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https://read.qxmd.com/read/30778827/augmented-renal-clearance-a-common-condition-in-critically-ill-children
#1
Tatjana Van Der Heggen, Evelyn Dhont, Harlinde Peperstraete, Joris R Delanghe, Johan Vande Walle, Peter De Paepe, Pieter A De Cock
BACKGROUND: Augmented renal clearance (ARC), an increase in kidney function with enhanced elimination of circulating solute, has been increasingly recognized in critically ill adults. In a pediatric intensive care setting, data are scarce. The primary objective of this study was to investigate the prevalence of ARC in critically ill children. Secondary objectives included a risk factor analysis for the development of ARC and a comparison of two methods for assessment of renal function...
February 18, 2019: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://read.qxmd.com/read/30778624/monitoring-of-tobramycin-serum-concentrations-in-selected-critically-ill-patients-receiving-selective-decontamination-of-the-digestive-tract-a-retrospective-evaluation
#2
J E Möhlmann, M van Luin, E M Mascini, H J van Leeuwen, M R de Maat
INTRODUCTION: Selective decontamination of the digestive tract (SDD) is a strategy in mechanically ventilated patients to reduce mortality. Treatment consists of enterally administered non-absorbable antibiotics, i.e., tobramycin. However, most intensive care unit (ICU) patients with SDD appear to have detectable tobramycin serum concentrations. The Rijnstate Hospital implemented a protocol for therapeutic drug monitoring (TDM) of tobramycin in patients at risk. The aim of this study was to evaluate the necessity of TDM in these patients and to optimize the current protocol...
February 18, 2019: European Journal of Clinical Pharmacology
https://read.qxmd.com/read/30778301/description-of-clinical-characteristics-of-vap-patients-in-mimic-database
#3
Qingqing Liu, Jin Yang, Jun Zhang, Fanfan Zhao, Xiaojie Feng, Xue Wang, Jun Lyu
Background: Ventilator-associated pneumonia (VAP) is a common and serious nosocomial infection of intensive-care units (ICUs). Accurate, timely diagnosis enables early VAP patients to receive appropriate therapies and reduce the occurrence of complication. However, so far clinical datas regarding the epidemiology and mortality of VAP are still limited. Medical Information Mart for Intensive Care (MIMIC) database is a free, open and public resource about ICU research database. MIMIC database is a free, open, public database that collects information on more than 40,000 ICU patients who are predominantly white people...
2019: Frontiers in Pharmacology
https://read.qxmd.com/read/30774399/the-impact-of-initial-antibiotic-treatment-failure-real-world-insights-in-patients-with-complicated-health-care-associated-intra-abdominal-infection
#4
Pascale Peeters, Kellie Ryan, Sudeep Karve, Danielle Potter, Elisa Baelen, Sonia Rojas-Farreras, Jesús Rodríguez-Baño
Purpose: The RECOMMEND study (NCT02364284; D4280R00005) assessed the clinical management patterns and treatment outcomes associated with initial antibiotic therapy (IAT; antibiotics administered ≤48 hours post-initiation of antibiotic therapy) for health care-associated infections across five countries. Patients and methods: Data were collected from a retrospective chart review of patients aged ≥18 years with health care-associated complicated intra-abdominal infection (cIAI)...
2019: Infection and Drug Resistance
https://read.qxmd.com/read/30773722/vitamin-d-supplemented-yogurt-drink-reduces-candida-infections-in-a-paediatric-intensive-care-unit-a-randomised-placebo-controlled-clinical-trial
#5
J Xie, L Zhu, T Zhu, Y Jian, Y Ding, M Zhou, X Feng
BACKGROUND: The prevalence of Candida infections in paediatric intensive care units (PICUs) has dramatically increased as a result of resistance to conventional anti-fungal treatments. Because vitamin D has been shown to exhibit fungicidal activity against Candida infection in an in vitro antimicrobial screening, we aimed to investigate the effect of vitamin D on Candida infections in the PICU. METHODS: Four hundred sixteen eligible children aged between 12 months to 5 years old admitted to the PICU, who were on broad-spectrum antibiotic therapy, participated in the study...
February 18, 2019: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://read.qxmd.com/read/30772341/events-within-the-first-year-of-life-but-not-the-neonatal-period-affect-risk-for-later-development-of-inflammatory-bowel-diseases
#6
Charles N Bernstein, Charles Burchill, Laura E Targownik, Harminder Singh, Leslie L Roos
BACKGROUND & AIMS: We performed a population-based study to determine whether there was an increased risk of inflammatory bowel diseases (IBD) in persons with critical events at birth and within 1 year of age. METHODS: We collected data from the University of Manitoba IBD Epidemiology Database, which contains records on all Manitobans diagnosed with IBD from 1984 through 2010 and matched controls. From 1970 individuals' records can be linked with those of their mothers, so we were able to identify siblings...
February 14, 2019: Gastroenterology
https://read.qxmd.com/read/30767829/healthcare-provider-diagnostic-testing-practices-for-identification-of-clostridioides-clostridium-difficile-in-children-an-emerging-infections-network-survey
#7
Larry K Kociolek, Preeta K Kutty, Philip M Polgreen, Susan E Beekmann
OBJECTIVE: To characterize healthcare provider diagnostic testing practices for identifying Clostridioides (Clostridium) difficile infection (CDI) and asymptomatic carriage in children. DESIGN: Electronic survey. METHODS: An 11-question survey was sent by e-mail or facsimile to all pediatric infectious diseases (PID) members of the Infectious Diseases Society of America's Emerging Infections Network (EIN). RESULTS: Among 345 eligible respondents who had ever responded to an EIN survey, 196 (57%) responded; 162 of these (83%) were aware of their institutional policies for CDI testing and management...
February 15, 2019: Infection Control and Hospital Epidemiology
https://read.qxmd.com/read/30767809/association-of-a-blood-culture-utilization-intervention-on-antibiotic-use-in-a-pediatric-intensive-care-unit
#8
Anna C Sick-Samuels, Charlotte Z Woods-Hill, James C Fackler, Pranita D Tamma, Sybil A Klaus, Elizabeth E Colantuoni, Aaron M Milstone
Blood cultures are essential for the evaluation of sepsis. However, they may sometimes be obtained inappropriately, leading to high false-positive rates, largely due to contamination.1 As a quality improvement project, clinician decision-support tools for evaluating patients with fever or signs and symptoms of sepsis were implemented in April 2014 in our pediatric intensive care unit (PICU). This initiative resulted in a 46% decrease in blood culture obtainment2 and has been replicated in other institutions...
February 15, 2019: Infection Control and Hospital Epidemiology
https://read.qxmd.com/read/30767176/community-acquired-fulminant-colitis-caused-by-binary-toxin-producing-clostridium-difficile-in-japan
#9
Noriaki Oguri, Akihito Sakuraba, Hiromu Morikubo, Oki Kikuchi, Taro Sato, Soutaro Tokunaga, Shintaro Minowa, Osamu Ikezaki, Tatsuya Mitsui, Miki Miura, Daisuke Saito, Mari Hayashida, Hideaki Mori, Takako Osaki, Shigeru Kamiya, Mitsutoshi Senoh, Haru Kato, Tadakazu Hisamatsu
We report a case of community-acquired fulminant colitis caused by Clostridium difficile in Japan. A 46-year-old woman was diagnosed with severe infectious enterocolitis and was admitted at another hospital. The stool culture was positive for toxigenic C. difficile. Since the patient presented with fulminant C. difficile infection (CDI) with toxic megacolon, respiratory insufficiency, and circulatory failure, she was transferred to Kyorin University Hospital for intensive care. Intubation and antibiotic therapy were performed...
February 14, 2019: Clinical Journal of Gastroenterology
https://read.qxmd.com/read/30765285/retrospective-study-of-pneumonia-due-to-panton-valentine-leukocidin-producing-staphylococcus-aureus-in-reunion
#10
C Vanhecke, R Girerd, M Dujardin, N Zemali, R Manaquin, P Duport, N Traversier, K Mougin-Damour, D Vandroux
OBJECTIVE: Panton-Valentine leukocidin-producing Staphylococcus aureus necrotizing pneumonia is an unusual cause of community-acquired pneumonia, although associated with a high case fatality. This infection mainly affects young individuals, without any history, and is most often preceded by flu-like symptoms. METHOD: We focused on patients presenting with Staphylococcus aureus necrotizing pneumonia in Reunion (Indian Ocean) admitted to the emergency department...
February 11, 2019: Médecine et Maladies Infectieuses
https://read.qxmd.com/read/30763978/-antibiotic-treatment-of-infections-in-burn-patients-a-systematic-review
#11
K S Houschyar, C Tapking, D Duscher, C Wallner, A Sogorski, S Rein, D Pförringer, G Reumuth, K Weissenberg, G Grieb, L K Branski, F Siemers, B Behr, M Lehnhardt
BACKGROUND: Due to the loss of the natural skin barrier function with reduced immune competence as a result of a plasma loss and the numerous intensive care interventions, burn patients are particularly at risk for infection. STUDY DESIGN: systematic review METHODS: A systematic review of German and English literature between 1990 and 2018 analyzes the epidemiological and diagnostic aspects as well as the therapeutic use of antibiotics in infections of burn patients in clinical trials...
February 14, 2019: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://read.qxmd.com/read/30763841/veterinary-pharmaceutical-residues-in-water-resources-and-tap-water-in-an-intensive-husbandry-area-in-france
#12
Lise Charuaud, Emilie Jardé, Anne Jaffrézic, Marine Liotaud, Quentin Goyat, Fabien Mercier, Barbara Le Bot
In intensive livestock areas, veterinary pharmaceutical residues (VPRs) can occur in water resources, but also in tap water because treatment processes are not designed to remove these contaminants. The main objective of this study is to assess the occurrence of VPRs in water resources and tap waters in Brittany. As several identical compounds are used in both veterinary and human medicine, a toolbox (stanols and pharmaceuticals) is used to help determine the origin of contamination in the case of mixed-use molecules...
January 24, 2019: Science of the Total Environment
https://read.qxmd.com/read/30761948/invasive-fungal-infection-in-crtically-ill-patients-hurdles-and-next-challenges
#13
Peral José, Francisco Alvarez-Lerma, Emilio Maseda, Pedro Olaechea, Javier Pemán, Cruz Soriano, Rafael Zaragoza
A narrative review from a multidisciplinary task force of experts in critical care medicine and clinical mycology was carried out. The multi drug-resistant species Candida auris has emerged simultaneously on several continents, causing hospital outbreaks, especially in critically ill patients. Although there are not enough data to support the routine use of continuous antibiotic prophylaxis in patients subjected to extracorporeal membrane oxygenator, a clear increase of invasive fungal infection (IFI) has been described with the use of this device...
February 14, 2019: Journal of Chemotherapy
https://read.qxmd.com/read/30760225/is-interleukin-6-a-better-predictor-of-successful-antibiotic-therapy-than-procalcitonin-and-c-reactive-protein-a-single-center-study-in-critically-ill-adults
#14
Lorenz Weidhase, Daniel Wellhöfer, Gero Schulze, Thorsten Kaiser, Tim Drogies, Ulrike Wurst, Sirak Petros
BACKGROUND: The aim of this study was to evaluate whether Interleukin-6 (IL-6) could be a faster indicator of treatment success in adults with severe sepsis and septic shock compared to procalcitonin (PCT) and C-reactive protein (CRP). METHODS: Data from adult patients with severe sepsis and septic shock managed at the medical intensive care unit (ICU) of the University Hospital Leipzig between September 2009 and January 2012 were analyzed retrospectively. Values for CRP, PCT and IL-6 on admission as well as after 24 and 48-72 h were collected...
February 13, 2019: BMC Infectious Diseases
https://read.qxmd.com/read/30760041/new-antibiotics-for-the-treatment-of-serious-infections-in-intensive-care-unit-patients
#15
Sebastiano Leone, Marco Cascella, Ilaria Pezone, Marco Fiore
Nowadays, the infections of patients admitted to Intensive Care Units (ICUs) are one of the major public health problems; this is due to several factors, in primis an increase in antibiotic resistance and the inappropriate use of antibiotics. This editorial focuses on both new antibiotics approved by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) in the last decade (2010-2019), and on agents in advanced phase of development that have been developed, or are already approved, for the treatment of serious infections due to multidrug-resistant (MDR) bacteria, both Gram-positive (GPB) and Gram-negative (GNB) bacteria...
February 14, 2019: Current Medical Research and Opinion
https://read.qxmd.com/read/30759805/pes-pathogens-in-severe-community-acquired-pneumonia
#16
REVIEW
Catia Cillóniz, Cristina Dominedò, Antonello Nicolini, Antoni Torres
Worldwide, there is growing concern about the burden of pneumonia. Severe community-acquired pneumonia (CAP) is frequently complicated by pulmonary and extra-pulmonary complications, including sepsis, septic shock, acute respiratory distress syndrome, and acute cardiac events, resulting in significantly increased intensive care admission rates and mortality rates. Streptococcus pneumoniae (Pneumococcus) remains the most common causative pathogen in CAP. However, several bacteria and respiratory viruses are responsible, and approximately 6% of cases are due to the so-called PES ( Pseudomonas aeruginosa , extended-spectrum β-lactamase Enterobacteriaceae , and methicillin-resistant Staphylococcus aureus ) pathogens...
February 12, 2019: Microorganisms
https://read.qxmd.com/read/30759094/an-attention-based-deep-learning-model-of-clinical-events-in-the-intensive-care-unit
#17
Deepak A Kaji, John R Zech, Jun S Kim, Samuel K Cho, Neha S Dangayach, Anthony B Costa, Eric K Oermann
This study trained long short-term memory (LSTM) recurrent neural networks (RNNs) incorporating an attention mechanism to predict daily sepsis, myocardial infarction (MI), and vancomycin antibiotic administration over two week patient ICU courses in the MIMIC-III dataset. These models achieved next-day predictive AUC of 0.876 for sepsis, 0.823 for MI, and 0.833 for vancomycin administration. Attention maps built from these models highlighted those times when input variables most influenced predictions and could provide a degree of interpretability to clinicians...
2019: PloS One
https://read.qxmd.com/read/30755094/abundance-and-removal-of-antibiotic-resistance-genes-args-in-the-rearing-environments-of-intensive-shrimp-aquaculture-in-south-china
#18
Linglong Wang, Haochang Su, Xiaojuan Hu, Yu Xu, Wujie Xu, Xiaoshuai Huang, Zhuojia Li, Yucheng Cao, Guoliang Wen
Although research regarding antibiotic resistance genes (ARGs) in aquaculture environments has gained increasing scientific interest, further studies are required to understand the abundances and removal mechanisms of ARGs during the entire rearing period of shrimp aquaculture. Thus, in this study, abundances, distributions and removal rates of ARGs in different environmental compartments of intensive shrimp farms in South China were investigated during the entire rearing period. The results indicated that sul1 and cmlA were the predominant ARGs in the water and sediment samples...
February 12, 2019: Journal of Environmental Science and Health. Part. B, Pesticides, Food Contaminants, and Agricultural Wastes
https://read.qxmd.com/read/30754087/sepsis-and-septic-shock-current-approaches-to-management
#19
Kelly Thompson, Balasubramanian Venkatesh, Simon Finfer
Sepsis, defined as life-threatening organ dysfunction due to a dysregulated host response to infection, is recognised by the World Health Organization as a global health priority. Each year, 5000 of the 18 000 adults with sepsis treated in Australian intensive care units die, with survivors suffering long-term physical, cognitive and psychological dysfunction, which is poorly recognised and frequently untreated. There are currently no effective pharmacological treatments for sepsis, making early recognition, resuscitation and immediate treatment with appropriate antibiotics the key to reducing the burden of resulting disease...
February 2019: Internal Medicine Journal
https://read.qxmd.com/read/30747739/donor-related-nontuberculous-mycobacterial-interface-infection-after-descemet-membrane-endothelial-keratoplasty
#20
Ruben Van Landeghem, Beatrijs Foets, Stefanie Desmet, Maarten Vanhaecke, Minh-Tri Hua
PURPOSE: To describe the first reported case of Mycobacterium chelonae-related interface keratitis after Descemet membrane endothelial keratoplasty (DMEK), successfully treated with DMEK exchange. METHODS: A case of donor-related DMEK interface keratitis, treated with medical therapy and DMEK exchange, was studied retrospectively. RESULTS: A patient with Fuchs endothelial dystrophy developed infectious interface keratitis after DMEK. In cultures of the donor cornea transport medium, M...
February 7, 2019: Cornea
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