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Intensive care infection

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https://www.readbyqxmd.com/read/28926643/skin-perfusion-pressure-as-an-indicator-of-tissue-perfusion-in-valvular-heart-surgery-preliminary-results-from-a-prospective-observational-study
#1
Young Song, Sarah Soh, Jae-Kwang Shim, Kyoung-Un Park, Young-Lan Kwak
Hemodynamic management aims to provide adequate tissue perfusion, which is often altered during cardiac surgery with cardiopulmonary bypass (CPB). We evaluated whether skin perfusion pressure (SPP) can be used for monitoring of adequacy of tissue perfusion in patients undergoing valvular heart surgery. Seventy-two patients undergoing valve replacement were enrolled. SPP and serum lactate level were assessed after anaesthesia induction (baseline), during CPB, after CPB-off, end of surgery, arrival at intensive care unit, and postoperative 6 h...
2017: PloS One
https://www.readbyqxmd.com/read/28923373/outbreak-of-burkholderia-cepacia-bacteraemia-in-a-tertiary-care-centre-due-to-contaminated-ultrasound-probe-gel
#2
Rehab Abdelfattah, Suliman Aljumaah, Ahmed Alqahtani, Sahar Althawadi, Irene Barron, Saleh Almofada
BACKGROUND: Burkholderia cepacia is a significant opportunistic organism in hospitalized and immunocompromised patients, particularly in cystic fibrosis [1] AIMS: We describe the epidemiological investigation of an outbreak of B. cepacia bacteraemia. METHODS: The study examined 14 patients during their admission to three ICUs (Intensive Care Units) in a tertiary care hospital between January-June 2016. The outbreak involved 9 (57%) female and 6 (43%) male patients...
September 15, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28919794/parenteral-nutrition-including-an-omega-3-fatty-acid-containing-lipid-emulsion-for-intensive-care-patients-in-china-a-pharmacoeconomic-analysis
#3
Yufei Feng, Chao Li, Tian Zhang, Lorenzo Pradelli
BACKGROUND/OBJECTIVES: Parenteral nutrition (PN) incorporating omega-3 fatty-acid-enriched lipid emulsions has been shown to be cost effective in Western populations. A pharmacoeconomic evaluation was performed within the Chinese intensive care unit (ICU) setting. This assessed whether the additional acquisition cost of PN with omega-3 fatty-acid-enriched lipid emulsion (SMOFlipid) vs standard PN was offset by improved clinical outcomes that can reduce subsequent costs. MATERIALS AND METHODS: A pharmacoeconomic discrete event simulation model was developed, based on an update to efficacy data from a previous international meta-analysis, with China-specific clinical and economic input parameters...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28919718/extended-infusion-versus-intermittent-infusion-of-imipenem-in-the-treatment-of-ventilator-associated-pneumonia
#4
Mohamed M Ibrahim, Tarek Fouad Tammam, Mohy El Deen Ebaed, Hatem A Sarhan, Gamal F Gad, Amal K Hussein
BACKGROUND: Mechanical ventilation support can be the main source of ventilator-associated pneumonia (VAP). VAP is a serious infection that may be associated with dangerous gram-negative bacteria mainly, and it leads to an increase in the mortality in the intensive care unit (ICU). Imipenem is one of the strongest antibiotics now available for treating VAP which is associated with gram-negative and gram-positive bacteria, and it belongs to beta-lactam antibiotic group (carbapenem). OBJECTIVE: This study tried to investigate the efficacy of imipenem against VAP when it was infused within 180 min versus the efficacy when it was infused within 30-60 min...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28918667/poor-outcomes-among-elderly-patients-hospitalized-for-influenza-like-illness
#5
Mine Durusa Tanriover, Tülay Bagci Bosi, Lale Ozisik, Emre Bilgin, Özlem Güzel Tunçcan, Özge Özgen, Necla Tülek, Metin Özsoy, Hasan Tezer, Tugba Bedir Demirdağ, Ates Kara, Sevgen Tanir Basaranoglu, Kubra Aykac, Aslinur Ozkaya-Parlakay, Belgin Gulhan, Serhat Unal
BACKGROUND AND OBJECTIVE: Global Influenza Hospital Surveillance Network is a worldwide initiative that aims to document the burden of influenza infections among acute admissions and the vaccine effectiveness in particular countries. As a partner of this platform, we aimed to determine the frequency of influenza infections among acute admissions with influenza like illness and the outcomes of the enrolled patients during the 2015-2016 influenza season in selected hospitals in Turkey. PATIENTS AND METHODS: The investigators screened the hospital admission registries, chart review or available records, and screened all patients hospitalized in the previous 24-48 hours or overnight in the predefined wards or emergency room...
September 18, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28916973/myeloperoxidase-can-differentiate-between-sepsis-and-non-infectious-sirs-and-predicts-mortality-in-intensive-care-patients-with-sirs
#6
Irene T Schrijver, Hans Kemperman, Mark Roest, Jozef Kesecioglu, Dylan W de Lange
BACKGROUND: Systemic inflammatory response syndrome (SIRS) is a clinical syndrome following inflammation. Clinically, it is difficult to distinguish SIRS following an infection, i.e., sepsis, from non-infectious SIRS. Myeloperoxidase is a hemeprotein stored in the neutrophil azurophilic granules and is one of the main pillars of neutrophil attack. Therefore, we hypothesized that myeloperoxidase can differentiate between sepsis and non-infectious SIRS in patients with systemic inflammatory response syndrome in the intensive care unit (ICU)...
September 15, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28914210/-sepsis-new-insights-new-definition
#7
W J Wiersinga, A R H van Zanten, K A Kaasjager, T van der Poll
- Incidence of sepsis is increasing, partly due to an ageing population, increased use of immunosuppressants, and antibiotic resistance. Sepsis survival has improved substantially, in part because of continuously improving intensive care and implementation of evidence-based guidelines.- Sepsis is defined as 'life-threatening organ dysfunction due to a dysregulated host response to infection'. The Sequential Organ Failure Assessment (SOFA) score can be used to estimate organ dysfunction severity.- In this article, we discuss the new sepsis definitions - including reactions to these definitions, an overview of current insights in sepsis pathogenesis, and the new treatment guidelines...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28913499/perioperative-hyperoxia-perhaps-a-malady-in-disguise
#8
REVIEW
Yalim Dikmen, Aybike Onur
Oxygen is an element, which is used liberally during several medical procedures. The use of oxygen during perioperative care is a controversial issue. Anesthesiologists use oxygen to prevent hypoxemia during surgical procedures, but the effects of its liberal use can be harmful. Another argument for using high oxygen concentrations is to prevent surgical site infections by increasing oxygen levels at the incision site. Although inconclusive, literature concerning the use of high oxygen concentrations during anesthesia show that this approach may cause hemodynamic changes, altered microcirculation and increased oxidative stress...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28912532/chronic-kidney-disease-is-associated-with-poorer-in-hospital-outcomes-in-patients-hospitalized-with-infections-electronic-record-analysis-from-china
#9
Guobin Su, Hong Xu, Gaetano Marrone, Bengt Lindholm, Zehuai Wen, Xusheng Liu, Juan-Jesus Carrero, Cecilia Stålsby Lundborg
Predominantly based on studies from high-income countries, reduced estimated glomerular filtration rate (eGFR) has been associated with increased risk of infections and infection-related hospitalizations (IRHs). We here explore in-hospital outcomes of IRHs in patients with different kidney function. A total of 6,283 adults, not on renal replacement therapy, with a discharge diagnosis of infection, and with an eGFR 1-12 months before index hospitalization, were included from four hospitals in China. We compared in-hospital outcomes (death, intensive care unit (ICU) admission, length of hospital stay (LOHS) and medical expenses), between patients with and without chronic kidney disease (CKD, defined as eGFR ≤ 60 ml/min per 1...
September 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28912009/an-inflammation-based-prognostic-score-the-c-reactive-protein-albumin-ratio-predicts-the-morbidity-and-mortality-of-patients-on-parenteral-nutrition
#10
J Llop-Talaveron, M B Badia-Tahull, E Leiva-Badosa
BACKGROUND: There is no "gold standard" score for predicting poor-nutrition-related outcomes. The objective of this study was to identify the optimal predictive score, based on inflammatory parameters, for the clinical outcomes of parenteral nutrition (PN). MATERIAL AND METHODS: This was a 4-year retrospective observational study of 460 patients treated with PN. C-reactive protein (CRP), prealbumin, albumin, CRP/prealbumin and CRP/albumin were studied as potential prognostic scores at the beginning of PN for clinical outcomes during PN...
August 21, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28910379/a-one-year-prospective-study-of-colonization-with-antimicrobial-resistant-organisms-on-admission-to-a-vietnamese-intensive-care-unit
#11
Duong Bich Thuy, James Campbell, Nguyen Van Minh Hoang, Truong Thi Thuy Trinh, Ha Thi Hai Duong, Nguyen Chi Hieu, Nguyen Hoang Anh Duy, Nguyen Van Hao, Stephen Baker, Guy E Thwaites, Nguyen Van Vinh Chau, C Louise Thwaites
There is a paucity of data regarding initial bacterial colonization on admission to Intensive Care Units (ICUs) in low and middle-income countries (LMICs). Patients admitted to ICUs in LMICs are at high-risk of subsequent infection with antimicrobial-resistant organisms (AROs). We conducted a prospective, observational study at the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam from November 2014 to January 2016 to assess the colonization and antimicrobial susceptibility of Staphylococcus aureus, Escherichia coli, Klebsiella spp...
2017: PloS One
https://www.readbyqxmd.com/read/28906137/treatment-of-achromobacter-ventilator-associated-pneumonia-in-critically-ill-trauma-patients
#12
G Christopher Wood, Brittany L Jonap, George O Maish, Louis J Magnotti, Joseph M Swanson, Bradley A Boucher, Martin A Croce, Timothy C Fabian
BACKGROUND: Achromobacter sp are nonfermenting Gram-negative bacilli (NFGNB) that rarely cause severe infections, including ventilator-associated pneumonia (VAP). Data on the treatment of Achromobacter pneumonia are very limited, and the organism has been associated with a high mortality rate. Thus, more data are needed on treating this organism. OBJECTIVE: To evaluate the treatment of Achromobacter VAP in critically ill trauma patients. METHODS: This retrospective, observational study evaluated critically ill trauma patients who developed Achromobacter VAP...
September 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28905701/outcomes-of-patients-with-severe-influenza-infection-admitted-to-intensive-care-units-a-retrospective-study-in-a-medical-centre
#13
Chien-Ming Chao, Chih-Cheng Lai, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Kuo-Shu Yuan, Chin-Ming Chen
PURPOSE: This study assessed clinical manifestations and prognostic factors of critically ill patients with severe influenza admitted to the intensive care unit (ICU) in Taiwan's recent outbreak. METHODOLOGY: Patients admitted to ICU for severe influenza between January 1, 2015, and March 31, 2016, were identified and their medical records were retrospectively reviewed. The primary endpoints were outcomes and predictors of in-hospital mortality. RESULTS: There were 125 patients with an average Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 20...
September 14, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28905331/antibiotic-distribution-into-cerebrospinal-fluid-can-dosing-safely-account-for-drug-and-disease-factors-in-the-treatment-of-ventriculostomy-associated-infections
#14
Nilesh Kumta, Jason A Roberts, Jeffrey Lipman, Menino Osbert Cotta
Ventriculostomy-associated infections, or ventriculitis, in critically ill patients are associated with considerable morbidity. Efficacious antibiotic dosing for the treatment of these infections may be complicated by altered antibiotic concentrations in the cerebrospinal fluid due to variable meningeal inflammation and antibiotic properties. Therefore, doses used to treat infections with a higher degree of meningeal inflammation (such as meningitis) may often fail to achieve equivalent exposures in patients with ventriculostomy-associated infections such as ventriculitis...
September 13, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28905133/rabbit-risk-score-and-icu-admission-due-to-infection-in-patients-with-rheumatoid-arthritis
#15
Herwig Pieringer, Rainer Hintenberger, Erich Pohanka, Clemens Steinwender, Jens Meier, Franz Gruber, Lorenz Auer-Hackenberg
Rheumatoid arthritis (RA) patients are at increased risk of infection. Aim of the present study was to investigate whether RA patients admitted to an intensive care unit (ICU) due to infection have higher Rheumatoid Arthritis Observation of Biologic Therapy (RABBIT) risk scores compared to control RA patients. Seventy-four RA patients (32.4% male) admitted to an ICU due to infection (from January 2002 to December 2013) and 74 frequency-matched control RA patients (16.2% male) were included in this cross-sectional study...
September 14, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28904483/fecal-carriage-of-extended-spectrum-beta-lactamase-producing-enterobacteriaceae-in-intensive-care-unit-patients
#16
Shalini Shenoy Mulki, Kavya Ramamurthy, Sevitha Bhat
BACKGROUND AND AIMS: Increasing and indiscriminate use of antibiotics has led the bacteria to develop resistance to most of the antibiotics. Beta-lactamase production is the mechanism of resistance to beta-lactams. Extended-spectrum beta-lactamases (ESBLs) have been found in the members of Enterobacteriaceae such as Escherichia coli and Klebsiella spp. which are the common health-care-associated pathogens. The aim was to study the rate of fecal carriage of ESBL-producing Enterobacteriaceae in patients admitted to the Intensive Care Unit (ICU) of tertiary care hospital and follow them subsequently for the development of infections...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28903171/-intraabdominal-infections
#17
Václava Adámková
Intraabdominal infections are the second most common cause of sepsis in intensive care units. Intraabdominal infections represent a wide variety of pathological conditions that involve lesions of all the intraabdominal organs. They also include intraperitoneal, retroperitoneal and parenchymal abscesses. The etiology of these infections usually includes organisms derived from the gut microbiota. The increasing rate of bacterial resistance is alarming. The treatment of intraabdominal infections is complex and involves source control and antibiotics...
June 2017: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28901717/preliminary-result-with-incisional-negative-pressure-wound-therapy-and-pectoralis-major-muscle-flap-for-median-sternotomy-wound-infection-in-a-high-risk-patient-population
#18
Federico Lo Torto, Ambra Monfrecola, Juste Kaciulyte, Pedro Ciudad, Donato Casella, Diego Ribuffo, Bruno Carlesimo
Deep sternal wound infection (DSWI) represents a dangerous complication that can follow open-heart surgery with median sternotomy access. Muscle flaps, such as monolateral pectoralis major muscle flap (MPMF), represent the main choices for sternal wound coverage and infection control. Negative pressure incision management system has proven to be able to reduce the incidence of these wounds' complications. Prevena(TM) represents one of these incision management systems and we aimed to evaluate its benefits. A total of 78 patients with major risk factors that presented post-sternotomy DSWI following cardiac surgery was selected...
September 13, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28900356/humidifiers-for-oxygen-therapy-what-risk-for-reusable-and-disposable-devices
#19
REVIEW
V La Fauci, G B Costa, A Facciolà, A Conti, R Riso, R Squeri
INTRODUCTION: Nosocomial pneumonia accounts for the vast majority of healthcare-associated infections (HAI). Although numerous medical devices have been discussed as potential vehicles for microorganisms, very little is known about the role played by oxygen humidifiers as potential sources of nosocomial pathogens. The purpose of this research was to evaluate the safety of the reuse of humidifiers by analysing the rate of microbial contamination in reusable and disposable oxygen humidifiers used during therapy, and then discuss their potential role in the transmission of respiratory pathogens...
June 2017: Journal of Preventive Medicine and Hygiene
https://www.readbyqxmd.com/read/28899886/brainstem-encephalitis-and-acute-polyneuropathy-associated-with-hepatitis-e-infection
#20
Omar Jabbar Salim, Amy Davidson, Kathy Li, John Paul Leach, Craig Heath
A 59-year-old man presented with feverish illness. His Glasgow Coma Scale was 15, had reduced visual acuity in the left eye with partial left ptosis and mild left hemiparesis with an extensor left plantar. Over 48 hours, he accrued multiple cranial nerves palsies and progressed to a flaccid paralysis necessitating admission to an intensive care unit.Cerebrospinal fluid (CSF) study showed 20 lymphocytes and raised protein. Viral and bacterial PCRs were negative. Samples for Lyme, blood-borne viruses, syphilis and autoantibodies were also negative...
September 11, 2017: BMJ Case Reports
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