Archive for April 29, 2016

Complicated Urinary Tract Infections: What’s a Lab To Do?

Journal of Clinical Microbiology May 2016 V.54 N.5 P.1189-1190

Stephen M. Brecher

aDepartment of Pathology and Laboratory Medicine, VA Boston HealthCare System, West Roxbury, Massachusetts, USA

bDepartment of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA

The article by Price et al. in this issue (T. K. Price et al., J Clin Microbiol 54:1216–1222, 2016, http://dx.doi.org/10.1128/JCM.00044-16) advocates for the use of a larger inoculum when culturing urine obtained by “in-and-out” catheterization in a selected female population.

Their findings and the resulting challenges will afford clinical microbiologists and specialty physicians an opportunity to review what will or should be done with the additional microbiological culture data.

PDF

http://jcm.asm.org/content/54/5/1189.full.pdf

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April 29, 2016 at 2:38 pm

Rethinking the Definition of Success in the Management of a Periprosthetic Joint Infection

The Journal of Bone & Joint Surgery SEPT.16, 2015 V.97 N.18 e64

Commentary on an article by Miguel M. Gomez, MD, et al.: “The Fate of Spacers in the Treatment of Periprosthetic Joint Infection”

 

In the article “The Fate of Spacers in the Management of Periprosthetic Joint Infection,” Gomez et al. raise two important questions with regard to the treatment of periprosthetic joint infection: What occurs with the patient during the interim between staged surgical treatments; and what occurs with the patient who does not undergo the subsequent stage of treatment?

This information is valuable as most reports on the outcome of a two-stage treatment for periprosthetic joint infection, in which infection eradication is attained in 85% to 90% of patients, have focused on showing results only for patients who completed the second stage. From their findings, Gomez et al. suggest that this may overestimate the rate of infection eradication, as some of these treated patients may have a subsequent infection. Equally importantly, the point is made that there are other possible outcomes after the index removal of the implant (failure to proceed with the second stage, surgical treatment other than reimplantation, amputation, fusion, resection arthroplasty, spacer retention, and death) that need to be described. The combination of reporting the success of the two-stage treatment and reporting the failures as defined above yields a much fuller picture of the impact of a periprosthetic joint infection. The authors are to be commended for asking and attempting to answer questions of great clinical import and in expanding the criteria for what defines a successful outcome….

 

abstract

http://jbjs.org/content/97/18/e64

 

PDF

http://jbjs.org/content/jbjsam/97/18/e64.full.pdf

April 29, 2016 at 2:37 pm

Implementing an Antibiotic Stewardship Program – Guidelines by the IDSA and the SHEA

Clinical Infectious Diseases May 15, 2016 V.62 N.10 e51-e77

Tamar F. Barlam, Sara E. Cosgrove, Lilian M. Abbo, Conan MacDougall, Audrey N. Schuetz, Edward J. Septimus, Arjun Srinivasan, Timothy H. Dellit, Yngve T. Falck-Ytter, Neil O. Fishman, Cindy W. Hamilton, Timothy C. Jenkins, Pamela A. Lipsett, Preeti N. Malani, Larissa S. May, Gregory J. Moran, Melinda M. Neuhauser, Jason G. Newland, Christopher A. Ohl, Matthew H. Samore, Susan K. Seo, and Kavita K. Trivedi

1Section of Infectious Diseases, Boston University School of Medicine, Boston, Massachusetts

2Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland

3Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida

4Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco

5Department of Medicine, Weill Cornell Medical Center/New York–Presbyterian Hospital, New York, New York

6Department of Internal Medicine, Texas A&M Health Science Center College of Medicine, Houston

7Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

8Division of Allergy and Infectious Diseases, University of Washington School of Medicine, Seattle

9Department of Medicine, Case Western Reserve University and Veterans Affairs Medical Center, Cleveland, Ohio

10Department of Medicine, University of Pennsylvania Health System, Philadelphia

11Hamilton House, Virginia Beach, Virginia

12Division of Infectious Diseases, Denver Health, Denver, Colorado

13Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University Schools of Medicine and Nursing, Baltimore, Maryland

14Division of Infectious Diseases, University of Michigan Health System, Ann Arbor

15Department of Emergency Medicine, University of California, Davis

16Department of Emergency Medicine, David Geffen School of Medicine, University of California, Los Angeles Medical Center, Sylmar

17Department of Veterans Affairs, Hines, Illinois

18Department of Pediatrics, Washington University School of Medicine in St. Louis, Missouri

19Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina

20Department of Veterans Affairs and University of Utah, Salt Lake City

21Infectious Diseases, Memorial Sloan Kettering Cancer Center, New York, New York

22Trivedi Consults, LLC, Berkeley, California

Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.

The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties.

These recommendations address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics.

PDF

http://cid.oxfordjournals.org/content/62/10/e51.full.pdf

April 29, 2016 at 2:35 pm

Implementing an Antibiotic Stewardship Program – Guidelines by the IDSA and the Society for Healthcare Epidemiology of America

Clinical Infectious Diseases May 15, 2016 V.62 N.10 P.1197-1202

Executive Summary

Tamar F. Barlam, Sara E. Cosgrove, Lilian M. Abbo, Conan MacDougall, Audrey N. Schuetz, Edward J. Septimus, Arjun Srinivasan, Timothy H. Dellit, Yngve T. Falck-Ytter, Neil O. Fishman, Cindy W. Hamilton, Timothy C. Jenkins, Pamela A. Lipsett, Preeti N. Malani, Larissa S. May, Gregory J. Moran, Melinda M. Neuhauser, Jason G. Newland, Christopher A. Ohl, Matthew H. Samore, Susan K. Seo, and Kavita K. Trivedi

1Section of Infectious Diseases, Boston University School of Medicine, Boston, Massachusetts

2Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland

3Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida

4Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco

5Department of Medicine, Weill Cornell Medical Center/New York–Presbyterian Hospital, New York, New York

6Department of Internal Medicine, Texas A&M Health Science Center College of Medicine, Houston

7Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

8Division of Allergy and Infectious Diseases, University of Washington School of Medicine, Seattle

9Department of Medicine, Case Western Reserve University and Veterans Affairs Medical Center, Cleveland, Ohio

10Department of Medicine, University of Pennsylvania Health System, Philadelphia

11Hamilton House, Virginia Beach, Virginia

12Division of Infectious Diseases, Denver Health, Denver, Colorado

13Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University Schools of Medicine and Nursing, Baltimore, Maryland

14Division of Infectious Diseases, University of Michigan Health System, Ann Arbor

15Department of Emergency Medicine, University of California, Davis

16Department of Emergency Medicine, David Geffen School of Medicine, University of California, Los Angeles Medical Center, Sylmar

17Department of Veterans Affairs, Hines, Illinois

18Department of Pediatrics, Washington University School of Medicine in St. Louis, Missouri

19Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina

20Department of Veterans Affairs and University of Utah, Salt Lake City

21Infectious Diseases, Memorial Sloan Kettering Cancer Center, New York, New York

22Trivedi Consults, LLC, Berkeley, California

Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.

The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties.

These recommendations address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics.

PDF

http://cid.oxfordjournals.org/content/62/10/1197.full.pdf

April 29, 2016 at 2:33 pm


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