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(ICU OR intensive care* OR critical*) AND (antibiotic OR antiinfective OR antimicrobial)

Lucy Foulston
Natural products are a rich source of bioactive compounds that have been used successfully in the areas of human health from infectious disease to cancer; however, traditional fermentation-based screening has provided diminishing returns over the last 20-30 years. Solutions to the unmet need of resistant bacterial infection are critically required. Technological advances in high-throughput genomic sequencing, coupled with ever-decreasing cost, are now presenting a unique opportunity for the reinvigoration of natural product discovery...
February 15, 2019: Current Opinion in Microbiology
Zhilong Yu, Wei Wang, Fanbin Kong, Mengshi Lin, Azlin Mustapha
Cellulose nanofibrils (CNFs) and silver nanoparticles (AgNPs) are nano-sized fillers widely used for enhancing the active functions of food packaging materials. However, nanomaterials may pose unexpected toxic effects on humans. Thus, the objective of this work was to develop a novel CNF/AgNP composite and investigate its properties and cytotoxicity. The CNF/AgNP composite was prepared via a reduction method using NaBH4 . The AgNPs embedded in the composite showed an average size of 10.72 ± 4.96 nm and a surface plasmon resonance (SPR) absorption peak at 397 nm...
February 15, 2019: International Journal of Biological Macromolecules
Joseph R Paonessa, Raj D Shah, Chiagozie I Pickens, Bryan D Lizza, Helen K Donnelly, Michael Malczynski, Chao Qi, Richard G Wunderink
BACKGROUND: Guidelines recommend empirical vancomycin or linezolid for suspected pneumonia patients at-risk for methicillin-resistant Staphylococcus aureus (MRSA). Unneeded vancomycin or linezolid use may unnecessarily alter host flora and expose patients to toxicity. We therefore sought to determine if rapid testing for MRSA in bronchoalveolar lavage (BAL) can safely decrease use of vancomycin or linezolid for suspected MRSA pneumonia. METHODS: Operating characteristics of the assay were initially validated against culture on residual BAL...
February 15, 2019: Chest
Brittney N V Scott, Tina Sarkar, Rachel M Kratofil, Paul Kubes, Ajitha Thanabalasuriar
It has long been appreciated that understanding the interactions between the host and the pathogens that make us sick is critical for the prevention and treatment of disease. As antibiotics become increasingly ineffective, targeting the host and specific bacterial evasion mechanisms are becoming novel therapeutic approaches. The technology used to understand host-pathogen interactions has dramatically advanced over the last century. We have moved away from using simple in vitro assays focused on single-cell events to technologies that allow us to observe complex multicellular interactions in real time in live animals...
February 18, 2019: Journal of Leukocyte Biology
Nathan Kuppermann, Peter S Dayan, Deborah A Levine, Melissa Vitale, Leah Tzimenatos, Michael G Tunik, Mary Saunders, Richard M Ruddy, Genie Roosevelt, Alexander J Rogers, Elizabeth C Powell, Lise E Nigrovic, Jared Muenzer, James G Linakis, Kathleen Grisanti, David M Jaffe, John D Hoyle, Richard Greenberg, Rajender Gattu, Andrea T Cruz, Ellen F Crain, Daniel M Cohen, Anne Brayer, Dominic Borgialli, Bema Bonsu, Lorin Browne, Stephen Blumberg, Jonathan E Bennett, Shireen M Atabaki, Jennifer Anders, Elizabeth R Alpern, Benjamin Miller, T Charles Casper, J Michael Dean, Octavio Ramilo, Prashant Mahajan
Importance: In young febrile infants, serious bacterial infections (SBIs), including urinary tract infections, bacteremia, and meningitis, may lead to dangerous complications. However, lumbar punctures and hospitalizations involve risks and costs. Clinical prediction rules using biomarkers beyond the white blood cell count (WBC) may accurately identify febrile infants at low risk for SBIs. Objective: To derive and validate a prediction rule to identify febrile infants 60 days and younger at low risk for SBIs...
February 18, 2019: JAMA Pediatrics
Eric R Coon, Ricardo A Quinonez, Daniel J Morgan, Sanket S Dhruva, Timmy Ho, Nathan Money, Alan R Schroeder
Importance: Efforts to combat medical overuse have gained traction in recent years, but success has been intermittent and shortcomings have been recognized. A commitment to a strong evidence base is needed to more broadly engage clinicians and reduce overuse. Observations: A structured MEDLINE search and a manual review of tables of contents from selected high-impact journals was performed to identify original research published in 2017 relevant to pediatric overuse...
February 18, 2019: JAMA Pediatrics
Soma Mandal, Samuel Njikan, Anuradha Kumar, Julie V Early, Tanya Parish
Bacterial persisters are a subpopulation of cells that exhibit phenotypic resistance during exposure to a lethal dose of antibiotics. They are difficult to target and thought to contribute to the long treatment duration required for tuberculosis. Understanding the molecular and cellular biology of persisters is critical to finding new tuberculosis drugs that shorten treatment. This review focuses on mycobacterial persisters and describes the challenges they pose in tuberculosis therapy, their characteristics and formation, how persistence leads to resistance, and the current approaches being used to target persisters within mycobacterial drug discovery...
February 18, 2019: Microbiology
Sofia Maraki, Grigoris Kastanis, Dimitra Stafylaki, Samer Masunt, Petros Kapsetakis, Effie Scoulica
Introduction: Human pasteurellosis is a severe human infection that accounts for 20-30 human deaths annually worldwide. Mucous secretions derived from pets comprise the primary source of infection, which are transmitted through animal scratches or bites. Case report: We describe a case of Pasteurella multocida wound infection in an immunocompetent adult with a decubitus ulcer of the lower extremity. The organism was also isolated from an oral swab of the patient's dog with which he reported close contact...
December 2018: Germs
Ranjana Beniwal, Lalit Kumar Gupta, Ashok Kumar Khare, Asit Mittal, Sharad Mehta, Manisha Balai
Background: Cutaneous adverse drug reactions (CADRs) are probably the most frequent of all manifestations of drug sensitivity. As a considerable number of new drugs are periodically introduced into the market, the incidence of CADR is likely to increase. The pattern of CADR and the causative drugs is likely to change accordingly. There is no uniformly accepted and reliable method of objectively assessing the causal link between drug and adverse reaction. Aim: To study the clinical patterns and causative drugs and compare causality assessment [World Health Organization (WHO) and Naranjo algorithm] of CADR among patients attending the dermatology department...
January 2019: Indian Dermatology Online Journal
Merilin Rosenberg, Krunoslav Ilić, Katre Juganson, Angela Ivask, Merja Ahonen, Ivana Vinković Vrček, Anne Kahru
This review was initiated by the COST action CA15114 AMICI "Anti-Microbial Coating Innovations to prevent infectious diseases," where one important aspect is to analyze ecotoxicological impacts of antimicrobial coatings (AMCs) to ensure their sustainable use. Scopus database was used to collect scientific literature on the types and uses of AMCs, while market reports were used to collect data on production volumes. Special attention was paid on data obtained for the release of the most prevalent ingredients of AMCs into the aqueous phase that was used as the proxy for their possible ecotoxicological effects...
2019: PeerJ
Helena Rosengren, Clare F Heal, Petra G Buettner
Background: Surgical site infection (SSI) rates for below-knee dermatological surgery are unacceptably high, particularly following complex flap and graft closures. The role of antibiotic prophylaxis for these surgical cases is uncertain. Objective: To determine whether SSI following complex dermatological closures on the leg could be reduced by antibiotic prophylaxis administered as a single oral preoperative dose. Methods: A total of 115 participants were randomized to 2 g of oral cephalexin or placebo 40-60 minutes prior to surgical incision in a prospective, randomized, double-blind, placebo-controlled trial at a primary care skin cancer clinic in North Queensland, Australia...
January 2019: Dermatology Practical & Conceptual
Isaac Ginsburg, Maya Korem, Erez Koren, James Varani
We postulate that the extensive cell and tissue damage inflicted by many infectious, inflammatory and post-inflammatory episodes is an enled result of a synergism among the invading microbial agents, host neutrophils and dead and dying cells in the nidus. Microbial toxins and other metabolites along with the plethora of pro-inflammatory agents released from activated neutrophils massively recruited to the infectious sites and high levels of cationic histones, other cationic peptides, proteinases and Th1 cytokines released from activated polymorphonuclear neutrophils (PMNs) and from necrotized tissues may act in concert (synergism) to bring about cell killing and tissue destruction...
2019: Journal of Inflammation Research
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
Sabine Zeidler, Volker Müller
Multidrug resistant (MDR) pathogens are one of the most pressing challenges of contemporary health care. Acinetobacter baumannii takes a predominant position, emphasized in 2017 by the World Health Organization. The increasing emergence of MDR strains strengthens the demand for new antimicrobials. Possible targets for such compounds might be proteins involved in resistance against low water activity environments, since A. baumannii is known for its pronounced resistance against desiccation stress. Despite the importance of desiccation resistance for persistence of this pathogen in hospitals, comparable studies and precise data on this topic are rare and the mechanisms involved are largely unknown...
February 17, 2019: Environmental Microbiology
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
E Álvarez Artero, A Campo Nuñez, M Garcia Bravo, O Cores Calvo, M Belhassen Garcia, J Pardo Lledias
INTRODUCTION: Urinary tract infections (UTIs) are one of the most frequent infections. In the elderly, they have multiple comorbidities. The objective of this work is to describe the clinical and microbiological epidemiology of elderly persons admitted for UTIs and to evaluate the suitability of empirical treatments and their implications regarding mortality. MATERIAL AND METHODS: An observational study was conducted during 2013-2015 in 4public hospitals, with patients older than 65 years who were admitted to the Internal Medicine service with a microbiological diagnosis of UTI...
February 14, 2019: Revista Clínica Española
Johan S Sáenz, Tamires Valim Marques, Rafael Simões Coelho Barone, José Eurico Possebon Cyrino, Susanne Kublik, Joseph Nesme, Michael Schloter, Susanne Rath, Gisle Vestergaard
BACKGROUND: Aquaculture is on the rise worldwide, and the use of antibiotics is fostering higher production intensity. However, recent findings suggest that the use of antibiotics comes at the price of increased antibiotic resistance. Yet, the effect of the oral administration of antibiotics on the mobility of microbial resistance genes in the fish gut is not well understood. In the present study, Piaractus mesopotamicus was used as a model to evaluate the effect of the antimicrobial florfenicol on the diversity of the gut microbiome as well as antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs) using a metagenomic approach...
February 18, 2019: Microbiome
Latania K Logan, Rachel L Medernach, T Nicholas Domitrovic, Jared R Rispens, Andrea M Hujer, Nadia K Qureshi, Steven H Marshall, David C Nguyen, Susan D Rudin, Xiaotian Zheng, Sreenivas Konda, Robert A Weinstein, Robert A Bonomo
INTRODUCTION: The pandemic of extended-spectrum beta-lactamase-(ESBL)-producing Enterobacteriaceae (Ent) is strongly linked to the dissemination of CTX-M-type-ESBL-Ent. We sought to define the epidemiology of infections in children due to an emerging resistance type, CTX-M-9-group-producing-Ent (CTX-M-9-grp-Ent). METHODS: A retrospective matched case-control analysis of children with CTX-M-9-grp-Ent infections who received medical care at three Chicago area hospitals was performed...
February 16, 2019: Infectious Diseases and Therapy
Raymond O'Connor, Jane O'Doherty, Andrew O'Regan, Aoife O'Neill, Claire McMahon, Colum P Dunne
OBJECTIVES: The purpose of this study was to examine the expectations of patients attending an urban primary care out-of-hours (OOH) facility with acute upper respiratory tract infection (acute URTI) regarding clinical examination, symptom management, information on their condition, reassurance, antibiotic treatment and other possible options including referral. DESIGN: Cross-sectional design. SETTING: One urban primary care OOH facility located in the midwest of Ireland...
February 15, 2019: BMJ Open
Dominique Pepper, Junfeng Sun, Chanu Rhee, Judith Welsh, John H Powers, Robert L Danner, Sameer S Kadri
BACKGROUND: Procalcitonin (PCT)-guided antibiotic discontinuation appears to decrease antibiotic use in critically ill patients, but its impact on survival remains less certain. METHODS: We searched PubMed, EMBASE, Scopus, Web of Science, and CENTRAL for RCTs of PCT-guided antibiotic discontinuation in critically ill adults reporting survival or antibiotic duration. Searches were conducted without language restrictions from inception to 07/23/2018. Two reviewers independently conducted all review stages; another adjudicated differences...
February 14, 2019: Chest
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