Impact of Inappropriate Antibiotic Therapy on Mortality in Patients With Ventilator-Associated Pneumonia and Blood Stream Infection

2009 ◽  
Vol 53 (2) ◽  
pp. 54-55
Author(s):  
&NA;
Keyword(s):  
Antibiotic Therapy ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Ventilator Associated Pneumonia

scholarly journals Surveilans Pasif dan Aktif Kejadian Infeksi Terkait Pelayanan Kesehatan di RSUD Provinsi NTB, 2017

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Eustachius Hagni Wardoyo ◽  
Edi Prasetyo Wibowo ◽  
I Gede Jayantika ◽  
I Gst Alit Rai Sudiadnya ◽  
Rolly Armand
Keyword(s):  
Health Care ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Central Line ◽  
Ventilator Associated Pneumonia ◽  
Site Infection ◽  
Health Care Associated Infections

Pendahuluan: Surveilans Health-care Associated Infections (HAIs) atau kejadian infeksi terkait pelayanan kesehatan dapat dilakukan baik secara aktif maupun pasif sesuai sumber daya yang dimiliki. Penelitian ini bertujuan mengetahui insidensi dan perbandingan hasil surveilans pasif dan aktif 4 jenis HAIs di RSUD Provinsi Nusa Tenggara Barat periode Januari-Oktober 2017. Empat jenis HAIs tersebut adalah Ventilator-associated Pneumonia (VAP), Catheter-associated Urinary Tract Infection (CAUTI), Central Line-associated Blood Stream Infection (CLABSI) dan Surgical Site infection (SSI). Metode: Surveilans pasif menggunakan data sekunder dengan menelusuri rekam medis, sedangkan surveilans aktif berdasarkan laporan Tim Pencegahan dan Pengendalian Infeksi (PPI). Hasil: Tidak ada perbedaan indikator yang digunakan dalam form VAP dan CLABSI pada surveilans pasif dan aktif. Namun pada form CAUTI dan SSI tidak mencantumkan gejala infeksi dan gejala panas di lokasi infeksi pada surveilans aktif. Perbandingan hasil surveilans pasif dan aktif berturut-turut adalah VAP 24,9 dan 0 per 1.000 ventilator days, CAUTI 49 dan 12 per 1.000 catheter days, CLABSI 18 dan 9 per 1.000 central line days, serta SSI 1,9 dan 1,4%. Kesimpulan: Ada perbedaan insidensi keempat jenis HAIs pada surveilans pasif dan aktif, karena penggunaan metodologi yang berbeda.

scholarly journals Σχέση μεταξύ επίπτωσης βακτηριαιμίας και πολυμορφισμού των Toll like receptors (TLRs) – 2,4,9 σε ασθενείς της ΜΕΘ

2018 ◽  
Author(s):  
Μαρία Χατζή
Keyword(s):  
Blood Stream Infection ◽  
Central Nervous System Infection ◽  
Blood Stream ◽  
Klebsiella Pneumonia ◽  
Ventilator Associated Pneumonia ◽  
Nucleotide Polymorphisms ◽  
Toll Like Receptors ◽  
Chain Reaction ◽  
Single Nucleotide ◽  
Polymerase Chain

Σκοπός : Οι μονονουκλεοτιδικοί πολυμορφισμοί των Toll like υποδοχέων [Toll-like Receptors - Single Nucleotide Polymorphisms (TLR-SNPs)] μπορούν να επηρεάσουν σημαντικά την ευαισθησία του ξενιστή στις λοιμώξεις. Σκοπός της μελέτης ήταν να διερευνηθεί ο συχνότητα τεσσάρων κοινών πολυμορφισμών των Toll-Like Receptors (TLRs) σε βαρέως πάσχοντες ασθενείς των Μονάδων Εντατικής Θεραπείας (ΜΕΘ) και η συσχέτισή τους με την επίπτωση των λοιμώξεων και την έκβαση των ασθενών στην κεντρική Ελλάδα.Μέθοδος: Η συχνότητα εμφάνισης των TLR2-Arg753Gln, TLR4-Asp299Gly, TLR4-Thr399Ile και πολυμορφισμών TLR9-T-1237C, η συσχέτισή τους με την επίπτωση των λοιμώξεων και τις κλινικές εκβάσεις των ασθενών αξιολογήθηκαν προοπτικά σε ασθενείς ΜΕΘ που υποβλήθηκαν σε μηχανικό αερισμό για περισσότερο από 48 ώρες. Η ανίχνευση των πολυμορφισμών έγινε με την αλυσιδωτή αντίδραση πολυμεράσης (Real-time Polymerase-Chain-Reaction –PCR).Αποτελέσματα: Κατά τη διάρκεια περιόδου 15 μηνών (Νοέμβριος 2011- Ιανουάριος 2013), 224 ασθενείς συμπεριελήφθησαν στην μελέτη και έγινε έλεγχος γονοτύπου. Οι 136 (60,7%) ασθενείς δεν παρουσίασαν μεταλλάξεις των TLRs, ενώ 88 (39,3%) έδειξαν πολυμορφισμούς των TLRs [μονών / μικτών: 56 (25 %) / 32 (14,3%), αντίστοιχα]. Η επίπτωση των γενετικών πολυμορφισμών TLR4-Asp299Gly, TLR4-Thr399Ile, μικτών TLR4-Asp299Gly / Thr399Ile, TLR9-T-1237C και TLR2-Arg753Gln ήταν 14,4%, 14,7%, 11,2%, 24,5% και 2,2%, αντίστοιχα. Οι πολυμορφισμοί TLR4 σχετίστηκαν με αυξημένη ευπάθεια προς συγκεκριμένες λοιμώξεις που σχετίζονται με την νοσηλεία στην ΜΕΘ, δηλαδή gram-αρνητικών λοιμώξεων του κεντρικού νευρικού συστήματος (Central Nervous System Infection - CNSI) και λοιμώξεων της ουροφόρου οδού (Urinary Tract Infection - UTI), από Acinetobacter baumannii και Klebsiella pneumonia, καθώς και με την πνευμονία που σχετίζεται με τον αναπνευστήρα (Ventilator-associated pneumonia -VAP) από Pseudomonas aeruginosa (Ρ <0.05). Ο πολυμορφισμός TLR9-T-1237C σχετίστηκε με χαμηλότερη επίπτωση καθώς και μικρότερο αριθμών υποτροπών των CNSI και UTI σε σύγκριση με την ομάδα μικτών TLR4 πολυμορφισμών (P≤0.039). Δεν βρέθηκε καμία συσχέτιση των TLRs πολυμορφισμών με την βακτηριαιμία (Blood Stream Infection -BSI). Οι πολυμορφισμοί των TLR4 σχετίστηκαν με αυξημένη διάρκεια νοσηλείας στην ΜΕΘ (P<0,0416). Ωστόσο, η χρονική εξέλιξη της σήψης και η έκβαση των ασθενών στην ΜΕΘ δεν συσχετίστηκαν με μεταλλάξεις των TLRs.Συμπεράσματα: Τα ευρήματά μας υποδηλώνουν ότι κοινοί πολυμορφισμοί των TLRs μπορεί να επιδρούν στον κλινικό φαινότυπο των λοιμώξεων που σχετίζονται με την νοσηλεία των ασθενών σε ΜΕΘ στην Ελλάδα. Έτσι, οι TLR4-SNPs μπορεί να σχετίζονται με την επίπτωση των CNSI, UTI και της VAP από gram αρνητικά παθογόνα και μπορεί να επηρεάσουν δυσμενώς τη νοσηρότητα της ΜΕΘ. Αντίθετα, η μετάλλαξη TLR9-T-1237C μπορεί να ασκήσει προστατευτική επίδραση έναντι συγκεκριμένων λοιμώξεων στη ΜΕΘ.

scholarly journals Association between Early Antibiotic Therapy and In-Hospital Mortality among Older Patients with SARS-CoV-2 Pneumonia

2021 ◽  
Author(s):  
Alain Putot ◽  
Kevin Bouiller ◽  
Caroline Laborde ◽  
Marine Gilis ◽  
Amélie Févre ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Older Patients ◽  
Proportional Hazards ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Cox Proportional Hazards ◽  
Clostridioides Difficile ◽  
Kaplan Meier

Abstract Background It is uncertain whether antibiotic therapy should be started in SARS CoV-2 pneumonia. We aimed to investigate the association between early antibiotic therapy and the risk of in-hospital mortality in older patients. Methods We performed a retrospective international cohort study (ANTIBIOVID) in five COVID-19 geriatric units in France and Switzerland. Among 1,357 consecutive patients aged 75 or more hospitalised and testing positive for SARS-CoV-2, 1072 had a radiologically confirmed pneumonia, of which 914 patients were still alive and hospitalized at 48 hours. To adjust for confounders, a propensity score for treatment was created, and stabilized inverse probability of treatment weighting (SIPTW) was applied. To assess the association between early antibiotic therapy and in-hospital 30-day mortality, SIPTW-adjusted Kaplan-Meier and Cox proportional hazards regression analyses were performed. Results Of the 914 patients with SARS-CoV-2 pneumonia, median age of 86, 428 (46.8%) received antibiotics in the first 48 hours after diagnosis. Among these patients, 147 (34.3%) died in hospital within one month vs 118 patients (24.3%) with no early antibiotic treatment. After SIPTW, early antibiotic treatment was not significantly associated with mortality (adjusted hazard ratio, 1.23; 95% CI, 0.92-1.63; P = .160). Microbiologically confirmed superinfections occurred rarely in both groups (bacterial pneumonia: 2.5% vs 1.5%, P = .220; blood stream infection: 8.2% vs 5.2%, P = .120; Clostridioides difficile colitis: 2.4% vs 1.0%, P = .222). Conclusions In a large multicentre cohort of older inpatients with SARS-CoV-2 pneumonia, early antibiotic treatment did not appear to be associated with an improved prognosis.

False aneurysm of the pulmonary trunk complicating complete transposition and presenting as pyrexia of unknown origin

1996 ◽  
Vol 6 (2) ◽  
pp. 166-170
Author(s):  
Leon M. Gerlis ◽  
Rafael Hirsch ◽  
Jane Somerville
Keyword(s):  
Antibiotic Therapy ◽  
False Aneurysm ◽  
Blood Stream Infection ◽  
Pulmonary Regurgitation ◽  
Acute Chest Pain ◽  
Unknown Origin ◽  
Blood Stream ◽  
Pulmonary Trunk ◽  
Low Grade ◽  
Complete Transposition

SummaryA patient with complete transposition and a ventricular septal defect was clinically improved by an atrial septectomy at nine years but continued sepsis in the thoracotomy scar resulted in blood-stream infection with Staphylococcus aureus at the age of 24 years. A deep nylon suture was found and removed at surgical exploration. Five months later she again became febrile and had a vasculitic skin rash which responded to antibiotic therapy. At that time she was cyanosed and had a restricted exercise tolerance and was found to have aneurysmal dilatation of the pulmonary trunk. A year later she had acute chest pain with increased breathlessness, fever, hepatomegaly and pulmonary regurgitation. The fever did not respond to antibiotic therapy and she died suddenly following removal of a Hickman line. At postmortem examination, there was found to be a false aneurysm in the mediastinum due to rupture of the aneurysmal pulmonary trunk. No evidence of infection was found and it was considered that the low grade pyrexia had been due to the large hematoma within the false aneurysm.

scholarly journals EVALUASI PELAKSANAAN SISTEM SURVEILANS HEALTHCARE ACQUIRED INFECTIONS (HAIS) DI RSU HAJI SURABAYA TAHUN 2020

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Aulia Rosyida ◽  
Laura Navika Yamani ◽  
Dwiono Mudjianto
Keyword(s):  
Research Method ◽  
Blood Stream Infection ◽  
Evaluation Study ◽  
Blood Stream ◽  
Observational Research ◽  
Ventilator Associated Pneumonia ◽  
Site Infection ◽  
Job Rotation ◽  
Implementation Support ◽  
Healthcare Acquired Infections

Healthcare Acquired Infections (HAIs) or nosocomial infections are infections that occur in patients during hospitalization. HAIs are classified into 4 namely Catheter-Associated Urinary Tract Infection, Surgical Site Infection, Ventilator-Associated Pneumonia, and Blood Stream Infection. The purpose of this study is to evaluate the implementation of the HAIs surveillance sistem. The research method used is a descriptive evaluation study with an observational research design. The data sources used are the Reports and dissemination of HAIs Surveillance at RSU Haji Surabaya in 2019-2020. The results showed that HAIs cases at RSU Haji Surabaya in 2020 were 0.03%. The problems in the implementation of HAIs surveillance are the accuracy and completeness of data reports, implementation support facilities, and employee participation in training has not been running optimally, application bundle items are under repair, and job rotation for employees. Conclusion : the implementation of HAIs surveillance activities is in accordance the Regulation of the Peraturan Menteri Kesehatan Republik Indonesia Number 27 of 2017 Tentang  Pedoman Pencegahan  Dan Pengendalian Infeksi  di Fasilitas Pelayanan Kesehatan, but the implementation still running unoptimally, researchers recommend the implementation of reward and punishment activities for surveillance officers as a solution to improve the sistem surveillance.

scholarly journals Rapid Identification of Pathogens in Positive Blood Culture of Patients with Sepsis: Review and Meta-Analysis of the Performance of the Sepsityper Kit

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Nils G. Morgenthaler ◽  
Markus Kostrzewa
Keyword(s):  
Blood Culture ◽  
Antibiotic Therapy ◽  
Positive Blood Culture ◽  
Blood Stream Infection ◽  
Meta Analysis ◽  
Extraction Methods ◽  
Blood Stream ◽  
Rapid Identification ◽  
Maldi Tof

Sepsis is one of the leading causes of deaths, and rapid identification (ID) of blood stream infection is mandatory to perform adequate antibiotic therapy. The advent of MALDI-TOF Mass Spectrometry for the rapid ID of pathogens was a major breakthrough in microbiology. Recently, this method was combined with extraction methods for pathogens directly from positive blood cultures. This review summarizes the results obtained so far with the commercial Sepsityper sample preparation kit, which is now approved forin vitrodiagnostic use. Summarizing data from 21 reports, the Sepsityper kit allowed a reliable ID on the species level of 80% of 3320 positive blood culture bottles. Gram negative bacteria resulted consistently in higher ID rates (90%) compared to Gram positive bacteria (76%) or yeast (66%). No relevant misidentifications on the genus level were reported at a log(score)cut-off of 1.6. The Sepsityper kit is a simple and reproducible method which extends the MALDI-TOF technology to positive blood culture specimens and shortens the time to result by several hours or even days. In combination with antibiotic stewardship programs, this rapid ID allows a much faster optimization of antibiotic therapy in patients with sepsis compared to conventional workflows.

Healthcare associated infections caused by non-fermenting Gram negative rods (NFGNR): six years of experience of a tertiary hospital

2013 ◽  
Vol 7 (2) ◽  
pp. 06-12
Author(s):  
Zahidul Hasan ◽  
Md. Kamrul Islam ◽  
Arifa Hossain
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Tertiary Hospital ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Gram Negative ◽  
Acinetobacter Spp ◽  
Tract Infections ◽  
Healthcare Associated

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12

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