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Critical ill patient and antibiotic

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https://www.readbyqxmd.com/read/28076304/the-use-of-liquid-chromatography-tandem-mass-spectrometry-for-therapeutic-drug-monitoring-of-antibiotics-in-cancer-patients
#1
Nahed El-Najjar, Jonathan Jantsch, André Gessner
Cancer remains a leading cause of mortality and morbidity worldwide. In addition to organ failure, the most frequent reasons for admission of cancer patients to intensive care units (ICU) are: infections and sepsis. As critically ill, the complexity of the health situation of cancer patients renders the standard antimicrobial regimen more complex and even inadequate which results in increased mortality rates. This is due to pathophysiological changes in the volume of distribution, increased clearance, as well as to organ dysfunction...
January 11, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28065252/additional-real-world-evidence-supporting-procalcitonin-as-an-effective-tool-to-improve-antibiotic-management-and-cost-of-the-critically-ill-patient
#2
EDITORIAL
Philipp Schuetz, Peter M Wahl
No abstract text is available yet for this article.
January 2017: Chest
https://www.readbyqxmd.com/read/28042237/gut-microbiome-surgical-complications-and-probiotics
#3
REVIEW
George Stavrou, Katerina Kotzampassi
The trigger for infectious complications in patients following major abdominal operations is classically attributed to endogenous enteral bacterial translocation, due to the critical condition of the gut. Today, extensive gut microbiome analysis has enabled us to understand that almost all "evidence-based" surgical or medical intervention (antibiotics, bowel preparation, opioids, deprivation of nutrition), in addition to stress-released hormones, could affect the relative abundance and diversity of the enteral microbiome, allowing harmful bacteria to proliferate in the place of depressed beneficial species...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28033162/an-ex-vivo-model-to-decipher-the-impact-of-extracorporeal-membrane-oxygenation-on-beta-lactam-degradation-kinetics
#4
Cyril Leven, Pierre Fillâtre, Antoine Petitcollin, Marie-Clémence Verdier, Jérôme Laurent, Nicolas Nesseler, Yoann Launey, Pierre Tattevin, Eric Bellissant, Erwan Flécher, Florian Lemaitre
BACKGROUND: As a consequence of drug sequestration, increase in volume of distribution or alteration of elimination, extracorporeal membrane oxygenation (ECMO) might lead to inadequate plasma concentrations of vital drugs. The aim of this experimental study was to develop an ex vivo model to better characterize the impact of ECMO procedure on beta-lactam antibiotics pharmacokinetics. METHODS: Plasma concentrations of cefotaxime, ceftazidime, cefepime, piperacillin, oxacillin, amoxicillin, and ceftriaxone were measured in an ex vivo ECMO circuit primed with whole human blood and compared to controls stored in glass tubes and polyvinyl chloride (PVC) tubing...
December 23, 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28030371/antibiotic-dosing-for-multidrug-resistant-pathogen-pneumonia
#5
Mohd H Abdul-Aziz, Jeffrey Lipman, Jason A Roberts
PURPOSE OF REVIEW: Nosocomial pneumonia caused by multidrug-resistant pathogens is increasing in the ICU, and these infections are negatively associated with patient outcomes. Optimization of antibiotic dosing has been suggested as a key intervention to improve clinical outcomes in patients with nosocomial pneumonia. This review describes the recent pharmacokinetic/pharmacodynamic data relevant to antibiotic dosing for nosocomial pneumonia caused by multidrug-resistant pathogens. RECENT FINDINGS: Optimal antibiotic treatment is challenging in critically ill patients with nosocomial pneumonia; most dosing guidelines do not consider the altered physiology and illness severity associated with severe lung infections...
December 24, 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28018869/pathogens-and-antimicrobial-susceptibility-profiles-in-critically-ill-patients-with-bloodstream-infections-a-descriptive-study
#6
Rachel D Savage, Robert A Fowler, Asgar H Rishu, Sean M Bagshaw, Deborah Cook, Peter Dodek, Richard Hall, Anand Kumar, François Lamontagne, François Lauzier, John Marshall, Claudio M Martin, Lauralyn McIntyre, John Muscedere, Steven Reynolds, Henry T Stelfox, Nick Daneman
BACKGROUND: Surveillance of antimicrobial resistance is vital to guiding empirical treatment of infections. Collating and reporting routine data on clinical isolate testing may offer more timely information about resistance patterns than traditional surveillance network methods. METHODS: Using routine microbiology testing data collected from the Bacteremia Antibiotic Length Actually Needed for Clinical Effectiveness retrospective cohort study, we conducted a descriptive secondary analysis among critically ill patients in whom bloodstream infections had been diagnosed in 14 intensive care units (ICUs) in Canada...
October 2016: CMAJ Open
https://www.readbyqxmd.com/read/28004983/methicillin-resistant-staphylococcus-aureus-pneumonia-in-critically-ill-trauma-and-burn-patients-a-retrospective-cohort-study
#7
Kristen L Bunnell, Andrew R Zullo, Christine Collins, Charles A Adams
BACKGROUND: The timing and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia in trauma patients are not well characterized. This information is critical for the selection of appropriate empiric antibiotics. The objective of this study was to determine the incidence of MRSA pneumonia in early-onset and late-onset pneumonia and to identify risk factors for MRSA in the trauma-burn intensive care unit (ICU). PATIENTS AND METHODS: We conducted a retrospective cohort study from January 2012 to March 2015 of patients in the trauma and burn ICU with clinical and microbiologic evidence of pneumonia...
December 22, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27994915/intravenous-colistin-use-for-multidrug-resistant-gram-negative-infections-in-pediatric-patients
#8
Ayşe Karaaslan, Eren Çağan, Eda Kepenekli Kadayifci, Serkan Atıcı, Gülşen Akkoç, Nurhayat Yakut, Sevliya Öcal Demir, Ahmet Soysal, Mustafa Bakır
BACKGROUND: The emergence of infections due to multidrug-resistant Gram-negative bacilli (MDR-GNB) has led to the resurrection of colistin use. The data on colistin use and drug-related adverse effects in children are scarce. AIMS: In this study, we aimed to evaluate the clinical efficacy and safety of colistin use in critically ill pediatric patients. STUDY DESIGN: This study has a retrospective study design. METHODS: Sixty-one critically ill children were identified through the department's patient files archive during the period from January 2011 to November 2014...
November 2016: Balkan Medical Journal
https://www.readbyqxmd.com/read/27992988/-risk-factors-for-methicillin-resistant-staphylococcus-aureus-bacteremia-a-multicenter-matched-case-control-study
#9
Paola Mariana Arias-Ortiz, Libia Del Pilar Calderón, Juan Sebastián Castillo, José Moreno, Aura Lucía Leal, Jorge Alberto Cortés, Carlos Arturo Álvarez, Grupo Grebo
INTRODUCTION: Methicillin-resistant Staphylococcus aureus is a frequent pathogen at critical care services. Its presence leads to increased hospital stays and mortality risk in patients with bacteremia. However, the etiology of this resistance marker has not been fully studied. OBJECTIVE: To identify risk factors associated with the emergence of methicillin-resistant S. aureus bacteremia in critically ill patients treated at intensive care units in Bogotá, Colombia...
December 1, 2016: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/27979825/the-critical-role-of-microbiota-within-cecal-crypts-on-the-regenerative-capacity-of-the-intestinal-epithelium-following-surgical-stress
#10
Alexander Zaborin, Monika Krezalek, Sanjiv Hyoju, Jennifer R DeFazio, Namrata Setia, Natalia Belogortseva, Vytautas P Bindokas, Qiti Guo, Olga Zaborina, John C Alverdy
Cecal crypts represent a unique niche that are normally occupied by the commensal microbiota. Due to their density and close proximity to stem cells, microbiota within cecal crypts may modulate epithelial regeneration. Here it is demonstrated that surgical stress, a process that invariably involves a short period of starvation, antibiotic exposure and tissue injury, results in cecal crypt evacuation of their microbiota. Crypts devoid of their microbiota display pathophysiological features characterized by abnormal stem cell activation as judged by Lgr5 staining, abnormal stem cell distribution with cells migrating toward the tips of the crypts, and an increase in TUNEL positive cells...
December 15, 2016: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/27976489/improving-the-quality-of-nurse-influenced-patient-care-in-the-intensive-care-unit
#11
Lynsey J Sutton, Rebecca J Jarden
BACKGROUND: Quality of care is a major focus in the intensive care unit (ICU). AIM: To describe a nurse-initiated quality improvement (QI) project that improved the care of critically ill patients in a New Zealand tertiary ICU. DESIGN: A framework for QI was developed and implemented as part of a practice change initiative. METHODS: Audit data were collected, analysed and reported across seven nurse-influenced patient care standards...
December 14, 2016: Nursing in Critical Care
https://www.readbyqxmd.com/read/27974890/clinical-significance-of-molecular-diagnostic-tools-for-bacterial-bloodstream-infections-a-systematic-review
#12
REVIEW
Jean Pierre Rutanga, Therese Nyirahabimana
Bacterial bloodstream infection (bBSI) represents any form of invasiveness of the blood circulatory system caused by bacteria and can lead to death among critically ill patients. Thus, there is a need for rapid and accurate diagnosis and treatment of patients with septicemia. So far, different molecular diagnostic tools have been developed. The majority of these tools focus on amplification based techniques such as polymerase chain reaction (PCR) which allows the detection of nucleic acids (both DNA and small RNAs) that are specific to bacterial species and sequencing or nucleic acid hybridization that allows the detection of bacteria in order to reduce delay of appropriate antibiotic therapy...
2016: Interdisciplinary Perspectives on Infectious Diseases
https://www.readbyqxmd.com/read/27974589/tigecycline-therapy-in-an-infant-for-ventriculoperitoneal-shunt-meningitis
#13
Melike Emiroglu, Gulsum Alkan, Hatice Turk Dagi
Shunt infections are seen in 3% to 20% of patients who have cerebrospinal fluid (CSF) shunts. Although the staphylococcal species are the most common cause of shunt-related infections, Gram-negative bacteria are increasingly reported with higher mortality rates. Tigecycline, a glycylcycline, is not approved for children. But in the era of nosocomial infections due to multidrug-resistant pathogens, it can be the life-saving option. We report an infant with ventriculoperitoneal shunt-related meningitis treated with a tigecycline combination regimen...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/27958229/epidemiological-study-of-sepsis-in-china-protocol-of-a-cross-sectional-survey
#14
Yi Yang, Jian-Feng Xie, Kai-Jiang Yu, Chen Yao, Jian-Guo Li, Xiang-Dong Guan, Jing Yan, Xiao-Chun Ma, Yan Kang, Cong-Shan Yang, Xiao-Qing Yao, Hong-Cai Shang, Hai-Bo Qiu
BACKGROUND: Sepsis is the leading cause of death among critically ill patients. Herein, we conducted a national survey to provide data on epidemiology and treatment of sepsis in the clinical practice in China, which has no detailed epidemiological data available on sepsis. METHODS: This was a prospective cross-sectional survey from December 1, 2015 to January 31, 2016 in all provinces/municipalities of the mainland of China. The primary outcome of this study was the incidence of sepsis, and the secondary outcome was its etiology in China...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27933276/acinetobacter-baumannii-isolated-from-lebanese-patients-phenotypes-and-genotypes-of-resistance-clonality-and-determinants-of-pathogenicity
#15
Elias Dahdouh, Micheline Hajjar, Monica Suarez, Ziad Daoud
Introduction:Acinetobacter baumannii is a nosocomial pathogen that usually affects critically ill patients. High mortality rates have been associated with MDR A. baumannii infections. Carbapenem resistance among these isolates is increasing worldwide and is associated with certain International Clones (ICs) and oxacillinases (OXAs). Moreover, this organism possesses a wide range of virulence factors, whose expression is not yet fully understood. In this study, clinical A. baumannii isolates are characterized in terms of antibiotic resistance, mechanisms of carbapenem resistance, clonality, and virulence...
2016: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/27929233/procalcitonin-guidance-safely-decreases-antibiotic-use-in-critically-ill-patients
#16
Nita Shrikant Kulkarni
No abstract text is available yet for this article.
October 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/27920421/a-missing-guide-wire-after-placement-of-peripherally-inserted-central-venous-catheter
#17
Muhammad Kashif, Hafiz Hashmi, Preeti Jadhav, Misbahuddin Khaja
BACKGROUND Central venous catheterization is a common tool used in critically ill patients to monitor central venous pressure and administer fluids and medications such as vasopressors. Here we present a case of a missing guide wire after placement of peripherally inserted central catheter (PICC), which was incidentally picked up by bedside ultrasound in the intensive care unit.  CASE REPORT A 50-year-old Hispanic male was admitted to the intensive care unit for alcohol intoxication. He was managed for septic shock and required placement of a peripherally inserted central line in his left upper extremity for antibiotics and vasopressor administration...
December 6, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27917707/management-of-pneumonia-in-the-pediatric-critical-care-unit-an-area-for-antimicrobial-stewardship
#18
Aimee M Dassner, David P Nicolau, Jennifer E Girotto
Pediatric pneumonia is one of the most common causes of childhood infection requiring hospitalization and is a substantial driver of antimicrobial use among hospitalized children. About 12-20% of pediatric patients hospitalized with community-acquired pneumonia (CAP) require critical care. Additionally, nosocomial pneumonias (i.e. hospital-acquired and ventilator-associated pneumonias) are responsible for 15-53% of hospital-associated infections and are the most common indication for empiric antibiotics in the pediatric intensive care unit...
December 4, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/27887595/antimicrobial-stewardship-of-chinese-ministry-of-health-reduces-multidrug-resistant-organism-isolates-in-critically-ill-patients-a-pre-post-study-from-a-single-center
#19
Xudong Ma, Jianfeng Xie, Yi Yang, Fengmei Guo, Zhiwei Gao, Hua Shao, Yingzi Huang, Congshan Yang, Haibo Qiu
BACKGROUND: China's Ministry of Health (MOH) has established a policy about the antimicrobial stewardship. To date, the effects of this policy on multidrug-resistant organism (MDRO) in critically ill patients are unknown. METHODS: A pre-post study was conducted on intensive care unit (ICU) patients from June 2010 to May 2011 and from June 2012 to May 2013. Bacterial cultures were conducted at ICU admission and discharge. In June 2011, our hospital started to administer the antimicrobial stewardship program of Chinese MOH...
November 25, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27863531/effects-of-continuous-renal-replacement-therapy-on-linezolid-pharmacokinetic-pharmacodynamics-a-systematic-review
#20
Gianluca Villa, Paola Di Maggio, A Raffaele De Gaudio, Andrea Novelli, Riccardo Antoniotti, Enrico Fiaccadori, Chiara Adembri
BACKGROUND: Major alterations in linezolid pharmacokinetic/pharmacodynamic (PK/PD) parameters might be expected in critically ill septic patients with acute kidney injury (AKI) who are undergoing continuous renal replacement therapy (CRRT). The present review is aimed at describing extracorporeal removal of linezolid and the main PK-PD parameter changes observed in critically ill septic patients with AKI, who are on CRRT. METHOD: Citations published on PubMed up to January 2016 were systematically reviewed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement...
November 19, 2016: Critical Care: the Official Journal of the Critical Care Forum
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