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https://www.readbyqxmd.com/read/28644225/adjuvant-steroid-therapy-in-community-acquired-pneumonia
#1
Caroline Bell Sisson
Despite medical advances, pneumonia is a leading cause of death worldwide. Because inflammation is a key defense mechanism, adjuvant corticosteroid therapy has long been considered but never widely recommended to treat pneumonia. New research is exploring potential benefits of this therapy, including reduced time to clinical stability, reduced hospital stay, reduced rates of treatment failure, and prevention of complications.
July 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28643188/impact-of-appropriateness-of-empiric-therapy-on-outcomes-in-community-onset-bacteremia-by-extended-spectrum-%C3%AE-lactamase-producing-escherichia-coli-and-klebisella-pneumoniae-definitively-treated-with-carbapenems
#2
E-J Joo, D A Park, N R Lee, S-Y Moon, J-K Choi, J-H Ko, K R Peck
Despite a significant increase of bloodstream infection caused by extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae in the community-setting, information regarding clinical outcomes of inappropriate empiric therapy (IAT) in patients with those infections is limited. A multicenter-retrospective cohort study was conducted in four hospitals. A total of 249 adults were identified to have community-onset bacteremia caused by ESBL-producing Escherichia coli and Klebsiella pneumoniae, and definitively treated with carbapenems...
June 23, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28643112/a-retrospective-study-of-antibiotic-de-escalation-in-patients-with-ventilator-associated-pneumonia-in-malaysia
#3
Rahela Ambaras Khan, Zoriah Aziz
Background Antibiotic de-escalation is an important strategy to conserve the effectiveness of broad-spectrum antibiotics. However, the outcome of this strategy for the treatment of ventilator-associated pneumonia (VAP) has not been widely studied in developing countries. Objectives To evaluate the outcome on intensive care unit (ICU) mortality, 28 days mortality, and length of ICU stay among VAP patients who receive de-escalation therapy. Setting This study was conducted in an ICU of a Malaysian public hospital...
June 22, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28642142/epidemiology-and-outcomes-of-bloodstream-infections-in-177-severe-burn-patients-from-an-industrial-disaster-a-multicenter-retrospective-study
#4
Chenqi Tang, Junqiang Li, Beiming Shou, Bohan Pan, Tiansheng Chen, Yongqiang Xiao, Xiaopeng Zheng, Shichu Xiao, Qian Tan, Zhaofan Xia
OBJECTIVES: To determine the characteristics of bloodstream infections (BSIs) and to evaluate the impact of BSIs on mortality in severe burn patients. METHODS: A retrospective observational study was conducted in 20 tertiary hospitals. A total of 185 Patients who experienced a massive dust explosion in eastern China were included. RESULTS: After exclusion, 177 patients were analyzed. The median total body surface area (TBSA) burned was 95% (interquartile range [IQR], 85%-98%)...
June 19, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28642140/emergence-of-carbapenem-resistant-enterobacteriaceae-isolated-from-patients-in-a-university-hospital-in-saudi-arabia-epidemiology-clinical-profiles-and-outcomes
#5
Fawzia E Alotaibi, Elham E Bukhari, Maha M Al-Mohizea, Taghreed Hafiz, Eman Bin Essa, Yasmeen I AlTokhais
Carbapenemase-producing Enterobacteriaceae have been steadily spreading worldwide during the last decade. Nine patients were identified prospectively and were followed during their hospitalization course to identify the epidemiology, clinical profiles and outcomes. These patients had one or more cultures positive for a CRE isolate, contributing to a total of eleven positive cultures from various sites without including duplicates of isolates obtained from the same site. Isolates from these patients included five Klebseilla pneumoniae, three Escherichia coli, and one Enterobacter aerogenes...
June 19, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28640662/using-probiotics-in-clinical-practice-where-are-we-now-a-review-of-existing-meta-analyses
#6
Mariangela Rondanelli, Milena Anna Faliva, Simone Perna, Attilio Giacosa, Gabriella Peroni, Anna Maria Castellazzi
The scientific literature has demonstrated that probiotics have a broad spectrum of activity, although often the results are contradictory. This study provides a critical overview of the current meta-analyses that have evaluated the efficacy of probiotics in physiological and pathological conditions, such as metabolic disease, antibiotic-associated and Clostridium difficile-associated diarrhea, IBS, constipation, IBD, chemotherapy-associated diarrhea, respiratory tract infection, ventilator-associated pneumonia, NAFLD, liver encephalopathy, periodontitis, depression, vaginosis, urinary tract infections, pancreatitis, incidence of ventilator-associated pneumonia, hospital infection and stay in ICU, mortality of post-trauma patients, necrotising enterocolitis in premature infants...
June 22, 2017: Gut Microbes
https://www.readbyqxmd.com/read/28640148/restrictive-versus-liberal-transfusion-strategies-for-red-blood-cell-transfusion-after-hip-or-knee-surgery-a-systematic-review-and-meta-analysis
#7
Tianli Mao, Fuqiang Gao, Jun Han, Wei Sun, Wanshou Guo, Zirong Li, Weiguo Wang
BACKGROUND: Red blood cell (RBC) transfusions are commonly used in surgical patients, but accompanied by many risks such as metabolic derangement, and allergic and febrile reactions. Indications for transfusion in patients after hip or knee surgery have not been definitively evaluated and remain controversial. We performed a meta-analysis to compare the benefits and harms of restrictive versus liberal transfusion strategies in patients after hip or knee surgery. METHODS: The PubMed, EMBASE, and Cochrane Library databases were searched for relevant studies through September 2015...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28640135/hospitalization-with-hypoglycemia-in-patients-without-diabetes-mellitus-a-retrospective-study-using-a-national-inpatient-database-in-japan-2008-2012
#8
Akahito Sako, Hideo Yasunaga, Hiroki Matsui, Kiyohide Fushimi, Hidetaka Hamasaki, Hisayuki Katsuyama, Tetsuro Tsujimoto, Atsushi Goto, Hidekatsu Yanai
We aimed to examine prevalence, patient characteristics, etiology, and clinical outcomes of hospitalized patients who had hypoglycemia without a diagnosis of diabetes mellitus, using a Japanese nationwide database.This was a retrospective observational study using a national database of acute-care inpatients in Japan. Nondiabetic patients aged ≥15 years who were hospitalized for hypoglycemia were eligible. We estimated the annual numbers of hospitalized cases in Japan. We also investigated the patient characteristics, and risk factors of in-hospital mortality...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28640002/trends-in-diagnoses-among-hospitalizations-of-hiv-infected-children-and-adolescents-in-the-us-2003-2012
#9
Stacey A Hurst, Alexander C Ewing, Sascha R Ellington, Athena P Kourtis
OBJECTIVE: Using data from 2003-2012, we updated a previous analysis of trends in hospitalizations of HIV-infected children and adolescents in the US. METHODS: We used data from the Kids´ Inpatient Database of the Healthcare Cost and Utilization Project to derive nationally representative estimates of the number of hospitalizations and the rates per 1000 hospitalizations of select discharge diagnoses and procedures in 2003, 2006, 2009, and 2012 among HIV-infected and HIV-uninfected children and adolescents ≤18 years, excluding hospitalizations for conditions related to pregnancy/delivery and neonatal diagnoses...
June 20, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28639934/first-description-of-methyltransferases-in-extensively-drug-resistant-klebsiella-pneumoniae-isolates-from-saudi-arabia
#10
Baha Abdalhamid, Nasreldin Elhadi, Samar Albunayan, Khaldoon Alsamman, Reem Aljindan
PURPOSE: The resistance determinants for carbapenems, fluoroquinolones and aminoglycosides were characterized in 16 extensively drug-resistant Klebsiella pneumoniae (XDRKPN) strains collected from Saudi hospitals during 2014. METHODOLOGY: PCR and sequencing were used to detect: blaKPC, blaNDM, blaVIM, blaIMP-1,blaOXA-48, blaCTX-M, blaTEM, blaSHV and ampC for β-lactam resistance; qnrA, qnrB, qnrS, aac(6')-Ib-cr, qepA and mutations of gyrA and parC for fluoroquinolone resistance; and aacA4, aacC2, aadA1, aphA6, armA and rmtB for aminoglycoside resistance...
June 22, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28639594/viral-aetiology-of-wheezing-in-children-under-five
#11
Prithi Sureka Mummidi, Radha Tripathy, Bhagirathi Dwibedi, Amarendra Mahapatra, Suryakanta Baraha
BACKGROUND & OBJECTIVES: Wheezing is a common problem in children under five with acute respiratory infections (ARIs). Viruses are known to be responsible for a considerable proportion of ARIs in children. This study was undertaken to know the viral aetiology of wheezing among the children less than five years of age, admitted to a tertiary care hospital in eastern India. METHODS: Seventy five children, under the age of five years admitted with wheezing, were included in the study...
February 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28639165/molecular-characterization-of-intestinal-carriage-of-carbapenem-resistant-enterobacteriaceae-among-inpatients-at-two-iranian-university-hospitals-first-report-of-co-production-of-bla-ndm-7-and-bla-oxa-48
#12
H Solgi, F Badmasti, Z Aminzadeh, C G Giske, M Pourahmad, F Vaziri, S A Havaei, F Shahcheraghi
Gastrointestinal colonization of carbapenem-resistant Enterobacteriaceae (CRE) could serve as a reservoir for the transmission of these pathogens in the clinical setting. The aim of this study was to investigate the intestinal carriage of CRE and to analyze risk factors for CRE carriage. Rectal swabs were collected from 95 patients at two Iranian university hospitals. CRE screening was performed using selective media (CHROMagar and MacConkey agar). Polymerase chain reaction (PCR) was used to detect carbapenemase-encoding genes...
June 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28639163/agr-functionality-affects-clinical-outcomes-in-patients-with-persistent-methicillin-resistant-staphylococcus-aureus-bacteraemia
#13
C K Kang, Y K Kim, S-I Jung, W B Park, K-H Song, K-H Park, P G Choe, H-C Jang, S Lee, Y-S Kim, Y G Kwak, K T Kwon, S Kiem, C-J Kim, E S Kim, H B Kim
Methicillin-resistant Staphylococcus aureus bacteremia (MRSAB) often persists despite appropriate antibiotic therapy. It is unclear what microbiological factors contribute to poor clinical outcomes in persistent MRSAB (pMRSAB). We aimed to identify clinical and microbiological risk factors for in-hospital mortality in pMRSAB. We analysed MRSAB cases prospectively collected between 2009 and 2016 at 11 hospitals in Korea, defining cases of pMRSAB as MRSAB lasting ≥5 days despite administration of effective antibiotics...
June 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28638594/high-burden-of-antimicrobial-resistance-among-gram-negative-bacteria-causing-healthcare-associated-infections-in-a-critical-care-unit-of-nepal
#14
Narayan Prasad Parajuli, Subhash Prasad Acharya, Shyam Kumar Mishra, Keshab Parajuli, Basista Prasad Rijal, Bharat Mani Pokhrel
BACKGROUND: Healthcare associated infections (HCAI) and antimicrobial resistance are principal threats to the patients of intensive care units and are the major determining factors for patient outcome. They are associated with increased morbidity, mortality, excess hospitalization and financial costs. The present study is an attempt to investigate the spectrum and antimicrobial resistance of bacterial isolates involved in healthcare associated infections (HCAI) in the patients of a critical care unit at a tertiary care university hospital in Kathmandu, Nepal...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28638419/diagnostic-yield-of-a-direct-quantitative-smear-of-lower-respiratory-tract-secretions-in-patients-with-suspected-pneumonia-compared-to-a-semi-quantitative-culture
#15
Shervin Shokouhi, Ilad Alavi Darazam, Maryam Sadeghi, Latif Gachkar, Samaneh Dolatshahi
BACKGROUND: Microorganism isolation from respiratory tract specimens is the standard of care in patients with suspected nosocomial and ventilator associated pneumonia. However, these methods are time-consuming and are influenced by several factors. A direct quantitative smear (DQS) with proper staining may be an easy, cost-effective, rapid method. We evaluated the diagnostic yield of direct smears compared to semi-quantitative culture methods. MATERIALS AND METHODS: Hospitalized, intubated patients with clinically suspected pneumonia and patients who underwent diagnostic bronchoscopic alveolar lavage (BAL) and trans-endotracheal aspiration (TEA) were enrolled in a prospective study...
2017: Tanaffos
https://www.readbyqxmd.com/read/28636854/cluster-randomized-crossover-trial-of-head-positioning-in-acute-stroke
#16
Craig S Anderson, Hisatomi Arima, Pablo Lavados, Laurent Billot, Maree L Hackett, Verónica V Olavarría, Paula Muñoz Venturelli, Alejandro Brunser, Bin Peng, Liying Cui, Lily Song, Kris Rogers, Sandy Middleton, Joyce Y Lim, Denise Forshaw, C Elizabeth Lightbody, Mark Woodward, Octavio Pontes-Neto, H Asita De Silva, Ruey-Tay Lin, Tsong-Hai Lee, Jeyaraj D Pandian, Gillian E Mead, Thompson Robinson, Caroline Watkins
BACKGROUND: The role of supine positioning after acute stroke in improving cerebral blood flow and the countervailing risk of aspiration pneumonia have led to variation in head positioning in clinical practice. We wanted to determine whether outcomes in patients with acute ischemic stroke could be improved by positioning the patient to be lying flat (i.e., fully supine with the back horizontal and the face upwards) during treatment to increase cerebral perfusion. METHODS: In a pragmatic, cluster-randomized, crossover trial conducted in nine countries, we assigned 11,093 patients with acute stroke (85% of the strokes were ischemic) to receive care in either a lying-flat position or a sitting-up position with the head elevated to at least 30 degrees, according to the randomization assignment of the hospital to which they were admitted; the designated position was initiated soon after hospital admission and was maintained for 24 hours...
June 22, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28636843/hospital-inpatient-admissions-with-dehydration-and-or-malnutrition-in-medicare-beneficiaries-receiving-enteral-nutrition-a-cohort-study
#17
Rachel Drake, Audrey Ozols, William J Nadeau, Mary Jo Braid-Forbes
BACKGROUND: Enteral nutrition (EN) supports many older and disabled Americans. This study describes the frequency and cost of acute care hospitalization with dehydration and/or malnutrition of Medicare beneficiaries receiving EN, focusing on those receiving home EN. METHODS: Medicare 5% Standard Analytic Files were used to determine Medicare spending for EN supplies and the proportion and cost of beneficiaries receiving EN, specifically home EN, admitted to the hospital with dehydration and/or malnutrition...
June 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28636666/molecular-and-microbiological-report-of-a-hospital-outbreak-of-ndm-1-carrying-enterobacteriaceae-in-mexico
#18
Paola Bocanegra-Ibarias, Elvira Garza-González, Rayo Morfín-Otero, Humberto Barrios, Licet Villarreal-Treviño, Eduardo Rodríguez-Noriega, Ulises Garza-Ramos, Santiago Petersen-Morfin, Jesus Silva-Sanchez
OBJECTIVES: To characterize the microbiological, molecular and epidemiological data of an outbreak of carbapenem-resistant Enterobacteriaceae (CRE) in a tertiary-care hospital in Mexico. METHODS: From September 2014 to July 2015, all CRE clinical isolates recovered during an outbreak in the Hospital Civil "Fray Antonio Alcalde" in Jalisco, Mexico were screened for antimicrobial susceptibility, carbapenemase production, carbapenemase-encoding genes, and plasmid profiles...
2017: PloS One
https://www.readbyqxmd.com/read/28636609/genomic-and-phenotypic-characterisation-of-fluoroquinolone-resistance-mechanisms-in-enterobacteriaceae-in-durban-south-africa
#19
John Osei Sekyere, Daniel Gyamfi Amoako
Resistance to fluoroquinolones (FQ) is being increasingly reported and found to be mediated by efflux pumps, plasmid-mediated quinolone resistance genes (PMQR) and mutations in gyrA, gyrB, parC and parE. However, studies reporting on FQ resistance mechanisms (FQRM), particularly in Africa, are focused mostly on Salmonella. This study used a whole-genome-based approach to describe FQRM in forty-eight clinical Enterobacteriaceae isolates comprising of Klebsiella pneumoniae (n = 21), Serratia marcescens (n = 12), Enterobacter spp...
2017: PloS One
https://www.readbyqxmd.com/read/28635201/hamman-rich-syndrome-a-forgotten-entity
#20
William Newmarch, Angelica Puopolo, Madina Weiler, Brian Casserly
The following report outlines the case of a 76-year-old gentleman who presented to the hospital with acute interstitial pneumonitis, a rare and rapidly progressive type of idiopathic interstitial pneumonia. The patient initially presented with a three-week history of progressive shortness of breath and cough which was diagnosed as community acquired pneumonia. Treatment with oral antibiotics was unsuccessful resulting in re-presentation the following week with type one respiratory failure. Investigations revealed widespread inflammatory changes consistent with an acute inflammatory process...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
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