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https://www.readbyqxmd.com/read/29615158/reduction-in-central-line-associated-bloodstream-infections-in-a-nicu-practical-lessons-for-its-achievement-and-sustainability
#1
Judith A Hawes, Kyong-Soon Lee
Central venous catheters are commonly used for the provision of parenteral nutrition and medications for critically ill neonates in the NICU. However, central line-associated bloodstream infections (CLABSIs) are a major complication associated with their use and remain an important cause of nosocomial sepsis in NICUs. Central line-associated bloodstream infection has shifted from being an expected routine complication of central line use to an adverse event now evaluated as a critical event with the goal of identifying root causes so future CLABSI events are prevented...
March 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29602480/-tunnelled-central-venous-catheter-infection-during-treatment-with-epoprostenol
#2
M Koszutski, M Faure, A Guillaumot, E Gomez, M Mercy, F Chabot, A Chaouat
INTRODUCTION: Pulmonary arterial hypertension is a pulmonary vascular disease with a poor prognosis. Continuous intravenous treatment with prostacyclin analogues requires the placement of a tunnelled catheter. The occurrence of catheter-related infections in this context is unusual due to the alkaline pH of the prostacyclin analogue solutions. OBSERVATION: A 50-year-old patient with inherited pulmonary artery hypertension, treated with bosentan, sildenafil and epoprostenol, experienced generalized malaise associated with a weight loss of 9kg over a 12-month period without evidence of a source of infection or malignancy...
March 28, 2018: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29514546/efficacy-and-safety-of-peripherally-inserted-central-venous-catheters-in-acute-cardiac-care-management
#3
Fabrizio Poletti, Claudio Coccino, Davide Monolo, Paolo Crespi, Giorgio Ciccioli, Giuseppe Cordio, Giovanni Seveso, Stefano De Servi
PURPOSE: Patients admitted to cardiac intensive care unit need administration of drugs intravenously often in concomitance of therapeutic techniques such as non-invasive ventilation, continuous renal replacement therapy and intra-aortic balloon counterpulsation. Therefore, the insertion of central venous catheters provides a reliable access for delivering medications, laboratory testing and hemodynamic monitoring, but it is associated with the risk of important complications. In our study, we tested the efficacy and safety of peripherally inserted central catheters to manage cardiac intensive care...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29512818/antibiotics-at-the-time-of-removal-of-central-venous-catheter-to-reduce-morbidity-and-mortality-in-newborn-infants
#4
REVIEW
Rowena L McMullan, Adrienne Gordon
BACKGROUND: Late-onset sepsis is associated with increased rates of mortality and morbidity in newborn infants, in addition to poorer long-term developmental outcomes and increased length of stay and hospital costs. Central line-associated blood stream infection (CLABSI) is the most common cause of late-onset sepsis in hospitalised infants, and prevention of CLABSI is a key objective in neonatal care. Increased frequency of CLABSI around the time of removal of central venous catheters (CVCs) has been reported, and use of antibiotics at the time of removal may reduce the incidence and impact of late-onset sepsis in vulnerable newborn infants...
March 7, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29506150/pharmacokinetics-of-piperacillin-in-critically-ill-patients-with-acute-kidney-injury-receiving-sustained-low-efficiency-diafiltration
#5
Mahipal G Sinnollareddy, Michael S Roberts, Jeffrey Lipman, Sandra L Peake, Jason A Roberts
Background: Piperacillin is a β-lactam penicillin antibiotic commonly used for the empirical therapy of sepsis and other hospital-acquired infections. However, knowledge regarding the effect of sustained low-efficiency diafiltration (SLED-f), a technique increasingly being used in ICUs, on piperacillin pharmacokinetics (PK) and dosing in critically ill patients is lacking. Objectives: To describe the PK of piperacillin during SLED-f and compare the results with those reported for other forms of renal replacement therapies...
March 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29470531/epidemiology-and-risk-factors-of-extensively-drug-resistant-pseudomonas-aeruginosa-infections
#6
Nattawan Palavutitotai, Anupop Jitmuang, Sasima Tongsai, Pattarachai Kiratisin, Nasikarn Angkasekwinai
BACKGROUND: The incidence of nosocomial infections from extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) has been increasing worldwide. We investigated the prevalence and factors associated with XDR-PA infections, including the factors that predict mortality. METHODS: We retrospectively studied a cohort of adult, hospitalized patients with P. aeruginosa (PA) infections between April and December 2014. RESULTS: Of the 255 patients with PA infections, 56 (22%) were due to XDR-PA, 32 (12...
2018: PloS One
https://www.readbyqxmd.com/read/29432818/differential-time-to-positivity-of-central-and-peripheral-blood-cultures-is-inaccurate-for-the-diagnosis-of-staphylococcus-aureus-long-term-catheter-related-sepsis
#7
H Bouzidi, A Emirian, A Marty, E Chachaty, A Laplanche, B Gachot, F Blot
OBJECTIVES: Differential time to positivity of cultures of blood drawn simultaneously from central venous catheter and peripheral sites is widely used to diagnose catheter-related bloodstream infections without removing the catheter. However, the accuracy of this technique for some pathogens, such as Staphylococcus aureus, is debated in routine practice. METHODS: In a 320-bed reference cancer centre, the charts of patients with at least one blood culture positive for S...
February 10, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29274029/endovascular-stent-based-revascularization-of-malignant-superior-vena-cava-syndrome-with-concomitant-implantation-of-a-port-device-using-a-dual-venous-approach
#8
Susanne Anton, T Oechtering, E Stahlberg, F Jacob, M Kleemann, J Barkhausen, J P Goltz
PURPOSE: The aim of this paper is to evaluate the safety and efficacy of endovascular revascularization of malignant superior vena cava syndrome (SVCS) and simultaneous implantation of a totally implantable venous access port (TIVAP) using a dual venous approach. MATERIALS AND METHODS: Retrospectively, 31 patients (mean age 67 ± 8 years) with malignant CVO who had undergone revascularization by implantation of a self-expanding stent into the superior vena cava (SVC) (Sinus XL®, OptiMed, Germany; n = 11 [Group1] and Protégé ™ EverFlex, Covidien, Ireland; n = 20 [Group 2]) via a transfemoral access were identified...
December 22, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29248382/risk-factors-for-nosocomial-infections-after-cardiac-surgery-in-newborns-with-congenital-heart-disease
#9
Heladia García, Beatriz Cervantes-Luna, Héctor González-Cabello, Guadalupe Miranda-Novales
BACKGROUND: Congenital heart diseases are among the most common congenital malformations. Approximately 50% of the patients with congenital heart disease undergo cardiac surgery. Nosocomial infections (NIs) are the main complications and an important cause of increased morbidity and mortality associated with congenital heart diseases. This study's objective was to identify the risk factors associated with the development of NIs after cardiac surgery in newborns with congenital heart disease...
November 23, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29212442/impact-of-inappropriate-antifungal-therapy-according-to-current-susceptibility-breakpoints-on-candida-bloodstream-infection-mortality-a-retrospective-analysis
#10
María Fernanda González-Lara, Pedro Torres-González, Patricia Cornejo-Juárez, Consuelo Velázquez-Acosta, Areli Martinez-Gamboa, Andrea Rangel-Cordero, Miriam Bobadilla-Del-Valle, Luis Ostrosky-Zeichner, Alfredo Ponce-de-León, José Sifuentes-Osornio
BACKGROUND: The mortality of Candida Bloodstream Infection (CBSI) remains high. Antifungal susceptibility breakpoints were recently updated for Candida species, the impact remains unknown. In this study we evaluated the impact of inappropriate antifungal treatment according to recent breakpoints on 30-day mortality of CBSI. METHODS: From June 2008 to July 2014, data on CBSI episodes from two tertiary-care centers, treated > 72 h were analyzed. Antifungal therapy and 30-day mortality were registered...
December 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29168373/kocuria-kristinae-caused-sepsis-in-an-infant-with-congenital-tufting-enteropathy
#11
Malik Aydin, Rainer Ganschow, Martin Jankofsky
Aydin M, Ganschow R, Jankofsky M. Kocuria kristinae-caused sepsis in an infant with congenital tufting enteropathy. Turk J Pediatr 2017; 59: 93-96. Congenital tufting enteropathy (CTE) is characterized by the early-onset of chronic diarrhea and the inability to develop. It is a rare congenital disease with a low prevalence of 1:50,000 - 100,000 live births p.a. The histopathology is characterized by villous atrophy and the characteristic epithelial tufts. Recent identification of causative mutations in EpCAM has enhanced our understanding of this disease...
2017: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/29148007/how-to-treat-arteriovenous-graft-infection-total-versus-partial-graft-excision
#12
Suh Min Kim, Seung-Kee Min, Sanghyun Ahn, Sang-Il Min, Jongwon Ha, Jung Kee Chung
INTRODUCTION: Arteriovenous graft (AVG) infection can result in life-threatening sepsis and loss of vascular access. A retrospective study was performed to establish an appropriate treatment strategy for AVG infection. METHODS: A total of 50 cases of AVG infection were treated between January 2005 and June 2016. The surgical methods used were total graft excision (TGE) (n = 34), or partial graft excision (PGE) with interposition graft (n = 16). RESULTS: Infection was noted at a puncture site (n = 22), a prior incision for surgery or endovascular therapy (n = 20), and abandoned (currently unused) grafts (n = 5)...
March 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29046259/assessing-the-impact-of-quality-improvement-measures-on-catheter-related-blood-stream-infections-and-catheter-salvage-experience-from-a-national-intestinal-failure-unit
#13
A Bond, A Teubner, M Taylor, C Cawley, A Abraham, M Dibb, P R Chadwick, M Soop, G Carlson, S Lal
BACKGROUND & AIMS: Prevention of catheter related blood stream infections (CRBSI) and salvage of infected central venous catheters (CVC) are vital to maintaining long term venous access in patients needing home parenteral nutrition (HPN). It remains unclear as to whether patients are best trained for catheter care at home or in hospital or whether CRBSIs are lower if the patient self-cares for the CVC. Furthermore, there is minimal data on the longer term outcome following salvage of infected catheter and limited consensus on agreed protocols for catheter salvage...
October 10, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28977087/complications-of-central-venous-catheter-insertion-in-a-teaching-hospital
#14
Pedro Henrique Comerlato, Taiane Francieli Rebelatto, Felipe Augusto Santiago de Almeida, Luiza Birck Klein, Marcio Manozzo Boniatti, Beatriz D Schaan, Dimitris Varvaki Rados
INTRODUCTION: Central venous catheters are fundamental to daily clinical practice. This procedure is mainly performed by residents, often without supervision or structured training. OBJECTIVE: To describe the characteristics of central venous catheterization and the complication rate related to it. METHOD: Retrospective cohort study. Adult patients undergoing central venous catheter insertion out of the intensive care unit (ICU) of a teaching hospital were selected from March 2014 to February 2015...
July 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28975040/small-volume-plasma-exchange-for-guillain-barr%C3%A3-syndrome-in-resource-poor-settings-a-safety-and-feasibility-study
#15
Md Badrul Islam, Zhahirul Islam, Shafiqur Rahman, Hubert P Endtz, Margreet C Vos, Mathieu van der Jagt, Pieter A van Doorn, Bart C Jacobs, Quazi D Mohammad
BACKGROUND: In Bangladesh, most patients with Guillain-Barré syndrome (GBS) cannot afford standard treatment with intravenous immunoglobulin (IVIG) or a standard plasma exchange (PE) course, which partly explains the high rate of mortality and residual disability associated with GBS in this country. Small volume plasma exchange (SVPE) is an affordable and potentially effective alternative form of plasma exchange. SVPE is the repeated removal of small volumes of supernatant plasma over several days via sedimentation of patient whole blood...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28950719/evaluation-of-thromboelastometry-in-sepsis-in-correlation-with-bleeding-during-invasive-procedures
#16
Pavel Lukas, Miroslav Durila, Jakub Jonas, Tomas Vymazal
Prolongation of prothrombin time (PT) is often encountered in patients with sepsis. On the other hand, thromboelastometry as a global coagulation test might yield normal results. The aim of our study was to evaluate whether prolonged PT in the presence of normal thromboelastometry parameters is associated with severe bleeding in patients with sepsis undergoing invasive procedures. In patients with sepsis undergoing low-risk bleeding invasive procedures (central venous catheter placement, dialysis catheter insertion, drain insertion, and so on) or high-risk bleeding invasive procedures (surgical tracheostomy, surgical laparotomy, thoracotomy, and so on), coagulation was assessed by thromboelastometry using EXTEM test (test for evaluation of the extrinsic pathway of coagulation, contains activator of extrinsic pathway) and with PT...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28904808/intracardiac-fistula-an-unusual-complication-of-catheter-related-blood-stream-infection
#17
Abhilash Koratala, Hussain Aboud, Robert Gibson, Karen K Hamilton
In end stage renal disease patients on dialysis, the use of catheter as a vascular access is associated with a significant risk of sepsis compared to an arterio-venous fistula. Our case emphasizes the importance of having high index of suspicion for unusual complications in patients presenting with possible catheter-related blood stream infection and early use of complementary tools such as trans-oesophageal echocardiography whenever applicable.
September 2017: JRSM Open
https://www.readbyqxmd.com/read/28854516/risk-of-morbidity-following-catheter-removal-among-neonates-with-catheter-associated-bloodstream-infection
#18
J S Garland, S Kanneberg, K A Mayr, D M Porter, A Vanden Heuvel, J Kurziak, T L McAuliffe
OBJECTIVE: We hypothesized that infectious morbidities following percutaneously inserted central venous catheter (PICC) removal would be greater among neonates with central-line associated bloodstream infection (CLBASI). STUDY DESIGN: This retrospective cohort study, included all neonates who required a PICC over a ten-year period. Outcomes assessed following PICC removal included: late bloodstream infection, rule-out sepsis workups, need for a subsequent PICC and antibiotic days and PICC days after PICC removal...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28807426/clinical-usefulness-of-catheter-drawn-blood-samples-and-catheter-tip-cultures-for-the-diagnosis-of-catheter-related-bloodstream-infections-in-neonatology-a-systematic-review
#19
REVIEW
Janita Ferreira, Paulo Augusto Moreira Camargos, Wanessa Trindade Clemente, Roberta Maia de Castro Romanelli
OBJECTIVES: Neonatal sepsis is the most frequent health care-associated infection in neonatal units. This study aimed to analyze articles on the clinical usefulness of catheter-drawn blood samples and catheter tip cultures for the diagnosis of intravascular catheter-related bloodstream infection (CRBSI) in neonates. METHODS: A systematic search was performed for studies published from 1987-2017, without language restriction. Observational studies carried out in neonates with CRBSI diagnosed using catheter-drawn blood samples or catheter tip cultures were included...
January 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/28790011/management-of-septic-shock-in-intermediate-care-unit
#20
Eric Meaudre, Cédric Nguyen, Claire Contargyris, Ambroise Montcriol, Erwan d'Aranda, Pierre Esnault, Mourad Bensalah, Bertrand Prunet, Julien Bordes, Philippe Goutorbe
BACKGROUND: While guidelines advocate goal-directed resuscitation based on timed bundles, the management of septic shock (SS) outside an ICU setting has been poorly studied in intermediate care units (IMCU). PATIENTS AND METHOD: We reviewed all cases of septic shock patients admitted to our IMCU between January 2013 and June 2014. The characteristics of sepsis, compliance of bundles, and outcomes were collected. The IMCU population was compared with the SS patients admitted to the ICU during the same period...
April 2018: Anaesthesia, Critical Care & Pain Medicine
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