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https://www.readbyqxmd.com/read/29149418/randomized-multicenter-trial-of-lateral-trendelenburg-versus-semirecumbent-body-position-for-the-prevention-of-ventilator-associated-pneumonia
#1
Gianluigi Li Bassi, Mauro Panigada, Otavio T Ranzani, Alberto Zanella, Lorenzo Berra, Massimo Cressoni, Vieri Parrini, Hassan Kandil, Giovanni Salati, Paola Selvaggi, Alessandro Amatu, Miquel Sanz-Moncosi, Emanuela Biagioni, Fernanda Tagliaferri, Mirella Furia, Giovanna Mercurio, Antonietta Costa, Tullio Manca, Simone Lindau, Jaksa Babel, Marco Cavana, Chiara Chiurazzi, Joan-Daniel Marti, Dario Consonni, Luciano Gattinoni, Antonio Pesenti, Janine Wiener-Kronish, Cecilia Bruschi, Andrea Ballotta, Pierpaolo Salsi, Sergio Livigni, Giorgio Iotti, Javier Fernandez, Massimo Girardis, Maria Barbagallo, Gabriella Moise, Massimo Antonelli, Maria Luisa Caspani, Antonella Vezzani, Patrick Meybohm, Vladimir Gasparovic, Edoardo Geat, Marcelo Amato, Michael Niederman, Theodor Kolobow, Antoni Torres
PURPOSE: The lateral Trendelenburg position (LTP) may hinder the primary pathophysiologic mechanism of ventilator-associated pneumonia (VAP). We investigated whether placing patients in the LTP would reduce the incidence of VAP in comparison with the semirecumbent position (SRP). METHODS: This was a randomized, multicenter, controlled study in invasively ventilated critically ill patients. Two preplanned interim analyses were performed. Patients were randomized to be placed in the LTP or the SRP...
November 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29149338/multiplex-respiratory-virus-testing-for-antimicrobial-stewardship-a-prospective-assessment-of-antimicrobial-use-and-clinical-outcomes-among-hospitalized-adults
#2
Makeda Semret, Ian Schiller, Barbara Ann Jardin, Charles Frenette, Vivian G Loo, Jesse Papenburg, Shelly A McNeil, Nandini Dendukuri
Background: Respiratory tract infections are frequent causes of hospitalization and initiation of empirical antimicrobial therapy. Testing for a broad panel of respiratory viruses has been advocated as a useful tool for antibiotic stewardship. We conducted a prospective observational study to assess the impact of rapid viral test results on antimicrobial prescriptions and clinical outcomes among hospitalized adults. Methods: Eight hundred patients admitted with respiratory symptoms were tested by a 12-virus respiratory panel (RVP) during 3 consecutive winters in Montreal, Canada...
November 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29149329/polymyxin-derivatives-nab739-and-nab815-are-more-effective-than-polymyxin-b-in-murine-escherichia-coli-pyelonephritis
#3
Martti Vaara, Timo Vaara, Carina Vingsbo Lundberg
Objectives: Extremely multiresistant strains of Enterobacteriaceae, such as those of Escherichia coli and Klebsiella pneumoniae, are emerging and spreading at a worrisome speed. Polymyxins (polymyxin B, colistin) are used as last-line therapy against such strains, in spite of their notable nephrotoxicity that may even require discontinuation of the therapy. We have previously developed polymyxin derivatives NAB739 and NAB815 that are better tolerated in cynomolgus monkeys than polymyxin B and are, in contrast to polymyxin B, excreted in the cynomolgus urine to a very significant degree...
November 14, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29149294/pharmacokinetics-pharmacodynamics-of-systemically-administered-polymyxin-b-against-klebsiella-pneumoniae-in-mouse-thigh-and-lung-infection-models
#4
Cornelia B Landersdorfer, Jiping Wang, Veronika Wirth, Ke Chen, Keith S Kaye, Brian T Tsuji, Jian Li, Roger L Nation
Background: The pharmacokinetic/pharmacodynamic (PK/PD) relationship for polymyxin B against Klebsiella pneumoniae infections is not known. Methods: Dose-fractionation studies with subcutaneous polymyxin B were conducted in neutropenic mice in which infection with three strains of K. pneumoniae had been produced in thighs or lungs. Dosing (thigh infection 0.5-120 mg/kg/day; lung infection 5-120 mg/kg/day) commenced 2 h after inoculation, and bacterial burden was measured 24 h later...
November 14, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29149242/long-term-carriage-of-extended-spectrum-%C3%AE-lactamase-producing-escherichia-coli-and-klebsiella-pneumoniae-in-the-general-population-in-the-netherlands
#5
Engeline van Duijkeren, Cornelia C H Wielders, Cindy M Dierikx, Angela H A M van Hoek, Paul Hengeveld, Christiaan Veenman, Alice Florijn, Aniek Lotterman, Lidwien A M Smit, Jaap T van Dissel, Catharina B M Maassen, Sabine C de Greeff
Background: This longitudinal study aimed to investigate (risk factors for) persistence of carriage and molecular characteristics of extended-spectrum and pAmpC β-lactamase-producing (ESBL/pAmpC) Escherichia coli and Klebsiella pneumoniae (ESBL-E/K) in adults in the Dutch community. Methods: Following a cross-sectional study (ESBL-E/K prevalence 4.5%), a subset of ESBL-E/K positive (n=76) and negative (n=249) individuals volunteered to provide five monthly faecal samples and questionnaires...
November 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29149199/epidemiology-and-clinical-profile-of-pathogens-responsible-for-the-hospitalization-of-children-in-sousse-area-tunisia
#6
Ines Brini, Aida Guerrero, Naila Hannachi, Jihene Bouguila, Dorothea Orth-Höller, Amira Bouhlel, Lamia Boughamoura, Benjamin Hetzer, Wegene Borena, Britta Schiela, Dorothee Von Laer, Jalel Boukadida, Heribert Stoiber
This study aimed to identify a broad spectrum of respiratory pathogens from hospitalized and not-preselected children with acute respiratory tract infections in the Farhat Hached University-hospital of Sousse, Tunisia. Between September 2013 and December 2014, samples from 372 children aged between 1 month and 5 years were collected, and tested using multiplex real-time RT-PCR by a commercial assay for 21 respiratory pathogens. In addition, samples were screened for the presence of Streptococcus pneumoniae 16S rDNA using real-time PCR...
2017: PloS One
https://www.readbyqxmd.com/read/29149185/linezolid-and-atorvastatin-impact-on-pneumonia-caused-by-staphyloccocus-aureus-in-rabbits-with-or-without-mechanical-ventilation
#7
Laure-Anne Pauchard, Mathieu Blot, Rémi Bruyere, Saber-Davide Barbar, Delphine Croisier, Lionel Piroth, Pierre-Emmanuel Charles
Pneumonia may involve methicillin-resistant Staphylococcus aureus (MRSA), with elevated rates of antibiotics failure. The present study aimed to assess the effect of statins given prior to pneumonia development. Spontaneously breathing (SB) or mechanically ventilated (MV) rabbits with pneumonia received atorvastatin alone, linezolid (LNZ) alone, or a combination of both (n = 5 in each group). Spontaneously breathing and MV untreated infected animals (n = 11 in each group), as well as uninfected animals (n = 5 in each group) were used as controls...
2017: PloS One
https://www.readbyqxmd.com/read/29149111/-bilateral-bronchopneumonia-due-to-rothia-mucilaginosa
#8
B De Escalante Yangüela, A Gracia Gutiérrez, B C Gracia Tello, V A Alastrué Del Castaño, E Bueno Juana, S Algárate Cajo
Rothia mucilaginosa (R. mucilaginosa), formerly named Stomatococcus mucilaginosus, is a facultatively anaerobic, encapsulated gram-positive coccus, which forms part of the normal oropharyngeal and is rarely considered to be a pathogen in immunocompetent patients, although it can produce, on rare occasions, serious infections like bacteremia, endocarditis and respiratory infections; such as pneumonia, pleural empyema or superinfection of bronchiectasis. We present the case of a 74-year-old male diagnosed with right basal pneumonia of torpid evolution with a poor initial response to different antibiotics, with clinical and radiological worsening and the appearance of bilateral bronchopneumonia with pseudonodular images...
November 17, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/29149019/incidence-and-consequences-of-near-drowning-related-pneumonia-a-descriptive-series-from-martinique-french-west-indies
#9
Laura Cerland, Bruno Mégarbane, Hatem Kallel, Yanick Brouste, Hossein Mehdaoui, Dabor Resiere
Drowning represents one major cause of accidental death. Near-drowning patients are exposed to aspiration that may result in pneumonia with life-threatening consequences. We designed this descriptive study to investigate the frequency, nature, and consequences of post-drowning pneumonia. One hundred and forty-four near-drowning patients (33 children and 111 adults) admitted during four years to the University Hospital of Martinique, French Indies, were included. Patients presented pre-hospital cardiac arrest (41%) and exhibited acute respiratory failure (54%), cardiovascular failure (27%), and lactic acidosis (75%) on admission...
November 17, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29148920/the-unexpected-impact-of-vaccines-on-secondary-bacterial-infections-following-influenza
#10
Amber M Smith, Victor C Huber
Influenza virus infections remain a significant health burden worldwide, despite available vaccines. Factors that contribute to this include a lack of broad coverage by current vaccines and continual emergence of novel virus strains. Further complicating matters, when influenza viruses infect a host, severe infections can develop when bacterial pathogens invade. Secondary bacterial infections (SBIs) contribute to a significant proportion of influenza-related mortality, with Streptococcus pneumoniae, Staphylococcus aureus, Streptococcus pyogenes, and Haemophilus influenzae as major coinfecting pathogens...
November 17, 2017: Viral Immunology
https://www.readbyqxmd.com/read/29148723/dna-microviscosity-characterization-with-particle-diffusometry-for-downstream-dna-detection-applications
#11
Katherine Noel Clayton, Gregory D Berglund, Jacqueline C Linnes, Tamara L Kinzer-Ursem, Steven T Wereley
Analytical characterization of DNA microviscosity provides critical biophysical insights into nuclear crowding, nucleic acid-based pharmaceutical development, and nucleic acid-based biosensor device design. However, most viscosity characterization methods require large sample volumes and destructive testing. In contrast, particle diffusometry, permits in situ analysis of DNA microviscosity with short measurement times (8 seconds) using small volumes (< 3L) which are compatible with DNA preparatory procedures...
November 17, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/29148380/high-rate-of-mcr-1-producing-escherichia-coli-and-klebsiella-pneumoniae-among-pigs-portugal
#12
Nicolas Kieffer, Marta Aires-de-Sousa, Patrice Nordmann, Laurent Poirel
The mcr-1 (mobile colistin resistance 1) gene, which encodes phosphoethanolamine transferase, has been recently identified as a source of acquired resistance to polymyxins in Escherichia coli. Using the SuperPolymyxin selective medium, we prospectively screened 100 pigs at 2 farms in Portugal for polymyxin-resistant Enterobacteriaceae and recovered 98 plasmid-mediated MCR-1-producing isolates. Most isolates corresponded to nonclonally related E. coli belonging to many sequence types; we also found 2 Klebsiella pneumoniae sequence types...
December 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29148267/detection-of-teschovirus-type-13-from-two-swine-herds-exhibiting-nervous-clinical-signs-in-growing-pigs
#13
J Carnero, C Prieto, L Polledo, F J Martínez-Lobo
Recently, the number of clinical reports of growing pigs showing neurological signs possibly related to viral infections has increased. The objective of this report was to describe two outbreaks of an atypical condition observed in 6- to 7-week-old pigs with a morbidity of 20% and a fatality rate of 60% in two unrelated farms of the same company. During the acute phase of the disease, fever, sudden death, neurological signs, ear necrosis and occasional corneal opacity were observed. Histopathological examination revealed interstitial pneumonia, lymphoid depletion and lymphocytic vasculitis in different organs and mild polioencephalomyelitis suggesting a potential viral infection...
November 16, 2017: Transboundary and Emerging Diseases
https://www.readbyqxmd.com/read/29147933/aerobic-bacteriological-studies-on-the-respiratory-tracts-of-apparently-healthy-and-pneumonic-camels-camelus-dromedaries-in-selected-districts-of-afar-region-ethiopia
#14
Mu'uz Gebru, Genene Tefera, Fufa Dawo, Tesfaye Sisay Tessema
A cross-sectional study was conducted to isolate and identify bacterial species from the respiratory tract of apparently healthy and pneumonic camels in Asayita and Dubti woredas in the Afar Region, Ethiopia. From a total of 74 lung tissue and 74 tracheal swab samples Staphylococcus aureus, 16.3%, Streptococcus equi subsp. equi, 13.0%, and Pasteurella multocida, 10.9%, were dominant isolates from pneumonic lungs; Escherichia coli, 12.7%, Proteus species, 10.9%, and Klebsiella pneumoniae, 9.1%, were the majority in the normal lungs...
November 16, 2017: Tropical Animal Health and Production
https://www.readbyqxmd.com/read/29147917/recommendations-for-perioperative-management-of-lung-cancer-patients-with-comorbidities
#15
REVIEW
Hiroyoshi Tsubochi, Tomoki Shibano, Shunsuke Endo
OBJECTIVES: To improve surgical outcomes, clinicians must provide optimal perioperative care for comorbidities identified as significant factors in risk models for patients undergoing lung cancer surgery. METHODS: We reviewed trends in perioperative care for idiopathic pulmonary fibrosis, cardiovascular diseases, and end-stage renal diseases in patients undergoing lung cancer surgery, as large clinical databases indicate that these comorbidities are significant risk factors for lung cancer surgery...
November 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29147774/assessment-of-mediastinal-lymph-node-size-in-pneumococcal-pneumonia-with-bacteremia
#16
Amit Chopra, Aakash Modi, Haroon Chaudhry, Recai Yucel, Neha Rane, John Fantauzzi, Frederic J Hellwitz, Marc A Judson
INTRODUCTION: The significance of mediastinal lymphadenopathy in bacterial pneumonia is unclear. METHODS: We performed a retrospective analysis of mediastinal lymph node size determined by chest CT in patients with bacteremic pneumococcal pneumonia. All patients who had positive blood cultures for streptococcus pneumonia over an 11-year period and had a chest CT scan (index CT) within 2 weeks of the positive blood culture were included in the study. Two thoracic radiologists and one pulmonologist independently examined the index CT plus any chest CT scans performed prior (pre-CT) or after (post-CT) the bacteremic episode...
November 16, 2017: Lung
https://www.readbyqxmd.com/read/29147471/experience-with-ceftaroline-for-treatment-of-methicillin-resistant-staphylococcus-aureus-pneumonia-in-a-community-hospital
#17
Apurwa Karki, Craig Thurm, Kelly Cervellione
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an organism causing significant mortality and morbidity with nosocomial infections. Ceftaroline is a new cephalosporin antibiotic that has activity against MRSA. In the USA, this antibiotic has not been approved for use in pneumonia caused by MRSA. Objectives: To review the use of ceftaroline in MRSA pneumonia in a US hospital and evaluate its clinical success. Methods: A retrospective study was conducted in an urban community hospital assessing the use of ceftaroline for MRSA pneumonia...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29147454/late-onset-chemo-radiation-induced-tracheoesophageal-fistula-in-squamous-cell-cancer-of-the-lung
#18
Ashraf Abugroun, Fatima Ahmed, Namrata Singh, Mojtaba Nadiri
We report a 72-year-old male with past medical history of stage IV squamous lung cancer treated with radiation therapy and chemotherapy with gemcitabine/carboplatin. One year later, he presented with hemoptysis treated with another session of palliative radiotherapy. Two weeks later, patient developed aspiration pneumonia and further workup showed trachea-esophageal fistula documented by barium swallow. This case shows a rare complication of chemotherapy and radiation therapy on the setting of primary lung cancer...
October 2017: World Journal of Oncology
https://www.readbyqxmd.com/read/29147071/exhaled-nitric-oxide-is-useful-in-symptomatic-radioactive-pneumonia-a-retrospective-study
#19
Jiancheng Li, Xiaobin Fu, Jie Fu
The aim was to defect the exhaled nitric oxide (eNO) prediction value of symptomatic radioactive pneumonia (SRP). 64 cases of lung cancer or esophagus cancer, who had the primary radiotherapy (intensity-modulated radiation therapy), were included from 2015 June to 2016 January. During the following, the patients were divided: the symptomatic radiation pneumonia group (SRP, with the CTCAE v4.0 score > 2) and the asymptomatic radiation pneumonia group (ASRP, with CTCAE v4.0 score ≤ 1). All the patients were measured eNO before and at the end of thoracic radiotherapy and gain the posttherapy eNO value and the eNO ratio (posttherapy eNO value/pretherapy eNO value), then the predictive values of eNO toward SRP were measured using the receiver-operating characteristic (ROC)...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/29146662/comparative-effectiveness-of-injectable-penicillin-versus-a-combination-of-penicillin-and-gentamicin-in-children-with-pneumonia-characterised-by-indrawing-in-kenya-a-retrospective-observational-study
#20
Lucas Malla, Rafael Perera-Salazar, Emily McFadden, Mike English
OBJECTIVES: Kenyan guidelines for antibiotic treatment of pneumonia recommended treatment of pneumonia characterised by indrawing with injectable penicillin alone in inpatient settings until early 2016. At this point, they were revised becoming consistent with WHO guidance after results of a Kenyan trial provided further evidence of equivalence of oral amoxicillin and injectable penicillin. This change also made possible use of oral amoxicillin for outpatient treatment in this patient group...
November 15, 2017: BMJ Open
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