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Critical care immunocompromised

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https://www.readbyqxmd.com/read/28928729/high-throughput-genetic-screen-reveals-that-early-attachment-and-biofilm-formation-are-necessary-for-full-pyoverdine-production-by-pseudomonas-aeruginosa
#1
Donghoon Kang, Natalia V Kirienko
Pseudomonas aeruginosa is a re-emerging, multidrug-resistant, opportunistic pathogen that threatens the lives of immunocompromised patients, patients with cystic fibrosis, and those in critical care units. One of the most important virulence factors in this pathogen is the siderophore pyoverdine. Pyoverdine serves several critical roles during infection. Due to its extremely high affinity for ferric iron, pyoverdine gives the pathogen a significant advantage over the host in their competition for iron. In addition, pyoverdine can regulate the production of multiple bacterial virulence factors and perturb host mitochondrial homeostasis...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28803505/extracorporeal-membrane-oxygenation-in-an-hiv-positive-man-with-severe-acute-respiratory-distress-syndrome-secondary-to-pneumocystis-and-cytomegalovirus-pneumonia
#2
Deirdre Morley, Almida Lynam, Edmund Carton, Ignacio Martin-Loeches, Gerard Sheehan, Niamh Lynn, Serena O'Brien, Fiona Mulcahy
The management of critically ill human immunodeficiency virus (HIV)-positive patients is challenging; however, intensive care unit-related mortality has declined significantly in recent years. There are 10 case reports in the literature of extracorporeal membrane oxygenation (ECMO) use in HIV-positive patients, of whom seven survived to hospital discharge. We describe a 33-year-old Brazilian man who presented with Pneumocystis jirovecii pneumonia and severe hypoxic respiratory failure. He developed refractory acute respiratory distress syndrome (ARDS) and was commenced on veno-venous ECMO...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28754461/evaluating-of-fungal-contamination-in-hospital-wet-cooling-systems-in-markazi-province-central-iran
#3
M Mosayebi, Z Eslamirad, R Hajihossein, B Ghorbanzadeh, M Shahverdi, M Didehdar
OBJECTIVE: Fungal infections are common complication among hospitalized patients especially between who is immunocompromised. Wet cooling systems in the hospital environment play a critical role as a source of these infections. The aim of this study was survey of wet cooling system of hospitals for fungal contamination in Arak city. MATERIALS AND METHODS: This study was conducted during May to September of 2016. Sampling was done as random. Samples were obtained from water and straw of 84 wet cooling systems of four hospitals in Arak city...
July 25, 2017: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/28634525/pseudomembranous-aspergillar-tracheobronchitis-in-a-non-neutropenic-critically-ill-patient-in-the-intensive-care-unit
#4
Sameen Khalid, Fnu Asad-Ur -Rahman, Aamer Abbass, Sigfredo Aldarondo, Khalid Abusaada
Invasive aspergillosis is an important cause of morbidity and mortality among immunocompromised patients. Prolonged neutropenia is the most common risk factor. It has rarely been reported to occur in non-neutropenic critically ill patients in the intensive care unit setting. Mortality rate in this group has been reported to be as high as 92%. We report a case of tracheobronchial aspergillosis in a non-neutropenic critically ill patient to highlight the fact that critically ill patients admitted in the intensive care unit can develop opportunistic infections such as invasive aspergillosis even in the absence of classic risk factors and prior history of immunosuppression...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28592328/severe-varicella-zoster-virus-pneumonia-a-multicenter-cohort-study
#5
Adrien Mirouse, Philippe Vignon, Prescillia Piron, René Robert, Laurent Papazian, Guillaume Géri, Pascal Blanc, Christophe Guitton, Claude Guérin, Naïke Bigé, Antoine Rabbat, Aurélie Lefebvre, Keyvan Razazi, Muriel Fartoukh, Eric Mariotte, Lila Bouadma, Jean-Damien Ricard, Amélie Seguin, Bertrand Souweine, Anne-Sophie Moreau, Stanislas Faguer, Arnaud Mari, Julien Mayaux, Francis Schneider, Annabelle Stoclin, Pierre Perez, Julien Maizel, Charles Lafon, Frédérique Ganster, Laurent Argaud, Christophe Girault, François Barbier, Lucien Lecuyer, Jérôme Lambert, Emmanuel Canet
BACKGROUND: Pneumonia is a dreaded complication of varicella-zoster virus (VZV) infection in adults; however, the data are limited. Our objective was to investigate the clinical features, management, and outcomes of critically ill patients with VZV-related community-acquired pneumonia (VZV-CAP). METHODS: This was an observational study of patients with VZV-CAP admitted to 29 intensive care units (ICUs) from January 1996 to January 2015. RESULTS: One hundred and two patients with VZV-CAP were included...
June 7, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28584849/carbapenem-resistant-enterobacteriaceae-infections-results-from-a-retrospective-series-and-implications-for-the-design-of-prospective-clinical-trials
#6
Elizabeth L Alexander, Jeffery Loutit, Mario Tumbarello, Richard Wunderink, Tim Felton, George Daikos, Karen Fusaro, Dan White, Shu Zhang, Michael N Dudley
BACKGROUND: The increasing incidence of multidrug-resistant Gram negatives, such as carbapenem-resistant Enterobacteriaceae (CRE), has resulted in a critical need for new antimicrobials. Most studies of new antimicrobials have been performed in patients with nondrug-resistant pathogens. We performed a retrospective analysis of patients with CRE infections to inform the design of phase 3 clinical trials. METHODS: This was a retrospective study at 22 centers in 4 countries...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28435744/diagnosis-of-spinal-epidural-abscess-a-case-report-and-literature-review
#7
Chidinma Chima-Melton, Michelle Pearl, Marni Scheiner
INTRODUCTION: Spinal epidural abscess (SEA) is a rare but serious cause of back pain in the critical care setting. It occurs most commonly in adults in their fifth and sixth decades of life. Risk factors include diabetes mellitus, alcoholism, AIDS or other immunocompromised states, cancer, intravenous drug use, trauma and spinal surgery. The clinical presentation can be non-specific but the classical triad includes back pain, fever and neurological deficits. Magnetic resonance imaging (MRI) with gadolinium is the diagnostic imaging modality of choice...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28425335/the-incidence-of-and-risk-factors-for-postintubation-hypotension-in-the-immunocompromised-critically-ill-adult
#8
Nathan J Smischney, Mohamed O Seisa, John Cambest, Robert A Wiegand, Kyle D Busack, Theodore O Loftsgard, Darrell R Schroeder, Daniel A Diedrich
OBJECTIVES: Our primary aim was to ascertain the frequency of postintubation hypotension in immunocompromised critically ill adults with secondary aims of arriving at potential risk factors for the development of postintubation hypotension and its impact on patient-related outcomes. METHODS: Critically ill adult patients (≥18 years) were included from January 1, 2010, to December 31, 2014. We defined immunocompromised as patients with any solid organ or nonsolid organ malignancy or transplant, whether solid organ or not, requiring current chemotherapy...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28410318/characteristics-and-outcome-of-patients-after-allogeneic-hematopoietic-stem-cell-transplantation-treated-with-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#9
MULTICENTER STUDY
Philipp Wohlfarth, Gernot Beutel, Pia Lebiedz, Hans-Joachim Stemmler, Thomas Staudinger, Matthieu Schmidt, Matthias Kochanek, Tobias Liebregts, Fabio Silvio Taccone, Elie Azoulay, Alexandre Demoule, Stefan Kluge, Morten Svalebjørg, Catherina Lueck, Johanna Tischer, Alain Combes, Boris Böll, Werner Rabitsch, Peter Schellongowski
OBJECTIVES: The acute respiratory distress syndrome is a frequent condition following allogeneic hematopoietic stem cell transplantation. Extracorporeal membrane oxygenation may serve as rescue therapy in refractory acute respiratory distress syndrome but has not been assessed in allogeneic hematopoietic stem cell transplantation recipients. DESIGN: Multicenter, retrospective, observational study. SETTING: ICUs in 12 European tertiary care centers (Austria, Germany, France, and Belgium)...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28390391/measuring-1-3-%C3%AE-d-glucan-in-tracheal-aspirate-bronchoalveolar-lavage-fluid-and-serum-for-detection-of-suspected-candida-pneumonia-in-immunocompromised-and-critically-ill-patients-a-prospective-observational-study
#10
Kang-Cheng Su, Kun-Ta Chou, Yi-Han Hsiao, Ching-Min Tseng, Vincent Yi-Fong Su, Yu-Chin Lee, Diahn-Warng Perng, Yu Ru Kou
BACKGROUND: While Candida pneumonia is life-threatening, biomarker measurements to early detect suspected Candida pneumonia are lacking. This study compared the diagnostic values of measuring levels of (1, 3)-β-D-glucan in endotracheal aspirate, bronchoalveolar lavage fluid, and serum to detect suspected Candida pneumonia in immunocompromised and critically ill patients. METHODS: This prospective, observational study enrolled immunocompromised, critically ill, and ventilated patients with suspected fungal pneumonia in mixed intensive care units from November 2010 to October 2011...
April 8, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28355466/invasive-mould-infections-in-the-icu-setting-complexities-and-solutions
#11
REVIEW
Matteo Bassetti, Emilio Bouza
Infections caused by filamentous fungi represent a major burden in the ICU. Invasive aspergillosis is emerging in non-neutropenic individuals with predisposing conditions, e.g. corticosteroid treatment, chronic obstructive pulmonary disease, liver cirrhosis, solid organ cancer, HIV infection and transplantation. Diagnosis is challenging because the signs and symptoms are non-specific, and initiation of additional diagnostic examinations is often delayed because clinical suspicion is low. Isolation of an Aspergillus species from the respiratory tract in critically ill patients, and tests such as serum galactomannan, bronchoalveolar lavage 1-3-β-d-glucan and specific PCR should be interpreted with caution...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28346081/pneumocystis-jiroveci-pneumonia-pjp-in-non-hiv-immunocompromised-individuals
#12
Kathleen Schoovaerts, Luc Dirix, Annemie Rutten, Jef Van Schaeren, Bruno Van Herendael, Sofie Van Grieken, Luc Heytens
OBJECTIVES: PJP is a major cause of morbidity and mortality in immunocompromised individuals. Diagnosing PJP is often difficult because respiratory signs might be minimal or absent and the sensitivity of a chest X-ray (CXR) is low. We studied the clinical risk factors in order to increase awareness and facilitate the diagnosis. METHODS: We studied a prospective case series over a one year period (from 1 January 2015 to 1 January 2016) and did a retrospective analysis (from 2013 to 2016) of all PJP positive bronchoalveolar lavage (BAL) analysis...
March 27, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28160958/opportunistic-fungal-infections-in-critical-care-units
#13
REVIEW
Deborah D Garbee, Stephanie S Pierce, Jennifer Manning
Fungal infections are rare compared with bacterial infections, but they are on the increase in critical care units. Diagnosis can be difficult, resulting in increased mortality. Immunocompromised patients are at higher risk for fungal infections, including organ transplant, oncology, and HIV/AIDS patients. Fatigue and fever are common symptoms that require critical care nurses to remain vigilant in assessment to identify at-risk patients and promote use of timely cultures and appropriate treatments for fungal infections...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28152729/reducing-hospital-aquired-pneumonia-hap-with-massey-screen
#14
Robyn Dunbar, Cheryl Clements, Margaret Bonawitz, Joanne McGovern
232 Background: Hospital Acquired Pneumonia (HAP) is a leading cause of prolonged hospitalization in patients. The oncology population is especially susceptible to critical illness related to an immunocompromised state. The purpose of this study was to implement the Massey Bedside Swallowing Screen upon admission to the oncology telemetry unit to detect any deficits that could potentially lead to HAP, in conjunction with strict oral care for identified high risk patients. METHODS: The importance of the Massey Bedside Swallowing Screen upon admission and the knowledge that early detection leads to better patient outcomes was educated to the nursing staff...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27753764/inherent-risk-factors-for-nosocomial-infection-in-the-long-stay-critically-ill-child-without-known-baseline-immunocompromise-a-post-hoc-analysis-of-the-crisis-trial
#15
Joseph A Carcillo, J Michael Dean, Richard Holubkov, John Berger, Kathleen L Meert, Kanwaljeet J S Anand, Jerry Zimmerman, Christopher J Newth, Rick Harrison, Jeri Burr, Douglas F Willson, Carol Nicholson, Michael J Bell, Robert A Berg, Thomas P Shanley, Sabrina M Heidemann, Heidi Dalton, Tammara L Jenkins, Allan Doctor, Angie Webster
BACKGROUND: Nosocomial infection remains an important health problem in long stay (>3 days) pediatric intensive care unit (PICU) patients. Admission risk factors related to the development of nosocomial infection in long stay immune competent patients in particular are not known. METHODS: Post-hoc analysis of the previously published Critical Illness Stress induced Immune Suppression (CRISIS) prevention trial database, to identify baseline risk factors for nosocomial infection...
November 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27713885/the-immunocompromised-oncohematological-critically-ill-patient-considerations-in-severe-infections
#16
REVIEW
Belén Encina, Leonel Lagunes, Marc Morales-Codina
Sepsis and septic shock remain a major cause of mortality among critically ill patient. This is particularly relevant among cancer patients as highlighted by different series showing that up to one in five patients admitted to intensive care units (ICU) with sepsis have cancer, and also, sepsis is a leading reason for ICU admission in patients with cancer. The classic predictors of mortality among these patients (such as cancer lineage, neutropenia degree, or bone marrow transplantation history) have changed during the last decades, and they should no longer be used to rule out ICU admission...
September 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27660289/interaction-between-2-nutraceutical-treatments-and-host-immune-status-in-the-pediatric-critical-illness-stress-induced-immune-suppression-comparative-effectiveness-trial
#17
Joseph A Carcillo, J Michael Dean, Richard Holubkov, John Berger, Kathleen L Meert, Kanwaljeet J S Anand, Jerry J Zimmerman, Christopher J L Newth, Rick Harrison, Jeri Burr, Douglas F Willson, Carol Nicholson, Michael J Bell, Robert A Berg, Thomas P Shanley, Sabrina M Heidemann, Heidi Dalton, Tammara L Jenkins, Allan Doctor, Angie Webster, Robert F Tamburro
BACKGROUND AND AIMS: The pediatric Critical Illness Stress-induced Immune Suppression (CRISIS) trial compared the effectiveness of 2 nutraceutical supplementation strategies and found no difference in the development of nosocomial infection and sepsis in the overall population. We performed an exploratory post hoc analysis of interaction between nutraceutical treatments and host immune status related to the development of nosocomial infection/sepsis. METHODS: Children from the CRISIS trial were analyzed according to 3 admission immune status categories marked by decreasing immune competence: immune competent without lymphopenia, immune competent with lymphopenia, and previously immunocompromised...
September 22, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27659437/a-5-year-surveillance-study-on-antimicrobial-resistance-of-acinetobacter-baumannii-clinical-isolates-from-a-tertiary-greek-hospital
#18
Sofia Maraki, Elpis Mantadakis, Viktoria Eirini Mavromanolaki, Diamantis P Kofteridis, George Samonis
BACKGROUND: Acinetobacter baumannii has emerged as a major cause of nosocomial outbreaks. It is particularly associated with nosocomial pneumonia and bloodstream infections in immunocompromised and debilitated patients with serious underlying pathologies. Over the last two decades, a remarkable rise in the rates of multidrug resistance to most antimicrobial agents that are active against A. baumannii has been noted worldwide. We evaluated the rates of antimicrobial resistance and changes in resistance over a 5-year period (2010-2014) in A...
September 2016: Infection & Chemotherapy
https://www.readbyqxmd.com/read/27612566/predicting-invasive-fungal-disease-due-to-candida-species-in-non-neutropenic-critically-ill-adult-patients-in-united-kingdom-critical-care-units
#19
MULTICENTER STUDY
Jason Shahin, Elizabeth J Allen, Krishna Patel, Hannah Muskett, Sheila E Harvey, Jonathan Edgeworth, Christopher C Kibbler, Rosemary A Barnes, Sharmistha Biswas, Neil Soni, Kathryn M Rowan, David A Harrison
BACKGROUND: Given the predominance of invasive fungal disease (IFD) amongst the non-immunocompromised adult critically ill population, the potential benefit of antifungal prophylaxis and the lack of generalisable tools to identify high risk patients, the aim of the current study was to describe the epidemiology of IFD in UK critical care units, and to develop and validate a clinical risk prediction tool to identify non-neutropenic, critically ill adult patients at high risk of IFD who would benefit from antifungal prophylaxis...
September 9, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27517077/intramuscular-injection-abscess-due-to-vrsa-a-new-health-care-challenge
#20
Senthil Nathan Sambandam, Ganeshkumar Jayasree Rohinikumar, Arif Gul, Varatharaj Mounasamy
Abscess formation following intramuscular injections is rare and they are most commonly seen in immunocompromised individuals. In this case series we present a cohort of three patients presented to us in a critically ill condition with an abscess due to intramuscular injection. Vancomycin resistant staphylococcus aureus was isolated from all three patients. These patients posed a major challenge to the healthcare system and the treating physician because of the: severity of illness, virulence and resistance of the organism, rarity of the situation, immune state of the patient, and lack of supporting evidence to properly guide management in the use of health resources...
June 2016: Archives of Bone and Joint Surgery
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