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Critical ill patient and antibiotic

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https://www.readbyqxmd.com/read/28923864/age-related-trends-in-adults-with-community-onset-bacteremia
#1
Ching-Chi Lee, Jiun-Ling Wang, Chung-Hsun Lee, Yuan-Pin Hung, Ming-Yuan Hong, Chia-Ming Chang, Wen-Chien Ko
To understand the epidemiological variation in bacteremia characteristics among differently aged populations, adults with community-onset bacteremia during a 6-year period were studied in a retrospective cohort. A total of 2,349 bacteremic patients were stratified into four age categories: young adults (18-44 years old; 196 patients, 8.3%), adults (45-64; 707, 30.1%), the elderly (65-84; 1,098, 46.7%), and the oldest old (≥ 85; 348, 14.8%). Age-related trends in critical illness (a Pitt bacteremia score ≥ 4) at bacteremia onset, antibiotic-resistant pathogens (ESBL-producing Escherichia coli, Klebsiella species, and Proteus mirabilis [EKP]; methicillin-resistant Staphylococcus aureus [MRSA]; and levofloxacin non-susceptible EKP), inappropriate empirical antibiotic therapy (EAT), and 4-week mortality rate were observed...
September 18, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28923330/decision-making-process-by-users-and-providers-of-health-care-services-during-the-ah1n1-epidemic-influenza-in-mexico-lessons-learned-and-challenges-ahead
#2
Víctor Huízar-Hernández, Armando Arredondo, Marta Caballero, Angélica Castro-Ríos, Sergio Flores-Hernández, Rogelio Pérez-Padilla, Hortensia Reyes-Morales
OBJECTIVE: The aim of the study was to analyze, using a decision analysis approach, the probability of severity of illness due to delayed utilization of health services and inappropriate hospital medical treatment during the 2009 AH1N1 influenza epidemic in Mexico. METHODS: Patients with influenza AH1N1 confirmed by the polymerase chain reaction (PCR) test from two hospitals in Mexico City, were included. Path methodology based upon literature and validated by clinical experts was followed...
April 2017: Archives of Medical Research
https://www.readbyqxmd.com/read/28915392/impact-of-antibiotic-therapy-in-severe-community-acquired-pneumonia-data-from-the-infauci-study
#3
J M Pereira, J Gonçalves-Pereira, O Ribeiro, J P Baptista, F Froes, J A Paiva
Antibiotic therapy (AT) is the cornerstone of the management of severe community-acquired pneumonia (CAP). However, the best treatment strategy is far from being established. To evaluate the impact of different aspects of AT on the outcome of critically ill patients with CAP, we performed a post hoc analysis of all CAP patients enrolled in a prospective, observational, multicentre study. Of the 502 patients included, 76% received combination therapy, mainly a β-lactam with a macrolide (80%). AT was inappropriate in 16% of all microbiologically documented CAP (n=177)...
September 4, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28906137/treatment-of-achromobacter-ventilator-associated-pneumonia-in-critically-ill-trauma-patients
#4
G Christopher Wood, Brittany L Jonap, George O Maish, Louis J Magnotti, Joseph M Swanson, Bradley A Boucher, Martin A Croce, Timothy C Fabian
BACKGROUND: Achromobacter sp are nonfermenting Gram-negative bacilli (NFGNB) that rarely cause severe infections, including ventilator-associated pneumonia (VAP). Data on the treatment of Achromobacter pneumonia are very limited, and the organism has been associated with a high mortality rate. Thus, more data are needed on treating this organism. OBJECTIVE: To evaluate the treatment of Achromobacter VAP in critically ill trauma patients. METHODS: This retrospective, observational study evaluated critically ill trauma patients who developed Achromobacter VAP...
September 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28906047/a-systematic-review-to-explore-influences-on-parental-attitudes-towards-antibiotic-prescribing-in-children
#5
REVIEW
Helen Bosley, Catherine Henshall, Jane V Appleton, Debra Jackson
AIM: To understand the factors influencing parental attitudes towards antibiotic prescribing. BACKGROUND: Overuse of antibiotics and inappropriate prescribing has resulted in rapid development of antimicrobial resistance (AMR), and is significant global threat to patient safety. In Primary Care settings, substantial numbers of antibiotics are prescribed for young children, despite viral nature of illness for which antibiotics are ineffective. Parents, play a vital role in decision making regarding accessing healthcare services and requesting treatment for their children...
September 14, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28905331/antibiotic-distribution-into-cerebrospinal-fluid-can-dosing-safely-account-for-drug-and-disease-factors-in-the-treatment-of-ventriculostomy-associated-infections
#6
Nilesh Kumta, Jason A Roberts, Jeffrey Lipman, Menino Osbert Cotta
Ventriculostomy-associated infections, or ventriculitis, in critically ill patients are associated with considerable morbidity. Efficacious antibiotic dosing for the treatment of these infections may be complicated by altered antibiotic concentrations in the cerebrospinal fluid due to variable meningeal inflammation and antibiotic properties. Therefore, doses used to treat infections with a higher degree of meningeal inflammation (such as meningitis) may often fail to achieve equivalent exposures in patients with ventriculostomy-associated infections such as ventriculitis...
September 13, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28893782/aminoglycoside-concentrations-required-for-synergy-with-carbapenems-against-pseudomonas-aeruginosa-determined-via-mechanistic-studies-and-modeling
#7
Rajbharan Yadav, Jürgen B Bulitta, Elena K Schneider, Beom Soo Shin, Tony Velkov, Roger L Nation, Cornelia B Landersdorfer
This study aimed to systematically identify the aminoglycoside concentrations required for synergy with a carbapenem and characterize the permeabilizing effect of aminoglycosides on the outer membrane of Pseudomonas aeruginosa Monotherapies and combinations of four aminoglycosides and three carbapenems were studied against P. aeruginosa strain AH298-GFP in 48 h static-concentration time-kill studies (SCTK) (inoculum; 10(7.6) CFU/mL). The outer membrane permeabilizing effect of tobramycin alone and in combination with imipenem was characterized via electron micrographs, confocal imaging and the nitrocefin assay...
September 11, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28888717/role-of-biomarkers-in-acute-traumatic-lung-injury
#8
REVIEW
Philipp Störmann, Thomas Lustenberger, Borna Relja, Ingo Marzi, Sebastian Wutzler
In severely injured patients severe thoracic trauma is common and can significantly influence the outcome of these critically ill patients by increased rates of mainly pulmonary complications. Furthermore, patients who sustained thoracic trauma are at increased risk for Acute Lung Injury (ALI) or Adult Respiratory Distress Syndrome (ARDS). Therapeutic options are limited, basically consisting of prophylactic antibiotic therapy and changing patient's positions. It is known, that ALI and ARDS differ clinically and pathobiologically from ALI/ARDS caused by other reasons, but the exact pathology remains elusive...
August 24, 2017: Injury
https://www.readbyqxmd.com/read/28869666/comprehensive-guidance-for-antibiotic-dosing-in-obese-adults
#9
Lina Meng, Emily Mui, Marisa K Holubar, Stan C Deresinski
BACKGROUND: Physiologic alterations seen in obesity commonly impact the pharmacokinetics (PK) and pharmacodynamics (PD) of antibiotics and may result in suboptimal dosing in this expanding but understudied population. Much of the published clinical and PK evidence to date consists of small patient populations and are retrospective with, not infrequently, heterogenous results that, in some cases, are contradictory. In the last 10 years, additional antimicrobial PK/PD and clinical data encompassing prolonged infusion strategies and examination of critically ill populations has emerged to inform antimicrobial dosing in obesity...
September 4, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28866975/influence-of-changing-endotracheal-tube-cuff-management-on-antibiotic-use-for-ventilator-associated-pneumonia-in-a-tertiary-intensive-care-unit
#10
Jai N Darvall, Irani Thevarajan, Simon Iles, Thomas Rechnitzer, Tim Spelman, Nerina Harley
BACKGROUND: Routine deflation of the endotracheal tube (ETT) cuff of critically ill patients receiving MV is common in Australia and New Zealand. Literature about ventilatorassociated pneumonia (VAP) and antibiotic use rates with different ETT cuff maintenance practices is lacking. OBJECTIVE: To determine the impact of a change in ETT cuff maintenance from a minimal leak technique to pressure manometry on the administration of antibiotics for VAP. DESIGN, SETTING AND PARTICIPANTS: A prospective, pre- post observational study conducted in a metropolitan tertiary referral intensive care unit...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28856066/estimation-of-time-period-for-effective-human-inhalational-anthrax-treatment-including-antitoxin-therapy
#11
Lewis Rubinson, Alfred Corey, Dan Hanfling
INTRODUCTION: Infrequent natural human inhalational anthrax cases coupled with high bioterrorism risk have brought about use of animal models to serve as the basis for approval of novel treatments. For inhalational anthrax, protective antigen (PA) drives much of the mortality, and raxibacumab, an anti-PA monoclonal antibody, has been approved for therapeutic use using the Animal Rule. Given the paucity of human inhalational anthrax clinical data including PA kinetics, the post-exposure period for effective treatment of human disease remains unknown...
July 28, 2017: PLoS Currents
https://www.readbyqxmd.com/read/28837364/to-which-extent-can-we-decrease-antibiotic-duration-in-critically-ill-patients
#12
José Garnacho-Montero, Angel Arenzana-Seisdedos, Jan De Waele, Marin H Kollef
Inadequate empirical antibiotic therapy is associated with higher mortality in critically ill patients with severe infections. Nevertheless, prolonged duration of antibiotic treatment is also potentially harmful. Development of new infections with more resistant pathogens is one of the arguments against the administration of prolonged courses of antibiotics. Areas covered: We aim to describe the optimal duration of antimicrobial therapy in the most common infections affecting critically ill patients. A literature search was performed to identify all clinical trials, observational studies, meta-analysis, and reviews about this topic from PubMed...
August 24, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28812224/risk-factors-for-totally-implantable-venous-access-device-associated-complications-in-cystic-fibrosis
#13
C McCarthy, O O'Carroll, M E O'Brien, T McEnery, A Franciosi, C Gunaratnam, N G McElvaney
BACKGROUND: Candidaemia is an important nosocomial infection, seen frequently in immunocompromised and critically ill patients and increasingly recognised in cystic fibrosis (CF) patients with totally implantable venous access devices (TIVADs). This study aims to investigate the incidence and risk factors for the development of TIVAD-associated candidaemia and to assess the rate of TIVAD-related complications in CF patients. METHODS: A 10-year retrospective study was carried out on adult CF patients attending a single centre...
August 15, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28803549/comparative-gut-microbiota-and-resistome-profiling-of-intensive-care-patients-receiving-selective-digestive-tract-decontamination-and-healthy-subjects
#14
Elena Buelow, Teresita D J Bello González, Susana Fuentes, Wouter A A de Steenhuijsen Piters, Leo Lahti, Jumamurat R Bayjanov, Eline A M Majoor, Johanna C Braat, Maaike S M van Mourik, Evelien A N Oostdijk, Rob J L Willems, Marc J M Bonten, Mark W J van Passel, Hauke Smidt, Willem van Schaik
BACKGROUND: The gut microbiota is a reservoir of opportunistic pathogens that can cause life-threatening infections in critically ill patients during their stay in an intensive care unit (ICU). To suppress gut colonization with opportunistic pathogens, a prophylactic antibiotic regimen, termed "selective decontamination of the digestive tract" (SDD), is used in some countries where it improves clinical outcome in ICU patients. Yet, the impact of ICU hospitalization and SDD on the gut microbiota remains largely unknown...
August 14, 2017: Microbiome
https://www.readbyqxmd.com/read/28797895/patterns-of-c-reactive-protein-ratio-predicts-outcomes-in-healthcare-associated-pneumonia-in-critically-ill-patients-with-cancer
#15
Ligia S C F Rabello, Pedro Póvoa, Jose R Lapa E Silva, Luciano C P Azevedo, Fernando Jose da Silva Ramos, Thiago Lisboa, Marcio Soares, Jorge I F Salluh
PURPOSE: Describe the patterns of C-reactive protein relative changes in response to antibiotic therapy in critically ill cancer patients with healthcare-associated pneumonia (HCAP) and its ability to predict outcome. METHODS: Secondary analysis of a prospective cohort of critically ill cancer patients with HCAP. CRP was sampled every other day from D0 to D6 of antibiotic therapy. Patients were classified according to an individual pattern of CRP-ratio response: fast - CRP at D4 of therapy was <0...
July 11, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28794881/procalcitonin-a-promising-diagnostic-marker-for-sepsis-and-antibiotic-therapy
#16
REVIEW
Ashitha L Vijayan, Vanimaya, Shilpa Ravindran, R Saikant, S Lakshmi, R Kartik, Manoj G
BACKGROUND: Sepsis is a global healthcare problem, characterized by whole body inflammation in response to microbial infection, which leads to organ dysfunction. It is becoming a frequent complication in hospitalized patients. Early and differential diagnosis of sepsis is needed critically to avoid unnecessary usage of antimicrobial agents and for proper antibiotic treatments through the screening of biomarkers that sustains with diagnostic significance. MAIN BODY OF ABSTRACT: Current targeting conventional markers (C-reactive protein, white blood cell, tumour necrosis factor-α, interleukins, etc...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28767914/comparison-of-enterovirus-detection-in-cerebrospinal-fluid-with-bacterial-meningitis-score-in-children
#17
COMPARATIVE STUDY
Frederico Ribeiro Pires, Andréia Christine Bonotto Farias Franco, Alfredo Elias Gilio, Eduardo Juan Troster
Objective: To measure the role of enterovirus detection in cerebrospinal fluid compared with the Bacterial Meningitis Score in children with meningitis. Methods: A retrospective cohort based on analysis of medical records of pediatric patients diagnosed as meningitis, seen at a private and tertiary hospital in São Paulo, Brazil, between 2011 and 2014. Excluded were patients with critical illness, purpura, ventricular shunt or recent neurosurgery, immunosuppression, concomitant bacterial infection requiring parenteral antibiotic therapy, and those who received antibiotics 72 hours before lumbar puncture...
April 2017: Einstein
https://www.readbyqxmd.com/read/28759427/negative-pressure-wound-therapy-for-patients-with-complex-abdominal-wounds
#18
Zhi Wang, Ming Bai, Xiao Long, Ru Zhao, Xiaojun Wang
The combination of open abdominal wounds and intra-abdominal infections is challenging to treat and often results in critical illness associated with high mortality. OBJECTIVE: The aim of this study is to evaluate the feasibility of using negative pressure wound therapy (NPWT) to manage complex abdominal wounds and summarize relevant treatment experiences. MATERIALS AND METHODS: A retrospective analysis of records from April 2012 to May 2015 identified 13 hospitalized patients with open abdominal wounds complicated by intra-abdominal infections...
July 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28758623/risk-factors-and-predictors-of-carbapenem-resistant-pseudomonas-aeruginosa-and-acinetobacter-baumannii-mortality-in-critically-ill-bacteraemic-patients-over-a-6-year-period-2010-15-antibiotics-do-matter
#19
Matthaios Papadimitriou-Olivgeris, Fotini Fligou, Anastasia Spiliopoulou, Kyriaki Koutsileou, Fevronia Kolonitsiou, Aikaterini Spyropoulou, Anastasia Zotou, Markos Marangos, Evangelos D Anastassiou, Myrto Christofidou, Iris Spiliopoulou
PURPOSE: Acinetobacter baumannii and Pseudomonas aeruginosa provoke serious infections, especially in intensive care unit (ICU) patients. METHODOLOGY: The risk factors and predictors of mortality for P. aeruginosa (n=84; 46 carbapenem-resistant) and A. baumannii (n=129; all carbapenem-resistant) bloodstream infections (BSIs) in an ICU were evaluated. Antibiotic susceptibility testing was performed using the agar disk diffusion method according to EUCAST guidelines...
July 31, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28756598/risk-factors-and-predictors-of-mortality-of-candidaemia-among-critically-ill-patients-role-of-antifungal-prophylaxis-in-its-development-and-in-selection-of-non-albicans-species
#20
Matthaios Papadimitriou-Olivgeris, Anastasia Spiliopoulou, Fotini Fligou, Iris Spiliopoulou, Lora Tanaseskou, Georgios Karpetas, Markos Marangos, Evangelos D Anastassiou, Myrto Christofidou
PURPOSE: The aim of the present study is to identify risk factors for development and predictors of mortality of candidaemia among critically ill patients. METHODS: A 1:7 case-control study was conducted during a 4-year period (2012-2015) in a Greek Intensive Care Unit (ICU). Candidaemia was confirmed by positive blood cultures. All yeasts were identified using API 20C AUX System or Vitek 2 Advanced Expert System. Epidemiologic data were collected from the ICU computerized database and patients' chart reviews...
July 29, 2017: Infection
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