scholarly journals Surveillance cultures for detection of rectal and lower respiratory tract carriage of colistin-resistant Gram-negative bacilli in intensive care unit patients: comparison of direct plating and pre-enrichment step

2019 ◽  
Vol 68 (9) ◽  
pp. 1269-1278
Author(s):  
Julija Germ ◽  
Tjaša Cerar Kišek ◽  
Barbara Kokošar Ulčar ◽  
Tatjana Lejko Zupanc ◽  
Tatjana Mrvič ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Direct Plating ◽  
Gram Negative ◽  
Surveillance Cultures ◽  
Enrichment Step

scholarly journals Paediatric nonbronchoscopic bronchoalveolar lavage overview and recommendations for clinical practice

2006 ◽  
Vol 62 (1) ◽  
Author(s):  
B. M. Morrow ◽  
M. J. Futter ◽  
A. C. Argent
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Practice ◽  
Respiratory Tract ◽  
Bronchoalveolar Lavage ◽  
Pulmonary Disease ◽  
Paediatric Intensive Care Unit ◽  
Lower Respiratory Tract ◽  
Paediatric Intensive Care ◽  
Coagulation Defects

NB-BAL is an effective procedure for the diagnosis of pulmonary disease processes in ventilated infants and children. This procedure is, however, not without risks to both patients and staff. Numerous complications of NB-BAL exist, with hypoxia being themost common. As a result, care should be taken in performing NB-BAL on haemodynamically unstable patients; patients with coagulation defects; and patients with cardiac or brain abnormalities.This paper presents an overview of paediatric nonbronchoscopic bronchoalveolar lavage (NB-BAL) including: the rationale for NB-BAL; the complications associated with the procedure; indications and contraindications. It also recommends an evidence-basedclinical guideline for performing the procedure in the paediatric intensive care unit. By following the NB-BAL guidelines presented in this paper, one can ensure that an effective specimen is obtained from the lower respiratory tract, whilst minimising the risk to the patient.

Effects of continuous lateral rotation therapy on pulmonary complications in liver transplant patients

1995 ◽  
Vol 4 (2) ◽  
pp. 133-139 ◽  
Author(s):  
K Whiteman ◽  
L Nachtmann ◽  
D Kramer ◽  
S Sereika ◽  
M Bierman
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Liver Transplant ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Continuous Lateral Rotation ◽  
Lateral Rotation

BACKGROUND: When liver transplant candidates and recipients suffer from pulmonary complications of immobility, the results can be life-threatening. Continuous lateral rotation therapy has been reported to decrease complications of immobility. OBJECTIVES: To determine whether continuous lateral rotation therapy decreases the duration of mechanical ventilation, intensive care unit length of stay, incidence or resolution of atelectasis, incidence or onset time of lower respiratory tract infection and pneumonia. METHODS: Sixty-nine subjects admitted to a liver transplant intensive care unit at a university teaching hospital were randomly assigned to continuous lateral rotation therapy or a stationary bed. All subjects were mechanically ventilated for 24 hours and had a Glasgow Coma Scale score of 11 or less upon admission to the study. Subjects were followed until out of bed, unable to rotate for 3 consecutive days, or transferred from the intensive care unit. Data and chest roentgenogram results were collected on admission and daily during the study. Sputum culture results were obtained if available as part of normal patient care. RESULTS: Incidence of lower respiratory tract infection was significantly lower and length of time to occurrence of lower respiratory tract infection was significantly longer in the continuous lateral rotation therapy group than in the stationary bed group. CONCLUSIONS: Although continuous lateral rotation therapy did not affect duration of mechanical ventilation, length of stay, or incidence of atelectasis, it was effective in decreasing the incidence of, and increasing onset time to, lower respiratory tract infection in the liver transplantation population.

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.

scholarly journals Genotyping of Different Pseudomonas Aeruginosa Morphotypes Arising from the Lower Respiratory Tract of a Patient Taken to an Intensive Care Unit

2008 ◽  
Vol 21 (4) ◽  
pp. 941-947 ◽  
Author(s):  
L. Putignani ◽  
R. Sessa ◽  
A. Petrucca ◽  
C. Manfredini ◽  
L. Coltella ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Opportunistic Pathogen ◽  
Growth Media ◽  
Environmental Bacterium ◽  
Genotypic Analysis

Pseudomonas aeruginosa is an opportunistic pathogen and an ubiquitous environmental bacterium. Fifty-seven days after hospitalization, we isolated three distinct P. aeruginosa morphotypes (smooth, rough and mucoid) from the lower respiratory tract of a patient admitted to a Cardiology Intensive Care Unit (ICU). Moreover, a group of nine colony variants, arising from the three P. aeruginosa isolates growing in laboratory growth media, were also isolated. The resulting 12 isolates were characterised for antibiotic resistance profile and subjected to genotypic analysis by fluorescent-Amplified Fragment Length Polymorphism (f-AFLP) and automated repetitive extragenic palindromic-PCR (rep-PCR) fingerprinting. The three smooth, rough and mucoid morphotypes presented different antibiotic resistance profiles and genotyping analysis showed that they belonged to distinct clones, indicating that at day 57 after the admission the patient was simultaneously colonized by three distinct P. aeruginosa isolates. On the other hand, the nine colony variants presented heterogeneous antibiotic resistance profiles and clustered together with the three parental isolates. The understanding of the link between genotype plasticity and antibiotic resistance may contribute to improving our knowledge of this life-threatening pathogen.

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