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https://www.readbyqxmd.com/read/29747905/prospective-evaluation-of-the-management-of-urinary-tract-infections-in-134-french-nursing-homes
#1
L Lemoine, C Dupont, A Capron, E Cerf, M Yilmaz, D Verloop, K Blanckaert, E Senneville, S Alfandari
OBJECTIVE: Prospective assessment of the management of urinary tract infections (UTI) in the nursing homes of the Hauts-de-France region. PATIENTS AND METHODS: A 50-question form had to be filled in for up to five consecutive residents treated for UTI in each nursing home. If necessary, diagnoses were reclassified according to the 2014 French Infectious Diseases Society guidelines. Analyses were presented per supposed (reported) and reclassified diagnoses. RESULTS: Of 397 contacted facilities, 134 participated and informed 444 UTI episodes...
May 7, 2018: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29740793/immune-checkpoint-receptors-homeostatic-regulators-of-immunity
#2
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/29722334/antibiotics-de-escalation-in-the-treatment-of-ventilator-associated-pneumonia-in-trauma-patients-a-retrospective-study-on-propensity-score-matching-method
#3
Hu Li, Chun-Hui Yang, Li-Ou Huang, Yu-Hui Cui, Dan Xu, Chun-Rong Wu, Jian-Guo Tang
Background: Antimicrobial de-escalation refers to starting the antimicrobial treatment with broad-spectrum antibiotics, followed by narrowing the drug spectrum according to culture results. The present study evaluated the effect of de-escalation on ventilator-associated pneumonia (VAP) in trauma patients. Methods: This retrospective study was conducted on trauma patients with VAP, who received de-escalation therapy (de-escalation group) or non-de-escalation therapy (non-de-escalation group)...
May 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29722052/the-methodological-quality-of-guidelines-for-hospital-acquired-pneumonia-and-ventilator-associated-pneumonia-a-systematic-review
#4
REVIEW
R Ambaras Khan, Z Aziz
WHAT IS KNOWN AND OBJECTIVES: Clinical practice guidelines serve as a framework for physicians to make decisions and to support best practice for optimizing patient care. However, if the guidelines do not address all the important components of optimal care sufficiently, the quality and validity of the guidelines can be reduced. The objectives of this study were to systematically review current guidelines for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), evaluate their methodological quality and highlight the similarities and differences in their recommendations for empirical antibiotic and antibiotic de-escalation strategies...
May 2, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29719873/ward-round-template-enhancing-patient-safety-on-ward-rounds
#5
Niall Gilliland, Natalie Catherwood, Shaouyn Chen, Peter Browne, Jacob Wilson, Helena Burden
Introduction and aims: Concerns had been raised at clinical governance regarding the safety of our inpatient ward rounds with particular reference to: documentation of clinical observations and National Early Warning Score (NEWS), compliance with Trust guidance for venous thromboembolism (VTE) risk assessment, antibiotic stewardship, palliative care and treatment escalation plans (TEP). This quality improvement project was conceived to ensure these parameters were considered and documented during the ward round, thereby improving patient care and safety...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29701398/trauma-an-unusual-cause-of-endocarditis
#6
Ana Braga, Marta Marques, Miguel Abecacis, José Pedro Neves
INTRODUCTION: Infective endocarditis (IE) remains a dangerous condition with considerable associated mortality. Usual risk factors for IE include the presence of a prosthetic heart valve, structural or congenital heart disease, intravenous drug use, and a recent history of invasive procedures. METHODS: The authors describe the case report of a patient with IE having trauma as an unusual risk factor. RESULTS: A 33-year old male patient was referred to our department due to infective endocarditis...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29686548/evaluating-predictors-of-invasive-candidiasis-in-patients-with-and-without-candidemia-on-micafungin
#7
Amy Carr, Peter Colley, Mezgebe Berhe, Hoa L Nguyen
Numerous risk factors have been linked to invasive candidiasis; however, they are nonspecific and often trigger empiric antifungal therapy in a large number of patients. Identification of more precise predictors could promote judicious use of empiric echinocandins. In this retrospective review, 127 patients with blood cultures positive for Candida spp. were compared to a randomly selected cohort of 134 patients on empiric micafungin for ≥3 days and with blood cultures negative for Candida spp. Factors associated with candidemia included total parenteral nutrition (TPN; 26...
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29642570/enhanced-efficacy-of-high-dose-oral-vancomycin-therapy-in-clostridium-difficile-diarrhea-for-hospitalized-adults-not-responsive-to-conventional-oral-vancomycin-therapy-antibiotic-stewardship-implications
#8
Burke A Cunha, Julia Sessa, Sharon Blum
Current therapy of Clostridium difficile diarrhea (CDD) is problematic. Optimal treatment for CDD remains oral vancomycin, but there is little data on oral vancomycin dosing regimens. The objective of this C. difficile diarrhea study was to compare the efficacy of "high dose" vancomycin, 500 mg (PO) q6h, as sole treatment and in those who after 72 h failed to respond to conventional doses of oral vancomycin, 125-250 mg (PO) q6h. Hospitalized adults with CDD were evaluated by various oral vancomycin regimens, i...
April 10, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29626019/diagnosis-and-management-of-sepsis
#9
Tom Evans
Sepsis is a common condition with high morbidity and mortality. Although many patients may require critical care, this article considers the features of sepsis that are of most relevance to acute general physicians. Recently updated definitions of sepsis and septic shock have been proposed which better identify patients who are likely to have a poor outcome, and therefore give an opportunity to escalate care. Despite these advances, there is still no molecular signature able to diagnose sepsis. Pathogenesis is complex, with many immune and non-immune mediators involved...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29623140/multidrug-resistant-acinetobacter-baumannii-an-emerging-health-threat-in-aseer-region-kingdom-of-saudi-arabia
#10
Mohammed K Almaghrabi, Martin R P Joseph, Mohammed M Assiry, Mohamed E Hamid
Objective: The study aims to determine the prevalence of multidrug-resistant A. baumannii in Aseer Region, Kingdom of Saudi Arabia. Methods: This study evaluated the antibiotic susceptibility of ninety-four ( n  = 94) clinical isolates of A. baumannii . The isolates were collected from the south region of Saudi Arabia, and notably Aseer Region, during the period from 15 October 2014 to 15 January 2015. The isolates were tentatively identified as A. baumannii by routine bench tests and were confirmed by using VITEK® 2 Compact...
2018: Canadian Journal of Infectious Diseases & Medical Microbiology
https://www.readbyqxmd.com/read/29622716/bilateral-multifocal-acute-lobar-nephronia-caused-by-enterococcus-faecalis
#11
Yoshiki Kusama, Kunio Muraki
An 8-year-old boy presented to our hospital with complaints of fever, epigastric pain and headache. Enterococcus faecalis were isolated from urine and blood culture, bacteraemic urinary tract infection was clinically diagnosed. Although vancomycin and ampicillin were administrated, fever did not subside. Contrast-enhanced CT (CECT) revealed bilateral and multiple wedge-shaped defects, thus prompting a diagnosis of acute lobar nephronia (ALN). After 7 days of antibiotic treatment, the patient's fever subsided...
April 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29617188/mechanisms-of-antimicrobial-resistance-among-hospital-associated-pathogens
#12
Ayesha Khan, William R Miller, Cesar A Arias
The introduction of antibiotics revolutionized medicine in the 20th -century permitting the treatment of once incurable infections. Widespread use of antibiotics, however, has led to the development of resistant organisms, particularly in the healthcare setting. Today, the clinician is often faced with pathogens carrying a cadre of resistance determinants that severely limit therapeutic options. The genetic plasticity of microbes allows them to adapt to stressors via genetic mutations, acquisition or sharing of genetic material and modulation of genetic expression leading to resistance to virtually any antimicrobial used in clinical practice...
April 4, 2018: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29600284/assembly-biochemical-characterization-immunogenicity-adjuvanticity-and-efficacy-of-shigella-artificial-invaplex
#13
K Ross Turbyfill, Kristen A Clarkson, Anthony R Vortherms, Edwin V Oaks, Robert W Kaminski
The native Invaplex (InvaplexNAT ) vaccine and adjuvant is an ion exchange-purified product derived from the water extract of virulent Shigella species. The key component of InvaplexNAT is a high-molecular-mass complex (HMMC) consisting of the Shigella lipopolysaccharide (LPS) and the invasin proteins IpaB and IpaC. To improve product purity and immunogenicity, artificial Invaplex (InvaplexAR ) was developed using recombinant IpaB and IpaC proteins and purified Shigella LPS to assemble an HMMC consisting of all three components...
March 2018: MSphere
https://www.readbyqxmd.com/read/29578073/de-escalation-and-discontinuation-of-empirical-antibiotic-treatment-in-a-cohort-of-allogeneic-hematopoietic-stem-cell-transplantation-recipients-during-the-pre-engraftment-period
#14
Giulia Gustinetti, Annamaria Raiola, Riccardo Varaldo, Federica Galaverna, Francesca Gualandi, Valerio Del Bono, Andrea Bacigalupo, Emanuele Angelucci, Claudio Viscoli, Malgorzata Mikulska
OBJECTIVES: to investigate rates and outcomes of antibiotic de-escalation during pre-engraftment neutropenia in allogeneic hematopoietic stem cell transplantation (HSCT) recipients. METHODS: 110 consecutive HSCT performed between 01/2013-03/2014 were analysed. De-escalation was defined as narrowing the spectrum of antibiotic treatment either within (early) or after 96 hours (late) from starting antibiotics. Discontinuation, considered a form of de-escalation, was defined as stopping antibiotics before engraftment...
March 22, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29563819/a-case-of-brucella-melitensis-endocarditis-in-a-patient-with-cardiovascular-implantable-electronic-device
#15
Wasl Al-Adsani, Ali Ahmad, Mohammad Al-Mousa
Background: Brucellosis is a bacterial infection, caused by the nonmotile gram-negative aerobic coccobacilli. The clinical manifestation of brucellosis is variable, ranging from mild disease to severe disease. The gold standard test to confirm the diagnosis of brucellosis is assaying blood, bone marrow, or other body fluids or by tissue culture. Preferred first-line treatment in adults with uncomplicated, nonlocalized disease consists of doxycycline-aminoglycoside combination. The recommended duration of treatment is 6 weeks...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29535975/extracellular-actin-is-a-receptor-for-mycoplasma-hyopneumoniae
#16
Benjamin B A Raymond, Ranya Madhkoor, Ina Schleicher, Cord C Uphoff, Lynne Turnbull, Cynthia B Whitchurch, Manfred Rohde, Matthew P Padula, Steven P Djordjevic
Mycoplasma hyopneumoniae , an agriculturally important porcine pathogen, disrupts the mucociliary escalator causing ciliostasis, loss of cilial function, and epithelial cell death within the porcine lung. Losses to swine production due to growth rate retardation and reduced feed conversion efficiency are severe, and antibiotics are used heavily to control mycoplasmal pneumonia. Notably, little is known about the repertoire of host receptors that M. hyopneumoniae targets to facilitate colonization. Here we show, for the first time, that actin exists extracellularly on porcine epithelial monolayers (PK-15) using surface biotinylation and 3D-Structured Illumination Microscopy (3D-SIM), and that M...
2018: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/29535544/prediction-of-imipenem-resistant-microorganisms-among-the-nosocomial-critically-ill-patients-with-gram-negative-bacilli-septicemia-a-simple-risk-score
#17
I-Ling Chen, Chen-Hsiang Lee, Shih-Wen Ting, Lily Yu-Chin Wang
Objectives: The increasing number of reports on infections due to carbapenem-resistant Gram-negative bacilli (GNB) has raised concerns, because they have complicated empiric or guided antibiotic therapy for critically ill patients. We aimed to develop a scoring system to predict nosocomial imipenem-resistant GNB (IR-GNB) septicemia among the critically ill patients. Materials and methods: The study included critically ill adult patients with nosocomial GNB septicemia at Kaohsiung Chang Gung Memorial Hospital (CGMH) in 2013-2015, and the scoring system for predicting IR-GNB septicemia was developed, followed by prospective validation conducted among patients at Linkou CGMH and Kaohsiung CGMH between January and June, 2016...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29534630/antibiotic-use-in-the-intensive-care-unit-optimization-and-de-escalation
#18
Maureen Campion, Gail Scully
Appropriate antimicrobial therapy is essential to ensuring positive patient outcomes. Inappropriate or suboptimal utilization of antibiotics can lead to increased length of stay, multidrug-resistant infections, and mortality. Critically ill intensive care patients, particularly those with severe sepsis and septic shock, are at risk of antibiotic failure and secondary infections associated with incorrect antibiotic use. Through the initiation of active empiric antibiotic therapy based upon local susceptibilities, daily evaluation of signs and symptoms of infection and narrowing of antibiotic therapy when feasible, providers can streamline the treatment of common intensive care unit (ICU) infections...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29530355/evaluation-for-occult-sepsis-incorporating-nirs-and-emergency-sonography
#19
Natalie Yu Yi Ng, Hannah Hui En Ang, Jacqueline Chieh Ling Tan, Weng Hoe Ho, Win Sen Kuan, Mui Teng Chua
PURPOSE: We aim to determine whether the combination of regional tissue oxygen saturation (StO2 ) measurement using near-infrared spectroscopy (NIRS), inferior vena cava (IVC) collapsibility and ejection fraction (EF) is able to detect occult sepsis. METHODS: We included adult patients in the emergency department with at least one of the following: fever; any one component of the quick sepsis-related organ function assessment (SOFA) score; heart rate≥100 beats per minute; or white cell count <4...
February 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29512393/value-of-the-eazyplex-%C3%A2-csf-direct-assay-in-rapid-diagnosis-of-invasive-meningococcal-disease-case-report
#20
Matthias Karrasch, Sven Eisenach, Ulrich Vogel, Jan Zinke, Otto W Witte, Albrecht Günther, Bernd Romeike, Jürgen Rödel
There is a need for easy-to-use molecular assays for diagnosis of invasive meningococcal disease. Here, we report the rapid identification of Neisseria meningitidis in a cerebrospinal fluid sample from a patient with purulent meningitis using a commercially available loop-mediated isothermal amplification assay, resulting in a prompt de-escalation of the initial empiric antibiotic therapy.
March 7, 2018: Acta Microbiologica et Immunologica Hungarica
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