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Valeria Fabre, Joe Amoah, Sara E Cosgrove, Pranita D Tamma
In a multicenter, observational propensity-score weighted cohort of 249 adults with uncomplicated Pseudomonas aeruginosa bloodstream infections, patients receiving short-course (median 9 days, interquartile range [IQR] 8-10) therapy had a similar odds of recurrent infection or death within 30 days as those receiving longer courses (median 16 days, IQR 14-17).
March 18, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Maddalena Giannella, Renato Pascale, Belén Gutiérrez-Gutiérrez, Angela Cano, Pierluigi Viale
Carbapenem-resistant Klebsiella pneumoniae (CR-KP) infections are associated with high morbidity and mortality rates. A therapeutic approach based on the patient risk stratification could improve outcome and avoid antibiotic misuse. Area covered: English literature search, from 2008 to 2018, was done using PubMed database. Risk factors for developing CR-KP infection in several settings were reviewed. Since, rectal carriage was a main risk factor for developing infection, we revised in deep clinical score to predict infection among colonized patients...
March 15, 2019: Expert Review of Anti-infective Therapy
Brett G Mitchell, Lisa Hall, Nicole White, Adrian G Barnett, Kate Halton, David L Paterson, Thomas V Riley, Anne Gardner, Katie Page, Alison Farrington, Christian A Gericke, Nicholas Graves
BACKGROUND: The hospital environment is a reservoir for the transmission of microorganisms. The effect of improved cleaning on patient-centred outcomes remains unclear. We aimed to evaluate the effectiveness of an environmental cleaning bundle to reduce health care-associated infections in hospitals. METHODS: The REACH study was a pragmatic, multicentre, randomised trial done in 11 acute care hospitals in Australia. Eligible hospitals had an intensive care unit, were classified by the National Health Performance Authority as a major hospital (public hospitals) or having more than 200 inpatient beds (private hospitals), and had a health-care-associated infection surveillance programme...
March 8, 2019: Lancet Infectious Diseases
Keith S Kaye, Louis B Rice, Aaron Dane, Viktor Stus, Olexiy Sagan, Elena Fedosiuk, Anita Das, David Skarinsky, Paul B Eckburg, Evelyn J Ellis-Grosse
BACKGROUND: ZTI-01 (fosfomycin for injection) is an epoxide antibiotic with a differentiated mechanism of action (MOA) inhibiting an early step in bacterial cell wall synthesis. ZTI-01 has broad in vitro spectrum of activity, including multidrug-resistant Gram-negative pathogens, and is being developed for treatment of complicated urinary tract infection (cUTI) and acute pyelonephritis (AP) in the United States. METHODS: Hospitalized adults with suspected or microbiologically confirmed cUTI/AP were randomized 1:1 to 6 g ZTI-01 q8h or 4...
March 6, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Philip A Pizzo
The association between fever and neutropenia and the risk for life-threatening infections in patients receiving cytotoxic chemotherapy has been known for 50 years. Indeed, infectious complications have been a leading cause of morbidity and mortality in patients with cancer. This review chronicles the progress in defining and developing approaches to the management of fever and neutropenia through observational and controlled clinical trials done by single institutions, as well as by national and international collaborative groups...
March 12, 2019: Annals of Internal Medicine
Roni Bitterman, Emilia Hardak, Marina Raines, Anat Stern, Tzila Zuckerman, Yishai Ofran, Noa Lavi, Luda Guralnik, Avraham Frisch, Olga Nudelman, Mical Paul, Ilana Oren
Invasive pulmonary aspergillosis (IPA) has dire consequences in hemato-oncological patients. We report our experience with performing routine baseline chest computed tomography for early diagnosis of IPA. We found high rates of proven or probable IPA diagnosed on admission among patients with newly diagnosed acute myeloid leukemia.
March 11, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Susan S Huang, Edward Septimus, Ken Kleinman, Julia Moody, Jason Hickok, Lauren Heim, Adrijana Gombosev, Taliser R Avery, Katherine Haffenreffer, Lauren Shimelman, Mary K Hayden, Robert A Weinstein, Caren Spencer-Smith, Rebecca E Kaganov, Michael V Murphy, Tyler Forehand, Julie Lankiewicz, Micaela H Coady, Lena Portillo, Jalpa Sarup-Patel, John A Jernigan, Jonathan B Perlin, Richard Platt
BACKGROUND: Universal skin and nasal decolonisation reduces multidrug-resistant pathogens and bloodstream infections in intensive care units. The effect of universal decolonisation on pathogens and infections in non-critical-care units is unknown. The aim of the ABATE Infection trial was to evaluate the use of chlorhexidine bathing in non-critical-care units, with an intervention similar to one that was found to reduce multidrug-resistant organisms and bacteraemia in intensive care units...
March 4, 2019: Lancet
Monira Sharif, Chris Ho Ming Wong, Amer Harky
Sternal wound infection (SWI) is one of the potential complications post cardiac surgery, and despite refined surgical techniques such as smaller incisions, antibiotic therapy, and optimised glycaemic control, the incidence rate is between <1% in elective cases with low risk factors and as high as 25% in patients with extensive risk factors. The presence of SWI will increase the perioperative morbidity and mortality rates and prolong the patient's hospital stay, therefore the prevention and diagnosis with appropriate management of such adverse outcomes at an early stage is important to prevent further progression as it can be fatal when the mediastinal structures are affected...
February 2, 2019: Heart, Lung & Circulation
Catia Cillóniz, Cristina Dominedò, Antoni Torres
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2019. Other selected articles can be found online at . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from .
March 9, 2019: Critical Care: the Official Journal of the Critical Care Forum
Aleksandra Leligdowicz, Michael A Matthay
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2019. Other selected articles can be found online at . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from .
March 9, 2019: Critical Care: the Official Journal of the Critical Care Forum
Maria Krutikov, Ananna Rahman, Simon Tiberi
PURPOSE OF REVIEW: Necrotizing pneumonia is a severe form of community-acquired pneumonia characterized by rapid progression of consolidation to necrosis and cavitation which may lead to pulmonary gangrene. Morbidity and mortality are high and chronic sequelae are frequent. The lack of guidance supports the review of the latest recommendations in the management of these pneumonias. RECENT FINDINGS: Antibiotic therapy alone may not be enough to alter the course of the infection, and regimens, adjunctive therapies like intravenous immunoglobulins, surgery may be required to alter the course of the disease especially with pulmonary gangrene...
February 26, 2019: Current Opinion in Pulmonary Medicine
Pranita D Tamma, Yohei Doi, Robert A Bonomo, J Kristie Johnson, Patricia J Simner
Understanding the nuances of AmpC β-lactamase mediated resistance can be challenging - even for the infectious diseases specialist. AmpC resistance can be classified into three categories: (a) inducible chromosomal resistance that emerges in the setting of a β-lactam compound, (b) stable derepression due to mutations in ampC regulatory genes, or (c) the presence of plasmid-mediated ampC genes. This review will mainly focus on inducible AmpC resistance in Enterobacteriaceae. Although several observational studies have explored optimal treatment for AmpC producers, few provide reliable insights into effective management approaches...
March 6, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Kimberly C Claeys, Natalia Blanco, Daniel J Morgan, Surbhi Leekha, Kaede V Sullivan
PURPOSE OF REVIEW: Urinary tract infections (UTIs), including catheter-associated UTIs, are among the most common bacterial infections in both inpatient and outpatient settings. Diagnosis of true UTI remains a clinical challenge, and excessive antimicrobial treatment of asymptomatic bacteriuria (ASB) or contaminated urine cultures is common. RECENT FINDINGS: Challenges with the appropriate diagnosis of UTIs include the lack of specific signs and symptoms, no definitive diagnostic criteria, high incidence of ASB, contamination of samples, and frequent lack of indications for ordering urine cultures...
March 5, 2019: Current Infectious Disease Reports
Timothy M Uyeki, Henry H Bernstein, John S Bradley, Janet A Englund, Thomas M File, Alicia M Fry, Stefan Gravenstein, Frederick G Hayden, Scott A Harper, Jon Mark Hirshon, Michael G Ison, B Lynn Johnston, Shandra L Knight, Allison McGeer, Laura E Riley, Cameron R Wolfe, Paul E Alexander, Andrew T Pavia
No abstract text is available yet for this article.
March 5, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Adrien Bouglé, Olivier Dujardin, Victoria Lepère, Nora Ait Hamou, Charles Vidal, Guillaume Lebreton, Joe-Elie Salem, Najoua El-Helali, Grégoire Petijean, Julien Amour
No abstract text is available yet for this article.
March 1, 2019: Anaesthesia, Critical Care & Pain Medicine
Satoshi Shibata, Toshiaki Kikuchi
Pneumocystis pneumonia (PCP) is an opportunistic disease that mainly affects patients with a deficiency of cell-mediated immunity, especially acquired immunodeficiency syndrome (AIDS). The incidence of PCP in these patients has declined substantially owing to the widespread use of antiretroviral therapy and PCP prophylaxis. However, PCP is still a major AIDS-related opportunistic infection, particularly in patients with advanced immunosuppression in whom human immunodeficiency virus type 1 (HIV-1) infection remains undiagnosed or untreated...
February 26, 2019: Respiratory Investigation
Mark E Nunnally, Arpit Patel
PURPOSE OF REVIEW: Sepsis-3 guidelines have implications in a deeper understanding of the biopathology of the disease. Further, the review focuses on timely topics and new literature on fluid resuscitation, the value of steroids in sepsis, and new therapeutic options such as angiotensin II, vitamin C, and thiamine as well as the emerging role of procalcitonin (PCT) in managing antibiotics. RECENT FINDINGS: Traditional therapies such as type of crystalloid fluid administration and steroid therapy for sepsis are currently under re-evaluation...
April 2019: Current Opinion in Anaesthesiology
Abrar K Thabit, Dania F Fatani, Maryam S Bamakhrama, Ola A Barnawi, Lana O Basudan, Shahad F Alhejaili
Treatment of bone and joint infections can be challenging as antibiotics should penetrate through the rigid bone structure and into the synovial space. Several pharmacokinetic studies measured the extent of penetration of different antibiotics into bone and joint tissues. This review discusses the results of these studies and compares them with minimum inhibitory concentrations (MIC) of common pathogens implicated in bone and joint infections in order to determine which antibiotics may have a greater potential in the treatment of such infections...
February 14, 2019: International Journal of Infectious Diseases: IJID
Wei Min Huang, Xu An Huang, Yan Ping Du, Liu Xia Li, Fang Fang Wu, Shao Qing Hong, Fang Xuan Tang, Zhang Qiang Ye
Background: Microaspiration of secretions around the tracheal cuff is a multifactorial process. Tracheal cuff shape might take a major part in its occurrence. The rationale for producing a taper-shaped cuff is established on the assumption that compared to a conventional cuff with a single fixed diameter, a continuum of minimum-to-maximum diameter sections might better fit the tracheal walls. Objectives: The primary objective of this meta-analysis was to compare ventilator-associated pneumonia (VAP) between tapered-cuff intubation and conventional-cuff intubation...
2019: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Roger Davies, Kieran O'Dea, Anthony Gordon
Immune therapy to ease the burden of sepsis has thus far failed to consistently improve patient outcomes. Advances in cancer immune therapy and awareness that prolonged immune-suppression in sepsis can leave patients vulnerable to secondary infection and death have driven resurgence in the field of sepsis immune-therapy investigation. As we develop and evaluate these novel therapies, we must learn from past experiences where single-mediator targeted immune therapies were blindly delivered to heterogeneous patient cohorts with complex and evolving immune responses...
November 2018: Journal of the Intensive Care Society
2019-02-27 03:52:23
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