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Critical ill patient and antibiotic

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https://www.readbyqxmd.com/read/28221905/efficacy-of-plant-derived-antimicrobials-in-controlling-enterohemorrhagic-escherichia-coli-virulence-in-vitro
#1
Sangeetha Ananda Baskaran, Anup Kollanoor-Johny, Meera Surendran Nair, Kumar Venkitanarayanan
Escherichia coli O157:H7 is a major foodborne pathogen that can cause serious human illness characterized by hemorrhagic diarrhea and kidney failure. The pathology of enterohemorrhagic E. coli O157:H7 (EHEC) infection is primarily mediated by verotoxins, which bind to the globotriaosylceramide receptor on host cells. Antibiotics are contraindicated for treating EHEC infection because they lead to increased verotoxin release, thereby increasing the risk of renal failure and death in patients. Thus, alternative strategies are needed for controlling EHEC infections in humans...
November 2016: Journal of Food Protection
https://www.readbyqxmd.com/read/28219190/-efficacy-and-safety-of-procalcitonin-guidance-in-reducing-the-duration-of-antibiotic-treatment-of-sepsis-patients
#2
X L Xu, F D Yan, J Q Yu, Q H Chen, H Lin, R Q Zheng
Objective: To assesse the efficacy and safety of procalcitonin-guided antibiotic treatment of sepsis patients in intensive care units (ICU). Methods: A prospective, randomised, controlled trial was gone in ICU of Northern Jiangsu People's Hospital.Between January 2013 and December 2015.One hundred and fifty-six patients assessed for eligibility were randomly assigned to the procalcitonin-guided group (PCT group, 79) or to regular antibiotic group (RAT group, 77). Patients who received antibiotics for presumed infection according to principle of antimicrobial usage...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28197051/benefits-of-and-untoward-events-during-intrahospital-transport-of-pediatric-intensive-care-unit-patients
#3
M M Harish, Suhail Sarwar Siddiqui, Natesh R Prabu, Harish K Chaudhari, Jigeeshu V Divatia, Atul Prabhakar Kulkarni
BACKGROUND AND AIMS: The transport of critically ill patients for procedures or imaging outside the Intensive Care Unit (ICU) is potentially hazardous; hence, the transport process must be organized and efficient. The literature about benefits of and untoward events (UEs) during intrahospital transport of pediatric critically ill patient is scarce. We, therefore, audited the UEs during and benefits of intrahospital transport of critically ill pediatric patients in our ICU. SUBJECTS AND METHODS: Eighty critically ill pediatric (<18 years) cancer patients, transported from the ICU for either diagnostic or therapeutic procedure over a period of 6 months, were included in the study...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28176533/simultaneous-assay-of-multiple-antibiotics-in-human-plasma-by-lc-ms-ms-importance-of-optimizing-formic-acid-concentration
#4
Feng Chen, Zhe-Yi Hu, S Casey Laizure, Joanna Q Hudson
AIM: Optimal dosing of antibiotics in critically ill patients is complicated by the development of resistant organisms requiring treatment with multiple antibiotics and alterations in systemic exposure due to diseases and extracorporeal drug removal. Developing guidelines for optimal antibiotic dosing is an important therapeutic goal requiring robust analytical methods to simultaneously measure multiple antibiotics. METHODS: An LC-MS/MS assay using protein precipitation for cleanup followed by a 6-min gradient separation was developed to simultaneously determine five antibiotics in human plasma...
February 8, 2017: Bioanalysis
https://www.readbyqxmd.com/read/28162982/revival-of-old-antibiotics-needs-the-state-of-evidence-and-expectations
#5
Hiba Zayyad, Noa Eliakim-Raz, Leonard Leibovici, Mical Paul
The gap between the emergence of antibiotic resistance and new antibiotic development has drawn attention to old antibiotics whose spectrum of coverage frequently comprises highly resistant bacteria. However, these antibiotics have frequently not undergone the structured process of antibiotic development of modern antibiotics, from pharmacokinetic/pharmacodynamic (PK/PD) studies establishing safe and effective dosing, establishment of susceptibility breakpoints, to clinical trials establishing clinical safety and effectiveness...
February 2, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28160023/the-intensive-care-medicine-research-agenda-on-multidrug-resistant-bacteria-antibiotics-and-stewardship
#6
REVIEW
Marin H Kollef, Matteo Bassetti, Bruno Francois, Jason Burnham, George Dimopoulos, Jose Garnacho-Montero, Jeffrey Lipman, Charles-Edouard Luyt, David P Nicolau, Maarten J Postma, Antonio Torres, Tobias Welte, Richard G Wunderink
PURPOSE: To concisely describe the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to the management of multidrug-resistant (MDR) bacteria, antibiotic use, and antimicrobial stewardship in the intensive care unit (ICU) setting. METHODS: Narrative review based on a systematic analysis of the medical literature, national and international guidelines, and expert opinion...
February 4, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28149487/clinical-response-and-outcome-of-pneumonia-due-to-multi-drug-resistant-acinetobacter-baumannii-in-critically-ill-patients
#7
Lida Shojaei, Mostafa Mohammadi, Mohammad-Taghi Beigmohammadi, Mahsa Doomanlou, Alireza Abdollahi, Mohammad Mehdi Feizabadi, Hossein Khalili
BACKGROUND AND OBJECTIVES: The frequency of multi-drug resistant Acinetobacter spp. infections is increasing in Iran. Considering availability of limited therapeutic options, clinical response and outcome of ventilator-associated pneumonia due to multi-drug resistant A.baumannii were evaluated in critically ill patients. MATERIALS AND METHODS: In this prospective study, 29 patients with carbapenem resistance A. baumannii ventilator-associated pneumonia were enrolled...
October 2016: Iranian Journal of Microbiology
https://www.readbyqxmd.com/read/28141912/high-volume-haemofiltration-for-sepsis-in-adults
#8
REVIEW
Emma Mj Borthwick, Christopher J Hill, Kannaiyan S Rabindranath, Alexander P Maxwell, Danny F McAuley, Bronagh Blackwood
BACKGROUND: Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU), despite advances in the treatment of patients with severe sepsis and septic shock, including early recognition, appropriate treatment with antibiotics and support of organs that may have been affected by the illness. High-volume haemofiltration (HVHF) is a blood purification technique that may improve outcomes in severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used in the ICU to treat critically ill patients with acute kidney injury (AKI)...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28141702/antibiotic-therapy-in-critically-ill-patients-expert-opinion-of-the-european-society-of-anaesthesia-intensive-care-scientific-subcommittee-a-narrative-review
#9
Ignacio Martin-Loeches, Marc Leone, Krisztina Madách, Claude Martin, Sharon Einav
Antimicrobial treatment is the cornerstone of infection treatment, and the selection of appropriate antibiotic treatment for critically ill patients is challenging. Clinicians working with critically ill patients usually feel a greater obligation towards their patient than towards maintenance of the delicate ecological balance of prevalent microbiological threats and their resistance patterns. Although antibiotic overtreatment is a frequent phenomenon, patient outcomes need not be compromised when antibiotic treatment is driven by informed decision-making...
January 30, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28141683/fever-in-the-emergency-department-predicts-survival-of-patients-with-severe-sepsis-and-septic-shock-admitted-to-the-icu
#10
Jonas Sundén-Cullberg, Rebecca Rylance, Jesper Svefors, Anna Norrby-Teglund, Jonas Björk, Malin Inghammar
OBJECTIVES: To study the prognostic value of fever in the emergency department in septic patients subsequently admitted to the ICU. DESIGN: Observational cohort study from the Swedish national quality register for sepsis. SETTING: Thirty ICU's in Sweden. PATIENTS: Two thousand two hundred twenty-five adults who were admitted to an ICU within 24 hours of hospital arrival with a diagnosis of severe sepsis or septic shock were included...
January 30, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28126443/quantification-of-meropenem-in-human-plasma-by-hilic-tandem-mass-spectrometry
#11
Jens Martens-Lobenhoffer, Stefanie M Bode-Böger
Meropenem is a substance from the carbapenem class of antibiotics. It is widely used in intensive care units to treat a broad range of severe bacterial infections. In this critically ill patient group therapeutic drug monitoring (TDM) is highly advisable in order to avoid under- as well as over-dosing. Here, we describe a HILIC-MS/MS method for the quantification of meropenem in human plasma which is suitable for TDM. After simple protein precipitation, the polar analyte was chromatographically separated by the HILIC mechanism on a silica based stationary phase with polyethylenimide coating...
January 19, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28114931/procalcitonin-guided-diagnosis-and-antibiotic-stewardship-revisited
#12
REVIEW
Ramon Sager, Alexander Kutz, Beat Mueller, Philipp Schuetz
Several controlled clinical studies have evaluated the potential of the infection biomarker procalcitonin (PCT) to improve the diagnostic work-up of patients with bacterial infections and its influence on decisions regarding antibiotic therapy. Most research has focused on lower respiratory tract infections and critically ill sepsis patients. A clinical utility for PCT has also been found for patients with urinary tract infections, postoperative infections, meningitis, and patients with acute heart failure with possible superinfection (i...
January 24, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28102514/carbapenemase-producing-klebsiella-pneumoniae-bloodstream-infection-in-critically-ill-patients-risk-factors-and-predictors-of-mortality
#13
M Papadimitriou-Olivgeris, F Fligou, C Bartzavali, A Zotou, A Spyropoulou, K Koutsileou, S Vamvakopoulou, N Sioulas, V Karamouzos, E D Anastassiou, I Spiliopoulou, M Christofidou, M Marangos
A significant increase in carbapenemase-producing Klebsiella pneumoniae (CP-Kp) bacteraemias has been observed worldwide. The objective of the present work was to study the risk factors and predictors of mortality of CP-Kp bacteraemias among critically ill patients. During a 4-year period (2012-3015), a matched 1:2 case-control study was conducted. Klebsiella pneumoniae was identified by Vitek 2 technology. Antibiotic susceptibility was performed by the agar disc diffusion method and Etest. The presence of the bla KPC, bla VIM and bla NDM genes was confirmed by polymerase chain reaction (PCR)...
January 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28101334/implementation-of-short-incubation-maldi-tof-ms-identification-from-positive-blood-cultures-in-routine-diagnostics-and-effects-on-empiric-antimicrobial-therapy
#14
Robin Köck, Jörg Wüllenweber, Dagmar Horn, Christian Lanckohr, Karsten Becker, Evgeny A Idelevich
BACKGROUND: Results of blood culture (BC) diagnostics should be swiftly available to guide treatment of critically ill patients. Conventional BC diagnostics usually performs species identification of microorganisms from mature solid medium colonies. Species identification might be speed up by using matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry (MS) of biomass from shortly incubated solid media. METHODS: This single-center analysis compared the applicability of MALDI-TOF-based species identification from shortly incubated cultures in laboratory routine vs...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28098629/right-dose-right-now-customized-drug-dosing-in-the-critically-ill
#15
Jason A Roberts, Anand Kumar, Jeffrey Lipman
Drugs are key weapons that clinicians have to battle against the profound pathologies encountered in critically ill patients. Antibiotics in particular are commonly used and can improve patient outcomes dramatically. Despite this, there are strong opportunities for further reducing the persisting poor outcomes for infected critically ill patients. However, taking these next steps for improving patient care requires a new approach to antibiotic therapy. Giving the right dose is highly likely to increase the probability of clinical cure from infection and suppress the emergence of resistant pathogens...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28097012/pharmacokinetics-and-pharmacodynamics-of-antibiotics-in-critically-ill-acute-kidney-injury-patients
#16
REVIEW
Welder Zamoner, Fernanda M de Freitas, Durval S S Garms, Mariele Gobo de Oliveira, André L Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and is associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administer antimicrobials in doses that achieve adequate serum levels, avoiding both overdosing and drug toxicity as well as underdosing and the risk of antibiotic resistance and higher mortality. Currently, there are no validated guidelines on antibiotic dose adjustments in septic patients with AKI...
December 2016: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28091345/propofol-as-a-risk-factor-for-icu-acquired-weakness-in-septic-patients-with-acute-respiratory-failure
#17
Peter A Abdelmalik, Goran Rakocevic
BACKGROUND: Critical illness polyneuropathy (CIN) and critical illness myopathy (CIM), together "ICU-Acquired weakness (ICUAW)," occur frequently in septic patients. One of the proposed mechanisms for ICUAW includes prolonged inactivation of sodium channels. Propofol, used commonly in patients with acute respiratory failure (ARF), primarily acts via enhancement of GABAergic transmission but may also increase sodium channel inactivation, suggesting a potential interaction. METHODS: Electronic medical records and EMG reports of patients with ICUAW and a diagnosis of either sepsis, septicaemia, severe sepsis, or septic shock, concurrent with a diagnosis of acute respiratory failure (ARF), were retrospectively analyzed in a single center university hospital...
January 16, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28090041/clinical-characteristics-of-stenotrophomonas-maltophilia-bacteremia-a-regional-report-and-a-review-of-a-japanese-case-series
#18
Hirotaka Ebara, Hideharu Hagiya, Yuto Haruki, Eisei Kondo, Fumio Otsuka
Objective Stenotrophomonas maltophilia is an emerging nosocomial pathogen that causes fatal infections in critically ill or immunocompromised patients. S. maltophilia bacteremia (SMB) is a rare condition, and its clinical characteristics in Japanese settings are not well known. Methods The medical charts of patients with SMB were retrospectively reviewed at two medical facilities (Okayama University Hospital and Tsuyama Chuo Hospital) for seven years. The data were analyzed along with those previously reported from other Japanese facilities...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28076304/the-use-of-liquid-chromatography-tandem-mass-spectrometry-for-therapeutic-drug-monitoring-of-antibiotics-in-cancer-patients
#19
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
#20
EDITORIAL
Philipp Schuetz, Peter M Wahl
No abstract text is available yet for this article.
January 2017: Chest
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