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ventilator associated pneumonia

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https://www.readbyqxmd.com/read/28079629/duration-of-pneumonia-therapy-and-the-role-of-biomarkers
#1
Katerina Kaziani, Adamantia Sotiriou, George Dimopoulos
PURPOSE OF REVIEW: Increasing antimicrobial resistance is a worldwide phenomenon that is threatening public health. Lower respiratory infections are one of the leading causes of morbidity that contribute to antibiotic consumption and thus the emergence of multidrug-resistant microbial strains. The goal of shortening antibiotic regimens' duration in common bacterial infections has been prioritized by antimicrobial stewardship programs as an action against this problem. RECENT FINDINGS: Data coming from randomized controlled trials, meta-analyses, and systematic reviews support the shortening of antimicrobial regimens in community-acquired, hospital-acquired, and ventilator-associated pneumonia...
January 12, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#2
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28074789/extracorporeal-membrane-oxygenation-in-severe-influenza-infection-with-respiratory-failure-a-systematic-review-and-meta-analysis
#3
Shashvat Sukhal, Jaskaran Sethi, Malini Ganesh, Pedro A Villablanca, Anita K Malhotra, Harish Ramakrishna
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) has been extensively used for potentially reversible acute respiratory failure associated with severe influenza A (H1N1) pneumonia; however, it remains an expensive, resource-intensive therapy, with a high associated mortality. This systematic review and meta-analysis aims to summarize and pool outcomes data available in the published literature to guide clinical decision-making and further research. METHODS: We conducted a systematic search of MEDLINE (1966 to April 15, 2015), EMBASE (1980 to April 15, 2015), CENTRAL, and Google Scholar for patients with severe H1N1 pneumonia and respiratory failure who received ECMO...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074126/the-emergence-of-carbapenem-resistant-klebsiella-pneumoniae-in-malaysia-correlation-between-microbiological-trends-with-host-characteristics-and-clinical-factors
#4
Ye-Mun Low, Polly Soo-Xi Yap, Kartini Abdul Jabar, Sasheela Ponnampalavanar, Rina Karunakaran, Rukumani Velayuthan, Chun-Wie Chong, Sazaly Abu Bakar, Mohd Yasim Md Yusof, Cindy Shuan-Ju Teh
BACKGROUND: Carbapenem resistant Enterobacteriaceae is a growing concern worldwide including Malaysia. The emergence of this pathogen is worrying because carbapenem is one of the 'last-line' antibiotics. The main objective of this study was to determine the prevalence of genetic mechanisms and clinical risk factors of carbapenem resistant Klebsiella pneumoniae (K. pneumoniae) in Malaysia. METHODS: In this study, seventeen carbapenem resistant K. pneumoniae strains isolated from a tertiary teaching hospital in 2013 were studied...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28073994/vibrating-mesh-nebulizer-compared-with-metered-dose-inhaler-in-mechanically-ventilated-subjects
#5
Meagan N Dubosky, Yi-Fan Chen, Mary E Henriksen, David L Vines
BACKGROUND: The impact of various aerosol delivery devices on patient outcomes during mechanical ventilation is unknown. If one method of delivery results in a higher ventilator-associated pneumonia (VAP) rate than another, multiple patient outcomes may be affected. This study aimed to determine whether there was a difference in VAP occurrence and patient outcomes (days receiving ventilation and in-hospital mortality) between the vibrating mesh nebulizer (AeroNeb Solo) and the metered-dose inhaler (MDI)...
January 10, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28073416/-pathogenic-features-and-prognosis-of-ventilator-associated-pneumonia-in-patients-with-liver-failure
#6
Z S Wu, F Zhang, D Y Shi, L Y Xiao, L Zhang, Y S Zheng
No abstract text is available yet for this article.
December 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28069649/antimicrobial-activity-of-ceftazidime-avibactam-when-tested-against-gram-negative-bacteria-isolated-from-patients-hospitalized-with-pneumonia-in-united-states-medical-centers-2011-2015
#7
Helio S Sader, Mariana Castanheira, Robert K Flamm
Bacterial isolates were collected from patients hospitalized with pneumonia (PHP), including ventilator-associated (VAP), from 76 USA medical centers in 2011-2015. The Gram-negative organisms (n=11,185; including 1,097 from VAP) were tested for susceptibility against ceftazidime-avibactam and comparators by broth microdilution method. β-lactamase-encoding genes were screened using a microarray based assay on selected isolates. Pseudomonas aeruginosa and Klebsiella spp. were the most common Gram-negatives isolated from PHP and VAP...
January 9, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28067677/the-microbiome-in-mechanically-ventilated-patients
#8
Yudong Yin, Peter Hountras, Richard G Wunderink
PURPOSE OF REVIEW: Discovery of a normal lung microbiome requires reassessment of our concepts of HAP/VAP pathogenesis and has important implications for clinical diagnosis and management. RECENT FINDINGS: Changes in the microbiome of dental plaque are associated with increased risk of HAP/VAP. A transition to a lung microbiome enriched with gut flora is found in ARDS with an increased inflammatory response in patients with this change in microbial flora. A characteristic microbiome pattern of higher amounts of bacterial DNA, lower community diversity, and greater relative abundance of a single species characterize pneumonia and occasionally identify bacteria not found in culture...
January 6, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28060857/pseudomonas-aeruginosa-ventilator-associated-pneumonia-induces-lung-injury-through-tnf-%C3%AE-c-jun-nh2-terminal-kinase-pathways
#9
Ying-Wei Yang, Yu-Zhen Jiang, Ching-Mei Hsu, Lee-Wei Chen
Ventilator-associated pneumonia (VAP) is a common nosocomial infection among intensive care unit (ICU) patients. Pseudomonas aeruginosa (PA) is the most common multidrug-resistant Gram-negative pathogen and VAP caused by PA carries a high rate of morbidity and mortality. This study examined the molecular mechanism of PA VAP-induced lung injury. C57BL/6 wild-type (WT) mice and JNK1 knockout (JNK1-/-) mice received mechanical ventilation (MV) for 3 h at 2 days after receiving nasal instillation of PA. The WT and JNK1-/- mice also received MV after the induction of lung injury by instillation of supernatants from PA-stimulated alveolar macrophages (AMs)...
2017: PloS One
https://www.readbyqxmd.com/read/28057653/hospitalisation-with-community-acquired-pneumonia-among-patients-with-type-2-diabetes-an-observational-population-based-study-in-spain-from-2004-to-2013
#10
Ana López-de-Andrés, Javier de Miguel-Díez, Isabel Jiménez-Trujillo, Valentín Hernández-Barrera, José M de Miguel-Yanes, Manuel Méndez-Bailón, Napoleón Pérez-Farinós, Miguel Á Ngel Salinero-Fort, Rodrigo Jiménez-García
OBJECTIVES: To describe trends in the incidence and outcomes of community-acquired pneumonia (CAP) hospitalisations among patients with or without diabetes in Spain (2004-2013). DESIGN: Retrospective, observational study using the Spanish National Hospital Discharge Database (Conjunto Mínimo Básico de Datos (CMBD)). SETTING: Spain. PARTICIPANTS: We used national hospital discharge data to select all hospital admissions for CAP...
January 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28051826/-vap-and-oral-hygiene-a-systematic-review
#11
F Guerra, F De Martino, M Capocci, F Rinaldo, A Mannocci, A De Biase, L Ottolenghi, G La Torre
Ventilator associated pneumonia (VAP) is a common nosocomial infection in intensive care units. International literature showed how the use of professional oral hygiene protocols provide an essential support in VAP prevention. The aim of this study is to provide a systematic and narrative updated review, to further demonstrate that a proper protocol of oral hygiene, in special needs patients, can reduce risk of developing VAP. In this study were analyzed 10 narrative and 3 systematic reviews. Systematic reviews were evaluated with AMSTAR checklist, INSA tool was used to analyze narrative reviews...
November 2016: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28049457/breathdx-molecular-analysis-of-exhaled-breath-as-a-diagnostic-test-for-ventilator-associated-pneumonia-protocol-for-a-european-multicentre-observational-study
#12
Pouline M P van Oort, Tamara Nijsen, Hans Weda, Hugo Knobel, Paul Dark, Timothy Felton, Nicholas J W Rattray, Oluwasola Lawal, Waqar Ahmed, Craig Portsmouth, Peter J Sterk, Marcus J Schultz, Tetyana Zakharkina, Antonio Artigas, Pedro Povoa, Ignacio Martin-Loeches, Stephen J Fowler, Lieuwe D J Bos
BACKGROUND: The diagnosis of ventilator-associated pneumonia (VAP) remains time-consuming and costly, the clinical tools lack specificity and a bedside test to exclude infection in suspected patients is unavailable. Breath contains hundreds to thousands of volatile organic compounds (VOCs) that result from host and microbial metabolism as well as the environment. The present study aims to use breath VOC analysis to develop a model that can discriminate between patients who have positive cultures and who have negative cultures with a high sensitivity...
January 3, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28034888/ultra-short-course-antibiotics-for-patients-with-suspected-ventilator-associated-pneumonia-but-minimal-and-stable-ventilator-settings
#13
Michael Klompas, Lingling Li, John T Menchaca, Susan Gruber
PURPOSE: Many patients started on antibiotics for possible ventilator-associated pneumonia (VAP) do not have pneumonia. Patients with minimal and stable ventilator settings may be suitable candidates for early antibiotic discontinuation. We compared outcomes amongst patients with suspected VAP but minimal and stable ventilator settings treated with 1-3 versus >3 days of antibiotics. METHODS: We identified consecutive adult patients started on antibiotics for possible VAP with daily minimum PEEPs ≤5cm H2O and FiO2s ≤40% for at least 3 days within a large tertiary care hospital between 2006-2014...
December 29, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28033143/probiotics-for-trauma-patients-should-we-be-taking-a-precautionary-approach
#14
Heather A Vitko, L Kathleen Sekula, Martin A Schreiber
The use of probiotics in the hospital setting is largely understudied and highly controversial. Probiotics are living organisms that, when taken internally, can produce an immunomodulating effect and improve the gastrointestinal (GI) mucosal barrier. Although used for centuries by healthy individuals for GI health, their use in the hospital setting is now gaining wide attention for the prevention of infectious complications such as antibiotic-associated diarrhea, Clostridium difficile infections, multiple-organ dysfunction syndrome, and ventilator-associated pneumonia...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28030502/operative-fixation-of-rib-fractures-after-blunt-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#15
George Kasotakis, Erik A Hasenboehler, Erik W Streib, Nimitt Patel, Mayur B Patel, Louis Alarcon, Patrick L Bosarge, Joseph Love, Elliott R Haut, John J Como
BACKGROUND: Rib fractures are identified in 10% of all injury victims and are associated with significant morbidity (33%) and mortality (12%). Significant progress has been made in the management of rib fractures over the last few decades, including operative reduction and internal fixation (rib ORIF); however, the subset of patients that would benefit most from this procedure remains ill-defined. The aim of this project was to develop evidence-based recommendations. METHODS: Population, intervention, comparison and outcome (PICO) questions were formulated for patients with and without flail chest...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28027685/effect-of-etomidate-on-pneumonia-development-in-critically-ill-nontrauma-patients
#16
Drayton A Hammond, Claire E Vines, Ashley L McPhee, Naleen Raj Bhandari, Kendrea M Jones, Nikhil Meena, Jacob T Painter
PURPOSE: To determine whether etomidate use before intubation increased development of hospital-acquired pneumonia (HAP) in critically ill, nontrauma patients. MATERIALS AND METHODS: A single-center, retrospective, cohort study of critically ill, nontrauma patients admitted to the medical intensive care unit (ICU) from 2012 to 2015 and intubated with or without etomidate was conducted. Demographics, comorbidities, primary diagnosis, critical illness scores, concomitant medications, and outcomes were obtained from medical records...
January 1, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28012492/guidelines-concordant-empiric-antimicrobial-therapy-and-mortality-in-patients-with-severe-community-acquired-pneumonia-requiring-mechanical-ventilation
#17
Yukiyo Sakamoto, Yasuhiro Yamauchi, Hideo Yasunaga, Hideyuki Takeshima, Wakae Hasegawa, Taisuke Jo, Hiroki Matsui, Kiyohide Fushimi, Takahide Nagase
BACKGROUND: Community-acquired pneumonia (CAP) has high morbidity and mortality among adults. Several clinical guidelines recommend prompt administration of combined antimicrobial therapy. However, the association between guidelines concordance and mortality in patients with severe pneumonia remains unclear. The present study aimed to examine the impact of guidelines-concordant empiric antimicrobial therapy on 7-day mortality in patients with extremely severe pneumonia who required mechanical ventilation at admission, using a nationwide inpatient database in Japan...
January 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28008700/knowledge-level-of-nurses-in-jordan-on-ventilator-associated-pneumonia-and-preventive-measures
#18
Zeinab M Hassan, Moayad A Wahsheh
BACKGROUND: Ventilator-associated pneumonia is the most prevalent infection in Intensive Care Units, with the highest mortality rate; crude mortality rates may be as high as 20-75%. Many practices such as prevention measures (e.g. hand washing, wearing gloves, suctioning, elevated head of bed between 30° and 45°) have demonstrated an effect of reducing the incidence of this infection. AIMS: To identify the level of nurses' knowledge of ventilator-associated pneumonia and prevention measures before an educational programme, identify the level of nurses' knowledge on ventilator-associated pneumonia and prevention post an educational programme and identify the reasons for not applying ventilator-associated pneumonia prevention measures among nurses in Jordan...
December 22, 2016: Nursing in Critical Care
https://www.readbyqxmd.com/read/28007308/a-point-prevalence-survey-of-healthcare-associated-infection-in-fifty-two-chinese-hospitals
#19
Y Chen, J Y Zhao, X Shan, X L Han, S G Tian, F Y Chen, X T Su, Y S Sun, L Y Huang, L Han
BACKGROUND: Healthcare-associated infection (HCAI) represents a major problem for patient safety worldwide. AIM: To demonstrate the prevalence, causative agents, and risk factors for HCAI in Chinese hospitals. METHODS: A one-day point-prevalence survey was conducted in 52 Chinese hospitals between October 2014 and March 2015. A web-based software system was developed for data entry and management. FINDINGS: Among 53,939 patients surveyed, the prevalence of patients with at least one HCAI was 3...
January 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28004323/rapid-mrsa-pcr-on-respiratory-specimens-from-ventilated-patients-with-suspected-pneumonia-a-tool-to-facilitate-antimicrobial-stewardship
#20
S E Trevino, M A Pence, J Marschall, M H Kollef, H M Babcock, C-A D Burnham
Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of pneumonia in ventilated patients. Our objective was to evaluate the GeneXpert MRSA/SA SSTI Assay (Xpert MRSA/SA) (Cepheid, Sunnyvale, CA) for use in lower respiratory tract (LRT) specimens for rapid MRSA detection and to determine the potentially saved antibiotic-days if a culture-based identification method was replaced by this assay. Remnant LRT samples from ventilated patients submitted to the microbiology laboratory for routine culture were tested using conventional culture and Xpert MRSA/SA...
December 21, 2016: European Journal of Clinical Microbiology & Infectious Diseases
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