Database : MEDLINE
Search on : Soft and Tissue and Infections [Words]
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[PMID]: 29506511
[Au] Autor:Seibt S; Gilchrist CA; Reed PW; Best EJ; Harnden A; Camargo CA; Grant CC
[Ad] Address:Paediatrics, Taranaki Base Hospital, New Plymouth, New Zealand.
[Ti] Title:Hospital readmissions with acute infectious diseases in New Zealand children < 2 years of age.
[So] Source:BMC Pediatr;18(1):98, 2018 Mar 05.
[Is] ISSN:1471-2431
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Infectious diseases are the leading cause of hospital admissions in young children. Hospitalisation with an infectious disease is a recurrent event for some children. Our objective was to describe risk factors for infectious disease readmission following hospital admission with an infectious disease in the first two years of life. METHODS: We performed a national cohort study of New Zealand children, born 2005-2009, with an infectious disease admission before age 24 months. Children readmitted with an infectious disease within 12 months of the first infectious disease admission were identified. Every infectious disease admission was categorised as a respiratory, enteric, skin and soft tissue, urinary or other infection. Independent associations of demographic and child health factors with infectious disease readmission were determined using multiple variable logistic regression. RESULTS: From 2005 to 2011, there were 69,902 infectious disease admissions for 46,657 children less than two years old. Of these 46,657 children, 10,205 (22%) had at least one infectious disease readmission within 12 months of their first admission. The first infectious disease admission was respiratory (54%), enteric (15%), skin or soft tissue (7%), urinary (4%) or other (20%). Risk of infectious disease readmission was increased if the first infectious disease admission was respiratory (OR = 1.87, 95% CI 1.78-1.95) but not if it was in any other infectious disease category. Risk factors for respiratory infectious disease readmission were male gender, Pacific or Maori ethnicity, greater household deprivation, presence of a complex chronic condition, or a first respiratory infectious disease admission during autumn or of ≥3 days duration. Fewer factors (younger age, male gender, presence of a complex chronic condition) were associated with enteric infection readmission. The presence of a complex chronic condition was the only factor associated with urinary tract infection readmission and none of the factors were associated with skin or soft tissue infection readmission. CONCLUSIONS: In children less than two years old, infectious disease readmission risk is increased if the first infectious disease admission is a respiratory infectious disease but not if it is another infectious disease category. Risk factors for respiratory infectious disease readmission are different from those for other infectious disease readmissions.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.1186/s12887-018-1079-x

  2 / 12159 MEDLINE  
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[PMID]: 29523721
[Au] Autor:Acquisto NM; Bodkin RP; Brown JE; Graman PS; Jones CMC; Li T; Hardy DJ; Dodds Ashley E
[Ad] Address:Department of Pharmacy, University of Rochester Medical Center, Rochester, New York, USA.
[Ti] Title:MRSA nares swab is a more accurate predictor of MRSA wound infection compared with clinical risk factors in emergency department patients with skin and soft tissue infections.
[So] Source:Emerg Med J;, 2018 Mar 09.
[Is] ISSN:1472-0213
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Skin and soft tissue infections (SSTI) caused by methicillin-resistant (MRSA) are prevalent in the emergency department (ED). We determined whether MRSA nasal carriage better identifies patients with MRSA wound infection than clinical risk factors or emergency medicine (EM) provider's choice of discharge prescriptions. METHODS: Adult patients presenting to a large academic medical centre ED in the USA with SSTI between May 2010 and November 2011 were screened. Research assistants administered a questionnaire regarding MRSA risk factors, and MRSA nares swab PCR testing, wound culture results and information on antibiotics prescribed at discharge were collected. Measures of classification accuracy for nares swab, individual risk factors and physician's prescription for MRSA coverage were compared with gold standard wound culture. RESULTS: During the study period, 116 patients with SSTI had both wound cultures and nares swabs for MRSA. was isolated in 59.5%, most often MRSA (75.4%). Thirty patients (25.9%) had a positive MRSA nares swab and culture for a sensitivity of 57.7% and specificity of 92.2%. Positive predictive value (PPV) for MRSA nares swab was 85.7% and positive likelihood ratio was 7.4, while negative predictive value was 72.8% and negative likelihood ratio 0.5. None of the individual risk factors nor EM provider's prescription for MRSA coverage had a PPV or positive likelihood ratio higher than nares swabs. CONCLUSIONS: MRSA nares swab is a more accurate predictor of MRSA wound infection compared with clinical risk factors or EM provider's choice of antibiotics. MRSA nares swab may be a useful tool in the ED.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  3 / 12159 MEDLINE  
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[PMID]: 29521041
[Au] Autor:Kawecki M; Pasek J; Cieslar G; Sieron A; Knefel G; Nowak M; Glik J
[Ad] Address:Centre for Burns Treatment, Siemianowice Slaskie, Poland.
[Ti] Title:Computerized planimetry evaluation of hyperbaric oxygen therapy in the treatment of diabetic foot.
[So] Source:Adv Clin Exp Med;27(1):39-44, 2018 Jan.
[Is] ISSN:1899-5276
[Cp] Country of publication:Poland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Diabetic foot ulcer is one of the major complications of diabetes mellitus in adults. OBJECTIVES: The aim of the study was to conduct a planimetry evaluation of the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of patients with vascular disorders caused by diabetic foot. MATERIAL AND METHODS: The study included 94 patients, 30 females (32%) and 64 males (68%), aged 33-76 years, with diabetes lasting 1.5-32 years, who underwent HBOT due to diabetic foot. All patients from that group underwent vascular procedures prior to HBOT. In qualifying patients for hyperbaric oxygen therapy, transcutaneous oximetry method was applied (30-60 exposures in hyperbaric oxygen at pressure of 2.5 ATA). Progress in wound healing was evaluated by computerized planimetry system IRIS 4. RESULTS: In 26 patients the wounds were completely closed and in 37 patients the topical state was significantly improved - the wound surface decreased by 34% in average. During the treatment, in 11 patients amputation of fingers and metatarsal necrotic bones was performed, while in 9 patients amputation was prevented. CONCLUSIONS: A planimetry evaluation showed that the application of HBOT in the treatment of diabetic foot enhances foot ulcer healing, reduces tissue damage, contributes to the reduction of complications related to soft tissue and bone infections.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.17219/acem/66392

  4 / 12159 MEDLINE  
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[PMID]: 29440139
[Au] Autor:Skedros JG; Adondakis MG; Brown EM; Oliver MR
[Ad] Address:Utah Orthopaedic Specialists, Murray, Utah, USA.
[Ti] Title: and olecranon bursitis/osteomyelitis: a case involving surgical and antibiotic treatment.
[So] Source:BMJ Case Rep;2018, 2018 Feb 12.
[Is] ISSN:1757-790X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:This report describes a 63-year-old generally healthy male with septic olecranon bursitis caused by The patient sustained a small laceration after striking the posterior aspect of his left elbow on a metal railing when he was at a public swimming pool. We concluded that was not initially detected because cultures were only kept for 5 days. Consequently, initial antibiotic treatment failed. and grew in a subsequent tissue culture. The infection did not respond to intravenous vancomycin although soft-tissue debridements were done. This likely reflected the presence of olecranon osteomyelitis (seen on MRI scans) in addition to inadequate treatment with this antibiotic in the setting of a polymicrobial infection. Eventually, the infection was eradicated with multiple soft-tissue debridements in addition to the continuation of vancomycin with daily intravenous piperacillin/tazobactam that was added for the final 4 weeks of antibiotic treatment.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process

  5 / 12159 MEDLINE  
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[PMID]: 29517217
[Au] Autor:Yildiz H; Yombi JC
[Ti] Title:Necrotizing Soft-Tissue Infections.
[So] Source:N Engl J Med;378(10):970, 2018 Mar 08.
[Is] ISSN:1533-4406
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:LETTER; COMMENT
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.1056/NEJMc1800049

  6 / 12159 MEDLINE  
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[PMID]: 29514033
[Ti] Title:Necrotizing Soft-Tissue Infections.
[So] Source:N Engl J Med;378(10):970-971, 2018 03 08.
[Is] ISSN:1533-4406
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:LETTER; COMMENT
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Process
[do] DOI:10.1056/NEJMc1800049

  7 / 12159 MEDLINE  
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[PMID]: 29447384
[Au] Autor:Lloyd BA; Murray CK; Shaikh F; Carson ML; Blyth DM; Schnaubelt ER; Whitman TJ; Tribble DR; Infectious Disease Clinical Research Program Trauma Infectious Disease Outcomes Study Group
[Ad] Address:San Antonio Military Medical Center, 3551 Roger Brooke Drive #3600, Fort Sam Houston, TX 78234.
[Ti] Title:Antimicrobial Prophylaxis with Combat-Related Open Soft-Tissue Injuries.
[So] Source:Mil Med;, 2018 Feb 13.
[Is] ISSN:1930-613X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Introduction: All Department of Defense (DoD) guidance documents recommend cefazolin or clindamycin as post-trauma antibiotic prophylaxis for open soft-tissue injuries. Although not advocated, some patients with open soft-tissue injuries also received expanded Gram-negative coverage (EGN) prophylaxis based on the judgment of front-line trauma providers. During the study period, revised guidelines in 2011/2012 re-emphasized recommendations for using cefazolin or clindamycin, and stewardship efforts in the DoD trauma community aimed to reduce the practice of adding EGN to guideline-recommended antibiotic prophylaxis. Our objective was to examine antibiotic utilization among wounded military personnel with open extremity soft-tissue injuries over a 5-yr period and assess the impact on infectious outcomes in patients who received EGN prophylaxis versus guideline-directed prophylaxis. Methods: The study population included military personnel with open extremity soft-tissue injuries sustained in Iraq and Afghanistan (2009-2014) who transferred to participating hospitals in the USA following medical evacuation. The analysis was restricted to patients who were hospitalized for at least seven days at a U.S. facility and excluded those who sustained open fractures. Post-trauma antibiotic prophylactic regimens were defined as narrow if they followed recommended guidance (e.g., IV cefazolin or clindamycin) or EGN coverage when the narrow regimen also included fluoroquinolones and/or aminoglycosides. Intravenous amoxicillin-clavulanate, which is commonly used at non-U.S. coalition theater hospitals, was also classified as narrow because it conformed to coalition antibiotic prophylaxis guidelines. This study was approved by the Infectious Disease Institutional Review Board of the Uniformed Services University of the Health Sciences. Results: A total of 287 wounded personnel with open soft-tissue injuries were assessed, of which 212 (74%) received narrow prophylaxis and 75 (26%) received EGN coverage (p < 0.001). Among patients in the narrow prophylaxis group, 81% were given cefazolin and/or clindamycin, while 19% received amoxicillin-clavulanate. In the EGN group, 88% and 12% received a fluoroquinolone and aminoglycoside, respectively. Use of EGN coverage significantly declined during the study period from 39% in 2009-2010 to 11% in 2013-2014 (p < 0.001). Approximately 3% of patients who received a narrow regimen developed an extremity skin and soft-tissue infection, while there were no skin and soft-tissue infections among patients in the EGN coverage group. Nonetheless, this was not a significant difference (p = 0.345). In addition, the proportion of non-extremity infections was not significantly different between narrow and EGN regimen groups (11% and 15%, respectively). There were also no significant differences between the narrow and EGN regimen groups related to duration of hospitalization (median of 19 versus 20 d). Conclusion: Use of non-guideline directed EGN-based post-trauma antibiotic prophylaxis does not improve infectious outcomes nor does it shorten hospital stay.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/milmed/usx125

  8 / 12159 MEDLINE  
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[PMID]: 29373647
[Au] Autor:Ugarte-Torres A; Gillrie MR; Griener TP; Church DL
[Ad] Address:Department of Medicine, Division of Infectious Diseases. Alberta Health Services, University of Calgary, Calgary Alberta, Canada.
[Ti] Title:Eggerthella lenta bloodstream infections are associated with increased mortality following empiric Piperacillin-Tazobactam (TZP) monotherapy: A population-based cohort study.
[So] Source:Clin Infect Dis;, 2018 Jan 24.
[Is] ISSN:1537-6591
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Background: Eggerthella lenta is a non-sporulating anaerobic gram-positive bacilli associated with polymicrobial intra-abdominal infections. Recently, E. lenta has been recognized as an important cause of anaerobic blood-stream infections (BSI) associated with high mortality. E. lenta has been reported to have high minimal inhibitory concentrations (MICs) to piperacillin-tazobactam (TZP), a broad-spectrum antibiotic with anaerobic coverage commonly used in multiple centers for empiric treatment of abdominal sepsis. Methods: We describe a retrospective population-based analysis of invasive E. lenta infections from 2009-2015. A logistic regression analysis for 30-day mortality risk factors was conducted. Results: We identified 107 cases of E. lenta infection, 95 (89%) were bloodstream infections, and 11 (10%) skin and soft tissue infections (SSTI) deep abscesses and 1 intra-abdominal abscess. Polymicrobial infections were found in 40%; 72% of isolates were from a gastrointestinal source, most commonly from appendicitis (33%) of which two-thirds were perforated. TZP MIC50 and MIC90 for E. lenta isolates were 32 and 64 µg/mL, respectively. The overall 30-day mortality for BSI was 23% and was independently associated with empiric TZP monotherapy (OR 4.4, 95% CI 1.2-16; p=0.02) and ICU stay (OR 6.2, 95% CI 1.4-27.3 p=0.01). 30-day mortality rates were significantly influenced by the use of different TZP MIC breakpoints. Conclusions: Our results demonstrate the increased recognition of E. lenta as an anaerobic opportunistic pathogen and highlight the need for improved empiric antimicrobial guidelines and TZP MIC breakpoints with better correlation to clinical outcomes to guide appropriate management of invasive E. lenta infections.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/cid/ciy057

  9 / 12159 MEDLINE  
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[PMID]: 29333818
[Au] Autor:Gentile Á; Bakir J; Ensinck G; Cancellara A; Casanueva EV; Firpo V; Caruso M; Lución MF; Santillán Iturres A; Molina F; Abate HJ; Gajo Gane A; López Papucci S; Grupo de Trabajo de Staphylococcus aureus
[Ad] Address:Hospital de Niños Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires. angelagentile21@gmail.com.
[Ti] Title:Infecciones por Staphylococcus aureus meticilino resistente adquirido en la comunidad: hospitalización y riesgo de letalidad en 10 centros pediátricos de Argentina. Community-acquired methicillin-resistant Staphylococcus aureus infections: hospitalization and case fatality risk in 10 pediatric facilities in Argentina.
[So] Source:Arch Argent Pediatr;116(1):e47-e53, 2018 Feb 01.
[Is] ISSN:1668-3501
[Cp] Country of publication:Argentina
[La] Language:eng; spa
[Ab] Abstract:INTRODUCTION: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are prevalent both in Argentina and worldwide, and they may have a severe clinical course. OBJECTIVES: To estimate the hospitalization rate and case fatality risk factors of CA-MRSA infection. METHODS: Cross-sectional, analytical study. All patients < 15 years old with community-acquired Staphylococcus aureus (CA-SA) infections admitted to 10 pediatric facilities between January 2012 and December 2014 were included. RESULTS: Out of 1141 patients with CA-SA, 904 (79.2%) had CA-MRSA. The rate of hospitalization of CA-MRSA cases (per 10 000 discharges) among patients < 5 years old was 27.6 in 2012, 35.2 in 2013, and 42.7 in 2014 (p = 0.0002). The 2-4-year-old group was the most affected one: 32.2, 49.4, and 54.4, respectively (p = 0.0057). The clinical presentations included skin and soft tissue infections: 66.2%, pneumonia: 11.5%, sepsis/bacteremia: 8.5%, osteomyelitis: 5.5%, arthritis: 5.2%, psoas abscess: 1.0%, pericarditis/endocarditis: 0.8%, meningitis: 0.6%, and other: 0.7%. In terms of antibiotic resistance, 11.1% had resistance to erythromycin; 8.4%, to gentamicin; and 0.6%, to trimethoprim-sulfamethoxazole. All strains were susceptible to vancomycin. The case fatality rate was 2.2% and associated risk factors were (odds ratio [95% confidence interval]) age > 8 years (2.78, 1.05-7.37), pneumonia (6.37, 2.3717.09), meningitis (19.53, 2.40-127.87), and sepsis/bacteremia (39.65, 11.94-145.55). CONCLUSIONS: The rate of CA-MRSA infection was high; the rate of hospitalization increased in the 2013-2014 period; the 2-4-year-old group was the most affected one. A higher case fatality risk was observed among patients > 8 years old and those with the clinical presentations of pneumonia, meningitis, and sepsis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.5546/aap.2018.eng.e47

  10 / 12159 MEDLINE  
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[PMID]: 29211672
[Au] Autor:Stevens DL; Bryant AE
[Ad] Address:From the Veterans Affairs Medical Center, Boise, ID; and the University of Washington School of Medicine, Seattle.
[Ti] Title:Necrotizing Soft-Tissue Infections.
[So] Source:N Engl J Med;377(23):2253-2265, 2017 Dec 07.
[Is] ISSN:1533-4406
[Cp] Country of publication:United States
[La] Language:eng
[Mh] MeSH terms primary: Anti-Bacterial Agents/therapeutic use
Debridement
Fasciitis, Necrotizing
[Mh] MeSH terms secundary: Anti-Inflammatory Agents, Non-Steroidal/adverse effects
Biomarkers/blood
Biopsy
C-Reactive Protein/analysis
Critical Illness
Fasciitis, Necrotizing/diagnosis
Fasciitis, Necrotizing/etiology
Fasciitis, Necrotizing/pathology
Fasciitis, Necrotizing/therapy
Gas Gangrene
Humans
Hyperbaric Oxygenation
Immunoglobulins, Intravenous/therapeutic use
Soft Tissue Infections
Streptococcal Infections/chemically induced
Streptococcus pyogenes
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:0 (Anti-Bacterial Agents); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Biomarkers); 0 (Immunoglobulins, Intravenous); 9007-41-4 (C-Reactive Protein)
[Em] Entry month:1712
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:171207
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMra1600673


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