Tag: infection
A hospital-wide intervention replacing ceftriaxone with cefotaxime to reduce rate of HAI in the ICU
Over the last decades, the incidence of healthcare-associated infections (HAI) caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) involved in poor outcomes has dramatically increased worldwide.... read more
Procalcitonin-Guided Antimicrobial Therapy in Critical Care
Procalcitonin guidance for antibiotic cessation improves short-term mortality in ICU patients. Previous meta-analyses showed that procalcitonin-guided antimicrobial management, compared with standard care, resulted in less... read more
Steroids in Septic Shock – Four Misconceptions and One Truth
The utility of steroids in sepsis has been debated passionately for decades. There is hope that steroids might improve mortality, but also fear that they could increase infectious complications. Practice varies widely. What... read more
The association between intravenous fluid resuscitation and mortality in older emergency department patients with suspected infection
Recent studies suggest that hypotension thresholds in current guidelines might be too low for older patients due to arterial stiffening, possibly leading to insufficient fluid resuscitation. We compared intravenous (IV) fluid... read more
Poor Communication Between Physicians and Nurses Linked to Patient Catheter Issues
Communication is contextual, and improving physician-nurse communication about appropriate catheter use may require innovations that address the identified contextual barriers. Several barriers to communication between physicians... read more
Sepsis: Personalization vs. Protocolization?
The history of intensive care has been littered with too many false dawns. Old management dogma, now derided, have been replaced by new and equally resolute convictions, many of which will, in time, undoubtedly follow a similar... read more
Get Well Soon: History’s Worst Plagues and the Heroes Who Fought Them
A witty, irreverent tour of history's worst plagues―from the Antonine Plague, to leprosy, to polio―and a celebration of the heroes who fought them. In 1518, in a small town in Alsace, Frau Troffea began dancing and... read more
Variation in Identifying Sepsis and Organ Dysfunction Using Administrative Versus Electronic Clinical Data and Impact on Hospital Outcome Comparisons
Variation in the accuracy of claims data for identifying sepsis and organ dysfunction limits their use for comparing hospitals' sepsis rates and outcomes. Using objective clinical data may facilitate more meaningful hospital... read more
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
