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Critical ill and resistency

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https://www.readbyqxmd.com/read/28525674/continuous-hemoadsorption-with-a-cytokine-adsorber-during-sepsis-a-review-of-the-literature
#1
Khosrow S Houschyar, Malcolm N Pyles, Susanne Rein, Ina Nietzschmann, Dominik Duscher, Zeshaan N Maan, Kristian Weissenberg, Hubertus M Philipps, Catharina Strauss, Beate Reichelt, Frank Siemers
Sepsis is a well-recognized healthcare issue worldwide, ultimately resulting in significant mortality, morbidity and resource utilization during and after critical illness. In its most severe form, sepsis causes multi-organ dysfunction that produces a state of critical illness characterized by severe immune dysfunction and catabolism. Sepsis induces the activation of complement factor via 3 pathways and the release of inflammatory cytokines such as tumor necrosis factor alpha (TNF-α) and interleukin-1beta (IL-1β), resulting in a systemic inflammatory response...
May 19, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28520859/the-role-of-patient-care-items-as-a-fomite-in-healthcare-associated-outbreaks-and-infection-prevention
#2
Hajime Kanamori, William A Rutala, David J Weber
Patient-care items can serve as a source or reservoir for healthcare associated pathogens in hospitals. We reviewed healthcare-associated outbreaks from medical equipment and provided infection prevention recommendations. Multiple healthcare-associated outbreaks via a contaminated patient-care item were identified, including infections with multidrug-resistant organisms. The type of patient-care items implicated as a fomite causing healthcare-associated infections (HAI) has changed over time. Patient populations at risk were most commonly critically ill patients in adult and neonatal ICUs...
May 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28501490/colistin-use-in-critically-ill-neonates-a%C3%A2-case-control-study
#3
Mehmet Sah İpek, Fesih Aktar, Nilufer Okur, Muhittin Celik, Erdal Ozbek
BACKGROUND: The aim of this study was to assess the safety and efficacy of colistin use in critically ill neonates. METHODS: This was a case-control study that included newborn infants with proven or suspected nosocomial infections between January 2012 and October 2015, at two centers in Diyarbakir, Turkey. The clinical and laboratory characteristics and outcomes of patients who received colistin therapy were reviewed and compared to patients who were treated with antimicrobial agents other than colistin during the same period...
March 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28485324/a-novel-porcine-model-of-septic-shock-induced-by-acute-respiratory-distress-syndrome-due-to-methicillin-resistant-staphylococcus-aureus
#4
Shuo Wang, Jun-Yu Wang, Tao Wang, Chen-Chen Hang, Rui Shao, Chun-Sheng Li
BACKGROUND: Sepsis is one of the main causes of mortality in critically ill patients following progression to septic shock. To investigate the pathophysiologic changes of sepsis, we developed a novel porcine model of septic shock induced by acute respiratory distress syndrome (ARDS) due to methicillin-resistant Staphylococcus aureus(MRSA) pneumonia. METHODS: Twenty-six male Landraces (Lvyuanweiye, Beijing, China) weighing 30 ± 2 kg were divided into four groups: sham group (SH; n = 5); cotton smoke inhalation group (SM; n = 6); MRSA pneumonia group (MR; n = 6); and septic shock group with cotton smoke inhalation + MRSA pneumonia (SS; n = 9)...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28478944/theoretical-and-experimental-evaluation-of-the-effects-of-an-argon-gas-mixture-on-the-pressure-drop-through-adult-tracheobronchial-airway-replicas
#5
Patrick D Litwin, Anna Luisa Reis Dib, John Chen, Michelle Noga, Warren H Finlay, Andrew R Martin
Argon has the potential to be a novel inhaled therapeutic agent, owing to the neuroprotective and organoprotective properties demonstrated in preclinical studies. Before human trials are performed, an understanding of varying gas properties on airway resistance during inhalation is essential. This study predicts the effect of an 80% argon/20% oxygen gas mixture on the pressure drop through conducting airways, and by extension the airway resistance, and then verifies these predictions experimentally using 3-D printed adult tracheobronchial airway replicas...
April 18, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28475585/acinetobacter-baumannii-strains-isolated-from-patients-in-intensive-care-units-in-goi%C3%A3-nia-brazil-molecular-and-drug-susceptibility-profiles
#6
Suellen Rocha Araújo Castilho, Cássia Silva de Miranda Godoy, Adriana Oliveira Guilarde, Juliana Lamaro Cardoso, Maria Cláudia Porfirio André, Ana Paula Junqueira-Kipnis, André Kipnis
Resistance to antimicrobial agents is increasing worldwide and imposes significant life-threatening risks to several different populations, especially those in intensive care units (ICUs). Bacteria can quickly develop or acquire resistance to antimicrobial drugs, and combined with their intrinsic potential to cause disease in humans, these bacteria can become deadly. Among Gram-negative bacteria, Acinetobacter baumannii is notorious as a frequent opportunistic pathogen associated with critically ill patients, and understanding the genetic basis of A...
2017: PloS One
https://www.readbyqxmd.com/read/28466147/appropriate-endpoints-for-evaluation-of-new-antibiotic-therapies-for-severe-infections-a-perspective-from-combacte-s-stat-net
#7
Jean-François Timsit, Marlieke E A de Kraker, Harriet Sommer, Emmanuel Weiss, Esther Bettiol, Martin Wolkewitz, Stavros Nikolakopoulos, David Wilson, Stephan Harbarth
PURPOSE: In this era of rising antimicrobial resistance, slowly refilling antibiotic development pipelines, and an aging population, we need to ensure that randomized clinical trials (RCTs) determine the added benefit of new antibiotic agents effectively and in a valid way, especially for severely ill patients. Unfortunately, universally accepted endpoints for the evaluation of new drugs in severe infections are lacking. METHODS: We review and discuss the current practices and challenges regarding endpoints in RCTs in this field and propose novel approaches...
May 2, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28462900/hyperdehydroepiandrosterone-in-neonates-with-hypoxic-ischemic-encephalopathy-and-circulatory-collapse
#8
Abdelmoneim Khashana, Engy Ahmed
BACKGROUND: Circulatory collapse is a very common complication of the critical illnesses in neonates including neonates with hypoxic ischemic encephalopathy; it can be the end result and cause of death of several conditions. Often, despite treatment with fluid resuscitation and vasopressor agents, circulatory collapse persist, and blood pressure can remain critically low, compromising adequate blood flow to vital organs and brain. Low blood pressure has been associated with increased mortality...
April 12, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28458172/efficacy-and-toxicity-of-high-dose-nebulized-colistin-for-critically-ill-surgical-patients-with-ventilator-associated-pneumonia-caused-by-multidrug-resistant-acinetobacter-baumannii
#9
Ji Young Jang, Hye Youn Kwon, Eun Hee Choi, Won-Yeon Lee, Hongjin Shim, Keum Seok Bae
PURPOSE: Few studies have compared nebulized and intravenous (IV) colistin for multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa pneumonia. This study compared the nephrotoxicity and clinical outcomes for these two delivery routes. METHODS: This study retrospectively compared 95 critically ill surgical patients who were diagnosed with Acinetobacter baumannii ventilator associated pneumonia and received colistin between March 2013 and January 2016...
April 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28444760/vancomycin-levels-are-frequently-subtherapeutic-in-critically-ill-patients-a-prospective-observational-study
#10
V Bakke, H Sporsem, E Von der Lippe, I Nordøy, Y Lao, H C Nyrerød, L Sandvik, K R Hårvig, J F Bugge, E Helset
BACKGROUND: Appropriate utilization of vancomycin is important to attain therapeutic targets while avoiding clinical failure and the development of antimicrobial resistance. Our aim was to observe the use of vancomycin in an intensive care population, with the main focus on achievement of therapeutic serum concentrations (15-20 mg/l) and to evaluate how this was influenced by dose regimens, use of guidelines and therapeutic drug monitoring. METHODS: A prospective observational study was carried out in the intensive care units at two tertiary hospitals in Norway...
April 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28444224/pharmacodynamics-of-colistin-and-fosfomycin-a-treasure-trove-combination-combats-kpc-producing-klebsiella-pneumoniae
#11
Miao Zhao, Zackery P Bulman, Justin R Lenhard, Michael J Satlin, Barry N Kreiswirth, Thomas J Walsh, Amanda Marrocco, Phillip J Bergen, Roger L Nation, Jian Li, Jing Zhang, Brian T Tsuji
Objectives: KPC-producing Klebsiella pneumoniae are an emerging public health problem around the globe. We defined the combinatorial pharmacodynamics and ability to suppress resistance of two 'old' antibiotics, fosfomycin and colistin, in time-kill experiments and hollow-fibre infection models (HFIM). Methods: Two KPC-2-producing K. pneumoniae isolates were used: one susceptible to both colistin and fosfomycin (KPC 9A: MIC colistin 0.25 mg/L and MIC fosfomycin ≤8 mg/L) and the other resistant to colistin and susceptible to fosfomycin (KPC 5A: MIC colistin 64 mg/L and MIC fosfomycin 32 mg/L)...
April 21, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28437207/persistent-delirium-in-chronic-critical-illness-as-a-prodrome-syndrome-before-death
#12
Anna DeForest, Craig D Blinderman
BACKGROUND: Chronic critical illness (CCI) patients have poor functional outcomes, high risk of mortality, and significant sequelae, including delirium and cognitive dysfunction. The prognostic significance of persistent delirium in patients with CCI has not been well described. OBJECTIVE: We report a case of a patient with CCI following major cardiac surgery who was hemodynamically stable following a long course in the cardiothoracic intensive care unit (CTICU), but had persistent and unremitting delirium...
May 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28421029/a-historical-view-of-motion-sickness-a-plague-at-sea-and-on-land-also-with-military-impact
#13
Doreen Huppert, Judy Benson, Thomas Brandt
Seasickness and its triggers, symptoms, and preventive measures were well known in antiquity. This chapter is based on an analysis of descriptions of motion sickness, in particular seasickness, in ancient Greek, Roman, and Chinese literature. A systematic search was made from the Greek period beginning with Homer in 800 BC to the late Roman period and ending with Aetios Amidenos in 600 AD, as well as in the Chinese medical classics dating from around 300 AD. Major aspects are the following: body movements caused by waves were identified in all cultures as the critical stimuli...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28420365/social-determinants-of-antibiotic-misuse-a-qualitative-study-of-community-members-in-haryana-india
#14
Anna K Barker, Kelli Brown, Muneeb Ahsan, Sharmila Sengupta, Nasia Safdar
BACKGROUND: Antibiotic resistance is a global public health crisis. In India alone, multi-drug resistant organisms are responsible for over 58,000 infant deaths each year. A major driver of drug resistance is antibiotic misuse, which is a pervasive phenomenon worldwide. Due to a shortage of trained doctors, access to licensed allopathic doctors is limited in India's villages. Pharmacists and unlicensed medical providers are commonly the primary sources of healthcare. Patients themselves are also key participants in the decision to treat an illness with antibiotics...
April 19, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28416774/microrna-100-suppresses-human-osteosarcoma-cell-proliferation-and-chemo-resistance-via-znrf2
#15
Qiang Xiao, Yu Yang, Qing An, Yong Qi
Osteosarcoma (OS) is a prevalent cancer worldwide. MicroRNAs (miRNAs) play critical roles in the growth, invasion and carcinogenesis of OS, whereas the underlying mechanisms remain ill-defined. Here, we addressed these questions. We detected significantly higher levels of ZNRF2, a ubiquitin ligase of the RING superfamily, and significantly lower levels of miR-100 in the OS specimens, compared to the paired normal bone tissues. The levels of ZNRF2 and miR-100 inversely correlated in the OS specimens. In addition, low miR-100 levels are associated with poor prognosis of the OS patients...
March 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/28416553/pharmacokinetics-and-dialytic-clearance-of-ceftazidime-avibactam-in-a-critically-ill-patient-on-continuous-venovenous-hemofiltration
#16
Eric Wenzler, Kristen L Bunnell, Susan C Bleasdale, Scott Benken, Larry H Danziger, Keith A Rodvold
Ceftazidime-avibactam 1.25 g every 8 hours was used to treat multi-drug resistant Pseudomonas aeruginosa bacteremia in a critically ill patient on continuous venovenous hemofiltration (CVVH). Pre-filter plasma drug concentrations of ceftazidime and avibactam were measured at 0, 1, 2, 4, 6, and 8 hours along with post-filter and ultrafiltrate concentrations at hours 2 and 6. Plasma pharmacokinetic parameters of ceftazidime and avibactam, respectively, were Cmax 61.10 and 14.54 mg/L, Cmin 31.96 and 8.45 mg/L, t1/2 6...
April 17, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28413520/prognosis-of-patients-with-acinetobacter-baumannii-infection-in-the-intensive-care-unit-a-retrospective-analysis
#17
Dong Xiao, Lu Wang, Daquan Zhang, Dongming Xiang, Qi Liu, Xuezhong Xing
The present retrospective study aimed to investigate the prognostic factors for critically ill patients with an Acinetobacter baumannii (A. baumannii) infection. A total of 37 patients from the intensive care unit (ICU) were enrolled in the study. Data was collected from patients, including age, gender, ethnicity, A. baumannii infection status, concurrent infection status, prescribed antibiotics, Acute Physiology and Chronic Health Evaluation II (APACHE II) and sepsis-related organ failure assessment (SOFA) scores, procalcitonin level, site of infection, shock, sepsis and renal replacement therapy status...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28412382/use-of-nebulized-antimicrobials-for-the-treatment-of-respiratory-infections-in-invasively-mechanically-ventilated-adults-a-position-paper-from-the-european-society-of-clinical-microbiology-and-infectious-diseases
#18
Jordi Rello, Candela Solé-Lleonart, Jean-Jacques Rouby, Jean Chastre, Stijn Blot, Garyfallia Poulakou, Charles-Edouard Luyt, Jordi Riera, Lucy B Palmer, Jose M Pereira, Tim Felton, Jayesh Dhanani, Matteo Bassetti, Tobias Welte, Jason A Roberts
With an established role in cystic fibrosis and bronchiectasis, nebulized antibiotics are increasingly being used to treat respiratory infections in critically ill invasively mechanically ventilated adult patients. Although there is limited evidence describing their efficacy and safety, in an era of need for new strategies to enhance antibiotic effectiveness because of a shortage of new agents and increases in antibiotic resistance, the potential of nebulization of antibiotics to optimize therapy is considered of high interest, particularly in patients infected with multidrug-resistant (MDR) pathogens...
April 13, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28409205/what-s-wrong-in-the-control-of-antimicrobial-resistance-in-critically-ill-patients-from-low-and-middle-income-countries
#19
Arjen M Dondorp, Direk Limmathurotsakul, Elizabeth A Ashley
No abstract text is available yet for this article.
April 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28396656/prescription-patterns-for-tigecycline-in-severely-ill-patients-for-non-fda-approved-indications-in-a-developing-country-a-compromised-outcome
#20
Rima A Moghnieh, Dania I Abdallah, Ismail A Fawaz, Tarek Hamandi, Mohammad Kassem, Nabila El-Rajab, Tamima Jisr, Anas Mugharbil, Nabila Droubi, Samaa Al Tabah, Loubna Sinno, Fouad Ziade, Ziad Daoud, Ahmad Ibrahim
Introduction: With the rise in antibiotic resistance, tigecycline has been used frequently in off-label indications, based on its in-vitro activity against multidrug-resistant organisms. In this study, our aim was to assess its use in approved and unapproved indications. Materials and Methods: This is a retrospective chart review evaluating a 2-year experience of tigecycline use for > 72 h in 153 adult patients inside and outside critical care unit from January 2012 to December 2013 in a Lebanese tertiary-care hospital...
2017: Frontiers in Microbiology
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