Pefloxacin in the treatment of nosocomial lower respiratory tract infections in intensive care patients

1988 ◽  
Vol 21 (6) ◽  
pp. 795-799 ◽  
Author(s):  
C. Martin ◽  
F. Gouin ◽  
F. Fourrier ◽  
W. Junginger ◽  
B. L. Prieur
Keyword(s):  
Intensive Care ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Respiratory Tract Infections ◽  
Intensive Care Patients ◽  
Tract Infections

scholarly journals Burden of multidrug resistant respiratory pathogens in intensive care units of tertiary care hospital

2019 ◽  
Vol 10 (2) ◽  
pp. 14-19 ◽  
Author(s):  
Dharm Raj Bhatta ◽  
Deependra Hamal ◽  
Rajani Shrestha ◽  
Supram HS ◽  
Pushpanjali Joshi ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Tract ◽  
Intensive Care Units ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Bacterial Pathogens ◽  
Multidrug Resistant ◽  
Lower Respiratory Tract Infections ◽  
Acinetobacter Species ◽  
Tract Infections

Background: Lower respiratory tract infections are one of the most common infections among the patients in Intensive Care Units (ICUs). Admission in ICUs and use of life supporting devices increase the risk of infection with multidrug resistant pathogens. Aims and Objectives: This study was aimed to determine the prevalence and antibiograms ofthe bacterial pathogens causing lower respiratory tract infectionsamong patients of ICUs. Materials and Methods: A total of 184 specimens from patients admitted in ICUswith lower respiratory tract infections were included in this study. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Carbapenamase detection was performed by modified Hodge test method.Detection of metallo beta lactamase (MBL) was tested by imipenem and imipenem/EDTA disc. Detection of Klebsiellapneumoniaecarbapenamase (KPC) was performed by imipenem and imipenem/phenyl boronic acid. Results: Out of 184 samples, 131 showed significant growth of bacterial pathogens. Acinetobacter species (42.6%), Staphylococcus aureus (16.9%) and Pseudomonasaeruginosa(13.9%)were the three most common isolates. Out of 22 imipenem resistant isolates of Acientobacter species, 9 were KPC producer, 4 were MBL producers and 3 isolates were positive for MBL and KPC both. Among the Acinetobacter species, 5.1% isolates were resistant to tigecycline and colistin. One isolate of Pseudomonas aeruginosa was positive for MBL. Conclusions:High prevalence of multidrug resistant bacteria in ICUs was recorded. Gram negative bacilli were predominantly associated with LRTI among ICU patients;Acinetobacterspecies being most common isolate. Detection of carbapenamase among the Acinetobacterand emergence of tigecycline resistancelimits the therapeutic options.Regular monitoring of such resistant isolates would be important for managing infection control in critical units.

scholarly journals Hyperimmune globulins in prevention and treatment of respiratory syncytial virus infections.

1995 ◽  
Vol 8 (1) ◽  
pp. 22-33 ◽  
Author(s):  
V G Hemming ◽  
G A Prince ◽  
J R Groothuis ◽  
G R Siber
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Syncytial Virus ◽  
High Risk ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Respiratory Tract Infections ◽  
Syncytial Virus ◽  
Tract Infections

Respiratory syncytial virus (RSV) is an important community and nosocomial respiratory pathogen for infants and young children. RSV causes especially severe disease in the prematurely born or those with chronic cardiopulmonary diseases. Elderly persons and those with T-cell deficiencies, such as bone marrow transplant recipients, are also at high risk for serious lower respiratory tract infections. To date, prevention of RSV infections by vaccination has proven elusive and no preventive drugs exist. Studies in animals and humans have shown that the lower respiratory tract can be protected from RSV infection by sufficient circulating RSV neutralizing antibody levels. Recently, an RSV hyperimmune immune globulin (RSVIG) was developed and tested for the prevention of RSV infections or reduction of disease severity. Passive immunization of high-risk children with RSVIG during the respiratory disease season effected significant reductions in RSV infections, hospitalizations, days of hospitalization, intensive care unit admissions, days in the intensive care unit, and ribavirin use. Studies in cotton rats and owl monkeys show that RSV infections can also be treated with inhalation of immune globulin at doses substantially smaller than required for parenteral treatment. Therapeutic trials of parenteral RSVIG have been completed and are pending analysis. The use of polyclonal, hyperimmune globulins and perhaps human monoclonal antibodies provides an additional approach to the prevention and perhaps the treatment of certain viral lower respiratory tract infections such as those caused by RSV.

Improvement in detecting bacterial infection in lower respiratory tract infections using the Intensive Care Infection Score (ICIS)

2016 ◽  
Vol 40 (3) ◽  
Author(s):  
Martha Kaeslin ◽  
Saskia Brunner ◽  
Janine Raths ◽  
Andreas Huber
Keyword(s):  
Intensive Care ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Hemoglobin Concentration ◽  
Potential Method ◽  
Lower Respiratory Tract Infections ◽  
Absolute Count ◽  
Tract Infections

AbstractImmediate treatment of lower respiratory tract infections (LRTI) caused by bacteria is important to reduce pneumonia and other complications such as systemic inflammatory response syndrome and sepsis. Nowadays procalcitonin (PCT) is the gold standard to differentiate between bacterial and non-bacterial infections in LRTI. The aim of this study was to evaluate if the new Intensive Care Infection Score (ICIS) which is a combination of various cellular measurements made on hematology analyzers could be a potential method to differentiate between bacterial and non-bacterial infections in LRTI.The ICIS is composed of five blood-cell derived parameters characterizing the early innate immune response; (1) mean fluorescence intensity of mature (segmented) neutrophils; (2) the difference in hemoglobin concentration between newly formed red blood cells and the mature ones; (3) absolute number of segmented neutrophils; (4) absolute count of antibody secreting lymphocytes and (5) absolute count of number of granulocytes.The discriminative power of ICIS to differentiate between patients with LRTI of bacterial and non-bacterial origin is as good or even better as the commonly used infection biomarkers PCT, CRP and IL-6.Beside PCT, CRP and IL-6, ICIS could be used as infection marker in LRTI.

scholarly journals Budget impact analysis of using procalcitonin to optimize antimicrobial treatment for patients with suspected sepsis in the intensive care unit and hospitalized lower respiratory tract infections in Argentina

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250711
Author(s):  
Osvaldo Ulises Garay ◽  
Gonzalo Guiñazú ◽  
Wanda Cornistein ◽  
Javier Farina ◽  
Ricardo Valentini ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Tract ◽  
Health System ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Budget Impact ◽  
Lower Respiratory Tract Infections ◽  
Suspected Sepsis ◽  
Tract Infections

Background Inappropriate antibiotic use represents a major global threat. Sepsis and bacterial lower respiratory tract infections (LRTIs) have been linked to antimicrobial resistance, carrying important consequences for patients and health systems. Procalcitonin-guided algorithms may represent helpful tools to reduce antibiotic overuse but the financial burden is unclear. The aim of this study was to estimate the healthcare and budget impact in Argentina of using procalcitonin-guided algorithms to guide antibiotic prescription. Methods A decision tree was used to model health and cost outcomes for the Argentinean health system, over a one-year duration. Patients with suspected sepsis in the intensive care unit and hospitalized patients with LRTI were included. Model parameters were obtained from a focused, non-systematic, local and international bibliographic search, and validated by a panel of local experts. Deterministic and probabilistic sensitivity analyses were performed to analyze the uncertainty of parameters. Results The model predicted that using procalcitonin-guided algorithms would result in 734.5 [95% confidence interval (CI): 1,105.2;438.8] thousand fewer antibiotic treatment days, 7.9 [95% CI: 18.5;8.5] thousand antibiotic-resistant cases avoided, and 5.1 [95% CI: 6.7;4.2] thousand fewer Clostridioides difficile cases. In total, this would save $422.4 US dollars (USD) [95% CI: $935;$267] per patient per year, meaning cost savings of $83.0 [95% CI: $183.6;$57.7] million USD for the entire health system and $0.4 [95% CI: $0.9;$0.3] million USD for a healthcare provider with 1,000 cases per year of sepsis and LRTI patients. The sensitivity analysis showed that the probability of cost-saving for the sepsis patient group was lower than for the LRTI patient group (85% vs. 100%). Conclusions Healthcare and financial benefits can be obtained by implementing procalcitonin-guided algorithms in Argentina. Although we found results to be robust on an aggregate level, some caution must be used when focusing only on sepsis patients in the intensive care unit.

scholarly journals A Cross -Sectional Study of Bacteriological Profile of Lower Respiratory Tract Infections in Neurosurgery Intensive Care Unit in Central Kerala

2021 ◽  
Vol 8 (24) ◽  
pp. 2077-2082
Author(s):  
Satheesh Chandra Sugatha Rao ◽  
Shara Beena
Keyword(s):  
Intensive Care ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Cross Sectional Study ◽  
Drug Resistant ◽  
Bacterial Isolates ◽  
Lower Respiratory Tract Infections ◽  
Cross Sectional ◽  
Tract Infections

BACKGROUND Lower respiratory tract infections are the most common bacterial infections in neurosurgery intensive care units (NSICU), resulting in high overall mortality. The emergence of antibiotic resistant pathogens poses a challenge to their empiric treatment. Regular surveillance of the prevalent strains and their susceptibility pattern, helps to revise the antibiotic policies and aids in better management of the patient. METHODS A cross sectional study was conducted in the Department of Neurosurgery and Microbiology, Government Medical College, Thrissur, over a period of 1 year, using lower respiratory tract specimens of 190 patients with acute respiratory symptoms admitted in neurosurgery intensive care unit. The specimens collected aseptically were processed immediately. Following culture, the bacterial isolates were identified using standard methods and antibiotic susceptibility was done by Kirby Bauer disc diffusion method. The data obtained was coded and entered in Microsoft Excel and expressed as percentage. RESULTS Bacterial isolates were obtained from 74 % samples. 82 % isolates were monomicrobial and 18 % were polymicrobial. Majority of the isolates were gram negative bacteria (94 %) followed by gram positive bacteria (6 %). The common gram-negative isolates were K. pneumoniae (36 %), A. baumannii (29 %), P. aeruginosa (20 %). Methicillin-resistant staph (MRSA) (3 %) and methicillinsusceptible staph (MSSA) (3 %) accounted for the gram positive cocci. 61 % isolates were multi drug resistant (MDR). Most common MDR organism was A. baumannii. It was observed that 26 % isolates were extended spectrum betalactamase (ESBL) producers. A high rate of resistance to cephalosporins, beta lactams, fluoroquinolones, aminoglycosides, and cotrimoxazole was observed. An emerging resistance to carbapenems was observed. CONCLUSIONS Proper microbiological work up and antibiotic stewardship programmes can limit spread of resistant organisms, thereby reducing the medical and economic burden of the patient. KEYWORDS Lower Respiratory Tract Infection, Neurosurgery ICU, Antimicrobial Susceptibility Tests, Multi Drug Resistant Organisms

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