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Critical ill and resistency

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https://www.readbyqxmd.com/read/28717834/characterizing-the-adherence-profiles-of-virulent-vibrio-parahaemolyticus-isolates
#1
Alisha M Aagesen, Sureerat Phuvasate, Yi-Cheng Su, Claudia C Häse
The human pathogen Vibrio parahaemolyticus is a leading cause of seafood-borne illness in the USA, and infections with V. parahaemolyticus typically result from eating raw or undercooked oysters. V. parahaemolyticus has been shown to be highly resistant to oyster depuration, suggesting that the bacterium possesses specific mechanisms or factors for colonizing oysters and persisting during depuration. In this study, we characterized eight different V. parahaemolyticus strains for differences in resistance to oyster depuration, biofilm formation, and motility...
July 17, 2017: Microbial Ecology
https://www.readbyqxmd.com/read/28716451/multidrug-resistant-pseudomonas-aeruginosa-lower-respiratory-tract-infections-in-the-intensive-care-unit-prevalence-and-risk-factors
#2
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/28716359/predictors-of-polymyxin-b-treatment-failure-in-gram-negative-healthcare-associated-infections-among-critically-ill-patients
#3
Bahiah Ismail, Mohd Nazri Shafei, Azian Harun, Saedah Ali, Mahamarowi Omar, Zakuan Zainy Deris
BACKGROUND: With increasing prevalence and spread of multidrug resistant Gram-negative infections, parenteral polymyxins resurged in clinical practice. The primary aim of the study was to determine the predictors of treatment failure and in-hospital mortality among critically ill patients treated with polymyxin B. METHODS: Demographic data, underlying diseases, procedures and details on polymyxin B therapy were retrospectively analyzed in a cohort of 84 patients who received intravenous polymyxin B in an intensive care unit from 2010 to 2014...
June 29, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28716301/discrete-%C3%AE-adrenergic-mechanisms-regulate-early-and-late-erythropoiesis-in-erythropoietin-resistant-anemia
#4
Shirin Hasan, Michael J Mosier, Andrea Szilagyi, Richard L Gamelli, Kuzhali Muthumalaiappan
BACKGROUND: Anemia of critical illness is resistant to exogenous erythropoietin. Packed red blood cells transfusions is the only treatment option, and despite related cost and morbidity, there is a need for alternate strategies. Erythrocyte development can be divided into erythropoietin-dependent and erythropoietin-independent stages. We have shown previously that erythropoietin-dependent development is intact in burn patients and the erythropoietin-independent early commitment stage, which is regulated by β1/β2-adrenergic mechanisms, is compromised...
July 14, 2017: Surgery
https://www.readbyqxmd.com/read/28710148/energy-protein-carbohydrate-and-lipid-intakes-and-their-effects-on-morbidity-and-mortality-in-critically-ill-adult-patients-a-systematic-review
#5
REVIEW
Anna Patkova, Vera Joskova, Eduard Havel, Miroslav Kovarik, Monika Kucharova, Zdenek Zadak, Miloslav Hronek
The guidelines for nutritional support in critically ill adult patients differ in various aspects. The optimal amount of energy and nutritional substrates supplied is important for reducing morbidity and mortality, but unfortunately this is not well known, because the topic is complex and every patient is individual. The aim of this review was to gather recent pertinent information concerning the nutritional support of critically ill patients in the intensive care unit (ICU) with respect to the energy, protein, carbohydrate, and lipid intakes and the effect of their specific utilization on morbidity and mortality...
July 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28708679/transpulmonary-pressure-describes-lung-morphology-during-decremental-positive-end-expiratory-pressure-trials-in-obesity
#6
Jacopo Fumagalli, Lorenzo Berra, Changsheng Zhang, Massimiliano Pirrone, Roberta R De Santis Santiago, Susimeire Gomes, Federico Magni, Glaucia A B Dos Santos, Desmond Bennett, Vinicius Torsani, Daniel Fisher, Caio Morais, Marcelo B P Amato, Robert M Kacmarek
OBJECTIVES: Atelectasis develops in critically ill obese patients when undergoing mechanical ventilation due to increased pleural pressure. The current study aimed to determine the relationship between transpulmonary pressure, lung mechanics, and lung morphology and to quantify the benefits of a decremental positive end-expiratory pressure trial preceded by a recruitment maneuver. DESIGN: Prospective, crossover, nonrandomized interventional study. SETTING: Medical and Surgical Intensive Care Units at Massachusetts General Hospital (Boston, MA) and University Animal Research Laboratory (São Paulo, Brazil)...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28706391/utility-of-a-novel-chromogenic-medium-as-a-screening-method-in-the-detection-of-carbapenemase-producing-enterobacteriaceae
#7
Anusha Chaturvedi, Gunjiganur Shankarappa Banashankari
INTRODUCTION: With the emergence of multidrug resistant Gram-negative bugs, there is an urgent need for rapid detection of these resistant organisms. AIM: This study was performed to assess the utility of a novel chromogenic medium in the detection of carbapenemase producing Enterobacteriaceae from various clinical specimens. MATERIALS AND METHODS: A total of 202 isolates of Enterobacteriaceae, which were resistant to meropenem (10 μg) disc by standard disc diffusion method, were analyzed over a period of 6 months...
July 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28694235/clinical-benefits-of-antimicrobial-de-escalation-in-adults-with-community-onset-monomicrobial-escherichia-coli-klebsiella-species-and-proteus-mirabilis-bacteremia
#8
Ching-Chi Lee, Jiun-Ling Wang, Chung-Hsun Lee, Yuan-Pin Hung, Ming-Yuan Hong, Hung-Jen Tang, Wen-Chien Ko
The clinical benefits of an antimicrobial de-escalation strategy were compared with those of a no-switch strategy in bacteremic patients. Adults with community-onset monomicrobial Escherichia coli, Klebsiella species and Proteus mirabilis bacteremia treated empirically using broad-spectrum beta-lactams, including third-generation cephalosporins (GCs), fourth-GC or carbapenems, were treated definitively with first- or second-GCs (de-escalation group), the same regimens as empirical antibiotics (no-switch group), or antibiotics with a broader-spectrum than empirical antibiotics (escalation group)...
July 7, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28693606/combined-use-of-serum-1-3-%C3%AE-d-glucan-and-procalcitonin-for-the-early-differential-diagnosis-between-candidaemia-and-bacteraemia-in-intensive-care-units
#9
Daniele Roberto Giacobbe, Malgorzata Mikulska, Mario Tumbarello, Elisa Furfaro, Marzia Spadaro, Angela Raffaella Losito, Alessio Mesini, Gennaro De Pascale, Anna Marchese, Marco Bruzzone, Paolo Pelosi, Michele Mussap, Alexandre Molin, Massimo Antonelli, Brunella Posteraro, Maurizio Sanguinetti, Claudio Viscoli, Valerio Del Bono
BACKGROUND: This study aimed to assess the combined performance of serum (1,3)-β-D-glucan (BDG) and procalcitonin (PCT) for the differential diagnosis between candidaemia and bacteraemia in three intensive care units (ICUs) in two large teaching hospitals in Italy. METHODS: From June 2014 to December 2015, all adult patients admitted to the ICU who had a culture-proven candidaemia or bacteraemia, as well as BDG and PCT measured closely to the time of the index culture, were included in the study...
July 10, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28689868/evaluation-of-hemodialysis-as-a-protective-technique-for-preventing-high-daily-dose-amikacin-nephrotoxicity-an-experimental-study-in-an-ovine-model
#10
Céline Pouzot-Nevoret, Mathieu Magnin, Jean-Yves Ayoub, Laurent Bourguignon, Pascal Maire, Damien Wertz, Isabelle Goy-Thollot, Anthony Barthélemy, Emmanuel Boselli, Bernard Allaouchiche, Jeanne Marie Bonnet-Garin
Changes in pharmacokinetic parameters of critical ill patients make the treatment of infections challenging, particularly when multidrug-resistant bacteria are involved. The aim of this study was to evaluate the ability of hemodialysis to reduce the exposure to high dose amikacin and prevent nephrotoxicity. Amikacin 50 mg/kg was administered intravenously to six adult sheep once-daily for four days. The sheep were divided in two groups according to the implementation (group 1) or not (group 2) of hemodialysis...
July 6, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28687210/antimicrobial-stewardship-approaches-in-the-intensive-care-unit
#11
REVIEW
Sarah B Doernberg, Henry F Chambers
Antimicrobial stewardship programs aim to monitor, improve, and measure responsible antibiotic use. The ICU, with its critically ill patients and prevalence of multiple drug-resistant pathogens, presents unique challenges. The article reviews approaches to stewardship with application to the ICU, including the value of diagnostics, principles of empirical and definitive therapy, and measures of effectiveness. There is good evidence that antimicrobial stewardship results in more appropriate antimicrobial use, shorter therapy durations, and lower resistance rates...
July 5, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28686744/should-we-treat-patients-with-only-one-set-of-positive-blood-cultures-for-extensively-drug-resistant-acinetobacter-baumannii-the-same-as-multiple-sets
#12
Aristine Cheng, Yu-Chung Chuang, Hsin-Yun Sun, Chia-Jui Yang, Hou-Tai Chang, Jia-Ling Yang, Wang-Huei Sheng, Yee-Chun Chen, Shan-Chwen Chang
Acinetobacter species are not considered skin commensals and under-treatment is an overriding concern when caring for critically-ill patients who are mostly at risk of extensively drug-resistant Acinetobacter baumannii (XDRAB) infections. Hence even a single blood culture yielding XDRAB will tend to prompt intervention. However, field observations suggest that patients with single-positive blood cultures had milder disease and were more likely to be recruited in interventional studies than those with multiple-positive blood cultures, yet no distinction is made in current clinical or trial recruitment practices...
2017: PloS One
https://www.readbyqxmd.com/read/28685297/hemodynamic-effects-of-lipid-based-oxygen-microbubbles-via-rapid-intravenous-injection-in-rodents
#13
Katherine J Black, Andrew T Lock, Lindsay M Thomson, Alexis R Cole, Xiaoqi Tang, Brian D Polizzotti, John N Kheir
PURPOSE: Low oxygen levels, or hypoxemia, is a common cause of morbidity and mortality in critically ill patients. Hypoxemia is typically addressed by increasing the fraction of inspired oxygen, the use of mechanical ventilation, or more invasive measures. Recently, the injection of oxygen gas directly into the bloodstream by packaging it within lipid-based oxygen microbubbles (LOMs) has been explored. The purpose of this work is to examine the acute hemodynamic effects of intravenous injections of LOMs...
July 6, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28679413/double-carbapenem-as-a-rescue-strategy-for-the-treatment-of-severe-carbapenemase-producing-klebsiella-pneumoniae-infections-a-two-center-matched-case-control-study
#14
Gennaro De Pascale, Gennaro Martucci, Luca Montini, Giovanna Panarello, Salvatore Lucio Cutuli, Daniele Di Carlo, Valentina Di Gravio, Roberta Di Stefano, Guido Capitanio, Maria Sole Vallecoccia, Piera Polidori, Teresa Spanu, Antonio Arcadipane, Massimo Antonelli
BACKGROUND: Recent reports have suggested the efficacy of a double carbapenem (DC) combination, including ertapenem, for the treatment of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) infections. We aimed to evaluate the clinical impact of such a regimen in critically ill patients. METHODS: This case-control (1:2), observational, two-center study involved critically ill adults with a microbiologically documented CR-Kp invasive infection treated with the DC regimen matched with those receiving a standard treatment (ST) (i...
July 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28673382/rational-use-of-dopamine-in-hypotensive-newborns-improving-our-understanding-of-the-effect-on-cerebral-autoregulation
#15
Vibeke Ramsgaard Eriksen
Hypotension in critically ill newborn infants is associated with higher mortality and higher risk of cerebral injuries. Yet treating hypotension has never been shown to improve outcomes. In fact, some studies have found that hypotensive newborn infants who were treated with dopamine fared worse than a comparable group of newborn infants who were not. Therefore, a concern has been raised that dopamine might cause the observed adverse outcomes. Cerebral autoregulation is a protective mechanism that maintains a fairly constant cerebral blood flow despite fluctuations in blood pressure...
July 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28658197/hydrocortisone-therapy-in-catecholamine-resistant-pediatric-septic-shock-a-pragmatic-analysis-of-clinician-practice-and-association-with-outcomes
#16
Blake Nichols, Sherri Kubis, Jennifer Hewlett, Nadir Yehya, Vijay Srinivasan
OBJECTIVES: The 2012 Surviving Sepsis Campaign pediatric guidelines recommend stress dose hydrocortisone in children experiencing catecholamine-dependent septic shock with suspected or proven absolute adrenal insufficiency. We evaluated whether stress dose hydrocortisone therapy in children with catecholamine dependent septic shock correlated with random serum total cortisol levels and was associated with improved outcomes. DESIGN: Retrospective cohort study. SETTING: Non-cardiac PICU...
June 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28657373/extended-infusion-of-beta-lactam-antibiotics-optimizing-therapy-in-critically-ill-patients-in-the-era-of-antimicrobial-resistance
#17
Nesrine A Rizk, Zeina A Kanafani, Hussam Z Tabaja, Souha S Kanj
Beta-lactams are at the cornerstone of therapy in critical care settings, but their clinical efficacy is challenged by the rise in bacterial resistance. Infections with multi-drug resistant organisms are frequent in intensive care units, posing significant therapeutic challenges. The problem is compounded by a dearth in the development of new antibiotics. In addition, critically-ill patients have unique physiologic characteristics that alter the drugs pharmacokinetics and pharmacodynamics. Areas covered: The prolonged infusion of antibiotics (extended infusion [EI] and continuous infusion [CI]) has been the focus of research in the last decade...
July 3, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28647517/proteomics-to-study-macrophage-response-to-viral-infection
#18
Tuula A Nyman, Sampsa Matikainen
Viral infections are a major burden to human and animal health. Immune response against viruses consists of innate and adaptive immunity which are both critical for the eradication of the viral infection. The innate immune system is the first line of defense against viral infections. Proper innate immune response is required for the activation of adaptive, humoral and cell-mediated immunity. Macrophages are innate immune cells which have a central role in detecting viral infections including influenza A and human immunodeficiency viruses...
June 21, 2017: Journal of Proteomics
https://www.readbyqxmd.com/read/28619105/patterns-of-antimicrobial-resistance-in-intensive-care-unit-patients-a-study-in-vietnam
#19
Giang M Tran, Thao P Ho-Le, Duc T Ha, Chau H Tran-Nguyen, Tuyet S M Nguyen, Thao T N Pham, Tuyet A Nguyen, Dung A Nguyen, Hoa Q Hoang, Ngoc V Tran, Tuan V Nguyen
BACKGROUND: Antimicrobial resistance has emerged as a major concern in developing countries. The present study sought to define the pattern of antimicrobial resistance in ICU patients with ventilator-associated pneumonia. METHODS: Between November 2014 and September 2015, we enrolled 220 patients (average age ~ 71 yr) who were admitted to ICU in a major tertiary hospital in Ho Chi Minh City, Vietnam. Data concerning demographic characteristics and clinical history were collected from each patient...
June 15, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28616666/the-role-of-psychosomatic-medicine-in-intensive-care-units
#20
REVIEW
Heidemarie Abrahamian, Diana Lebherz-Eichinger
Critically ill patients, their relatives, and intensive care staff are consistently exposed to stress. The principal elements of this exceptional burden are confrontation with a life-threatening disease, specific environmental conditions at the intensive care unit, and the social characteristics of intensive care medicine. The short- and long-term consequences of these stressors include a feeling of helplessness, distress, anxiety, depression, and even posttraumatic stress disorders. Not only the patients, but also their relatives and intensive care staff are at risk of developing such psychopathologies...
June 14, 2017: Wiener Medizinische Wochenschrift
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