Francesco Alessandri, Francesco Pugliese, Silvia Angeletti, Massimo Ciccozzi, Alessandro Russo, Claudio M Mastroianni, Gabriella d'Ettorre, Mario Venditti, Giancarlo Ceccarelli
BACKGROUND: Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infection, associated with considerable mortality and morbidity in critically ill patients; however, its diagnosis and management remain challenging since clinical assessment is often poorly reliable. The aim of this systematic review was to evaluate the role of PCT in the diagnosis and management of critical ill patients affected by VAP. METHODS: We performed a systematic review of the evidence published over the last 10 years and currently available in medical literature search databases (Pubmed, Embase, Web of Knowledge, Cochrane Libraries) and searching clinical trial registries...
October 9, 2020: Advances in Experimental Medicine and Biology
Yuyao Yin, Chunjiang Zhao, Henan Li, Longyang Jin, Qi Wang, Ruobing Wang, Yawei Zhang, Jiangang Zhang, Hui Wang
Hospital-acquired pneumonia (HAP) is a significant nosocomial infection; data on the distribution and antimicrobial resistance profiles of HAP in China are limited. We included 2827 adult patients with HAP from the Chinese Antimicrobial Resistance Surveillance of Nosocomial Infections network admitted in 15 Chinese teaching hospitals between 2007 and 2016. Clinical data and antimicrobial susceptibility of isolated pathogens were obtained from the medical records and central laboratory, respectively. Multivariable logistic regression was performed to determine the risk factors for mortality and multidrug resistance (MDR)...
October 7, 2020: European Journal of Clinical Microbiology & Infectious Diseases
Stephen J Evans, Aled E L Roberts, Andrew Conway Morris, A John Simpson, Llinos G Harris, Dietrich Mack, Rowena E Jenkins, Thomas S Wilkinson
Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of ventilator-associated pneumonia (VAP). Patients with VAP have poorly functioning neutrophils, related to increased levels of the complement fragment C5a. The antibiotic linezolid has been useful in controlling MRSA-related VAP infections; however clinical benefit does not always correlate with antimicrobial effect, suggesting the possibility of immunomodulatory properties. Here the effects of linezolid on healthy and dysfunctional neutrophils (modelled by C5a-induced injury) was investigated...
October 2, 2020: Scientific Reports
Agnieszka Litwin, Olga Fedorowicz, Wieslawa Duszynska
Introduction: In recent years, an increase in healthcare-associated infections (HAIs) caused by resistant pathogens, which is a clinically troublesome trend, has been observed. The aim of the study was to analyze the microbial factors of HAIs and the drug resistance of microorganisms to selected antibiotics and their consumption. Material and Methods: The retrospective study included 3708 patients hospitalized in the intensive care unit (ICU) of the University Teaching Hospital in Wroclaw, who were diagnosed with 742 HAIs in the period from 1 January 2011 to 31 December 2018...
September 23, 2020: International Journal of Environmental Research and Public Health
M Kolář, L Doubravská
The paper provides clear definitions of the basic concepts of nosocomial pneumonias. Specifically, definitions and classifications of HAP and VAP, general treatment principles and specific recommended procedures for antibiotic therapy are given as applicable in the Czech Republic.
2020: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Adam P Wagner, Virve I Enne, David M Livermore, Jean V Craig, David A Turner
BACKGROUND: Hospital-acquired pneumonia (HAP) is pneumonia occurring ≥48 hours after admission; it is the most common hospital-acquired infection contributing to death. Ventilator-associated pneumonia (VAP) arises ≥48-72 hours after intubation. Opinions differ on whether VAP is a HAP subset; the same pathogens predominate in both. Compared with VAP-free controls, patients developing VAP are twice as likely to die, and have significantly longer ICU stays. Guidelines recommend that microbiological cultures should guide antibiotic treatment, but these lack sensitivity and take 48-72 hours to process, meaning that initial therapy must be empiric, generally with broad-spectrum agents...
September 21, 2020: Journal of Hospital Infection
Kashif Hussain, Muhammad Sohail Salat, Gul Ambreen, Ambreen Mughal, Sidra Idrees, Mehreen Sohail, Javaid Iqbal
BACKGROUND: Recently intravenous (IV) and aerosolized (ASZ) colistin have been used for treating ventilator-associated pneumonia (VAP) due to colistin susceptible multidrug-resistant Gram-negative bacteria (MDR-GNB). Colistin has limited lung penetration. We compared the efficacy and safety of IV-alone versus IV+ASZ-colistin for treating VAP in neonates. METHODS: This retrospective matched case-control-study was performed at NICU of the Aga Khan University Hospital, Pakistan between January 2015 and December 2018...
September 7, 2020: Expert Opinion on Drug Safety
Amanda C Zangirolami, Lucas D Dias, Kate C Blanco, Carolina S Vinagreiro, Natalia M Inada, Luis G Arnaut, Mariette M Pereira, Vanderlei S Bagnato
Hospital-acquired infections are a global health problem that threatens patients' treatment in intensive care units, causing thousands of deaths and a considerable increase in hospitalization costs. The endotracheal tube (ETT) is a medical device placed in the patient's trachea to assist breathing and delivering oxygen into the lungs. However, bacterial biofilms forming at the surface of the ETT and the development of multidrug-resistant bacteria are considered the primary causes of ventilator-associated pneumonia (VAP), a severe hospital-acquired infection for significant mortality...
August 31, 2020: Proceedings of the National Academy of Sciences of the United States of America
Dongni Hou, Mohan Ju, Ying Wang, Donghui Zhang, Duming Zhu, Ming Zhong, Chenjun Zhou, Yuanlin Song, Xunjia Cheng
Etiological diagnosis is essential for anti-infective therapy in patients with ventilator-associated pneumonia (VAP). The present study aimed to evaluate the capacity of sequential PCR coupled to electrospray ionization mass spectrometry (PCR/ESI-MS) tests as a rapid diagnostic technique for patients with VAP. A total of 12 patients diagnosed with VAP were enrolled at the intensive care unit in Zhongshan Hospital, Fudan University. Mini-bronchoalveolar lavage fluid specimens were prospectively collected on VAP 0, 5 and 10 days following the beginning of mechanical ventilation...
October 2020: Experimental and Therapeutic Medicine
Patricia Cornejo-Juárez, Ivan González-Oros, Paola Mota-Castañeda, Diana Vilar-Compte, Patricia Volkow-Fernández
BACKGROUND: Patients with cancer have several risk factors for developing respiratory failure requiring mechanical ventilation (MV). The emergence of multidrug resistant bacteria (MDRB) has become a public health problem, creating a new burden on medical care in hospitals, particularly for patients admitted to the intensive care unit (ICU). AIM: To describe risk factors for ventilator-acquired pneumonia (VAP) in patients with cancer and to evaluate the impact of MDRB...
August 7, 2020: World Journal of Critical Care Medicine
Otavio T Ranzani, Ana Motos, Chiara Chiurazzi, Adrian Ceccato, Mariano Rinaudo, Gianluigi Li Bassi, Miquel Ferrer, Antoni Torres
BACKGROUND: There is no clear guidance on empiric antibiotic coverage against Staphylococcus aureus (S. aureus) for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). OBJECTIVES: To evaluate if the presence of clusters of Gram-positive cocci in Gram staining of respiratory samples predicts S. aureus as HAP/VAP pathogen. DATA SOURCES: MEDLINE, PubMed, Embase, Scielo, CINAHL and Scopus, from inception to 15/07/2017 (update on 31/10/2019) and original data from a single-centre database (PROSPERO: CRD42017072138)...
August 18, 2020: Clinical Microbiology and Infection
Thalita Bento Talizin, Cláudia Maria Dantas de Maio Carrilho, Cintia Magalhães Carvalho Grion, Lucienne Tibery Queiroz Cardoso, Marcos Toshiyuki Tanita, Karine Maria Boll, Ivanil Aparecida Moro Kauss, Josiane Festti, Camila Ribeiro Lopes, Leticia Maria Alves da Silva, Isabella Patruceli de Azevedo, Késia Paes, Eduardo Alexandrino Medeiros
OBJECTIVES: To analyse the use of polymyxins for the treatment of ventilator-associated pneumonia (VAP) at a teaching hospital where carbapenem-resistant gram-negative bacteria are endemic. PATIENTS AND METHODS: This was a historical cohort study of patients receiving polymyxins to treat VAP in ICUs at a public university hospital in southern Brazil between January 1, 2017 and January 31, 2018. RESULTS: During the study period, 179 cases of VAP were treated with polymyxins...
2020: PloS One
Dilip D Karad, Yogesh Somani, Hemant Khande, Bipin Yadav, Arun S Kharat
The emergence of resistance against commonly used antibiotics has become a serious global concern. The rapid development of antibiotic resistance exhibited by Enterobacteriaceae has caused an increasing concern regarding untreatable bacterial infections. Here, we isolated four pathogens from a geriatric female patient who was hospitalized for a month with ventilator-associated pneumonia (VAP) and fever. The organisms isolated from the tracheal aspirates and urine included Klebsiella pneumoniae, pandrug-resistant Providencia rettgeri, and Acinetobacter baumannii...
July 31, 2020: Acta Biochimica Polonica
Daniela Bandić-Pavlović, Tajana Zah-Bogović, Marta Žižek, Luka Bielen, Vesna Bratić, Pero Hrabač, Domagoj Slačanac, Slobodan Mihaljević, Branka Bedenić
Ventilator-associated pneumonia (VAP) is a serious and common complication in patients admitted to intensive care unit (ICU) and contributes to mortality. Multidrug Gram-negative bacteria such as Acinetobacter baumannii , Pseudomonas aeruginosa, and Klebsiella pneumoniae are frequently associated with VAP in ICU. A prospective study was set up in three ICUs of the University Hospital Center Zagreb and one ICU in General Hospital Pula from September 2017 to March 2018. Antibiotic susceptibility was determined by broth microdilution method...
July 30, 2020: Journal of Chemotherapy
Weiping Liu, Tianhui Guo, Haoxue Li, Yuping Zhao, Kai Zhang, Yunting Hai, Yueying Jiao, Huimin Xing, Binbin Xu, Haibo Bai, Huan Bao, Shuai Zhang, Wei Ren, Lifang Yang, Huijun Yang, Junwei Tian, Meng Wang, Yongfang Yang
BACKGROUND: Healthcare-associated infection (HAI) is a crucial factor influencing medical quality. Studies about HAI management situations are rare, especially for the Inner Mongolia region of China. Therefore, this study aimed to investigate management procedures and the overall evaluation of HAI in order to inform HAI management improvement more scientifically. METHODS: A questionnaire was used to investigate HAI-related prevention and control indicators in tertiary hospitals in the Inner Mongolia region from July 2018 to June 2019...
July 14, 2020: Annals of Palliative Medicine
Céline Monard, Jonathan Pehlivan, Gabriel Auger, Sophie Alviset, Alexy Tran Dinh, Paul Duquaire, Nabil Gastli, Camille d'Humières, Adel Maamar, André Boibieux, Marion Baldeyrou, Julien Loubinoux, Olivier Dauwalder, Vincent Cattoir, Laurence Armand-Lefèvre, Solen Kernéis
BACKGROUND: Improving timeliness of pathogen identification is crucial to allow early adaptation of antibiotic therapy and improve prognosis in patients with pneumonia. We evaluated the relevance of a new syndromic rapid multiplex PCR test (rm-PCR) on respiratory samples to guide empirical antimicrobial therapy in adult patients with community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), and ventilator-acquired pneumonia (VAP). METHODS: This retrospective multicenter study was conducted in four French university hospitals...
July 14, 2020: Critical Care: the Official Journal of the Critical Care Forum
Ignacio Martin-Loeches
It is widely known that pneumonia (either community acquired or hospital acquired, as like ventilator associated pneumonia (VAP)), is the most frequent type of severe infection and continues to pose a significant burden on healthcare services worldwide. Despite new diagnostic developments, most pneumonia cases continue to be difficult to diagnose clinically, partly due to acquired antibiotic resistance and the lack of a 'gold standard' method of diagnosis. In other words, the lack of a rapid, accurate diagnostic test, as well as the uncertainty of the initial etiologic diagnosis and the risk stratification, results in empirical antibiotic treatments...
July 5, 2020: Antibiotics
Chiara Robba, Paola Rebora, Erika Banzato, Eveline J A Wiegers, Nino Stocchetti, David K Menon, Giuseppe Citerio
BACKGROUND: No large prospective data are available on ventilator-associated pneumonia (VAP) in patients with traumatic brain injury (TBI). RESEARCH QUESTION: To evaluate the incidence, timing and risk factors of VAP after TBI and its effect on patients' outcome. STUDY DESIGN: and Methods: Analysis of the CENTER-TBI dataset, a large, multicenter, prospective, observational study including TBI patients admitted to European intensive care units (ICU), mechanically ventilated for ≥48 hours, and with an ICU length of stay (LOS) ≥72 hours...
July 4, 2020: Chest
Luciana F Galhardo, Gilson F Ruivo, Fernanda O Santos, Tamires T Ferreira, Juliana Santos, Mariella Vp L Eão, Debora Pallos
PURPOSE: This study aimed to evaluate the impact of oral care and use of chlorhexidine gluconate on the prevention of ventilator-associated pneumonia (VAP) in patients admitted to an intensive care unit (ICU). MATERIALS AND METHODS: An evaluation was performed on 229 patients admitted to ICU in 2012 (before implementation of oral care protocol) and 329 in 2013 (after the protocol). Oral care was based on the removal of secretions from the oral cavity with 0.12% chlorhexidine solution for brushing and sterile gauze for cleaning before a new aspiration...
April 1, 2020: Oral Health & Preventive Dentistry
Awad Al-Omari, Abbas Al Mutair, Saad Alhumaid, Samer Salih, Ahmed Alanazi, Hesham Albarsan, Maha Abourayan, Maha Al Subaie
Background: Antimicrobial stewardship (AMS) programs have shown to reduce the emergence of antimicrobial resistance (AMR) and health-care-associated infections (HAIs), and save health-care costs associated with an inappropriate antimicrobial use. The primary objective of this study was to compare the consumption and cost of antimicrobial agents using defined daily dose (DDD) and direct cost of antibiotics before and after the AMS program implementation. Secondary objective was to determine the rate of HAIs [ Clostridium difficile ( C...
2020: Antimicrobial Resistance and Infection Control
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