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Infection control in ICU

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https://www.readbyqxmd.com/read/28931394/the-efficacy-of-initial-ventilation-strategy-for-adult-immunocompromised-patients-with-severe-acute-hypoxemic-respiratory-failure-study-protocol-for-a-multicentre-randomized-controlled-trial-venim
#1
Tao Wang, Gang Liu, Kun He, Xin Lu, Xianquan Liang, Meng Wang, Rong Zhu, Zongru Li, Feng Chen, Jun Ke, Qingming Lin, Chuanyun Qian, Bo Li, Jie Wei, Jingjun Lv, Li Li, Yanxia Gao, Guofeng Wu, Xiaohong Yu, Weiqin Wei, Ying Deng, Fengping Wang, Hong Zhang, Yun Zheng, Hong Zhan, Jinli Liao, Yingping Tian, Dongqi Yao, Jingsong Zhang, Xufeng Chen, Lishan Yang, Jiali Wu, Yanfen Chai, Songtao Shou, Muming Yu, Xudong Xiang, Dongshan Zhang, Fengying Chen, Xiufeng Xie, Yong Li, Bo Wang, Wenzhong Zhang, Yongli Miao, Michael Eddleston, Jianqiang He, Yong Ma, Shengyong Xu, Yi Li, Huadong Zhu, Xuezhong Yu
BACKGROUND: Acute respiratory failure (ARF) is still one of the most severe complications in immunocompromised patients. Our previous systematic review showed noninvasive mechanical ventilation (NIV) reduced mortality, length of hospitalization and ICU stay in AIDS/hematological malignancy patients with relatively less severe ARF, compared to invasive mechanical ventilation (IMV). However, this systematic review was based on 13 observational studies and the quality of evidence was low to moderate...
September 20, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28927475/impact-of-discontinuing-contact-precautions-for-mrsa-and-esble-in-an-intensive-care-unit-a-prospective-noninferiority-before-and-after-study
#2
Laurie Renaudin, Mathieu Llorens, Christophe Goetz, Sébastien Gette, Vincente Citro, Sylvia Poulain, Marie-Laure Vanson, Jocelyne Sellies
OBJECTIVE To compare incidence densities of methicillin-resistant Staphylococcus aureus (MRSA) or extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBLE) acquisition in the intensive care unit (ICU) before and after discontinuation of contact precautions (CP) and application of standard precautions (SP). DESIGN Prospective noninferiority before-and-after study comparing 2 periods: January 1, 2012, to January 31, 2014 (the CP period) and February 1, 2014, to February 29, 2016 (the SP period). SETTING A 16-bed polyvalent ICU in France with only single-bed rooms with dedicated equipment and reusable medical devices...
September 20, 2017: Infection Control and Hospital Epidemiology
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
#3
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/28906284/effect-of-transfusion-on-mortality-and-other-adverse-events-among-critically-ill-septic-patients-an-observational-study-using-a-marginal-structural-cox-model
#4
Claire Dupuis, Maité Garrouste-Orgeas, Sébastien Bailly, Christophe Adrie, Dany Goldgran-Toledano, Elie Azoulay, Stéphane Ruckly, Guillaume Marcotte, Bertrand Souweine, Michael Darmon, Yves Cohen, Carole Schwebel, Guillaume Lacave, Lila Bouadma, Jean-Francois Timsit
OBJECTIVES: RBC transfusion is often required in patients with sepsis. However, adverse events have been associated with RBC transfusion, raising safety concerns. A randomized controlled trial validated the 7 g/dL threshold, but previously transfused patients were excluded. Cohort studies led to conflicting results and did not handle time-dependent covariates and history of treatment. Additional data are thus warranted to guide patient's management. DESIGN: To estimate the effect of one or more RBC within 1 day on three major outcomes (mortality, ICU-acquired infections, and severe hypoxemia) at day 30, we used marginal structural models...
September 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28905133/rabbit-risk-score-and-icu-admission-due-to-infection-in-patients-with-rheumatoid-arthritis
#5
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/28893449/successful-control-of-2-simultaneous-outbreaks-of-oxa-48-carbapenemase-producing-enterobacteriaceae-and-multidrug-resistant-acinetobacter-baumannii-in-an-intensive-care-unit
#6
A Robustillo-Rodela, V Pérez-Blanco, M A Espinel Ruiz, G Ruiz Carrascoso, J C Figueira Iglesias, D Abad Martín
BACKGROUND: This report describes a double outbreak of OXA-48-producing Enterobacteriaceae (OXA-48-PE) and multidrug-resistant Acinetobacter baumannii (MRAB) in an intensive care unit (ICU) and the effectiveness of measures implemented, including decontamination with vaporized hydrogen peroxide (VHP). METHODS: Affected patients were isolated in a confined area and cared for by dedicated personnel. Four percent chlorhexidine soap was used for patient daily hygiene...
September 8, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28892925/impact-of-antibiotic-stewardship-program-on-prescribing-pattern-of-antimicrobials-in-patients-of-medical-intensive-care-unit
#7
Nishal Shah, Anuradha Joshi, Barna Ganguly
INTRODUCTION: Rising concerns about antimicrobial resistance and inadequate development of effective new anti-infective drugs have stimulated universal efforts to strengthen infection-control interventions. Antimicrobial stewardship is a rational, systematic approach to promote the optimal selection, dosing, and duration of therapy for antimicrobial agents throughout the course of their use in order to improve the outcomes. AIM: Since in Shree Krishna Hospital (SKH), Antibiotic Stewardship Program (ASP) was first implemented in 2013, this study was planned to assess any change in antimicrobial use before and after implementation of ASP and to study the rate and pattern of antimicrobial use in medical ICU...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28887643/clinical-predictors-of-methicillin-resistant-staphylococcus-aureus-in-nosocomial-and-healthcare-associated-pneumonia-a-multicenter-matched-case-control-study
#8
J Torre-Cisneros, C Natera, F Mesa, M Trikic, J Rodríguez-Baño
The situations in which coverage for methicillin-resistant Staphylococcus aureus (MRSA) in the empirical treatment of nosocomial pneumonia (NP) or severe healthcare-associated pneumonia (HCAP) is needed are poorly defined, particularly outside intensive care units (ICUs). Our aim was to characterize if the risk of MRSA NP/HCAP can be defined by clinical variables. We designed an observational, retrospective, multicenter, case-control study to analyze the association between defined clinical variables and risk of MRSA NP/HCAP in non-ICU patients using conditional multivariable logistic regression...
September 8, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28879405/infection-control-interventions-affected-by-resource-shortages-impact-on-the-incidence-of-bacteremias-caused-by-carbapenem-resistant-pathogens
#9
E Kousouli, O Zarkotou, L Politi, K Polimeri, G Vrioni, K Themeli-Digalaki, A Tsakris, S Pournaras
We evaluated an infection control (IC) program influenced by personnel and material resource shortages on the incidence of bloodstream infections (BSI) due to carbapenem-resistant Klebsiella pneumoniae (CRKP), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CRPA) in an endemic region. Between January 2010 and December 2015, all BSI episodes caused by CRKP, CRAB, and CRPA were recorded. An IC bundle was implemented in January 2012. We evaluated the effect of the interventions on BSI rates between the pre-intervention (2010-2011) and intervention (2012-2013) periods, using an interrupted time-series model...
September 6, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28877171/preventable-proportion-of-intubation-associated-pneumonia-role-of-adherence-to-a-care-bundle
#10
Antonella Agodi, Martina Barchitta, Annalisa Quattrocchi, Emiliano Spera, Giovanni Gallo, Francesco Auxilia, Silvio Brusaferro, Marcello Mario D'Errico, Maria Teresa Montagna, Cesira Pasquarella, Stefano Tardivo, Ida Mura
OBJECTIVE: The aim of the present study was to estimate the preventable proportion of Intubation-Associated Pneumonia (IAP) in the Intensive Care Units (ICUs) participating in the Italian Nosocomial Infections Surveillance in ICUs (SPIN-UTI) network, taking into account differences in intrinsic patients' risk factors, and additionally considering the compliance with the European bundle for IAP prevention. METHODS: A prospective patient-based survey was conducted and all patients staying in ICU for more than 2 days were enrolled in the surveillance...
2017: PloS One
https://www.readbyqxmd.com/read/28857851/antifungal-prevention-of-systemic-candidiasis-in-immunocompetent-icu-adults-systematic-review-and-meta-analysis-of-clinical-trials
#11
Hervé Dupont, Yazine Mahjoub, Taieb Chouaki, Emmanuel Lorne, Elie Zogheib
OBJECTIVES: The aim of this study was to identify the impact of antifungal prevention in critically ill immunocompetent adult patients on mortality and subsequent infection. DATA SOURCES: A systematic review and meta-analysis of randomized controlled trials comparing any antifungal use versus placebo to prevent candidiasis in ICU patients were performed. STUDY SELECTION: Searches were performed on PubMed, Embase, Scopus, main conference proceedings, and ClinicalTrials...
August 28, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28853230/risk-factors-for-multidrug-resistant-gram-negative-infection-in-burn-patients
#12
Mark L Vickers, Joel M Dulhunty, Emma Ballard, Paul Chapman, Michael Muller, Jason A Roberts, Menino O Cotta
BACKGROUND: Infection with multidrug-resistant (MDR) Gram-negative organisms leads to poorer outcomes in the critically ill burn patient. The aim of this study was to identify the risk factors for MDR Gram-negative pathogen infection in critically ill burn patients admitted to a major tertiary referral intensive care unit (ICU) in Australia. METHODS: A retrospective case-control study of all adult burn patients admitted over a 7-year period was conducted. Twenty-one cases that cultured an MDR Gram-negative organism were matched with 21 controls of similar age, gender, burn size and ICU stay...
August 29, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28839364/omega-3-fish-oil-reduces-mortality-due-to-severe-sepsis-with-acute-gastrointestinal-injury-grade-iii
#13
Huaisheng Chen, Wei Wang, Chengying Hong, Ming Zhang, Yingcai Hong, Su Wang, Huadong Zhang
BACKGROUND: Sepsis plays an important role in acute gastrointestinal injury (AGI). Our research was designed to determine the effects of omega-3 fish oil (FO) in patients suffering from severe sepsis combined with AGI III, and the ability of FO to modulate immune function. METHODS: Seventy-eight patients diagnosed with severe sepsis with AGI III and a need for mechanical ventilation were randomized to two groups. In the FO group, 50 g of long chain fatty acid soybean oil (n = 6) and 10 g of FO (n = 3) were administered as total parenteral nutrition (TPN)...
July 2017: Pharmacognosy Magazine
https://www.readbyqxmd.com/read/28836817/high-frequency-of-methicillin-resistant-staphylococcus-aureus-mrsa-with-sccmec-type-iii-and-spa-type-t030-in-karaj-s-teaching-hospitals-iran
#14
Bahareh Bayat, Masoumeh Hallaj Zade, Samaneh Mansouri, Enayat Kalantar, Kourosh Kabir, Ehsan Zahmatkesh, Mohammad Noori Sepehr, Mohammmad Hassan Naseri, Davood Darban-Sarokhalil
Methicillin-resistant Staphylococcus aureus (MRSA) has been one of the most important antibiotic-resistant pathogen in many parts of the world over the past decades. This cross-sectional study was conducted to investigate MRSA isolated between July 2013 and July 2014 in Karaj, Iran. All tested isolates were collected in teaching hospitals from personnel, patients, and surfaces and each MRSA was analyzed by SCCmec and spa typing. Antibiotic susceptibility testing was accomplished by disk diffusion method. Out of 49 MRSA isolates from the Karaj's teaching hospitals, 82%, 10%, and 6% of the isolates were SCCmec types III, II, and I, respectively...
August 24, 2017: Acta Microbiologica et Immunologica Hungarica
https://www.readbyqxmd.com/read/28830529/oral-hygiene-in-intensive-care-unit-patients-with-photodynamic-therapy-study-protocol-for-randomised-controlled-trial
#15
Gabriela Alves Da Collina, Anna Carolina Ratto Tempestini-Horliana, Daniela de Fátima Teixeira da Silva, Priscila Larcher Longo, Maria Luisa Faria Makabe, Christiane Pavani
BACKGROUND: In intensive care units (ICUs), nosocomial infections are prevalent conditions and they have been related to high mortality indexes. Some studies have suggested that inefficient oral hygiene and ventilator-associated pneumonia (VAP) are related. Nowadays, in the Brazilian public health system there is no well-defined protocol for oral hygiene in an ICU. Due to the drawbacks of the use of antibiotics, photodynamic therapy (PDT) has emerged as an interesting technique in order to reduce antimicrobial-resistant pathogens...
August 22, 2017: Trials
https://www.readbyqxmd.com/read/28822340/endothelial-glycocalyx-biomarkers-increase-in-patients-with-infection-during-emergency-department-treatment
#16
Lisa Smart, Stephen P J Macdonald, Sally Burrows, Erika Bosio, Glenn Arendts, Daniel M Fatovich
PURPOSE: Endothelial glycocalyx (EG) shedding may promote organ failure in sepsis. This study describes temporal changes in EG biomarkers from Emergency Department (ED) arrival, and associations with clinical characteristics. MATERIALS AND METHODS: This prospective observational study included 23 patients with simple infection, 86 with sepsis and 29 healthy controls. Serum EG biomarkers included syndecan-1, syndecan-4 and hyaluronan. Samples were taken on enrolment in the ED (T0), 1 hour (T1), 3 hours (T3) and 12 to 24 hours (T24) later...
July 2, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28819694/thoracic-corpectomy-for-neoplastic-vertebral-bodies-using-a-navigated-lateral-extracavitary-approach-a-single-center-consecutive-case-series-technique-and-analysis
#17
Sebastian Hartmann, Christoph Wipplinger, Anja Tschugg, Pujan Kavakebi, Alexander Örley, Pierre Pascal Girod, Claudius Thomé
Thoracic myelopathy is often caused by vertebral body fractures resulting from neoplastic conditions, traumatic events, or infectious diseases. One of the preferred procedures for treating it is the lateral extracavitary approach (LECA) with single-level or multilevel decompressive corpectomy and reconstruction. The aim of this retrospective study was to analyze the thoracic lateral extracavitary approach with corpectomy using vertebral body replacement systems (VBR-S) and dorsal reconstruction. Twenty-four patients with metastatic or primary lesions of thoracic vertebrae T2-T12 underwent spinal decompression and ventral column reconstruction with correction of spinal deformity via a LECA...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28806982/software-guided-versus-nurse-directed-blood-glucose-control-in-critically-ill-patients-the-logic-2-multicenter-randomized-controlled-clinical-trial
#18
Jasperina Dubois, Tom Van Herpe, Roosmarijn T van Hooijdonk, Ruben Wouters, Domien Coart, Pieter Wouters, Aimé Van Assche, Guy Veraghtert, Bart De Moor, Joost Wauters, Alexander Wilmer, Marcus J Schultz, Greet Van den Berghe, Dieter Mesotten
BACKGROUND: Blood glucose control in the intensive care unit (ICU) has the potential to save lives. However, maintaining blood glucose concentrations within a chosen target range is difficult in clinical practice and holds risk of potentially harmful hypoglycemia. Clinically validated computer algorithms to guide insulin dosing by nurses have been advocated for better and safer blood glucose control. METHODS: We conducted an international, multicenter, randomized controlled trial involving 1550 adult, medical and surgical critically ill patients, requiring blood glucose control...
August 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28804720/integron-mediated-antibiotic-resistance-in-acinetobacter-baumannii-isolated-from-intensive-care-unit-patients-babol-north-of-iran
#19
Mitra Deylam Salehi, Elaheh Ferdosi-Shahandashti, Yosef Yahyapour, Soraya Khafri, Abazar Pournajaf, Ramazan Rajabnia
BACKGROUND: We investigated the integron types and their relation with antibiotic resistance among A. baumannii isolates collected from intensive care unit patients, Babol, north of Iran. METHODS: In this cross-sectional study, a total of 73 bronchoalveolar lavage samples were obtained from patients in ICU. Susceptibility testing was performed by disk diffusion method. Types of integrons were identified by an integrase gene PCR. RESULTS: In total, 47...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28790779/device-associated-healthcare-associated-infections-da-hai-and-the-caveat-of-multiresistance-in-a-multidisciplinary-intensive-care-unit
#20
Inam Danish Khan, Atoshi Basu, Sheshadri Kiran, Shaleen Trivedi, Priyanka Pandit, Anupam Chattoraj
BACKGROUND: Device-Associated Healthcare-Associated Infections (DA-HAI), including Ventilator-Associated Pneumonia (VAP), Central-Line-Associated Blood Stream Infection (CLABSI), and Catheter-Related Urinary Tract Infection (CAUTI), are considered as principal contributors to healthcare hazard and threat to patient safety as they can cause prolonged hospital stay, sepsis, and mortality in the ICU. The study intends to characterize DA-HAI in a tertiary care multidisciplinary ICU of a teaching hospital in eastern India...
July 2017: Medical Journal, Armed Forces India
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