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https://www.readbyqxmd.com/read/29463684/strategy-to-reduce-e-coli-bacteraemia-based-on-cohort-data-from-a-london-teaching-hospital
#1
Desmond Hsu, Mark Melzer
BACKGROUND AND AIM: In 2017, National Health Service Improvement set a 10% reduction target for Escherichia coli bacteraemia by 2018, followed by a 50% reduction in healthcare-associated Gram-negative bacteraemias by 2022. We analysed consecutive cases of E. coli bacteraemia and devised a strategy to achieve these targets. METHODS: From December 2012 to November 2013, demographic, clinical and microbiological data were prospectively collected on all patients with bacteraemia at the Royal London Hospital in East London, UK...
February 20, 2018: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29459607/forgotten-encrusted-ureteral-stents-removal-multimodal-endourologic-approach
#2
P K Saha, M S Hossain, K C Ghosh, M S Alam, S Nabi, B K Saha, F H Pathan
Ureteral stent placement is a common procedure in urologic practice. Forgotten, encrusted D/J stents represent a difficult problem for urologists. The major complications are infection, impaired renal function, migration, encrustation, stone formation and multiple fragmentation of stent. A consensus on the best therapeutic approach is still lacking. Here we present our experience with endoscopic management of this challenging problem and discuss the multimodal endourologic approaches for treating forgotten, encrusted ureteral stents...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29456043/colistin-alone-versus-colistin-plus-meropenem-for-treatment-of-severe-infections-caused-by-carbapenem-resistant-gram-negative-bacteria-an-open-label-randomised-controlled-trial
#3
Mical Paul, George L Daikos, Emanuele Durante-Mangoni, Dafna Yahav, Yehuda Carmeli, Yael Dishon Benattar, Anna Skiada, Roberto Andini, Noa Eliakim-Raz, Amir Nutman, Oren Zusman, Anastasia Antoniadou, Pia Clara Pafundi, Amos Adler, Yaakov Dickstein, Ioannis Pavleas, Rosa Zampino, Vered Daitch, Roni Bitterman, Hiba Zayyad, Fidi Koppel, Inbar Levi, Tanya Babich, Lena E Friberg, Johan W Mouton, Ursula Theuretzbacher, Leonard Leibovici
BACKGROUND: Colistin-carbapenem combinations are synergistic in vitro against carbapenem-resistant Gram-negative bacteria. We aimed to test whether combination therapy improves clinical outcomes for adults with infections caused by carbapenem-resistant or carbapenemase-producing Gram-negative bacteria. METHODS: A randomised controlled superiority trial was done in six hospitals in Israel, Greece, and Italy. We included adults with bacteraemia, ventilator-associated pneumonia, hospital-acquired pneumonia, or urosepsis caused by carbapenem-non-susceptible Gram-negative bacteria...
February 15, 2018: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29442147/-urosepsis
#4
Mathias W Pletz, Sebastian Weis, Christina Forstner, Florian Wagenlehner
Urosepsis is defined as a severe disease due to organ failure caused by a urinary tract infection. An empirical antibiotic therapy should be instigated within the first hour after diagnosis. Urine cultures and blood cultures should be performed before antibiotic treatment. Further diagnostics should be carried out at an early stage to enable an interventional focus control in the case of urinary tract obstruction or abscess formation, if necessary. Gram-negative pathogens are most frequently isolated. Extended spectrum beta-lactamase (ESBL) forming bacteria as a cause of urosepsis are increasing...
February 7, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29441108/is-vaginal-reflux-associated-with-urinary-tract-infection-in-female-children-under-the-age-of-36-months
#5
Yu Bin Kim, Chih Lung Tang, Ja Wook Koo
Purpose: To determine the relationship between vaginal reflux (VR) and urinary tract infection (UTI) in female children aged <36 months. Methods: A single center retrospective study was performed for 191 girls aged <36 months, with a diagnosis of febrile UTI, who underwent a voiding cystourethrography (VCUG) for assessment of vesicoureteral reflux (VUR) at Sanggye Paik Hospital. Fifty-one girls, who underwent VCUG for assessment of congenital hydronephrosis or renal pelvis dilatation, without a UTI, formed the control group...
January 2018: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29422729/outcome-of-patients-admitted-to-a-tertiary-referral-intensive-care-unit-with-urosepsis-needing-source-control
#6
Chaitra C Rao, Pradeep Rangappa, Karthik Rao, Ipe Jacob
Introduction: Urosepsis is one of the common causes of admission to the Intensive Care Unit (ICU). It has traditionally been treated with antibiotics, but surgical management with Double J [DJ] ureteral stents is gaining popularity. This study compares patients with complicated urosepsis who underwent surgical source control by ureteral stenting with those managed medically. Materials and Methods: The study enrolled patients admitted to a tertiary adult ICU with a diagnosis of urosepsis over a period of 2 years...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29421810/is-there-a-role-for-double-j-stent-culture-in-contemporary-urology
#7
Diomidis Kozyrakis, Stefanos Perikleous, Styliani-Elissavet Chatzistamou, Dimitris Kateris, Georgios Soukias, Anastasios Karatzas, Ioannis Dimitriadis
INTRODUCTION: To present the incidence of bacterial colonization on ureteral double J stents (DJS); isolate the uropathogens; define the rate of multi-resistant bacteria strains (MRBS) and present their clinical importance. MATERIALS AND METHODS: <unterline></unterline> The whole body of 105 DJSs was examined for the presence of uropathogens. RESULTS: The main etiology for stent placement was lithiasis (57.1%). The most frequently cultured microorganisms were staphylococcus (28...
February 8, 2018: Urologia Internationalis
https://www.readbyqxmd.com/read/29379606/escherichia-hermannii-as-the-sole-pathogen-in-urosepsis-case-report
#8
R A Haasdijk, J van Ingen
No abstract text is available yet for this article.
January 2018: New Microbes and New Infections
https://www.readbyqxmd.com/read/29372354/urinary-tract-infections-following-radical-cystectomy-and-urinary-diversion-a-review-of-1133-patients
#9
Thomas G Clifford, Behrod Katebian, Christine M Van Horn, Soroush T Bazargani, Jie Cai, Gus Miranda, Siamak Daneshmand, Hooman Djaladat
OBJECTIVE: To investigate the incidence and microbiology of urinary tract infection (UTI) within 90 days following radical cystectomy (RC) and urinary diversion. METHODS: We reviewed 1133 patients who underwent RC for bladder cancer at our institution between 2003 and 2013; 815 patients (72%) underwent orthotopic diversion, 274 (24%) ileal conduit, and 44 (4%) continent cutaneous diversion. 90-day postoperative UTI incidence, culture results, antibiotic sensitivity/resistance and treatment were recorded through retrospective review...
January 25, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29371597/immunological-consequences-of-kidney-cell-death
#10
REVIEW
Maysa Sarhan, Anne von Mässenhausen, Christian Hugo, Rainer Oberbauer, Andreas Linkermann
Death of renal cells is central to the pathophysiology of acute tubular necrosis, autoimmunity, necrotizing glomerulonephritis, cystic kidney disease, urosepsis, delayed graft function and transplant rejection. By means of regulated necrosis, immunogenic damage-associated molecular patterns (DAMPs) and highly reactive organelles such as lysosomes, peroxisomes and mitochondria are released from the dying cells, thereby causing an overwhelming immunologic response. The rupture of the plasma membrane exhibits the "point of no return" for the immunogenicity of regulated cell death, explaining why apoptosis, a highly organized cell death subroutine with long-lasting plasma membrane integrity, elicits hardly any immune response...
January 25, 2018: Cell Death & Disease
https://www.readbyqxmd.com/read/29359836/factors-and-outcomes-in-association-with-sepsis-differ-between-simultaneous-pancreas-kidney-and-single-kidney-transplant-recipients
#11
Thomas Schachtner, Marina Zaks, Natalie M Otto, Andreas Kahl, Petra Reinke
As immunosuppressive therapy has improved in simultaneous pancreas/kidney transplant recipients (SPKTRs), infection has become the major limitation of disease-free survival. We studied all SPKTRs and deceased-donor kidney transplant recipients (KTRs) between 2003 and 2015. 36/134 SPKTRs (26.9%) were diagnosed with sepsis among which 13/36 SPKTRs (36.1%) developed severe sepsis/septic shock. A control group of 98 SPKTRs without sepsis and 61/538 KTRs (11.3%) with sepsis were used for comparison. Among SPKTRs, female sex, low BMI, CMV-seronegativity, CMV-disease, and acute cellular rejection increased the risk for sepsis (p<0...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29340897/invasion-and-translocation-of-uropathogenic-escherichia-coli-isolated-from-urosepsis-and-patients-with-community-acquired-urinary-tract-infection
#12
B Owrangi, N Masters, A Kuballa, C O'Dea, T L Vollmerhausen, M Katouli
Uropathogenic Escherichia coli (UPEC) strains are found in high numbers in the gut of patients with urinary tract infections (UTIs). We hypothesised that in hospitalised patients, UPEC strains might translocate from the gut to the blood stream and that this could be due to the presence of virulence genes (VGs) that are not commonly found in UPEC strains that cause UTI only. To test this, E. coli strains representing 75 dominant clonal groups of UPEC isolated from the blood of hospitalised patients with UTI (urosepsis) (n = 22), hospital-acquired (HA) UTI without blood infection (n = 24) and strains isolated from patients with community-acquired (CA)-UTIs (n = 29) were tested for their adhesion to, invasion and translocation through Caco-2 cells, in addition to the presence of 34 VGs associated with UPEC...
January 16, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29338914/prophylactic-antibiotics-following-radical-cystectomy-reduces-urinary-tract-infections-and-readmission-for-sepsis-from-a-urinary-source
#13
Ryan P Werntz, Ann Martinez-Acevedo, Hamed Amadi, Ryan Kopp, Jeffrey La Rochelle, Theresa Koppie, Christopher Amling, Kamran P Sajadi
INTRODUCTION: Urinary tract infections (UTI) and sepsis contribute significantly to the morbidity associated with cystectomy and urinary diversion in the first 30 days. We hypothesized that continuous antibiotic prophylaxis decreased UTIs in the first 30 days following radical cystectomy. METHODS: Patients with urothelial carcinoma of the bladder who underwent a radical cystectomy with urinary diversion for bladder cancer at Oregon Health and Science University from January 2014 to May 2015 were included in the study...
January 12, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29322236/-urosepsis
#14
Mathias W Pletz, Sebastian Weis, Christina Forstner, Florian Wagenlehner
Urosepsis is defined as a severe disease due to organ failure caused by a urinary tract infection. An empirical antibiotic therapy should be instigated within the first hour after diagnosis. Urine cultures and blood cultures should be performed before antibiotic treatment. Further diagnostics should be carried out at an early stage to enable an interventional focus control in the case of urinary tract obstruction or abscess formation, if necessary. Gram-negative pathogens are most frequently isolated. Extended spectrum beta-lactamase (ESBL) forming bacteria as a cause of urosepsis are increasing...
January 10, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29288398/comparison-of-fosfomycin-against-fluoroquinolones-for-transrectal-prostate-biopsy-prophylaxis-an-individual-patient-data-meta-analysis
#15
REVIEW
Matthew J Roberts, Susan Scott, Patrick N Harris, Kurt Naber, Florian M E Wagenlehner, Suhail A R Doi
PURPOSE: To systematically review and meta-analyse available evidence comparing fosfomycin trometamol (FT) to fluoroquinolone (FQ) prophylaxis to prevent transrectal ultrasound-guided prostate biopsy (TRUSPB) related infectious complications. METHODS: Electronic databases were queried for studies comparing FT to FQ-based TRUSPB prophylaxis. Studies were assessed for comparable outcomes and methodological quality (ROBINS-I modification). The primary outcome measure was the relative odds of overall infectious complications following TRUSPB according to FT/FQ treatment, which was evaluated with meta-analysis...
December 29, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/29207766/successful-management-of-urosepsis-with-ceftriaxone-sulbactam-edta-a-case-report-of-penem-sparing-approach
#16
Amit Bery, Candy Sodhi, Rishu Bhanot
Over the past decade, the Anti-Microbial Resistance (AMR) among members of Enterobacteriaceae family is on rise mainly due to rapid spread of strains producing Extended-Spectrum Beta-Lactamases (ESBLs) and Metallo Beta-Lactamases (MBLs). Hence, the choice of drugs available for these resistant strains is diminishing and their treatment is becoming more challenging. This is a case of complicated Urinary Tract Infection (cUTI) due to ESBL producing E. coli leading to septic shock which was successfully managed with Antibiotic Adjuvant Entity (AAE), a combination of ceftriaxone+sulbactam+EDTA...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29181135/graves-disease-thyrotoxicosis-and-propylthiouracil-related-agranulocytosis-successfully-treated-with-therapeutic-plasma-exchange-and-g-csf-followed-by-total-thyroidectomy
#17
Anna Candoni, Federico De Marchi, Fabio Vescini, Sara Mauro, Cristina Rinaldi, Marco Piemonte, Nicholas Rabassi, Maria Vittoria Dubbini, Renato Fanin
Antithyroid drugs can be a rare cause of agranulocytosis (0.5% of treated patients). Suspension of these drugs is mandatory in these patients and may result in worsening hyperthyroidism. We report the case of a 27-year-old woman who is 3 months post-partum, breastfeeding, and suffering with Graves' disease hyperthyroidism treated first with methimazole and then with propylthiouracil due to a methimazole allergy. She was admitted for urosepsis and agranulocytosis. The patient was diagnosed with propylthiouracil related agranulocytosis, diffuse toxic goiter and thyro-gastric syndrome...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/29171624/-antimicrobial-susceptibility-of-bacteria-causing-urosepsis
#18
Manuel Catalán, Inés Cerón, Gastón Astroza
No abstract text is available yet for this article.
June 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29151053/protocol-of-the-sepsivit-study-a-prospective-observational-study-to-determine-whether-continuous-heart-rate-variability-measurement-during-the-first-48-hours-of-hospitalisation-provides-an-early-warning-for-deterioration-in-patients-presenting-with-infection
#19
Vincent M Quinten, Matijs van Meurs, Maurits H Renes, Jack J M Ligtenberg, Jan C Ter Maaten
INTRODUCTION: One in five patients with sepsis deteriorates within 48 hours after hospital admission. Regrettably, a clear tool for the early detection of deterioration is still lacking. The SepsiVit study aims to determine whether continuous heart rate variability (HRV) measurement can provide an early warning for deterioration in patients presenting with suspected infection or sepsis to the emergency department (ED). METHODS AND ANALYSIS: The protocol of a prospective observational study in the ED...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150394/efficacy-of-prostatic-artery-embolization-for-catheter-dependent-patients-with-large-prostate-sizes-and-high-comorbidity-scores
#20
Shivank Bhatia, Vishal K Sinha, Bruce R Kava, Christopher Gomez, Sardis Harward, Sanoj Punnen, Issam Kably, Jeffrey Miller, Dipen J Parekh
PURPOSE: To evaluate efficacy and safety of prostate artery embolization (PAE) in urinary catheter-dependent patients with large prostate volumes and high comorbidity scores. MATERIALS AND METHODS: A retrospective single-center review was conducted of 30 patients with urinary retention at time of PAE from November 2014 through February 2017. Mean (range) age was 73.1 years (48-94 y), age-adjusted Charlson comorbidity index was 4.5 (0-10), duration of urinary retention was 63...
January 2018: Journal of Vascular and Interventional Radiology: JVIR
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