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antibiotic care

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
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
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
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
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
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
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
Karthik Madhavan, Lee Onn Chieng, Valerie L Armstrong, Michael Y Wang
OBJECTIVEDiscitis and osteomyelitis are seen in end-stage renal disease (ESRD) patients due to repeated vascular access for hemodialysis and urinary tract infections leading to recurrent bacteremia. Discitis and osteomyelitis are underdiagnosed due to the nonspecific initial presentation of back pain. In this article, we review the literature for better understanding of the problem and the importance of early diagnosis by primary care physicians and nephrologists. In addition, we discuss the decision-making, follow-up, management, and neurological outcomes...
February 15, 2019: Journal of Neurosurgery. Spine
Gloria Hui Min Cheng, Claris Jia-Yi Shi, Beatrice Jia Ying Lee, Kevin Boon Leong Lim
Cast immobilization is a noninvasive and effective option in the treatment of fractures in children. However, its use can be associated with complications, such as pressure sores, skin infections, thermal injuries, and joint stiffness. In clinical practice, retained foreign objects in casts are not uncommon. This study aims to ascertain reasons for foreign objects being retained in casts and their effects on the skin. Eighteen children with retained foreign objects in their casts were identified and interviewed...
February 12, 2019: Journal of Pediatric Orthopedics. Part B
Chanu Rhee, Travis M Jones, Yasir Hamad, Anupam Pande, Jack Varon, Cara O'Brien, Deverick J Anderson, David K Warren, Raymund B Dantes, Lauren Epstein, Michael Klompas
Importance: Sepsis is present in many hospitalizations that culminate in death. The contribution of sepsis to these deaths, and the extent to which they are preventable, is unknown. Objective: To estimate the prevalence, underlying causes, and preventability of sepsis-associated mortality in acute care hospitals. Design, Setting, and Participants: Cohort study in which a retrospective medical record review was conducted of 568 randomly selected adults admitted to 6 US academic and community hospitals from January 1, 2014, to December 31, 2015, who died in the hospital or were discharged to hospice and not readmitted...
February 1, 2019: JAMA network open
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
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
Abdulrahman Hakami, Evita Zwartkruis, Teodora Radonic, Johannes M A Daniels
BACKGROUND: Pulmonary carcinoids are included in the group of neuroendocrine tumors (NET) and derive from pulmonary neuroendocrine cells. The incidence of these tumors is increasing, but disease awareness remains low among clinicians. The synchronous presentation of lung cancer and mycobacterial infection is well known but the combination of pulmonary carcinoid and mycobacterial infection is rare. CASE PRESENTATION: We treated a 45-year-old female who presented with recurrent pneumonia...
February 15, 2019: BMC Pulmonary Medicine
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
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
Danielle Walsh, Robert Gekle, Robert Bramante, Eric Decena, Christopher Raio, David Levy
The sepsis order set at our institution was created with the intent to facilitate the prompt initiation of appropriate sepsis care. Once clinical features meeting criteria for systemic inflammatory response syndrome (SIRS) are identified and an infectious source is considered, a "sepsis huddle" is concomitantly initiated. The sepsis huddle was implemented in March of 2016 in order to increase compliance with the sepsis bundles. The sepsis huddle is called via overhead paging system in the emergency department (ED) to notify all staff that there is a patient present who meets SIRS criteria with concern for sepsis requiring immediate attention...
February 7, 2019: American Journal of Emergency Medicine
Janneke Evelyne Stalenhoef, Cees van Nieuwkoop, Darius Cameron Wilson, Willize Elizabeth van der Starre, Tanny J K van der Reijden, Nathalie Manon Delfos, Eliane Madeleine Sophie Leyten, Ted Koster, Hans Christiaan Ablij, Johannes Jan Willem van 't Wout, Jaap Tamino van Dissel
BACKGROUND: A reduction in duration of antibiotic therapy is crucial in minimizing the development of antimicrobial resistance, drug-related side effects and health care costs. The minimal effective duration of antimicrobial therapy for febrile urinary tract infections (fUTI) remains a topic of uncertainty, especially in male patients, those of older age or with comorbidities. Biomarkers have the potential to objectively identify the optimal moment for cessation of therapy. METHODS: A secondary analysis of a randomized placebo-controlled trial among 35 primary care centers and 7 emergency departments of regional hospitals in the Netherlands...
February 14, 2019: BMC Infectious Diseases
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
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