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https://www.readbyqxmd.com/read/29150897/determining-best-outcomes-from-community-acquired-pneumonia-and-how-to-achieve-them
#1
REVIEW
Jane Hadfield, Lesley Bennett
Community-acquired pneumonia (CAP) is a common acute medical illness with a standard, effective treatment that was introduced before the evidenced-based medicine era. Mortality rates have improved in recent decades but improvements have been minimal when compared to other conditions such as acute coronary syndromes. The standardized approach to treatment makes CAP a target for comparative performance and outcome measures. While easy to collect, simplistic outcomes such as mortality, readmission and length of stay are difficult to interpret as they can be affected by subjective choices and health care resources...
November 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29150377/urgent-versus-post-stabilisation-antiretroviral-treatment-in-hospitalised-hiv-infected-children-in-kenya-push-a-randomised-controlled-trial
#2
Irene N Njuguna, Lisa M Cranmer, Vincent O Otieno, Cyrus Mugo, Hellen M Okinyi, Sarah Benki-Nugent, Barbra Richardson, Joshua Stern, Elizabeth Maleche-Obimbo, Dalton C Wamalwa, Grace C John-Stewart
BACKGROUND: Urgent antiretroviral therapy (ART) among hospitalised HIV-infected children might accelerate recovery or worsen outcomes associated with immune reconstitution. We aimed to compare urgent versus post-stabilisation ART among hospitalised HIV-infected children in Kenya. METHODS: In this unmasked randomised controlled trial, we randomly assigned (1:1) HIV-infected, ART-naive children aged 0-12 years who were eligible for treatment to receive ART within 48 h (urgent group) or in 7-14 days (post-stabilisation group) at four hospitals in Kenya (two in Nairobi and two in western Kenya)...
November 14, 2017: Lancet HIV
https://www.readbyqxmd.com/read/29150371/emergence-of-polymyxin-b-resistance-in-a-polymyxin-b-susceptible-kpc-producing-klebsiella-pneumoniae-causing-bloodstream-infection-in-a-neutropenic-patient-during-polymyxin-b-therapy
#3
Alexandre P Zavascki, Raquel Girardello, Cibele M Magagnin, Laura C Antochevis, Rafael A Maciel, Jussara K Palmeiro, Ana C Gales
The emergence of resistance to polymyxins in KPC-producing Klebsiella pneumoniae isolates has been a major clinical problem. This study evaluated the molecular mechanisms associated with polymyxin B (PMB) resistance that emerged in a previously PMB-susceptible KPC-2-producing K. pneumoniae during PMB therapy for a bloodstream infection in a neutropenic patient. The first isolate (PMB-susceptible) was obtained while the patient was receiving meropenem and other isolates were recovered from 2 sets of blood cultures in different dates while the patient was receiving PMB therapy (4 of 6 blood cultures bottles yielded isolates with full PMB resistance)...
October 19, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29150336/urinary-tract-infections-in-neonates-with-unexplained-pathological-indirect-hyperbilirubinemia-prevalence-and-significance
#4
Elif Bahat Ozdogan, Mehmet Mutlu, Secil Arslansoyu Camlar, Gülcin Bayramoglu, Sebnem Kader, Yakup Aslan
BACKGROUND: It is controversial to test for urinary tract infection (UTI) in patients with unexplained indirect hyperbilirubinemia in the first 2 weeks of life. We aimed to study the prevalence and significance of UTIs in such neonates who were requiring phototherapy. METHODS: Subjects were 2- to 14-day-old neonates with indirect bilirubin levels above phototherapy limit with no other abnormality in their bilirubinaemia-related etiologic workup. UTI was diagnosed by 2 consecutive positive cultures obtained by catheterisation, documenting growth of >10,000 colonies of the same microorganism with consistent antibiograms...
October 28, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29149965/comparision-of-ureteral-stent-colonization-between-deceased-and-live-donor-renal-transplant-recipients
#5
M Sarier, D Seyman, S Tekin, I Duman, B Uygun, M Demir, E Kukul, A H Yavuz
BACKGROUND: The use of a ureteral stent can cause a urinary tract infection (UTI), although it reduces urologic complications. UTIs are associated with a higher rate of ureteral stent colonization (USC). The aim of this study was to compare USC in living and deceased donor renal transplant recipients. MATERIAL AND METHODS: We conducted a prospective study of 48 patients who underwent renal transplantation between January and December 2016. The stents were removed aseptically, the inner surface of proximal and distal ends of stents were irrigated with liquid culture medium, and then they were vortexed for bacteriological investigation...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149880/analytical-performance-of-envisia-a-genomic-classifier-for-usual-interstitial-pneumonia
#6
Yoonha Choi, Jiayi Lu, Zhanzhi Hu, Daniel G Pankratz, Huimin Jiang, Manqiu Cao, Cristina Marchisano, Jennifer Huiras, Grazyna Fedorowicz, Mei G Wong, Jessica R Anderson, Edward Y Tom, Joshua Babiarz, Urooj Imtiaz, Neil M Barth, P Sean Walsh, Giulia C Kennedy, Jing Huang
BACKGROUND: Clinical guidelines specify that diagnosis of interstitial pulmonary fibrosis (IPF) requires identification of usual interstitial pneumonia (UIP) pattern. While UIP can be identified by high resolution CT of the chest, the results are often inconclusive, making surgical lung biopsy necessary to reach a definitive diagnosis (Raghu et al., Am J Respir Crit Care Med 183(6):788-824, 2011). The Envisia genomic classifier differentiates UIP from non-UIP pathology in transbronchial biopsies (TBB), potentially allowing patients to avoid an invasive procedure (Brown et al...
November 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29149805/observational-cohort-study-safety-outcomes-in-children-using-proton-pump-inhibitors-or-histamine-2-receptor-antagonists
#7
Eline Houben, Saga Johansson, Péter Nagy, Fernie J A Penning-van Beest, Ernst J Kuipers, Ron M C Herings
OBJECTIVE: Acid suppression with histamine-2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs) is recommended for children with persistent gastroesophageal reflux disease symptoms. In this retrospective, observational postauthorization study, we aimed to assess and compare safety outcomes in pediatric first-time users of esomeprazole, other PPIs, or H2RAs. METHODS: Data on children (aged 0-18 years) first dispensed esomeprazole, other PPIs, or H2RAs between September 2008 and August 2011 were obtained from the Dutch PHARMO Database Network...
November 17, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29149418/randomized-multicenter-trial-of-lateral-trendelenburg-versus-semirecumbent-body-position-for-the-prevention-of-ventilator-associated-pneumonia
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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