, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28219190/-efficacy-and-safety-of-procalcitonin-guidance-in-reducing-the-duration-of-antibiotic-treatment-of-sepsis-patients
#7
X L Xu, F D Yan, J Q Yu, Q H Chen, H Lin, R Q Zheng
Objective: To assesse the efficacy and safety of procalcitonin-guided antibiotic treatment of sepsis patients in intensive care units (ICU). Methods: A prospective, randomised, controlled trial was gone in ICU of Northern Jiangsu People's Hospital.Between January 2013 and December 2015.One hundred and fifty-six patients assessed for eligibility were randomly assigned to the procalcitonin-guided group (PCT group, 79) or to regular antibiotic group (RAT group, 77). Patients who received antibiotics for presumed infection according to principle of antimicrobial usage...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28216060/incidence-of-fever-in-labor-and-risk-of-neonatal-sepsis
#8
Craig V Towers, Angela Yates, Nikki Zite, Casey Smith, Lindsey Chernicky, Bobby Howard
BACKGROUND: The current recommendation regarding the management of a term newborn delivered of a mother with an intrapartum fever or a diagnosis of clinical chorioamnionitis is that the neonate should have baseline laboratory work drawn along with blood cultures and be universally treated with antibiotics until culture results return. These guidelines report that the rate of intrapartum fever is about 3%; however, a few large studies suggest that the rate is higher at about 7%. OBJECTIVE: To prospectively evaluate the rate of fever during labor in a large number of deliveries and determine the rate of early onset neonatal sepsis in newborns delivered from mothers with an intrapartum fever compared with the newborns that delivered from mothers that did not have an intrapartum fever...
February 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28215612/postoperative-infections-after-excision-of-neurogenic-heterotopic-ossifications-at-the-hip-risk-factors-and-causative-organisms
#9
L Gatin, F Genêt, A Dinh, P Denormandie
BACKGROUND: Neurogenic heterotopic ossification (NHO) is usually treated by surgical excision. Post-operativeinfection (POI) is a possible complication, whose epidemiology, causative organisms, and risk factors are poorly known.We therefore conducted a case-control study to 1) identify the risk factors for POI after surgical excision of NHO at the hip, 2) determine the frequency of POI, 3) and identify the causative organisms. HYPOTHESIS: Risk factors for POI after NHO excision at the hip can be identified...
February 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28206733/end-of-life-decisions-in-34-slovene-intensive-care-units-a-nationwide-prospective-clinical-study
#10
Miha Orazem, Urh Groselj, Manca Stojan, Neza Majdic, Gaj Vidmar, Stefan Grosek
BACKGROUND: To determine how end-of-life decisions (EOLD) on limitations of life- sustaining treatment (LST) are made in three different types of intensive care units (ICUs) in Slovenia. METHODS: A national multicenter prospective study among 31 adult and three pediatric/neonatal ICUs (PICUs). The questionnaire form on EOLD was designed to assess the clinical practice. Data were collected between January 1, 2013, and March 31, 2013. For statistical analysis we used IBM® SPSS® Statistics 20 software package...
February 15, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28206705/erysipelothrix-rhusiopathiae-bloodstream-infection-a-22-year-experience-at-mayo-clinic-minnesota
#11
E M Tan, J R Marcelin, N Adeel, R J Lewis, M J Enzler, P K Tosh
Erysipelothrix rhusiopathiae is a facultatively anaerobic Gram-positive bacillus found mostly in swine, fish and sheep. E. rhusiopathiae classically causes cutaneous eruptions in butchers, fish handlers and veterinarians. Based solely on case reports, 90% of E. rhusiopathiae bloodstream infections (BSI) have been associated with infective endocarditis (IE). To assess the true frequency of IE in E. rhusiopathiae BSI as well as other clinical associations, we performed a retrospective cohort analysis of E...
February 16, 2017: Zoonoses and Public Health
https://www.readbyqxmd.com/read/28197738/vaccines-for-staphylococcus-aureus-and-target-populations
#12
Clarissa Pozzi, Reuben Olaniyi, Lassi Liljeroos, Ilaria Galgani, Rino Rappuoli, Fabio Bagnoli
Staphylococcus aureus is a leading pathogen in surgical site, intensive care unit, and skin infections, as well as healthcare-associated pneumonias. These infections are associated with an enormous burden of morbidity, mortality, and increase of hospital length of stay and patient cost. S. aureus is impressively fast in acquiring antibiotic resistance, and multidrug-resistant strains are a serious threat to human health. Due to resistance or insufficient effectiveness, antibiotics and bundle measures leave a tremendous unmet medical need worldwide...
February 15, 2017: Current Topics in Microbiology and Immunology
https://www.readbyqxmd.com/read/28197051/benefits-of-and-untoward-events-during-intrahospital-transport-of-pediatric-intensive-care-unit-patients
#13
M M Harish, Suhail Sarwar Siddiqui, Natesh R Prabu, Harish K Chaudhari, Jigeeshu V Divatia, Atul Prabhakar Kulkarni
BACKGROUND AND AIMS: The transport of critically ill patients for procedures or imaging outside the Intensive Care Unit (ICU) is potentially hazardous; hence, the transport process must be organized and efficient. The literature about benefits of and untoward events (UEs) during intrahospital transport of pediatric critically ill patient is scarce. We, therefore, audited the UEs during and benefits of intrahospital transport of critically ill pediatric patients in our ICU. SUBJECTS AND METHODS: Eighty critically ill pediatric (<18 years) cancer patients, transported from the ICU for either diagnostic or therapeutic procedure over a period of 6 months, were included in the study...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28195096/genotyping-of-clinical-and-environmental-multidrug-resistant-enterococcus-faecium-strains
#14
Leili Shokoohizadeh, Ashraf Mohabati Mobarez, Masoud Alebouyeh, Mohammad Reza Zali, Reza Ranjbar
CONTEXT: Multidrug resistant (MDR) Enterococcus faecium is a nosocomial pathogen and clonal complex 17 (CC17) is the main genetic subpopulation of E. faecium in hospitals worldwide. AIMS: There has thus far been no report of major E. faecium clones in Iranian hospitals. SUBJECTS AND METHODS: The present study analyzed strains of MDR E. faecium obtained from patients and the Intensive Care Unit environments using pulsed field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) to determine the antibiotic resistance patterns and genetic features of the dominant...
January 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28193661/determining-the-clinical-utility-of-an-absolute-procalcitonin-value-for-predicting-a-positive-culture-result
#15
Erica M Caffarini, Joshua DeMott, Gourang Patel, Ishaq Lat
Various procalcitonin ranges have been established to guide antimicrobial therapy; however, there are no data that establish whether the initial procalcitonin value will determine the likelihood of a positive culture result. This study aims to establish if the initial procalcitonin value on clinical presentation can provide positive predictive value of any positive culture result.This was a retrospective study of 813 medical intensive care unit patients. Data points collected included patient demographics, procalcitonin assays, source of infection, culture results, and length of stay...
February 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28187812/family-discussions-on-life-sustaining-interventions-in-neurocritical-care
#16
M M Adil, D Larriviere
Approximately 20% of all deaths in the USA occur in the intensive care unit (ICU) and the majority of ICU deaths involves decision of de-escalation of life-sustaining interventions. Life-sustaining interventions may include intubation and mechanical ventilation, artificial nutrition and hydration, antibiotic treatment, brain surgery, or vasoactive support. Decision making about goals of care can be defined as an end-of-life communication and the decision-making process between a clinician and a patient (or a surrogate decision maker if the patient is incapable) in an institutional setting to establish a plan of care...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187809/management-of-bacterial-central-nervous-system-infections
#17
M C Brouwer, D van de Beek
Bacterial infections of the central nervous system present as a medical emergency, thus requiring rapid diagnosis and immediate treatment. The most prevalent bacterial infections seen in the intensive care unit can be summarized as acute bacterial meningitis, subdural empyema, intracerebral abscess, and ventriculitis, which all commonly involve the brain parenchyma. The infections can either be community-acquired or hospital-acquired, e.g., after neurosurgical intervention, as a complication of severe neurotrauma or related to indwelling cerebrospinal fluid drains...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187785/longevity-and-gender-as-the-risk-factors-of-methicillin-resistant-staphylococcus-aureus-infections-in-southern-poland
#18
Monika Pomorska-Wesołowska, Anna Różańska, Joanna Natkaniec, Barbara Gryglewska, Anna Szczypta, Mirosława Dzikowska, Agnieszka Chmielarczyk, Jadwiga Wójkowska-Mach
BACKGROUND: The proportion of older people among the general population has risen. Staphylococcus aureus (SA) constitutes a significant problem. Underlying disease and functional debility, predispose the older adult to staphylococcal carriage and infection, specially bloodstream infection and pneumonia. METHODS: This is a retrospective cohort study of older patients with SA infections. We analyzed a database containing the results of laboratory cultures from patients treated in 2013 for SA infections and selected 613 hospitalized and non-hospitalized people aged ≥60 years...
February 10, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28181665/multidrug-resistant-bacteria-among-patients-with-ventilatorassociated-pneumonia-in-an-emergency-intensive-care-unit-egypt
#19
Magda M Azzab, Rehab H El-Sokkary, Mohamed M Tawfeek, Manar G Gebriel
Ventilator-associated pneumonia (VAP) is the most common hospital-acquired infection among mechanically ventilated patients. Our objectives were to determine the incidence of VAP, isolate multidrug-resistant bacteria, identify the most prevalent resistant strains and identify their antibiotic susceptibility pattern. The VAP rate was calculated. The isolated microbes were identified and tested for antibiotic susceptibilities. The minimum inhibitory concentrations were determined of imipenem, meropenem and ertapenem for Klebsiella isolates...
February 1, 2017: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
https://www.readbyqxmd.com/read/28181033/clinical-and-microbiological-determinants-of-severe-and-fatal-outcomes-in-patients-infected-with-enterobacteriaceae-producing-extended-spectrum-%C3%AE-lactamase
#20
L Surgers, A Boyd, P-Y Boelle, V Lalande, P-A Jolivot, P-M Girard, G Arlet, C Cambier, A Homor, D Decre, J-L Meynard
Although extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae have become a worldwide public health concern, little is known regarding the clinical course of colonized or infected individuals. Our objective was to characterize the determinants of fatal outcomes related to ESBL-producing microorganisms at a large hospital in Paris, France. In 2012-2013, all consecutive patients with clinical samples testing positive for ESBL-producing Enterobacteriaceae at Saint-Antoine Hospital were identified...
February 8, 2017: European Journal of Clinical Microbiology & Infectious Diseases
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