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https://www.readbyqxmd.com/read/29151282/epidemiology-and-impact-of-bloodstream-infections-among-kidney-transplant-recipients-a-retrospective-single-center-experience
#1
Ali M Shendi, Gabriel Wallis, Helena Painter, Mark Harber, Sophie Collier
BACKGROUND: Bloodstream infections (BSI) represent an important source of morbidity and mortality, as well as an increasing therapeutic challenge, among solid organ transplant recipients. Understanding the epidemiological and microbiological characteristics of BSI following renal transplantation is paramount to the implementation of appropriate preventative and therapeutic measures. METHODS: We conducted a retrospective review of all BSI episodes occurring between July 2009 and April 2016 in adult patients, who received a renal transplant at Royal Free London hospital...
November 19, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29150371/emergence-of-polymyxin-b-resistance-in-a-polymyxin-b-susceptible-kpc-producing-klebsiella-pneumoniae-causing-bloodstream-infection-in-a-neutropenic-patient-during-polymyxin-b-therapy
#2
Alexandre P Zavascki, Raquel Girardello, Cibele M Magagnin, Laura C Antochevis, Rafael A Maciel, Jussara K Palmeiro, Ana C Gales
The emergence of resistance to polymyxins in KPC-producing Klebsiella pneumoniae isolates has been a major clinical problem. This study evaluated the molecular mechanisms associated with polymyxin B (PMB) resistance that emerged in a previously PMB-susceptible KPC-2-producing K. pneumoniae during PMB therapy for a bloodstream infection in a neutropenic patient. The first isolate (PMB-susceptible) was obtained while the patient was receiving meropenem and other isolates were recovered from 2 sets of blood cultures in different dates while the patient was receiving PMB therapy (4 of 6 blood cultures bottles yielded isolates with full PMB resistance)...
October 19, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29148930/use-of-mixed-oil-fat-emulsion-to-improve-intestinal-failure-associated-liver-disease-in-long-term-home-parenteral-nutrition-a-case-report
#3
Ryan T Hurt, Manpreet S Mundi
Home parenteral nutrition (HPN) is a life-saving therapy for patients who are not able to use their gastrointestinal tract. There are a number of complications associated with HPN, including metabolic bone disease, intestinal failure-associated liver disease (IFALD), and catheter-related bloodstream infections. We present a case of a 32-year-old HPN patient who initially developed biopsy-proven IFALD (total bilirubin, 2.4 mg/dL) while on long-term HPN. His HPN was initiated due to myopathic intestinal dysmotility and pseudo-obstruction when he was 15 years old...
November 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29148002/targeting-zero-catheter-related-bloodstream-infections-in-pediatric-intensive-care-unit-a-retrospective-matched-case-control-study
#4
Daniele G Biasucci, Mauro Pittiruti, Alessandra Taddei, Enzo Picconi, Alessandro Pizza, Davide Celentano, Marco Piastra, Giancarlo Scoppettuolo, Giorgio Conti
INTRODUCTION: The aim of this study was to evaluate the effectiveness and safety of a new three-component 'bundle' for insertion and management of centrally inserted central catheters (CICCs), designed to minimize catheter-related bloodstream infections (CRBSIs) in critically ill children. METHODS: Our 'bundle' has three components: insertion, management, and education. Insertion and management recommendations include: skin antisepsis with 2% chlorhexidine; maximal barrier precautions; ultrasound-guided venipuncture; tunneling of the catheter when a long indwelling time is expected; glue on the exit site; sutureless securement; use of transparent dressing; chlorhexidine sponge dressing on the 7th day; neutral displacement needle-free connectors...
November 8, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29147867/population-structure-of-candida-parapsilosis-no-genetic-difference-between-french-and-urugayan-isolates-using-microsatellite-length-polymorphism
#5
Marie Desnos-Ollivier, Victoria Bórmida, Philippe Poirier, Céline Nourrisson, Dinorah Pan, Stéphane Bretagne, Andrès Puime, Françoise Dromer
Candida parapsilosis is a human commensal yeast, frequently involved in infection worldwide and especially in neonates. It is the second species responsible for bloodstream infections in Uruguay and the third species in France. We were interested in knowing whether the population structure of isolates responsible for candidemia in France and in Uruguay was different. Genotyping methods based on microsatellite length polymorphism (MLP) have been described and are especially used for investigation of local outbreaks...
November 16, 2017: Mycopathologia
https://www.readbyqxmd.com/read/29146383/not-just-antibiotics-is-cancer-chemotherapy-driving-antimicrobial-resistance
#6
REVIEW
Lito E Papanicolas, David L Gordon, Steve L Wesselingh, Geraint B Rogers
The global spread of antibiotic-resistant pathogens threatens to increase the mortality of cancer patients significantly. We propose that chemotherapy contributes to the emergence of antibiotic-resistant bacteria within the gut and, in combination with antibiotics, drives pathogen overgrowth and translocation into the bloodstream. In our model, these processes are mediated by the effects of chemotherapy on bacterial mutagenesis and horizontal gene transfer, the disruption of commensal gut microbiology, and alterations to host physiology...
November 13, 2017: Trends in Microbiology
https://www.readbyqxmd.com/read/29143662/heat-treatment-and-false-positive-heartworm-antigen-testing-in-ex-vivo-parasites-and-dogs-naturally-infected-by-dirofilaria-repens-and-angiostrongylus-vasorum
#7
Luigi Venco, Simone Manzocchi, Marco Genchi, Laura H Kramer
BACKGROUND: Heartworm antigen testing is considered sensitive and specific. Currently available tests are reported as detecting a glycoprotein found predominantly in the reproductive tract of the female worm and can reach specificity close to 100%. Main concerns regard sensitivity in the case of light infections, the presence of immature females or cases of all-male infections. Research and development have been aimed at increasing sensitivity. Recently, heat treatment of serum prior to antigen testing has been shown to result in an increase in positive antigen test results, presumably due to disruption of natural antigen-antibody complexes...
November 9, 2017: Parasites & Vectors
https://www.readbyqxmd.com/read/29143643/subcutaneous-dirofilariosis-dirofilaria-repens-an-infection-spreading-throughout-the-old-world
#8
REVIEW
Claudio Genchi, Laura Kramer
BACKGROUND: Two main Dirofilaria species infect dogs: D. immitis and D. repens. While D. immitis has a worldwide distribution, D. repens is currently found only in Europe, Asia, and Africa. Adult D. repens are located in subcutaneous tissues of natural hosts where they survive for long periods of time. First-stage larvae, microfilariae, circulate in the peripheral bloodstream, where they are taken up by the mosquito intermediate hosts. Infected mosquitoes then transmit infective third-stage (L3) larvae to new hosts through the blood meal...
November 9, 2017: Parasites & Vectors
https://www.readbyqxmd.com/read/29142743/anti-candida-activity-of-antimicrobial-impregnated-central-venous-catheters
#9
L Cobrado, A Silva-Dias, M M Azevedo, A Rodrigues
Background: Whenever the rate of central line-associated bloodstream infections (CLABSIs) remains high even after the implementation of preventive strategies, the use of chlorhexidine/silver sulfadiazine (CSS) or minocycline/rifampin (MR)-impregnated central venous catheters (CVCs) is currently recommended. Nevertheless, the efficacy of such CVCs against Candida albicans and other emerging non-albicans spp. has been insufficiently studied. This study aims to compare the activity of CSS and MR-impregnated CVCs against the yeasts most frequently isolated from CLABSIs...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29142077/syndromic-panel-based-testing-in-clinical-microbiology
#10
REVIEW
Poornima Ramanan, Alexandra L Bryson, Matthew J Binnicker, Bobbi S Pritt, Robin Patel
The recent development of commercial panel-based molecular diagnostics for the rapid detection of pathogens in positive blood culture bottles, respiratory specimens, stool, and cerebrospinal fluid has resulted in a paradigm shift in clinical microbiology and clinical practice. This review focuses on U.S. Food and Drug Administration (FDA)-approved/cleared multiplex molecular panels with more than five targets designed to assist in the diagnosis of bloodstream, respiratory tract, gastrointestinal, or central nervous system infections...
January 2018: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/29139180/successful-heart-transplantation-in-patients-with-active-staphylococcus-bloodstream-infection-and-suspected-mechanical-circulatory-support-device-infection
#11
Timothy Sullivan, Sarah Taimur, Meenakshi Rana, Gopi Patel, Sean Pinney, Anelechi Anyanwu, Shirish Huprikar
BACKGROUND: An active bloodstream infection (BSI) is typically considered a contraindication to heart transplantation (HT). However, in some patients with Staphylococcus bacteremia and mechanical circulatory support device infection, positive blood cultures may persist until removal of the infected device, and eradicating the infection prior to HT may not be possible. We report the outcomes of six patients with active Staphylococcus BSI at the time of HT. METHODS: All cases of HT performed at The Mount Sinai Hospital from 2009 through 2015 were reviewed...
November 15, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29135819/prophylactic-rtpa-in-the-prevention-of-line-associated-thrombosis-and-infection-in-short-bowel-syndrome
#12
Lynn M Malec, James Cooper, Jeffrey Rudolph, Marian G Michaels, Margaret V Ragni
BACKGROUND: Central venous access devices (CVADs) are essential for total parenteral nutrition administration in patients with short bowel syndrome (SBS). However, they are fraught with complications including infection and venous thromboembolism (VTE), which increases associated morbidity and mortality in this population. There is evidence linking the development of CVAD-associated thrombosis and line-related infection. Thus, it has been postulated that prevention of catheter-related clot formation could minimize the risk of infection originating from the catheter...
November 10, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29134938/short-term-incubation-of-positive-blood-cultures-in-brain-heart-infusion-broth-accelerates-identification-of-bacteria-by-matrix-assisted-laser-desorption-ionization-time-of-flight-mass-spectrometry
#13
Ignacio Torres, Estela Gimenez, Tania Pascual, Felipe Bueno, Dixie Huntley, Mireia Martínez, David Navarro
PURPOSE: Fast identification of bacteria directly from positive blood cultures (BCs) by matrix-assisted laser desorption/ionization time-of-flight mass-spectrometry (MALDI-TOF MS) can be achieved either using the MALDI Sepsityper kit (protein extraction method) or after a short-term pre-cultivation step on solid medium. We developed a new method that involves short-term enrichment of positive BCs in brain-heart infusion broth (BHI) prior to MALDI-TOF MS analysis. METHODOLOGY: Eighty-four BCs flagged as positive were included in this study; these were processed in parallel either directly using the MALDI Sepsityper kit or following a short-term culture either in BHI or on Columbia blood agar with 5 % sheep blood (CBA)...
November 14, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29128346/mortality-risk-factors-among-non-icu-patients-with-nosocomial-vascular-catheter-related-bloodstream-infections-a-prospective-cohort-study
#14
Patrick Saliba, Ana Hornero, Guillermo Cuervo, Immaculada Grau, Emilio Jimenez, Dolors García, Fe Tubau, Jose María Martínez-Sánchez, Jordi Carratalà, Miquel Pujol
BACKGROUND: Vascular catheter-related bloodstream infections (CRBSIs) are highly preventable hospital-acquired infections and a major threat to patient safety. While there is significant information regarding CRBSI outcome among Intensive Care Unit (ICU) patients, data regarding non-ICU patients are scarce. AIM: To determine the risk factors associated with 30-day mortality among non-ICU patients with nosocomial CRBSIs. METHODS: Prospective cohort study of non-ICU patients with nosocomial CRBSIs in a tertiary-care centre, between January 2004 and December 2014...
November 8, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29127502/piperacillin-tazobactam-as-alternative-to-carbapenems-for-icu-patients
#15
REVIEW
Benoit Pilmis, Vincent Jullien, Alexis Tabah, Jean-Ralph Zahar, Christian Brun-Buisson
Several studies suggest that alternatives to carbapenems, and particulary beta-lactam/beta-lactamase inhibitor combinations, can be used for therapy of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE)-related infections in non-ICU patients. Little is known concerning ICU patients in whom achieving the desired plasmatic pharmacokinetic/pharmacodynamic (PK/PD) target may be difficult. Also, in vitro susceptibility to beta-lactamase inhibitors might not translate into clinical efficacy. We reviewed the recent clinical studies examining the use of BL/BLI as alternatives to carbapenems for therapy of bloodstream infection, PK/PD data and discuss potential ecological benefit from avoiding the use of carbapenems...
November 10, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29126814/a-daily-topical-decontamination-regimen-reduces-catheter-related-bloodstream-infections-in-haematology-patients
#16
C Samuelson, H Kaur, E I Kritsotakis, S D Goode, A Nield, D Partridge
OBJECTIVES: To assess impact of a topical decontamination regimen on rates of catheter-related bloodstream infections (CRBSI) in intensively-treated haematology patients. METHODS: A historically-controlled cohort study was used to evaluate the effect of applying chlorhexidine or Octenisan® body washes and nasal Prontoderm® ointment for 5 days around the time of Hickman line insertion on the incidence of CRBSI and infection-free catheter time. Lines inserted during a 24 month period prior to implementation of the decolonisation regimen were compared with those inserted during a 12 month period after the intervention was applied...
November 7, 2017: Journal of Infection
https://www.readbyqxmd.com/read/29123565/lemierre-s-syndrome-a-rare-cause-of-disseminated-sepsis-requiring-multi-organ-support
#17
John Rae, Katie Misselbrook
Lemierre's syndrome is a rare complication of acute pharyngitis characterised by septicaemia with infective thrombophlebitis of the internal jugular vein, most commonly due to Fusobacterium necrophorum. It characteristically affects healthy young adults causing persistent pyrexia and systemic sepsis presenting several days after an initial pharyngitis. Septic emboli seed via the bloodstream to distant sites including the lung, joints, skin, liver, spleen and brain. Prolonged antimicrobial therapy is required and admission to intensive care common...
November 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29122697/early-administration-of-appropriate-antimicrobial-agent-to-improve-the-outcome-of-carbapenem-resistant-acinetobacter-baumannii-complex-bacteremic-pneumonia
#18
Seong Yeon Park, Eun Jung Lee, Tark Kim, Shi Nae Yu, Ki-Ho Park, Mi Suk Lee, Se Yoon Park, Min Hyok Jeon, Tae Hyong Kim, Eun Ju Choo
BACKGROUND: Carbapenem resistant Acinetobacter baumannii complex (CRABC) is an emerging pathogen that causes bloodstream infections and nosocomial pneumonia. This study aimed to describe the severe infection associated with CRABC bacteremic pneumonia and to investigate risk factors for 28-day mortality. METHODS: All patients ≥18 years of age with a CRABC bacteremic pneumonia were enrolled retrospectively at five teaching hospitals in South Korea. Empirical antimicrobial therapy was defined as appropriate if administration of at least one antimicrobial agent, to which the causative pathogen was susceptible, more than 48 hours, within 5 days of the onset of bacteremia...
November 6, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29121235/management-of-an-outbreak-of-exophiala-dermatitidis-bloodstream-infections-at-an-outpatient-oncology-clinic
#19
Amber Marie Vasquez, D Zavasky, N A Chow, L Gade, E Zlatanic, S Elkind, A P Litvintseva, Peter G Pappas, J R Perfect, S G Revankar, S R Lockhart, T M Chiller, J Ackelsberg, S Vallabhaneni
Exophiala (Wangiella) dermatitidis is a dematiaceous fungus that can grow in yeast or mold forms and is typically found in decaying organic matter. It can cause central nervous system disease, particularly in immunocompromised patients, and has been implicated as a respiratory pathogen in cystic fibrosis patients [1,2]. It has also been identified as a colonizer in the gastrointestinal tract [3]. However, bloodstream infections with this organism are exceedingly rare.
November 7, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29119023/improvement-in-quality-metrics-outcomes-and-patient-and-family-satisfaction-in-a-neurosciences-intensive-care-unit-after-creation-of-a-dedicated-neurocritical-care-team
#20
Yaw Sarpong, Premkumar Nattanmai, Ginger Schelp, Robert Bell, Keerthivaas Premkumar, Erin Stapleton, Ashley McCormick, Christopher R Newey
Introduction: Dedicated neurointensivists have been shown to improve outcome measurements in the neurosciences intensive care unit (NSICU). Quality outcome data in relation to patient and family satisfaction is lacking. This study evaluated the impact of newly appointed neurointensivists and creation of a neurocritical care team on quality outcome measures including patient satisfaction in a NSICU. Methods: This is a retrospective study of data over 36 months from a 14-bed NSICU evaluating quality outcome measures and anonymous patient satisfaction questionnaires before and after neurointensivists appointment...
2017: Critical Care Research and Practice
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