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Critical ill patient and antibiotic

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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
#1
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
#2
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
https://www.readbyqxmd.com/read/27857510/the-diagnostic-accuracy-of-serum-procalcitonin-for-bacteremia-in-critically-ill-children
#3
Marianne E Nellis, Steven Pon, Ashley E Giambrone, Nana E Coleman, Jonathan Reiss, Elizabeth Mauer, Bruce M Greenwald
BACKGROUND: Bacterial sepsis is frequently encountered in children admitted to the Pediatric Intensive Care Unit (PICU) and requires early recognition and treatment. Procalcitonin (PCT) is a serum biomarker with a high sensitivity to predict bacteremia in critically-ill adults. This study sought to evaluate the diagnostic accuracy of PCT for bacteremia in febrile children in the PICU. METHODS: This retrospective observational study used data from children admitted to the PICU from October 2010 to October 2012...
November 2016: Infectious Diseases in Clinical Practice: IDCP
https://www.readbyqxmd.com/read/27837233/critically-ill-patients-demonstrate-large-interpersonal-variation-in-intestinal-microbiota-dysregulation-a-pilot-study
#4
Jacqueline M Lankelma, Lonneke A van Vught, Clara Belzer, Marcus J Schultz, Tom van der Poll, Willem M de Vos, W Joost Wiersinga
PURPOSE: The intestinal microbiota has emerged as a virtual organ with essential functions in human physiology. Antibiotic-induced disruption of the microbiota in critically ill patients may have a negative influence on key energy resources and immunity. We set out to characterize the fecal microbiota composition in critically ill patients both with and without sepsis and to explore the use of microbiota-derived markers for clinical outcome measurements in this setting. METHODS: In this prospective observational cohort study we analyzed the fecal microbiota of 34 patients admitted to the intensive care unit...
November 11, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27836381/universal-protocol-for-the-rapid-automated-detection-of-carbapenem-resistant-gram-negative-bacilli-directly-from-blood-cultures-by-matrix-assisted-laser-desorption-ionisation-time-of-flight-mass-spectrometry-maldi-tof-ms
#5
Marina Oviaño, Katrin Sparbier, Maria José Barba, Markus Kostrzewa, Germán Bou
Detection of carbapenemase-producing bacteria directly from blood cultures is a major challenge, as patients with bacteraemia are critically ill. Early detection can be helpful for selection of the most appropriate antibiotic therapy as well as adequate control of outbreaks. In the current study, a novel matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF)-based method was developed for the rapid, automated detection of carbapenemase-producing Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii directly from blood cultures...
October 20, 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27830927/observational-clinical-study-on-organ-dysfunction-associated-with-dosing-of-antibiotics-in-a-paediatric-intensive-care-unit
#6
Sascha Tafelski, Alexander Gratopp, Florian Richter, Sylvia Kramer, Claudia Spies, Klaus D Wernecke, Irit Nachtigall
BACKGROUND: Medication errors are of concern especially in paediatric patients. This study investigates impact of dosing errors of antibiotics on outcome in critically ill paediatric patients. METHODS: Retrospective study including all consecutive patients admitted to one university paediatric intensive care unit (PICU) in 2010 with length of PICU stay >24hrs, age <18 years and antibiotic therapy. Antibiotic dosages were evaluated for compliance with recommended dosing individually adapted for bodyweight, age and organ function...
November 10, 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/27816564/community-health-workers-provide-integrated-community-case-management-using-malaria-rapid-diagnostic-test-kits
#7
Bright C Orji, Namratha Rao, Elizabeth Thompson, William R Brieger, Emmanuel 'Dipo Otolorin
BACKGROUND: Throughout Nigeria malaria is an endemic disease. Efforts to treat malaria can also be combined with other illnesses including pneumonia and diarrhea, which are killing children under five years of age. The use of Rapid Diagnostic Test (RDT) aids early diagnosis of malaria and informs when other illnesses should be considered. Those with positive RDT results should be treated with Artemisinin-based Combination Therapy (ACTs), while those with negative RDTs results are further investigated for pneumonia and diarrhea...
October 26, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27815709/stage-directed-therapy-of-pleural-empyema
#8
REVIEW
Martin Reichert, Matthias Hecker, Biruta Witte, Johannes Bodner, Winfried Padberg, Markus A Weigand, Andreas Hecker
PURPOSE: Intensivists and surgeons are often confronted with critically ill patients suffering from pleural empyema. Due to it' s multifactorial pathogenesis and etiology, medicals should be sensitized to recognize the different stages of the disease. Besides a whole bundle of different established classification systems, the progress of pleural effusions can be subdivided into the early exudative, the intermediate fibropurulent and the late organized phase according to the classification of the American Thoracic Society...
November 4, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27790429/act-fast-as-time-is-less-high-faecal-carriage-of-carbapenem-resistant-enterobacteriaceae-in-critical-care-patients
#9
Sanjith Saseedharan, Manisa Sahu, Edwin Joseph Pathrose, Sarita Shivdas
INTRODUCTION: Carbapenem-resistant Enterobacteriaceae (CRE) are drug-resistant Gram-negative bacteria that are present in the community as well as in hospitals. Their infection and colonisation puts critically ill patients at high risk due to the drug-resistant nature of the strains and possible spreading of these organisms, even in a hospital environment. AIM: To examine the presence and types of Enterobacteriaceae species in patients admitted directly from the community...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27778318/oral-hygiene-care-for-critically-ill-patients-to-prevent-ventilator-associated-pneumonia
#10
REVIEW
Fang Hua, Huixu Xie, Helen V Worthington, Susan Furness, Qi Zhang, Chunjie Li
BACKGROUND: Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in people who have received mechanical ventilation for at least 48 hours. VAP is a potentially serious complication in these patients who are already critically ill. Oral hygiene care (OHC), using either a mouthrinse, gel, toothbrush, or combination, together with aspiration of secretions, may reduce the risk of VAP in these patients. OBJECTIVES: To assess the effects of oral hygiene care on incidence of ventilator-associated pneumonia in critically ill patients receiving mechanical ventilation in hospital intensive care units (ICUs)...
October 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27776162/incidence-clinical-outcome-and-risk-factors-of-intensive-care-unit-infections-in-the-lagos-university-teaching-hospital-luth-lagos-nigeria
#11
Anthony A Iwuafor, Folasade T Ogunsola, Rita O Oladele, Oyin O Oduyebo, Ibironke Desalu, Chukwudi C Egwuatu, Agwu U Nnachi, Comfort N Akujobi, Ita O Ita, Godwin I Ogban
BACKGROUND: Infections are common complications in critically ill patients with associated significant morbidity and mortality. AIM: This study determined the prevalence, risk factors, clinical outcome and microbiological profile of hospital-acquired infections in the intensive care unit of a Nigerian tertiary hospital. MATERIALS AND METHODS: This was a prospective cohort study, patients were recruited and followed up between September 2011 and July 2012 until they were either discharged from the ICU or died...
2016: PloS One
https://www.readbyqxmd.com/read/27771302/blurred-lines-dysbiosis-and-probiotics-in-the-intensive-care-unit
#12
Lee E Morrow, Paul Wischmeyer
Clinicians have traditionally dichotomized bacteria as friendly commensals or harmful pathogens. However, the line separating the two has become blurred with the recognition that the intestinal microbiome is a complex entity wherein species can shift sides - from friend to foe and back again - based on crucial factors in their local environment. Significant disruptions in the homeostasis of the microbiome, a phenomenon called 'dysbiosis,' is increasingly associated with a host of untoward effects. Intensive care unit patients are at high risk for dysbiosis given high rates of antibiotic use, acute changes in diet, and the stress of critical illness...
October 19, 2016: Chest
https://www.readbyqxmd.com/read/27771187/optimising-meropenem-dosing-in-critically-ill-australian-indigenous-patients-with-severe-sepsis
#13
Danny Tsai, Penelope Stewart, Rajendra Goud, Stephen Gourley, Saliya Hewagama, Sushena Krishnaswamy, Steven C Wallis, Jeffrey Lipman, Jason A Roberts
Currently there are no pharmacokinetic (PK) data to guide antibiotic dosing in critically ill Australian Indigenous patients with severe sepsis. This study aimed to determine whether the population pharmacokinetics of meropenem were different between critically ill Australian Indigenous and critically ill Caucasian patients. Serial plasma and urine samples as well as clinical and demographic data were collected over two dosing intervals from critically ill Australian Indigenous patients. Plasma meropenem concentrations were assayed by validated chromatography...
September 29, 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27761766/de-novo-synthesis-and-functional-analysis-of-polyphosphate-loaded-poly-ethylene-glycol-hydrogel-nanoparticles-targeting-pyocyanin-and-pyoverdin-production-in-pseudomonas-aeruginosa-as-a-model-intestinal-pathogen
#14
Yushu Yin, Georgia Papavasiliou, Olga Y Zaborina, John C Alverdy, Fouad Teymour
The human gastrointestinal tract is the primary site of colonization of multidrug resistant pathogens and the major source of life-threatening complications in critically ill and immunocompromised patients. Eradication measures using antibiotics carry further risk of antibiotic resistance. Furthermore, antibiotic treatment can adversely shift the intestinal microbiome toward domination by resistant pathogens. Therefore, approaches directed to prevent replacement of health promoting microbiota with resistant pathogens should be developed...
October 19, 2016: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/27751781/epico-3-0-empirical-antifungal-therapy-in-critically-ill-hematology-patients
#15
Pedro Llinares, Isabel Ruiz, Rafael Zaragoza, Ricard Ferrer, Alejandro H Rodríguez, Emilio Maseda, Santiago Grau
BACKGROUND: Although in the past decade the management of invasive fungal infections has improved, a number of controversies persist regarding empirical antifungal treatment in critically-ill hematology patients. AIMS: To identify key clinical knowledge to elaborate a set of recommendations, with a high level of consensus, necessary for the approach to fungal infections in critically-ill hematology patients. METHODS: A Spanish prospective questionnaire, which measures consensus through the Delphi technique, was anonymously answered and e-mailed by 30 multidisciplinary national experts, all specialists in fungal invasive infections from six scientific national societies; intensivists, anesthesiologists, microbiologists, pharmacologists and specialists in infectious diseases...
October 14, 2016: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/27741423/treatment-of-patients-with-acute-colonic-diverticulitis-complicated-by-abscess-formation-a-systematic-review-and-meta-analysis
#16
Rasmus Gregersen, Laura Quitzau Mortensen, Jakob Burcharth, Hans-Christian Pommergaard, Jacob Rosenberg
PURPOSE: This study aimed to systematically review the literature and present the evidence on outcomes after treatment for acute diverticulitis with abscess formation. Secondly, the paper aimed to compare different treatment options. METHODS: PubMed, EMBASE and the Cochrane Library were searched. Two authors screened the records independently, initially on title and abstract and subsequently on full-text basis. Articles describing patients treated acutely for Hinchey Ib and II were included...
October 11, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27731492/prolonged-administration-of-%C3%AE-lactam-antibiotics-a-comprehensive-review-and-critical-appraisal
#17
Michael Osthoff, Martin Siegemund, Gianmarco Balestra, Mohd Hafiz Abdul-Aziz, Jason A Roberts
Prolonged infusion of β-lactam antibiotics as either extended (over at least 2 hours) or continuous infusion is increasingly applied in intensive care units around the world in an attempt to optimise treatment with this most commonly used class of antibiotics, whose effectiveness is challenged by increasing resistance rates. The pharmacokinetics of β-lactam antibiotics in critically ill patients is profoundly altered secondary to an increased volume of distribution and the presence of altered renal function, including augmented renal clearance...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27729010/significance-of-soluble-triggering-receptor-expressed-on-myeloid-cells-1-elevation-in-patients-admitted-to-the-intensive-care-unit-with-sepsis
#18
P E Charles, R Noel, F Massin, J Guy, P E Bollaert, J P Quenot, S Gibot
BACKGROUND: Among septic patients admitted to the intensive care unit (ICU), early recognition of those with the highest risk of death is of paramount importance. Since clinical judgment is sometimes uncertain biomarkers could provide additional information likely to guide critical illness management. We evaluated the prognostic value of soluble Triggering Receptor Expressed by Myeloid cells 1 (sTREM-1), procalcitonin (PCT) and leucocyte surface expression of CD64. METHODS: This was a prospective cohort study, which included 190 septic patient admitted to the ICU in two hospitals...
October 12, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27714706/what-s-new-in-multidrug-resistant-pathogens-in-the-icu
#19
Gabor Zilahi, Antonio Artigas, Ignacio Martin-Loeches
Over the last several decades, antibacterial drug use has become widespread with their misuse being an ever-increasing phenomenon. Consequently, antibacterial drugs have become less effective or even ineffective, resulting in a global health security emergency. The prevalence of multidrug-resistant organisms (MDROs) varies widely among regions and countries. The primary aim of antibiotic stewardship programs is to supervise the three most influential factors contributing to the development and transmission of MDROs, namely: (1) appropriate antibiotic prescribing; (2) early detection and prevention of cross-colonization of MDROs; and (3) elimination of reservoirs...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27714667/challenges-in-the-management-of-patients-with-maple-syrup-urine-disease-diagnosed-by-newborn-screening-in-a-developing-country
#20
Leniza G De Castro-Hamoy, Mary Anne D Chiong, Sylvia C Estrada, Cynthia P Cordero
Maple syrup urine disease (MSUD) is a rare inborn error of metabolism resulting from a deficiency in the branched-chain alpha-ketoacid dehydrogenase complex. MSUD has been reported to be the most common inborn error of metabolism in the Philippines. We described all patients with maple syrup urine disease patients diagnosed through newborn screening during its first 2 years of implementation and the challenges encountered during their medical management. There were 24 patients diagnosed with maple syrup urine disease for the 2-year period...
October 6, 2016: Journal of Community Genetics
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