scholarly journals Nosocomial Bacteremia Caused by Antibiotic‐Resistant Gram‐Negative Bacteria in Critically Ill Patients: Clinical Outcome and Length of Hospitalization

2002 ◽  
Vol 34 (12) ◽  
pp. 1600-1606 ◽  
Author(s):  
Stijn Blot ◽  
Koenraad Vandewoude ◽  
Dirk De Bacquer ◽  
Francis Colardyn
Keyword(s):  
Clinical Outcome ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Gram Negative Bacteria ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Nosocomial Bacteremia ◽  
Length Of Hospitalization

scholarly journals Population Pharmacokinetic Analysis of Colistin Methanesulfonate and Colistin after Intravenous Administration in Critically Ill Patients with Infections Caused by Gram-Negative Bacteria

2009 ◽  
Vol 53 (8) ◽  
pp. 3430-3436 ◽  
Author(s):  
D. Plachouras ◽  
M. Karvanen ◽  
L. E. Friberg ◽  
E. Papadomichelakis ◽  
A. Antoniadou ◽  
...  
Keyword(s):  
Steady State ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Compartment Model ◽  
Population Pharmacokinetic Analysis ◽  
Pharmacokinetic Analysis ◽  
Population Pharmacokinetic ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Colistin Methanesulfonate

ABSTRACT Colistin is used to treat infections caused by multidrug-resistant gram-negative bacteria (MDR-GNB). It is administered intravenously in the form of colistin methanesulfonate (CMS), which is hydrolyzed in vivo to the active drug. However, pharmacokinetic data are limited. The aim of the present study was to characterize the pharmacokinetics of CMS and colistin in a population of critically ill patients. Patients receiving colistin for the treatment of infections caused by MDR-GNB were enrolled in the study; however, patients receiving a renal replacement therapy were excluded. CMS was administered at a dose of 3 million units (240 mg) every 8 h. Venous blood was collected immediately before and at multiple occasions after the first and the fourth infusions. Plasma CMS and colistin concentrations were determined by a novel liquid chromatography-tandem mass spectrometry method after a rapid precipitation step that avoids the significant degradation of CMS and colistin. Population pharmacokinetic analysis was performed with the NONMEM program. Eighteen patients (6 females; mean age, 63.6 years; mean creatinine clearance, 82.3 ml/min) were included in the study. For CMS, a two-compartment model best described the pharmacokinetics, and the half-lives of the two phases were estimated to be 0.046 h and 2.3 h, respectively. The clearance of CMS was 13.7 liters/h. For colistin, a one-compartment model was sufficient to describe the data, and the estimated half-life was 14.4 h. The predicted maximum concentrations of drug in plasma were 0.60 mg/liter and 2.3 mg/liter for the first dose and at steady state, respectively. Colistin displayed a half-life that was significantly long in relation to the dosing interval. The implications of these findings are that the plasma colistin concentrations are insufficient before steady state and raise the question of whether the administration of a loading dose would benefit critically ill patients.

scholarly journals Colonization and infection by colistin-resistant Gram-negative bacteria in a cohort of critically ill patients

2011 ◽  
Vol 17 (11) ◽  
pp. E9-E11 ◽  
Author(s):  
F. Kontopidou ◽  
D. Plachouras ◽  
E. Papadomichelakis ◽  
G. Koukos ◽  
I. Galani ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Gram Negative Bacteria ◽  
Gram Negative

Colonization Status and Appropriate Antibiotic Therapy for Nosocomial Bacteremia Caused by Antibiotic-Resistant Gram-Negative Bacteria in an Intensive Care Unit

2005 ◽  
Vol 26 (6) ◽  
pp. 575-579 ◽  
Author(s):  
Stijn Blot ◽  
Pieter Depuydt ◽  
Dirk Vogelaers ◽  
Johan Decruyenaere ◽  
Jan De Waele ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antibiotic Therapy ◽  
Empiric Antibiotic Therapy ◽  
Gram Negative Bacteria ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Nosocomial Bacteremia ◽  
Appropriate Therapy ◽  
Colonization Status

AbstractObjective:Timely initiation of antibiotic therapy is crucial for severe infection. Appropriate antibiotic therapy is often delayed for nosocomial infections caused by antibiotic-resistant bacteria. The relationship between knowledge of colonization caused by antibiotic-resistant gram-negative bacteria (ABR-GNB) and rate of appropriate initial antibiotic therapy for subsequent bacteremia was evaluated.Design:Retrospective cohort study.Setting:Fifty-four-bed intensive care unit (ICU) of a university hospital. In this unit, colonization surveillance is performed through routine site-specific surveillance cultures (urine, mouth, trachea, and anus). Additional cultures are performed when presumed clinically relevant.Patients:ICU patients with nosocomial bacteremia caused by ABR-GNB.Results:Infectious and microbiological characteristics and rates of appropriate antibiotic therapy were compared between patients with and without colonization prior to bacteremia. Prior colonization was defined as the presence (detected ≥ 2 days before the onset of bacteremia) of the same ABR-GNB in colonization and subsequent blood cultures. During the study period, 157 episodes of bacteremia caused by ABR-GNB were suitable for evaluation. One hundred seventeen episodes of bacteremia (74.5%) were preceded by colonization. Appropriate empiric antibiotic therapy (started within 24 hours) was administered for 74.4% of these episodes versus 55.0% of the episodes that occurred without prior colonization. Appropriate therapy was administered within 48 hours for all episodes preceded by colonization versus 90.0% of episodes without prior colonization.Conclusion:Knowledge of colonization status prior to infection is associated with higher rates of appropriate therapy for patients with bacteremia caused by ABR-GNB (Infect Control Hosp Epidemiol 2005;26:575-579).

scholarly journals Clinical characteristics and risk factors for the isolation of multi-drug-resistant Gram-negative bacteria from critically ill patients with COVID-19

2021 ◽  
Vol 110 ◽  
pp. 165-171
Author(s):  
A. Baiou ◽  
A.A. Elbuzidi ◽  
D. Bakdach ◽  
A. Zaqout ◽  
K.M. Alarbi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Characteristics ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Gram Negative

scholarly journals Risk factors for bronchial acquisition of resistant Gram-negative bacteria in critically ill patients and outcome

Critical Care ◽  
2012 ◽  
Vol 16 (S1) ◽  
Author(s):  
I Papakonstantinou ◽  
E Perivolioti ◽  
C Vrettou ◽  
I Baraboutis ◽  
E Magira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Gram Negative Bacteria ◽  
Gram Negative
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