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Infection control in ICU

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https://www.readbyqxmd.com/read/27920416/re-evaluating-the-inhibition-of-stress-erosions-revise-a-protocol-for-pilot-randomized-controlled-trial
#1
Waleed Alhazzani, Gordon Guyatt, John C Marshall, Richard Hall, John Muscedere, Francois Lauzier, Lehana Thabane, Mohammed Alshahrani, Shane W English, Yaseen M Arabi, Adam M Deane, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook, On Behalf Of
INTRODUCTION: Clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (ICU), most commonly prescribing proton pump inhibitors (PPIs). However, the incidence of gastrointestinal (GI) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. Therefore, a large randomized clinical trial (RCT) is needed to inform modern practice. The aim of this multicenter pilot trial is to determine the feasibility of performing a large RCT to investigate the efficacy and safety of withholding intravenous pantoprazole...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27917737/a-pediatric-approach-to-ventilator-associated-events-surveillance
#2
Noelle M Cocoros, Gregory P Priebe, Latania K Logan, Susan Coffin, Gitte Larsen, Philip Toltzis, Thomas J Sandora, Marvin Harper, Julia S Sammons, James E Gray, Donald Goldmann, Kelly Horan, Michael Burton, Paul A Checchia, Matthew Lakoma, Shannon Sims, Michael Klompas, Grace M Lee
OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27916878/burkholderia-contaminans-colonization-from-contaminated-liquid-docusate-colace-in-a-immunocompetent-adult-with-legionnaire-s-disease-infection-control-implications-and-the-potential-role-of-candida-pellucosa
#3
Burke A Cunha, John Gian, Bertamaria Dieguez, Elsa Santos-Cruz, Daniela Matassa, Steve Gerson, Pat Daniels, Carlos Rosales, Rodger P Silletti
Objective:B. contaminans was cultured from respiratory secretions and liquid docusate (Colace) in a Neurosurgical Intensive Care Unit (NICU) patient with community-acquired Legionnaire's disease but not from another bottle given to the patient. Unexpectedly, C. pelliculosa was cultured from two bottles, but not the B. contaminans bottle or respiratory secretions. Methods:B. cepacia, later identified as B. contaminans, was cultured from a bottle of liquid docusate (Colace) dispensed to a non-cystic fibrosis patient...
November 30, 2016: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27916077/-intestinal-barrier-dysfunction-and-its-related-factors-in-patients-with-sepsis
#4
W Liu, X H Wang, X J Yang, X Y Zhang, W J Qi
Objective: To investigate the relationship between related factors of intestinal barrier dysfunction in patients with sepsis or septic shock and severity of the condition. Methods: A prospective observational study was conducted in 31 sepsis patients, 28 septic shock patients, and 21 postoperative patients without sepsis (control group) who were admitted to intensive care unit (ICU) of General Hospital of Ningxia Medical University between November 2015 and June 2016. Blood samples were collected from the patients within 24 hours following admission to ICU...
November 29, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27906423/analysis-of-factors-influenced-by-the-effectiveness-of-non-invasive-ventilation-in-the-treatment-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-with-different-severities
#5
J-J Zhu, L-J Liu
OBJECTIVE: To investigate the correlation of levels of procalcitonin (PCT) and blood lactic acid with the effectiveness of the non-invasive ventilation (NIV) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with different severities. PATIENTS AND METHODS: We used a case-control method to study patients who were admitted for AECOPD to the ICU at the Second Affiliated Hospital of Soochow University from January 1, 2012, to December 31, 2014...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27902412/the-staff-education-to-reducing-ventilator-associated-pneumonia
#6
Gurdal Yilmaz, Hava Aydin, Mustafa Aydin, Sedat Saylan, Hulya Ulusoy, Iftihar Koksal
Mechanical ventilation (MV) is a life-saving invasive procedure performed in intensive care units (ICUs) where critical patients are given advanced support. The purpose of this study was to assess the effect of personnel training on the incidence of ventilator-associated pneumonia (VAP). The study, performed prospectively in the ICU, was planned in two periods. In both periods, patient's characteristics were recorded on patient data forms. In the second period, ICU physicians and assistant health personnel were given regular theoretical and practical training...
October 17, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27902388/the-exploration-of-risk-factors-of-concurrent-bacteremia-among-critically-ill-patients-with-severe-dengue
#7
Chin-Ming Chen, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Hui-Chun Chao, Chiu-Yin Yeh, Wen-Liang Yu
We investigated the clinical features of intensive care unit (ICU) patients with a concomitant severe dengue infection and bacteremia to identify risk factors for this comorbidity. The records of all ICU dengue patients admitted during a July 31-November 31, 2015 were reviewed. Patients with "concurrent bacteremia" (positive bacterial blood culture within 72 hours of ICU admission) were identified. ICU admission was required for 142 patients; 22 (15.5%) had concurrent bacteremia. Streptococcus spp. was the most common pathogen, then Escherichia coli, and then Staphylococcus spp...
November 7, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27899531/a-respiratory-therapist-disease-management-program-for-patients-hospitalized-with-copd
#8
Patty C Silver, Marin H Kollef, Darnetta Clinkscale, Peggy Watts, Robin Kidder, Brittany Eads, Debbie Bennett, Carolyn Lora, Michael Quartaro
BACKGROUND: Patients with COPD often require repeated emergency department visits and hospitalizations for COPD exacerbations. Such readmissions increase health-care costs and expose COPD patients to the added risks of nosocomial infections and increased mortality. METHODS: To determine whether a respiratory therapist (RT) disease management program could reduce re-hospitalization and emergency department visits, a prospective, single-center, unblinded, randomized trial was performed...
November 29, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27898352/management-of-the-open-abdomen-using-negative-pressure-wound-therapy-with-instillation-in-severe-abdominal-sepsis-a-review-of-48-cases-in-hospital-mexico-costa-rica
#9
Pablo Sibaja, Alfredo Sanchez, Guillermo Villegas, Alvaro Apestegui, Esteban Mora
INTRODUCTION: Despite the numerous advances in recent years, severe abdominal sepsis (with associated organ failure associated with infection) remains a serious, life-threatening condition with a high mortality rate. OA is a viable alternative to the previously used scheduled repeat laparotomy or continuous peritoneal lavage. The use of Negative Pressure Wound Therapy (NPWT) has been described as a successful method of management of the open abdomen. Adding instillation of saline solution to NPWT in a programmed and controlled manner, could offer the clinician an additional tool for the management of complex septic abdomen...
November 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27894327/a-statistical-analysis-protocol-for-the-time-differentiated-target-temperature-management-after-out-of-hospital-cardiac-arrest-tth48-clinical-trial
#10
Hans Kirkegaard, Asger Roer Pedersen, Ville Pettilä, Jakob Hjort, Bodil Steen Rasmussen, Inge de Haas, Jørgen Feldbæk Nielsen, Susanne Ilkjær, Anne Kaltoft, Anni Nørgaard Jeppesen, Anders Morten Grejs, Christophe Henri Valdemar Duez, Alf Inge Larsen, Valdo Toome, Urmet Arus, Fabio Silvio Taccone, Christian Storm, Timo Laitio, Markus B Skrifvars, Eldar Søreide
BACKGROUND: The TTH48 trial aims to determine whether prolonged duration (48 hours) of targeted temperature management (TTM) at 33 (±1) °C results in better neurological outcomes compared to standard duration (24 hours) after six months in comatose out-of-hospital cardiac arrest (OHCA) patients. METHODS: TTH48 is an investigator-initiated, multicentre, assessor-blinded, randomised, controlled superiority trial of 24 and 48 hours of TTM at 33 (±1) ° C performed in 355 comatose OHCA patients aged 18 to 80 years who were admitted to ten intensive care units (ICUs) in six Northern European countries...
November 28, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27893741/downregulation-of-blood-monocyte-hla-dr-in-icu-patients-is-also-present-in-bone-marrow-cells
#11
Valérie Faivre, Anne-Claire Lukaszewicz, Didier Payen
BACKGROUND: The downregulation of blood monocyte HLA-DR expression also occurs in tissue infiltrative cells in a context of acute clinical inflammation, especially sepsis. This context favors the development of secondary infections and results from various mechanisms. Little is known about HLA-DR expression on bone marrow (BM) cells of the monocyte lineage, the source of circulating monocytes. This study analyzed the BM HLA-DR expression in ICU patients compared to BM monocytes from non-ICU patients and to blood monocytes of control healthy donors...
2016: PloS One
https://www.readbyqxmd.com/read/27884765/efficacy-of-clarithromycin-naproxen-oseltamivir-combination-in-the-treatment-of-patients-hospitalized-for-influenza-a-h3n2-infection-an-open-label-randomized-controlled-phase-2b-3-trial
#12
Ivan Fn Hung, Kelvin Kw To, Jasper Fw Chan, Vincent Cc Cheng, Kevin Sh Liu, Anthony Tam, Tuen-Ching Chan, Anna Jinxia Zhang, Patrick Li, Tin-Lun Wong, Ricky Zhang, Michael Ks Cheung, William Leung, Johnson Yn Lau, Manson Fok, Honglin Chen, Kwok-Hung Chan, Kwok-Yung Yuen
BACKGROUND: Influenza causes excessive hospitalizations and deaths. Single agent treatment with oseltamivir in severe influenza might be insufficient. The study assessed the efficacy and safety of oseltamivir-clarithromycin-naproxen combination for treatment of serious influenza. METHODS: From February to April 2015, we conducted a prospective open-label randomized-controlled trial. Adult patients hospitalized for A(H3N2) influenza were randomly assigned to a 2-day combination of clarithromycin 500mg, naproxen 200mg and oseltamivir 75mg twice daily, followed by 3 days of oseltamivir; or oseltamivir 75mg twice daily without placebos for 5 days as control (1:1)...
November 21, 2016: Chest
https://www.readbyqxmd.com/read/27884473/icu-ward-design-and-nosocomial-infection-rates-a-cross-sectional-study-in-germany
#13
A Stiller, C Schröder, A Gropmann, F Schwab, M Behnke, C Geffers, W Sunder, J Holzhausen, P Gastmeier
BACKGROUND: There is increasing interest in the effects of hospital and ward design on multi-faceted infection control. Definitive evidence is rare and the state of knowledge about current ward design is lacking. OBJECTIVE: To collect data on the current status of ward design for intensive care units (ICUs) and to analyse associations between particular design factors and nosocomial infection rates. METHODS: In 2015, operational infrastructure data were collected via an online questionnaire from ICUs participating voluntarily in the German nosocomial infection surveillance system (KISS)...
October 20, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/27883412/prolonged-hospitalization-of-patients-with-hospital-acquired-pneumoniae-in-the-intensive-care-unit-%C3%A2-morbidity-mortality-and-costs-of
#14
Anna Różańska, Marta Wałaszek, Zdzisław Wolak, Małgorzata Bulanda
BACKGROUND: The objective of this study was to determine epidemiological rates of hospital-acquired pneumonia (HAP) in the Polish ICU and direct costs associated with excess length of stay incurred by the hospital. MATERIAL AND METHODS: The studied data concern patients hospitalized in the years 2010–2012 in a 9-bed ICU of a multi-profile hospital in the Małopolskie Province. Centers for Disease Control and Prevention diagnostic criteria were the basis for the development of definitions of infections...
2016: Przegla̧d Epidemiologiczny
https://www.readbyqxmd.com/read/27867562/analysis-of-risk-factors-for-and-the-prognosis-of-postoperative-acute-respiratory-distress-syndrome-in-patients-with-stanford-type-a-aortic-dissection
#15
Mei-Fang Chen, Liang-Wan Chen, Hua Cao, Yong Lin
BACKGROUND: To explore the risk factors for and the prognosis of postoperative acute respiratory distress syndrome (ARDS) in patients with Stanford type A aortic dissection (AD). METHODS: This retrospective nested case-control study included 527 Stanford type A AD patients who were divided into ARDS groups and non-ARDS groups. The clinical features of the groups were examined. RESULTS: The fifty-nine patients in the ARDS group exhibited extended durations of cardiopulmonary bypass (CPB) (P=0...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27863959/transmission-of-staphylococcus-aureus-between-health-care-workers-the-environment-and-patients-in-an-intensive-care-unit-a-longitudinal-cohort-study-based-on-whole-genome-sequencing
#16
James R Price, Kevin Cole, Andrew Bexley, Vasiliki Kostiou, David W Eyre, Tanya Golubchik, Daniel J Wilson, Derrick W Crook, A Sarah Walker, Timothy E A Peto, Martin J Llewelyn, John Paul
BACKGROUND: Health-care workers have been implicated in nosocomial outbreaks of Staphylococcus aureus, but the dearth of evidence from non-outbreak situations means that routine health-care worker screening and S aureus eradication are controversial. We aimed to determine how often S aureus is transmitted from health-care workers or the environment to patients in an intensive care unit (ICU) and a high-dependency unit (HDU) where standard infection control measures were in place. METHODS: In this longitudinal cohort study, we systematically sampled health-care workers, the environment, and patients over 14 months at the ICU and HDU of the Royal Sussex County Hospital, Brighton, England...
November 15, 2016: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27852379/-investigation-of-molecular-epidemiology-of-methicillin-resistant-staphylococcus-aureus-in-department-of-critical-care-medicine
#17
Y X Qin, Q D Li, X Y Wan, L Y Bi, J Wang
Objective: To investigate the feature of antimicrobial resistance, homology and other molecular epidemiology of methicillin-resistant staphylococcus aureus(MRSA) in Department of Critical Care Medicine(ICU). Methods: From October 2010 to December 2011, 149 strains of MRSA were collected and identified through sputum culture of patients from 10 ICUs of 10 teaching hospitals distributed in 9 chinese central city of China. Susceptibility testing to 18 kinds of antibiotic was performed, the method of pulsed field gel electrophoresis (PFGE) was used to analyze the homology, and the technique of multilocus sequencing typing (MLST) was used to identify the sequence type (ST)...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27852357/a-multifaceted-approach-to-reduction-of-catheter-associated-urinary-tract-infections-in-the-intensive-care-unit-with-an-emphasis-on-stewardship-of-culturing
#18
Katherine M Mullin, Christopher S Kovacs, Cynthia Fatica, Colette Einloth, Elizabeth A Neuner, Jorge A Guzman, Eric Kaiser, Venu Menon, Leticia Castillo, Marc J Popovich, Edward M Manno, Steven M Gordon, Thomas G Fraser
BACKGROUND Catheter-associated urinary tract infections (CAUTIs) are among the most common hospital-acquired infections (HAIs). Reducing CAUTI rates has become a major focus of attention due to increasing public health concerns and reimbursement implications. OBJECTIVE To implement and describe a multifaceted intervention to decrease CAUTIs in our ICUs with an emphasis on indications for obtaining a urine culture. METHODS A project team composed of all critical care disciplines was assembled to address an institutional goal of decreasing CAUTIs...
November 17, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27847697/comparison-of-the-effect-of-open-and-closed-endotracheal-suctioning-methods-on-pain-and-agitation-in-medical-icu-patients-a-clinical-trial
#19
Raziyeh Dastdadeh, Abbas Ebadi, Amir Vahedian-Azimi
BACKGROUND: Endotracheal suctioning is a necessary procedure practiced by nurses in intensive care units to remove lung secretions. This procedure leads to higher oxygenation levels and reduced breathing difficulties. It also prevents atelectasis, pulmonary infections, and the accumulation of secretions. OBJECTIVES: The present study aims to compare the effectiveness of open and closed endotracheal suction tube systems on pain and agitation in patients under mechanical ventilation...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27826443/belgian-hand-hygiene-campaigns-in-icu-2005-2015
#20
Sylvanus Fonguh, Annie Uwineza, Boudewijn Catry, Anne Simon
BACKGROUND: Healthcare-associated infections (HCAI) are still a major problem especially in most intensive care units (ICU). Incompliance by clinical staff with hand hygiene (HH) increases rates of preventable infections. We report the outcome of the Belgian national hand hygiene campaign from 2005 to 2015 with focus on intensive care units. METHODS: Using the World Health organisation (WHO) standardised observation roster, trained infection control teams measured adherence to HH guidelines by direct observation...
2016: Archives of Public Health, Archives Belges de Santé Publique
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