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Infection control in ICU

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https://www.readbyqxmd.com/read/28731836/mortality-rate-and-antibiotic-resistance-in-complicated-diverticulitis-report-of-272-consecutive-patients-worldwide-a-prospective-cohort-study
#1
Federico Coccolini, Mattia Trevisan, Giulia Montori, Massimo Sartelli, Fausto Catena, Marco Ceresoli, Antonio Costanzo, Arianna Heyer, Luca Ansaloni
BACKGROUND: Complicated diverticulitis (CD) is a common problem for surgeons. In treating it, as a general principle, every verified source of infection should be controlled. Supplementary antimicrobial management involves a delicate balance of optimizing empirical therapy while reducing unnecessary antibiotic use. The necessity to know the most frequent infecting pathogens and their spectra of resistance is becoming pivotal. The aim of this study was to determine the microbiologic profile of complicated intra-abdominal infections (IAIs) secondary to CD, to analyze the role of empirical antimicrobial therapy, and to describe the clinical aspects of CD worldwide...
July 21, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28720671/the-impact-of-ventilator-associated-events-in-critically-ill-subjects-with-prolonged-mechanical-ventilation
#2
Hidetsugu Kobayashi, Shigehiko Uchino, Masanori Takinami, Shoichi Uezono
BACKGROUND: The Centers for Disease Control and Prevention recently released a surveillance definition for respiratory complications in ventilated patients, ventilator-associated events (VAE), to replace ventilator-associated pneumonia (VAP). VAE consists of ventilator-associated conditions (VAC), infection-related ventilator-associated complications (IVAC), and possible VAP. A duration of mechanical ventilation of at least 4 d is required to diagnose VAE. However, the observed duration of mechanical ventilation was < 4 d in many previous studies...
July 18, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28717513/unexpected-intensive-care-transfer-of-admitted-patients-with-severe-sepsis
#3
Gabriel Wardi, Arvin R Wali, Julian Villar, Vaishal Tolia, Christian Tomaszewski, Christian Sloane, Peter Fedullo, Jeremy R Beitler, Matthew Nolan, Daniel Lasoff, Rebecca E Sell
BACKGROUND: Patients with severe sepsis generally respond well to initial therapy administered in the emergency department (ED), but a subset later decompensate and require unexpected transfer to the intensive care unit (ICU). This study aimed to identify clinical factors that can predict patients at increased risk for delayed transfer to the ICU and the association of delayed ICU transfer with mortality. METHODS: This is a nested case-control study in a prospectively collected registry of patients with severe sepsis and septic shock at two EDs...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28716451/multidrug-resistant-pseudomonas-aeruginosa-lower-respiratory-tract-infections-in-the-intensive-care-unit-prevalence-and-risk-factors
#4
Trang D Trinh, Evan J Zasowski, Kimberly C Claeys, Abdalhamid M Lagnf, Shravya Kidambi, Susan L Davis, Michael J Rybak
Intensive care unit (ICU) admission is a risk for multidrug-resistant (MDR) Pseudomonas aeruginosa, but factors specific to critically ill pneumonia patients are not fully characterized. Objective was to determine risk factors associated with MDR P. aeruginosa pneumonia among ICU patients. This was a retrospective case-control study of P. aeruginosa pneumonia in the ICU; cystic fibrosis and colonizers were excluded. Risk factors included comorbid conditions and prior healthcare exposure (anti-pseudomonal antibiotics, hospitalizations, nursing home, P...
June 19, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28702465/a-dynamic-transmission-model-to-evaluate-the-effectiveness-of-infection-control-strategies
#5
Karim Khader, Alun Thomas, W Charles Huskins, Molly Leecaster, Yue Zhang, Tom Greene, Andrew Redd, Matthew H Samore
BACKGROUND: The advancement of knowledge about control of antibiotic resistance depends on the rigorous evaluation of alternative intervention strategies. The STAR*ICU trial examined the effects of active surveillance and expanded barrier precautions on acquisition of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) in intensive care units. We report a reanalyses of the STAR*ICU trial using a Bayesian transmission modeling framework. METHODS: The data included admission and discharge times and surveillance test times and results...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28699136/intrawound-application-of-vancomycin-changes-the-responsible-germ-in-elective-spine-surgery-without-significant-effect-on-the-rate-of-infection-a-randomized-prospective-study
#6
B Mirzashahi, M Chehrassan, S M J Mortazavi
PURPOSE: Surgical site infection (SSI) is a costly complication associated with spine surgery. The impact of intrawound vancomycin has not been strongly postulated to decrease the risk of surgical site infection. We designed study to determine whether intrawound vancomycin application reduces the risk of SSI in patients after spine surgery. METHODS: A prospective randomized control trial study to evaluate the patients with elective spine surgery in a period of 15 month was designed...
July 11, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28697755/spread-of-resistant-gram-negatives-in-a-sri-lankan-intensive-care-unit
#7
Kavinda Tissera, Veranja Liyanapathirana, Nilanthi Dissanayake, Vasanthi Pinto, Asela Ekanayake, Manjula Tennakoon, Dinuka Adasooriya, Dulmini Nanayakkara
BACKGROUND: Infections with multi drug resistant (MDR) organisms are a major problem in intensive care units (ICUs). Proper infection control procedures are mandatory to combat the spread of resistant organisms within ICUs. Well stablished surveillance programmes will enhance the adherence of the staff to infection control protocols. The study was conducted to assess the feasibility of using basic molecular typing methods and routine hospital data for laboratory surveillance of resistance organisms in resource limited settings...
July 11, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28697503/update-of-sepsis-in-the-intensive-care-unit
#8
Kelly Roveran Genga, James A Russell
Sepsis, the most common cause of admission to an intensive care unit (ICU), has had an increased incidence and prevalence over the last years with a simultaneous decrease in its short-term mortality. Sepsis survivors are more frequently discharged from hospital and often experience long-term outcomes such as late mortality, immune dysfunction, secondary infections, impaired quality of life, and unplanned readmissions. Early recognition and management of sepsis have challenged emergency care and critical care physicians and nurses...
July 12, 2017: Journal of Innate Immunity
https://www.readbyqxmd.com/read/28695245/risk-factors-for-peri-procedural-arterial-ischaemic-stroke-in-children-with-cardiac-disease
#9
Hiroko Asakai, Belinda Stojanovski, John C Galati, Dianna Zannino, Michael Cardamone, Darren Hutchinson, Michael M H Cheung, Mark T Mackay
Improved survival of children with congenital heart disease has led to increasing focus on neurodevelopmental outcome, as close to half of the infants undergoing cardiac surgery are affected by neurodevelopmental disability. Stroke is particularly important as it frequently results in permanent neurologic sequelae. The aim of this study was to investigate risk factors for peri-procedural arterial ischaemic stroke (AIS) in children with cardiac disease. A retrospective case-control analysis of children aged <18 years with radiologically confirmed AIS following a cardiac procedure admitted to the Royal Children's Hospital Melbourne between 1993 and 2010...
July 11, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28693625/a-role-for-antimicrobial-stewardship-in-clinical-sepsis-pathways-a-prospective-interventional-study
#10
John Burston, Suman Adhikari, Andrew Hayen, Heather Doolan, Melissa L Kelly, Kathy Fu, Tomas O Jensen, Pamela Konecny
OBJECTIVE To evaluate the impact of early infectious diseases (ID) antimicrobial stewardship (AMS) intervention on inpatient sepsis antibiotic management. DESIGN Interventional, nonrandomized, controlled study. SETTING Tertiary-care referral hospital, Sydney, Australia. PATIENTS Consecutive, adult, non-intensive care unit (non-ICU) inpatients triggering an institutional clinical sepsis pathway from May to August 2015. INTERVENTION All patients reviewed by an ID Fellow within 24 hours of sepsis pathway trigger underwent case review and clinic file documentation of recommendations...
July 11, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28687211/preventing-transmission-of-multidrug-resistant-pathogens-in-the-intensive-care-unit
#11
REVIEW
Jeffrey R Strich, Tara N Palmore
Infection control in the intensive care unit (ICU) has seen many advances, including rapid molecular screening tests for resistant organisms and chlorhexidine use in daily baths. Although these developments advance the cause of infection prevention, compliance with some of the basic measures remains elusive. Hand hygiene, antimicrobial stewardship, and reduction in device use remain the low-technology interventions that could have a major impact on nosocomial transmission of antimicrobial-resistant organisms...
July 5, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28681751/assessment-of-surgical-risk-factors-in-the-development-of-ventilator-associated-pneumonia-in-neurosurgical-intensive-care-unit-patients-alarming-observations
#12
Deepashu Sachdeva, Daljit Singh, Poonam Loomba, Amandeep Kaur, Monica Tandon, Ishu Bishnoi
BACKGROUND: Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in patients receiving mechanical ventilation (MV) and contributes to a longer intensive care unit (ICU) stay, duration of MV, and a high morbidity and mortality. OBJECTIVE: The purpose of study was to determine the incidence of VAP in neurosurgery ICU patients and to assess the probable contributing neurosurgical risk factors like the site and nature of the lesion in the brain, the duration of surgery, blood loss during surgery, and infection elsewhere in the body, in the development of VAP...
July 2017: Neurology India
https://www.readbyqxmd.com/read/28669363/the-effect-of-adding-comorbidities-to-current-centers-for-disease-control-and-prevention-central-line-associated-bloodstream-infection-risk-adjustment-methodology
#13
Sarah S Jackson, Surbhi Leekha, Laurence S Magder, Lisa Pineles, Deverick J Anderson, William E Trick, Keith F Woeltje, Keith S Kaye, Kristen Stafford, Kerri Thom, Timothy J Lowe, Anthony D Harris
BACKGROUND Risk adjustment is needed to fairly compare central-line-associated bloodstream infection (CLABSI) rates between hospitals. Until 2017, the Centers for Disease Control and Prevention (CDC) methodology adjusted CLABSI rates only by type of intensive care unit (ICU). The 2017 CDC models also adjust for hospital size and medical school affiliation. We hypothesized that risk adjustment would be improved by including patient demographics and comorbidities from electronically available hospital discharge codes...
July 3, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28659886/molecular-epidemiology-and-risk-factors-of-carbapenem-resistant-klebsiella-pneumoniae-infections-in-eastern-china
#14
Bing Zheng, Yingxin Dai, Yang Liu, Weiyang Shi, Erkuan Dai, Yichao Han, Dandan Zheng, Yuetian Yu, Min Li
Background: The increasing prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) poses an immediate threat to treatment worldwide. This retrospective study assessed the molecular epidemiology and determined the risk factors for and outcomes of CRKP infections in a general teaching hospital in Shanghai, China. Methods: From January 2013 to July 2015, 100 consecutive unique CRKP isolates isolated from hospitalized patients were collected. Isolates were screened for antibiotic resistance genes by polymerase chain reaction and molecular typing was performed by pulsed-field gel electrophoresis (PFGE)...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28647219/higher-mortality-of-severe-influenza-patients-with-probable-aspergillosis-than-those-with-and-without-other-coinfections
#15
Yee-Huang Ku, Khee-Siang Chan, Chun-Chieh Yang, Che-Kim Tan, Yin-Ching Chuang, Wen-Liang Yu
BACKGROUND/PURPOSE: Aspergillus-associated infection might comprise up to 23-29% of severe influenza patients from the community throughout stay in an intensive care unit (ICU). In Taiwan, cases of severe influenza with aspergillosis are increasingly reported. Therefore, we describe the relative risk of mortality among severe influenza patients with aspergillosis and other coinfections compared to severe influenza patients without Aspergillus coinfections. METHODS: We retrospectively reviewed 124 adult patients with severe influenza in a tertiary medical center in southern Taiwan from January 2015 through March 2016...
June 21, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28638594/high-burden-of-antimicrobial-resistance-among-gram-negative-bacteria-causing-healthcare-associated-infections-in-a-critical-care-unit-of-nepal
#16
Narayan Prasad Parajuli, Subhash Prasad Acharya, Shyam Kumar Mishra, Keshab Parajuli, Basista Prasad Rijal, Bharat Mani Pokhrel
BACKGROUND: Healthcare associated infections (HCAI) and antimicrobial resistance are principal threats to the patients of intensive care units and are the major determining factors for patient outcome. They are associated with increased morbidity, mortality, excess hospitalization and financial costs. The present study is an attempt to investigate the spectrum and antimicrobial resistance of bacterial isolates involved in healthcare associated infections (HCAI) in the patients of a critical care unit at a tertiary care university hospital in Kathmandu, Nepal...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28625267/-application-of-quality-control-chart-in-quality-control-for-nosocomial-infection-in-intensive-care-unit
#17
Yumei Cheng, Yuanyi Liu, Difen Wang
OBJECTIVE: To explore the application value of control chart in the management of nosocomial infection in intensive care unit (ICU) by using quality control chart to monitor the infections in ICU. METHODS: From October 2011 to June 2016, ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI), namely the three catheters, occurred in ICU of the Affiliated Hospital of Guizhou Medical University were monitored and recorded monthly, then the data was imput into the Excel, and the data was analyzed using SPSS...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625234/-effect-of-global-end-diastolic-volume-index-guidance-fluid-resuscitation-in-elderly-patients-with-septic-shock
#18
Shuang Ma, Rumin Zhang, Shifu Wang, Meiling Zhao, Lei Wang, Yun Zhang
OBJECTIVE: To evaluate the effect of global end diastolic volume index (GEDVI) on fluid resuscitation in elderly patients with septic shock. METHODS: A prospective randomized controlled trial (RCT) was conducted. Septic shock patients over 65 years admitted to intensive care unit (ICU) of Shandong Province, Zibo Central Hospital from January 2013 to December 2015 were enrolled. The patients were randomly divided into control group and observation group, 20 cases in each group...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28619005/effects-of-immunonutrition-on-biomarkers-in-traumatic-brain-injury-patients-in-malaysia-a-prospective-randomized-controlled-trial
#19
Vineya Rai Hakumat Rai, Lee Fern Phang, Sheau Fung Sia, Amirah Amir, Jeyaganesh S Veerakumaran, Mustafa Kassim Abdulazez Kassim, Rafidah Othman, Pei Chien Tah, Pui San Loh, Mohamad Irfan Othman Jailani, Gracie Ong
BACKGROUND: Head injury is one of the top three diagnosis leading to intensive care unit (ICU) admission in Malaysia. There has been growing interest in using immunonutrition as a mode of modulating the inflammatory response to injury or infection with the aim of improving clinical outcome. The aim of the present study was to evaluate the effect of an immunonutrition on biomarkers (IL-6, glutathione, CRP, total protein and albumin) in traumatic brain injury patients. METHODS: Thirty six patients with head injury admitted to neurosurgical ICU in University Malaya Medical Centre were recruited for this study, over a 6-month period from July 2014 to January 2015...
June 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28616203/reduced-rate-of-intensive-care-unit-acquired-gram-negative-bacilli-after-removal-of-sinks-and-introduction-of-water-free-patient-care
#20
Joost Hopman, Alma Tostmann, Heiman Wertheim, Maria Bos, Eva Kolwijck, Reinier Akkermans, Patrick Sturm, Andreas Voss, Peter Pickkers, Hans Vd Hoeven
BACKGROUND: Sinks in patient rooms are associated with hospital-acquired infections. The aim of this study was to evaluate the effect of removal of sinks from the Intensive Care Unit (ICU) patient rooms and the introduction of 'water-free' patient care on gram-negative bacilli colonization rates. METHODS: We conducted a 2-year pre/post quasi-experimental study that compared monthly gram-negative bacilli colonization rates pre- and post-intervention using segmented regression analysis of interrupted time series data...
2017: Antimicrobial Resistance and Infection Control
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