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https://www.readbyqxmd.com/read/29755705/appropriate-duration-of-intravenous-treatment-of-candidemia-and-timing-of-step-down-to-oral-therapy-in-non-neutropenic-patients
#1
REVIEW
Rita Wilson Dib, Ray Hachem, Anne-Marie Chaftari, Issam Raad
In this review, we have analyzed the available literature pertaining to the total duration of intravenous (IV) therapy and the appropriate timing of step down to oral therapy in the management of candidemia. Overview of the guidelines and literature seem to indicate that a minimum of 14 days of antifungal therapy is required in the treatment of candidemia without deeply seated infection. However, this was never based on evidence. Furthermore, step down to oral therapy seems to be dependent on the clinical stability criteria of the patient with candidemia after 4 to 7 days of IV therapy...
2018: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/29746596/the-hyr1-protein-from-the-fungus-candida-albicans-is-a-cross-kingdom-immunotherapeutic-target-for-acinetobacter-bacterial-infection
#2
Priya Uppuluri, Lin Lin, Abdullah Alqarihi, Guanpingsheng Luo, Eman G Youssef, Sondus Alkhazraji, Nannette Y Yount, Belal A Ibrahim, Michael Anthony Bolaris, John E Edwards, Marc Swidergall, Scott G Filler, Michael R Yeaman, Ashraf S Ibrahim
Different pathogens share similar medical settings and rely on similar virulence strategies to cause infections. We have previously applied 3-D computational modeling and bioinformatics to discover novel antigens that target more than one human pathogen. Active and passive immunization with the recombinant N-terminus of Candida albicans Hyr1 (rHyr1p-N) protect mice against lethal candidemia. Here we determine that Hyr1p shares homology with cell surface proteins of the multidrug resistant Gram negative bacterium, Acinetobacter baumannii including hemagglutinin (FhaB) and outer membrane protein A (OmpA)...
May 10, 2018: PLoS Pathogens
https://www.readbyqxmd.com/read/29734957/hospital-level-variability-in-broad-spectrum-antibiotic-use-for-children-with-acute-leukemia-undergoing-hematopoietic-cell-transplantation
#3
Caitlin W Elgarten, Staci D Arnold, Yimei Li, Yuan-Shung V Huang, Marcie L Riches, Jeffrey S Gerber, Richard Aplenc, Wael Saber, Brian T Fisher
OBJECTIVETo explore the prevalence and drivers of hospital-level variability in antibiotic utilization among hematopoietic cell transplant (HCT) recipients to inform antimicrobial stewardship initiatives.DESIGNRetrospective cohort study using data merged from the Pediatric Health Information System and the Center for International Blood and Marrow Transplant Research.SETTINGThe study included 27 transplant centers in freestanding children's hospitals.METHODSThe primary outcome was days of broad-spectrum antibiotic use in the interval from day of HCT through neutrophil engraftment...
May 8, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29724214/multiple-challenges-of-antibiotic-use-in-a-large-hospital-in-ethiopia-a-ward-specific-study-showing-high-rates-of-hospital-acquired-infections-and-ineffective-prophylaxis
#4
Girma Gutema, Helle Håkonsen, Ephrem Engidawork, Else-Lydia Toverud
BACKGROUND: This project aims to study the use of antibiotics in three clinical wards in the largest tertiary teaching hospital in Ethiopia for a period of 1 year. The specific aims were to assess the prevalence of patients on antibiotics, quantify the antibiotic consumption and identify the main indications of use. METHOD: The material was all the medical charts (n = 2231) retrieved from three clinical wards (internal medicine, gynecology/obstetrics and surgery) in Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa between September 2013 and September 2014...
May 3, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29722200/emergency-department-presentations-in-early-stage-breast-cancer-patients-receiving-adjuvant-and-neoadjuvant-chemotherapy
#5
Monica Tang, Patrick Horsley, Craig R Lewis
(Neo)adjuvant chemotherapy for early stage breast cancer is associated with side-effects, resulting in increased emergency department (ED) presentations. Treatment-related toxicity can affect quality of life, compromise chemotherapy delivery and treatment outcomes, and increase healthcare use. We performed a retrospective study of ED presentations in patients receiving curative chemotherapy for early breast cancer to identify factors contributing to ED presentations. Of 102 patients, 39 (38%) presented to ED within 30 days of chemotherapy, resulting in 63 ED presentations in total...
May 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29720244/administration-of-taurolidine-citrate-lock-solution-for-prevention-of-central-venous-catheter-infection-in-adult-neutropenic-haematological-patients-a-randomised-double-blinded-placebo-controlled-trial-taurcat
#6
C Gudiol, S Nicolae, C Royo-Cebrecos, M Aguilar-Guisado, I Montero, C Martín-Gandul, M Perayre, D Berbel, M Encuentra, M Arnan, J M Cisneros-Herreros, J Carratalà
BACKGROUND: Catheter-related bloodstream infection (CRBSI) is one of the most frequent complications in patients with cancer who have central venous catheters (CVCs) implanted and is associated with substantial morbidity and mortality. Taurolidine is a non-antibiotic agent with broad-spectrum antimicrobial activity, which has been used as a lock solution to prevent CRBSI in some settings. However, little is known about its usefulness in high-risk adult neutropenic patients with cancer...
May 2, 2018: Trials
https://www.readbyqxmd.com/read/29707670/morphological-changes-and-induction-of-antifungal-resistance-in-aspergillus-fumigatus-due-to-different-co2-levels
#7
Sima Darabian, Sayed Jamal Hashemi, Sadegh Khodavaisy, Somayeh Sharifynia, Mohammad Kord, Maryam Akbari Dana, Farzad Aala, Sassan Rezaie
Background and Purpose: Aspergillosis is one of the most common opportunistic fungal infections in immunocompromised and neutropenic patients. Aspergillus fumigatus ( A. fumigatus ) is the most common causative agent of this infection. Due to variable CO2 concentrations that pathogens are exposed to during the infection process and to understand the role of CO2 , we examined the effects of various CO2 concentrations as one of the environmental factors on morphological changes and induction of antifungal resistance in A...
September 2017: Advances in Medical Mycology (Iran)
https://www.readbyqxmd.com/read/29701766/colonization-with-levofloxacin-resistant-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-and-risk-of-bacteremia-in-hematopoietic-stem-cell-transplant-recipients
#8
Michael J Satlin, Kalyan D Chavda, Thomas M Baker, Liang Chen, Elena Shashkina, Rosemary Soave, Catherine B Small, Samantha E Jacobs, Tsiporah B Shore, Koen van Besien, Lars F Westblade, Audrey N Schuetz, Vance G Fowler, Stephen G Jenkins, Thomas J Walsh, Barry N Kreiswirth
Background: Bacteremia caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) is associated with inadequate empirical therapy and substantial mortality in neutropenic patients. Strategies are needed to identify neutropenic patients at high risk of these infections. Methods: We collected perianal swabs from patients undergoing hematopoietic stem cell transplantation (HSCT) from April 2014-September 2016 on admission and weekly thereafter. Patients received prophylactic levofloxacin while neutropenic...
April 26, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29687743/clinical-outcomes-of-treatment-with-filgrastim-versus-a-filgrastim-biosimilar-and-febrile-neutropenia-associated-costs-among-patients-with-nonmyeloid-cancer-undergoing-chemotherapy
#9
Lee S Schwartzberg, Lincy S Lal, Sanjeev Balu, Kim Campbell, Lee Brekke, Andrew DeLeon, Caitlin Elliott, Stephanie Korrer
BACKGROUND: Granulocyte colony-stimulating factors such as filgrastim are used to decrease the incidence of febrile neutropenia (FN) among patients with nonmyeloid cancers undergoing chemotherapy treatment. Although the biosimilar filgrastim-sndz has been approved in the United States since 2015, limited real-world comparisons of filgrastim-sndz versus reference filgrastim (filgrastim-ref) have been conducted. OBJECTIVE: To compare FN incidence and assess overall FN-related health care resource utilization and medical costs among U...
April 24, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29670926/-clostridium-tertium-an-unusual-cause-of-pyogenic-liver-abscess
#10
Mohamed Barakat, Steven Hernandez, Janeeka Benoit, Seyedmohammad Pourshahid, Yusufal Mamoon, George T Martin
Pyogenic liver abscess (PLA) is the result of portal vein pyemia, which usually originates from the hepatobiliary system or the gastrointestinal tract. Gram-negative organisms are the most common causative pathogens in PLA. Clostridium tertium is an anaerobic gram-positive, low-virulence organism that most commonly affects neutropenic patients with hematological malignancy and has not been reported to cause PLA. We report an unusual presentation of a C. tertium infection as a PLA in a previously healthy, immunocompetent patient with no identifiable source of portal pyemia...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29670632/quantitative-simulations-predict-treatment-strategies-against-fungal-infections-in-virtual-neutropenic-patients
#11
Sandra Timme, Teresa Lehnert, Maria T E Prauße, Kerstin Hünniger, Ines Leonhardt, Oliver Kurzai, Marc Thilo Figge
The condition of neutropenia, i.e., a reduced absolute neutrophil count in blood, constitutes a major risk factor for severe infections in the affected patients. Candida albicans and Candida glabrata are opportunistic pathogens and the most prevalent fungal species in the human microbiota. In immunocompromised patients, they can become pathogenic and cause infections with high mortality rates. In this study, we use a previously established approach that combines experiments and computational models to investigate the innate immune response during blood stream infections with the two fungal pathogens C...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29662673/epidemiology-and-management-of-healthcare-associated-bloodstream-infections-in-non-neutropenic-immunosuppressed-patients-a-review-of-the-literature
#12
REVIEW
Nursel Calik Basaran, Sibel Ascioglu
Advancements in medicine have led to a considerable increase in the proportion of patients living with severe chronic diseases, malignancies, and HIV infections. Most of these conditions are associated with acquired immune-deficient states and treatment-related immunosuppression. Although infections as a result of neutropenia have long been recognized and strategies for management were developed, non-neutropenic immunosuppression has been overlooked. Recently, community-acquired infections in patients with frequent, significant exposure to healthcare settings and procedures have been classified as 'healthcare-associated infections' since they are more similar to hospital-acquired infections...
November 2017: Therapeutic Advances in Infectious Disease
https://www.readbyqxmd.com/read/29661631/chlorhexidine-containing-dressings-in-the-prevention-of-central-venous-catheter-related-bloodstream-infections-a-cost-and-resource-utilization-analysis
#13
Sebastian M Heimann, Lena M Biehl, Jörg Janne Vehreschild, Bernd Franke, Oliver A Cornely, Maria J G T Vehreschild
BACKGROUND: A recent study reported a reduction in probable/definite central venous catheter (CVC)-related bloodstream infections (CRBSIs) in neutropenic high-risk patients using CVC dressings with a chlorhexidine-containing gel pad. METHODS: Based on published data, a health-economic analysis was performed to analyze the economic effect of using CVC dressings with a chlorhexidine-containing gel pad compared to non-chlorhexidine control dressings. A micro-costing approach was used to determine CRBSI-related direct treatment cost factors...
April 13, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29653202/clinicopathological-feature-and-outcome-of-pythiosis
#14
Maria Nina Chitasombat, Noppadol Larbcharoensub, Ariya Chindamporn, Theerapong Krajaejun
OBJECTIVES: Vascular pythiosis is a life-threatening infection, caused by Pythium insidiosum. We presented the clinical presentation, serodiagnosis, pathology, and outcome from our institution. METHODS: We retrospectively analyzed patients with proven vascular pythiosis at Ramathibodi Hospital, Mahidol University, Bangkok, Thailand from January 2006 to December 2016. RESULTS: Thirteen patients were analyzed, eight thalassemias. Five had aplastic anemia, myelodysplasia, acute leukemia, cirrhosis, and alcoholism...
April 10, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29629702/galactomannan-antigen-test-for-early-diagnosis-of-invasive-aspergillus-infection-in-pediatric-febrile-neutropenia
#15
LETTER
Jogender Kumar, Amitabh Singh, Rachna Seth, Immaculata Xess, Sushil Kumar Kabra
Invasive aspergillosis is a major concern in neutropenic patients. We studied the utility of Galactomannan antigen detection test in serum using ELISA technique for early detection of invasive aspergillosis. Diagnostic accuracy of Galactomannan index (GMI) test was maximum at a cut-off of > 1.5 with a negative predictive value of more than 95%.
March 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29627985/strategic-approaches-to-overcome-resistance-against-gram-negative-pathogens-using-%C3%AE-lactamase-inhibitors-and-%C3%AE-lactam-enhancers-activity-of-three-novel-diazabicyclooctanes-wck-5153-zidebactam-wck-5107-and-wck-4234
#16
Krisztina M Papp-Wallace, Nhu Q Nguyen, Michael R Jacobs, Christopher R Bethel, Melissa D Barnes, Vijay Kumar, Saralee Bajaksouzian, Susan D Rudin, Philip N Rather, Satish Bhavsar, Tadiparthi Ravikumar, Prasad K Deshpande, Vijay Patil, Ravindra Yeole, Sachin S Bhagwat, Mahesh V Patel, Focco van den Akker, Robert A Bonomo
Limited treatment options exist to combat infections caused by multidrug-resistant (MDR) Gram-negative bacteria possessing broad-spectrum β-lactamases. The design of novel β-lactamase inhibitors is of paramount importance. Here, three novel diazabicyclooctanes (DBOs), WCK 5153, zidebactam (WCK 5107), and WCK 4234 (compounds 1-3, respectively), were synthesized and biochemically characterized against clinically important bacteria. Compound 3 inhibited class A, C, and D β-lactamases with unprecedented k2 / K values against OXA carbapenemases...
April 20, 2018: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29627080/assessment-and-management-of-diarrhea-following-vegf-receptor-tki-treatment-in-patients-with-ovarian-cancer
#17
REVIEW
Joyce Liu, Shibani Nicum, Peter Reichardt, Kenneth Croitoru, Beate Illek, Manuela Schmidinger, Catherine Rogers, Christin Whalen, Gordon C Jayson
Angiogenesis is a proven clinical target for the treatment of advanced epithelial ovarian cancer. Vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) offer patients potential new treatment regimens as they can be given as monotherapy, in combination with poly(ADP-ribose) polymerase (PARP) inhibitors, or with and following cytotoxic chemotherapy. If VEGFR-TKIs are licensed for use in ovarian cancer, patients will require prompt and effective management of adverse events, including diarrhea, to optimize compliance and benefit...
April 4, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29626024/pyrexia-of-unknown-origin
#18
Cristina Fernandez, Nick J Beeching
The syndrome of pyrexia of unknown origin (PUO) was first defined in 1961 but remains a clinical challenge for many physicians. Different subgroups with PUO have been suggested, each requiring different investigative strategies: classical, nosocomial, neutropenic and HIV-related. This could be expanded to include the elderly as a fifth group. The causes are broadly divided into four groups: infective, inflammatory, neoplastic and miscellaneous. Increasing early use of positron emission tomography-computed tomography (PET-CT) and the development of new molecular and serological tests for infection have improved diagnostic capability, but up to 50% of patients still have no cause found despite adequate investigations...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29621565/p-aeruginosa-blood-stream-infection-isolates-a-full-house-of-virulence-genes-in-isolates-associated-with-rapid-patient-death-and-patient-survival
#19
K L McCarthy, A M Wailan, A V Jennison, T J Kidd, D L Paterson
We have recently characterised the epidemiology of P. aeruginosa blood stream infection (BSI) in a large retrospective multicentre cohort study [1]. Utilising corresponding patient BSI isolates we aimed to characterise the genotypic virulence profile of the P. aeruginosa isolates that were associated with rapid death in the non-neutropenic host. Five P. aeruginosa BSI episodes were identified from a larger cohort of P. aeruginosa BSI episodes previously described by McCarthy et al. [1]. The genotypic profile of another 5 isolates from this cohort in whom the non-neutropenic host had survived one year post the BSI was also analysed for comparison...
April 2, 2018: Microbial Pathogenesis
https://www.readbyqxmd.com/read/29619027/predictive-virtual-infection-modeling-of-fungal-immune-evasion-in-human-whole-blood
#20
Maria T E Prauße, Teresa Lehnert, Sandra Timme, Kerstin Hünniger, Ines Leonhardt, Oliver Kurzai, Marc Thilo Figge
Bloodstream infections by the human-pathogenic fungi Candida albicans and Candida glabrata increasingly occur in hospitalized patients and are associated with high mortality rates. The early immune response against these fungi in human blood comprises a concerted action of humoral and cellular components of the innate immune system. Upon entering the blood, the majority of fungal cells will be eliminated by innate immune cells, i.e., neutrophils and monocytes. However, recent studies identified a population of fungal cells that can evade the immune response and thereby may disseminate and cause organ dissemination, which is frequently observed during candidemia...
2018: Frontiers in Immunology
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