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https://www.readbyqxmd.com/read/29768465/stopping-the-effective-non-fluoroquinolone-antibiotics-at-day-7-vs-continuing-until-day-14-in-adults-with-acute-pyelonephritis-requiring-hospitalization-a-randomized-non-inferiority-trial
#1
Pavankumar Rudrabhatla, Surendran Deepanjali, Jharna Mandal, Rathinam Palamalai Swaminathan, Tamilarasu Kadhiravan
OBJECTIVE: To evaluate whether stopping the effective antibiotic treatment following clinical improvement at Day 7 (Truncated treatment) would be non-inferior to continued treatment until Day 14 (Continued treatment) in patients with acute pyelonephritis (APN) requiring hospitalization treated with non-fluoroquinolone (non-FQ) antibiotics. METHODS: Hospitalized adult men and non-pregnant women with culture-confirmed APN were eligible for participation after they had clinically improved following empirical or culture-guided treatment with intravenous non-FQ antibiotic(s)...
2018: PloS One
https://www.readbyqxmd.com/read/29768131/a-new-scoring-system-to-predict-blood-stream-infections-in-patients-with-complicated-intra-abdominal-infections-experience-from-a-tertiary-referral-hospital-in-china
#2
Jinjian Huang, Jianan Ren, Luise Brakert, Jiao Jiao, Qinjie Liu, Gefei Wang, Xiuwen Wu, Steven W M Olde Damink
BACKGROUND: This purpose of this study was to investigate the effects of blood stream infections (BSIs) on the prognosis of patients with complicated intra-abdominal infections (IAIs) and to make predictions based on patients' characteristics on admission. PATIENTS AND METHODS: One hundred eighty-seven patients with complicated IAI in 2014 and 2015 were included in our retrospective analysis, except for those diagnosed with central line-associated blood stream infections (CLABSIs)...
May 2018: Surgical Infections
https://www.readbyqxmd.com/read/29766208/-adequate-anti-infective-treatment-importance-of-individual-dosing-and-application
#3
A Brinkmann, A C Röhr, A Köberer, T Fuchs, W A Krüger, C König, D Richter, M A Weigand, O R Frey
Sepsis-induced changes in pharmacokinetic parameters are a well-known problem in intensive care medicine. Dosing of antibiotics in this setting is therefore challenging. Alterations to the substance-specific kinetics of anti-infective substances have an effect on the distribution and excretion processes in the body. Increased clearance and an increased distribution volume (Vd ) and particularly compromized organ function with reduced antibiotic elimination are often encountered in patients with sepsis. Renal replacement treatment, which is frequently used in intensive care medicine, represents a substantial intervention in this system...
May 15, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29764503/bacteriological-profile-of-neonatal-sepsis-and-antibiotic-susceptibility-pattern-of-isolates-admitted-at-kanti-children-s-hospital-kathmandu-nepal
#4
Nikita Singh Yadav, Saroj Sharma, Dhiraj Kumar Chaudhary, Prabhat Panthi, Pankaj Pokhrel, Anil Shrestha, Pappu Kumar Mandal
OBJECTIVE: Neonatal sepsis is a major cause of morbidity and mortality of newborns (< 1 month of age). Septicemia and drug resistance is a predominant issue for neonatal death in Nepal. This study is intended to find bacteriological profile of neonatal sepsis and antibiotic susceptibility pattern of the isolates from neonates at Kanti Children's Hospital, Kathmandu, Nepal. RESULTS: Out of 350 suspected cases of neonatal sepsis, 59 (16.9%) cases showed positive blood culture...
May 15, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29763753/a-prospective-study-of-cancer-survivors-and-risk-of-sepsis-within-the-regards-cohort
#5
Justin Xavier Moore, Tomi Akinyemiju, Alfred Bartolucci, Henry E Wang, John Waterbor, Russell Griffin
BACKGROUND: Hospitalized cancer patients are nearly 10 times more likely to develop sepsis when compared to patients with no cancer history. We compared the risk of sepsis between cancer survivors and no cancer history participants, and examined whether race was an effect modifier. METHODS: We performed a prospective analysis of data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We categorized participants as "cancer survivors" or "no cancer history" derived from self-reported responses of being diagnosed with any cancer, excluding non-melanoma skin cancer...
May 11, 2018: Cancer Epidemiology
https://www.readbyqxmd.com/read/29763469/rapid-diagnosis-of-bloodstream-infections-in-the-critically-ill-evaluation-of-the-broad-range-pcr-esi-ms-technology
#6
Martina Tassinari, Silvia Zannoli, Patrizia Farabegoli, Maria Federica Pedna, Anna Pierro, Antonio Mastroianni, Riccardo Fontan, Luciano Luongo, Giuseppe Sarnataro, Elisa Menegatti, Assunta Caruso, Vittorio Sambri
Bloodstream infection (BSI) and associated sepsis represent a major source of mortality in industrialized countries. Prompt treatment with targeted antibiotics affects both the financial impact and the clinical outcome of BSI: every hour gained in initiating the correct antimicrobial therapy significantly increases the probability of patient survival. However, the current standard-of-care, which depends on blood culture-based diagnosis, are often unable to provide such a fast response. Fast and sensitive molecular techniques for the detection of sepsis-related pathogens from primary blood samples are strongly needed...
2018: PloS One
https://www.readbyqxmd.com/read/29761674/screening-arab-israeli-pregnant-women-for-group-b-streptococcus-by-the-amplivue-gbs-assay-are-the-rates-higher-than-the-national-average
#7
Marwan Hakim, Adel Jabour, Miriam Anton, Meggie Hakim, Sahar Kheirallah
BACKGROUND: The recommendation of the U.S. Centers for Disease Control and Prevention regarding universal screening for Group B Streptococcus (GBS) at 35-37 weeks gestational age in pregnancy is not accepted in Israel. The National Council for Obstetrics, Neonatology and Genetics recommends intrapartum prophylaxis, mainly based on risk factors, to prevent early neonatal GBS infection. This policy is based on past studies demonstrating low colonization rates of the bacteria in Israeli pregnant women and very low neonatal sepsis rates...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29756282/acute-arthritis-predictive-factors-and-current-practice-in-the-approach-to-diagnosis-and-management-across-two-hospitals-in-sydney
#8
Katrina Pavic, Jay Pandya, Sophie Sebak, Amith Shetty, David Spencer, N Nicholas Manolios
BACKGROUND: Literature pertaining to the predictive factors for septic arthritis is limited. AIMS: The primary objective was to investigate the predictive factors for septic arthritis. The secondary objectives were to investigate the predictive factors for crystal arthritis and to explore current practises in the management of acute arthritis. METHODS: A retrospective analysis was undertaken. All patients with an acute arthritis who underwent a joint aspiration for diagnostic and management purposes were considered for inclusion...
May 14, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29756072/managing-antibiotics-wisely-a-quality-improvement-programme-in-a-tertiary-neonatal-unit-in-the-uk
#9
Vasiliki Makri, Gemma Davies, Stephanie Cannell, Katherine Willson, Lucy Winterson, Joanna Webb, Amit Kandhari, Maha Mansour, Joanne Thomas, Geraint Morris, Jean Matthes, Sujoy Banerjee
Microbial resistance to antibiotics is a serious global health problem compounded by antibiotic overuse and limited investment in new antibiotic research. Inappropriate perinatal antibiotic exposure is increasingly linked to lifelong adverse outcomes through its impact on the developing microbiome. Antibiotic stewardship may be the only effective preventative strategy currently available. As the first tertiary neonatal unit in the UK to collaborate in an international quality improvement programme (QIP) with Vermont Oxford Network (VON), we present the results of our antibiotic stewardship initiative...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29753570/xanthogranulomatous-pyelonephritis-a-complicated-febrile-urinary-tract-infection-detected-by-point-of-care-ultrasound-in-the-emergency-department
#10
Ryan Gibbons, Nicole Leonard, Mark Magee, Allison Zanaboni, Jessica Patterson, Thomas Costantino
BACKGROUND: Febrile urinary tract infections (UTIs) include a spectrum of pathologies from uncomplicated pyelonephritis to urosepsis, including xanthogranulomatous pyelonephritis (XGP). Most febrile UTIs are treated with antibiotics alone, but studies indicate nearly 12% of cases of presumed simple pyelonephritis require emergent urologic intervention. How to identify these individuals, while limiting unnecessary advanced imaging and delays in diagnosis, challenges all emergency providers...
May 9, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#11
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29751120/evaluation-of-a-risk-guided-strategy-for-empiric-carbapenem-use-in-febrile-neutropenia
#12
Ai Leng Khoo, Ying Jiao Zhao, Monica Teng, Ding Ying, Jing Jin, Yen Lin Chee, Li Mei Poon, Siew Eng Lim, Liang Piu Koh, Wee Joo Chng, Boon Peng Lim, Li Yang Hsu, Louis Yi Ann Chai
Febrile neutropenia (FN) is associated with substantial morbidity and necessitate empiric broad spectrum antibiotic treatment. We evaluated a risk-guided FN management strategy using empiric piperacillin-tazobactam and carbapenem in a prospective cohort study. The analysis involved 723 FN episodes in hospitalised adult patients, including those with severe sepsis or prior infection/colonisation with extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. Propensity score matching analysis was used to adjust for baseline differences between treatment groups and produced 267 matched pairs...
May 8, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29750801/streptococcus-agalactiae-carriage-among-pregnant-women-living-in-rio-de-janeiro-brazil-over-a-period-of-eight-years
#13
Ana Caroline N Botelho, Juliana G Oliveira, Andreia P Damasco, Késia T B Santos, Ana Flávia M Ferreira, Gabriel T Rocha, Penélope S Marinho, Rita B G Bornia, Tatiana C A Pinto, Marco A Américo, Sergio E L Fracalanzza, Lúcia M Teixeira
Group B Streptococcus (GBS) carriage by pregnant women is the primary risk factor for early-onset GBS neonatal sepsis. Intrapartum antibiotic prophylaxis (IAP) can prevent this transmission route, and two main approaches are recommended to base the selection of pregnant women to be submitted to IAP: the risk-based and the culture-based strategies. In Brazil, compliance to such recommendations is poor, and not much is known about GBS carriage. In the present study, 3,647 pregnant women living in Rio de Janeiro State, Brazil, were screened for GBS anogenital colonization, over a period of 8 years (2008-2015)...
2018: PloS One
https://www.readbyqxmd.com/read/29746564/multiple-bacterial-infections-increase-the-risk-of-hepatic-encephalopathy-in-patients-with-cirrhosis
#14
Lan-Ting Yuan, Seng-Kee Chuah, Shih-Cheng Yang, Chih-Ming Liang, Cheng-Kun Wu, Wei-Chen Tai, Tsung-Hsing Hung, Seng-Howe Nguang, Jiunn-Wei Wang, Kuo-Lun Tseng, Ming-Kun Ku, Pin-I Hsu, Deng-Chyang Wu, Chien-Ning Hsu
OBJECTIVE: Patients with liver cirrhosis (LC) are at increased risk for bacterial infections. It is not fully understood how exposure to infections induces further development of hepatic encephalopathy (HE). This study estimated risks of infection associated with HE among patients with LC. METHODS: A nested case-control study of 14,428 adult patients with LC was performed using the population-based Longitudinal Health Insurance Database 2000 in Taiwan. Cases were cirrhotic patients who developed HE during follow-up...
2018: PloS One
https://www.readbyqxmd.com/read/29742943/comparison-between-presepsin-and-procalcitonin-in-early-diagnosis-of-neonatal-sepsis
#15
Agustin Iskandar, Maimun Z Arthamin, Kristin Indriana, Muhammad Anshory, Mina Hur, Salvatore Di Somma
BACKGROUND: Neonatal sepsis remains worldwide one of the leading causes of morbidity and mortality in both term and preterm infants. Lower mortality rates are related to timely diagnostic evaluation and prompt initiation of empiric antibiotic therapy. Blood culture, as gold standard examination for sepsis, has several limitations for early diagnosis, so that sepsis biomarkers could play an important role in this regard. This study was aimed to compare the value of the two biomarkers presepsin and procalcitonin in early diagnosis of neonatal sepsis...
May 9, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29742584/predictive-validity-of-sepsis-3-definitions-and-sepsis-outcomes-in-critically-ill-patients-a-cohort-study-in-49-icus-in-argentina
#16
Elisa Estenssoro, Vanina S Kanoore Edul, Cecilia I Loudet, Javier Osatnik, Fernando G Ríos, Daniela N Vázquez, Mario O Pozo, Bernardo Lattanzio, Fernando Pálizas, Francisco Klein, Damián Piezny, Paolo N Rubatto Birri, Graciela Tuhay, Anatilde Díaz, Analía Santamaría, Graciela Zakalik, Arnaldo Dubin
OBJECTIVES: The new Sepsis-3 definitions have been scarcely assessed in low- and middle-income countries; besides, regional information of sepsis outcomes is sparse. Our objective was to evaluate Sepsis-3 definition performance in Argentina. DESIGN: Cohort study of 3-month duration beginning on July 1, 2016. SETTINGS: Forty-nine ICUs. PATIENTS: Consecutive patients admitted to the ICU with suspected infection that triggered blood cultures and antibiotic administration...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742468/native-septic-arthritis-is-not-an-immediate-surgical-emergency
#17
Nicolas Lauper, Marie Davat, Ergys Gjika, Camillo Müller, Wilson Belaieff, Didier Pittet, Benjamin A Lipsky, Didier Hannouche, Ilker Uçkay
Acute native joint septic arthritis is generally considered a surgical emergency, requiring drainage within hours, including during night, weekend or holiday shifts. However, there are few data supporting the need for the disruption caused by this degree of urgency. METHODS: We performed a retrospective review of all adult patients seen in our medical center from 1997-2015 with culture-proven septic arthritis and noted the epidemiology of sequelae, and their possible association with a delay in surgical drainage...
May 6, 2018: Journal of Infection
https://www.readbyqxmd.com/read/29740793/immune-checkpoint-receptors-homeostatic-regulators-of-immunity
#18
REVIEW
Antonio Riva, Shilpa Chokshi
Alcoholic liver disease (ALD) is an escalating global problem accounting for more than 3 million deaths annually. Bacterial infections are diagnosed in 25-47% of hospitalized patients with cirrhosis and represent the most important trigger for acute decompensation, multi-organ failure, septic shock and death. Current guidelines recommend intensive antibiotic therapy, but this has led to the emergence of multi-drug resistant bacteria, which are associated with increased morbidity and mortality rates. As such, there is a pressing need to explore new paradigms for anti-infective therapy and host-directed immunomodulatory therapies are a promising approach...
May 8, 2018: Hepatology International
https://www.readbyqxmd.com/read/29740065/comparison-of-first-line-and-second-line-terlipressin-versus-sole-norepinephrine-in-fulminant-ovine-septic-shock
#19
Tim G Kampmeier, Philip H Arnemann, Michael Hessler, Laura M Seidel, Karsten Becker, Andrea Morelli, Sebastian W Rehberg, Christian Ertmer
The Surviving Sepsis Guidelines suggest the use of vasopressin in case of catecholamine-refractory septic shock. Terlipressin (TP) as a V1 -selective AVP analogue is a potential alternative, though data regarding the first-line administration in septic shock are scarce. The present study explored and compared the effects of first-line vs. second-line infusion of TP or sole norepinephrine regarding organ function, fluid and norepinephrine requirements and survival in fulminant ovine septic shock. Peritoneal sepsis was induced in 23 ewes after laparotomy and faecal withdrawal from the caecum...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29736287/acute-parotitis-after-lower-limb-amputation-a-case-report-of-a-rare-complication
#20
Konstantinos Ioannis Avgerinos, Nikolaos Degermetzoglou, Sofia Theofanidou, Georgia Kritikou, Ioannis Bountouris
Background: Postoperative parotitis is a rare complication that occurs usually after abdominal surgery. Parotitis has never been described as a complication of vascular operations, in literature. In the present article, we describe a case of a postamputation parotitis along with its management and its possible pathogenesis. Case Report: An 83-year-old diabetic man was emergently admitted to hospital because of gangrene below the right ankle and sepsis. The patient underwent a lower limb amputation above the knee...
2018: Case Reports in Otolaryngology
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