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Infection control in ICU

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https://www.readbyqxmd.com/read/29782519/increased-circulating-microrna-122-is-a-biomarker-for-discrimination-and-risk-stratification-in-patients-defined-by-sepsis-3-criteria
#1
Tim Rahmel, Simon T Schäfer, Ulrich H Frey, Michael Adamzik, Jürgen Peters
BACKGROUND: Sepsis is now operationally defined as life-threatening organ dysfunction caused by an infection, identified by an acute change in SOFA-Score of at least two points, including clinical chemistry such as creatinine or bilirubin concentrations. However, little knowledge exists about organ-specific microRNAs as potentially new biomarkers. Accordingly, we tested the hypotheses that micro-RNA-122, the foremost liver-related micro-RNA (miR), 1) discriminates between sepsis and infection, 2) is an early predictor for mortality, and 3) improves the prognostic value of the SOFA-score...
2018: PloS One
https://www.readbyqxmd.com/read/29777534/is-it-necessary-to-have-a-dentist-within-an-intensive-care-unit-team-report-of-a-randomised-clinical-trial
#2
Wanessa Teixeira Bellissimo-Rodrigues, Mayra Gonçalves Menegueti, Gilberto Gambero Gaspar, Hayala Cristina Cavenague de Souza, Maria Auxiliadora-Martins, Anibal Basile-Filho, Roberto Martinez, Fernando Bellissimo-Rodrigues
OBJECTIVE: To evaluate the effectiveness of dental treatment in improving oral health in critical patients. METHODS: This randomised clinical trial was conducted in a general intensive care unit (ICU) at a tertiary care public facility from 1 January 2011 to 8 August 2013. Data from 254 adult patients staying in the ICU for 48 hours or more were analysed. The experimental group (n = 127) had access to dental treatment provided by a dentist four to five times a week, in addition to routine oral hygiene, whereas the control group (n = 127) had access only to routine oral hygiene, including topical application of chlorhexidine, provided by the ICU nursing staff...
May 18, 2018: International Dental Journal
https://www.readbyqxmd.com/read/29770752/ventilator-bundle-compliance-and-risk-of-ventilator-associated-events
#3
Bryan D Harris, Gale A Thomas, Matthew H Greene, Steven S Spires, Thomas R Talbot
OBJECTIVEVentilator bundles encompass practices that reduce the risk of ventilator complications, including ventilator-associated pneumonia. The impact of ventilator bundles on the risk of developing ventilator-associated events (VAEs) is unknown. We sought to determine whether decreased compliance to the ventilator bundle increases the risk for VAE development.DESIGNNested case-control study.SETTINGThis study was conducted at 6 adult intensive care units at an academic tertiary-care center in Tennessee.PATIENTSIn total, 273 patients with VAEs were randomly matched in a 1:4 ratio to controls by mechanical ventilation duration and ICU type...
June 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29763777/incorporation-of-point-of-care-ultrasound-into-morning-round-is-associated-with-improvement-in-clinical-outcomes-in-critically-ill-patients-with-sepsis
#4
Zhonghua Chen, Yucai Hong, Junru Dai, Lifeng Xing
OBJECTIVES: Point-of-care ultrasound (POCUS) has been widely used in the intensive care unit (ICU). However, it is largely unknown whether the use of POCUS is associated with improved patient-important outcomes. The study aimed to investigate whether incorporation of POCUS during morning round on a routine basis was able to improve clinical outcomes in critically ill patients with sepsis. DESIGN: It was a prospective observational study. SETTING: A tertiary care emergency intensive care unit...
May 11, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#5
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29751127/temporal-trends-and-patterns-in-antimicrobial-resistant-gram-negative-bacteria-implicated-in-intensive-care-unit-acquired-infections-a-cohort-based-surveillance-study-in-istanbul-turkey
#6
Bulent Durdu, Evangelos I Kritsotakis, Andrew C K Lee, Perihan Torun, Ismail N Hakyemez, Bilge Gultepe, Turan Aslan
OBJECTIVES: This study assessed trends and patterns in antimicrobial resistant intensive care unit (ICU)-acquired infections caused by Gram-negative bacteria (GNB) in Istanbul, Turkey. METHODS: Bacterial culture and antibiotic susceptibility data were collected for all GNB causing nosocomial infections in five adult ICUs of a large university hospital during 2012-2015. Multi-resistance patterns were categorised as multidrug (MDR), extensively-drug (XDR) and pandrug (PDR)-resistance...
May 8, 2018: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29735825/high-level-aminoglycoside-resistance-in-acinetobacter-baumannii-recovered-from-intensive-care-unit-patients-in-northeastern-india
#7
Supriya Upadhyay, Annie Bakorlin Khyriem, Prithwis Bhattacharya, Amitabha Bhattacharjee, Santa Ram Joshi
Background: Acinetobacter baumannii has emerged as an important nosocomial pathogen, its ability to acquire resistance to carbapenems and aminoglycosides, has complicated their treatment regimen. The present study investigates the prevalence and diversity of aminoglycoside-modifying enzymes and 16S methyltransferases in A. baumannii isolates recovered from patients admitted in Intensive Care Unit (ICU) of a tertiary referral hospital in Northeastern India. Materials and Methods: We investigated the high-level aminoglycoside-resistance (HLAR) (gentamicin and amikacin minimum inhibitory concentration ≥ 512 μg/ml) among 164 multidrug-resistant A...
January 2018: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29730473/the-intensive-care-unit-icu-course-and-outcome-in-acute-on-chronic-liver-failure-are-comparable-to-other-populations
#8
Philippe Meersseman, Lies Langouche, Johannie du Plessis, Hannelie Korf, Michaël Mekeirele, Wim Laleman, Frederik Nevens, Alexander Wilmer, Greet Van den Berghe, Schalk W van der Merwe
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation of cirrhosis, development of organ failure and high short term mortality. Whether the outcome in ACLF patients admitted to the ICU with organ failure differs from other ICU populations is unknown. We compared the clinical course and host response in ICU patients with or without ACLF, matched for baseline severity of illness scores and characteristics. METHODS: From the large prospective EPaNIC randomized control trial database (n=4640), 133 patients were identified with cirrhosis of whom 71 fulfilled the CLIF criteria for ACLF...
May 3, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29716584/clinicians-attitude-towards-a-placebo-controlled-randomised-clinical-trial-investigating-the-effect-of-neuraminidase-inhibitors-in-adults-hospitalised-with-influenza
#9
Naomi Bradbury, Jonathan Nguyen-Van-Tam, Wei Shen Lim
BACKGROUND: The value of neuraminidase inhibitors (NAIs) in reducing severe clinical outcomes from influenza is debated. A clinical trial to generate better evidence is desirable. However, it is unknown whether UK clinicians would support a placebo-controlled trial. A survey was conducted to determine the attitude of clinicians towards a clinical trial and their current practice in managing adults admitted to hospital with suspected influenza. METHODS: Senior clinicians (n = 50) across the UK actively involved in the care of patients hospitalised with severe respiratory infections and/or respiratory infection research were invited to participate in an on-line survey...
May 2, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29715703/icu-readmission-after-cardiac-surgery-still-a-matter-of-concern
#10
Philipp Kolat, Patricia Guttenberger, Michael Ried, Julia Kapahnke, Assad Haneya, Christof Schmid, Claudius Diez
BACKGROUND:  Despite improvements in diagnostics and perioperative care, readmission to intensive care unit (ICU) after cardiac surgery is still a severe drawback for patients with considerable morbidity, mortality, and costs. Aim of this retrospective analysis was to disentangle independent risk factors for ICU readmission. MATERIAL AND METHODS:  Between 01/2004 and 12/2012, 336 out of 9,555 (3.5%) patients undergoing cardiac surgery at the Department of Cardiothoracic Surgery in Regensburg (Germany) were readmitted to ICU...
May 1, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29714447/low-levels-of-vitamin-d-are-associated-with-nosocomial-infections-but-not-with-short-term-mortality-in-critically-ill-patients
#11
Işıl Köse, Çiler Zincircioğlu, Hüseyin Özkarakaş, Meltem Çakmak, Gürsel Ersan, Lütfiye Kuzucu, Şükran Köse, Nimet Şenoğlu
Background/aim: A prospective observational study was conducted to determine the relationship between vitamin D deficiency and nosocomial infections among intensive care unit (ICU) patients. Materials and methods: Demographic data, season of admission, vitamin D levels at admission, premorbid lifestyle scores, comorbid conditions, and admission diagnosis were recorded in 306 ICU patients. Infections that developed at least 48 h after admission to the ICU were the primary outcome, and ICU, hospital, and 1-year mortality were the secondary outcomes...
April 30, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29713464/an-observational-case-study-of-hospital-associated-infections-in-a-critical-care-unit-in-astana-kazakhstan
#12
Dmitriy Viderman, Yekaterina Khamzina, Zhannur Kaligozhin, Makhira Khudaibergenova, Agzam Zhumadilov, Byron Crape, Azliyati Azizan
Background: Hospital Associated infections (HAI) are very common in Intensive Care Units (ICU) and are usually associated with use of invasive devices in the patients. This study was conducted to determine the prevalence and etiological agents of HAI in a Surgical ICU in Kazakhstan, and to assess the impact of these infections on ICU stay and mortality. Objective: To assess the rate of device-associated infections and causative HAI etiological agents in an ICU at the National Research Center for Oncology and Transplantation (NRCOT) in Astana, Kazakhstan...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29701662/feasibility-of-a-lactobacillus-casei-drink-in-the-intensive-care-unit-for-prevention-of-antibiotic-associated-diarrhea-and-clostridium-difficile
#13
Cathy Alberda, Sam Marcushamer, Tayne Hewer, Nicole Journault, Demetrios Kutsogiannis
Background: Over 70% of patients are prescribed antibiotics during their intensive care (ICU) admission. The gut microbiome is dramatically altered early in an ICU stay, increasing the risk for antibiotic associated diarrhea (AAD) and Clostridium difficile infections (CDI). Evidence suggests that some probiotics are effective in the primary prevention of AAD and CDI. Aim: To demonstrate safety and feasibility of a probiotic drink in ICU patients. Methods: ICU patients initiated on antibiotics were recruited, and matched with contemporary controls...
April 26, 2018: Nutrients
https://www.readbyqxmd.com/read/29699468/lower-respiratory-tract-infection-and-short-term-outcome-in-patients-with-acute-respiratory-distress-syndrome
#14
Fernando G Zampieri, Pedro Póvoa, Jorge I Salluh, Alejandro Rodriguez, Sandrine Valade, José Andrade Gomes, Jean Reignier, Elena Molinos, Jordi Almirall, Nicolas Boussekey, Lorenzo Socias, Paula Ramirez, William N Viana, Anahita Rouzé, Saad Nseir, Ignacio Martin-Loeches
OBJECTIVE: To assess whether ventilator-associated lower respiratory tract infections (VA-LRTIs) are associated with mortality in critically ill patients with acute respiratory distress syndrome (ARDS). MATERIALS AND METHODS: Post hoc analysis of prospective cohort study including mechanically ventilated patients from a multicenter prospective observational study (TAVeM study); VA-LRTI was defined as either ventilator-associated tracheobronchitis (VAT) or ventilator-associated pneumonia (VAP) based on clinical criteria and microbiological confirmation...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29698542/point-prevalence-of-healthcare-associated-infections-and-antibiotic-use-in-three-large-swiss-acute-care-hospitals
#15
Aliki Metsini, Miriam Vazquez, Rami Sommerstein, Jonas Marschall, Cathy Voide, Nicolas Troillet, Céline Gardiol, Didier Pittet, Walter Zingg, The Swissnoso Network
BACKGROUND: The overall burden of healthcare-associated infections (HAIs) remains high, even in high-income countries. However, the current burden of HAI in Switzerland is unknown. Prevalence surveys have a long tradition in the field of infection prevention and control for measuring both HAI and antimicrobial use. The objective of this survey was to test the point prevalence survey (PPS) methodology of the European Centre for Disease Prevention and Control (ECDC) in acute-care hospitals in Switzerland...
April 26, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29692589/occurrence-of-bla-genes-encoding-carbapenem-resistant-pseudomonas-aeruginosa-and-acinetobacter-baumannii-from-intensive-care-unit-in-a-tertiary-care-hospital
#16
Jayanthi Siva Subramaniyan, Jeya Meenakshi Sundaram
CONTEXT: ICU shows increasing incidence of infection associated with the use of invasive procedures for the diagnostic purpose as well as the indiscriminate use of antibiotics. Pseudomonas aeruginosa and Acinetobacter species are "very successful" pathogen and the emergence of the Metallo-β-Lactamases (MBL) is becoming a therapeutic challenge. AIMS: To isolate the Nonfermenting Gram negative bacilli from the ICU samples. To identify the metallo betalactamase producers and to detect the bla gene presence among the Pseudomonas aeruginosa and Acinetobacter baumannii ...
April 2018: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/29678711/healthcare-associated-infections-after-subarachnoid-hemorrhage
#17
Yasser B Abulhasan, Najayeb Alabdulraheem, Ian Schiller, Susan P Rachel, Nandini Dendukuri, Mark R Angle, Charles Frenette
OBJECTIVE: Healthcare-associated infections (HAIs) after subarachnoid hemorrhage (SAH) are prevalent; however, data describing epidemiology of infection is limited. This study reports incidence rates, risk factors and the resulting SAH patient-related outcomes. METHODS: We studied the incidence of ICU-acquired HAIs over a 6-year period. We used Bayesian Model Averaging to identify risk factors associated with an increased risk of HAIs, particularly urinary tract infections (UTI), pneumonia and ventriculostomy-associated infections (VAI)...
April 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29670613/innate-immunity-in-the-persistent-inflammation-immunosuppression-and-catabolism-syndrome-and-its-implications-for-therapy
#18
REVIEW
Hiroyuki Horiguchi, Tyler J Loftus, Russell B Hawkins, Steven L Raymond, Julie A Stortz, McKenzie K Hollen, Brett P Weiss, Elizabeth S Miller, Azra Bihorac, Shawn D Larson, Alicia M Mohr, Scott C Brakenridge, Hironori Tsujimoto, Hideki Ueno, Frederick A Moore, Lyle L Moldawer, Philip A Efron
Clinical and technological advances promoting early hemorrhage control and physiologic resuscitation as well as early diagnosis and optimal treatment of sepsis have significantly decreased in-hospital mortality for many critically ill patient populations. However, a substantial proportion of severe trauma and sepsis survivors will develop protracted organ dysfunction termed chronic critical illness (CCI), defined as ≥14 days requiring intensive care unit (ICU) resources with ongoing organ dysfunction...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29667378/alarming-results-of-nosocomial-infections-in-a-multicenter-program-of-surveillance-in-polish-intensive-care-units
#19
Michał Wałaszek, Anna Różańska, Małgorzata Bulanda, Jadwiga Wojkowska-Mach, Polish Society of Hospital Infections Team
INTRODUCTION: Nosocomial bloodstream infections (BSI) among patients in intensive care units (ICU) are the most common form of nosocomial infections and they are serious complications of the treatment process. The etiological factors of these infections and the proper antibiotic therapy can influence the effects of patient treatment. The aim of the study was to analyze the epidemiology, microbiology and antibiotic therapy of nosocomial BSI in Polish ICU patients. MATERIALS AND METHODS: The retrospective study covered patients hospitalized in seven ICUs for adults with a general profile, located in southern Poland...
2018: Przegla̧d Epidemiologiczny
https://www.readbyqxmd.com/read/29659759/community-acquired-legionella-pneumonia-in-hiv-infected-adult-patients-a-matched-case-control-study
#20
Catia Cillóniz, Lucia Miguel-Escuder, María Luisa Pedro-Bonet, Vicenç Falcó, Yessica Lopez, Carolina García-Vidal, Albert Gabarrús, Asunción Moreno, Antoni Torres, José M Miró
We investigated whether the clinical presentations and outcomes (length of hospital stay [LOS], intensive care unit[ICU] admission, 30-day mortality) of Legionella pneumonia in HIV-infected patients were comparable to those without HIV infection.Clinical presentation and outcomes in HIV-infected patients with Legionella pneumonia did not differ from patients without HIV infection.
April 12, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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