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Infection control in ICU

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https://www.readbyqxmd.com/read/28439517/incidence-and-risk-factors-for-organ-space-infection-after-radiofrequency-assisted-hepatectomy-or-ablation-of-liver-tumors-in-a-single-center-more-than-meets-the-eye
#1
Ioannis Karavokyros, Stamatios Orfanos, Anastasios Angelou, Antonia Meropouli, Dimitrios Schizas, John Griniatsos, Emmanouil Pikoulis
INTRODUCTION: Surgical site infections (SSIs) and especially organ/space infection (O/SI) after resection or ablation of liver tumors are associated with increased morbidity and mortality. A secondary blood stream infection (BSI) is considered an O/SI but the exact prevalence is unknown. We aimed to investigate the incidence of O/SI and BSIs in a cohort of consecutive patients after liver resection or ablation, to seek for a possible connection between them and to search for potential risk factors...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28433240/an-elicitation-study-of-critical-care-nurses-salient-hand-hygiene-beliefs
#2
Susan E Piras, Jana Lauderdale, Ann Minnick
AIM: To describe critical care nurses' hand hygiene attitudinal, normative referent, and control beliefs. BACKGROUND: Hand hygiene is the primary strategy to prevent healthcare-associated infections. Social influence is an underdeveloped hand hygiene strategy. METHODS: This qualitative descriptive study was conducted with 25 ICU nurses in the southeastern United States. Data were collected using the Nurses' Salient Belief Instrument. RESULTS: Thematic analysis generated four themes: Hand Hygiene is Protective; Nurses look to Nurses; Time-related Concerns; and Convenience is Essential...
April 19, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28427403/preoperative-carbohydrate-load-and-intraoperatively-infused-omega-3-polyunsaturated-fatty-acids-positively-impact-nosocomial-morbidity-after-coronary-artery-bypass-grafting-a-double-blind-controlled-randomized-trial
#3
Gibran Roder Feguri, Paulo Ruiz Lúcio de Lima, Danilo de Cerqueira Borges, Laura Ramos Toledo, Larissa Nadaf Batista, Thaís Carvalho E Silva, Neuber José Segri, José Eduardo de Aguilar-Nascimento
BACKGROUND: A strategy of limited preoperative fasting, with carbohydrate (CHO) loading and intraoperative infusion of omega-3 polyunsaturated fatty acids (ω-3 PUFA), has seldom been tried in cardiovascular surgery. Brief fasting, followed by CHO intake 2 h before anesthesia, may improve recovery from CABG procedures and lower perioperative vasoactive drug requirements. Infusion of ω-3 PUFA may reduce occurrences of postoperative atrial fibrillation (POAF) and shorten hospital stays...
April 20, 2017: Nutrition Journal
https://www.readbyqxmd.com/read/28425261/central-line-associated-blood-stream-infections-characteristics-and-risk-factors-for-mortality-over-a-5-5-year-period
#4
Aynur Atilla, Zahide Doğanay, Hale Kefeli Çelik, Mehmet Derya Demirağ, Sırrı S Kiliç
BACKGROUND/AIM: Central line-associated bloodstream infections (CLABSIs) are associated with substantial morbidity and mortality and the infection rates vary in a wide range1397645907(high: 62.5%; low: 20%) in developing countries. We aimed to investigate the characteristics and the risk factors for mortality in patients with CLABSIs in intensive care units (ICUs) and provide the relevant data. MATERIALS AND METHODS: The electronic medical records database and file records obtained through active surveillance by an infection control committee of a hospital were screened to identify patients with CLABSIs hospitalized from January 2008 through July 2013...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28421246/immunoglobulin-g-for-patients-with-necrotising-soft-tissue-infection-instinct-a-randomised-blinded-placebo-controlled-trial
#5
Martin B Madsen, Peter B Hjortrup, Marco B Hansen, Theis Lange, Anna Norrby-Teglund, Ole Hyldegaard, Anders Perner
PURPOSE: The aim of the INSTINCT trial was to assess the effect of intravenous polyspecific immunoglobulin G (IVIG) compared with placebo on self-reported physical function in intensive care unit (ICU) patients with necrotising soft tissue infection (NSTI). METHODS: We randomised 100 patients with NSTI 1:1 to masked infusion of 25 g of IVIG (Privigen, CSL Behring) or an equal volume of 0.9% saline once daily for the first 3 days of ICU admission. The primary outcome was the physical component summary (PCS) score of the 36-item short form health survey (SF-36) 6 months after randomisation; patients who had died were given the lowest possible score (zero)...
April 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28413996/from-vap-to-vae-implications-of-the-new-cdc-definitions-on-a-burn-intensive-care-unit-population
#6
Anne M Lachiewicz, David J Weber, David van Duin, Shannon S Carson, Lauren M DiBiase, Samuel W Jones, William A Rutala, Bruce A Cairns, Emily E Sickbert-Bennett
Ventilator-associated pneumonia (VAP) is a frequent complication of severe burn injury. Comparing the current ventilator-associated event-possible VAP definition to the pre-2013 VAP definition, we identified considerably fewer VAP cases in our burn ICU. The new definition does not capture many VAP cases that would have been reported using the pre-2013 definition. Infect Control Hosp Epidemiol 2017;1-3.
April 17, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28412677/differential-analysis-of-clinical-efficacy-on-patients-with-serious-infection-in-icu-by-different-meropenem-regimens
#7
Wei-Min Wang, Xu-Sheng An, Xiang-Cheng Zhang, Liang-Liang Hui, Shi-Guang Guo, Bei-Bei Chen, Kui Zang, Fu-Tai Shang, Long-Chuan Wu
To investigate the difference in clinical efficacy and safety of different meropenem regimens on patients with serious infection in ICU. Then, 228 patients with serious infection in ICU were divided by random into control group (intermittent administration in 1000mg/30min single dose) and research group (continuous administration in 200mg/10min +800mg/180min), respectively. The blood concentration of meropenem were recorded in two groups at different time points, and difference in treatment effectiveness, iconographic effectiveness, bacterial eradication rate, 28-day survival rate and many other clinical scoring indices (SOFA, APACHEII, CPIS, and SIRS) were compared between two groups...
November 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28408415/impact-of-international-quality-improvement-collaborative-on-congenital-heart-surgery-in-pakistan
#8
Amina Khan, Ahmed Abdullah, Huzaifa Ahmad, Arjumand Rizvi, Sehrish Batool, Kathy J Jenkins, Kimberlee Gauvreau, Muneer Amanullah, Anwar Haq, Nadeem Aslam, Fauzia Minai, Babar Hasan
BACKGROUND: The International Quality Improvement Collaborative (IQIC) was formed to reduce mortality and morbidity from congenital heart disease (CHD) surgeries in low/middle-income countries. OBJECTIVES: We conducted this study to compare the postoperative outcomes of CHD surgeries at a centre in Pakistan before and after joining IQIC. METHODS: The IQIC provides guidelines targeting key drivers responsible for morbidity and mortality in postoperativepatients with CHD...
April 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28399851/babesiosis-in-long-island-review-of-62-cases-focusing-on-treatment-with-azithromycin-and-atovaquone
#9
Ekaterina A Kletsova, Eric D Spitzer, Bettina C Fries, Luis A Marcos
BACKGROUND: Babesiosis is a potentially life-threatening, tick-borne infection endemic in New York. The purpose of this study was to review recent trends in babesiosis management and outcomes focusing on patients, who were treated with combination of azithromycin and atovaquone. METHODS: A retrospective chart review of patients seen at Stony Brook University Hospital between 2008 and 2014 with peripheral blood smears positive for Babesia was performed. Clinical and epidemiological information was recorded and analyzed...
April 11, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28396937/bifurcation-analysis-and-global-dynamics-of-a-mathematical-model-of-antibiotic-resistance-in-hospitals
#10
Xiuli Cen, Zhilan Feng, Yiqiang Zheng, Yulin Zhao
Antibiotic-resistant bacteria have posed a grave threat to public health by causing a number of nosocomial infections in hospitals. Mathematical models have been used to study transmission dynamics of antibiotic-resistant bacteria within a hospital and the measures to control antibiotic resistance in nosocomial pathogens. Studies presented in Lipstich et al. (Proc Natl Acad Sci 97(4):1938-1943, 2000) and Lipstich and Bergstrom (Infection control in the ICU environment. Kluwer, Boston, 2002) have provided valuable insights in understanding the transmission of antibiotic-resistant bacteria in a hospital...
April 10, 2017: Journal of Mathematical Biology
https://www.readbyqxmd.com/read/28394975/-risk-factors-for-acute-kidney-injury-in-patients-treated-with-polymyxin-b-experience-from-139-cases-at-a-tertiary-university-hospital-in-colombia
#11
Johanna Osorio, Jackeline Barreto, Claudia F Samboni, Lina A Cándelo, Luis C Álvarez, Susana Benavidez, Roso P Téllez, Dagoberto Santofimio, Jorge A Ramos, Carlos A Gómez
BACKGROUND: The rise of infections caused by multidrug-resistant Gram negative bacilli (MDR-GNB), added to paucity of newer therapy, have led to increase polymyxin B use, despite adverse renal toxicity profile. AIM: To determine the incidence and risk factors associated to acute kidney injury (AKI) and polymyxin B use, in patients with infections caused by MDR-GNB. METHODS: A retrospective cohort, with a nested case-control study of adults who received polymyxin B for more than 48 hours at a tertiary university hospital in Colombia (2011-2015) was performed...
February 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28386264/factors-associated-with-mortality-in-patients-with-autoimmune-diseases-admitted-to-the-intensive-care-unit-in-bogota-colombia
#12
Jorge Armando Carrizosa, Jorge Aponte, Diego Cartagena, Ricard Cervera, Maria Teresa Ospina, Alexander Sanchez
Patients with autoimmune diseases (ADs) are a challenge for the intensivist; it is hard to differentiate among infection, disease activity, and combinations of both, leading to high mortality. This study is a retrospective analysis of 124 critically ill patients admitted to the intensive care unit (ICU) in a university hospital between 2008 and 2016. Bivariate case-control analysis was performed, using patients who died as cases; later, analysis using a logistic regression model with variables that were associated with mortality was conducted...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28384861/molecular-characterization-of-multidrug-resistant-strains-of-acinetobacter-baumannii-isolated-from-intensive-care-units-in-west-of-iran
#13
Parviz Mohajeri, Abbas Farahani, Rasa Sheini Mehrabzadeh
INTRODUCTION: According to the results of various studies using phenotypic methods, the prevalence of Multidrug Resistant (MDR) Acinetobacter baumannii (A. baumannii) isolates has been increasing worldwide. Pulsed-Field Gel Electrophoresis (PFGE) technique is known as the gold standard method to determine clonal characterization of bacterial species, especially A. baumannii. AIM: To determine the clonal relatedness and investigate the prevalence of integron classes 1 and 2 and genes encoding OXA-23 and 24 in A...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28382598/patients-with-anca-associated-vasculitis-admitted-to-the-intensive-care-unit-with-acute-vasculitis-manifestations-a-retrospective-and-comparative-multicentric-study
#14
Julien Demiselle, Johann Auchabie, François Beloncle, Philippe Gatault, Steven Grangé, Damien Du Cheyron, Jean Dellamonica, Sonia Boyer, Dimitri Titeca Beauport, Lise Piquilloud, Julien Letheulle, Christophe Guitton, Nicolas Chudeau, Guillaume Geri, François Fourrier, René Robert, Emmanuel Guérot, Julie Boisramé-Helms, Pierre Galichon, Pierre-François Dequin, Alexandre Lautrette, Pierre-Edouard Bollaert, Ferhat Meziani, Loïc Guillevin, Nicolas Lerolle, Jean-François Augusto
PURPOSE: Data for ANCA-associated vasculitis (AAV) patients requiring intensive care are scarce. METHODS: We included 97 consecutive patients with acute AAV manifestations (new onset or relapsing disease), admitted to 18 intensive care units (ICUs) over a 10-year period (2002-2012). A group of 95 consecutive AAV patients with new onset or relapsing disease, admitted to two nephrology departments with acute vasculitis manifestations, constituted the control group...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28380034/soluble-membrane-receptors-interleukin-6-procalcitonin-and-c-reactive-protein-as-prognostic-markers-in-patients-with-severe-sepsis-and-septic-shock
#15
Juan-Jesús Ríos-Toro, Mercedes Márquez-Coello, José-María García-Álvarez, Andrés Martín-Aspas, Ricardo Rivera-Fernández, Ana Sáez de Benito, José-Antonio Girón-González
BACKGROUND: The objective of this study was to explore the diagnostic and prognostic value of soluble triggering receptor expressed on myeloid cell 1 (sTREM-1), soluble cluster of differentiation 14 (sCD14), soluble cluster of differentiation 163 (sCD163), interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) serum levels for patients with severe sepsis and septic shock in an intensive care unit (ICU). METHODS: Fifty patients admitted at the ICU with the diagnosis of severe sepsis or septic shock were studied...
2017: PloS One
https://www.readbyqxmd.com/read/28362030/effect-of-universal-chlorhexidine-decolonisation-on-the-infection-rate-in-intensive-care-patients
#16
Wiesława Duszyńska, Barbara Adamik, Karolina Lentka-Bera, Katarzyna Kulpa, Agata Nieckula-Schwarz, Agnieszka Litwin, Łukasz Stróżecki, Andrzej Kübler
BACKGROUND: Healthcare-associated infections (HAIs), particularly intensive care unit-acquired infections (HAI-ICU), are an important cause of morbidity and mortality in hospitals. Most of these infections are caused by multidrugresistant organisms. The results of recent studies have suggested that daily bathing with chlorhexidine (CHX)-universal decolonisation can prevent ICU infections. The purpose of the study was to determine the influence of CHX bathing on the rate and type of HAI-ICU in critically ill patients...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28361751/glutamine-dipeptide-supplemented-parenteral-nutrition-improves-the-clinical-outcomes-of-critically-ill-patients-a-systematic-evaluation-of-randomised-controlled-trials
#17
Peter Stehle, Björn Ellger, Dubravka Kojic, Astrid Feuersenger, Christina Schneid, John Stover, Daniela Scheiner, Martin Westphal
BACKGROUND & AIMS: Early randomised controlled trials (RCTs) testing whether parenteral nutrition regimens that include glutamine dipeptides improves the outcomes of critically ill patients demonstrated convincingly that this regimen associates with reduced mortality, infections, and hospital stays. However, several new RCTs on the same question challenged this. To resolve this controversy, the present meta-analysis was performed. Stringent eligibility criteria were used to select only those RCTs that tested the outcomes of critically ill adult patients without hepatic and/or renal failure who were haemodynamically and metabolically stabilised and who were administered glutamine dipeptide strictly according to current clinical guidelines (via the parenteral route at 0...
February 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28356109/systematic-review-and-meta-analysis-of-mortality-of-patients-infected-with-carbapenem-resistant-klebsiella-pneumoniae
#18
REVIEW
Liangfei Xu, Xiaoxi Sun, Xiaoling Ma
PURPOSE: Carbapenem resistant K. pneumoniae (CRKP) has aroused widespread attention owing to its very limited therapeutic options, and this strain has increased rapidly in recent years. Although it is accepted that drug resistance is associated with increased mortality in general, but some other studies found no such relationship. To estimate mortality of patients infected with CRKP in general and analyze factors for mortality of this infection, thus, we conducted this systematic review and meta-analysis...
March 29, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28355466/invasive-mould-infections-in-the-icu-setting-complexities-and-solutions
#19
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/28353579/intensive-insulin-therapy-for-preventing-postoperative-infection-in-patients-with-traumatic-brain-injury-a-randomized-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Yan Wang, Jin-Ping Li, Ying-Lun Song, Qi-Huang Zhao
OBJECTIVE: To assess the effect of intensive insulin therapy (IIT) for preventing postoperative infection in patients with traumatic brain injury (TBI). METHODS: In total, 88 patients with TBI were randomly divided into 2 groups, 44 in each group. One group (group ITT) received IIT and the other group (group CIT) received conventional insulin therapy (CIT). This study was conducted between February 2013 and January 2016. Outcomes included infection rate, mortality, and neurological outcome (measured by the Glasgow Outcome Scale [GOS])...
March 2017: Medicine (Baltimore)
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