In Vitro Evaluation of Cefpirome: An Australasian Study of Isolates from Intensive Care Unit and Hematology/Oncology Patients

BACKGROUNDFor alcohol-based hand rubs, the currently recommended application time of 30 seconds is longer than the actual time spent in clinical practice. We investigated whether a shorter application time of 15 seconds is microbiologically safe in neonatal intensive care and may positively influence compliance with the frequency of hand antisepsis actions.METHODSWe conducted in vitro experiments to determine the antimicrobial efficacy of hand rubs within 15 seconds, followed by clinical observations to assess the effect of a shortened hand antisepsis procedure under clinical conditions in a neonatal intensive care unit (NICU). An independent observer monitored the frequency of hand antisepsis actions during shifts.RESULTSAll tested hand rubs fulfilled the requirement of equal or even significantly higher efficacy within 15 seconds when compared to a reference alcohol propan-2-ol 60% (v/v) within 30 seconds. Microbiologically, reducing the application time to 15 seconds had a similar effect when compared to 30-second hand rubbing, but it resulted in significantly increased frequency of hand antisepsis actions (7.9±4.3 per hour vs 5.8±2.9 per hour; P=.05).CONCLUSIONTime pressure and workload are recognized barriers to compliance. Therefore, reducing the recommended time for hand antisepsis actions, using tested and well-evaluated hand rub formulations, may improve hand hygiene compliance in clinical practice.Infect Control Hosp Epidemiol 2017;38:1430–1434

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The in vitro activity of cefotaxime versus bacteria involved in selected infections of hospitalized patients outside of the intensive care unit

Diagnostic Microbiology and Infectious Disease ◽

10.1016/0732-8893(95)00050-k ◽

1995 ◽

Vol 22 (1-2) ◽

pp. 13-17 ◽

Cited By ~ 9

Author(s):

Gary V. Doern

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hospitalized Patients ◽

Vitro Activity ◽

In Vitro Activity

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Pressure-Limited Ventilation of Infants with Low-Compliance Lungs: The Efficacy of an Adult Circle System Versus Two Free-Standing Intensive Care Unit Ventilator Systems Using an In Vitro Model

Anesthesia & Analgesia ◽

10.1097/00000539-199909000-00017 ◽

1999 ◽

Vol 89 (3) ◽

pp. 638 ◽

Cited By ~ 3

Author(s):

G. W. Stevenson ◽

Babette Horn ◽

Michael Tobin ◽

Edwin H. Chen ◽

Michael Sautel ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

In Vitro Model ◽

Free Standing ◽

System Versus ◽

Vitro Model

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Serratia marcescans Contamination of Antiseptic Soap Containing Triclosan: Implications for Nosocomial Infection

Infection Control ◽

10.1017/s0195941700060690 ◽

1984 ◽

Vol 5 (9) ◽

pp. 427-430 ◽

Cited By ~ 29

Author(s):

M. Anita Barry ◽

Donald E. Craven ◽

Theresa A. Goularte ◽

Deborah A. Lichtenberg

Keyword(s):

Intensive Care Unit ◽

Pseudomonas Aeruginosa ◽

Intensive Care ◽

Nosocomial Infection ◽

Surgical Intensive Care Unit ◽

Minimal Bactericidal Concentration ◽

Surgical Intensive Care ◽

Time Kill ◽

The Impact

Abstract During a recent investigation in our surgical intensive care unit, we found that several bottles of the antiseptic handwashing soap, OR Scrub®, were contaminated with Serratia marcescens. OR Scrub® contains 1% triclosan, lanolin, and detergents. The antimicrobial efficacy of OR Scrub® was examined in vitro using serial two-fold dilutions of soap inoculated with various concentrations of different nosocomial pathogens. The minimal bactericidal concentration (MBC) of OR Scrub® against Pseudomonas aeruginosa and several strains of S. marcescens was ≤1:2 By comparison, a non-antiseptic soap from the same manufacturer (Wash®) and 4% chlorhexidine (Hibiclens®) had MBCs for all strains tested of at least 1:64. Time-kill curves confirmed the findings of the initial experiments.This is the first report of extrinsic contamination of antiseptic soap containing triclosan. No infections could be attributed to the contaminated soap, but sporadic outbreaks of Serratia have occurred in the intensive care unit with no identifiable source. Although there have been few studies on the impact of antiseptic soap in reducing nosocomial infection, we question whether a soap with the limitations of OR Scrub® should be used in intensive care units or operating rooms.

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Accurate Measurement of Functional Residual Capacity and Oxygen Consumption of Patients on Mechanical Ventilation

Anaesthesia and Intensive Care ◽

10.1177/0310057x8301100212 ◽

1983 ◽

Vol 11 (2) ◽

pp. 151-157 ◽

Cited By ~ 4

Author(s):

Kevin R. Cooper ◽

Peter A. Boswell

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Oxygen Consumption ◽

Functional Residual Capacity ◽

Lung Model ◽

Capacity Measurement ◽

Icu Patients ◽

Residual Capacity

We developed an apparatus and technique for the simultaneous measurement of functional residual capacity and oxygen uptake (V̇O2) for use in intensive care unit (ICU) patients. The accuracy of the functional residual capacity measurement was proven using an in vitro lung model and the reproducibility of this measurement was established by use in ICU patients. We tested the accuracy of the V̇O2 measurement in comparison with two other methods in common use among ICU patients and our method proved accurate. We conclude that this technique for measurement of functional residual capacity and V̇O2 is highly accurate and easily applied to patients on any mode of mechanical ventilation.

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Removal of Remdesivir’s Metabolite GS-441524 by Hemodialysis in a Double Lung Transplant Recipient with COVID-19

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01521-20 ◽

2020 ◽

Vol 64 (11) ◽

Cited By ~ 5

Author(s):

Minh Patrick Lê ◽

Quentin Le Hingrat ◽

Pierre Jaquet ◽

Paul-Henri Wicky ◽

Vincent Bunel ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Lung Transplant ◽

Multiple Organ ◽

Therapeutic Options ◽

Viable Option ◽

Transplant Patients ◽

Organ Dysfunctions

ABSTRACT Remdesivir has reported efficacy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro and in vivo. Drug-drug interactions limit therapeutic options in transplant patients. Remdesivir and its metabolite GS-441524 are excreted principally in urine. In intensive care unit (ICU) settings, in which multiple-organ dysfunctions can occur rapidly, hemodialysis may be a viable option for maintaining remdesivir treatment, while improving tolerance, by removing both remdesivir’s metabolite (GS-441524) and sulfobutylether β-cyclodextrin sodium (SEBCD). Additional studies may prove informative, particularly in the evaluations of therapeutic options for coronavirus disease 2019 (COVID-19).

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Pediatric Cancer Outcomes in an Intensive Care Unit in Pakistan

Journal of Global Oncology ◽

10.1200/jgo.18.00215 ◽

2019 ◽

pp. 1-5

Author(s):

Gull Zareen Khan Sial ◽

Saadiya Javed Khan

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Developing Countries ◽

Intensive Care ◽

Pediatric Oncology ◽

Retrospective Chart Review ◽

Developed Countries ◽

Therapeutic Interventions ◽

Disease Stage ◽

Oncology Patients

PURPOSE Although cancer is uncommon, it is a significant cause of pediatric morbidity and mortality in the developing world. The need for intensive care in pediatric oncology has increased with more intense chemotherapeutic interventions. It is important to identify patients who will benefit from management in the intensive care unit (ICU), given the resource limitation in developing countries. In this review, we examine our institutional experience with pediatric patients with cancer needing ICU care. METHODS A retrospective chart review from December 2015 to June 2017 was performed with institutional review board approval for all pediatric oncology patients admitted to the ICU. Data collection included age, diagnosis, disease stage, Pediatric Risk of Mortality (PRISM III) score, and therapeutic interventions. RESULTS We reviewed 59 pediatric oncology ICU medical records. There were 36 boys (61%) and 23 girls (39%). The median age was 4 years. Average stay in the ICU was 4.6 days. Three significant reasons for ICU referral were respiratory distress, sepsis, and circulatory collapse. There were 34 ICU survivors (57.6%). Among those who survived the ICU, 20 patients (58.8%) later died of therapy-related complications. Factors related to increased ICU mortality included the need for mechanical ventilation, the need for inotropic support, the number of failing organs, and a high PRISM III score. CONCLUSION The mortality rate for pediatric oncology patients admitted to the ICU in developing countries is higher than in developed countries. Mortality was significantly related to the need for mechanical ventilation. PRISM III scoring can help identify patients who can benefit from ICU treatment, which is expensive in resource-limited low- and middle-income countries such as Pakistan.

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