Antibiotic Decisions in the ICU: A Dragon’s Tale

Medical decision-making about antibiotic use in critically ill patients is challenging and complex. The need for antibiotic stewardship requires judicious prescription and choice of antimicrobials, as the need for effective... read more

Utility of Adjunct Antibiotics After I+D – Systematic Review + Meta-Analysis

Skin and soft tissue abscesses are a common emergency department (ED) presentation. The approach to management has changed little in recent decades: incision and drainage (I+D) and then discharge home with follow up. However,... read more

Current efforts to fight sepsis aren’t working. We need a bolder approach

Thanks to antibiotics, vaccinations, and public health advances like modern sanitation, it's easy to think that Americans live largely free of the infectious diseases that once took such a toll. That’s partially right:... read more

Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile

The hospital environment is a source of pathogen transmission. The effect of enhanced disinfection strategies on the hospital-wide incidence of infection has not been investigated in a multicentre, randomised controlled trial.... read more

Association of the Quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) Score With Excess Hospital Mortality in Adults With Suspected Infection in Low- and Middle-Income Countries

In this retrospective secondary analysis of 9 diverse LMIC cohorts that included 6569 hospitalized adults with suspected infection, a qSOFA score greater than or equal to 2 was significantly associated with increased likelihood... read more

Whole Blood – More than the Sum of Its Components?

This retrospective analysis was conducted in a US Military population across 6 combat hospitals in Iraq and Afghanistan between January 2004 and October 2007. Patient's transfused at least 1 unit RBCs met inclusion criteria... read more

A 10-year review of total hospital onset ICU bloodstream infections at an Academic Medical Center

Across all ICUs, the rates of primary BSIs progressively fell from 2.11/1000 patient days in FY05 to 0.32/1000 patient days in FY14; an 85.0% decrease (P<0.0001). Secondary BSIs also progressively decreased from 3.56/1000... read more

Assessment of Clinical Criteria for Sepsis

The Third International Consensus Definitions Task Force defined sepsis as "life-threatening organ dysfunction due to a dysregulated host response to infection." The performance of clinical criteria for this sepsis definition... read more

Low-dose Corticosteroids for Adult Patients with Septic Shock

The results of this systematic review provide an evidence summary to inform clinicians regarding decisions to use corticosteroids in adult patients with septic shock. We found that assignment to treatment with corticosteroids... read more

Blood Cultures Drawn From Arterial Catheters Are Reliable for the Detection of Bloodstream Infection in Critically Ill Children

Arterial catheters may serve as an additional source for blood cultures in children when peripheral venipuncture is challenging. The aim of the study was to evaluate the accuracy of cultures obtained through indwelling arterial... read more

Can A Cocktail Of Vitamins And Steroids Cure A Major Killer In Hospitals?

Scientists have launched two large studies to test a medical treatment that, if proven effective, could have an enormous impact on the leading cause of death in American hospitals. The treatment is aimed at sepsis, a condition... read more

ECMO in Sepsis

In this episode, Zack talks with Heidi Dalton about ECMO use in Sepsis. This is another controversial area with pediatric literature showing strong results while the adult results have been less impressive. Heidi has been... read more

Petition to Retire the Surviving Sepsis Campaign Guidelines

Concern regarding the Surviving Sepsis Campaign (SSC) guidelines dates back to their inception. Guideline development was sponsored by Eli Lilly and Edwards Life Sciences as part of a commercial marketing campaign. Throughout... read more

Epidemiology of Sepsis in Turkish ICUs

The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms,... read more

Diagnosis of Sepsis from a Drop of Blood by Measurement of Spontaneous Neutrophil Motility in a Microfluidic Assay

Current methods for the diagnosis of sepsis have insufficient precision, causing regular misdiagnoses. Microbiological tests can help to diagnose sepsis, but are usually too slow to have an impact on timely clinical decision-making.... read more

Excess dietary zinc worsens Clostridium difficile infection

The consumption of dietary supplements and cold therapies containing high concentrations of zinc is now being called into question, following research that suggests it may worsen Clostridium difficile infection. The findings... read more

Is It CHF? Sepsis? Something Else?

A 59-year-old morbidly obese woman with a history of congestive heart failure presented with three days of intermittent chest discomfort. She characterized it as heartburn—a mid-epigastric burning sensation radiating up... read more

Risk of Recurrence After Surviving Severe Sepsis

Risk of recurrence after surviving severe sepsis is substantial regardless of patient characteristics or infection sites. Further research is necessary to find underlying mechanisms for the high risk of recurrence in these... read more

Empiric Antibiotics Tend To Be Prolonged in ICU

Using antibiotics in critically ill patients is very much walking a tightrope. No one wants to miss an infection in a patient who could go downhill quickly, but no one wants to overuse these precious drugs, either.... read more

The Emerging Role of the Microbiota in the ICU

The importance of the intestinal and lung microbiotas is often overlooked on the ICU. Currently, we can explore the microbiome using a vast array of techniques, giving us 'meta' libraries of data, which has allowed researchers... read more

Risk Factors for HAI After Pediatric Cardiac Surgery

Mechanical ventilation greater than or equal to 3 days, dopamine use, genetic abnormality, and delayed sternal closure were associated with healthcare-associated infections after pediatric cardiac surgery. Since the use of... read more