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Critical ill and resistency

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https://www.readbyqxmd.com/read/29755727/antimicrobial-resistance-profile-of-e-coli-isolated-from-raw-cow-milk-and-fresh-fruit-juice-in-mekelle-tigray-ethiopia
#1
Haftay Abraha Tadesse, Netsenet Berhe Gidey, Kidane Workelule, Hagos Hailu, Seyfe Gidey, Abrha Bsrat, Habtamu Taddele
Aim: Foodborne illnesses represent a public health problem in developed and developing countries. They cause great suffering and are transmitted directly or indirectly between animals and humans and circulate in the global environment . E. coli are among them, causing a major public health problem. The aim of this study was therefore to study the antimicrobial resistance profile of E. coli from raw cow milk and fruit juice. Materials and Methods: A cross-sectional study was conducted from October 2016 to June 2017 on 258 samples collected from milk shops ( n = 86), dairy farms ( n = 86), and fruit juice ( n = 86) in different subcities of Mekelle...
2018: Veterinary Medicine International
https://www.readbyqxmd.com/read/29751023/invasive-device-associated-infections-caused-by-pseudomonas-aeruginosa-in-critically-ill-patients-evolution-over-10-years
#2
Francisco Álvarez-Lerma, Pedro Olaechea-Astigarraga, Mercedes Palomar-Martínez, Mercedes Catalan, Xavier Nuvials, Ricardo Gimeno, María Pilar Gracia Arnillas, Iratxe Seijas Betolaza
We assessed invasive device-associated infections caused by Pseudomonas aeruginosa over 10 years (2007-2016) based on data from the ENVIN-HELICS registry (200 Spanish ICUs). P. aeruginosa was the leading pathogen except in the last two years in which there was a slight decrease, with Escherichia coli as the leading etiology. The rate of infections caused by P. aeruginosa remained between 12.0% and 14.6% throughout the study period. There was a significant increase of isolates resistant to imipenem, meropenem, ceftazidime, cefepime and piperacillin-tazobactam...
May 8, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29742584/predictive-validity-of-sepsis-3-definitions-and-sepsis-outcomes-in-critically-ill-patients-a-cohort-study-in-49-icus-in-argentina
#3
Elisa Estenssoro, Vanina S Kanoore Edul, Cecilia I Loudet, Javier Osatnik, Fernando G Ríos, Daniela N Vázquez, Mario O Pozo, Bernardo Lattanzio, Fernando Pálizas, Francisco Klein, Damián Piezny, Paolo N Rubatto Birri, Graciela Tuhay, Anatilde Díaz, Analía Santamaría, Graciela Zakalik, Arnaldo Dubin
OBJECTIVES: The new Sepsis-3 definitions have been scarcely assessed in low- and middle-income countries; besides, regional information of sepsis outcomes is sparse. Our objective was to evaluate Sepsis-3 definition performance in Argentina. DESIGN: Cohort study of 3-month duration beginning on July 1, 2016. SETTINGS: Forty-nine ICUs. PATIENTS: Consecutive patients admitted to the ICU with suspected infection that triggered blood cultures and antibiotic administration...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29741076/monitoring-of-hospital-acquired-pneumonia-in-patients-with-severe-brain-injury-on-first-access-to-intensive-neurological-rehabilitation-first-year-of-observation
#4
Gianfranco Beghi, Antonio De Tanti, Paolo Serafini, Chiara Bertolino, Antonietta Celentano, Graziella Taormina
Nosocomial or hospital acquired pneumonia (HAP) is an illness contracted during a hospital stay, generally with onset 48 hours or more after admission to hospital, or within 14 days of discharge from hospital. HAP is divided into subgroups: Ventilator-associated pneumonia (VAP), accounting for 86% of hospital acquired pneumonia, and stroke-associated pneumonia (SAP). The incidence of SAP in neurological intensive care units (NICUs) is 4.1-56.6%, in medical intensive care units (MICUs) it is 17-50%, in stroke units it is 3...
May 9, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29735833/echinocandins-their-role-in-the-management-of-candida-biofilms
#5
Subramanian Swaminathan, Shweta Kamat, Nalini Adele Pinto
The importance of antifungal agents and their clinical implications has received little attention in comparison to antibiotics, particularly in the health-care setting. However, apart from bacterial infections rising in hospitals, the incidences of fungal infections are growing with the development of resistance to conventional antifungal agents. Newer antifungal agents such as echinocandins (ECs) have been extensively studied over the past decade and are recognised as a superior treatment compared with prior antifungals as a first line of therapy in tertiary institutions...
January 2018: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29724123/evidence-supporting-clinical-use-of-proportional-assist-ventilation-a-systematic-review-and-meta-analysis-of-clinical-trials
#6
Bharath Kumar Tirupakuzhi Vijayaraghavan, Shatha Hamed, Aditi Jain, Timothy Chimunda, Irene Telias, Jan O Friedrich, Karen E A Burns
BACKGROUND: While proportional assist ventilation (PAV), generates pressure in proportion to effort without a preselected target, proportional assist ventilation plus (PAV+) measures compliance and resistance, calculates work of breathing, and adjusts support to a preset assistance level. OBJECTIVE: To summarize randomized controlled trials (RCTs) comparing invasive or noninvasive PAV or PAV+ in critically ill patients. DATA SOURCES: We searched multiple databases to April 2017 without language restrictions and conference proceedings from 5 meetings to identify randomized parallel-group and crossover RCTs that compared invasive or noninvasive PAV or PAV+ to another mode in critically ill adults or children and reported at least 1 clinically important outcome...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29700761/development-and-first-evaluation-of-a-novel-multiplex-real-time-pcr-on-whole-blood-samples-for-rapid-pathogen-identification-in-critically-ill-patients-with-sepsis
#7
Kirsten van de Groep, Martine P Bos, Paul H M Savelkoul, Anna Rubenjan, Christel Gazenbeek, Willem J G Melchers, Tom van der Poll, Nicole P Juffermans, David S Y Ong, Marc J M Bonten, Olaf L Cremer
Molecular tests may enable early adjustment of antimicrobial therapy and be complementary to blood culture (BC) which has imperfect sensitivity in critically ill patients. We evaluated a novel multiplex real-time PCR assay to diagnose bloodstream pathogens directly in whole blood samples (BSI-PCR). BSI-PCR included 11 species- and four genus-specific PCRs, a molecular Gram-stain PCR, and two antibiotic resistance markers. We collected 5 mL blood from critically ill patients simultaneously with clinically indicated BC...
April 26, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29675561/de-escalation-of-antifungal-treatment-in-critically-ill-patients-with-suspected-invasive-candida-infection-incidence-associated-factors-and-safety
#8
Karim Jaffal, Julien Poissy, Anahita Rouze, Sébastien Preau, Boualem Sendid, Marjorie Cornu, Saad Nseir
BACKGROUND: Antifungal treatment is common in critically ill patients, but only a small proportion of patients receiving antifungals have a proven fungal infection. However, antifungal treatment has side effects such as toxicity, emergence of resistance, and high cost. Moreover, empirical antifungal treatment is still a matter for debate in these patients. Our study aimed to determine the incidence, associated factors, and safety of de-escalation of antifungals in critically ill patients...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29670404/evaluation-of-vancomycin-therapy-in-the-adult-icus-of-a-teaching-hospital-in-southern-iran
#9
Afsaneh Vazin, Motahare Mahi Birjand, Masoud Darake
Background: Vancomycin resistance in intensive care units (ICUs) accounts for significant morbidity and excess costs. The objective of the present study was to determine the appropriateness of vancomycin use in the various ICUs of Nemazee Hospital, Shiraz, Iran. Methods: This prospective study was performed on 95 critically ill patients (48 males and 47 females) who were treated with vancomycin for at least 3 subsequent doses in 6 ICUs during 12 months. Required demographic, clinical, and paraclinical data were collected by a pharmacist...
2018: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29660161/the-fgf-23-klotho-axis-and-its-relationship-with-phosphorus-calcium-vitamin-d-pth-aldosterone-severity-of-disease-and-outcome-in-hospitalised-foals
#10
A M Kamr, K A Dembek, B E Hildreth, P R Morresey, R A Rathgeber, T A Burns, A A Zaghawa, R E Toribio
BACKGROUND: Fibroblast growth factor-23 (FGF-23) and klotho are key regulators of vitamin D and parathyroid hormone (PTH) synthesis as well as phosphorus and calcium homeostasis; however, information on the FGF-23/klotho axis in healthy and hospitalised foals is lacking. OBJECTIVES: The aims of this study were to measure serum FGF-23 and klotho concentrations and determine their association with serum phosphorus, total calcium (TCa), vitamin D metabolite [25(OH)D, 1,25(OH)2 D], PTH, and aldosterone concentrations, disease severity, and mortality in hospitalised foals...
April 16, 2018: Equine Veterinary Journal
https://www.readbyqxmd.com/read/29658187/overview-of-intensive-care-unit-related-physical-and-functional-impairments-and-rehabilitation-related-devices
#11
REVIEW
Katie Koester, Heidi Troeller, Sara Panter, Emily Winter, Jayshil J Patel
Rehabilitation after critical illness requires a multidisciplinary effort. Nutrition support of critically ill patients aims to correct the imbalance between protein synthesis and protein degradation to maximize strengthening and muscle mass, whereas physical and occupational therapists focus on optimizing strength and mobility through functional activity to help intensive care (ICU) patients return to their precritical illness level of function and improve quality of life. Early mobility has become the new standard of care for ICU patients...
April 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29656714/epidemiology-of-sepsis-in-intensive-care-units-in-turkey-a-multicenter-point-prevalence-study
#12
Nur Baykara, Halis Akalın, Mustafa Kemal Arslantaş, Volkan Hancı, Çiğdem Çağlayan, Ferda Kahveci, Kubilay Demirağ, Canan Baydemir, Necmettin Ünal
BACKGROUND: The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms, and outcome of sepsis in intensive care units (ICUs) in Turkey. METHODS: A total of 132 ICUs from 94 hospitals participated. All patients (aged > 18 years) present at the participating ICUs or admitted for any duration within a 24-h period (08:00 on January 27, 2016 to 08:00 on January 28, 2016) were included...
April 16, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29656032/bioenergetics-and-synaptic-plasticity-as-potential-targets-for-individualizing-treatment-for-depression
#13
REVIEW
J Blair Price, Carrie Bronars, Sophie Erhardt, Kathyrn R Cullen, Lilly Schwieler, Michael Berk, Ken Walder, Sean L McGee, Mark A Frye, Susannah J Tye
Disruptions of bioenergetic signaling and neurogenesis are hallmarks of depression physiology and are often the product of dysregulation of the inflammatory, stress-response, and metabolic systems. These systems are extensively interrelated at the physiological level, yet the bulk of the literature to date addresses pathophysiological mechanisms in isolation. A more integrated understanding of the etiology, progression, and treatment response profiles of depression is possible through wider consideration of relevant preclinical and clinical studies that examine the result of disruptions in these systems...
April 12, 2018: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/29649596/population-pharmacokinetics-and-pharmacodynamics-of-fosfomycin-in-non-critically-ill-patients-with-bacteremic-urinary-infection-caused-by-multidrug-resistant-escherichia-coli
#14
Vicente Merino-Bohorquez, Fernando Docobo-Pérez, Jesús Sojo, Isabel Morales, Carmen Lupión, Dolores Martín, Manuel Cameán, William Hope, Álvaro Pascual, Jesús Rodríguez-Baño
The aim of the present study was to describe the population pharmacokinetics of fosfomycin for patients with bacteraemic urinary tract infection (B-UTI). The analysis identified optimal regimens, based on pharmacodynamic targets and assessed the adequacy of CLSI and EUCAST susceptibility breakpoints for Escherchia coli. MethodsSixteen patients with B-UTI caused by multidrug-resistant E. coli, (FOREST clinical trial) received intravenous fosfomycin (4g/Q6h) were analysed. A population pharmacokinetic analysis was performed, and Monte Carlo simulations were undertaken using 4g/Q6h or 8g/Q8h...
April 9, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29628014/invasive-candidiasis-in-critically-ill-patients-a-prospective-cohort-study-in-2-tertiary-care-centers
#15
Hasan M Al-Dorzi, Hussam Sakkijha, Raymond Khan, Tarek Aldabbagh, Aron Toledo, Pendo Ntinika, Sameera M Al Johani, Yaseen M Arabi
BACKGROUND: Invasive candidiasis is not uncommon in critically ill patients but has variable epidemiology and outcomes between intensive care units (ICUs). This study evaluated the epidemiology, characteristics, management, and outcomes of patients with invasive candidiasis at 6 ICUs of 2 tertiary care centers. METHODS: This was a prospective observational study of all adults admitted to 6 ICUs in 2 different hospitals between August 2012 and May 2016 and diagnosed to have invasive candidiasis by 2 intensivists according to predefined criteria...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29623443/pharmacokinetic-and-pharmacodynamic-considerations-of-antibiotics-of-last-resort-in-treating-gram-negative-infections-in-adult-critically-ill-patients
#16
REVIEW
Mojdeh S Heavner, Kimberly C Claeys, Anne M Masich, Jeffrey P Gonzales
PURPOSE OF REVIEW: We provide an overview of antimicrobials that are considered last resort for the treatment of resistant gram-negative infections in adult critically ill patients. The role in therapy, pharmacodynamic (PD) goals, and pharmacokinetic (PK) changes in critical illness for aminoglycosides, polymyxins, tigecycline, fosfomycin, and fluoroquinolones are summarized. RECENT FINDINGS: Altered PK in septic patients in the intensive care unit (ICU) is observed with many of our agents of last resort...
April 5, 2018: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/29619336/risk-of-acute-kidney-injury-in-critically-ill-surgical-patients-with-presumed-pneumonia-is-not-impacted-by-choice-of-methicillin-resistant-staphylococcus-aureus-therapy
#17
Kelsey B Billups, Erica E Reed, Gary S Phillips, Kurt B Stevenson, Steven M Steinberg, Claire V Murphy
Background: Vancomycin and linezolid are standard treatment options for nosocomial methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. While acute kidney injury (AKI) is commonly attributed to vancomycin, existing data has not definitely confirmed vancomycin as an independent risk factor for AKI. Aims: This study aimed to quantify the incidence of AKI in Surgical Intensive Care Unit (ICU) patients receiving empiric vancomycin or linezolid for nosocomial pneumonia and to identify risk factors for AKI with a focus on MRSA antibiotic therapy...
January 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29604109/procalcitonin-monitoring-as-a-guide-for-antimicrobial-therapy-a-review-of-current-literature
#18
Elizabeth W Covington, Megan Z Roberts, Jenny Dong
Effective antimicrobial stewardship practices are increasingly essential to best utilize the current arsenal of antimicrobials for the shortest necessary duration to minimize the development of antimicrobial resistance, secondary infections, and health care costs. Monitoring of serum procalcitonin (PCT) levels represents an effective antimicrobial stewardship strategy to differentiate bacterial infections from viral infections and noninfectious inflammatory conditions. Current literature illustrates the merits of PCT monitoring in reducing duration of antibiotic therapy without detrimental effects on mortality or infection relapses...
March 31, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29593035/a-highly-conserved-leucine-in-mammarenavirus-matrix-z-protein-is-required-for-z-interaction-with-the-virus-l-polymerase-and-z-stability-in-cells-harboring-an-active-viral-ribonucleoprotein
#19
Masaharu Iwasaki, Juan C de la Torre
Mammarenaviruses cause chronic infections in their natural rodent hosts. Infected rodents shed infectious virus into excreta. Humans are infected through mucosal exposure to aerosols or direct contact of abraded skin with fomites, resulting in a wide-range of manifestations from asymptomatic or mild febrile illness to severe life-threatening hemorrhagic fever. The mammarenavirus matrix Z protein has been shown to be a main driving force of virus budding and to act as a negative regulator of viral RNA synthesis...
March 28, 2018: Journal of Virology
https://www.readbyqxmd.com/read/29577278/evaluation-of-enterococcus-faecium-nrrl-b-2354-as-a-surrogate-for-salmonella-during-extrusion-of-low-moisture-food
#20
Tushar Verma, Xinyao Wei, Soon Kiat Lau, Andreia Bianchini, Kent M Eskridge, Jeyamkondan Subbiah
Salmonella in low-moisture foods is an emerging challenge due to numerous food product recalls and foodborne illness outbreaks. Identification of suitable surrogate is critical for process validation at industry level due to implementation of new Food Safety Modernization Act of 2011. The objective of this study was to evaluate Enterococcus faecium NRRL B-2354 as a surrogate for Salmonella during the extrusion of low-moisture food. Oat flour, a low-moisture food, was adjusted to different moisture (14% to 26% wet basis) and fat (5% to 15% w/w) contents and was inoculated with E...
March 25, 2018: Journal of Food Science
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