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https://www.readbyqxmd.com/read/28093134/management-of-clostridium-difficile-infection-in-inflammatory-bowel-disease-expert-review-from-the-clinical-practice-updates-committee-of-the-aga-institute
#1
REVIEW
Sahil Khanna, Andrea Shin, Ciarán P Kelly
The purpose of this expert review is to synthesize the existing evidence on the management of Clostridium difficile infection in patients with underlying inflammatory bowel disease. The evidence reviewed in this article is a summation of relevant scientific publications, expert opinion statements, and current practice guidelines. This review is a summary of expert opinion in the field without a formal systematic review of evidence. Best Practice Advice 1: Clinicians should test patients who present with a flare of underlying inflammatory bowel disease for Clostridium difficile infection...
February 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28092204/impact-of-combination-therapy-and-early-de-escalation-on-outcome-of-ventilator-associated-pneumonia-caused-by-pseudomonas-aeruginosa
#2
Laurène Deconinck, Agnès Meybeck, Pierre Patoz, Nicolas Van Grunderbeeck, Nicolas Boussekey, Arnaud Chiche, Pierre-Yves Delannoy, Hugues Georges, Olivier Leroy
BACKGROUND: Pseudomonas aeruginosa is a common cause of ventilator-associated pneumonia (VAP). Guidelines recommend dual coverage of P. aeruginosa, but the beneficial effect of combination therapy is controversial. We described antibiotic prescriptions and evaluated the clinical impact of initial combination antibiotic therapy and de-escalation strategy in patients with VAP caused by P. aeruginosa. METHODS: Between 1994 and 2014, all 100 patients with VAP caused by P...
January 16, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28077586/redeploying-%C3%AE-lactam-antibiotics-as-a-novel-antivirulence-strategy-for-the-treatment-of-methicillin-resistant-staphylococcus-aureus-infections
#3
Elaine M Waters, Justine K Rudkin, Simone Coughlan, Geremy C Clair, Joshua N Adkins, Suzanna Gore, Guoqing Xia, Nikki S Black, Tim Downing, Eoghan O'Neill, Aras Kadioglu, James P O'Gara
Innovative approaches to the use of existing antibiotics is an important strategy in efforts to address the escalating antimicrobial resistance crisis. We report a new approach to the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections by demonstrating that oxacillin can be used to significantly attenuate the virulence of MRSA despite the pathogen being resistant to this drug. Using mechanistic in vitro assays and in vivo models of invasive pneumonia and sepsis, we show that oxacillin-treated MRSA strains are significantly attenuated in virulence...
January 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28053969/pneumococcal-urinary-antigen-test-use-in-diagnosis-and-treatment-of-pneumonia-in-seven-utah-hospitals
#4
Devin M West, Lindsay M McCauley, Jeffrey S Sorensen, Al R Jephson, Nathan C Dean
The pneumocococcal urine antigen test increases specific microbiological diagnosis over conventional culture methods in pneumonia patients. Data are limited regarding its yield and effect on antibiotic prescribing among patients with community-onset pneumonia in clinical practice. We performed a secondary analysis of 2837 emergency department patients admitted to seven Utah hospitals over 2 years with international diagnostic codes version 9 codes and radiographic evidence of pneumonia. Mean age was 64.2 years, 47...
October 2016: ERJ Open Research
https://www.readbyqxmd.com/read/28002979/antibiotic-stewardship-in-community-acquired-pneumonia
#5
Diego Viasus, Milly Vecino-Moreno, Juan M De La Hoz, Jordi Carratalà
Community-acquired pneumonia (CAP) continues to be associated with significant mortality and morbidity. As with other infectious diseases, in recent years there has been a marked increase in resistance to the antibiotics commonly used against the pathogens that cause CAP. Antimicrobial stewardship denotes coordinated interventions to improve and measure the appropriate use of antibiotics by encouraging the selection of optimal drug regimens. Areas covered: Several elements can be applied to antibiotic stewardship strategies for CAP in order to maintain or improve patient outcomes...
December 27, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27999274/microbial-etiology-of-pneumonia-epidemiology-diagnosis-and-resistance-patterns
#6
REVIEW
Catia Cilloniz, Ignacio Martin-Loeches, Carolina Garcia-Vidal, Alicia San Jose, Antoni Torres
Globally, pneumonia is a serious public health concern and a major cause of mortality and morbidity. Despite advances in antimicrobial therapies, microbiological diagnostic tests and prevention measures, pneumonia remains the main cause of death from infectious disease in the world. An important reason for the increased global mortality is the impact of pneumonia on chronic diseases, along with the increasing age of the population and the virulence factors of the causative microorganism. The increasing number of multidrug-resistant bacteria, difficult-to-treat microorganisms, and the emergence of new pathogens are a major problem for clinicians when deciding antimicrobial therapy...
December 16, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27999046/rapid-eucast-disc-diffusion-testing-of-mdr-escherichia-coli-and-klebsiella-pneumoniae-inhibition-zones-for-extended-spectrum-cephalosporins-can-be-reliably-read-after-6%C3%A2-h-of-incubation
#7
Inga Fröding, Martin Vondracek, Christian G Giske
OBJECTIVES: The need for rapid antibiotic susceptibility testing increases with escalating levels of antimicrobial resistance in Enterobacteriaceae. Our objective was to evaluate the accuracy of reading EUCAST disc diffusion, ROSCO ESBL and carbapenemase detection kits and the Mast Carbapenemase Activity Test (CAT-ID) disc, after 6 h of incubation. METHODS: We used a collection of 128 isolates of Escherichia coli and Klebsiella pneumoniae with a wide variety of resistance mechanisms...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27977886/self-assembled-arginine-rich-peptides-as-effective-antimicrobial-agents
#8
Gujie Mi, Di Shi, Whitney Herchek, Thomas J Webster
Bacteria can adapt to their ever-changing environment to develop a resistance to commonly-used antibiotics. This escalating evolution of bacteria coupled with a diminished number of effective antibiotics have caused a global healthcare crisis. New antimicrobials and novel approaches to tackle this problem are urgently needed. Antimicrobial peptides are of particular interest in this endeavor due to their broad spectrum antimicrobial properties as well as ability to combat multi-drug resistant bacteria. Most peptides have both hydrophobic and hydrophilic regions that enables them to be soluble in an aqueous solution, yet can insert into and subsequently disintegrate lipid rich membranes through diverse mechanisms...
December 15, 2016: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/27955625/frequency-of-empiric-antibiotic-de-escalation-in-an-acute-care-hospital-with-an-established-antimicrobial-stewardship-program
#9
Peter Liu, Christopher Ohl, James Johnson, John Williamson, James Beardsley, Vera Luther
BACKGROUND: Expanding antimicrobial resistance patterns in the face of stagnant growth in novel antibiotic production underscores the importance of antibiotic stewardship in which de-escalation remains an integral component. We measured the frequency of antibiotic de-escalation in a tertiary care medical center with an established antimicrobial stewardship program to provide a plausible benchmark for de-escalation. METHODS: A retrospective, observational study was performed by review of randomly selected electronic medical records of 240 patients who received simultaneous piperacillin/tazobactam and vancomycin from January to December 2011 at an 885-bed tertiary care medical center...
December 12, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27939520/tapping-into-salmonella-typhimurium-lt2-genome-in-a-quest-to-explore-its-therapeutic-arsenal-a-metabolic-network-modeling-approach
#10
Kusum Mehla, Jayashree Ramana
S. typhimurium, the classical broad-host-range serovar is a widely distributed cause of food-borne illness. Escalating antibiotic resistance and potential of conjugal transmission to other pathogens attributable to its broad spectrum host specificities have aided S. typhimurium to emerge as a global health threat. To keep pace with ever evolving bacterial defenses, there is dire need to restock the antibiotic pipeline. Genome scale metabolic reconstructions present immense possibilities to decipher physiological properties of an organism using constraint-based methods The systems-level approaches of genome scale metabolic networks interrogation open up new avenues of drug target identification against deadly infectious diseases...
December 7, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27909252/nurses-as-antibiotic-brokers-institutionalized-praxis-in-the-hospital
#11
Alex Broom, Jennifer Broom, Emma Kirby, Graham Scambler
We are likely moving rapidly toward a post-antibiotic era, as a result of escalating antimicrobial resistance, rapidly declining antibiotic production and profligate overuse. Hitherto research has almost exclusively focused on doctors' prescribing, with nurses' roles in antibiotic use remaining virtually invisible. Drawing on interviews with 30 nurses, we focus on nurses as brokers of doctors' antibiotic decisions, nursing capacity to challenge doctors' decisions, and, "back stage" strategies for circumnavigating organizational constraints...
November 30, 2016: Qualitative Health Research
https://www.readbyqxmd.com/read/27899924/global-antimicrobial-stewardship-a-closer-look-at-the-formidable-implementation-challenges
#12
John J L Tiong, Jason S E Loo, Chun-Wai Mai
Antimicrobial stewardship (AMS) has been touted as one of the key strategies required in tackling worldwide escalation of antibiotic resistance. Although AMS has optimized antibiotic usage and reduced the incidence of resistance development in some regions, its full global potential has been curtailed by various AMS-impeding factors. This article seeks to highlight in a detailed perspective, the key challenges that hamper global AMS endeavors, some of which include the paucity of effective implementation strategies that cater for the challenging settings of developing nations, the slow response of governments, uncoordinated AMS activities as well as implementation fragmentation across different sectors and countries...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/27898208/-design-and-implementation-of-an-outpatient-parenteral-antimicrobial-therapy-program-in-primary-care-the-experience-at-a-second-level-hospital
#13
M Ruiz-Campuzano, E García-Vázquez, J J Hernández-Roca, J Gómez-Gómez, M Canteras-Jordana, E Mené-Fenor, A Hernández-Torres, A Peláez-Ballesta
OBJECTIVE: Outpatient parenteral antimicrobial therapy (OPAT) programs are a good assistance option in a wide variety of infectious diseases. Our aim was to design and implement an OPAT program in the area of influence of a second-level hospital, with no Home Hospitalization Service available, being necessary close collaboration between hospitalization and Primary Care teams, describe our cohort, analyse the antimicrobial treatment indicated and evaluate the prognostic and risk factors associated with readmission and mortality...
November 28, 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27894805/leaching-behavior-of-veterinary-antibiotics-in-animal-manure-applied-soils
#14
Min Pan, L M Chu
Agricultural fields worldwide are being contaminated by the escalating application of veterinary antibiotics (VAs) via animal manure and biosolids applied as fertilizers or of wastewater for irrigation, resulting in soil degradation and damage to the health of terrestrial environments. This paper describes a series of column studies investigating the leaching behavior of five VAs, tetracycline (TC), sulfamethazine (SMZ), norfloxacin (NOR), erythromycin (ERY) and chloramphenicol (CAP), under different simulated rainfall conditions that could occur in agricultural environments...
February 1, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/27864449/what-are-the-critical-steps-in-processing-blood-cultures-a-prospective-audit-evaluating-current-practice-of-reporting-blood-cultures-in-a-centralised-laboratory-serving-secondary-care-hospitals
#15
Manjula Meda, James Clayton, Reela Varghese, Jayakeerthi Rangaiah, Clive Grundy, Farnaz Dashti, David Garner, Katherine Groves, Karen Fitzmaurice, E Hutley
AIMS: To assess current procedures of processing positive blood cultures against national standards with an aim to evaluate its clinical impact and to determine the utility of currently available rapid identification and susceptibility tests in processing of blood cultures. METHODS: Blood cultures from three secondary care hospitals, processed at a centralised laboratory, were prospectively audited. Data regarding processing times, communication with prescribers, changes to patient management and mortality within 30 days of a significant blood culture were collected in a preplanned pro forma for a 4-week period...
November 18, 2016: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/27850332/693-de-escalation-of-antibiotics-in-culture-positive-critically-ill-adults-with-pneumonia
#16
Peter Zepke, Jeffrey Fish
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850331/692-practice-patterns-for-antibiotic-de-escalation-in-mrsa-culture-negative-sepsis
#17
Farid Sadaka, Matthew Korobey, Alexis Dumm, Greggory Wegener, Rachna Kumar, Alex Bryant, Jackyln O'Brien
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27845849/an-experimental-model-for-the-rapid-screening-of-compounds-with-potential-use-against-mycobacteria
#18
Sofia Santos Costa, Elizeth Lopes, Elisa Azzali, Diana Machado, Tatiane Coelho, Pedro Eduardo Almeida da Silva, Miguel Viveiros, Marco Pieroni, Isabel Couto
Infections caused by Mycobacterium tuberculosis and other mycobacteria are major challenges for global public health. Particularly worrisome are infections caused by multidrug-resistant bacteria, which are increasingly difficult to treat because of the loss of efficacy of the current antibacterial agents, a problem that continues to escalate worldwide. There has been a limited interest and investment on the development of new antibacterial agents in the past decades. This has led to the current situation, in which there is an urgent demand for innovative therapeutic alternatives to fight infections caused by multidrug-resistant pathogens, such as multidrug-resistant tuberculosis...
November 2016: Assay and Drug Development Technologies
https://www.readbyqxmd.com/read/27811073/laboratory-diagnosis-of-pneumonia-in-the-molecular-age
#19
REVIEW
Antoni Torres, Nelson Lee, Catia Cilloniz, Jordi Vila, Menno Van der Eerden
Pneumonia remains a worldwide health problem with a high rate of morbidity and mortality. Identification of microbial pathogens which cause pneumonia is an important area for optimum clinical management of pneumonia patients and is a big challenge for conventional microbiological methods. The development and implementation of molecular diagnostic tests for pneumonia has been a major advance in the microbiological diagnosis of respiratory pathogens in recent years. However, with new knowledge regarding the microbiome, together with the recognition that the lungs are a dynamic microbiological ecosystem, our current concept of pneumonia is not totally realistic as this new concept of pneumonia involves a dysbiosis or alteration of the lung microbiome...
December 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27798219/impact-of-antibiotic-de-escalation-on-clinical-outcomes-in-community-acquired-pneumococcal-pneumonia
#20
Diego Viasus, Antonella F Simonetti, Carolina Garcia-Vidal, Jordi Niubó, Jordi Dorca, Jordi Carratalà
BACKGROUND: Although antibiotic de-escalation is regarded as a measure that reduces selection pressure, adverse drug effects and costs, evidence supporting this practice in community-acquired pneumococcal pneumonia (CAPP) is lacking. METHODS: We carried out a retrospective analysis of prospectively collected data of a cohort of hospitalized adults with CAPP. Pneumococcal aetiology was established in patients with one or more positive cultures for Streptococcus pneumoniae obtained from blood, sterile fluids or sputum, and/or a positive urinary antigen test...
October 20, 2016: Journal of Antimicrobial Chemotherapy
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