Posts filed under ‘Bacterias’

Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis

LANCET Infectious Diseases November 5, 2018

Background

Infections due to antibiotic-resistant bacteria are threatening modern health care. However, estimating their incidence, complications, and attributable mortality is challenging. We aimed to estimate the burden of infections caused by antibiotic-resistant bacteria of public health concern in countries of the EU and European Economic Area (EEA) in 2015, measured in number of cases, attributable deaths, and disability-adjusted life-years (DALYs).

Methods

We estimated the incidence of infections with 16 antibiotic resistance–bacterium combinations from European Antimicrobial Resistance Surveillance Network (EARS-Net) 2015 data that was country-corrected for population coverage. We multiplied the number of bloodstream infections (BSIs) by a conversion factor derived from the European Centre for Disease Prevention and Control point prevalence survey of health-care-associated infections in European acute care hospitals in 2011–12 to estimate the number of non-BSIs. We developed disease outcome models for five types of infection on the basis of systematic reviews of the literature.

Findings

From EARS-Net data collected between Jan 1, 2015, and Dec 31, 2015, we estimated 671 689 (95% uncertainty interval [UI] 583 148–763 966) infections with antibiotic-resistant bacteria, of which 63·5% (426 277 of 671 689) were associated with health care. These infections accounted for an estimated 33 110 (28 480–38 430) attributable deaths and 874 541 (768 837–989 068) DALYs. The burden for the EU and EEA was highest in infants (aged <1 year) and people aged 65 years or older, had increased since 2007, and was highest in Italy and Greece.

Interpretation

Our results present the health burden of five types of infection with antibiotic-resistant bacteria expressed, for the first time, in DALYs. The estimated burden of infections with antibiotic-resistant bacteria in the EU and EEA is substantial compared with that of other infectious diseases, and has increased since 2007. Our burden estimates provide useful information for public health decision-makers prioritising interventions for infectious diseases.

Funding

European Centre for Disease Prevention and Control.

FULL TEXT

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(18)30605-4/fulltext

PDF

https://www.thelancet.com/action/showPdf?pii=S1473-3099%2818%2930605-4

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November 7, 2018 at 8:38 am

IMAGES IN CLINICAL MEDICINE – Spinal Brucellosis

N Engl J of Med October 25, 2018 V.379 P.e28

Christine Cho, M.D., and Michihiko Goto, M.D.

A 62-year-old man presented to the emergency department with a 6-month history of worsening low back pain, fevers, chills, night sweats, and weight loss. He regularly traveled to Mexico and had occasionally consumed unprocessed dairy products. He had no history of tuberculosis infection or known exposure. Laboratory studies revealed a white-cell count of 10,600 per cubic millimeter (reference range, 3700 to 10,500) and an erythrocyte sedimentation rate of 65 mm per hour (reference range, 0 to 15)…..

FULL TEXT

https://www.nejm.org/doi/full/10.1056/NEJMicm1803513?query=infectious-disease

PDF

https://www.nejm.org/doi/pdf/10.1056/NEJMicm1803513

November 6, 2018 at 8:19 am

Should Acute Q-Fever Patients be Screened for Valvulopathy to Prevent Endocarditis?

Clinical Infectious Diseases August 1, 2018 V.67 N.3 P.360-366

Marit M A de Lange; Laura E V Gijsen; Cornelia C H Wielders; Wim van der Hoek; Arko Scheepmaker

We found no difference in occurrence of chronic Q-fever between patients with or without a newly detected valvulopathy at time of acute Q-fever diagnosis. Thus, universal screening is not justified and would lead to unnecessary and undesirable long-term antibiotic use.

FULL TEXT

https://academic.oup.com/cid/article/67/3/360/4877027

PDF (CLIC en PDF)

November 4, 2018 at 8:29 am

Regional Spread of an Outbreak of Carbapenem-Resistant Enterobacteriaceae Through an Ego Network of Healthcare Facilities

Clinical Infectious Diseases August 1, 2018 V.67 N.3 P.407-410

EDITOR’S CHOICE

Michael J Ray; Michael Y Lin; Angela S Tang; M Allison Arwady; Mary Alice Lavin

Using social network analysis to construct an ego network around a hospital that experienced an outbreak of a rare carbapenem-resistant Enterobacteriaceae, we accurately predicted which hospitals outbreak patients would subsequently visit and, therefore, the hospitals that reported additional cases.

FULL TEXT

https://academic.oup.com/cid/article/67/3/407/4836930

PDF (CLIC en PDF)

November 4, 2018 at 8:27 am

Gepotidacin for the Treatment of Uncomplicated Urogenital Gonorrhea: A Phase 2, Randomized, Dose-Ranging, Single-Oral Dose Evaluation

Clinical Infectious Diseases August 15, 2018 V.67 N.4 P.505-512

Stephanie N Taylor; David H Morris; Ann K Avery; Kimberly A Workowski; Byron E Batteiger

In this phase 2 study, single oral doses of gepotidacin were ≥95% effective for bacterial eradication in culture-proven uncomplicated urogenital gonorrhea. New antibiotics for drug-resistant Neisseria gonorrhoeae are urgently needed. With additional evaluation, gepotidacin may provide an alternative therapeutic option.

FULL TEXT

https://academic.oup.com/cid/article/67/4/504/4958398

PDF (CLIC en PDF)

November 4, 2018 at 8:25 am

Prophylactic Antimicrobial Therapy for Acute Aspiration Pneumonitis

Clinical Infectious Diseases August 15, 2018 V.67 N.4 P.513-518

EDITOR’S CHOICE

Vlad Dragan; Yanliang Wei; Marion Elligsen; Alex Kiss; Sandra A N Walker

In a cohort of patients with acute aspiration pneumonitis, antibiotics within 48 hours of macroaspiration was not associated with reduced mortality compared to supportive care only, yet resulted in the need for more frequent antibiotic escalation and fewer antibiotic-free days.

FULL TEXT

https://academic.oup.com/cid/article/67/4/513/4846855

PDF (CLIC en PDF)

November 4, 2018 at 8:23 am

NEUMONÍA ASOCIADA A VENTILACIÓN MECÁNICA. ACTUALIZACIÓN Y RECOMENDACIONES INTER-SOCIEDADES, SOCIEDAD ARGENTINA DE INFECTOLOGÍA – SOCIEDAD ARGENTINA DE TERAPIA INTENSIVA

Medicina (B Aires). 2018;78(2):99-106.

Pneumonia associated with mechanical ventilation. Update and recommendations inter- Societies SADI-SATI.

[Article in Spanish]

Cornistein W1, Colque ÁM2, Staneloni MI3, Monserrat Lloria M4, Lares M5, González AL5, Fernández Garcés A6, Carbone E7.

Author information

1 Hospital General de Agudos Dr. Cosme Argerich, Hospital Universitario Austral, Buenos Aires, Argentina. E-mail: wandacornistein@gmail.com.

2 Complejo Médico Churruca Visca, Buenos Aires, Argentina.

3 Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

4 Hospital Prof. Alejandro Posadas, Buenos Aires, Argentina.

5 Hospital Interzonal General de Agudos San Martín de La Plata, Argentina.

6 Clínica AMEBPBA (Mutual de Empleados del Banco de la Provincia de Buenos Aires), Argentina.

7 Hospital Aeronáutico Central, Buenos Aires, Argentina.

Abstract

Representatives of the Argentine Society of Infectious Diseases (SADI) and the Argentine Society of Intensive Therapy (SATI) worked together on the development of specific recommendations for the diagnosis, treatment and prevention of ventilator-associated pneumonia (VAP). The methodology used was the analysis of the literature published in the last 15 years, complemented with the opinion of experts and local data. This document aims to offer basic tools to optimize diagnosis based on clinical and microbiological criteria, orientation in empirical and targeted antibiotic schemes, news on posology and administration of antibiotics in critical patients and to promote effective measures to reduce the risk of VAP. It also offers a diagnostic and treatment algorithm and considerations on inhaled antibiotics. The joint work of both societies -infectious diseases and intensive care- highlights the concern for the management of VAP and the importance of ensuring improvement in daily practices. This guideline established recommendations to optimize the diagnosis, treatment and prevention of VAP in order to reduce morbidity and mortality, days of hospitalization, costs and resistance to antibiotics due to misuse of antimicrobials.

PDF

http://www.medicinabuenosaires.com/PMID/29659359.pdf

November 3, 2018 at 10:43 am

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