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Critically ill infectious diseases

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https://www.readbyqxmd.com/read/28661973/determinants-of-antibiotic-tailoring-in-pediatric-intensive-care-a-national-survey
#1
Patricia S Fontela, Caroline Quach, Mohammad E Karim, Douglas F Willson, Elaine Gilfoyle, James Dayre McNally, Milagros Gonzales, Jesse Papenburg, Steven Reynolds, Jacques Lacroix
OBJECTIVES: To describe the criteria that currently guide empiric antibiotic treatment in children admitted to Canadian PICUs. DESIGN: Cross-sectional survey. SETTING: Canadian PICUs. SUBJECTS: Pediatric intensivists and pediatric infectious diseases specialists. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We used focus groups and literature review to design the survey questions and its four clinical scenarios (sepsis, pneumonia, meningitis, and intra-abdominal infections)...
June 28, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28658101/propensity-score-matched-analysis-comparing-the-clinical-outcome-of-klebsiella-pneumoniae-and-escherichia-coli-causing-community-onset-monomicrobial-bacteremia
#2
COMPARATIVE STUDY
Tsung-Hang Kuo, Chao-Yung Yang, Chung-Hsun Lee, Chih-Chia Hsieh, Wen-Chien Ko, Ching-Chi Lee
Bacteremia is a life-threatening condition that is associated with substantial healthcare costs. Escherichia coli and Klebsiella pneumoniae are the leading causes of community-onset gram-negative bacteremia. However, a comprehensive comparison between these pathogens involved in bacteremia episodes has yet to be reported.In this retrospective cohort study, adults with community-onset monomicrobial bacteremia caused by E coli or K pneumoniae were recruited in the emergency department of a medical center during a 6-year period, and the clinical variables were collected retrospectively from medical records...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639000/infections-in-neurocritical-care
#3
John C O'Horo, Priya Sampathkumar
Neurointensive care (NICU) patients experience complex infectious disease challenges. Central nervous system (CNS) infections are difficult to diagnose and treat, and post-neurosurgical patients are vulnerable to a unique set of healthcare-acquired infections (HAI) in addition to those typical of critically ill patients. The purpose of this review is to summarize the approach to suspected infection in the NICU and discuss management of several infectious syndromes in the NICU setting.
June 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28636443/personal-protective-equipment-supply-chain-lessons-learned-from-recent-public-health-emergency-responses
#4
Anita Patel, Maryann M D'Alessandro, Karen J Ireland, W Greg Burel, Elaine B Wencil, Sonja A Rasmussen
Personal protective equipment (PPE) that protects healthcare workers from infection is a critical component of infection control strategies in healthcare settings. During a public health emergency response, protecting healthcare workers from infectious disease is essential, given that they provide clinical care to those who fall ill, have a high risk of exposure, and need to be assured of occupational safety. Like most goods in the United States, the PPE market supply is based on demand. The US PPE supply chain has minimal ability to rapidly surge production, resulting in challenges to meeting large unexpected increases in demand that might occur during a public health emergency...
May 2017: Health Security
https://www.readbyqxmd.com/read/28620385/the-antibody-secreting-cell-response-to-infection-kinetics-and-clinical-applications
#5
REVIEW
Michael J Carter, Ruth M Mitchell, Patrick M Meyer Sauteur, Dominic F Kelly, Johannes Trück
Despite the availability of advances in molecular diagnostic testing for infectious disease, there is still a need for tools that advance clinical care and public health. Current methods focus on pathogen detection with unprecedented precision, but often lack specificity. In contrast, the host immune response is highly specific for the infecting pathogen. Serological studies are rarely helpful in clinical settings, as they require acute and convalescent antibody testing. However, the B cell response is much more rapid and short-lived, making it an optimal target for determining disease aetiology in patients with infections...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28601946/clinical-management-of-patients-with-ebola-virus-disease-in-high-resource-settings
#6
G Marshall Lyon, Aneesh K Mehta, Bruce S Ribner
Like most viral illnesses in humans, supportive care of the patient is the mainstay of clinical care for patients with Ebola virus disease (EVD). The goal is to maintain and sustain the patient until a specific immune response develops and clears the viral infection. Clearly, antiviral therapy may eventually help speed recovery, but supportive care will likely always be the centerpiece of care of the patient with EVD. While terrible in terms of human suffering and loss, the EVD outbreak of 2014-2016 provided an unheralded opportunity to advance our understanding in the care of patients (WHO 2016)...
June 11, 2017: Current Topics in Microbiology and Immunology
https://www.readbyqxmd.com/read/28601141/neuropsychiatric-aspects-of-infectious-diseases-an-update
#7
REVIEW
Sahil Munjal, Stephen J Ferrando, Zachary Freyberg
Among the critically ill, infectious diseases can play a significant role in the etiology of neuropsychiatric disturbances. All critical care physicians are familiar with delirium as a secondary complication of systemic infection. This article focuses on key infectious diseases that commonly and directly produce neuropsychiatric symptoms, including direct infection of the central nervous system, human immunodeficiency virus infection, and AIDS.
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28584373/prospective-analysis-of-skin-findings-in-surgical-critically-ill-patients-intensive-care-unit
#8
Suzan Demir Pektas, Arzu Kahveci Demir
BACKGROUND: Intensive Care Units (ICUs) are places where critically ill patients are managed. AIM: We aimed to investigate skin disorders that developed in critically ill surgical patients during their stay in the ICU. METHODS: The prevalence of dermatological disorders and factors affecting their clinical features was prospectively analyzed in surgical ICU patients. We recorded age, sex, type of ICU, comorbidities, skin disorders, time to consultation, duration of ICU stay, and mortality rate...
May 2017: Indian Journal of Dermatology
https://www.readbyqxmd.com/read/28579084/j%C3%A3-vea-consensus-guidelines-for-the-treatment-of-candida-peritonitis-and-other-intra-abdominal-fungal-infections-in-non-neutropenic-critically-ill-adult-patients
#9
Javier Pemán, Gerardo Aguilar, Juan Carlos Valía, Miguel Salavert, David Navarro, Rafael Zaragoza
BACKGROUND: Although the management of the invasive candidiasis has improved in the last decade, controversial issues yet remain, especially in the diagnostic and therapeutic approaches to Candida peritonitis and other forms of intra-abdominal fungal infections. AIMS: We sought to identify core clinical knowledge about intra-abdominal fungal infections and to achieve high-agreement recommendations required to care for critically ill adult patients with Candida peritonitis and other forms of intra-abdominal fungal infection...
May 31, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28569640/prevalence-of-serum-antibody-titers-against-canine-distemper-virus-and-canine-parvovirus-in-dogs-hospitalized-in-an-intensive-care-unit
#10
Jennifer L Mahon, Elizabeth A Rozanski, April L Paul
OBJECTIVE To determine the prevalence of dogs hospitalized in an intensive care unit (ICU) with serum antibody titers against canine distemper virus (CDV) and canine parvovirus (CPV). DESIGN Prospective observational study. ANIMALS 80 dogs. PROCEDURES Dogs hospitalized in an ICU for > 12 hours between February 1 and June 1, 2015, that had at least 0.25 mL of serum left over from diagnostic testing were eligible for study inclusion. Dogs with serum antibody titers > 1:32 (as determined by serum neutralization) and > 1:80 (as determined by hemagglutination inhibition) were considered seropositive for CDV and CPV, respectively...
June 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28529738/therapeutic-benefits-of-glutamine-an-umbrella-review-of-meta-analyses
#11
Marc P McRae
Glutamine may be an essential amino acid in patients with catabolic disease, as it has been demonstrated that circulating glutamine levels drop during critical illness and following major surgery; this may result in an increase in secondary infection risk, recovery time and mortality rates. However, there is much discrepancy in the literature with regards to randomized controlled studies, and therefore, the present study is an umbrella review of published meta-analyses, conducted to examine the effectiveness of glutamine's role as a therapeutic agent...
May 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28520859/the-role-of-patient-care-items-as-a-fomite-in-healthcare-associated-outbreaks-and-infection-prevention
#12
Hajime Kanamori, William A Rutala, David J Weber
Patient-care items can serve as a source or reservoir for healthcare associated pathogens in hospitals. We reviewed healthcare-associated outbreaks from medical equipment and provided infection prevention recommendations. Multiple healthcare-associated outbreaks via a contaminated patient-care item were identified, including infections with multidrug-resistant organisms. The type of patient-care items implicated as a fomite causing healthcare-associated infections (HAI) has changed over time. Patient populations at risk were most commonly critically ill patients in adult and neonatal ICUs...
May 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28462212/animal-models-of-hospital-acquired-pneumonia-current-practices-and-future-perspectives
#13
REVIEW
Kenny Bielen, Bart 's Jongers, Surbhi Malhotra-Kumar, Philippe G Jorens, Herman Goossens, Samir Kumar-Singh
Lower respiratory tract infections are amongst the leading causes of mortality and morbidity worldwide. Especially in hospital settings and more particularly in critically ill ventilated patients, nosocomial pneumonia is one of the most serious infectious complications frequently caused by opportunistic pathogens. Pseudomonas aeruginosa is one of the most important causes of ventilator-associated pneumonia as well as the major cause of chronic pneumonia in cystic fibrosis patients. Animal models of pneumonia allow us to investigate distinct types of pneumonia at various disease stages, studies that are not possible in patients...
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28412382/use-of-nebulized-antimicrobials-for-the-treatment-of-respiratory-infections-in-invasively-mechanically-ventilated-adults-a-position-paper-from-the-european-society-of-clinical-microbiology-and-infectious-diseases
#14
Jordi Rello, Candela Solé-Lleonart, Jean-Jacques Rouby, Jean Chastre, Stijn Blot, Garyfallia Poulakou, Charles-Edouard Luyt, Jordi Riera, Lucy B Palmer, Jose M Pereira, Tim Felton, Jayesh Dhanani, Matteo Bassetti, Tobias Welte, Jason A Roberts
With an established role in cystic fibrosis and bronchiectasis, nebulized antibiotics are increasingly being used to treat respiratory infections in critically ill invasively mechanically ventilated adult patients. Although there is limited evidence describing their efficacy and safety, in an era of need for new strategies to enhance antibiotic effectiveness because of a shortage of new agents and increases in antibiotic resistance, the potential of nebulization of antibiotics to optimize therapy is considered of high interest, particularly in patients infected with multidrug-resistant (MDR) pathogens...
April 13, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28409203/the-role-of-infection-models-and-pk-pd-modelling-for-optimising-care-of-critically-ill-patients-with-severe-infections
#15
REVIEW
T Tängdén, V Ramos Martín, T W Felton, E I Nielsen, S Marchand, R J Brüggemann, J B Bulitta, M Bassetti, U Theuretzbacher, B T Tsuji, D W Wareham, L E Friberg, J J De Waele, V H Tam, Jason A Roberts
Critically ill patients with severe infections are at high risk of suboptimal antimicrobial dosing. The pharmacokinetics (PK) and pharmacodynamics (PD) of antimicrobials in these patients differ significantly from the patient groups from whose data the conventional dosing regimens were developed. Use of such regimens often results in inadequate antimicrobial concentrations at the site of infection and is associated with poor patient outcomes. In this article, we describe the potential of in vitro and in vivo infection models, clinical pharmacokinetic data and pharmacokinetic/pharmacodynamic models to guide the design of more effective antimicrobial dosing regimens...
July 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28377522/human-health-alters-the-sustainability-of-fishing-practices-in-east-africa
#16
Kathryn J Fiorella, Erin M Milner, Charles R Salmen, Matthew D Hickey, Dan O Omollo, Abdi Odhiambo, Brian Mattah, Elizabeth A Bukusi, Lia C H Fernald, Justin S Brashares
Understanding feedbacks between human and environmental health is critical for the millions who cope with recurrent illness and rely directly on natural resources for sustenance. Although studies have examined how environmental degradation exacerbates infectious disease, the effects of human health on our use of the environment remains unexplored. Human illness is often tacitly assumed to reduce human impacts on the environment. By this logic, ill people reduce the time and effort that they put into extractive livelihoods and, thereby, their impact on natural resources...
April 18, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28353455/pharmacogenomic-influence-on-sepsis-outcome-in-critically-ill-patients
#17
Sarah Allegra, Giovanna Fatiguso, Lorena Baietto, Silvia Corcione, Fabio Favata, Alessandra Ariaudo, Nicole Pagani, Vito Marco Ranieri, Francesco Giuseppe De Rosa, Giovanni Di Perri, Antonio D'Avolio
In infectious and inflammatory diseases, pharmacogenetics affects treatment efficacy and toxicity. Moreover, recent studies suggest its important role in predicting the clinical outcome of sepsis. Our aim was to investigate the influence of single nucleotide polymorphisms (SNPs) in genes which we supposed to be involved in linezolid elimination upon sepsis outcome. Fourteen ICU-admitted patients in therapy with intravenous linezolid (600mg q12h) were enrolled and classified into three groups: group 0 for sepsis, 1 for severe sepsis and 2 for septic shock...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28333760/antibiotic-associated-apoptotic-enterocolitis-in-the-absence-of-a-defined-pathogen-the-role-of-intestinal-microbiota-depletion
#18
Philipp Wurm, Walter Spindelboeck, Robert Krause, Johannes Plank, Gottfried Fuchs, Mina Bashir, Wolfgang Petritsch, Bettina Halwachs, Cord Langner, Christoph Högenauer, Gregor Gorkiewicz
OBJECTIVE: Antibiotic therapy is a major risk factor for the development of diarrhea and colitis with varying severity. Often the origin of antibiotic-associated gastrointestinal deterioration remains elusive and no specific infectious agents could be discerned. PATIENTS: We represent three cases of intractable high-volume diarrhea associated with combined antibiotic and steroid therapy in critically ill patients not fitting into established disease entities. Cases presented with severe apoptotic enterocolitis resembling acute intestinal graft-versus-host-disease...
June 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28331993/molecular-characterization-and-phylogenetic-analysis-of-human-influenza-a-viruses-isolated-in-iran-during-the-2014-2015-season
#19
Elham Moasser, Farida Behzadian, Afagh Moattari, Fatemeh Fotouhi, Amir Rahimi, Hassan Zaraket, Seyed Younes Hosseini
Influenza A viruses are an important cause of severe infectious diseases in humans and are characterized by their fast evolution rate. Global monitoring of these viruses is critical to detect newly emerging variants during annual epidemics. Here, we sought to genetically characterize influenza A/H1N1pdm09 and A/H3N2 viruses collected in Iran during the 2014-2015 influenza season. A total of 200 nasopharyngeal swabs were collected from patients with influenza-like illnesses. Swabs were screened for influenza A and B using real-time PCR...
July 2017: Archives of Virology
https://www.readbyqxmd.com/read/28290130/the-choosing-wisely-initiative-in-infectious-diseases
#20
REVIEW
Clara Lehmann, Reinhard Berner, Johannes R Bogner, Oliver A Cornely, Katja de With, Susanne Herold, Winfried V Kern, Sebastian Lemmen, Mathias W Pletz, Bernhard Ruf, Bernd Salzberger, Hans Jürgen Stellbrink, Norbert Suttorp, Andrew J Ullmann, Gerd Fätkenheuer, Norma Jung
OBJECTIVE: "Choosing Wisely" is a growing international campaign aiming at practice changes to improve patient health and safety by both, conduct of essential and avoidance of unnecessary diagnostic, preventive and therapeutic procedures. The goal is to create an easily recognizable and distributable list ("Choosing Wisely items") that addresses common over- and underuse in the management of infectious diseases. METHODS: The German Society of Infectious Diseases (DGI) participates in the campaign "Klug Entscheiden" by the German Society of Internal Medicine...
June 2017: Infection
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