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health-care associated pneumonia

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https://www.readbyqxmd.com/read/28092309/microbiota-targeted-therapies-on-the-intensive-care-unit
#1
Bastiaan W Haak, Marcel Levi, W Joost Wiersinga
PURPOSE OF REVIEW: The composition and diversity of the microbiota of the human gut, skin, and several other sites is severely deranged in critically ill patients on the ICU, and it is likely that these disruptions can negatively affect outcome. We here review new and ongoing studies that investigate the use of microbiota-targeted therapeutics in the ICU, and provide recommendations for future research. RECENT FINDINGS: Practically every intervention in the ICU as well as the physiological effects of critical illness itself can have a profound impact on the gut microbiota...
January 13, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28077751/performance-of-health-workers-using-an-electronic-algorithm-for-the-management-of-childhood-illness-in-tanzania-a-pilot-implementation-study
#2
Clotilde Rambaud-Althaus, Amani Shao, Josephine Samaka, Ndeniria Swai, Seneca Perri, Judith Kahama-Maro, Marc Mitchell, Valérie D'Acremont, Blaise Genton
In low-resource settings, where qualified health workers (HWs) are scarce and childhood mortality high, rational antimicrobial prescription for childhood illnesses is a challenge. To assess whether smartphones running guidelines, as compared with paper support, improve consultation process and rational use of medicines for children, a pilot cluster-randomized controlled study was conducted in Tanzania. Nine primary health-care facilities (HFs) were randomized into three arms: 1) paper algorithm, 2) electronic algorithm on a smartphone, and 3) control...
January 11, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28069652/antimicrobial-susceptibility-of-pseudomonas-aeruginosa-results-from-four-years-2012-2015-of-the-international-network-for-optimal-resistance-monitoring-inform-program-in-the-united-states
#3
Helio S Sader, Michael D Huband, Mariana Castanheira, Robert K Flamm
Pseudomonas aeruginosa represents a major cause of health-care associated infections, and inappropriate initial antimicrobial therapy is associated with increased morbidity and mortality. The International Network for Optimal Resistance Monitoring (INFORM) program monitors the in vitro activity of ceftazidime-avibactam and many comparators agents. We evaluated the antimicrobial susceptibility of 7,452 P. aeruginosa isolates collected from 79 USA medical centers in 2012-2015. The isolates were collected and tested consecutively for susceptibility by broth microdilution method...
January 9, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28057059/invasive-pneumococcal-disease-caused-by-mucoid-serotype-3-streptococcus-pneumoniae-a-case-report-and-literature-review
#4
Naomi Sugimoto, Yuka Yamagishi, Jun Hirai, Daisuke Sakanashi, Hiroyuki Suematsu, Naoya Nishiyama, Yusuke Koizumi, Hiroshige Mikamo
BACKGROUND: Among the different serotypes of Streptococcus pneumoniae, serotype 3 has received global attention. We report the fatal case of a 76-year-old Japanese man who had an invasive pneumococcal disease associated with pneumonia caused by serotype 3 S. pneumoniae. CASE PRESENTATION: The patient had a history of hypertension, laryngeal cancer, chronic obstructive pulmonary disease, and type 2 diabetes mellitus. Following a cerebral arteriovenous malformation hemorrhage, he underwent surgery to remove the hematoma and began rehabilitation...
January 4, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28051232/epidemiology-of-nosocomial-infections-about-70-cases
#5
Mohamed Hedfi, Hassen Khouni, Youssra Massoudi, Cherif Abdelhedi, Karim Sassi, Adnen Chouchen
Background - The infections associated with care (IAS) constitute a major public health problem by the morbi- mortality than they generate as well as by their cost to support. The prevention of these infections has become a priority for several years everywhere in the world and in the occurrence in Tunisia. Aim - The purpose of our study is to assess the prevalence of nosocomial infections as well as develop their microbiologic  profiles in the different departments of  the hospital of FSI  Marsa Tunisia and try to highlight the risk factors that can influence these infections Methods - It was a retrospective study about  patients with noscomila infection who were admitted in the different care unit of the Hospital of FSI  Marsa and this on a period of 6 years from 1 January 2009 to 31 December 2014 Results - We have identified seventy(70) patients having contracted a nososcomial infection during the period of study for 24600 hospital admission, with a prevalence rate of 0...
July 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28043925/fatal-community-acquired-ribotype-002-clostridium-difficile-bacteremia
#6
Nicolas Dauby, Agnès Libois, Johan Van Broeck, Michel Delmée, Olivier Vandenberg, Delphine Martiny
Extra-colonic infections, and especially bacteremia, are infrequent manifestations of Clostridium difficile infection. C. difficile bacteremia is generally health-care associated and polymicrobial. We report the case of a patient on hunger strike that presented a C. difficile colitis and mono-microbial bacteremia on its admission to the hospital. Multilocus variable number tandem repeat analysis of stool and blood isolates indicated clonality. The strain was characterized as a ribotype 002, an emerging ribotype previously associated with high fatality rate...
December 30, 2016: Anaerobe
https://www.readbyqxmd.com/read/28033143/probiotics-for-trauma-patients-should-we-be-taking-a-precautionary-approach
#7
Heather A Vitko, L Kathleen Sekula, Martin A Schreiber
The use of probiotics in the hospital setting is largely understudied and highly controversial. Probiotics are living organisms that, when taken internally, can produce an immunomodulating effect and improve the gastrointestinal (GI) mucosal barrier. Although used for centuries by healthy individuals for GI health, their use in the hospital setting is now gaining wide attention for the prevention of infectious complications such as antibiotic-associated diarrhea, Clostridium difficile infections, multiple-organ dysfunction syndrome, and ventilator-associated pneumonia...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28008700/knowledge-level-of-nurses-in-jordan-on-ventilator-associated-pneumonia-and-preventive-measures
#8
Zeinab M Hassan, Moayad A Wahsheh
BACKGROUND: Ventilator-associated pneumonia is the most prevalent infection in Intensive Care Units, with the highest mortality rate; crude mortality rates may be as high as 20-75%. Many practices such as prevention measures (e.g. hand washing, wearing gloves, suctioning, elevated head of bed between 30° and 45°) have demonstrated an effect of reducing the incidence of this infection. AIMS: To identify the level of nurses' knowledge of ventilator-associated pneumonia and prevention measures before an educational programme, identify the level of nurses' knowledge on ventilator-associated pneumonia and prevention post an educational programme and identify the reasons for not applying ventilator-associated pneumonia prevention measures among nurses in Jordan...
December 22, 2016: Nursing in Critical Care
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
#9
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/27965626/high-prevalence-of-gut-microbiota-colonization-with-broad-spectrum-cephalosporin-resistant-enterobacteriaceae-in-a-tunisian-intensive-care-unit
#10
Elaa Maamar, Sana Ferjani, Ali Jendoubi, Samia Hammami, Zaineb Hamzaoui, Laure Mayonnove-Coulange, Mabrouka Saidani, Aouatef Kammoun, Amel Rehaiem, Salma Ghedira, Mohamed Houissa, Ilhem Boutiba-Ben Boubaker, Amine Slim, Veronique Dubois
Healthcare-associated infections due to cefotaxime-resistant (CTX-R) Enterobacteriaceae have become a major public health threat, especially in intensive care units (ICUs). Often acquired nosocomially, CTX-R Enterobacteriaceae can be introduced initially by patients at admission. This study aimed to determine the prevalence and genetic characteristics of CTX-R Enterobacteriaceae-intestinal carriage in ICU patients, to evaluate the rate of acquisition of these organisms during hospitalization, and to explore some of the associated risk factors for both carriage and acquisition...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/27960213/complication-of-community-acquired-pneumonia-including-cardiac-complications
#11
Marcos I Restrepo, Luis F Reyes, Antonio Anzueto
Community-acquired pneumonia (CAP) represents an important public health problem and carries significant morbidity, mortality, and costs. The incidence of CAP is highest among children and elderly patients, but the mortality is much higher in patients older than 65 years. Despite the advances in medicine, the administration of antimicrobials, and the overall better care, there are still patients with CAP dying due to systemic complications all over the world. A continuum of CAP disease progression may involve multiple organs beyond the pulmonary parenchyma...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27960210/community-acquired-pneumonia-in-latin-america
#12
Hernán A Iannella, Carlos M Luna
Community-acquired pneumonia (CAP) is associated with significant morbidity and mortality in Latin America and the Caribbean (LAC) region. Poverty, socioeconomic factors, and malnutrition influence the incidence and outcome of CAP in LAC. In LAC, Streptococcus pneumoniae is the most frequent microorganism responsible for CAP, (incidence: 24-78%); the incidence of atypical microorganisms is similar to other regions of the world. Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a growing problem in the LAC region, with the Caribbean being the second most affected area worldwide after Sub-Saharan Africa...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27960209/community-acquired-pneumonia-in-sub-saharan-africa
#13
Stephen J Aston, Jamie Rylance
Community-acquired pneumonia (CAP) in sub-Saharan Africa is a common cause of adult hospitalization and is associated with significant mortality. Human immunodeficiency virus (HIV) prevalence in the region leads to differences in CAP epidemiology compared with most high-income settings: patients are younger, and coinfection with tuberculosis and opportunistic infections is common and difficult to diagnose. Resource limitations affect the availability of medical expertise as well as radiological and laboratory diagnostic services...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27960205/the-role-of-streptococcus-pneumoniae-in-community-acquired-pneumonia
#14
Charles Feldman, Ronald Anderson
Streptococcus pneumoniae (the pneumococcus) remains one of the most common causes of bacterial community-acquired pneumonia (CAP), encompassing infections mild enough to be treated on an outpatient basis, as well as those requiring hospital care, or even intensive care unit admission. This microorganism is associated with a significant burden of disease, causing substantial morbidity and mortality worldwide, and generating considerable health-care costs. The reason that pneumococcal CAP remains such a common cause of disease relates to the presence of several risk factors for this infection in patients throughout the world...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27940521/incidence-risk-factors-and-associated-mortality-of-central-line-associated-bloodstream-infections-at-an-intensive-care-unit-in-northern-india
#15
S B Mishra, R Misra, A Azim, A K Baronia, K N Prasad, T N Dhole, M Gurjar, R K Singh, B Poddar
OBJECTIVE: To evaluate the incidence, risk factors and associated mortality of central line-associated bloodstream infection (CLABSI) in an adult intensive care unit (ICU) in India. DESIGN: This prospective observational study was conducted over a period of 16 months at a tertiary care referral medical center. SETTING: We conducted this study over a period of 16 months at a tertiary care referral medical center. PARTICIPANTS: All patients with a central venous catheter (CVC) for >48 h admitted to the ICU were enrolled...
December 8, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27927163/phenotypic-and-molecular-detection-of-the-bla-kpc-gene-in-clinical-isolates-from-inpatients-at-hospitals-in-s%C3%A3-o-luis-ma-brazil
#16
Patricia Cristina Saldanha Ribeiro, Andrea Souza Monteiro, Sirlei Garcia Marques, Sílvio Gomes Monteiro, Valério Monteiro-Neto, Martina Márcia Melo Coqueiro, Ana Cláudia Garcia Marques, Rosimary de Jesus Gomes Turri, Simone Gonçalves Santos, Maria Rosa Quaresma Bomfim
BACKGROUND: Bacteria that produce Klebsiella pneumoniae carbapenemases (KPCs) are resistant to broad-spectrum β-lactam antibiotics. The objective of this study was to phenotypically and genotypically characterize the antibiotic susceptibility to carbapenems of 297 isolates recovered from clinical samples obtained from inpatients at 16 hospitals in São Luis (Maranhão, Brazil). METHODS: The study was conducted using phenotypic tests and molecular methods, including polymerase chain reaction (PCR), sequencing and enterobacterial repetitive intergenic consensus (ERIC)-PCR...
December 7, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27922906/patient-outcomes-after-early-versus-late-tracheostomy-in-the-puerto-rico-trauma-hospital
#17
Ana M Romero Vázquez, Omar García Rodríguez, Ediel Ramos Meléndez, Pablo Rodríguez Ortiz
OBJECTIVE: This study aimed to evaluate the impact of early tracheostomy (ET, ≤7 days) versus that of late tracheostomy (LT, >7 days) on outcomes such as hospital length of stay (LOS), intensive care unit (ICU) days, mechanical ventilation (MV) days, and mortality ratio. METHODS: A historical cohort study was undertaken using charts of patients admitted to the Puerto Rico Trauma Hospital who required MV and underwent tracheostomies, from 2000 to 2013. A logistic regression was performed to evaluate the association between timing of tracheostomy and complications and mortality...
December 5, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27920416/re-evaluating-the-inhibition-of-stress-erosions-revise-a-protocol-for-pilot-randomized-controlled-trial
#18
Waleed Alhazzani, Gordon Guyatt, John C Marshall, Richard Hall, John Muscedere, Francois Lauzier, Lehana Thabane, Mohammed Alshahrani, Shane W English, Yaseen M Arabi, Adam M Deane, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook, On Behalf Of
INTRODUCTION: Clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (ICU), most commonly prescribing proton pump inhibitors (PPIs). However, the incidence of gastrointestinal (GI) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. Therefore, a large randomized clinical trial (RCT) is needed to inform modern practice. The aim of this multicenter pilot trial is to determine the feasibility of performing a large RCT to investigate the efficacy and safety of withholding intravenous pantoprazole...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27916584/immunological-and-infectious-risk-factors-for-lung-cancer-in-us-veterans-with-hiv-a-longitudinal-cohort-study
#19
Keith Sigel, Juan Wisnivesky, Kristina Crothers, Kirsha Gordon, Sheldon T Brown, David Rimland, Maria C Rodriguez-Barradas, Cynthia Gibert, Matthew Bidwell Goetz, Roger Bedimo, Lesley S Park, Robert Dubrow
BACKGROUND: HIV infection is independently associated with risk of lung cancer, but few data exist for the relation between longitudinal measurements of immune function and lung-cancer risk in people living with HIV. METHODS: We followed up participants with HIV from the Veterans Aging Cohort Study for a minimum of 3 years between Jan 1, 1998, and Dec 31, 2012, and used cancer registry data to identify incident cases of lung cancer. The index date for each patient was the later of the date HIV care began or Jan 1, 1998...
December 1, 2016: Lancet HIV
https://www.readbyqxmd.com/read/27902412/staff-education-aimed-at-reducing-ventilator-associated-pneumonia
#20
Gurdal Yilmaz, Hava Aydin, Mustafa Aydin, Sedat Saylan, Hulya Ulusoy, Iftihar Koksal
Mechanical ventilation is a life-saving invasive procedure performed in intensive care units (ICUs) where critical patients are given advanced support. The purpose of this study was to assess the effect of personnel training on the incidence of ventilator-associated pneumonia (VAP). The study, performed prospectively in the ICU, was planned in two periods. In both periods, patient characteristics were recorded on patient data forms. In the second period, ICU physicians and assistant health personnel were given regular theoretical and practical training...
December 2016: Journal of Medical Microbiology
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