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antibiotics in icu patients

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https://www.readbyqxmd.com/read/28811241/utility-of-prior-cultures-in-predicting-antibiotic-resistance-of-bloodstream-infections-due-to-gram-negative-pathogens-a-multicenter-observational-cohort-study
#1
Derek R MacFadden, Bryan Coburn, Nirav Shah, Ari Robicsek, Rachel Savage, Marion Elligsen, Nick Daneman
OBJECTIVES: Appropriate empiric antibiotic therapy in patients with bloodstream infections due to Gram-negative pathogens can improve outcomes. We evaluated the utility of prior microbiologic results for guiding empiric treatment in Gram-negative bloodstream infections. METHODS: We conducted a multi-center observational cohort study, in two large health systems in Canada and the United States, including 1,832 hospitalized patients with Gram-negative bloodstream infection (community, hospital, and ICU acquired) from April 2010 to March 2015...
August 12, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28804720/integron-mediated-antibiotic-resistance-in-acinetobacter-baumannii-isolated-from-intensive-care-unit-patients-babol-north-of-iran
#2
Mitra Deylam Salehi, Elaheh Ferdosi-Shahandashti, Yosef Yahyapour, Soraya Khafri, Abazar Pournajaf, Ramazan Rajabnia
BACKGROUND: We investigated the integron types and their relation with antibiotic resistance among A. baumannii isolates collected from intensive care unit patients, Babol, north of Iran. METHODS: In this cross-sectional study, a total of 73 bronchoalveolar lavage samples were obtained from patients in ICU. Susceptibility testing was performed by disk diffusion method. Types of integrons were identified by an integrase gene PCR. RESULTS: In total, 47...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28803549/comparative-gut-microbiota-and-resistome-profiling-of-intensive-care-patients-receiving-selective-digestive-tract-decontamination-and-healthy-subjects
#3
Elena Buelow, Teresita D J Bello González, Susana Fuentes, Wouter A A de Steenhuijsen Piters, Leo Lahti, Jumamurat R Bayjanov, Eline A M Majoor, Johanna C Braat, Maaike S M van Mourik, Evelien A N Oostdijk, Rob J L Willems, Marc J M Bonten, Mark W J van Passel, Hauke Smidt, Willem van Schaik
BACKGROUND: The gut microbiota is a reservoir of opportunistic pathogens that can cause life-threatening infections in critically ill patients during their stay in an intensive care unit (ICU). To suppress gut colonization with opportunistic pathogens, a prophylactic antibiotic regimen, termed "selective decontamination of the digestive tract" (SDD), is used in some countries where it improves clinical outcome in ICU patients. Yet, the impact of ICU hospitalization and SDD on the gut microbiota remains largely unknown...
August 14, 2017: Microbiome
https://www.readbyqxmd.com/read/28803455/effect-of-positive-perioperative-donor-and-recipient-respiratory-bacterial-cultures-on-early-post-transplant-outcomes-in-lung-transplant-recipients
#4
Crystal K Howell, Christopher A Paciullo, Marshall G Lyon, David Neujahr, Peter Lyu, George Cotsonis, Michael Hurtik
BACKGROUND: It is standard practice to administer prophylactic antibiotics post lung transplantation. However, no studies have evaluated the impact of culture positivity. The purpose of this study was to evaluate early post-transplant outcomes of culture-positive and culture-negative lung transplant (LT) recipients and the appropriateness of the empiric regimens used. METHODS: Adult patients who received an LT at Emory University Hospital between January 1, 2010 and August 31, 2015 were reviewed and stratified into three groups: (i) culture-positive appropriate empiric treatment, (ii) culture-positive inappropriate empiric treatment, and (iii) culture-negative...
August 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28797895/patterns-of-c-reactive-protein-ratio-predicts-outcomes-in-healthcare-associated-pneumonia-in-critically-ill-patients-with-cancer
#5
Ligia S C F Rabello, Pedro Póvoa, Jose R Lapa E Silva, Luciano C P Azevedo, Fernando Jose da Silva Ramos, Thiago Lisboa, Marcio Soares, Jorge I F Salluh
PURPOSE: Describe the patterns of C-reactive protein relative changes in response to antibiotic therapy in critically ill cancer patients with healthcare-associated pneumonia (HCAP) and its ability to predict outcome. METHODS: Secondary analysis of a prospective cohort of critically ill cancer patients with HCAP. CRP was sampled every other day from D0 to D6 of antibiotic therapy. Patients were classified according to an individual pattern of CRP-ratio response: fast - CRP at D4 of therapy was <0...
July 11, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28790042/multicentre-randomised-controlled-trial-to-investigate-the-usefulness-of-continuous-pneumatic-regulation-of-tracheal-cuff-pressure-for-reducing-ventilator-associated-pneumonia-in-mechanically-ventilated-severe-trauma-patients-the-agate-study-protocol
#6
Nicolas Marjanovic, Denis Frasca, Karim Asehnoune, Catherine Paugam, Sigismond Lasocki, Carole Ichai, Jean-Yves Lefrant, Marc Leone, Claire Dahyot-Fizelier, Julien Pottecher, Dominique Falcon, Benoit Veber, Jean-Michel Constantin, Sabrina Seguin, Jérémy Guénézan, Olivier Mimoz
INTRODUCTION: Severe trauma represents the leading cause of mortality worldwide. While 80% of deaths occur within the first 24 hours after trauma, 20% occur later and are mainly due to healthcare-associated infections, including ventilator-associated pneumonia (VAP). Preventing underinflation of the tracheal cuff is recommended to reduce microaspiration, which plays a major role in the pathogenesis of VAP. Automatic devices facilitate the regulation of tracheal cuff pressure, and their implementation has the potential to reduce VAP...
August 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28790011/management-of-septic-shock-in-an-intermediate-care-unit
#7
Eric Meaudre, Cédric Nguyen, Claire Contargyris, Ambroise Montcriol, Erwan d'Aranda, Pierre Esnault, Mourad Bensalah, Bertrand Prunet, Julien Bordes, Philippe Goutorbe
BACKGROUND: While guidelines advocate goal-directed resuscitation based on timed bundles, the management of SS outside an ICU setting has been poorly studied in intermediate care units (IMCU). PATIENTS AND METHOD: We reviewed all cases of septic shock patients admitted to our IMCU between January 2013 and June 2014. The characteristics of sepsis, compliance of bundles, and outcomes were collected. The IMCU population was compared with the SS patients admitted to the ICU during the same period...
August 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28780877/-identification-of-risk-factors-of-multiresistant-infections-on-two-intensive-care-units
#8
Marcell Szabó, Noémi Kanász, Katalin Darvas, János Gál
INTRODUCTION: Intensive care units are favourable environment for infections, many of them are caused by antibiotic resistant bacteria. AIM: Identifying risk factors of ICU-acquired multiresistant infections. METHOD: We performed observational study on two academic intensive care units (a multidisciplinary and a surgical ICU) between 01/09/2014 and 30/11/2015. Patients with a first infection caused by predefined organisms (P. aeruginosa, E...
August 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28777909/cave-canem-hbo%C3%A2-therapy-efficacy-on-capnocytophaga-canimorsus-infections-a-case-series
#9
Mariano Marmo, Romolo Villani, Raffaele Maria Di Minno, Giuseppe Noschese, Matteo Paganini, Silvia Quartesan, Alex Rizzato, Gerardo Bosco
BACKGROUND: Dog bites are a frequent injury, but the incidence and type of lesions vary across countries. Although only few patients develop complications, the treatment of advanced injuries has a considerable medical, social and economic impact. A frequently isolated pathogen in dog bite wounds is Capnocytophaga canimorsus, a bacterium that can cause sepsis or meningitis. Hyperbaric oxygen (HBO₂) therapy has been shown to be useful in treating anaerobic infections, most likely because it creates an inhospitable environment for the bacterium and enhances the patient's immune response...
March 2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/28758623/risk-factors-and-predictors-of-carbapenem-resistant-pseudomonas-aeruginosa-and-acinetobacter-baumannii-mortality-in-critically-ill-bacteraemic-patients-over-a-6-year-period-2010-15-antibiotics-do-matter
#10
Matthaios Papadimitriou-Olivgeris, Fotini Fligou, Anastasia Spiliopoulou, Kyriaki Koutsileou, Fevronia Kolonitsiou, Aikaterini Spyropoulou, Anastasia Zotou, Markos Marangos, Evangelos D Anastassiou, Myrto Christofidou, Iris Spiliopoulou
PURPOSE: Acinetobacter baumannii and Pseudomonas aeruginosa provoke serious infections, especially in intensive care unit (ICU) patients. METHODOLOGY: The risk factors and predictors of mortality for P. aeruginosa (n=84; 46 carbapenem-resistant) and A. baumannii (n=129; all carbapenem-resistant) bloodstream infections (BSIs) in an ICU were evaluated. Antibiotic susceptibility testing was performed using the agar disk diffusion method according to EUCAST guidelines...
July 31, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28757818/procalcitonin-assisted-antibiotic-strategy-in-sepsis
#11
Domonkos Trásy, Zsolt Molnár
Sepsis is one of the biggest challenges in critical care nowadays. Defining sepsis is a difficult task on its own and its diagnosis and treatment requires well trained, devoted personnel with interdisciplinary collaboration in order to provide the patients the best chance for survival. Immediate resuscitation, early adequate antimicrobial therapy, source control and highly sophisticated organ support on the intensive care units are all inevitable necessities for successful recovery. To help fast and accurate diagnosis biomarkers have been measured for decades...
May 2017: EJIFCC
https://www.readbyqxmd.com/read/28756598/risk-factors-and-predictors-of-mortality-of-candidaemia-among-critically-ill-patients-role-of-antifungal-prophylaxis-in-its-development-and-in-selection-of-non-albicans-species
#12
Matthaios Papadimitriou-Olivgeris, Anastasia Spiliopoulou, Fotini Fligou, Iris Spiliopoulou, Lora Tanaseskou, Georgios Karpetas, Markos Marangos, Evangelos D Anastassiou, Myrto Christofidou
PURPOSE: The aim of the present study is to identify risk factors for development and predictors of mortality of candidaemia among critically ill patients. METHODS: A 1:7 case-control study was conducted during a 4-year period (2012-2015) in a Greek Intensive Care Unit (ICU). Candidaemia was confirmed by positive blood cultures. All yeasts were identified using API 20C AUX System or Vitek 2 Advanced Expert System. Epidemiologic data were collected from the ICU computerized database and patients' chart reviews...
July 29, 2017: Infection
https://www.readbyqxmd.com/read/28754148/nosocomial-bacterial-infections-and-their-antimicrobial-susceptibility-patterns-among-patients-in-ugandan-intensive-care-units-a-cross-sectional-study
#13
Peter Agaba, Janat Tumukunde, J V B Tindimwebwa, Arthur Kwizera
BACKGROUND: The intensive care unit (ICU) admits critically ill patients requiring advanced airway, respiratory, cardiac and renal support. Despite the highly-specialized interventions, the mortality and morbidity is still high due to a number of reasons including nosocomial infections, which are the most likely complications in hospitalized patients with the rates being highest among ICU patients. METHODS: In this cross-sectional study of 111 adult patients admitted to 2 of the ICUs in Uganda, we set out to describe the commonest bacterial infections, their antimicrobial susceptibility patterns and factors associated with development of a nosocomial infection...
July 28, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28753737/uplc-ms-ms-method-for-therapeutic-drug-monitoring-of-ten-antibiotics-used-in-intensive-care-units
#14
Nahed El-Najjar, Julian Hösl, Thomas Holzmann, Jonathan Jantsch, André Gessner
Large variation in the levels of different ß-lactams and other antibiotics used in critically ill patients has been documented. The aim of this study is to establish and validate a fast ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) method for the simultaneous analysis of ten antibiotics (Meropenem, Cefepime, Ceftazidime, Piperacillin, Benzylpenicillin, Ampicillin, Flucloxacillin, Linezolid, and Sulfamethoxazole/Trimethoprim) in human plasma according to European Medicines Agency (EMA) guidelines...
July 28, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28749114/characteristics-and-outcomes-of-patients-with-hematological-malignancies-admitted-for-intensive-care-a-single-centre-experience
#15
Shafaq Maqsood, Farhana Badar, Abdul Hameed
Background and Purpose: Patients with hematological malignancies admitted to an intensive care unit (ICU) generally have a high mortality rate. The aim of our study was to assess the characteristics and outcomes of such patients and to identify factors predicting ICU mortality. Material and Methods: This retrospective chart review was conducted in the intensive care unit (ICU) of Shaukat Khanum Memorial Cancer Hospital and Research Centre over a period of 5 years, from January 2010 to January 2015. Results: Characteristics :A total of 213 patients were included in this study...
July 27, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28745260/implementation-of-an-antimicrobial-stewardship-program-in-a-neonatal-intensive-care-unit
#16
Nneka I Nzegwu, Michelle R Rychalsky, Loren A Nallu, Xuemei Song, Yanhong Deng, Amber M Natusch, Robert S Baltimore, George R Paci, Matthew J Bizzarro
OBJECTIVE To evaluate antimicrobial utilization and prescription practices in a neonatal intensive care unit (NICU) after implementation of an antimicrobial stewardship program (ASP). DESIGN Quasi-experimental, interrupted time-series study. SETTING A 54-bed, level IV NICU in a regional academic and tertiary referral center. PATIENTS AND PARTICIPANTS All neonates prescribed antimicrobials from January 1, 2011, to June 30, 2016, were eligible for inclusion. INTERVENTION Implementation of a NICU-specific ASP beginning July 2012...
July 26, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28743652/molecular-epidemiology-of-carbapenem-resistant-klebsiella-pneumonia-at-a-turkish-center-is-the-increase-of-resistance-a-threat-for-europe
#17
Aslıhan Candevir Ulu, Tülin Güven Gökmen, Filiz Kibar, Behice Kurtaran, Cansu Önlen, Ferit Kuşçu, Ayşe Seza İnal, Süheyla Kömür, Akgün Yaman, Hasan Salih Zeki Aksu, Yeşim Taşova
INTRODUCTION: In recent years carbapenem resistant Klebsiella pneumoniae has became an important threat to hospitalized patients. Our aim in this study was to identify the genetic mechanisms of carbapenem resistance in our center. MATERIALS AND METHODS: In this study, a total of 98K. pneumoniae isolated from patients who registered at Cukurova University Balcali Hospital and determined phenotypically carbapenem resistant were screened for genotypic presence of carbapenemase enzymes with the multiplex-PCR in the period of 2013-2014...
July 22, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28739223/decreased-mortality-in-patients-prescribed-vancomycin-after-implementation-of-antimicrobial-stewardship-program
#18
Erin L Conway, John A Sellick, Amy Horey, Kristen Fodero, Michael C Ott, Michael P Krajewski, Kari A Mergenhagen
BACKGROUND: The impact of an antimicrobial stewardship program (ASP) on 30-day mortality rates was evaluated in patients prescribed vancomycin in a Veterans Affairs hospital. METHODS: A retrospective chart review of patients receiving a minimum of 48 hours of vancomycin during October 2006-July 2014. A multivariate logistic regression analysis was used to determine predictors of mortality. Interventions of the ASP consist of appropriate antibiotic selection, dosing, microbiology, and treatment duration...
July 21, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28738787/procalcitonin-guided-antibiotic-therapy-in-critically-ill-adults-a-meta-analysis
#19
Tao Zhang, Yan Wang, Qianting Yang, Yalin Dong
BACKGROUND: As a novel biomarker of inflammation, procalcitonin (PCT) has proven useful to guide antibiotic therapy in intensive care unit (ICU). However, there are controversial on mortality. The aim of this study was to evaluate the utility of PCT-guided antibiotic therapy in critically ill adults and determine whether studies are sufficient. METHODS: A systematic search in PubMed, Embase and Cochrane was performed. We included only randomized controlled trials which compared the safety and efficacy between PCT-guided or standard antibiotic therapy groups in ICU adults...
July 24, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28737573/investigating-the-impact-of-different-suspicion-of-infection-criteria-on-the-accuracy-of-quick-sepsis-related-organ-failure-assessment-systemic-inflammatory-response-syndrome-and-early-warning-scores
#20
Matthew M Churpek, Ashley Snyder, Sarah Sokol, Natasha N Pettit, Dana P Edelson
OBJECTIVE: Studies in sepsis are limited by heterogeneity regarding what constitutes suspicion of infection. We sought to compare potential suspicion criteria using antibiotic and culture order combinations in terms of patient characteristics and outcomes. We further sought to determine the impact of differing criteria on the accuracy of sepsis screening tools and early warning scores. DESIGN: Observational cohort study. SETTING: Academic center from November 2008 to January 2016...
July 21, 2017: Critical Care Medicine
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