Practical Management of Invasive Candidiasis in Critically Ill Patients

The heterogeneity of this patient population necessitated the creation of a mixed working group comprising experts in clinical microbiology, infectious diseases and intensive care medicine, all chosen on the basis of their... read more

Sustained reduction of catheter-associated bloodstream infections with enhancement of catheter bundle by chlorhexidine dressings over 11 years

The addition of chlorhexidine dressings to all CVC and arterial lines to an ongoing catheter bundle was associated with a sustained 11-year reduction of all catheter-associated bloodstream infections. This large real-world... read more

How and Whom to Monitor for Seizures in an ICU

Prevalence of seizures detected by continuous electroencephalography was significantly higher than with routine electroencephalography. Prevalence was particularly high in post convulsive status epilepticus, CNS infection,... read more

The Glutamine Debate in Surgery and Critical Care

Three recent meta-analyses have confirmed traditional glutamine (GLN)-supplemented (or "GLN-Complemented" – providing GLN for completeness of amino acid content) TPN is safe, reduces mortality and improves outcome in surgical... read more

How to Deal with Severe Acute Pancreatitis in the Critically Ill

Management of severe acute pancreatitis (SAP) is multimodal with emphasis on monitoring, adequate fluid resuscitation, avoiding prophylactic use of antibiotics, cause-directed procedures or treatment, and organ support. There... read more

Defining Sepsis on the Wards

The aim of this study is to look at the prevalence (commonness) of sepsis across acute hospitals (hospitals with an emergency department) across Wales using the currently used and new definitions of sepsis. Sepsis is a major... read more

New Approaches Reduces Inappropriate Antibiotic Usage

A UC Davis study of 9 emergency departments and urgent care centers in California and Colorado found educating physicians and patients about safe antibiotic use can cut overuse by 30%. The study, funded under a contract from... read more

Post-discharge Impact of Healthcare-associated Infections in a Developing Country

The impact of healthcare-associated infections (HCAIs) on in-hospital mortality, morbidity, length-of-stay, and costs has been extensively reported. However, few studies have focused on the follow-up of HCAI-affected subjects... read more

Antibiotics for Sepsis

Antibiotics for Sepsis - Does Each Hour Really Count? Or is it Incestuous Amplification? - by Prof Mervyn Singer "Each hour's delay in initiating antibiotics costs lives" is a doctrine that has attained quasi religious status.... read more

In-hospital Mortality Associated with the Misdiagnosis or Unidentified Site of Infection at Admission

Rapid detection, early resuscitation, and appropriate antibiotic use are crucial for sepsis care. Accurate identification of the site of infection may facilitate a timely provision of appropriate care. We aimed to investigate... read more

Identifying At-Risk Patients for Sub-optimal Beta-lactam Exposure in Critically Ill Patients with Severe Infections

Conventional beta-lactam dosing is flawed in critically ill patients. Useful tools such as the MeroRisk Calculator need to be comprehensively evaluated clinically, and if successful should be added into clinical practice... read more

The Epidemiology of Symptomatic Catheter-associated Urinary Tract Infections in the ICU

Catheter-associated urinary tract infection (CAUTI) occurs frequently in critical illness with significant morbidity, mortality, and additional hospital costs. The epidemiology of symptomatic ward-acquired CAUTI (within 48... read more

Environment key battle ground in fight to tackle antibiotic resistance

The environment could be as important a battle ground as the clinic in the global fight against the spread of antibiotic resistance, new research has shown. A study conducted at the University of Exeter Medical School concluded... read more

Cost-effectiveness analysis of initial treatment strategies for mild-to-moderate Clostridium difficile infection in hospitalized patients

A decision-analytic model revealed vancomycin to be cost-effective, compared with metronidazole, for treatment of initial episodes of mild-to-moderate Clostridium difficile infection (CDI) in adult inpatients. From the hospital... read more

Risk Factors at Index Hospitalization Associated With Longer-term Mortality in Adult Sepsis Survivors

In this cohort study of 94 748 adult sepsis survivors, age, male sex, 1 or more severe comorbidities, prehospitalization dependency, nonsurgical status, acute severity of illness, site of infection, and organ dysfunction... read more

Antibiotics, Immunosuppressive Drugs and the Downfall of the Human Immune System

Today I'll discuss two more factors that can debilitate the human immune system (allowing the microbiome to better cause disease). They are antibiotics (when used too frequently) and immunosuppressive drugs: two of the most... read more

Placards Do Not Improve Hand Hygiene Adherence

Hand hygiene placards posted in a Denver hospital — including one that featured an image of two eyes looking directly at the viewer with a reminder to clean their hands — did not result in measurable improvements in hand... read more

Addressing Shortcomings in Infection and Sepsis Treatment Should Be Top of the Priority List

Hospitals are increasingly facing the challenge of cutting costs while also improving clinical outcomes. This is certainly true in the infectious disease sector, as unrecognized or ineffectively treated bacterial infections... read more

Closed ICU Model Linked to 100% Reduction in Several HAIs

A closed intensive care unit model, in which a patient is evaluated and admitted under an intensivist and patient care orders are written by ICU staff, can help reduce rates of several healthcare-associated infections (HAI),... read more

Early Sepsis Screening in the Emergency Department

This single-center retrospective analysis shows promising results with NEWS as a screening tool primarily because it can be done at triage and does not require any laboratory evaluation. This study adds to the current knowledge... read more

Sedation Practice in ECMO-Treated Patients with ARDS

Our objective was to characterize sedation management in adult patients with severe respiratory distress syndrome (ARDS) treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). We conducted a retrospective... read more

A Positive Fluid Balance is an Independent Prognostic Factor in Patients with Sepsis

Intravenous fluid administration is an essential component of sepsis management, but a positive fluid balance has been associated with worse prognosis. We analyzed whether a positive fluid balance and its persistence over... read more