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435 papers 100 to 500 followers
https://www.readbyqxmd.com/read/28975470/infections-of-the-central-nervous-system-in-returning-travelers-and-immigrants
#1
REVIEW
Haley Thompson, Kiran Thakur
PURPOSE OF REVIEW: This review highlights current knowledge in travel-related neuroinfectious diseases, providing insight on approaches to prevention, diagnosis, and treatment of infections of the central nervous system (CNS) in travelers and immigrants. RECENT FINDINGS: Updates on travel vaccine recommendations including vaccine-specific interactions with immunosuppressive agents, advances in Zika virus and dengue virus vaccine development, new diagnostic criteria for neurocysticercosis, updates on treatment approaches for tuberculosis meningitis...
October 3, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/29101576/trends-in-community-versus-health-care-acquired-methicillin-resistant-staphylococcus-aureus-infections
#2
REVIEW
David P Calfee
Since the first clinical isolate of methicillin-resistant Staphylococcus aureus was described in 1961, this pathogen has established itself as a leading cause of health care-associated infections. More recently, MRSA has become a relatively common cause of infection among persons without typical health care-associated risk factors and is now the most common cause of community-onset purulent skin and soft-tissue infections in many regions of the USA. The appearance of "community-associated" MRSA is not due to the expansion of health care-associated MRSA into the community but rather the result of the independent emergence of a novel clone of MRSA...
November 3, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/29511909/resistance-trends-and-treatment-options-in-gram-negative-ventilator-associated-pneumonia
#3
REVIEW
Nathaniel J Rhodes, Caroline E Cruce, J Nicholas O'Donnell, Richard G Wunderink, Alan R Hauser
PURPOSE OF REVIEW: Hospital-acquired and ventilator-associated pneumonia (VAP) are frequent causes of infection among critically ill patients. VAP is the most common hospital-acquired bacterial infection among mechanically ventilated patients. Unfortunately, many of the nosocomial Gram-negative bacteria that cause VAP are increasingly difficult to treat. Additionally, the evolution and dissemination of multi- and pan-drug resistant strains leave clinicians with few treatment options. VAP patients represent a dynamic population at risk for antibiotic failure and under-dosing due to altered antibiotic pharmacokinetic parameters...
March 6, 2018: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/29619607/pharmacokinetic-pharmacodynamic-considerations-of-beta-lactam-antibiotics-in-adult-critically-ill-patients
#4
REVIEW
Anne M Masich, Mojdeh S Heavner, Jeffrey P Gonzales, Kimberly C Claeys
PURPOSE OF REVIEW: Beta-lactam antibiotics are commonly prescribed in critically ill patients for a variety of infectious conditions. Our understanding of how critical illness alters beta-lactam pharmacokinetics/pharmacodynamics (PK/PD) is rapidly evolving. RECENT FINDINGS: There is a growing body of literature in adult patients demonstrating that physiological alterations occurring in critically ill patients may limit our ability to optimally dose beta-lactam antibiotics to reach these PK/PD targets...
April 4, 2018: Current Infectious Disease Reports
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
#5
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/29789960/cutaneous-manifestations-of-infections-in-solid-organ-transplant-recipients
#6
REVIEW
Cory J Pettit, Katherine Mazurek, Benjamin Kaffenberger
PURPOSE OF REVIEW: Post-transplant infections present a formidable challenge to the physician due to their varied presentation. Many of these infections begin by inoculation following skin compromise or disseminate to the skin hematogenously, making cutaneous manifestations of infection an important diagnostic clue in the immunocompromised. Quality research in this field is lacking, and this articles seeks to review the literature and present a guide to physicians in order for them to suspect certain infections by their cutaneous presentation...
May 22, 2018: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/29876674/multidrug-resistant-pseudomonas-infections-hard-to-treat-but-hope-on-the-horizon
#7
REVIEW
Lynn Nguyen, Joshua Garcia, Katherine Gruenberg, Conan MacDougall
PURPOSE OF REVIEW: As the sixth most common nosocomial pathogen in the USA, Pseudomonas aeruginosa poses a significant threat to patients within the healthcare system. Its intrinsic and acquired resistance mechanisms also significantly limit the choices for antimicrobial therapy, prompting an increase in the research and development of antibacterial agents with enhanced activity against multidrug-resistant (MDR) P. aeruginosa. While many approved and pipeline antibiotics have activity against wild-type P...
June 6, 2018: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/29959605/primary-prevention-of-clostridium-difficile-associated-diarrhea-current-controversies-and-future-tools
#8
REVIEW
Zachary A Rubin, Elise M Martin, Paul Allyn
PURPOSE OF REVIEW: Clostridium difficile infection (CDI) is a major cause of morbidity and mortality in hospitalized patients and rates in most places have not decreased significantly despite broad efforts by both hospitals and public health entities. This review aims to provide readers with a better understanding of the limitations of current prevention strategies. We also review potential future tools that may be available for the primary prevention of CDI in the next decade. RECENT FINDINGS: Research over the last decade has expanded our appreciation of the role of asymptomatic shedding in the healthcare setting and in the community...
June 29, 2018: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/29971402/management-considerations-in-infective-endocarditis-a-review
#9
REVIEW
Andrew Wang, Jeffrey G Gaca, Vivian H Chu
Importance: Infective endocarditis occurs in approximately 15 of 100 000 people in the United States and has increased in incidence. Clinicians must make treatment decisions with respect to prophylaxis, surgical management, specific antibiotics, and the length of treatment in the setting of emerging, sometimes inconclusive clinical research findings. Observations: Community-associated infective endocarditis remains the predominant form of the disease; however, health care accounts for one-third of cases in high-income countries...
July 3, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29954243/evaluation-of-meropenem-extended-versus-intermittent-infusion-dosing-protocol-in-critically-ill-patients
#10
Nabeela Ahmed, Shin-Pung Jen, Diana Altshuler, John Papadopoulos, Vinh P Pham, Yanina Dubrovskaya
Extended infusion (EI) administration of β-lactams can improve target attainment in critically ill patients with altered pharmacokinetics/pharmacodynamics. To optimize meropenem dosing in patients with severe sepsis/septic shock, our Antimicrobial Stewardship Program implemented a EI meropenem (EIM) protocol in an 18-bed Medical Intensive Care Unit in March 2014. In this retrospective study, we compared intensive care unit (ICU) mortality and clinical response in patients who received meropenem for ≥72 hours administered per EIM protocol of 1 g over 3 hours every 8 hours versus intermittent infusion (IIM) protocol of 500 mg over 30 minutes every 6 hours...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29705221/early-corticosteroids-for-pneumocystis-pneumonia-in-adults-without-hiv-are-not-associated-with-better-outcome
#11
Patrick M Wieruszewski, Jason N Barreto, Erin Frazee, Craig E Daniels, Pritish K Tosh, Ross A Dierkhising, Kristin C Mara, Andrew H Limper
BACKGROUND: Evidence supporting adjunctive corticosteroids during the treatment of Pneumocystis jirovecii pneumonia (PcP) in adults without HIV is minimal and controversial. METHODS: This retrospective cohort study included P jirovecii pneumonia-positive, hospitalized patients without HIV admitted to the Mayo Clinic from 2006 to 2016. Change from baseline in the respiratory component of the Sequential Organ Failure Assessment score (SOFAresp ) at day 5 was compared between early (within 48 h) steroid recipients and nonrecipients by using multivariable logistic regression and in a propensity-matched analysis...
April 26, 2018: Chest
https://www.readbyqxmd.com/read/29781385/procalcitonin-guided-use-of-antibiotics-for-lower-respiratory-tract-infection
#12
David T Huang, Donald M Yealy, Michael R Filbin, Aaron M Brown, Chung-Chou H Chang, Yohei Doi, Michael W Donnino, Jonathan Fine, Michael J Fine, Michelle A Fischer, John M Holst, Peter C Hou, John A Kellum, Feras Khan, Michael C Kurz, Shahram Lotfipour, Frank LoVecchio, Octavia M Peck-Palmer, Francis Pike, Heather Prunty, Robert L Sherwin, Lauren Southerland, Thomas Terndrup, Lisa A Weissfeld, Jonathan Yabes, Derek C Angus
Background The effect of procalcitonin-guided use of antibiotics on treatment for suspected lower respiratory tract infection is unclear. Methods In 14 U.S. hospitals with high adherence to quality measures for the treatment of pneumonia, we provided guidance for clinicians about national clinical practice recommendations for the treatment of lower respiratory tract infections and the interpretation of procalcitonin assays. We then randomly assigned patients who presented to the emergency department with a suspected lower respiratory tract infection and for whom the treating physician was uncertain whether antibiotic therapy was indicated to one of two groups: the procalcitonin group, in which the treating clinicians were provided with real-time initial (and serial, if the patient was hospitalized) procalcitonin assay results and an antibiotic use guideline with graded recommendations based on four tiers of procalcitonin levels, or the usual-care group...
May 20, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29349705/stool-cultures-at-the-icu-get-rid-of-it
#13
Carolin F Manthey, Darja Dranova, Martin Christner, Laura Berneking, Stefan Kluge, Ansgar W Lohse, Valentin Fuhrmann
BACKGROUND: Stool cultures for Campylobacter, Salmonella and Shigella and/or Yersinia spp. are frequently ordered in critically ill patients with diarrhea. The aim of this study is to analyze the diagnostic yield in a large cohort of critically ill patients. Therefore, we performed a cohort study at the Department of Intensive Care Medicine of a University Hospital (11 ICUs). RESULTS: From all patients who were admitted to the ICU between 2010 and 2015, stool cultures were taken from 2...
January 18, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/28784214/overview-of-immunosuppressive-therapy-in-solid-organ-transplantation
#14
REVIEW
Curtis D Holt
Mechanisms of rejection, new pharmacologic approaches, and genomic medicine are major foci for current research in transplantation. It is hoped that these new agents and personalized immunosuppression will provide for less toxic regimens that are effective in preventing both acute and chronic allograft rejection. Until new agents are available, practitioners must use various combinations of currently approved agents to find the best regimens for improved long-term outcomes.
September 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29401173/clinical-presentation-of-autoimmune-and-viral-encephalitides
#15
Divyanshu Dubey, Michel Toledano, Andrew McKeon
PURPOSE OF REVIEW: We describe clinical and diagnostic features of various autoimmune and viral encephalitis subtypes. RECENT FINDINGS: Population-based studies have demonstrated both autoimmune and viral causes have similar prevalence and incident rates. Repertoire of autoimmune biomarkers has considerably increased with discovery of many novel neural antibodies including glial fibrillary acidic proteinα-immunoglobulin G. Similarly, with use of next generation sequencing and DNA libraries, many viral causes are being detected which would have been categorized as encephalitis of unknown cause a decade ago...
April 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29278528/treatment-of-severe-skin-and-soft-tissue-infections-a-review
#16
Jason P Burnham, Marin H Kollef
PURPOSE OF REVIEW: To review the salient features of the management of severe skin and soft tissue infections (SSTIs), including toxic shock syndrome, myonecrosis/gas gangrene, and necrotizing fasciitis. RECENT FINDINGS: For severe SSTIs, intensive care, source control, and broad-spectrum antimicrobials are required for the initial phase of illness. There is an increasing focus on the utility of rapid diagnostic tests to help in selection and de-escalation of antimicrobials for SSTIs...
April 2018: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29293475/pharmacokinetics-and-pharmacodynamics-of-antibiotics-in-central-nervous-system-infections
#17
Roland Nau, Jana Seele, Marija Djukic, Helmut Eiffert
PURPOSE OF REVIEW: The barriers surrounding the central nervous system (CNS) together with the emergence of multiresistant pathogens pose a therapeutic challenge for the effective treatment of CNS infections. RECENT FINDINGS: In addition to vancomycin, colistin and aminoglycosides, classically used for intrathecal injection, drug concentrations in cerebrospinal fluid after intrathecal injection of daptomycin and tigecyclin were recently studied. SUMMARY: The entry of antiinfectives into the CNS compartments is determined by the physicochemical properties of the drug and by conditions in the host...
February 2018: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29324504/aspergillus-and-other-respiratory-fungal-infections-in-the-icu-diagnosis-and-management
#18
José-Artur Paiva, Paulo Mergulhão, José Manuel Pereira
PURPOSE OF REVIEW: Filamentous fungi respiratory infections, namely because of Aspergillus, Mucorales, Fusarium, or Scedosporium, show rising incidence and occur more in populations which are not classically immunosuppressed. This and their persistent dismal prognosis are the focus of this review. RECENT FINDINGS: Both an early diagnosis, rooted on a high level of suspicion and based on clinical picture, radiology, cultural microbiological exams, fungal biomarkers, PCR and biopsy, and an early therapy, including immunorecovery, whenever possible, good antifungal selection, and surgery for source control, are paramount to maximize the outcome in these diseases...
April 2018: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29337703/new-antibiotics-for-ventilator-associated-pneumonia
#19
Matteo Bassetti, Antionio Vena, Nadia Castaldo, Elda Righi, Maddalena Peghin
PURPOSE OF REVIEW: Ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR) bacteria represents a global emerging problem. Delayed prescription of an adequate treatment for VAP has been associated with higher morbidity and mortality. New molecules have been developed to face the need of compounds that are active against resistant Gram-positive and Gram-negative pathogens. The aim of this review is to summarize the current scenario of new therapeutic options for the treatment of VAP...
April 2018: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29058580/sleeping-with-the-enemy-clostridium-difficile-infection-in-the-intensive-care-unit
#20
REVIEW
Florian Prechter, Katrin Katzer, Michael Bauer, Andreas Stallmach
Over the last years, there was an increase in the number and severity of Clostridium difficile infections (CDI) in all medical settings, including the intensive care unit (ICU). The current prevalence of CDI among ICU patients is estimated at 0.4-4% and has severe impact on morbidity and mortality. An estimated 10-20% of patients are colonized with C. difficile without showing signs of infection and spores can be found throughout ICUs. It is not yet possible to predict whether and when colonization will become infection...
October 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
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