Posts filed under ‘GUIDELINES’

Guidelines for management of community-acquired pneumonia in adults.

Medicina (B Aires). 2015;75(4):245-57.

[Article in Spanish]

Lopardo G1, Basombrío A, Clara L, Desse J, De Vedia L, Di Libero E, Gañete M, López Furst MJ, Mykietiuk A, Nemirovsky C, Osuna C, Pensotti C, Scapellato P.

Author information

1Sociedad Argentina de Infectología, Buenos Aires, Argentina. E-mail: glopardo@intramed.net

Abstract

Community-acquired pneumonia in adults is a common cause of morbidity and mortality particularly in the elderly and in patients with comorbidities. Most episodes are of bacterial origin, Streptococcus pneumoniae is the most frequently isolated pathogen. Epidemiological surveillance provides information about changes in microorganisms and their susceptibility. In recent years there has been an increase in cases caused by community-acquired meticillin resistant Staphylococcus aureus and Legionella sp. The chest radiograph is essential as a diagnostic tool. CURB-65 score and pulse oximetry allow stratifying patients into those who require outpatient care, general hospital room or admission to intensive care unit. Diagnostic studies and empirical antimicrobial therapy are also based on this stratification. The use of biomarkers such as procalcitonin or C-reactive protein is not part of the initial evaluation because its use has not been shown to modify the initial approach. We recommend treatment with amoxicillin for outpatients under 65 year old and without comorbidities, for patients 65 years or more or with comorbidities amoxicillin-clavulanic/sulbactam, for patients hospitalized in general ward ampicillin-sulbactam with or without the addition of clarithromycin, and for patients admitted to intensive care unit ampicillin-sulbactam plus clarithromycin. Suggested treatment duration is 5 to 7 days for outpatients and 7 to 10 for those who are hospitalized. During the influenza season addition of oseltamivir for hospitalized patients and for those with comorbidities is suggested.

PDF

http://www.medicinabuenosaires.com/PMID/26339883.pdf

February 18, 2017 at 8:42 am

Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America

Clin Infect Dis. 2013 Jan;56(1):e1-e25.

Osmon DR1, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, Rao N, Hanssen A, Wilson WR; Infectious Diseases Society of America.

Author information

1Division of Infectious Diseases, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. osmon.douglas@mayo.edu

Abstract

These guidelines are intended for use by infectious disease specialists, orthopedists, and other healthcare professionals who care for patients with prosthetic joint infection (PJI). They include evidence-based and opinion-based recommendations for the diagnosis and management of patients with PJI treated with debridement and retention of the prosthesis, resection arthroplasty with or without subsequent staged reimplantation, 1-stage reimplantation, and amputation.

PDF

http://cid.oxfordjournals.org/content/56/1/e1.full.pdf

February 14, 2017 at 8:09 am

Meningoencefalitis Amebiana Primaria (Amebas de Vida Libre) – Septiembre 2012

Direccion Nacional de Epidemiología – Secretaría de Salud de Mexico

Manual de Procedimientos Estandarizados para la Vigilancia Epidemiológica

ÍNDICE

Introducción …………………………………………………………11

Marco Legal ………………………………………………………….12

Justificación ………………………………………………………….12

Objetivos Generales ……………………………………………….12

Mecanismos de Vigilancia Epidemiológica ……………….13

Metodologías y Procedimientos para la Vigilancia Epidemiológica ……………………………………………………………………………. 13

Factores de Riesgo …………………………………………………14

La Vigilancia Epidemiológica ………………………………….14

Acciones y Funciones de Vigilancia Epidemiológica …. 15

Indicadores de Evaluación de Meningoencefalitis Amebiana Primaria…………………………………………………………………18

Procedimientos de Laboratorio ………………………………..19

Análisis de la Información ……………………………………….22

Colaboración Interinstitucional ……………………………….24

Difusión de la Información ……………………………………..27

Capacitación ………………………………………………………….27

Supervisión ……………………………………………………………28

Bibliografía ……………………………………………………………29

Anexos …………………………………………………………………..31

 

PDF

http://www.epidemiologia.salud.gob.mx/doctos/infoepid/vig_epid_manuales/16_2012_Manual_Meningoencefalitis_vFinal_7nov12.pdf

February 13, 2017 at 8:43 am

Guía de práctica clínica sobre el uso de las pruebas de liberación de interferón-γ para el diagnóstico de TBC

Enf Inf & Microb Clinica Mayo 2016 V.34 N.05 e1-e13

Consensus statement

Miguel Santin, José-María García-García, José Domínguez

a Service of Infectious Diseases, Bellvitge University Hospital-IDIBELL, Barcelona, Spain

b Department of Clinical Sciences, University of Barcelona, Barcelona, Spain

c Clinical Unit of Pneumology, Hospital San Agustín, Avilés, Asturias, Spain

d Service of Microbiology, Research Institute Trias i Pujol, Hospital Gremans Trias i Pujol, Barcelona, Spain

e Department of Genetics and Microbiology, Universidad Autónoma de Barcelona, Barcelona, Spain

f CIBER Respiratory Diseases, Madrid, Spain

Introducción

Las técnicas de detección in vitro de interferón-gamma (IGRA, del inglés interferon-gamma release assays) están ampliamente implantadas para el diagnóstico de infección tuberculosa en países de baja prevalencia. Sin embargo, no hay consenso sobre su aplicación. El objetivo fue desarrollar una guía de práctica clínica para el uso de los IGRA en los diferentes escenarios clínicos en España.

Métodos

Un grupo de expertos compuesto por especialistas en enfermedades infecciosas, enfermedades respiratorias, microbiología, pediatría y medicina preventiva, junto con un metodólogo formularon las preguntas clínicas y los desenlaces de interés, llevaron a cabo una búsqueda sistemática de la literatura, sintetizaron la evidencia y graduaron su calidad, y formularon las recomendaciones siguiendo la metodología Grading of Recommendations of Assessment Development and Evaluations (GRADE).

Resultados

El grupo de trabajo formuló las recomendaciones sobre el uso de los IGRA para el diagnóstico de infección tuberculosa en el estudio de contactos (adultos y niños), trabajadores sanitarios, pacientes inmunosuprimidos (pacientes infectados por el virus de la inmunodeficiencia humana, pacientes afectos de enfermedades inflamatorias inmunomediadas candidatos a terapias biológicas y pacientes que requieren trasplante de órganos), y en el diagnóstico de enfermedad tuberculosa activa. La mayor parte de las recomendaciones fueron débiles, principalmente debido a la falta de evidencia de calidad para establecer un balance entre beneficios y daños de los IGRA en comparación con la prueba de la tuberculina.

Conclusión

Este documento proporciona una guía basada en la evidencia para el uso de los IGRA en el diagnóstico de infección tuberculosa en pacientes en riesgo de tuberculosis o con sospecha de enfermedad activa. Esta guía es aplicable en la atención especializada y primaria, y salud pública.

PDF

http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90452011&pident_usuario=0&pcontactid=&pident_revista=28&ty=22&accion=L&origen=zonadelectura&web=www.elsevier.es&lan=en&fichero=28v34n05a90452011pdf001.pdf

 

February 11, 2017 at 7:21 pm

Inter-society consensus for the management of respiratory infections: acute bronchitis and chronic obstructive pulmonary disease.

Medicina (B Aires). 2013;73(2):163-73.

Article in Spanish

Lopardo G1, Pensotti C, Scapellato P, Caberlotto O, Calmaggi A, Clara L, Klein M, Levy Hara G, López Furst MJ, Mykietiuk A, Pryluka D, Rial MJ, Vujacich C, Yahni D.

Author information

1Sociedad Argentina de Infectología, Argentina. glopardo@intramed.net

Abstract

The Argentine Society for Infectious Diseases and other national societies issued updated practical guidelines for the management of acute bronchitis (AB) and reactivations of chronic obstructive pulmonary disease (COPD) with the aim of promoting rational use of diagnostic and therapeutic resources.

AB is a condition characterized by inflammation of the bronchial airways which affects adults and children without underlying pulmonary disease. It is usually caused by a virus.

The diagnosis is based on clinical findings after community acquired pneumonia has been ruled out. Treatment of AB is mainly symptomatic. Antibiotics should be used in immune-compromised hosts, patients with chronic respiratory or cardiac diseases and in the elderly with co-morbidities.

Reactivation of COPD is defined as an acute change in the patient’s baseline clinical situation beyond normal day to day variations, with an increase in dyspnea, sputum production and/or sputum purulence, warranting a change in medication. An increase in one symptom is considered a mild exacerbation, two as moderate, and the presence of three symptoms is considered a severe exacerbation.

An infectious agent can be isolated in sputum in 50 to 75% of COPD reactivations. Moderate and severe episodes must be treated with antibiotics, amoxicillin/ beta-lactamase inhibitor, macrolides and fluoroquinolones are first choice drugs.

PDF

http://www.medicinabuenosaires.com/PMID/23570768.pdf

February 9, 2017 at 2:53 pm

Multisociety guideline on reprocessing flexible GI endoscopes – 2016 update.

Gastrointestinal Endoscopy February 2017 V.85 N.2 P.:282-294.e1

Reprocessing Guideline Task Force, Petersen BT, Cohen J, Hambrick RD 3rd, Buttar N, Greenwald DA, Buscaglia JM, Collins J, Eisen G.

The beneficial role of GI endoscopy for the prevention, diagnosis, and treatment of many digestive diseases and cancer is well established.

Like many sophisticated medical devices, the endoscope is a complex, reusable instrument that requires meticulous cleaning and reprocessing in strict accordance with manufacturer and professional organization guidance before being used on subsequent patients.

To date, published episodes of pathogen transmission related to GI endoscopy using standard end-viewing instruments have been associated with failure to follow established cleaning and  disinfection/sterilization guidelines or use of defective equipment.

Recent reports pertaining to transmission among patients undergoing specialized procedures using side-viewing duodenoscopes with distal tip elevators have raised questions about the best methods for the cleaning and disinfection or sterilization of these devices between patient uses …

PDF

http://www.giejournal.org/article/S0016-5107(16)30647-2/pdf

February 2, 2017 at 9:08 pm

Executive Summary: Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society

Clinical Infectious Diseases September 15, 2016 V.63 N.5 P. 575-582           

IDSA GUIDELINE

Andre C. Kalil, Mark L. Metersky, Michael Klompas, John Muscedere, Daniel A. Sweeney, Lucy B. Palmer, Lena M. Napolitano, Naomi P. O’Grady, John G. Bartlett, Jordi Carratalà, Ali A. El Solh, Santiago Ewig, Paul D. Fey, Thomas M. File, Jr, Marcos I. Restrepo, Jason A. Roberts, Grant W. Waterer, Peggy Cruse, Shandra L. Knight, and Jan L. Brozek

1Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha

2Division of Pulmonary and Critical Care Medicine, University of Connecticut School of Medicine, Farmington

3Brigham and Women’s Hospital and Harvard Medical School

4Harvard Pilgrim Health Care Institute, Boston, Massachusetts

5Department of Medicine, Critical Care Program, Queens University, Kingston, Ontario, Canada

6Division of Pulmonary, Critical Care and Sleep Medicine, University of California, San Diego

7Department of Medicine, Division of Pulmonary Critical Care and Sleep Medicine, State University of New York at Stony Brook

8Department of Surgery, Division of Trauma, Critical Care and Emergency Surgery, University of Michigan, Ann Arbor

9Department of Critical Care Medicine, National Institutes of Health, Bethesda

10Johns Hopkins University School of Medicine, Baltimore, Maryland

11Department of Infectious Diseases, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute, Spanish Network for Research in Infectious Diseases, University of Barcelona, Spain

12Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University at Buffalo, Veterans Affairs Western New York Healthcare System, New York

13Thoraxzentrum Ruhrgebiet, Department of Respiratory and Infectious Diseases, EVK Herne and Augusta-Kranken-Anstalt Bochum, Germany

14Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha

15Summa Health System, Akron, Ohio

16Department of Medicine, Division of Pulmonary and Critical Care Medicine, South Texas Veterans Health Care System and University of Texas Health Science Center at San Antonio

17Burns, Trauma and Critical Care Research Centre, The University of Queensland

18Royal Brisbane and Women’s Hospital, Queensland

19School of Medicine and Pharmacology, University of Western Australia, Perth, Australia

20Library and Knowledge Services, National Jewish Health, Denver, Colorado

21Department of Clinical Epidemiology and Biostatistics and Department of Medicine, McMaster University, Hamilton, Ontario, Canada

It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient’s individual circumstances.

These guidelines are intended for use by healthcare professionals who care for patients at risk for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), including specialists in infectious diseases, pulmonary diseases, critical care, and surgeons, anesthesiologists, hospitalists, and any clinicians and healthcare providers caring for hospitalized patients with nosocomial pneumonia. The panel’s recommendations for the diagnosis and treatment of HAP and VAP are based upon evidence derived from topic-specific systematic literature reviews.

PDF

http://cid.oxfordjournals.org/content/63/5/575.full.pdf+html

 

http://cid.oxfordjournals.org/content/63/5/e61.full.pdf+html

 

January 27, 2017 at 8:14 am

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