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https://www.readbyqxmd.com/read/28102514/carbapenemase-producing-klebsiella-pneumoniae-bloodstream-infection-in-critically-ill-patients-risk-factors-and-predictors-of-mortality
#1
M Papadimitriou-Olivgeris, F Fligou, C Bartzavali, A Zotou, A Spyropoulou, K Koutsileou, S Vamvakopoulou, N Sioulas, V Karamouzos, E D Anastassiou, I Spiliopoulou, M Christofidou, M Marangos
A significant increase in carbapenemase-producing Klebsiella pneumoniae (CP-Kp) bacteraemias has been observed worldwide. The objective of the present work was to study the risk factors and predictors of mortality of CP-Kp bacteraemias among critically ill patients. During a 4-year period (2012-3015), a matched 1:2 case-control study was conducted. Klebsiella pneumoniae was identified by Vitek 2 technology. Antibiotic susceptibility was performed by the agar disc diffusion method and Etest. The presence of the bla KPC, bla VIM and bla NDM genes was confirmed by polymerase chain reaction (PCR)...
January 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28098629/right-dose-right-now-customized-drug-dosing-in-the-critically-ill
#2
Jason A Roberts, Anand Kumar, Jeffrey Lipman
Drugs are key weapons that clinicians have to battle against the profound pathologies encountered in critically ill patients. Antibiotics in particular are commonly used and can improve patient outcomes dramatically. Despite this, there are strong opportunities for further reducing the persisting poor outcomes for infected critically ill patients. However, taking these next steps for improving patient care requires a new approach to antibiotic therapy. Giving the right dose is highly likely to increase the probability of clinical cure from infection and suppress the emergence of resistant pathogens...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28096487/a-clostridium-difficile-specific-gel-forming-protein-required-for-optimal-spore-germination
#3
M Lauren Donnelly, William Li, Yong-Qing Li, Lauren Hinkel, Peter Setlow, Aimee Shen
: Clostridium difficile is a Gram-positive spore-forming obligate anaerobe that is a leading cause of antibiotic-associated diarrhea worldwide. In order for C. difficile to initiate infection, its aerotolerant spore form must germinate in the gut of mammalian hosts. While almost all spore-forming organisms use transmembrane germinant receptors to trigger germination, C. difficile uses the pseudoprotease CspC to sense bile salt germinants. CspC activates the related subtilisin-like protease CspB, which then proteolytically activates the cortex hydrolase SleC...
January 17, 2017: MBio
https://www.readbyqxmd.com/read/28076746/characteristics-of-patients-presenting-to-an-after-hours-clinic-results-of-a-magnet-analysis
#4
Lyle R Turner, Christopher Pearce, Madeleine Borg, Adam McLeod, Marianne Shearer, Danielle Mazza
After-hours access to general practice (GP) is critical to supporting accessibility and reducing emergency department demand. To understand who utilises after-hours GP services, this study examined the characteristics of presentations to an Eastern Melbourne after-hours clinic between 2005 and 2014. Descriptive analyses of patient and presentation characteristics, diagnoses, medications and pathology were conducted. Across the study period, 39.1% of presentations to the clinic (N=64,800) were by patients under 18 years of age...
January 12, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28076304/the-use-of-liquid-chromatography-tandem-mass-spectrometry-for-therapeutic-drug-monitoring-of-antibiotics-in-cancer-patients
#5
Nahed El-Najjar, Jonathan Jantsch, André Gessner
Cancer remains a leading cause of mortality and morbidity worldwide. In addition to organ failure, the most frequent reasons for admission of cancer patients to intensive care units (ICU) are: infections and sepsis. As critically ill, the complexity of the health situation of cancer patients renders the standard antimicrobial regimen more complex and even inadequate which results in increased mortality rates. This is due to pathophysiological changes in the volume of distribution, increased clearance, as well as to organ dysfunction...
January 11, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28065331/antimicrobial-stewardship-in-kansas-results-from-a-statewide-survey
#6
Carrie Poteete, Joseph M Scaletta
BACKGROUND: The availability of effective antibiotics is considered one of the most important developments in medicine. However, many organisms that were once susceptible to common antibiotics are becoming resistant. Antimicrobial stewardship programs (ASPs) are considered to be vital for combating the emergence of resistance. To understand current antimicrobial stewardship practices in Kansas, the authors designed a 36-question survey. Results of this survey will be used to develop a coordinated, public health strategy for improving current practices...
January 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28054923/descriptive-longitudinal-study-results-applied-to-statistical-models-to-assess-the-impact-of-early-microbiological-cultures-on-the-economic-burden-of-treatment-for-infected-diabetic-foot-ulcers-at-a-mexican-public-health-facility
#7
Luz-Ma-Adriana Balderas-Peña, Daniel Sat-Muñoz, Rosa-Emilia Ramírez-Conchas, Moisés-Roberto Alvarado-Iñiguez, Javier-Eduardo García-de-Alba-García, Eduardo Cruz-Corona, José-Luis Chávez-Hurtado, José-Martín Chagollán-Ramírez
Infection plays a critical role in health care and impacts the cost of the treatment of diabetic foot ulcers (DFU). To examine the cost reduction associated with the multidisciplinary treatment of infected DFU (IDFU) by obtaining early (ie, within 48 hours of admission) microbiological culture results, a descriptive, longitudinal study was conducted. Data were collected prospectively from patient medical charts of a cohort of 67 patients (mean age, 56.14 ± 12.3 years; mean duration of diabetes, 14.95 ± 8 years) with IDFU treated at a Mexican public health facility from January 1 to April 30, 2010...
December 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/28036056/genetic-regulation-of-virulence-and-antibiotic-resistance-in-acinetobacter-baumannii
#8
REVIEW
Carsten Kröger, Stefani C Kary, Kristina Schauer, Andrew D S Cameron
Multidrug resistant microorganisms are forecast to become the single biggest challenge to medical care in the 21st century. Over the last decades, members of the genus Acinetobacter have emerged as bacterial opportunistic pathogens, in particular as challenging nosocomial pathogens because of the rapid evolution of antimicrobial resistances. Although we lack fundamental biological insight into virulence mechanisms, an increasing number of researchers are working to identify virulence factors and to study antibiotic resistance...
December 28, 2016: Genes
https://www.readbyqxmd.com/read/28018869/pathogens-and-antimicrobial-susceptibility-profiles-in-critically-ill-patients-with-bloodstream-infections-a-descriptive-study
#9
Rachel D Savage, Robert A Fowler, Asgar H Rishu, Sean M Bagshaw, Deborah Cook, Peter Dodek, Richard Hall, Anand Kumar, François Lamontagne, François Lauzier, John Marshall, Claudio M Martin, Lauralyn McIntyre, John Muscedere, Steven Reynolds, Henry T Stelfox, Nick Daneman
BACKGROUND: Surveillance of antimicrobial resistance is vital to guiding empirical treatment of infections. Collating and reporting routine data on clinical isolate testing may offer more timely information about resistance patterns than traditional surveillance network methods. METHODS: Using routine microbiology testing data collected from the Bacteremia Antibiotic Length Actually Needed for Clinical Effectiveness retrospective cohort study, we conducted a descriptive secondary analysis among critically ill patients in whom bloodstream infections had been diagnosed in 14 intensive care units (ICUs) in Canada...
October 2016: CMAJ Open
https://www.readbyqxmd.com/read/28004983/methicillin-resistant-staphylococcus-aureus-pneumonia-in-critically-ill-trauma-and-burn-patients-a-retrospective-cohort-study
#10
Kristen L Bunnell, Andrew R Zullo, Christine Collins, Charles A Adams
BACKGROUND: The timing and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia in trauma patients are not well characterized. This information is critical for the selection of appropriate empiric antibiotics. The objective of this study was to determine the incidence of MRSA pneumonia in early-onset and late-onset pneumonia and to identify risk factors for MRSA in the trauma-burn intensive care unit (ICU). PATIENTS AND METHODS: We conducted a retrospective cohort study from January 2012 to March 2015 of patients in the trauma and burn ICU with clinical and microbiologic evidence of pneumonia...
December 22, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27992988/-risk-factors-for-methicillin-resistant-staphylococcus-aureus-bacteremia-a-multicenter-matched-case-control-study
#11
Paola Mariana Arias-Ortiz, Libia Del Pilar Calderón, Juan Sebastián Castillo, José Moreno, Aura Lucía Leal, Jorge Alberto Cortés, Carlos Arturo Álvarez, Grupo Grebo
INTRODUCTION: Methicillin-resistant Staphylococcus aureus is a frequent pathogen at critical care services. Its presence leads to increased hospital stays and mortality risk in patients with bacteremia. However, the etiology of this resistance marker has not been fully studied. OBJECTIVE: To identify risk factors associated with the emergence of methicillin-resistant S. aureus bacteremia in critically ill patients treated at intensive care units in Bogotá, Colombia...
December 1, 2016: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/27990491/livestock-vaccinations-translate-into-increased-human-capital-and-school-attendance-by-girls
#12
Thomas L Marsh, Jonathan Yoder, Tesfaye Deboch, Terry F McElwain, Guy H Palmer
To fulfill the United Nation's Sustainable Development Goals (SDGs), it is useful to understand whether and how specific agricultural interventions improve human health, educational opportunity, and food security. In sub-Saharan Africa, 75% of the population is engaged in small-scale farming, and 80% of these households keep livestock, which represent a critical asset and provide protection against economic shock. For the 50 million pastoralists, livestock play an even greater role. Livestock productivity for pastoralist households is constrained by multiple factors, including infectious disease...
December 2016: Science Advances
https://www.readbyqxmd.com/read/27988146/simplified-antibiotic-regimens-for-treatment-of-clinical-severe-infection-in-the-outpatient-setting-when-referral-is-not-possible-for-young-infants-in-pakistan-simplified-antibiotic-therapy-trial-satt-a-randomised-open-label-equivalence-trial
#13
Fatima Mir, Imran Nisar, Shiyam S Tikmani, Benazir Baloch, Sadia Shakoor, Fyezah Jehan, Imran Ahmed, Simon Cousens, Anita K M Zaidi
BACKGROUND: Parenteral antibiotic therapy for young infants (aged 0-59 days) with suspected sepsis is sometimes not available or feasible in countries with high neonatal mortality. Outpatient treatment could save lives in such settings. We aimed to assess the equivalence of two simplified antibiotic regimens, comprising fewer injections and oral rather than parenteral administration, compared with a reference treatment for young infants with clinical severe infection. METHODS: We undertook the Simplified Antibiotic Therapy Trial (SATT), a three-arm, randomised, open-label, equivalence trial in five communities in Karachi, Pakistan...
December 14, 2016: Lancet Global Health
https://www.readbyqxmd.com/read/27986722/detection-of-eskape-bacterial-pathogens-at-the-point-of-care-using-isothermal-dna-based-assays-in-a-portable-de-gas-microfluidic-diagnostic-assay-platform
#14
Lars D Renner, Jindong Zan, Linda I Hu, Manuel Martinez, Pedro J Resto, Adam C Siegel, Clint Torres, Sara B Hall, Tom R Slezak, Tuan H Nguyen, Douglas B Weibel
: An estimated 1.5B microbial infections occur globally each year and result in ∼4.6M deaths. A technology gap associated with commercially available diagnostic tests in remote and underdeveloped regions prevents timely pathogen identification for effective antibiotic chemotherapies for infected patients. The result is a trial-and-error approach that is limited in effectiveness and increases risk for patients while contributing to antimicrobial drug resistance and reduces the lifetime of antibiotics...
December 16, 2016: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/27976489/improving-the-quality-of-nurse-influenced-patient-care-in-the-intensive-care-unit
#15
Lynsey J Sutton, Rebecca J Jarden
BACKGROUND: Quality of care is a major focus in the intensive care unit (ICU). AIM: To describe a nurse-initiated quality improvement (QI) project that improved the care of critically ill patients in a New Zealand tertiary ICU. DESIGN: A framework for QI was developed and implemented as part of a practice change initiative. METHODS: Audit data were collected, analysed and reported across seven nurse-influenced patient care standards...
December 14, 2016: Nursing in Critical Care
https://www.readbyqxmd.com/read/27959299/drug-induced-liver-injury
#16
Leslie A Hamilton, Angela Collins-Yoder, Rachel E Collins
Drug-induced liver injury (DILI) can result from both idiosyncratic and intrinsic mechanisms. This article discusses the clinical impact of DILI from a broad range of medications as well as herbal and dietary supplements. Risk factors for idiosyncratic DILI (IDILI) are the result of multiple host, environmental, and compound factors. Some triggers of IDILI often seen in critical care include antibiotics, antiepileptic medications, statins, novel anticoagulants, proton pump inhibitors, inhaled anesthetics, nonsteroidal anti-inflammatory agents, methotrexate, sulfasalazine, and azathioprine...
October 2016: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/27958229/epidemiological-study-of-sepsis-in-china-protocol-of-a-cross-sectional-survey
#17
Yi Yang, Jian-Feng Xie, Kai-Jiang Yu, Chen Yao, Jian-Guo Li, Xiang-Dong Guan, Jing Yan, Xiao-Chun Ma, Yan Kang, Cong-Shan Yang, Xiao-Qing Yao, Hong-Cai Shang, Hai-Bo Qiu
BACKGROUND: Sepsis is the leading cause of death among critically ill patients. Herein, we conducted a national survey to provide data on epidemiology and treatment of sepsis in the clinical practice in China, which has no detailed epidemiological data available on sepsis. METHODS: This was a prospective cross-sectional survey from December 1, 2015 to January 31, 2016 in all provinces/municipalities of the mainland of China. The primary outcome of this study was the incidence of sepsis, and the secondary outcome was its etiology in China...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27933276/acinetobacter-baumannii-isolated-from-lebanese-patients-phenotypes-and-genotypes-of-resistance-clonality-and-determinants-of-pathogenicity
#18
Elias Dahdouh, Micheline Hajjar, Monica Suarez, Ziad Daoud
Introduction:Acinetobacter baumannii is a nosocomial pathogen that usually affects critically ill patients. High mortality rates have been associated with MDR A. baumannii infections. Carbapenem resistance among these isolates is increasing worldwide and is associated with certain International Clones (ICs) and oxacillinases (OXAs). Moreover, this organism possesses a wide range of virulence factors, whose expression is not yet fully understood. In this study, clinical A. baumannii isolates are characterized in terms of antibiotic resistance, mechanisms of carbapenem resistance, clonality, and virulence...
2016: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/27931213/assessment-of-core-drug-use-indicators-using-who-inrud-methodology-at-primary-healthcare-centers-in-bahawalpur-pakistan
#19
Muhammad Atif, Muhammad Rehan Sarwar, Muhammad Azeem, Mubeen Naz, Salma Amir, Kashaf Nazir
BACKGROUND: Proper utilization of medicines is a critical component of pharmaceutical care plan. The aim of this study was to assess drug use pattern at ten primary healthcare centers (PHCCs) of the Bahawalpur district of the Punjab province of Pakistan by employing the WHO/INRUD core drug use indicators. METHODS: This was a descriptive, non-experimental and cross-sectional study. For the prescribing indicators, 1000 prescriptions (100 prescriptions per PHCC) were systematically sampled out of the total 290,000 prescriptions written during January to December 2014...
December 8, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27920421/a-missing-guide-wire-after-placement-of-peripherally-inserted-central-venous-catheter
#20
Muhammad Kashif, Hafiz Hashmi, Preeti Jadhav, Misbahuddin Khaja
BACKGROUND Central venous catheterization is a common tool used in critically ill patients to monitor central venous pressure and administer fluids and medications such as vasopressors. Here we present a case of a missing guide wire after placement of peripherally inserted central catheter (PICC), which was incidentally picked up by bedside ultrasound in the intensive care unit.  CASE REPORT A 50-year-old Hispanic male was admitted to the intensive care unit for alcohol intoxication. He was managed for septic shock and required placement of a peripherally inserted central line in his left upper extremity for antibiotics and vasopressor administration...
December 6, 2016: American Journal of Case Reports
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