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https://www.readbyqxmd.com/read/28101656/off-label-use-of-antimicrobials-in-neonates-in-a-tertiary-children-s-hospital
#1
Niina Laine, Ann Marie Kaukonen, Kalle Hoppu, Marja Airaksinen, Harri Saxen
PURPOSE: Off-label (OL) use of drugs for hospitalized children is very common. OL use occurs especially in the youngest patients, neonates. This study focused on the OL use of antimicrobials in neonates. To our knowledge, only few studies have focused on the prevalence of OL use of antimicrobials in neonates. METHODS: We investigated the OL use of antimicrobials in neonates in a tertiary children's hospital. First, we investigated what were the most consumed OL antimicrobials in defined daily doses according to hospital's registry data from neonatal intensive care unit (NICU) during 2009-2014...
January 18, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28096977/high-rates-of-multidrug-resistance-among-uropathogenic-escherichia-coli-in-children-and-analyses-of-esbl-producers-from-nepal
#2
Narayan Prasad Parajuli, Pooja Maharjan, Hridaya Parajuli, Govardhan Joshi, Deliya Paudel, Sujan Sayami, Puspa Raj Khanal
BACKGROUND: Emergence of Extended-spectrum beta-lactamase producing Escherichia coli causing urinary tract infections (UTI) among pediatric patients is an increasing problem worldwide. However, very little is known about pediatric urinary tract infections and antimicrobial resistance trend from Nepal. This study was conducted to assess the current antibiotic resistance rate and ESBL production among uropathogenic Escherichia coli in pediatric patients of a tertiary care teaching hospital of Nepal...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28096976/effect-of-handrubbing-using-locally-manufactured-alcohol-based-handrubs-in-paediatric-wards-in-harare-zimbabwe
#3
Muchaneta Gudza-Mugabe, Marcelyn T Magwenzi, Hilda A Mujuru, Mutsa Bwakura-Dangarembizi, Valerie Robertson, Alexander M Aiken
We assessed bacterial contamination of hands of adults present in paediatric wards in two tertiary-care hospitals in Harare, Zimbabwe and the microbiologic efficacy of locally-manufactured alcohol-based hand rub (ABHR). During unannounced visits, samples were collected using hand-print and hand-rinse methods. Samples were collected from 152 individuals (16 nurses, 10 doctors, 28 students, 86 parents/guardians, 12 others). Contamination of hands with Gram-negative bacteria was found in 91% of adults tested with a mean of 14...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28095658/therapeutic-assessment-of-primaquine-for-radical-cure-of-plasmodium-vivax-malaria-at-primary-and-tertiary-care-centres-in-southwestern-india
#4
Rishikesh Kumar, Vasudeva Guddattu, Kavitha Saravu
Acquaintance is scanty on primaquine (PQ) efficacy and Plasmodium vivax recurrence in Udupi district, Karnataka, India. We assessed the efficacy of 14 days PQ regimen (0.25 mg/kg/day) to prevent P. vivax recurrence. Microscopically, aparasitemic adults (≥18 years) after acute vivax malaria on day 28 were re-enrolled into 15 months' long follow-up study. A peripheral blood smear examination was performed with participants at every 1-2 month interval. A nested PCR test was performed to confirm the mono-infection with P...
December 2016: Korean Journal of Parasitology
https://www.readbyqxmd.com/read/28092222/varied-presentations-of-leptospirosis-experience-from-a-tertiary-care-hospital-in-north-india
#5
Rama Chaudhry, Karnika Saigal, Tej Bahadur, Kamla Kant, Bishwanath Chourasia, Nitin Gupta
Leptospirosis has been recognised as an emerging global public health problem. The aim of our study was to explore the epidemiological and clinical pattern of disease occurrence in suspected cases and to search for any existing co-infections. Ours was a retrospective study in patients with acute febrile illness in north India over a period of three years (April 2011 to June 2014). Serological diagnosis of leptospirosis was made using the PanBio IgM ELISA kit. Using modified Faine's criteria, presumptive and possible diagnosis was made in 57% and 34% cases, respectively...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/28089474/what-happened-to-the-complication-the-importance-of-acs-nsqip-pediatric-in-optimizing-quality-improvement-initiatives-for-resident-education
#6
Bennett W Calder, Joseph V Sakran, Christian J Streck, Robert A Cina
OBJECTIVE: Morbidity and Mortality (M&M) conference is considered the golden hour of surgical education. Most training programs lack standardized methods to evaluate self-reported outcomes and contributions to resident education. The purpose of this study was to determine whether residents underreport pediatric postoperative complications thereby limiting a comprehensive educational opportunity and the ability to adequately perform quality improvement during M&M conference. DESIGN: A retrospective analysis of resident reports submitted to the M&M committee at an academic medical center was conducted over 1 year...
January 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28089143/long-term-mortality-following-pseudomonas-aeruginosa-bloodstream-infection
#7
K L McCarthy, D L Paterson
BACKGROUND: Pseudomonas aeruginosa bloodstream infections (BSI) are associated with substantial short-term mortality. There is little data on long-term mortality associated with this BSI. AIM: To describe mortality rates up to one year post infection and the significant factors associated with death. METHODS: Positive blood cultures for P. aeruginosa were identified retrospectively from January 2008 to January 2011 at seven tertiary care hospitals...
November 30, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28089138/bloodstream-infections-in-children-caused-by-carbapenem-resistant-versus-carbapenem-susceptible-gram-negative-microorganisms-risk-factors-and-outcome
#8
Yasemin Ozsurekci, Kubra Aykac, Ali Bulent Cengiz, Sevgen Tanır Basaranoglu, Banu Sancak, Sevilay Karahan, Ates Kara, Mehmet Ceyhan
Carbapenems are often considered the last resort agents reserved for treatment of infections due to highly antimicrobial resistant organisms such as A. baumannii and P. aeruginosa. However, carbapenem-resistant Gram-negative (CRGN) pathogens have become much more prevalent in the last decade. The objective of this study was to determine risk factors for and outcome of bacteremia caused by Gram-negative microorganisms in a pediatric tertiary-care hospital. Among 97 patients with hospital-acquired Gram-negative bacteremia, 66 patients with carbapenem-susceptible Gram-negative pathogens (CSGN) were compared with the remaining 31 with CRGN isolates...
January 3, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28089100/community-onset-clostridium-difficile-infection-at-a-tertiary-medical-center-in-southern-taiwan-2007-2015
#9
Chin-Shiang Tsai, Yuan-Pin Hung, Jen-Chieh Lee, Nan-Yao Lee, Po-Lin Chen, Ling-Shan Syue, Ming-Chi Li, Chia-Wen Li, Wen-Chien Ko
BACKGROUND: Clostridium difficile infection (CDI) is well-known as the major cause of infectious diarrhea in hospitalized patients. Community-onset CDI (CO-CDI) is an emerging threat. However, clinical information of CO-CDI in Taiwan remains scarce. METHODS: A retrospective study was conducted at a medical center in southern Taiwan. Symptomatic patients between 2007 and 2015 with C. difficile toxin or tcdB detected in stool were identified as CDI, and were classified as CO-CDI [including community-associated CDI (CA-CDI) and community-onset health care facility-associated CDI (CO-HCFA-CDI)] and health care facility-onset CDI (HCFO-CDI)...
December 18, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28079867/reducing-peripherally-inserted-central-catheters-in-the-neonatal-intensive-care-unit
#10
A J Vachharajani, N A Vachharajani, H Morris, A Niesen, A Elward, D A Linck, A M Mathur
OBJECTIVE: Our objective was to safely reduce the number of peripherally inserted central catheters (PICCs) inserted in infants with umbilical venous catheter using quality improvement methods. STUDY DESIGN: In a tertiary neonatal intensive care unit, a questionnaire designed to prompt critical thinking around the decision to place a PICC, along with an updated standardized feeding guideline was introduced. PICC insertion in 86 infants with umbilical venous catheter (pre intervention) with birth weight 1000-1500 g were compared with 115 infants (post intervention) using Fisher's exact test...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28079604/prior-use-of-calcium-channel-blockers-is-associated-with-decreased-mortality-in-critically-ill-patients-with-sepsis-a-prospective-observational-study
#11
Maryse A Wiewel, Lonneke A van Vught, Brendon P Scicluna, Arie J Hoogendijk, Jos F Frencken, Aeilko H Zwinderman, Janneke Horn, Olaf L Cremer, Marc J Bonten, Marcus J Schultz, Tom van der Poll
OBJECTIVES: Experimental studies suggest that calcium channel blockers can improve sepsis outcome. The aim of this study was to determine the association between prior use of calcium channel blockers and the outcome of patients admitted to the ICU with sepsis. DESIGN: A prospective observational study. SETTING: The ICUs of two tertiary care hospitals in the Netherlands. PATIENTS: In total, 1,060 consecutive patients admitted with sepsis were analyzed, 18...
January 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28078559/empirical-combination-of-a-%C3%AE-lactam-to-vancomycin-may-not-improve-outcomes-of-methicillin-susceptible-staphylococcus-aureus-bacteremia-compared-to-vancomycin-monotherapy
#12
G E Park, J-H Ko, S Y Cho, Y E Ha, N Y Lee, C-I Kang, D R Chung, J-H Song, K R Peck
To evaluate effect of empirical combination of a β-lactam to vancomycin and vancomycin monotherapy in Staphylococcus aureus bacteremia (MSSA-B), we conducted a retrospective cohort study. Electronic medical records of individuals who were diagnosed with MSSA-B between January 2005 and February 2015 at a tertiary care center were reviewed. Patients were classified into three groups according to empirical antibiotic regimen (BL group, β-lactam; VAN group, vancomycin; BV group, combination of β-lactam and vancomycin), and 30-day all-cause mortality of each group was compared...
January 11, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28078558/respiratory-syncytial-virus-associated-hospitalizations-in-preterm-infants-of-29-to-32%C3%A2-weeks-gestational-age-using-a-risk-score-tool-for-palivizumab-prophylaxis
#13
B Resch, V S Bramreiter, S Kurath-Koller, T Freidl, B Urlesberger
To evaluate the efficacy of palivizumab in infants of 29 to 32 weeks of gestational age (GA) based on a risk score tool developed for Austria. Retrospective single-center cohort study including all preterm infants of 29 (+0) to 32 (+6) weeks of GA born between 2004 and 2012 at a tertiary care university hospital. Data on RSV-related hospitalizations over the first 2 years of life were analyzed and compared between those having received palivizumab and those without. The study population was comprised of 789 of 816 screened infants, of whom 262 (33%) had received palivizumab and 527 (67%) had not...
January 11, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28077517/two-phase-hospital-associated-outbreak-of-mycobacterium-abscessus-investigation-and-mitigation
#14
Arthur W Baker, Sarah S Lewis, Barbara D Alexander, Luke F Chen, Richard J Wallace, Barbara A Brown-Elliott, Pamela J Isaacs, Lisa C Pickett, Chetan B Patel, Peter K Smith, John M Reynolds, Jill Engel, Cameron R Wolfe, Carmelo A Milano, Jacob N Schroder, Robert D Davis, Matthew G Hartwig, Jason E Stout, Nancy Strittholt, Eileen K Maziarz, Jennifer Horan Saullo, Kevin C Hazen, Richard J Walczak, Ravikiran Vasireddy, Sruthi Vasireddy, Celeste M McKnight, Deverick J Anderson, Daniel J Sexton
BACKGROUND: Nontuberculous mycobacteria (NTM) commonly colonize municipal water and cause healthcare-associated outbreaks. We investigated a biphasic outbreak of Mycobacterium abscessus at a tertiary care hospital. METHODS: Case patients had recent hospital exposure and laboratory-confirmed colonization or infection with M. abscessus from January 2013 through December 2015. We conducted a multidisciplinary epidemiologic, field, and laboratory investigation. RESULTS: The incidence rate of M...
January 11, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28077203/clostridium-difficile-infection-in-older-adults-systematic-review-of-efforts-to-reduce-occurrence-and-improve-outcomes
#15
Leisa L Marshall, Samuel Peasah, Gregg A Stevens
OBJECTIVE: Provide a systematic review of the primary literature on efforts to reduce Clostridium difficile infection (CDI) occurrence and improve outcomes in older adults. DATA SOURCES, STUDY SELECTION, DATA EXTRACTION: PubMed and CINAHL databases were searched for research studies using search terms CDI, CDI prevention, reduction, control, management, geriatric, elderly, adults 65 years of age and older. The MeSH categories Aged and Aged, 80 and older, were used...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28072493/patterns-of-infections-aetiological-agents-and-antimicrobial-resistance-at-a-tertiary-care-hospital-in-northern-tanzania
#16
Happiness Houka Kumburu, Tolbert Sonda, Blandina Theophil Mmbaga, Michael Alifrangis, Ole Lund, Gibson Kibiki, Frank M Aarestrup
OBJECTIVE: To determine the causative agents of infections and their antimicrobial susceptibility at a tertiary care hospital in Moshi, Tanzania, to guide optimal treatment. METHODS: A total of 590 specimens (stool (56), sputum (122), blood (126) and wound swabs (286)) were collected from 575 patients admitted in the medical and surgical departments. The bacterial species were determined by conventional methods and disk diffusion was used to determine the antimicrobial susceptibility pattern of the bacteria isolates...
January 10, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28068437/association-between-early-lactate-levels-and-30-day-mortality-in-clinically-suspected-sepsis-in-children
#17
Halden F Scott, Lina Brou, Sara J Deakyne, Allison Kempe, Diane L Fairclough, Lalit Bajaj
Importance: Improving emergency care of pediatric sepsis is a public health priority, but optimal early diagnostic approaches are unclear. Measurement of lactate levels is associated with improved outcomes in adult septic shock, but pediatric guidelines do not endorse its use, in part because the association between early lactate levels and mortality is unknown in pediatric sepsis. Objective: To determine whether the initial serum lactate level is associated with 30-day mortality in children with suspected sepsis...
January 9, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28060181/predicting-periarticular-infection-in-children-with-septic-arthritis-of-the-hip-regionally-derived-criteria-may-not-apply-to-all-populations
#18
Christian A Refakis, Alexandre Arkader, Keith D Baldwin, David A Spiegel, Wudbhav N Sankar
BACKGROUND: The management of septic arthritis of the hip in children can be complicated by the presence of additional coexisting periarticular infections (PAIs). Criteria predicting the presence of PAI have recently been proposed by Rosenfeld and colleagues with the goal of using magnetic resonance imaging (MRI) efficiently in the workup of septic arthritis. The purpose of this study was to determine the applicability of recently published predictive criteria for PAI (developed in the Southwestern United States using a variety of joints) to septic arthritis of the hip treated at a large Northeastern tertiary care center...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28059918/quality-improvement-initiatives-in-colorectal-surgery-value-of-physician-feedback
#19
Joshua A Waters, Todd Francone, Peter W Marcello, Patricia L Roberts, David J Schoetz, Thomas E Read, Caitlin Stafford, Rocco Ricciardi
BACKGROUND: The impact of process improvement through surgeon feedback on outcomes is unclear. OBJECTIVE: We sought to evaluate the effect of biannual surgeon-specific feedback on outcomes and adherence to departmental and Surgical Care Improvement Project process measures on colorectal surgery outcomes. DESIGN: This was a retrospective analysis of prospectively collected 100% capture surgical quality improvement data. SETTING: This study was conducted at the department of colorectal surgery at a tertiary care teaching hospital from January 2008 through December 2013...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28059916/does-hospital-transfer-impact-outcomes-after-colorectal-surgery
#20
Christopher J Chow, Wolfgang B Gaertner, Christine C Jensen, Bradford Sklow, Robert D Madoff, Mary R Kwaan
BACKGROUND: With increasing public reporting of outcomes and bundled payments, hospitals and providers are scrutinized for morbidity and mortality. The impact of patient transfer before colorectal surgery has not been well characterized in a risk-adjusted fashion. OBJECTIVE: We hypothesized that hospital-to-hospital transfer would independently predict morbidity and mortality beyond traditional predictor variables. DESIGN: We constructed a retrospective cohort of 158,446 patients who underwent colorectal surgery using the 2009-2013 American College of Surgeons National Surgical Quality Improvement Program database...
February 2017: Diseases of the Colon and Rectum
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