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Daniel Schwarzkopf, Carolin Fleischmann-Struzek, Hendrik Rüddel, Konrad Reinhart, Daniel O Thomas-Rüddel
BACKGROUND: Sepsis is a major cause of preventable deaths in hospitals. Feasible and valid methods for comparing quality of sepsis care between hospitals are needed. The aim of this study was to develop a risk-adjustment model suitable for comparing sepsis-related mortality between German hospitals. METHODS: We developed a risk-model using national German claims data. Since these data are available with a time-lag of 1.5 years only, the stability of the model across time was investigated...
2018: PloS One
Lisa K Torres, Augustine M K Choi
No abstract text is available yet for this article.
March 20, 2018: American Journal of Respiratory and Critical Care Medicine
Ewa A Woźnica, Małgorzata Inglot, Ryszard K Woźnica, Lidia Łysenko
Despite continuous progress in medicine, sepsis remains the main cause of deaths in the intensive care unit. Liver failure complicating sepsis/septic shock has a significant impact on mortality in this group of patients. The pathophysiology of sepsis-associated liver dysfunction is very complicated and still not well understood. According to the Surviving Sepsis Campaign (SSC) Guidelines, the diagnosis of liver dysfunction during sepsis is based on the increase in bilirubin concentration >2 mg/dL and the occurrence of coagulation disorders with INR > 1...
March 20, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Gabriela Ensinck, Adriana Ernst, Gustavo Lazarte, Antonela Romagnoli, Yanina Sguassero, Nanci Míguez, Santiago López Papucci, Alicia Aletti, Ana Chiossone, Fernanda Pigozzi, Matías Pinotti, Ana Cantador
INTRODUCTION: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are a common reason for consultation in pediatrics. Most of them present as skin and soft tissue infections; however, invasive infections have increased during the last decade. OBJECTIVES: The main objective was to describe the clinical-epidemiological characteristics of CA-MRSA infections. The secondary objective was to compare prevalence, clinical presentation and antibiotic susceptibility with a pre-study period (1/2004-12/2007)...
April 1, 2018: Archivos Argentinos de Pediatría
Michael Mazzeffi, Srikar Jonna, Natalia Blanco, Orestes Mavrothalassitis, Obi Odekwu, Magali Fontaine, Peter Rock, Kenichi Tanaka, Kerri Thom
BACKGROUND: Kidney transplant patients are frequently anemic and at risk for red blood cell (RBC) transfusion. Previous studies suggest that pre-transplant RBC transfusion may improve kidney transplant outcomes; however, RBC transfusion is also associated with infection. The purpose of our study was to characterize the relationships between intraoperative RBC transfusion, delayed graft function (DGF), postoperative surgical site infection (SSI), and sepsis. METHODS: Analysis was performed on a historical cohort of adult kidney transplant patients from a single medical center during a two-year period...
March 20, 2018: Journal of Anesthesia
Jennifer Rickard, Christian Ngarambe, Leonard Ndayizeye, Blair Smart, Robert Riviello, Jean Paul Majyambere
BACKGROUND: Management of critically ill patients is challenging in a low-resource setting. In Rwanda, peritonitis is a common surgical condition where patients often present late, with advanced disease. We aim to describe critical care management of patients with peritonitis in Rwanda. METHODS: Data were collected at a tertiary referral hospital in Rwanda on patients undergoing operation for peritonitis over a 6-month period. Data included epidemiology, hospital course and outcomes...
March 19, 2018: World Journal of Surgery
A Torri, S Bertini, P Schiavone, F Congestrì, M Matteucci, M Sparacino, G Testa, M F Pedna, V Sambri
Shewanella algae are Gram-negative, nonfermentative, motile bacilli, classified in the genus Shewanella in 1985. These environmental bacteria are occasionally identified in human infections, with a relatively strong association with exposure to seawater during warm seasons. This report describes a case series of 17 patients with infection correlated to S. algae in the coastal area of Romagna, Italy, from 2013 to 2016. The types of infection included otitis, pneumonia, sepsis and soft tissue (wound). Exposure to the marine environment during hot months was confirmed in 12 of 17 patients...
May 2018: New Microbes and New Infections
Olivier Nardi, Elizabeth Zavala, Claude Martin, Serafim Nanas, Thomas Scheeren, Andrea Polito, Xavi Borrat, Djillali Annane
OBJECTIVE: Evaluation of the ratio of oxyhaemoglobin to total haemoglobin in skeletal muscle (StO2 ) using near-infrared spectroscopy may aid in the monitoring of patients with sepsis. This study assessed the benefits and risks of targeting StO2 in adults with severe sepsis or septic shock. DESIGN: A European randomised controlled trial was performed on two parallel groups. SETTING: Five intensive care units (ICU) in France, Greece, Spain and Germany were used for the study...
March 19, 2018: BMJ Open
Risa Inagawa, Hideshi Okada, Genzou Takemura, Kodai Suzuki, Chihiro Takada, Hirohisa Yano, Yoshiaki Ando, Takahiro Usui, Yasuaki Hotta, Nagisa Miyazaki, Akiko Tsujimoto, Ryogen Zaikokuji, Atsumu Matsumoto, Tomonori Kawaguchi, Tomoaki Doi, Takahiro Yoshida, Shozo Yoshida, Keisuke Kumada, Hiroaki Ushikoshi, Izumi Toyoda, Shinji Ogura
BACKGROUND: The most recent diagnostic criteria for sepsis includes organ failure. Microvascular endothelial injury is thought to lead to the multiple organ failure seen in sepsis, although the precise mechanism is still controversial. Acute respiratory distress syndrome (ARDS) is the primary complication during the sequential development of multiple organ dysfunction in sepsis, and endothelial injury is deeply involved. Sugar-protein glycocalyx coats all healthy vascular endothelium, and its disruption is one factor thought to contribute to microvascular endothelial dysfunction during sepsis...
March 16, 2018: Chest
Hiroki Saito, Tcheun Borzykowski, Claire Kilpatrick, Daniela Pires, Benedetta Allegranzi, Didier Pittet
No abstract text is available yet for this article.
March 16, 2018: American Journal of Infection Control
Oliver Kamp, Oliver Jansen, Rolf Lefering, Renate Meindl, Christian Waydhas, Thomas A Schildhauer, Ume Hamsen
BACKGROUND: Sepsis and multiple organ failure (MOF) remain one of the main causes of death after multiple trauma. Trauma- and infection-associated immune reactions play an important role in the pathomechanism of MOF, but the exact pathways remain unknown. Spinal cord injury (SCI) may lead to an altered immune response, and some studies suggest a prognostic advantage for such patients having sepsis or multiple trauma. Yet these findings need to be evaluated in larger cohorts of trauma patients...
January 1, 2018: Journal of Intensive Care Medicine
Guido Woeste
Most procedures in gastrointestinal (GI) surgery require reconstruction with an anastomosis. Depending on the location within the GI tract, the perfusion and comorbidities of the patients there is a risk for anastomotic leakage. In case of peritonitis with sepsis usually a surgical treatment is required. A stable patient can be treated nonoperatively. In the following overview different treatment options of anastomotic leakage after surgery of the GI tract are described. In case of a leakage of an esophagojejunal or esophagogastric anastomosis after resection of the esophagus or stomach endoscopic treatment can be successful using either clip or stent or negative pressure therapy (NPT)...
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Swati Sharma, Beena Uppal, Vikas Manchanda, Anuj Sud
No abstract text is available yet for this article.
March 19, 2018: Infectious Diseases
Shaden Jobran, Randa Kattan, Jamal Shamaa, Hiyam Marzouqa, Musa Hindiyeh
BACKGROUND: Human adenoviruses have an important role in paediatric respiratory tract infections. They are estimated to cause 2-5% of the overall respiratory tract infections and 4-10% of all pneumonias. The aim of this study was to evaluate the clinical presentation and effect of adenoviral infection on the management of infected infants. METHODS: Data were collected from the medical records of patients infected with adenovirus and admitted to Caritas Baby Hospital...
February 21, 2018: Lancet
Adrien Koeltz, Stephane Lastere, Sylvain Jean-Baptiste
During the 2014-2015 chikungunya outbreak in French Polynesia, 64 patients with confirmed chikungunya virus infection were admitted into intensive care. Sixty-three were nonpregnant adults; 11 had an atypical form, 21 had severe sepsis or septic shock, and 18 died. These findings indicate that critical illness frequently complicates the course of chikungunya virus infection.
April 2018: Emerging Infectious Diseases
Saraschandra Vallabhajosyula, Hamza A Rayes, Ankit Sakhuja, Mohammad Hassan Murad, Jeffrey B Geske, Jacob C Jentzer
The data on speckle-tracking echocardiography (STE) in patients with sepsis are limited. This systematic review from 1975 to 2016 included studies in adults and children evaluating cardiovascular dysfunction in sepsis, severe sepsis, and septic shock utilizing STE for systolic global longitudinal strain (GLS). The primary outcome was short- or long-term mortality. Given the significant methodological and statistical differences between published studies, combining the data using meta-analysis methods was not appropriate...
January 1, 2018: Journal of Intensive Care Medicine
Takamitsu Masuda, Tomohisa Shoko, Yoshizumi Deguchi
Disseminated intravascular coagulation (DIC) often complicates sepsis, and its early treatment is crucial for improving patient outcomes. Coagulation markers may enable earlier diagnosis of DIC. The purpose of this study was to evaluate whether the risk of DIC onset can be predicted using coagulation markers. Patients who showed symptoms of systemic inflammatory response syndrome ≥2 and the quick Sequential Organ Failure Assessment score ≥2 points were investigated. All blood samples collected from the time of hospital admission to 7 days postadmission were investigated...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
Nikhil Satchidanand, Timothy J Servoss, Ranjit Singh, Angela M Bosinski, Penny Tirpak, Linda L Horton, Bruce J Naughton
BACKGROUND: Early, data-driven discussion surrounding palliative care can improve care delivery and patient experience. OBJECTIVE: To develop a 30-day mortality prediction tool for older patients in intensive care unit (ICU) with pneumonia that will initiate palliative care earlier in hospital course. DESIGN: Retrospective Electronic Health Record (EHR) review. SETTING: Four urban and suburban hospitals in a Western New York hospital system...
January 1, 2018: American Journal of Hospice & Palliative Care
Jayashree Veerasamy, Jayalakshmi Jayarajan
Pneumonia with bacteremia accounts for the majority (70%) of cases of invasive pneumococcal diseases. Laboratory characterization of pneumococci is routinely done by sensitivity to optochin. We identified an atypical presentation of optochin-resistant pneumococci in blood isolate of a patient with sepsis. Polymerase chain reaction for autolysin (lytA) and pneumolysin (ply) was positive in the bile soluble isolate. Gene sequencing revealed synonymous single nucleotide polymorphism type of functional mutation in lytA gene...
January 2018: International Journal of Applied and Basic Medical Research
Carlos Rodríguez-Lucas, M Rosario Rodicio, Isabel Costales, José Antonio Boga, Fernando Vazquez, Javier Fernández
Blood stream infections are serious conditions associated with high morbi-mortality. In this study, the new Sepsis Flow Chip (SFC) assay for identification of Gram-negative bacteria and their antimicrobial resistance genes was evaluated in positive blood cultures (BCs). SFC is a microarray with a broad panel comprising the most frequent causative agents of sepsis and antimicrobial resistance genes associated with them. A total of 100 prospective BCs, positive for Gram-negative bacilli, were assessed in the routine of the clinical microbiology laboratory and also applying the SFC assay...
February 14, 2018: Diagnostic Microbiology and Infectious Disease
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