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327 papers 100 to 500 followers
https://www.readbyqxmd.com/read/28083768/invasive-fungal-tracheobronchitis-in-mechanically-ventilated-critically-ill-patients-underlying-conditions-diagnosis-and-outcomes
#1
Chun-Yu Lin, Wei-Lun Liu, Che-Chia Chang, Hou-Tai Chang, Han-Chung Hu, Kuo-Chin Kao, Ning-Hung Chen, Ying-Jen Chen, Cheng-Ta Yang, Chung-Chi Huang, George Dimopoulos
BACKGROUND: Invasive fungal tracheobronchitis (IFT) is a severe form of pulmonary fungal infection that is not limited to immunocompromised patients. Although respiratory failure is a crucial predictor of death, information regarding IFT in critically ill patients is limited. METHODS: In this retrospective, multicenter, observational study, we enrolled adults diagnosed as having IFT who had been admitted to the intensive care unit between January 2007 and December 2015...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28155050/relation-between-presence-of-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-in-systematic-rectal-swabs-and-respiratory-tract-specimens-in-icu-patients
#2
Hélène Carbonne, Matthieu Le Dorze, Anne-Sophie Bourrel, Hélène Poupet, Claire Poyart, Emmanuelle Cambau, Jean-Paul Mira, Julien Charpentier, Rishma Amarsy
BACKGROUND: The choice of empirical antimicrobial therapy for pneumonia in intensive care unit (ICU) is a challenge, since pneumonia is often related to multidrug-resistant pathogens, particularly extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E). To prevent the overuse of broad-spectrum antimicrobial therapy, the main objective of this study was to test the performance of digestive colonization surveillance as a predictor of ESBL-E presence or absence in respiratory samples performed in ICU and to evaluate the impact of time sampling (≤5 days or >5 days) on such prediction...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28029487/newly-approved-antibiotics-and-antibiotics-reserved-for-resistant-infections-implications-for-emergency-medicine
#3
REVIEW
Maryann Mazer-Amirshahi, Ali Pourmand, Larissa May
Millions of patients are evaluated every year in the emergency department (ED) for bacterial infections. Emergency physicians often diagnose and prescribe initial antibiotic therapy for a variety of bacterial infections, ranging from simple urinary tract infections to severe sepsis. In life-threatening infections, inappropriate choice of initial antibiotic has been shown to increase morbidity and mortality. As such, initiation of appropriate antibiotic therapy on the part of the emergency physician is critical...
January 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27908327/ready-for-prime-time-biomarkers-in-sepsis
#4
REVIEW
Brit Long, Alex Koyfman
Sepsis is a common condition managed in the emergency department. Current diagnosis relies on physiologic criteria and suspicion of a source of infection using history, physical examination, laboratory studies, and imaging studies. The infection triggers a host response with the aim to destroy the pathogen, and this response can be measured. A reliable biomarker for sepsis should assist with earlier diagnosis, improve risk stratification, or improve clinical decision making. Current biomarkers for sepsis include lactate, troponin, and procalcitonin...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27908330/sepsis-in-special-populations
#5
REVIEW
Matthew P Borloz, Khalief E Hamden
Sepsis is recognized by the presence of physiologic and laboratory changes that reflect the inflammatory response to infection on cellular and systemic levels. Comorbid conditions, such as cirrhosis, end-stage renal disease, and obesity, alter patients' susceptibility to infection and their response to it once present. Baseline changes in vital signs and chronic medications often mask clues to the severity of illness. The physiologic, hematologic, and biochemical adjustments that accompany pregnancy and the puerperium introduce similar challenges...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27908331/sepsis-resuscitation-in-resource-limited-settings
#6
REVIEW
Brian Meier, Catherine Staton
Our evolving understanding of the physiologic processes that lead to sepsis has led to updated consensus guidelines outlining priorities in the recognition and treatment of septic patients. However, an enormous question remains when considering how to best implement these guidelines in settings with limited resources, which include rural US emergency departments and low- and middle-income countries. The core principles of sepsis management should be a priority in community emergency departments. Similarly, cost-effective interventions are key priorities in low- and middle-income countries; however, consideration must be given to the unique challenges associated with such settings...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27908336/appropriate-antibiotic-therapy
#7
REVIEW
Michael G Allison, Emily L Heil, Bryan D Hayes
Prescribing antibiotics is an essential component of initial therapy in sepsis. Early antibiotics are an important component of therapy, but speed of administration should not overshadow the patient-specific characteristics that determine the optimal breadth of antimicrobial therapy. Cultures should be drawn before antibiotic therapy if it does not significantly delay administration. Combination antibiotic therapy against gram-negative infections is not routinely required, and combination therapy involving vancomycin and piperacillin/tazobactam is associated with an increase in acute kidney injury...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27908337/source-identification-and-source-control
#8
REVIEW
Zeke P Oliver, Jack Perkins
Identifying sources of infection and establishing source control is an essential component of the workup and treatment of sepsis. Investigation with history, physical examination, laboratory tests, and imaging can in identifying sources of infection. All organ systems have the potential to develop sources of infection. However, there are inherent difficulties presented by some that require additional diligence, namely, urinalysis, chest radiographs, and intraabdominal infections. Interventions include administration of antibiotics and may require surgical or other specialist intervention...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28198727/new-guidelines-for-nosocomial-pneumonia
#9
Mark L Metersky, Andre C Kalil
PURPOSE OF REVIEW: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) remain important causes of morbidity and mortality in hospitalized patients. New evidence-based guidelines for the diagnosis and treatment of these entities were released by the Infectious Diseases Society of America and the American Thoracic Society in 2016. This review summarizes the recommendations contained within these guidelines and their supporting rationale. RECENT FINDINGS: With respect to diagnosis of HAP and VAP, the guidelines suggest using semiquantitative cultures of noninvasively obtained respiratory samples instead of quantitative cultures of invasively obtained samples...
February 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28212143/staphylococcus-aureus-infections-some-second-thoughts
#10
Willem J B van Wamel
PURPOSE OF REVIEW: Staphylococcus aureus (S. aureus) is well known for its ability to cause life-threatening infections. On the other hand, this bacterium can thrive as a commensal on and in human tissues without causing much problems. How big a threat is S. aureus actually? Furthermore, commensalism is associated with biofilms, where can we find them, and which natural and artificial components activate biofilm formation? RECENT FINDINGS: Recent findings on S. aureus carriage on skin, mucosa, and in wounds indicate the presence of large numbers of S...
February 15, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28203777/2017-infectious-diseases-society-of-america-s-clinical-practice-guidelines-for-healthcare-associated-ventriculitis-and-meningitis
#11
Allan R Tunkel, Rodrigo Hasbun, Adarsh Bhimraj, Karin Byers, Sheldon L Kaplan, W Michael Scheld, Diederik van de Beek, Thomas P Bleck, Hugh J L Garton, Joseph R Zunt
No abstract text is available yet for this article.
February 14, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28030371/antibiotic-dosing-for-multidrug-resistant-pathogen-pneumonia
#12
Mohd H Abdul-Aziz, Jeffrey Lipman, Jason A Roberts
PURPOSE OF REVIEW: Nosocomial pneumonia caused by multidrug-resistant pathogens is increasing in the ICU, and these infections are negatively associated with patient outcomes. Optimization of antibiotic dosing has been suggested as a key intervention to improve clinical outcomes in patients with nosocomial pneumonia. This review describes the recent pharmacokinetic/pharmacodynamic data relevant to antibiotic dosing for nosocomial pneumonia caused by multidrug-resistant pathogens. RECENT FINDINGS: Optimal antibiotic treatment is challenging in critically ill patients with nosocomial pneumonia; most dosing guidelines do not consider the altered physiology and illness severity associated with severe lung infections...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28067676/severe-community-acquired-pneumonia-optimal-management
#13
Davide Leoni, Jordi Rello
PURPOSE OF REVIEW: Community-acquired pneumonia (CAP) is the leading cause of mortality among infectious diseases. Several efforts have been implemented to achieve better outcomes, but an important proportion of patients continue dying. This review focuses on the newest research on prognostic factors and diagnostics, opening new perspectives in the management of CAP. RECENT FINDINGS: CAP survival improved in recent years despite an increasing incidence of severe presentations...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28079631/the-role-of-methicillin-resistant-staphylococcus-aureus-in-skin-and-soft-tissue-infections
#14
Matteo Bassetti, Alessia Carnelutti, Elda Righi
PURPOSE OF REVIEW: Methicillin-resistant Staphylococcus aureus (MRSA) has become a major public health issue worldwide over the last years. MRSA is frequently implicated in the development of skin and soft tissue infections, leading to significant increases in morbidity, mortality and overall healthcare costs. RECENT FINDINGS: In order to face the threat of MRSA, major changes in clinical management of skin and soft tissue infections are required. The identification of populations at risk for the acquisition of infections due to MRSA, together with the improvement of the diagnostic techniques, is paramount...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28118221/prevention-of-ventilator-associated-pneumonia
#15
Gianluigi Li Bassi, Tarek Senussi, Eli Aguilera Xiol
PURPOSE OF REVIEW: Ventilator-associated pneumonia (VAP) is an iatrogenic disease. Here we appraise recent advancements in the development and testing of strategies to prevent VAP. We also provide recommendations on the most promising interventions that should be applied. RECENT FINDINGS: In the last year, preventive bundles have consistently let to a reduction of VAP. A few trials on endotracheal tubes (ETTs) with novel cuffs failed to translate positive bench findings into clinical settings...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28134677/are-there-any-reasons-to-change-our-behavior-in-necrotizing-fasciitis-with-the-advent-of-new-antibiotics
#16
Francesco Menichetti, Simone Giuliano, Simona Fortunato
PURPOSE OF REVIEW: The treatment of necrotizing fasciitis requires a multifaceted approach, consisting of surgical source control with immediate surgical debridement along with life support, clinical monitoring, and antimicrobial therapy. Many drugs are now available for the treatment of this life-threatening infectious disease, and the purpose of this review is to provide the reader with an updated overview of the newest therapeutic options. RECENT FINDINGS: Because most necrotizing soft tissue infections are polymicrobial, broad-spectrum coverage is advisable...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28134678/what-is-new-in-the-management-of-skin-and-soft-tissue-infections-in-2016
#17
Garyphallia Poulakou, Efthymia Giannitsioti, Sotirios Tsiodras
PURPOSE OF REVIEW: Skin and soft tissue infections (SSTIs) are the most frequent infectious cause of referrals to emergency departments and hospital admissions in developed world, contributing to significant morbidity and healthcare expenditures. We sought to review recent literature covering epidemiology and management of SSTIs. RECENT FINDINGS: Incidence trends of SSTIs were increasing worldwide with Staphylococcus aureus and streptococci predominating and methicillin-resistant S...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28169858/central-nervous-system-infections-in-immunocompromised-patients
#18
Romain Sonneville, Eric Magalhaes, Geert Meyfroidt
PURPOSE OF REVIEW: Although rare, central nervous system (CNS) infections are increasingly being recognized in immunocompromised patients. The goal of the present review is to provide a practical diagnostic approach for the intensivist, and to briefly discuss some of the most prevalent conditions. RECENT FINDINGS: Immunocompromised patients presenting with new neurological symptoms should always be suspected of a CNS infection. These infections carry a poor prognosis, especially if intracranial hypertension, severely altered mental status or seizures are present...
April 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27924470/emerging-issues-and-treatment-strategies-in-carbapenem-resistant-enterobacteriaceae-cre
#19
REVIEW
Dana R Bowers, Vanthida Huang
Carbapenems are the broadest spectrum antimicrobials utilized in the treatment of serious infections since the 1980s. Soon after their introduction, the discovery of carbapenem-resistant Enterobacteriaceae (CRE) was reported in the 1990s. Invasive CRE infections are associated with high mortality and limited treatment options making care for patients with these infections challenging for clinicians. Current practice has reverted back to the use of "older" antimicrobials, such as the polymyxins, tigecycline, and fosfomycin, to combat invasive CRE infections...
December 2016: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28159154/viral-pneumonia-and-acute-respiratory-distress-syndrome
#20
REVIEW
Raj D Shah, Richard G Wunderink
Respiratory viruses are a common cause of severe pneumonia and acute respiratory distress syndrome (ARDS) in adults. The advent of new diagnostic technologies, particularly multiplex reverse transcription polymerase chain reaction, have increased the recognition of viral respiratory infections in critically ill adults. Supportive care for adults with ARDS caused by respiratory viruses is similar to the care of patients with ARDS from other causes. Although antiviral therapy is available for some respiratory viral infections, further research is needed to determine which groups of patients would benefit...
March 2017: Clinics in Chest Medicine
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