Posts filed under ‘CONSENSOS’

2017 CONSENSO INTER-INSTITUCIONAL – IACS – Recomendaciones para el abordaje de distintos escenarios epidemiológicos. 99 pags

Capítulo 1 “VIGILANCIA EPIDEMIOLÓGICA EN INSTITUCIONES DE AGUDOS”

Capítulo 2 “HIGIENE DE MANOS”

Capítulo 3 “LIMPIEZA Y DESINFECCIÓN DE SUPERFICIES DE INSTITUCIONES DE SALUD”

Capítulo 4 “MEDIDAS DE AISLAMIENTO”

Capítulo 5 “OPTIMIZACIÓN DEL USO DE ANTIMICROBIANOS”

LINK

http://www.vihda.gov.ar/Sitio%20VIHDAII/vihda/archivos/Consenso%20SADI%202017%20final.pdf

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October 3, 2018 at 3:05 pm

Guideline – Guidance document for prevention of C. difficile infection in acute healthcare settings

Clinical Microbiology and Infection October 2018 V.24 N.10 P.1051–1054

Tschudin-Sutter, E.J. Kuijper, A. Durovic, M.J.G.T. Vehreschild, F. Barbut, C. Eckert, F. Fitzpatrick, M. Hell, T. Norèn, J. O’Driscoll, J. Coia, P. Gastmeier, L. von Müller, M.H. Wilcox, A.F. Widmer on behalf of the Committee

Scope

Clostridium difficile infection (CDI) is the most important infective cause of healthcare-associated diarrhoea in high income countries and one of the most important healthcare-associated pathogens in both Europe and the United States. It is associated with high morbidity and mortality resulting in both societal and financial burden. A significant proportion of this burden is potentially preventable by a combination of targeted infection prevention and control measures and antimicrobial stewardship. The aim of this guidance document is to provide an update on recommendations for prevention of CDI in acute care settings to provide guidance to those responsible for institutional infection prevention and control programmes.

Methods

An expert group was set up by the European society of clinical microbiology and infectious diseases (ESCMID) Study Group for C. difficile (ESGCD), which performed a systematic review of the literature on prevention of CDI in adults hospitalized in acute care settings and derived respective recommendations according to the GRADE approach. Recommendations are stratified for both outbreak and endemic settings.

Questions addressed by the guideline and recommendations

This guidance document provides thirty-six statements on strategies to prevent CDI in acute care settings, including 18 strong recommendations. No recommendation was provided for three questions.

FULL TEXT

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(18)30195-2/fulltext

PDF

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(18)30195-2/pdf

September 29, 2018 at 10:34 am

Antimicrobial Prophylaxis for Adult Patients With Cancer-Related Immunosuppression – ASCO and IDSA Clinical Practice Guideline Update.

Journal of Clinical Oncology  September 2018

Purpose

To provide an updated joint ASCO/Infectious Diseases Society of America (IDSA) guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with cancer and its treatment.

Methods

ASCO and IDSA convened an update Expert Panel and conducted a systematic review of relevant studies from May 2011 to November 2016. The guideline recommendations were based on the review of evidence by the Expert Panel.

Results

Six new or updated meta-analyses and six new primary studies were added to the updated systematic review.

Recommendations

Antibacterial and antifungal prophylaxis is recommended for patients who are at high risk of infection, including patients who are expected to have profound, protracted neutropenia, which is defined as < 100 neutrophils/µL for > 7 days or other risk factors. Herpes simplex virus–seropositive patients undergoing allogeneic hematopoietic stem-cell transplantation or leukemia induction therapy should receive nucleoside analog-based antiviral prophylaxis, such as acyclovir. Pneumocystis jirovecii prophylaxis is recommended for patients receiving chemotherapy regimens that are associated with a > 3.5% risk for pneumonia as a result of this organism (eg, those with ≥ 20 mg prednisone equivalents daily for ≥ 1 month or on the basis of purine analog usage). Treatment with a nucleoside reverse transcription inhibitor (eg, entecavir or tenofovir) is recommended for patients at high risk of hepatitis B virus reactivation. Recommendations for vaccination and avoidance of prolonged contact with environments that have high concentrations of airborne fungal spores are also provided within the updated guideline. Additional information is available at http://www.asco.org/supportive-care-guidelines.

abstract

http://ascopubs.org/doi/pdf/10.1200/JCO.18.00374

PDF (CLIC en DOWNLOAD)

September 22, 2018 at 4:11 pm

A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology

Clinical Infectious Diseases September 15, 2018 V.67 N.6 P.813–816

IDSA GUIDELINE

J Michael Miller; Matthew J Binnicker; Sheldon Campbell; Karen C Carroll; Kimberle C Chapin …

The critical nature of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician/advanced practice provider and the microbiologists who provide enormous value to the healthcare team.

This document, developed by experts in laboratory and adult and pediatric clinical medicine, provides information on which tests are valuable and in which contexts, and on tests that add little or no value for diagnostic decisions.

This document presents a system-based approach rather than specimen-based approach, and includes bloodstream and cardiovascular system infections, central nervous system infections, ocular infections, soft tissue infections of the head and neck, upper and lower respiratory infections, infections of the gastrointestinal tract, intra-abdominal infections, bone and joint infections, urinary tract infections, genital infections, and other skin and soft tissue infections; or into etiologic agent groups, including arthropod-borne infections, viral syndromes, and blood and tissue parasite infections.

Each section contains introductory concepts, a summary of key points, and detailed tables that list suspected agents; the most reliable tests to order; the samples (and volumes) to collect in order of preference; specimen transport devices, procedures, times, and temperatures; and detailed notes on specific issues regarding the test methods, such as when tests are likely to require a specialized laboratory or have prolonged turnaround times.

In addition, the pediatric needs of specimen management are also emphasized. There is intentional redundancy among the tables and sections, as many agents and assay choices overlap.

The document is intended to serve as a guidance for physicians in choosing tests that will aid them to quickly and accurately diagnose infectious diseases in their patients.

FULL TEXT

https://academic.oup.com/cid/article/67/6/813/5088024

PDF (CLIC en PDF)

September 2, 2018 at 10:40 am

South African guideline for the management of community-acquired pneumonia in adults

Journal of Thoracic Disease June 2017 V.9 N.6 P.1469-1502.

South African Thoracic Society; Federation of Infectious Diseases Societies of Southern Africa.

Tom H. Boyles1, Adrian Brink1,2, Greg L. Calligaro3, Cheryl Cohen4,5, Keertan Dheda3, Gary Maartens6, Guy A. Richards7, Richard van Zyl Smit3, Clifford Smith8, Sean Wasserman1, Andrew C. Whitelaw9,10, Charles Feldman11; South African Thoracic Society, Federation of Infectious Diseases Societies of Southern Africa

Improving the care of patients with community-acquired pneumonia (CAP) in South Africa is particularly important because of the high burden of disease and the need to improve standards of antibiotic prescribing in the face of rising antimicrobial resistance (AMR). The purpose of this document is to provide clinicians guidance as to the recommended management of patients with CAP. This is an update for clinicians, which takes into account important advances and controversies in the management of patients with CAP.

FULL TEXT

http://jtd.amegroups.com/article/view/13850/11576

PDF

http://jtd.amegroups.com/article/view/13850/pdf

August 29, 2018 at 11:23 am

Hypervirulent Klebsiella pneumoniae: a Call for Consensus Definition and International Collaboration

Journal of Clinical Microbiology September 2018 V.56 N.9

Sohei Harada, Yohei Doi

Hypervirulent Klebsiella pneumoniae strains have higher potential to cause more severe and disseminated infections than classic K. pneumoniae strains. While initially reported from East Asian countries, cases have now been identified worldwide, sometimes in conjunction with extensive drug resistance.

In this issue of the Journal of Clinical Microbiology, T. A. Russo et al. (J Clin Microbiol 56:e00776-18, 2018, https://doi.org/10.1128/JCM.00776-18) validated the diagnostic accuracy of biomarkers that differentiate hypervirulent K. pneumoniae strains from classic strains.

This represents a major step forward in building a consensus definition and designing international studies aimed at elucidating the global epidemiology, clinical features, and outcome of this important pathogen.

FULL TEXT

https://jcm.asm.org/content/56/9/e00959-18?etoc=

PDF

https://jcm.asm.org/content/jcm/56/9/e00959-18.full.pdf

August 28, 2018 at 8:28 am

Human Immunodeficiency Virus Drug Resistance: 2018 Recommendations of the International Antiviral Society-USA Panel.

Clinical Infectious Diseases July 20, 2018             

Günthard HF1, Calvez V2, Paredes R3,4, Pillay D5, Shafer RW6, Wensing AM7, Jacobsen DM8, Richman DD9.

Author information

1 University Hospital Zürich and Institute of Medical Virology, University of Zurich, Switzerland.

2 Pierre et Marie Curie University and Pitié-Salpêtriere Hospital, Paris, France.

3 Infectious Diseases Service and IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.

4 Africa Health Research Institute, KwaZulu Natal, South Africa.

5 University College London, United Kingdom.

6 Stanford University Medical School, California.

7 University Medical Center Utrecht, The Netherlands.

8 International Antiviral Society-USA, San Francisco.

9 Veterans Affairs San Diego Healthcare System and University of California San Diego.

Abstract

BACKGROUND:

Contemporary antiretroviral therapies (ART) and management strategies have diminished both human immunodeficiency virus (HIV) treatment failure and the acquired resistance to drugs in resource-rich regions, but transmission of drug-resistant viruses has not similarly decreased. In low- and middle-income regions, ART roll-out has improved outcomes, but has resulted in increasing acquired and transmitted resistances. Our objective was to review resistance to ART drugs and methods to detect it, and to provide updated recommendations for testing and monitoring for drug resistance in HIV-infected individuals.

METHODS:

A volunteer panel of experts appointed by the International Antiviral (formerly AIDS) Society-USA reviewed relevant peer-reviewed data that were published or presented at scientific conferences. Recommendations were rated according to the strength of the recommendation and quality of the evidence, and reached by full panel consensus.

RESULTS:

Resistance testing remains a cornerstone of ART. It is recommended in newly-diagnosed individuals and in patients in whom ART has failed. Testing for transmitted integrase strand-transfer inhibitor resistance is currently not recommended, but this may change as more resistance emerges with widespread use. Sanger-based and next-generation sequencing approaches are each suited for genotypic testing. Testing for minority variants harboring drug resistance may only be considered if treatments depend on a first-generation nonnucleoside analogue reverse transcriptase inhibitor. Different HIV-1 subtypes do not need special considerations regarding resistance testing.

CONCLUSIONS:

Testing for HIV drug resistance in drug-naive individuals and in patients in whom antiretroviral drugs are failing, and the appreciation of the role of testing, are crucial to the prevention and management of failure of ART.

FULL TEXT

https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy463/5055715

PDF (CLIC en PDF)

August 21, 2018 at 8:09 am

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