Posts filed under ‘Health Care-Associated Infections’

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)

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November 4, 2018 at 8:27 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

INFECCIÓN del TRACTO URINARIO ASOCIADA a SONDA VESICAL. ACTUALIZACIÓN Y RECOMENDACIONES INTERSOCIEDADES

Medicina (B Aires). 2018;78(4):258-264.

An update on catheter-associated urinary tract infection. Inter-Society recommendations.

[Article in Spanish]

Cornistein W1, Cremona A2, Chattas AL3, Luciani A4, Daciuk L5, Juárez PA6, Colque AM7.

Author information

1 Hospital Universitario Austral, Buenos Aires, Argentina. E-mail: wandacornistein@gmail.com.

2 Hospital Italiano de La Plata, La Plata, Argentina.

3 Hospital Dr. Ignacio Pirovano, Buenos Aires, Argentina.

4 Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.

5 Hospital Prof. Dr. Alejandro Posadas, El Palomar, Argentina.

6 Hospital de la Madre y el Niño, La Rioja, Argentina.

7 Complejo Médico Churruca Visca, Buenos Aires, Argentina.

Abstract

Representatives of the Argentine Society of Infectious Diseases (SADI) and the Argentine Society of Intensive Therapy (SATI) issued the present recommendations on diagnosis, treatment, and prevention of catheter associated urinary tract infection (CA-UTI). Articles published during 2006-2016 were analyzed in the light of experts’ opinion and local data. This document aims to offer basic strategies to optimize the diagnosis based on clinical and microbiological criteria, provide guidance in empirical and targeted antibiotic schemes, and promote effective measures to reduce the risk of CA-UTI. The joint work of both societies highlights the experts’ concern about the mismanagement of CA-UTI, which is associated to the indiscriminate use of antimicrobials, and the importance of improving daily practices of CA-UTI management. Through these recommendations, local guidelines are established to optimize the diagnosis, treatment and prevention of CAUTI in order to reduce morbimortality, days of hospitalization, costs and antibiotic resistance due to the misuse of antimicrobials.

PDF

http://www.medicinabuenosaires.com/PMID/30125253.pdf

November 3, 2018 at 10:40 am

Understanding the Mechanism of Bacterial Biofilms Resistance to Antimicrobial Agents.

Open Microbiol J. 2017 Apr 28;11:53-62.

Singh S1, Singh SK2, Chowdhury I3, Singh R2.

1 Department of Kriya Sharir, Institute of Medical Sciences, Banaras Hindu University, Varanasi- 221 005 UP India.

2 Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA, USA.

3 Department of Obstetrics and Gynecology; Morehouse School of Medicine, Atlanta, GA, USA.

Abstract

A biofilm is a group of microorganisms, that causes health problems for the patients with indwelling medical devices via attachment of cells to the surface matrix. It increases the resistance of a microorganism for antimicrobial agents and developed the human infection. Current strategies are removed or prevent the microbial colonies from the medical devices, which are attached to the surfaces. This will improve the clinical outcomes in favor of the patients suffering from serious infectious diseases. Moreover, the identification and inhibition of genes, which have the major role in biofilm formation, could be the effective approach for health care systems. In a current review article, we are highlighting the biofilm matrix and molecular mechanism of antimicrobial resistance in bacterial biofilms.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427689/pdf/TOMICROJ-11-53.pdf

 

October 14, 2018 at 10:44 am

Biofilms: survival mechanisms of clinically relevant microorganisms.

Clinical Microbiology Reviews April 2002 V.15 N.2 P.167-93.

Donlan RM1, Costerton JW.

1 Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. rld8@cdc.gov

Abstract

Though biofilms were first described by Antonie van Leeuwenhoek, the theory describing the biofilm process was not developed until 1978. We now understand that biofilms are universal, occurring in aquatic and industrial water systems as well as a large number of environments and medical devices relevant for public health. Using tools such as the scanning electron microscope and, more recently, the confocal laser scanning microscope, biofilm researchers now understand that biofilms are not unstructured, homogeneous deposits of cells and accumulated slime, but complex communities of surface-associated cells enclosed in a polymer matrix containing open water channels. Further studies have shown that the biofilm phenotype can be described in terms of the genes expressed by biofilm-associated cells. Microorganisms growing in a biofilm are highly resistant to antimicrobial agents by one or more mechanisms. Biofilm-associated microorganisms have been shown to be associated with several human diseases, such as native valve endocarditis and cystic fibrosis, and to colonize a wide variety of medical devices. Though epidemiologic evidence points to biofilms as a source of several infectious diseases, the exact mechanisms by which biofilm-associated microorganisms elicit disease are poorly understood. Detachment of cells or cell aggregates, production of endotoxin, increased resistance to the host immune system, and provision of a niche for the generation of resistant organisms are all biofilm processes which could initiate the disease process. Effective strategies to prevent or control biofilms on medical devices must take into consideration the unique and tenacious nature of biofilms. Current intervention strategies are designed to prevent initial device colonization, minimize microbial cell attachment to the device, penetrate the biofilm matrix and kill the associated cells, or remove the device from the patient. In the future, treatments may be based on inhibition of genes involved in cell attachment and biofilm formation.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC118068/pdf/0012.pdf

October 14, 2018 at 10:41 am

Biofilm formation: a clinically relevant microbiological process.

Clinical Infectious Disseases October 15, 2001 V.33 N.8 P.1387-92.

Donlan RM1.

1 Biofilm Laboratory, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. rld8@cdc.gov

Abstract

Microorganisms universally attach to surfaces and produce extracellular polysaccharides, resulting in the formation of a biofilm. Biofilms pose a serious problem for public health because of the increased resistance of biofilm-associated organisms to antimicrobial agents and the potential for these organisms to cause infections in patients with indwelling medical devices. An appreciation of the role of biofilms in infection should enhance the clinical decision-making process.

FULL TEXT

https://academic.oup.com/cid/article/33/8/1387/347551

PDF (CLIC en PDF)

 

October 14, 2018 at 10:39 am

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