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GNB sepsis

Alix Pantel, Julien Monier, Jean-Philippe Lavigne
Objectives: To evaluate the performance of the Accelerate Pheno™ system for the identification and antimicrobial susceptibility testing (AST) of a panel of Gram-negative bacilli (GNB) with different resistance profiles (e.g. penicillinases, ESBLs, cephalosporinase overproduction, carbapenemases, impermeability) directly from positive blood cultures in <7 h. Methods: A panel of 105 clinical strains previously characterized for the presence of β-lactamase-encoding genes was tested...
February 20, 2018: Journal of Antimicrobial Chemotherapy
M Cristina Vazquez-Guillamet, Rodrigo Vazquez, Scott T Micek, Marin H Kollef
Background: Predicting antimicrobial resistance in gram-negative bacteria (GNB) could balance the need for administering appropriate empiric antibiotics while also minimizing the use of clinically unwarranted broad-spectrum agents. Our objective was to develop a practical prediction rule able to identify patients with GNB infection at low risk for resistance to piperacillin-tazobactam (PT), cefepime (CE), and meropenem (ME). Methods: The study included adult patients with sepsis or septic shock due to bloodstream infections caused by GNB admitted between 2008 and 2015 from Barnes-Jewish Hospital...
October 30, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Joanna Jammal, Fadia Zaknoon, Amram Mor
We recently reported the aptitude of a membrane-active lipopeptide (C10OOc12O) to sensitize gram-negative bacilli (GNB) to host antibacterial proteins. Here we explored the potential of harnessing such capacity in the presence of antibiotics. For this purpose, we compared Escherichia coli sensitization to antibiotics in broth and plasma; assessed inner and outer membrane damages using scanning electron microscopy, dyes, and mutant strains; and assessed the ability to affect disease course using the mouse peritonitis-sepsis model for mono- and combination therapies...
September 13, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Venkatesh Sampath, Neil Mulrooney, Aloka L Patel, Jonathan Cohen, Liyun Zhang, Jeffery Garland, Pascal M Lavoie, John Dagle, Pippa Simpson
BACKGROUND: The genetic basis of sepsis susceptibility in preterm infants remains understudied. Herein, we investigated the nucleotide binding-oligomerization domain (NOD)-like receptor (NLR) family of immune receptors as putative loci for preterm sepsis susceptibility. OBJECTIVE: To determine whether single nucleotide polymorphisms (SNPs) in NLR genes are associated with blood stream infections (BSI) in premature infants. METHODS: An international cohort of infants with gestational age (GA) <35 weeks were genotyped for SNPs in the ATG16L1, CARD8, NLRP3, NOD2, and NOD1 genes...
August 3, 2017: Neonatology
Soledad Urzúa, Marcela Ferrés, Patricia García, Amparo Sánchez, Matías Luco
INTRODUCTION: Late onset sepsis (LOS) remains an important cause of morbidity and mortality in neonatal intensive care units (NICU). The empirical use of vancomycin and other broad spectrum antibiotics is very frequent and is associated with the emergence of resistant agents, infection by gram-negative bacilli (GNB), fungal infections and increased morbidity and mortality. OBJECTIVE: To evaluate the impact of 5 intervention protocols designed to reduce infections and promote the rational use of antibiotics (AB) in a single NICU...
April 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Teresa R Zembower, Kelly M Maxwell, Robert B Nadler, John Cashy, Marc H Scheetz, Chao Qi, Anthony J Schaeffer
BACKGROUND: We evaluated the effectiveness of targeted antimicrobial prophylaxis in transrectal ultrasound guided prostate biopsy (TRUSP). METHODS: A prospective, non-randomized cohort study was conducted. Rectal swab cultures plated on non-selective blood agar and on selective MacConkey agar supplemented with ciprofloxacin identified ciprofloxacin-susceptible and -resistant gram-negative bacteria (CS-GNB and CR-GNB). Patients with CS-GNB received ciprofloxacin while those with CR-GNB received directed prophylaxis...
June 7, 2017: BMC Infectious Diseases
Nobuyuki Saito, Kazuhiro Sugiyama, Testu Ohnuma, Takashi Kanemura, Michitaka Nasu, Yuya Yoshidomi, Yuta Tsujimoto, Hiroshi Adachi, Hiroyuki Koami, Aito Tochiki, Kota Hori, Yukiko Wagatsuma, Hisashi Matsumoto
Septic shock-associated mortality in intensive care units (ICUs) remains high, with reported rates ranging 30-50%. In particular, Gram-negative bacilli (GNB), which induce significant inflammation and consequent multiple organ failure, are the etiological bacterial agent in 40% of severe sepsis cases. Hemoperfusion using polymyxin B-immobilized fiber (PMX), which adsorbs endotoxin, is expected to reduce the inflammatory sepsis cascade due to GNB. However, the clinical efficacy of this treatment has not yet been demonstrated...
2017: PloS One
Joanna Jammal, Fadia Zaknoon, Galoz Kaneti, Ayelet S Hershkovits, Amram Mor
To address the need for novel alternatives to antibiotics, we attempted to sensitize gram-negative bacilli to innate antibacterial protagonists. We report a lipopeptide-like sequence (C10OOc12O) that inflicted outer membrane damage at a low micromolar range, whereas measurable bacterial growth inhibition in broth medium required >10-fold higher concentrations. In serum, however, C10OOc12O induced antibacterial activity in a manner suppressible by anticomplement antibodies or heat treatment and acted synergistically with exogenous lysozyme in broth and serum media...
May 15, 2017: Journal of Infectious Diseases
I-Hsiu Su, Wen-Chien Ko, Chung-Hsin Shih, Fang-Hao Yeh, Yung-Nien Sun, Jung-Chih Chen, Po-Lin Chen, Hsien-Chang Chang
Gram-negative bacteria (GNBs) are common pathogens causing severe sepsis. Rapid evaluation of drug susceptibility would guide effective antibiotic treatment and promote life-saving. A total of 78 clinical isolates of 13 Gram-negative species collected between April 2013 and November 2013 from two medical centers in Tainan were tested. Bacterial morphology changes in different concentrations of antibiotics were observed under the electric field of a quadruple electrode array using light microscopy. The minimal inhibitory concentrations (MICs) of four antimicrobial agents, namely, cefazolin, ceftazidime, cefepime, and doripenem, were determined by the dielectrophoretic antimicrobial susceptibility testing (dAST) and by the conventional broth dilution testing (BDT)...
March 31, 2017: Analytical Chemistry
Eren Çağan, Evrim Kıray Baş, Hüseyin Selim Asker
BACKGROUND The emergence of infections related to multidrug-resistant Gram-negative bacilli (MDR-GNB) reintroduced the use of colistin, an antibiotic that was previously abandoned due to adverse effects. However, because of its limited use in neonatal intensive care units, there is very little data about the effectiveness and safety of colistin in children and newborns. In this study, which will be the largest case study in the literature, we aimed to evaluate the effectiveness and safety of colistin in full-term and preterm newborns...
January 30, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
C Gudiol, C Royo-Cebrecos, C Tebe, E Abdala, M Akova, R Álvarez, G Maestro-de la Calle, A Cano, C Cervera, W T Clemente, P Martín-Dávila, A Freifeld, L Gómez, T Gottlieb, M Gurguí, F Herrera, A Manzur, G Maschmeyer, Y Meije, M Montejo, M Peghin, J Rodríguez-Baño, I Ruiz-Camps, T C Sukiennik, J Carratalà
INTRODUCTION: Bloodstream infection (BSI) due to extended-spectrum β-lactamase-producing Gram-negative bacilli (ESBL-GNB) is increasing at an alarming pace worldwide. Although β-lactam/β-lactamase inhibitor (BLBLI) combinations have been suggested as an alternative to carbapenems for the treatment of BSI due to these resistant organisms in the general population, their usefulness for the treatment of BSI due to ESBL-GNB in haematological patients with neutropaenia is yet to be elucidated...
January 23, 2017: BMJ Open
Ayşe Karaaslan, Eren Çağan, Eda Kepenekli Kadayifci, Serkan Atıcı, Gülşen Akkoç, Nurhayat Yakut, Sevliya Öcal Demir, Ahmet Soysal, Mustafa Bakır
BACKGROUND: The emergence of infections due to multidrug-resistant Gram-negative bacilli (MDR-GNB) has led to the resurrection of colistin use. The data on colistin use and drug-related adverse effects in children are scarce. AIMS: In this study, we aimed to evaluate the clinical efficacy and safety of colistin use in critically ill pediatric patients. STUDY DESIGN: This study has a retrospective study design. METHODS: Sixty-one critically ill children were identified through the department's patient files archive during the period from January 2011 to November 2014...
November 2016: Balkan Medical Journal
Tariq Mahmud Tariq, Esmatullah Rasool
OBJECTIVE: To determine the frequency of pathogens causing bloodstream infections and evaluate their trends and antibiogram patterns among in-patients in a paediatric tertiary care centre. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan in two phases, from January 2010 to December 2015. METHODOLOGY: Results of blood cultures from suspected cases of sepsis admitted in the FMIC, from January 2010 to December 2012 (Period-1), and from January 2013 to December 2015 (Period-2) were completed...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Sheng Tao Yan, Li Chao Sun, Hong Bing Jia, Wen Gao, Jian Ping Yang, Guo Qiang Zhang
OBJECTIVE: The aim of this study was to evaluate procalcitonin (PCT) diagnostic accuracy in discriminating gram-negative (GN) from gram-positive (GP) bloodstream infections and determining the relationship between PCT levels, infection sites, and pathogen types. METHODS: Clinical and laboratory data were collected from patients with blood culture (BC)-positive sepsis between January 2014 and December 2015. PCT levels at different infection sites were compared, as was the presence of GN and GP bloodstream infection...
April 2017: American Journal of Emergency Medicine
Rajeev Soman, Neha Gupta, Mitesh Suthar, Jatin Kothari, Alan Almeida, Anjali Shetty, Camilla Rodrigues
BACKGROUND: Central-line-associated blood-stream infection (CLABSI) is a highly consequential nosocomial infection. The most effective management includes the removal of the infected catheter. Retention of the catheter and antibiotic lock therapy (ALT) along with systemic antibiotics may be attempted only if there are unusual extenuating circumstances. CLABSIs due to Gram-negative bacteria (GNB) is more common in our setting and the organisms are often highly resistant. Hence, there is a need to explore the use of novel antimicrobials for catheter lock solutions along with antibiofilm agents...
February 2016: Journal of the Association of Physicians of India
Ming-Horng Tsai, I-Ta Lee, Shih-Ming Chu, Reyin Lien, Hsuan-Rong Huang, Ming-Chou Chiang, Ren-Huei Fu, Jen-Fu Hsu, Yhu-Chering Huang
Extended-spectrum β-lactamase (ESBL)-producing Gram-negative bacteremia (GNB) in the neonatal intensive care unit was characterized by comparison with two control groups: a susceptible control group and a general base population group over 2001 to 2012. The influence of ESBL production on mortality was studied in all study subjects and ESBL-GNB isolates were microbiologically characterized. We identified 77 episodes of ESBL-GNB (14.2% of all neonatal late-onset GNB), which were caused by Klebsiella spp. (62...
2016: PloS One
Claudia-Elena Pleşca, Mihaela Cătălina Luca, A St Luca, Simona Constantinescu, Luminiţa Smaranda Iancu
UNLABELLED: Microbial resistance is an increasingly serious threat to global public health and it is linked to patient's age, immune status, and also antibiotic overuse or misuse and repeated hospitalizations. The high incidence of infections caused by multidrug-resistant bacteria requires rethinking the first-line therapeutic schemes. AIM: Retrospective study of the etiologic and antibiotic resistance profile of the bacterial strains isolated from immunocompromised hosts diagnosed with severe systemic infections, aimed at gaining a better understanding of the potential infectious sources and optimizing the antibiotic therapy...
October 2015: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
Ming-Horng Tsai, I Hsyuan Wu, Chiang-Wen Lee, Shih-Ming Chu, Reyin Lien, Hsuan-Rong Huang, Ming-Chou Chiang, Ren-Huei Fu, Jen-Fu Hsu, Yhu-Chering Huang
BACKGROUND: Gram-negative bacillary (GNB) bloodstream infections account for 20%-30% of neonatal late-onset sepsis (LOS). We aimed to identify the incidence, clinical characteristics, and risk factors for adverse outcomes in neonates with GNB LOS. METHODS: All patients with GNB LOS admitted to the neonatal intensive care units (NICUs) of a university-affiliated teaching hospital in Taiwan from January 1, 2004-December 31, 2011, were enrolled. A case-control-control study was performed to evaluate risk factors for acquisition of neonatal GNB LOS...
February 2016: American Journal of Infection Control
Fu-Chun Kuo, Shih-Min Wang, Ching-Fen Shen, Yun-Ju Ma, Tzong-Shiann Ho, Jiann-Shiuh Chen, Chao-Neng Cheng, Ching-Chuan Liu
BACKGROUND/PURPOSE: Acute leukemia is the most common pediatric hematological malignancy. Bloodstream infections (BSIs) are severe complications in these patients during chemotherapy. This study aims to explore clinical features, laboratory, and microbiological characteristics of BSIs in acute leukemic children. METHODS: Patients aged < 18 years, diagnosed with acute myeloid leukemia or acute lymphocytic leukemia with BSIs from January 2004 to December 2013 were enrolled...
August 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Maja Surbatovic, Nada Popovic, Danilo Vojvodic, Ivan Milosevic, Gordana Acimovic, Milan Stojicic, Milic Veljovic, Jasna Jevdjic, Dragan Djordjevic, Sonja Radakovic
Sepsis is a principal cause of death in critical care units worldwide and consumes considerable healthcare resources. The aim of our study was to determine whether the early cytokine profile can discriminate between Gram-positive and Gram-negative bacteraemia (GPB and GNB, respectively) and to assess the prognostic value regarding outcome in critically ill patients with severe abdominal sepsis. The outcome measure was hospital mortality. Blood samples were obtained from 165 adult patients with confirmed severe abdominal sepsis...
June 16, 2015: Scientific Reports
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