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https://www.readbyqxmd.com/read/29322236/-urosepsis
#1
Mathias W Pletz, Sebastian Weis, Christina Forstner, Florian Wagenlehner
Urosepsis is defined as a severe disease due to organ failure caused by a urinary tract infection. An empirical antibiotic therapy should be instigated within the first hour after diagnosis. Urine cultures and blood cultures should be performed before antibiotic treatment. Further diagnostics should be carried out at an early stage to enable an interventional focus control in the case of urinary tract obstruction or abscess formation, if necessary. Gram-negative pathogens are most frequently isolated. Extended spectrum beta-lactamase (ESBL) forming bacteria as a cause of urosepsis are increasing...
January 10, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29310494/effectiveness-of-vancomycin-or-beta-lactam-therapy-in-ampicillin-susceptible-enterococcus-spp-bloodstream-infections
#2
Jesse M Fletcher, Shawn J Kram, Christina B Sarubbi, Deverick J Anderson, Bridgette L Kram
BACKGROUND: De-escalation to a beta-lactam improves outcomes for patients with a methicillin-susceptible Staphylococcus aureus bloodstream infection (BSI). Whether a similar strategy is appropriate for enterococcal species is less clear. OBJECTIVE: To determine whether definitive antibiotic selection affects outcomes for patients with an ampicillin-susceptible enterococcal BSI. METHODS: This retrospective cohort study included patients over 18 years of age receiving definitive therapy with vancomycin or a beta-lactam for one or more blood cultures positive for Enterococcus spp...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29290229/antibiotic-treatment-of-lower-respiratory-tract-infections
#3
R Cohen, F Angoulvant, S Biscardi, F Madhi, F Dubos, Y Gillet
Lower respiratory tract infections, i.e., bronchitis, bronchiolitis, and pneumonia, are the second leading cause of antibiotic prescriptions. The vast majority of these infections are due to viruses and are self-limited diseases: most patients recover spontaneously. These two facts explain that antibiotic prescriptions must be limited to some clinical situations for which the diagnosis has to be done early. The first message of this manuscript is to strengthen non-antibiotic prescriptions in many situations such as bronchitis and bronchiolitis...
December 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29276300/multilayer-model-of-pharmacy-participation-in-the-antimicrobial-stewardship-program-at-a-large-academic-medical-center
#4
Yanina Dubrovskaya, Marco R Scipione, Justin Siegfried, Shin-Pung Jen, Vinh Pham, John Papadopoulos, Arnold Decano, Tyler Lewis, Arash Dabestani
Purpose: Leveraging pharmacy personnel resources for the purpose of antimicrobial stewardship program (ASP) operations presents a challenging task. We describe our experience integrating all pharmacists into an ASP, and evaluate the impact on ASP interventions, antimicrobial utilization, rate of selected hospital-onset infections and readmission. Summary: During a study period (January 1 to December 31, 2015), a total of 14 552 ASP-related pharmacy interventions were performed (ASP clinical pharmacotherapy specialists [CPS] n = 4025; non-ASP CPS n = 4888; hospital pharmacists n = 5639)...
October 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29236303/impact-of-antimicrobial-stewardship-program-on-hospitalized-patients-at-the-intensive-care-unit-a-prospective-audit-and-feedback-study
#5
Maher R Khdour, Hussein O Hallak, Mamoon Al-Deyab, Mowafq A Nasif, Aliaa M Khalili, Ahamad A Dallashi, Mohammad B Khofash, Michael G Scott
AIMS: Inappropriate use of antibiotics is one of the most important factors contributing to the emergence of drug resistant pathogens. The purpose of this study was to measure the clinical impact of Antimicrobial Stewardship Program (ASP) interventions on hospitalized patients at the Intensive care unit at Palestinian Medical Complex. METHODS: A prospective audit with intervention and feedback by ASP team within 48-72h of antibiotic administration began in Sep, 2015...
December 13, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29201017/characterization-of-metagenomes-in-urban-aquatic-compartments-reveals-high-prevalence-of-clinically-relevant-antibiotic-resistance-genes-in-wastewaters
#6
Charmaine Ng, Martin Tay, Boonfei Tan, Thai-Hoang Le, Laurence Haller, Hongjie Chen, Tse H Koh, Timothy M S Barkham, Karina Y-H Gin
The dissemination of antimicrobial resistance (AMR) is an escalating problem and a threat to public health. Comparative metagenomics was used to investigate the occurrence of antibiotic resistant genes (ARGs) in wastewater and urban surface water environments in Singapore. Hospital and municipal wastewater (n = 6) were found to have higher diversity and average abundance of ARGs (303 ARG subtypes, 197,816 x/Gb) compared to treated wastewater effluent (n = 2, 58 ARG subtypes, 2,692 x/Gb) and surface water (n = 5, 35 subtypes, 7,985 x/Gb)...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29184409/nanomaterials-for-alternative-antibacterial-therapy
#7
REVIEW
Hassan A Hemeg
Despite an array of cogent antibiotics, bacterial infections, notably those produced by nosocomial pathogens, still remain a leading factor of morbidity and mortality around the globe. They target the severely ill, hospitalized and immunocompromised patients with incapacitated immune system, who are prone to infections. The choice of antimicrobial therapy is largely empirical and not devoid of toxicity, hypersensitivity, teratogenicity and/or mutagenicity. The emergence of multidrug-resistant bacteria further intensifies the clinical predicament as it directly impacts public health due to diminished potency of current antibiotics...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/29181890/acute-kidney-injury-induced-by-concomitant-use-of-vancomycin-and-piperacillin-tazobactam-in-pediatrics
#8
Manal Abouelkheir, Sarah Alsubaie
BACKGROUND: Vancomycin is very commonly used in combination with piperacillin-tazobactam (PTZ) as an initial empiric therapy for moderate to severe infections, whenever coverage for both methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa is required. The combination of vancomycin and PTZ in adults has recently been reported to significantly increase the risk of developing acute kidney injury (AKI) relative to vancomycin monotherapy; such reports in pediatrics are sparse...
November 27, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29173155/imaging-of-bacteria-is-there-any-hope-for-the-future-based-on-past-experience
#9
Thomas Ebenhan, Elena Lazzeri, Olivier Gheysens
Infectious diseases remain a major health problem and cause of death worldwide. It is expected that the socio-economic impact will further intensify due to escalating resistance to antibiotics, an ageing population and an increase in the number of patients under immunosuppressive therapy and implanted medical devices. Even though radiolabeled probes and leukocytes are routinely used in clinical practice, it might still be difficult to distinguish sterile inflammation from inflammation caused by bacteria. Moreover, the majority of these probes are based on the attraction of leukocytes which may be hampered in neutropenic patients...
November 21, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29162991/magnusiomyces-capitatus-a-new-and-emerging-pathogen-linked-to-keratomycosis
#10
Ankit Shah, Thomas Mauger
We describe our experience managing a case of fungal keratitis in a 71-year-old immunocompetent woman. Intracameral cultures isolated Magnusiomyces capitatus, a dimorphic commensal microbe with limited pathogenicity, in an immune competent patient. Repeated corneal cultures for bacteria and fungus were negative. Initial broad-spectrum topical fortified antibiotics were eventually escalated to include topical natamycin and voriconazole and oral voriconazole. The patient underwent emergent corneal transplantation, but recurrent infection eventually required anterior chamber washout and intracameral injection of amphotericin B...
2017: Digital Journal of Ophthalmology: DJO
https://www.readbyqxmd.com/read/29153444/retrospective-evaluation-of-piperacillin-tazobactam-imipenem-cilastatin-and-meropenem-used-on-surgical-floors-at-a-tertiary-care-hospital-in-saudi-arabia
#11
Eman Youssif, Mohammed Aseeri, Sahal Khoshhal
BACKGROUND: The appropriate use of broad-spectrum antibiotics, including appropriate de-escalation, is essential to reduce the emergence of antibiotic resistance. In surgical floors antibiotics are prescribed for prophylaxis (mostly, single dose), empirical treatment (started if infection is suspected till bacteria are identified with its sensitivity to antibiotics), or treatment of well-defined infection of previously isolated bacteria with its sensitivity to antibiotics. In this study, we aimed to evaluate the use of broad-spectrum antibiotics based on requests for cultures and de-escalation based on sensitivity results of culture tests at tertiary care hospital...
November 15, 2017: Journal of Infection and Public Health
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
#12
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/29122393/how-do-professional-relationships-influence-surgical-antibiotic-prophylaxis-decision-making-a-qualitative-study
#13
Jennifer K Broom, Alex F Broom, Emma R Kirby, Jeffrey J Post
BACKGROUND: Surgical antibiotic prophylaxis (SAP) is a critical area to optimize to reduce the escalation of antimicrobial resistance. This article explores the ways by which interpersonal relationships influence SAP decision making. METHODS: Twenty surgeons and anesthetists participated in in-depth semistructured interviews on SAP prescribing. Results were analyzed using the framework approach. RESULTS: Analysis revealed 3 ways by which interpersonal relationships influence SAP: relationship dynamics between the surgeon and the anesthetist determine appropriateness of SAP, particularly operative risk ownership; perceived hierarchies within, and between, surgical and anesthetist specialties influence antibiotic prescribing decisions; and surgical distance from the antimicrobial stewardship team, which influences use of antimicrobial stewardship principles...
November 7, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29074435/the-natural-compound-magnolol-affects-growth-biofilm-formation-and-ultrastructure-of-oral-candida-isolates
#14
Jawad Behbehani, Sheikh Shreaz, Mohammad Irshad, Maribassapa Karched
The incidence of oral candidosis has increased in recent years due to the escalation in HIV-infection, cancer treatments, organ transplantation, and diabetes. In addition, corticosteroid use, dentures, and broad-spectrum antibiotic use have also contributed to the problem. Treatment of oral candidosis has continued to be problematic because of the potential toxicity of antifungals in clinical use, and, above all, development of drug resistance among patients. In this study, the antifungal effect of magnolol was investigated against 64 strains of Candida spp...
October 23, 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/29067203/prospective-study-evaluating-the-incidence-of-bacteraemia-and-bacteruria-in-afebrile-and-febrile-neutropaenic-dogs-undergoing-chemotherapy
#15
Kimberly Shaffer, Jonathan Bach, Ruthanne Chun
The purpose of this prospective study was to determine the incidence and character of bacteraemia and bacteruria in afebrile and febrile neutropaenic dogs undergoing cytotoxic chemotherapy. Fifty-five neutropaenic dogs presenting to the University of Wisconsin Veterinary Medical Teaching Hospital were enrolled for a total of 57 neutropaenic episodes. The overall incidence of bacteraemia was 12.3% (n = 7/57). Three afebrile dogs and four febrile dogs were bacteraemic; this difference was not significant (P = 0...
November 2016: Veterinary Medicine and Science
https://www.readbyqxmd.com/read/29052092/a-72-h-intervention-for-improvement-of-the-rate-of-optimal-antibiotic-therapy-in-patients-with-bloodstream-infections
#16
R Murri, F Taccari, T Spanu, T D'Inzeo, I Mastrorosa, F Giovannenze, G Scoppettuolo, G Ventura, C Palazzolo, M Camici, S Lardo, B Fiori, M Sanguinetti, R Cauda, M Fantoni
Antimicrobial stewardship programs are implemented to optimize the use of antibiotics and control the spread of antibiotic resistance. Many antimicrobial stewardship interventions have demonstrated significant efficacy in reducing unnecessary prescriptions of antibiotics, the duration of antimicrobial therapy, and mortality. We evaluated the benefits of a combination of rapid diagnostic tests and an active re-evaluation of antibiotic therapy 72 h after the onset of bloodstream infection (BSI). All patients with BSI from November 2015 to November 2016 in a 1100-bed university hospital in Rome, where an Infectious Disease Consultancy Unit (Unità di Consulenza Infettivologica, UDCI) is available, were re-evaluated at the bedside 72 h after starting antimicrobial therapy and compared to two pre-intervention periods: the UDCI was called by the ward physician for patients with BSI and the UDCI was called directly by the microbiologist immediately after a pathogen was isolated from blood cultures...
October 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29031431/implementing-an-antibiotic-stewardship-program-at-a-long-term-acute-care-hospital-in-detroit-michigan
#17
Ammara Mushtaq, Reda A Awali, Suganya Chandramohan, Amar Krishna, Caitlin Biedron, Olufemi Jegede, Teena Chopra
BACKGROUND: The objective of the study was to assess health care providers' (HCPs) knowledge and attitude toward antimicrobial resistance (AMR) and implement an antimicrobial stewardship program (ASP) in a long-term acute care hospital (LTACH). METHODS: A questionnaire on antibiotic use and resistance was administered to HCP in an LTACH in Detroit, Michigan, between August 2011 and October 2011. Concurrently, a retrospective review of common antibiotic prescription practices and costs was conducted...
October 11, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29026666/bedside-twist-drill-aspiration-of-cerebral-abscess-less-than-2-5-cm-in-size-a-case-series-and-discussion
#18
Tyler Carson, Dan Miulli
BACKGROUND: Intracranial abscess remains a potentially deadly condition despite development of newer antibiotics and improved surgical methods. Many studies have evaluated the surgical indications for abscess drainage, and it has been generally accepted that intracranial abscesses greater than 2.5 cm may best be treated with surgical intervention followed by antibiotic therapy. More recently, studies have shown good results with stereotactic aspiration of abscesses to 1 cm in size. Furthermore, a recent case series in 2014 of 103 cases of bedside twist drill aspiration of cerebral abscess >2...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29018966/safety-and-cost-benefit-of-an-ambulatory-program-for-patients-with-low-risk-neutropenic-fever-at-an-australian-centre
#19
Benjamin W Teh, Christine Brown, Trish Joyce, Leon J Worth, Monica A Slavin, Karin A Thursky
BACKGROUND: Neutropenic fever (NF) is a common complication of cancer chemotherapy. Patients at low risk of medical complications from NF can be identified using a validated risk assessment and managed in an outpatient setting. This is a new model of care for Australia. This study described the implementation of a sustainable ambulatory program for NF at a tertiary cancer centre over a 12-month period. METHODS: Peter MacCallum Cancer Centre introduced an ambulatory care program in 2014, which identified low-risk NF patients, promoted early de-escalation to oral antibiotics, and early discharge to a nurse-led ambulatory program...
October 10, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28980026/-bacterial-sepsis-diagnostics-and-calculated-antibiotic-therapy
#20
REVIEW
D C Richter, A Heininger, T Brenner, M Hochreiter, M Bernhard, J Briegel, S Dubler, B Grabein, A Hecker, W A Krüger, K Mayer, M W Pletz, D Störzinger, N Pinder, T Hoppe-Tichy, S Weiterer, S Zimmermann, A Brinkmann, M A Weigand, Christoph Lichtenstern
The mortality of patients with sepsis and septic shock is still unacceptably high. An effective antibiotic treatment within 1 h of recognition of sepsis is an important target of sepsis treatment. Delays lead to an increase in mortality; therefore, structured treatment concepts form a rational foundation, taking relevant diagnostic and treatment steps into consideration. In addition to the assumed focus and individual risks of each patient, local resistance patterns and specific problem pathogens must be taken into account for selection of anti-infection treatment...
October 2017: Der Anaesthesist
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