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tertiary care infection

Hyeri Seok, Cheol-In Kang, Kyungmin Huh, Sun Young Cho, Young Eun Ha, Doo Ryeon Chung, Kyong Ran Peck
BACKGROUND: Fluoroquinolones are antibiotics commonly used in the treatment of infections caused by Streptococcus pneumoniae. However, rates of fluoroquinolone resistance are increasing with their frequent use. We designed this study to verify current fluoroquinolone resistance rates and risk factors for community-onset pneumococcal pneumonia. METHODS: A retrospective case-control study was conducted in a tertiary referral hospital. The study population comprised patients admitted for pneumococcal pneumonia between January 2011 and May 2017...
March 22, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Ananya Doda, Gita Negi, Dushyant Singh Gaur, Meena Harsh
INTRODUCTION: Health-care professionals are trained health-care providers who occupy a potential vanguard position in human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) prevention programs and the management of AIDS patients. This study was performed to assess HIV/AIDS-related knowledge, attitude, and practice (KAP) and perceptions among health-care professionals at a tertiary health-care institution in Uttarakhand, India, and to identify the target group where more education on HIV is needed...
January 2018: Asian Journal of Transfusion Science
Sowmya Kaimal, Jithendriya Madhukara
AIM: To collect data pertaining to oral drug provocation testing (DPT) in hospitalized patients with antiretroviral (ARV)/antitubercular agent-induced rashes. METHODS: Patients with cutaneous adverse drug reactions (ADRs) to ARV/antitubercular drugs and who underwent oral DPT during a 5-year period were included in this study. RESULTS: Data were collected from the records of 21 patients. Of the 21, 19 had HIV infection. The most commonly implicated drug was nevirapine (NVP), followed by cotrimoxazole and antitubercular agents...
January 2018: Journal of the International Association of Providers of AIDS Care
E D Manea, I Stefan, C Olariu, O C Calina, R E Jipa, A Hristea
BACKGROUND: In our country, the national program for hepatitis C virus treatment with ombitasvir/paritaprevir/ritonavir and dasabuvir was approved for patients with stage four of liver fibrosis and stage three associated with specific comorbidities. Our aim was to analyze the characteristics associated with the presence of adverse events in patients receiving this antiviral regimen, with ribavirin in cirrhotic patients. METHODS: We prospectively studied a cohort of adults with hepatitis C virus infection with Child A cirrhosis, treated for 12 weeks with ombitasvir/paritaprevir/ritonavir/dasabuvir and ribavirin, which have been followed in an infectious diseases tertiary-care hospital...
January 2018: Acta Gastro-enterologica Belgica
Andrew W Artenstein, Jennifer Friderici, Paul Visintainer
Introduction: Spinal epidural abscess (SEA), a highly morbid and potentially lethal deep tissue infection of the central nervous system has more than tripled in incidence over the past decade. Early recognition at the point of initial clinical presentation may prevent irreversible neurologic injury or other serious, adverse outcomes. To facilitate early recognition of SEA, we developed a predictive scoring model. Methods: Using data from a 10-year, retrospective, case-control study of adults presenting for care at a tertiary-care, regional, academic medical center, we used the Integrated Discrimination Improvement Index (IDI) to identify candidate discriminators and created a multivariable logistic regression model, refined based on p-value significance...
March 2018: Western Journal of Emergency Medicine
Esmeralda Highton, M Guadalupe Pérez, Carola Cedillo Villamagua, María I Sormani, María S Mussini, Adela Isasmendi, José Pinheiró, Vanesa Reijtman, Moira Taicz, Alejandra Mastroianni, María E García, María T Rosanova
INTRODUCTION: Osteoarticular infections are an important cause of morbidity and may present with bacteremia. The epidemiology has changed in recent years. OBJECTIVES: To describe the epidemiological, clinical, and evolutionary characteristics of children with osteoarticular infections and compare patients with and without bacteremia. POPULATION AND METHODS: Retrospective cohort. Patients younger than 18 years admitted between January 1st, 2016 and December 31st, 2016 suspected of osteoarticular infections who had undergone an arthrocentesis and/or joint biopsy were included...
April 1, 2018: Archivos Argentinos de Pediatría
Amelia K Sofjan, Benjamin O Casey, Boxin A Xu, Jonathan Amadio, Alejandro Restrepo, M Jahangir Alam, Kevin W Garey
BACKGROUND: The Accelerate PhenoTestTM BC kit (AXDX) provides rapid organism identification (ID) and antimicrobial susceptibility testing (AST) results. Its potential role for antimicrobial stewardship is unknown. OBJECTIVE: To compare the diagnostic accuracy of AXDX with conventional methods (CMs) and assess AXDX's potential role for antimicrobial stewardship in patients with Gram-positive bloodstream infections (BSIs). METHODS: This retrospective cohort study included adults with Staphylococcus aureus or Enterococcus spp BSIs from July 2014 to January 2016 at a tertiary care medical center...
March 1, 2018: Annals of Pharmacotherapy
Nongnooch Poowanawittayakom, Anamika Dutta, Shannon Stock, Sunkaru Touray, Richard T Ellison, Stuart M Levitz
The epidemic of illicit intravenous drug use (IVDU) in the United States has been accompanied by a surge in drug overdose deaths and infectious sequelae. Candida albicans infections were associated with injection of contaminated impure brown heroin in the 1970s-1990s; however, candidiasis accompanying IVDU became considerably rarer as the purity of the heroin supply increased. We reviewed cases of candidemia occurring over a recent 7-year period in persons >14 years of age at a tertiary care hospital in central Massachusetts...
April 2018: Emerging Infectious Diseases
Adham Abu Taha, Ayman Daoud, Sawsan Zaid, Sajida Sammour, Maram Belleh, Refqa Daifi
BACKGROUND: Active surveillance is important in infection control programmes, allowing the detection of patients colonised with multi-drug resistant organisms and preventing the spread of multi-drug resistant organisms. The aim of this study was to determine the rate of asymptomatic colonisation with multi-drug resistant organisms and the prevalence of each organism in patients transferred to An-Najah National University Hospital, Nablus, occupied Palestinian territory. METHODS: Patients transferred from other hospitals between January and December, 2015, were screened at time of admission by taking nasal, groin, and axillary swabs...
February 21, 2018: Lancet
Dirk Westhölter, Jens Hiller, Ulrike Denzer, Susanne Polywka, Francis Ayuk, Meike Rybczynski, Thomas Horvatits, Swantje Gundlach, Nicole Fischer, Marylyn M Addo, Sven Peine, Burkhard Göke, Ansgar W Lohse, Marc Lütgehetmann, Sven Pischke
BACKGROUND: Routine Hepatitis E Virus (HEV) testing of blood products has recently been implemented in Great-Britain and the Netherlands. The relevance of transfusion-transmitted HEV infections is still controversially discussed in Europe. METHODS: All blood donations at the University Medical Center Hamburg-Eppendorf were prospectively tested for HEV-RNA by pooled PCR from October 2016 to May 2017. Reactive samples were individually re-tested. Additionally, stored samples from previous donations of positive donors were tested to determine the duration of HEV-viremia...
March 15, 2018: Journal of Hepatology
Madhuri M Sopirala, Asma Syed, Roman Jandarov, Margaret Lewis
BACKGROUND: In January 2015, the Centers for Disease Control and Prevention (CDC)/National Health Safety Network (NHSN) changed the definition of catheter-associated urinary tract infection (CAUTI). We evaluated the outcomes of a robust CAUTI prevention program when we performed surveillance using the old definition (before 2015) versus the new definition (after 2015). This is the first study to evaluate how the change in CDC/NHSN definitions affected the outcomes of a CAUTI reduction program...
March 16, 2018: American Journal of Infection Control
Dubbaka Srujana, Manpreet Kaur, Jayanand Urkude, Anubha Rathi, Namrata Sharma, Jeewan S Titiyal
PURPOSE: To evaluate the functional and anatomical outcomes of repeat penetrating keratoplasty (PK) in optically failed therapeutic grafts. DESIGN: Prospective interventional case series METHODS: All cases admitted at the apex tertiary care centre for repeat keratoplasty following optically failed therapeutic PK were enrolled over a period of one year. Repeat optical PK was performed in all eyes. Primary outcome measures were postoperative graft clarity and visual acuity...
March 14, 2018: American Journal of Ophthalmology
Ashley Gionfriddo, Mika L Nonoyama, Peter C Laussen, Peter N Cox, Megan Clarke, Alejandro A Floh
OBJECTIVES: To promote standardization, the Centers for Disease Control and Prevention introduced a new ventilator-associated pneumonia classification, which was modified for pediatrics (pediatric ventilator-associated pneumonia according to proposed criteria [PVAP]). We evaluated the frequency of PVAP in a cohort of children diagnosed with ventilator-associated pneumonia according to traditional criteria and compared their strength of association with clinically relevant outcomes. DESIGN: Retrospective cohort study...
March 15, 2018: Pediatric Critical Care Medicine
Zhen Li, Xinmei Zhou, Jing Cao, Zheng Li, Xia Wan, Jiaqian Li, Jing Jiao, Ge Liu, Ying Liu, Fangfang Li, Baoyun Song, Jingfen Jin, Liu Yilan, Xianxiu Wen, Shouzhen Cheng, Xinjuan Wu
AIMS AND OBJECTIVES: To gain insight into nurses' knowledge and attitudes regarding major immobility complications (pressure ulcers, pneumonia, deep vein thrombosis and urinary tract infections) and explore the correlation of nurses' knowledge and attitudes with the incidence of these complications. BACKGROUND: Immobility complications have adverse consequences, and effective management requires appropriate knowledge, attitudes and skills. Evidence about nurses' knowledge and attitudes regarding immobility complications is lacking...
March 15, 2018: Journal of Clinical Nursing
Farouq Muhammad Dayyab, Garba Iliyasu, Aliyu Aminu, Zaiyad Garba Habib, Abdulwasiu Bolaji Tiamiyu, Sirajo Haliru Tambuwal, Muhammad Musa Borodo, Abdulrazaq Garba Habib
Background: Hospital-acquired infections (HAIs) are an important cause of morbidity and mortality. This study examined the epidemiology, clinical outcomes and microbiological profile of HAIs. Methods: This prospective study was carried out on patients identified to have developed HAIs while admitted to the medical wards, surgical wards, dialysis unit and intensive care unit (ICU) of the hospital. Patients were recruited consecutively until the target study population was reached...
March 12, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
Ashish Singh, Abhimanyu Kapoor, Rajneesh Kumar Singh, Anand Prakash, Anu Behari, Ashok Kumar, Vinay Kumar Kapoor, Rajan Saxena
Backgrounds/Aims: A residual gallbladder (RGB) following a partial/subtotal cholecystectomy may cause symptoms that require its removal. We present our large study regarding the problem of a RGB over a 15 year period. Methods: This study involved a retrospective analysis of patients managed for symptomatic RGB from January 2000 to December 2015. Results: A RGB was observed in 93 patients, who had a median age of 45 (25-70) years, and were comprised of 69 (74...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Rajesh Kumar Wadhwa, Aisha Nazeer, Ayesha Aslam Rai, Nasir Hassan Luck
OBJECTIVES: We investigated the incidence of gastrointestinal disorders requiring endoscopic and histopathologic diagnoses in renal transplant recipients. MATERIALS AND METHODS: In this retrospective analysis, we examined records of patients seen at the Department of Hepato-Gastroenterology and Transplantation Sciences, Sindh Institute of Urology and Trans?lantation (Karachi, Pakistan) from January 2010 to December 2014. Renal transplant recipients with gastrointestinal disorders who required endoscopy, including proctoscopy and upper and lower gastrointestinal endoscopy as per indication, were included...
March 9, 2018: Experimental and Clinical Transplantation
Katherine Murphy, Tim Cooksley, Phil Haji-Michael
Background: There has been a significant increase in the number of patients presenting with cancer related emergencies and potentially requiring critical care admission. Aim: To analyse the short and long term outcomes of patients with solid tumours requiring unplanned medical admission to a specialist cancer intensive care unit (ICU). Design: An unplanned cohort study. Methods: A retrospective analysis of patients admitted to a United Kingdom specialist tertiary oncology CCU between September 2009 and September 2015...
March 9, 2018: QJM: Monthly Journal of the Association of Physicians
David D Walker, Michael Z David, Dominic Catalano, Robert Daum, Michael B Gluth
Objective Despite the rising incidence of methicillin-resistant Staphylococcus aureus (MRSA) otologic infections, choice of treatment remains controversial. Only fluoroquinolone-containing ototopical preparations are approved by the US Food and Drug Administration for middle ear application. Furthermore, American Academy of Otolaryngology-Head and Neck Surgery Foundation guidelines advocate ototopical monotherapy for both tympanostomy tube otorrhea and acute otitis externa. Unfortunately, MRSA may be ciprofloxacin resistant...
March 1, 2018: Otolaryngology—Head and Neck Surgery
L Carey, C Desouza, A Moorcroft, A Elgalib
The aim of this study was to describe the obstetrical and virological outcomes in HIV-infected pregnant women who delivered at a district general hospital in south London in the period from 2008 to 2014. Our review identified 137 pregnancies; most (60%, 63/105) of them were unplanned. The commonest mode of delivery was spontaneous vaginal delivery (SVD) (42%, 48/114) followed by emergency Caesarean section (32%, 36/114). Gestational age at delivery was ≥37 weeks in most (84%, 91/106) of the cases. Maternal HIV VL at or closest to delivery was undetectable (<40 copies/mL), <400 copies/mL and >1000 copies/mL in 73% (94/129), 90% (116/129) and 6% (8/129) of the pregnancies, respectively...
March 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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