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Immunocompromised critical care

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https://www.readbyqxmd.com/read/29788443/pediatric-infectious-diseases-meets-the-future
#1
Janet R Gilsdorf, Paul Spearman, Janet A Englund, Tina Q Tan, Kristina A Bryant
Pediatric infectious diseases physicians are dedicated to the diagnosis, prevention, and management of infections in children. As such, we play large, and important, roles in the clinical care of children from birth to late adolescence and in infection prevention, antimicrobial stewardship, research pertaining to infections, public health, international and global health, and advocacy for children's health. Furthermore, we are critical to the education of future physicians (in general), pediatricians, and infectious diseases doctors...
May 19, 2018: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29762868/candidemia-in-children-epidemiology-prevention-and-management
#2
REVIEW
Elpis Mantadakis, Zoe Dorothea Pana, Theoklis Zaoutis
Candidemia is the leading cause of invasive fungal infections in hospitalized children. The highest rates of candidemia have been recorded in neonates and infants <1 year of age. Candidemia is more frequent in neonates and young infants than in adults, and is associated with better clinical outcomes, but higher inpatient costs. Over the last 10 years, a declining trend has been noted in the incidence of pediatric candidemia in the US and elsewhere due to the hospital-wide implementation of central-line insertion and maintenance bundles that emphasize full sterile barrier precautions, chlorhexidine skin preparation during line insertion, meticulous site and tubing care, and daily discussion of catheter necessity...
May 15, 2018: Mycoses
https://www.readbyqxmd.com/read/29718296/epidemiology-and-outcomes-of-hospitalizations-with-invasive-aspergillosis-in-the-united-states-2009-2013
#3
Marya D Zilberberg, Brian H Nathanson, Rachel Harrington, James R Spalding, Andrew F Shorr
Background: Though invasive aspergillosis (IA) complicates care of up to 13% of patients with immunocompromise, little is known about its morbidity and mortality burden in the United States. Methods: We analyzed the Health Care Utilization Project's data from the Agency for Healthcare Research and Quality for 2009-2013. Among subjects with high-risk conditions for IA, IA was identified via International Classification of Diseases, Ninth Revision, Clinical Modification codes 117...
April 28, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29715551/severe-infections-in-critically-ill-solid-organ-transplant-patients
#4
REVIEW
Andre C Kalil, Uriel Sandkovsky, Diana F Florescu
BACKGROUND: Severe infections are among the most common causes of death in immunocompromised patients admitted to the intensive care unit. The epidemiology, diagnosis, and treatment of these infections has evolved in the last decade. AIMS: We aim to provide a comprehensive review of these severe infections in this population. SOURCES: Review of the literature pertaining to severe infections in critically ill solid organ transplant (SOT) patients...
April 28, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29692984/the-potential-harm-of-cytomegalovirus-infection-in-immunocompetent-critically-ill-children
#5
Raidan Alyazidi, Srinivas Murthy, Jennifer A Slyker, Soren Gantt
Cytomegalovirus (CMV) is a ubiquitous infection that causes disease in congenitally infected children and immunocompromised patients. Although nearly all CMV infections remain latent and asymptomatic in immunologically normal individuals, numerous studies have found that systemic viral reactivation is common in immunocompetent critically ill adults, as measured by detection of CMV in the blood (viremia). Furthermore, CMV viremia is strongly correlated with adverse outcomes in the adult intensive care unit (ICU), including prolonged stay, duration of mechanical ventilation, and death...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29565639/otolaryngology-in-critical-care
#6
Jisha Joshua, Eric Scholten, Daniel Schaerer, Mahmood F Mafee, Thomas H Alexander, Laura E Crotty Alexander
Diseases affecting the ear, nose and throat are prevalent in intensive care settings and often require combined medical and surgical management. Upper airway occlusion can occur from malignant tumor growth, allergic reactions, and bleeding events and may require close monitoring and interventions by intensivists, sometimes necessitating surgical management. With the increased prevalence of immunocompromised patients, aggressive infections of the head and neck likewise require prompt recognition and treatment...
March 22, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29494484/the-burden-of-fungal-diseases-in-romania
#7
Mihai Mareș, Valentina Ruxandra Moroti-Constantinescu, David W Denning
OBJECTIVE: To estimate for the first time the burden of fungal infections in Romania. METHODS: Data derived from the World Health Organization (WHO), National Institute of Statistics, Romanian public health agencies and non-profit health organizations, and published annual reports on local epidemiology were used in the present study. When no data were available, specific at-risk populations were used to calculate frequencies of serious fungal diseases, using previously published epidemiological parameters...
March 1, 2018: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29454654/invasive-pulmonary-aspergillosis-and-influenza-co-infection-in-immunocompetent-hosts-case-reports-and-review-of-the-literature
#8
Melisa M Shah, Eric I Hsiao, Carl M Kirsch, Amit Gohil, Supriya Narasimhan, David A Stevens
Invasive pulmonary aspergillosis (IPA) is classically considered an illness of severely immunocompromised patients with limited host defenses. However, IPA has been reported in immunocompetent but critically ill patients. This report describes two fatal cases of pathologically confirmed IPA in patients with influenza in the intensive care unit. One patient had influenza B infection, whereas the other had influenza A H1N1. Both patients died despite broad-spectrum antimicrobials, mechanical ventilation, and vasopressor support...
February 2, 2018: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29404282/colonization-infection-and-the-accessory-genome-of-klebsiella-pneumoniae
#9
REVIEW
Rebekah M Martin, Michael A Bachman
Klebsiella pneumoniae is a Gram-negative pathogen that has a large accessory genome of plasmids and chromosomal gene loci. This accessory genome divides K. pneumoniae strains into opportunistic, hypervirulent, and multidrug-resistant groups and separates K. pneumoniae from two closely related species, Klebsiella variicola and Klebsiella quasipneumoniae . Some strains of K. pneumoniae act as opportunistic pathogens, infecting critically ill and immunocompromised patients. These K. pneumoniae are a common cause of health-care associated infections including pneumonia, urinary tract infections (UTIs), and bloodstream infections...
2018: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/29355141/an-observational-study-of-incidence-risk-factors-outcome-of-systemic-inflammatory-response-organ-dysfunction-following-major-trauma
#10
Satish Balkrishna Dharap, Sanket Vishnu Ekhande
BACKGROUND & OBJECTIVES: Trauma is known to lead to systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS), which is often a cause of late deaths after injury. SIRS and MODS have been objectively measured using scoring systems. This prospective observational study was carried out in a tertiary care hospital in India to evaluate SIRS and MODS following trauma in terms of their incidence, the associated risk factors and the effect on the outcome...
September 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29305548/epidemiology-clinical-characteristics-and-antimicrobial-susceptibility-profiles-of-human-clinical-isolates-of-staphylococcus-intermedius-group
#11
Melanie L Yarbrough, William Lainhart, C A Burnham
The veterinary pathogens in the Staphylococcus intermedius group (SIG) are increasingly recognized as causes of human infection. Shared features between SIG and Staphylococcus aureus may result in the misidentification of SIG in human clinical cultures. This study examined the clinical and microbiological characteristics of isolates recovered at a tertiary-care academic medical center. From 2013 to 2015, 81 SIG isolates were recovered from 62 patients. Patients were commonly ≥50 years old, diabetic, and/or immunocompromised...
March 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29275461/tumor-immuno-environment-in-cancer-progression-and-therapy
#12
Pawel Kalinski, James E Talmadge
The approvals of Provenge (Sipuleucel-T), Ipilimumab (Yervoy/anti-CTLA-4) and blockers of the PD-1 - PD-L1/PD-L2 pathway, such as nivolumab (Opdivo), pembrolizumab (Keytruda), or atezolizumab (Tecentriq), have established immunotherapy as a key component of comprehensive cancer care. Further, murine mechanistic studies and studies in immunocompromised patients have documented the critical role of immunity in effectiveness of radio- and chemotherapy. However, in addition to the ability of the immune system to control cancer progression, it can also promote tumor growth, via regulatory T cells (Tregs), myeloid-derived dendritic cells (MDSCs) and tumor associated macrophages (TAM), which can enhance survival of cancer cells directly or via the regulation of the tumor stroma...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29202739/the-lung-microbiome-in-patients-with-pneumocystosis
#13
J Kehrmann, B Veckollari, D Schmidt, O Schildgen, V Schildgen, N Wagner, M Zeschnigk, L Klein-Hitpass, O Witzke, J Buer, J Steinmann
BACKROUND: Pneumocystis jirovecii pneumonia (PCP) is an opportunistic fungal infection that is associated with a high morbidity and mortality in immunocompromised individuals. In this study, we analysed the microbiome of the lower respiratory tract from critically ill intensive care unit patients with and without pneumocystosis. METHODS: Broncho-alveolar fluids from 65 intubated and mechanically ventilated intensive care unit patients (34 PCP+ and 31 PCP- patients) were collected...
December 4, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29199253/-effects-of-pharmacist-intervention-on-the-treatment-of-infectious-diseases-in-critically-ill-patients
#14
REVIEW
Masaharu Imaura
 The pathological conditions of patients who require intensive care are usually complex and extremely severe; their health and life are in a critical state. Therefore, correct, rapid treatment of these conditions is indispensable. Furthermore, the selection of drugs and adjustment of their dosage for an immediate effect are important. Moreover, most patients are immunocompromised and present an extremely high level of risk for complications involving infectious diseases. Since such complications may lead to life-threatening outcomes, a rational dosage regimen to achieve sufficient antimicrobial activity from the initial stage of treatment is essential...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/29142383/assessment-of-doripenem-meropenem-and-imipenem-against-respiratory-isolates-of-pseudomonas-aeroginosa-in-a-tertiary-care-hospital-of-north-india
#15
Arti Negi, Mridu Anand, Avinash Singh, Awadhesh Kumar, Chinmoy Sahu, Kashi Nath Prasad
Objective: Pseudomonas aeruginosa is one of the leading pathogen causing healthcare-associated infections, particularly in immunocompromised and critically ill patients. The development of carbapenem resistance in P. aeruginosa infections is worrisome. Data specifically comparing the susceptibility of the three available carbapenems are lacking in the Indian subcontinent. Materials and Methods: We evaluated the minimum inhibitory concentrations (MICs) of the three commonly used carbapenems- imipenem, meropenem, and doripenem against, 435 P...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29140969/risk-factors-for-ventilator-associated-events-in-a-picu
#16
Raeley Guess, Jarin Vaewpanich, Jorge A Coss-Bu, Siriporn Phongjitsiri, Curtis Kennedy, Jeffrey Starke, Satid Thammasitboon
OBJECTIVE: The term ventilator-associated events includes ventilator-associated condition, infection-related ventilator-associated complication, and ventilator-associated pneumonia. We sought to identify potential new risk factors for ventilator-associated condition and infection-related ventilator-associated complication in the PICU population. DESIGN: Matched case control study. SETTING: Children's hospital at a tertiary care academic medical center...
January 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28928729/high-throughput-genetic-screen-reveals-that-early-attachment-and-biofilm-formation-are-necessary-for-full-pyoverdine-production-by-pseudomonas-aeruginosa
#17
Donghoon Kang, Natalia V Kirienko
Pseudomonas aeruginosa is a re-emerging, multidrug-resistant, opportunistic pathogen that threatens the lives of immunocompromised patients, patients with cystic fibrosis, and those in critical care units. One of the most important virulence factors in this pathogen is the siderophore pyoverdine. Pyoverdine serves several critical roles during infection. Due to its extremely high affinity for ferric iron, pyoverdine gives the pathogen a significant advantage over the host in their competition for iron. In addition, pyoverdine can regulate the production of multiple bacterial virulence factors and perturb host mitochondrial homeostasis...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28803505/extracorporeal-membrane-oxygenation-in-an-hiv-positive-man-with-severe-acute-respiratory-distress-syndrome-secondary-to-pneumocystis-and-cytomegalovirus-pneumonia
#18
Deirdre Morley, Almida Lynam, Edmund Carton, Ignacio Martin-Loeches, Gerard Sheehan, Niamh Lynn, Serena O'Brien, Fiona Mulcahy
The management of critically ill human immunodeficiency virus (HIV)-positive patients is challenging; however, intensive care unit-related mortality has declined significantly in recent years. There are 10 case reports in the literature of extracorporeal membrane oxygenation (ECMO) use in HIV-positive patients, of whom seven survived to hospital discharge. We describe a 33-year-old Brazilian man who presented with Pneumocystis jirovecii pneumonia and severe hypoxic respiratory failure. He developed refractory acute respiratory distress syndrome (ARDS) and was commenced on veno-venous ECMO...
February 2018: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28754461/evaluating-of-fungal-contamination-in-hospital-wet-cooling-systems-in-markazi-province-central-iran
#19
M Mosayebi, Z Eslamirad, R Hajihossein, B Ghorbanzadeh, M Shahverdi, M Didehdar
OBJECTIVE: Fungal infections are common complication among hospitalized patients especially between who is immunocompromised. Wet cooling systems in the hospital environment play a critical role as a source of these infections. The aim of this study was survey of wet cooling system of hospitals for fungal contamination in Arak city. MATERIALS AND METHODS: This study was conducted during May to September of 2016. Sampling was done as random. Samples were obtained from water and straw of 84 wet cooling systems of four hospitals in Arak city...
July 25, 2017: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/28634525/pseudomembranous-aspergillar-tracheobronchitis-in-a-non-neutropenic-critically-ill-patient-in-the-intensive-care-unit
#20
Sameen Khalid, Fnu Asad-Ur -Rahman, Aamer Abbass, Sigfredo Aldarondo, Khalid Abusaada
Invasive aspergillosis is an important cause of morbidity and mortality among immunocompromised patients. Prolonged neutropenia is the most common risk factor. It has rarely been reported to occur in non-neutropenic critically ill patients in the intensive care unit setting. Mortality rate in this group has been reported to be as high as 92%. We report a case of tracheobronchial aspergillosis in a non-neutropenic critically ill patient to highlight the fact that critically ill patients admitted in the intensive care unit can develop opportunistic infections such as invasive aspergillosis even in the absence of classic risk factors and prior history of immunosuppression...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
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