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Empiric antibiotic treatment of sepsis

Gamze Ozgurhan, Oznur Vermezoglu, Didem Ocal Topcu, Adem Karbuz, Aysel Vehapoglu, Bulent Hacihamdioglu
Although rotavirus gastroenteritis is quite common in the pediatric population, secondary bacterial sepsis following rotavirus infection is a rare clinical entity. Gram-negative bacilli are the fifth most common cause of meningitis in infants but this infection rarely occurs after gastroenteritis. Here, we report a 2.5-month-old infant who developed Escherichia coli (E. coli) meningitis after acute rotavirus gastroenteritis. The 2.5-month-old male infant with fever, vomiting, and watery diarrhea that started 1 day earlier was admitted to the hospital...
2016: Case Reports in Infectious Diseases
Raquel M Martinez, Donna M Wolk
Bacteremia and sepsis are conditions associated with high mortality and are of great impact to health care operations. Among the top causes of mortality in the United States, these conditions cause over 600 fatalities each day. Empiric, broad-spectrum treatment is a common but often a costly approach that may fail to effectively target the correct microbe, may inadvertently harm patients via antimicrobial toxicity or downstream antimicrobial resistance. To meet the diagnostic challenges of bacteremia and sepsis, laboratories must understand the complexity of diagnosing and treating septic patients, in order to focus on creating algorithms that can help direct a more targeted approach to antimicrobial therapy and synergize with existing clinical practices defined in new Surviving Sepsis Guidelines...
August 2016: Microbiology Spectrum
Rafael Barberena Moraes, Julián Alberto Viteri Guillén, William Javier Castillo Zabaleta, Flavia Kessler Borges
OBJECTIVE: To evaluate the prevalence of antibiotic de-escalation in patients diagnosed with severe sepsis or septic shock at a public academic tertiary hospital and to evaluate antibiotic adequacy and culture positivity. METHODS: The prevalence of antibiotic de-escalation, the adequacy of antibiotic treatment and the rates of culture positivity were analyzed in patients with severe sepsis and septic shock between April and December 2013 at an intensive care unit in a tertiary university hospital...
September 2016: Revista Brasileira de Terapia Intensiva
Elio Castagnola, Livia Gargiullo, Salvatore Renna, Anna Loy, Francesco Risso, Andrea Moscatelli, Ivana Baldelli, Giuliana Cangemi, Roberto Bandettini
Background Colonization/infection by antibiotic-resistant bacteria is becoming a major threat to health care systems. Case report Two septic neonates were readmitted in our hospital few days after hospital discharge. In both of them, microbiological workup revealed an infection caused by multiresistant pathogens. Noteworthy, one baby had received intensive care management for 4 weeks, whereas the other had been vaginally delivered and sent home on his second day of life. Conclusion These cases suggest that in countries and/or hospital with high prevalence of colonization/infection by resistant pathogens in nurseries, neonatal intensive care units, and obstetric wards, the choice of initial therapy of suspected sepsis in a neonate readmitted from home soon after discharge should take into account the possibility of an infection due to a multiresistant pathogen...
September 2016: American Journal of Perinatology
Nidhi Jain, Malvi Savani, Manyoo Agarwal, Dipen Kadaria
BACKGROUND: Hypoglycemia in a critical care setting is often multifactorial with iatrogenic insulin use, sulfonylurea (SU) use, sepsis, adrenal insufficiency and insulinoma among the common causes. Insulin autoimmune syndrome (IAS) is a rare cause of hypoglycemia characterized by the presence of insulin-binding autoantibodies to the sulfhydryl group-containing agents. We report a case of methimazole-induced IAS managed in the intensive care unit. CASE PRESENTATION: A 76-year-old woman with a history of primary hyperthyroidism was sent from a nursing home for unresponsiveness...
August 2016: Therapeutic Advances in Endocrinology and Metabolism
Arieh Riskin, Yael Aloni, Amir Kugelman, Arina Toropine, Waseem Said, David Bader
Objective Although its incidence is declining with the widespread use of intrapartum antibiotics, early-onset sepsis (EOS) continues to be associated with high morbidity and mortality. Maternal, infant, and peripartum risk factors, as well as infant's laboratory tests, have been used to try and identify asymptomatic newborns at risk. In this study, we reevaluate the management of newborns at risk for EOS by comparing our outcomes using two different approaches. Study Design Comparison of clinical data and outcomes of newborns at risk for EOS between two study periods, in which we have used two different protocols for their evaluation and management...
August 17, 2016: American Journal of Perinatology
Barış Ata Borsa, Mehmet Ersoy Aldağ, Birsen Tunalı, Uğur Dinç, Zeynep Güngördü Dalar, Veli Cengiz Özalp
The high prevalence of Bacillus species in nature and the detection of these bacteria as contaminant in cultures may lead diagnostic dilemma, however they should still be considered as a pathogen particularly in case of repeated positive cultures from patients with risk factors. Bacillus pumilus is a bacteria, though rarely, been reported as the causative agent of various infections such as sepsis, endocarditis, skin infections and food poisoning in human. In this report, a sepsis case in an immunocompetent patient caused by B...
July 2016: Mikrobiyoloji Bülteni
Young Kyung Yoon, Dae Won Park, Jang Wook Sohn, Hyo Youl Kim, Yeon-Sook Kim, Chang-Seop Lee, Mi Suk Lee, Seong-Yeol Ryu, Hee-Chang Jang, Young Ju Choi, Cheol-In Kang, Hee Jung Choi, Seung Soon Lee, Shin Woo Kim, Sang Il Kim, Eu Suk Kim, Jeong Yeon Kim, Kyung Sook Yang, Kyong Ran Peck, Min Ja Kim
BACKGROUND: The purported value of empirical therapy to cover methicillin-resistant Staphylococcus aureus (MRSA) has been debated for decades. The purpose of this study was to evaluate the effects of inappropriate empirical antibiotic therapy on clinical outcomes in patients with healthcare-associated MRSA bacteremia (HA-MRSAB). METHODS: A prospective, multicenter, observational study was conducted in 15 teaching hospitals in the Republic of Korea from February 2010 to July 2011...
2016: BMC Infectious Diseases
Marcelino Rivera, Boyd Viers, Patrick Cockerill, Deepak Agarwal, Ramila Mehta, Amy Krambeck
INTRODUCTION: We aim to describe pre- and postoperative predictors of infection-related complications in individuals undergoing percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS: Patients treated with PCNL from 2009 to 2013 were reviewed. Patients with positive urine or stone cultures received extended antimicrobial treatment. All others received 7 days of empirical therapy preoperatively and postoperatively. Pre- and postoperative predictors of infectious complication were identified...
September 2016: Journal of Endourology
Shlomi Bulkowstein, Shalom Ben-Shimol, Noga Givon-Lavi, Rimma Melamed, Eilon Shany, David Greenberg
BACKGROUND: We compared demographic and clinical characteristics of early-onset sepsis (EOS) and community-acquired late onset sepsis (CA-LOS) in infants. METHODS: Our medical center is the sole hospital in southern-Israel, enabling incidence calculations. EOS (<7 days) and CA-LOS (7-90 days) episodes recorded between 2007 and 2013 were reviewed. Univariate and multivariate analyses were performed. RESULTS: 70 EOS and 114 CA-LOS episodes were recorded...
2016: BMC Pediatrics
Peter Daley, Adam Comerford, Jurgienne Umali, Carla Penney
Background. Direct disk diffusion susceptibility testing provides faster results than standard microtitre susceptibility. The direct result may impact patient outcome in sepsis if it is accurate and if physicians use the information to promptly and appropriately change antibiotic treatment. Objective. To compare the performance of direct disk diffusion with standard susceptibility and to consider physician decisions in response to these early results, for community acquired bacteremia with Gram-negative Bacilli...
2016: Canadian Journal of Infectious Diseases & Medical Microbiology
Mohamed Mansor Manan, Nazedah Ain Ibrahim, Noorizan Abd Aziz, Hanis Hanum Zulkifly, Yaser Mohammed Ali Al-Worafi, Chiau Ming Long
INTRODUCTION: To identify and assess the characteristics, risk and outcome of neonates treated with empiric antibiotics for suspected early onset sepsis (EOS). MATERIAL AND METHODS: This is a retrospective study conducted at a Malaysian government hospital. Records of neonatal patients admitted within 72 h of life and prescribed with empirical antibiotic therapy for suspected EOS were reviewed. RESULTS: Three hundred and twenty-three cases met the inclusion criteria and were divided into gestational age (premature < 36 weeks; term ≥ 37 weeks) and birth weight (low birth weight (LBW) < 2...
June 1, 2016: Archives of Medical Science: AMS
B Du
No abstract text is available yet for this article.
June 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Wendy van Herk, Martin Stocker, Annemarie M C van Rossum
Early diagnosis and timely treatment of early onset neonatal sepsis (EOS) are essential to prevent life threatening complications. Subtle, nonspecific clinical presentation and low predictive values of biomarkers complicate early diagnosis. This uncertainty commonly results in unnecessary and prolonged empiric antibiotic treatment. Annually, approximately 395,000 neonates (7.9% of live term births) are treated for suspected EOS in the European Union, while the incidence of proven EOS varies between 0.01 and 0...
July 5, 2016: Journal of Infection
Yi-Chien Lee, Chih-Yen Hsiao, Miao-Chiu Hung, Sheng-Che Hung, Hung-Ping Wang, Yun-Jhong Huang, Jann-Tay Wang
The purpose of this study is to compare the clinical features and treatment outcomes among patients with bacteremic urinary tract infection (UTI) caused by multidrug-resistant (MDR) and non-MDR Enterobacteriaceae and to identify whether MDR pathogens were independently associated with severe sepsis or septic shock at presentation.The clinical data of adult patients visiting and being treated at Chia-Yi Christian Hospital due to bacteremic UTI caused by Enterobacteriaceae from January 2006 to August 2015 were retrospectively analyzed...
May 2016: Medicine (Baltimore)
Roberta Maia de Castro Romanelli, Lêni Márcia Anchieta, Ana Carolina Bueno E Silva, Lenize Adriana de Jesus, Viviane Rosado, Wanessa Trindade Clemente
OBJECTIVE: The aim of this study was to compare two different empiric treatments for late-onset neonatal sepsis, vancomycin and oxacillin, in a neonatal intensive care unit with a high prevalence of coagulase-negative Staphylococcus. METHODS: A cross-sectional study was conducted in an neonatal intensive care unit from 2011 to 2014. Data from the medical records of at-risk newborns were collected daily. Infections were defined according to the National Health Surveillance Agency criteria...
September 2016: Jornal de Pediatria
Vanessa Quan, Jennifer R Verani, Cheryl Cohen, Anne von Gottberg, Susan Meiring, Clare L Cutland, Stephanie J Schrag, Shabir A Madhi
Data on neonatal group B streptococcal (GBS) invasive disease burden are needed to refine prevention policies. Differences in surveillance methods and investigating for cases can lead to varying disease burden estimates. We compared the findings of laboratory-based passive surveillance for GBS disease across South Africa, and for one of the provinces compared this to a real-time, systematic, clinical surveillance in a population-defined region in Johannesburg, Soweto. Passive surveillance identified a total of 799 early-onset disease (EOD, <7 days age) and 818 LOD (late onset disease, 7-89 days age) cases nationwide...
2016: PloS One
Junaid Iqbal, Kevin R Dufendach, John C Wellons, Maria G Kuba, Hilary H Nickols, Oscar G Gómez-Duarte, James L Wynn
Neonatal meningitis is a rare but devastating condition. Multi-drug resistant (MDR) bacteria represent a substantial global health risk. This study reports on an aggressive case of lethal neonatal meningitis due to a MDR Escherichia coli (serotype O75:H5:K1). Serotyping, MDR pattern and phylogenetic typing revealed that this strain is an emergent and highly virulent neonatal meningitis E. coli isolate. The isolate was resistant to both ampicillin and gentamicin; antibiotics currently used for empiric neonatal sepsis treatment...
2016: Infectious Diseases
Zivanit Ergaz, Shmuel Benenson, Noa Ofek-Shlomai, Sinan Abu-Leil, Benjamin Bar-Oz
INTRODUCTION: Early prediction of late onset sepsis is imperative in order to improve survival and reduce long-term complications. Since clinical deterioration is detrimental, empiric antibiotic treatment is initiated once sepsis is suspected. Symptoms that may indicate invasive infection are non-specific. Previous risk scores offered to improve clinical decision-making but provided low predictive values. AIMS: To evaluate the quantitative early alert of software application compared to clinical judgment by the treating physician, and the "gold standard" of positive blood and/or positive cerebrospinal fluid...
January 2016: Harefuah
L Ashkenazi-Hoffnung, Y Mozer-Glassberg, E Bilavsky, R Yassin, R Shamir, J Amir
BACKGROUND: Although infections post liver transplantation are a main cause of morbidity and mortality, data are limited on transplanted children. The objective of this study was to investigate the incidence, etiology, and predictors of infection in pediatric liver transplant recipients (LTR) in the specific practical clinical setting of hospitalization for fever in order to elucidate the appropriate management of these patients. METHODS: Clinical and laboratory data were retrospectively collected for all febrile pediatric LTR hospitalized from 2004 to 2012...
June 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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