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[PMID]:28454768
[Au] Autor:Kotkowski K; Ellison RT; Barysauskas C; Barton B; Allison J; Mack D; Finberg RW; Reznek M
[Ad] Endereço:Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address: kevin.kotkowski@umassmemorial.org.
[Ti] Título:Association of hospital contact precaution policies with emergency department admission time.
[So] Source:J Hosp Infect;96(3):244-249, 2017 Jul.
[Is] ISSN:1532-2939
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Contact precautions are a widely accepted strategy to reduce in-hospital transmission of meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). However, these practices may have unintended deleterious effects on patients. AIM: To evaluate the effect of a modification in hospital-wide contact precaution practices on emergency department (ED) admission times. METHODS: During the study period, the hospital changed its contact precaution policy from requiring contact precautions for all patients with a history of MRSA or VRE to only those who presented with clinical conditions likely to contaminate the environment with pathogens. An interrupted time series analysis of ED admission times for adults for one year preceding and one year following this change was performed at a two-campus hospital. The main outcome was admission time, defined as time from decision to admit to arrival in an inpatient bed, for patients with MRSA or VRE compared with all other patients. The in-hospital MRSA and VRE acquisition rates were evaluated over the same period and have been published previously. FINDINGS: At one campus, admission time decreased immediately by 161min for MRSA patients (P=0.008) and 135min for VRE patients (P=0.003), and both continued to decrease over the duration of the study. There was no significant change in admission time at the second campus. CONCLUSIONS: Modifying contact precaution requirements for MRSA and VRE may be associated with improved ED admission time without significantly altering in-hospital MRSA and VRE acquisition.
[Mh] Termos MeSH primário: Infecção Hospitalar/prevenção & controle
Medicina de Emergência/métodos
Infecções por Bactérias Gram-Positivas/diagnóstico
Controle de Infecções/métodos
Staphylococcus aureus Resistente à Meticilina/isolamento & purificação
Admissão do Paciente
Enterococos Resistentes à Vancomicina/isolamento & purificação
[Mh] Termos MeSH secundário: Adulto
Portador Sadio/diagnóstico
Serviço Hospitalar de Emergência
Hospitais
Seres Humanos
Política Organizacional
Estudos Retrospectivos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


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[PMID]:29361927
[Au] Autor:Lin Z; Feng X; Zheng L; Moonasar N; Shen L; Wu R; Chen F
[Ad] Endereço:The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, No. 270 West College Road, Wenzhou, Zhejiang, 325027, China.
[Ti] Título:Incidence of endophthalmitis after 23-gauge pars plana vitrectomy.
[So] Source:BMC Ophthalmol;18(1):16, 2018 Jan 23.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Endophthalmitis is a rare but severe complication following PPV. The incidence of endophthalmitis varies between 20-gauge, 23-gauge, and 25-gauge incisions. The incidence and clinical features of endophthalmitis after 23-gauge PPV in an eye hospital in China was reported in this study. METHODS: Data of the eyes that underwent 23-gauge PPV from January 2011 to December 2014 at the Eye Hospital of Wenzhou Medical University was retrospectively collected. All the information was obtained from the electronic medical system. The exclusion criteria included: (1) preoperative diagnosis of endophthalmitis; (2) history of vitrectomy; (3) intraocular surgery within 6 months; (4) history of ocular penetrating trauma; (5) sutures for any of the 3 sclerotomy incisions; (6) patients with cancer, acquired immune deficiency syndrome, or taking drugs that may influence the immune system. The diagnosis of endophthalmitis was based on clinical characteristics and/or culture results from an operative sample. RESULTS: Three thousand nine hundred seventy nine eyes that underwent 23-gauge PPV surgery were included in this study. Among these eyes, 3 eyes developed endophthalmitis after surgery, giving an incidence of 0.075% (3/3979). The period in which endophthalmitis developed ranged from 1 to 5 days post-operation. The visual acuity decreased to hand motions or light perception postoperatively. The culture of aqueous and vitreous of the 2 eyes revealed Staphylococcus epidermidis and enterococcus faecalis respectively, however was negative for the third eye. All 3 eyes had a favorable response to the treatment of vitreous tap and intravitreal antibiotics injection. Two eyes gained visual acuity of 0.05 and 0.5, respectively at the final visit. CONCLUSIONS: Endophthalmitis is a rare but sight-threatening complication after 23-gauge pars plana vitrectomy. The peak duration of onset was within 5 days post-operation, with gram positive cocci being the common pathogenic organism.
[Mh] Termos MeSH primário: Endoftalmite/epidemiologia
Infecções Oculares Bacterianas/epidemiologia
Microcirurgia/efeitos adversos
Doenças Retinianas/cirurgia
Infecções Estafilocócicas/epidemiologia
Infecção da Ferida Cirúrgica/epidemiologia
Vitrectomia/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Humor Aquoso/microbiologia
China/epidemiologia
Endoftalmite/diagnóstico
Endoftalmite/microbiologia
Enterococcus faecalis/isolamento & purificação
Infecções Oculares Bacterianas/diagnóstico
Infecções Oculares Bacterianas/microbiologia
Feminino
Seguimentos
Infecções por Bactérias Gram-Positivas/diagnóstico
Infecções por Bactérias Gram-Positivas/epidemiologia
Infecções por Bactérias Gram-Positivas/microbiologia
Seres Humanos
Incidência
Masculino
Microcirurgia/instrumentação
Meia-Idade
Estudos Retrospectivos
Infecções Estafilocócicas/diagnóstico
Infecções Estafilocócicas/microbiologia
Staphylococcus epidermidis/isolamento & purificação
Infecção da Ferida Cirúrgica/microbiologia
Ultrassonografia
Acuidade Visual
Vitrectomia/instrumentação
Corpo Vítreo/diagnóstico por imagem
Corpo Vítreo/microbiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0678-5


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[PMID]:29269698
[Au] Autor:Nakanishi K; Kawano H; Amano T; Omori Y; Kanma H; Hirano T
[Ad] Endereço:Department of Stroke and Cerebrovascular Medicine, Kyorin University.
[Ti] Título:[Stroke due to infective endocarditis diagnosed by the retrieved thrombus: a case report].
[So] Source:Rinsho Shinkeigaku;58(1):35-40, 2018 Jan 26.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:A 80-years-old woman suddenly presented with aphasia, right hemiparesis, and dysesthesia. MRA showed the left middle cerebral artery occlusion. She was diagnosed as hyperacute ischemic stroke. She was treated with intravenous recombinant tissue plasminogen activator and underwent endovascular thrombectomy. On admission, she had a fever and high C reactive protein, and was treated with antibiotic therapy. The pathological diagnosis of the retrieved thrombus revealed the cluster of the gram positive cocci. The blood culture was negative and thransthoracic echocardiogram did not detect the vegetation. She was finally diagnosed as cardioembolic stroke due to infective endocarditis based on the pathological diagnosis of the retrieved thrombus. The pathological diagnosis of the retrieved thrombus was quite important to clarify the cause of ischemic stroke.
[Mh] Termos MeSH primário: Endocardite/complicações
Endocardite/diagnóstico
Procedimentos Endovasculares/métodos
Infecções por Bactérias Gram-Positivas
Acidente Vascular Cerebral/etiologia
Acidente Vascular Cerebral/terapia
Trombectomia/métodos
Trombose/complicações
Trombose/microbiologia
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Endocardite/microbiologia
Endocardite/patologia
Feminino
Cocos Gram-Positivos
Seres Humanos
Infusões Intravenosas
Angiografia por Ressonância Magnética
Acidente Vascular Cerebral/diagnóstico por imagem
Trombose/patologia
Ativador de Plasminogênio Tecidual/administração & dosagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-001099


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[PMID]:29443752
[Au] Autor:Li X; Fan S; Lin X; Liu L; Zheng J; Zhou X; Heep A
[Ad] Endereço:Department of Neonatology.
[Ti] Título:The first case report of Enterococcus gallinarum meningitis in neonate: A literature review.
[So] Source:Medicine (Baltimore);97(7):e9875, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Enterococcus gallinarum meningitis (EGM) is rarely found in normal adults and even rarer in children. To our knowledge, EGM in neonate has not been reported previously. PATIENTS CONCERNS: Here we reported the first case of EGM in neonate. Prolonged fever was the only manifestation for the case after admission. DIAGNOSES: Cerebrospinal fluid cultures showed that the isolate was Enterococcus gallinarum and sensitive to linezolid. INTERVENTIONS: Ceftriaxone, beta lactam type, and vancomycin were used respectively, but not effective. OUTCOMES: The temperature went down to normal after linezolid was used and the baby was discharged in good condition in the end. LESSONS: This case indicated that EGM could also occur in neonate and fever could be the only obvious manifestation. Thus, the effective antibiotics and adequate duration are very important and linezolid is a potential good choice, especially for vancomycin-resistant patients.
[Mh] Termos MeSH primário: Infecções por Bactérias Gram-Positivas
Linezolida/administração & dosagem
Meningites Bacterianas
Enterococos Resistentes à Vancomicina
[Mh] Termos MeSH secundário: Antibacterianos/administração & dosagem
Infecções por Bactérias Gram-Positivas/tratamento farmacológico
Infecções por Bactérias Gram-Positivas/microbiologia
Infecções por Bactérias Gram-Positivas/fisiopatologia
Seres Humanos
Recém-Nascido
Masculino
Meningites Bacterianas/tratamento farmacológico
Meningites Bacterianas/microbiologia
Meningites Bacterianas/fisiopatologia
Testes de Sensibilidade Microbiana/métodos
Resultado do Tratamento
Enterococos Resistentes à Vancomicina/efeitos dos fármacos
Enterococos Resistentes à Vancomicina/isolamento & purificação
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); ISQ9I6J12J (Linezolid)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009875


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[PMID]:29258361
[Au] Autor:Galluzzo M; D'Adamio S; Bianchi L; Talamonti M
[Ad] Endereço:a Department of Dermatology , University of Rome 'Tor Vergata ,' Rome , Italy.
[Ti] Título:Pharmacokinetic drug evaluation of dalbavancin for the treatment of skin infections.
[So] Source:Expert Opin Drug Metab Toxicol;14(2):197-206, 2018 Feb.
[Is] ISSN:1744-7607
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Acute bacterial skin and skin structure infections (ABSSIs), defined as a bacterial infection of the skin with a lesion size area of at least 75 cm, are a leading cause of hospital admission and ambulatory care visits worldwide. Dalbavancin is a lipoglycopeptide antibiotic recently approved by the United States Food and Drug Administration (FDA) and by European Medicines Agency (EMA) for ABSSSIs. The authors review and provide updates of efficacy and safety by several studies on dalbavancin. Areas covered: A PubMed search was performed for relevant literature. We especially focused our attention on pharmacokinetics. Expert opinion: Dalbavancin provides an important new therapy for management of ABSSI, maintaining a spectrum of activity similar to vancomycin against gram-positive organisms. Use of dalbavancin, with its 1-week-shot treatment, consist in a reduction of the length of hospital stay or in a reduction of hospital admissions, with important cost savings.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Dermatopatias Bacterianas/tratamento farmacológico
Teicoplanina/análogos & derivados
[Mh] Termos MeSH secundário: Animais
Antibacterianos/economia
Antibacterianos/farmacocinética
Redução de Custos
Infecções por Bactérias Gram-Positivas/tratamento farmacológico
Infecções por Bactérias Gram-Positivas/economia
Infecções por Bactérias Gram-Positivas/microbiologia
Hospitalização/estatística & dados numéricos
Seres Humanos
Tempo de Internação
Dermatopatias Bacterianas/economia
Dermatopatias Bacterianas/microbiologia
Teicoplanina/administração & dosagem
Teicoplanina/economia
Teicoplanina/farmacocinética
Vancomicina/uso terapêutico
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 61036-62-2 (Teicoplanin); 6Q205EH1VU (Vancomycin); 808UI9MS5K (dalbavancin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1080/17425255.2018.1420162


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[PMID]:28467378
[Au] Autor:Ali L; Goraya MU; Arafat Y; Ajmal M; Chen JL; Yu D
[Ad] Endereço:College of Animal Sciences, Fujian Agriculture and Forestry University, Fuzhou 350002, China. liaqatpaksw@yahoo.com.
[Ti] Título:Molecular Mechanism of Quorum-Sensing in Enterococcus faecalis: Its Role in Virulence and Therapeutic Approaches.
[So] Source:Int J Mol Sci;18(5), 2017 May 03.
[Is] ISSN:1422-0067
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Quorum-sensing systems control major virulence determinants in , which causes nosocomial infections. The . quorum-sensing systems include several virulence factors that are regulated by the operon, which encodes the cytolysin toxin. In addition, the . Fsr regulator system controls the expression of gelatinase, serine protease, and enterocin O16. The cytolysin and Fsr virulence factor systems are linked to enterococcal diseases that affect the health of humans and other host models. Therefore, there is substantial interest in understanding and targeting these regulatory pathways to develop novel therapies for enterococcal infection control. Quorum-sensing inhibitors could be potential therapeutic agents for attenuating the pathogenic effects of . . Here, we discuss the regulation of cytolysin, the LuxS system, and the Fsr system, their role in . -mediated infections, and possible therapeutic approaches to prevent . infection.
[Mh] Termos MeSH primário: Infecção Hospitalar/microbiologia
Enterococcus faecalis/patogenicidade
Infecções por Bactérias Gram-Positivas/microbiologia
Percepção de Quorum/fisiologia
[Mh] Termos MeSH secundário: Antibacterianos/farmacologia
Antibacterianos/uso terapêutico
Proteínas de Bactérias/genética
Biofilmes/efeitos dos fármacos
Biofilmes/crescimento & desenvolvimento
Liases de Carbono-Enxofre/genética
Infecção Hospitalar/tratamento farmacológico
Enterococcus faecalis/efeitos dos fármacos
Enterococcus faecalis/genética
Regulação Bacteriana da Expressão Gênica/fisiologia
Infecções por Bactérias Gram-Positivas/tratamento farmacológico
Seres Humanos
Perforina/genética
Percepção de Quorum/efeitos dos fármacos
Virulência
Fatores de Virulência/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Bacterial Proteins); 0 (Virulence Factors); 126465-35-8 (Perforin); EC 4.4.- (Carbon-Sulfur Lyases); EC 4.4.1.21 (LuxS protein, Bacteria)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


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[PMID]:27771978
[Au] Autor:Schreiber MP; Shorr AF
[Ad] Endereço:a Department of Internal Medicine , Section of Pulmonary Disease & Critical Care , 110 Irving St NW, Washington , DC , USA.
[Ti] Título:Challenges and opportunities in the treatment of ventilator-associated pneumonia.
[So] Source:Expert Rev Anti Infect Ther;15(1):23-32, 2017 01.
[Is] ISSN:1744-8336
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Ventilator-associated pneumonia (VAP) is a distinct clinical entity characterized by an onset after 48 hours of the application of mechanical ventilation (MV). Protocols exist to aid in the prevention of VAP, but this infection carries a devastating impact on patient morbidity and potentially mortality. Areas covered: In this review we present key concepts from existing guidelines to aid clinicians. Challenges remain in defining this disease and, most importantly appropriate empiric antimicrobial treatment is the main determinant of outcome. We highlight that the selection of initial antibiotics is critical, as VAP can by caused by a broad array of drug resistant organisms (DROs), the appropriate duration of treatment for VAP is an evolving concept, but may, in part, be guided by biomarkers, and provide focus on diagnostic challenges, initial therapies and treatment strategies for VAP. Both traditional and novel antimicrobials are presented, including developments in the modes of delivery. Expert commentary: The clinical approach to VAP continues to evolve. Recent evidence regarding the changes in microbiology, diagnostics approaches, and treatment strategies for VAP are important for clinicians to remain informed of to provide optimal patient care.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Cuidados Críticos/métodos
Pneumopatias Fúngicas/tratamento farmacológico
Pneumonia Bacteriana/tratamento farmacológico
Pneumonia Associada à Ventilação Mecânica/diagnóstico
Pneumonia Associada à Ventilação Mecânica/tratamento farmacológico
[Mh] Termos MeSH secundário: Antibacterianos/administração & dosagem
Antibacterianos/efeitos adversos
Infecções por Bactérias Gram-Negativas/diagnóstico
Infecções por Bactérias Gram-Negativas/tratamento farmacológico
Infecções por Bactérias Gram-Negativas/microbiologia
Infecções por Bactérias Gram-Negativas/mortalidade
Infecções por Bactérias Gram-Positivas/diagnóstico
Infecções por Bactérias Gram-Positivas/tratamento farmacológico
Infecções por Bactérias Gram-Positivas/microbiologia
Seres Humanos
Pneumopatias Fúngicas/diagnóstico
Pneumopatias Fúngicas/microbiologia
Pneumopatias Fúngicas/mortalidade
Pneumonia Bacteriana/diagnóstico
Pneumonia Bacteriana/microbiologia
Pneumonia Bacteriana/mortalidade
Pneumonia Associada à Ventilação Mecânica/microbiologia
Pneumonia Associada à Ventilação Mecânica/mortalidade
Guias de Prática Clínica como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161101
[St] Status:MEDLINE


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[PMID]:29195768
[Au] Autor:Menon V; Davis R; Shackel N; Espedido BA; Beukers AG; Jensen SO; van Hal SJ
[Ad] Endereço:Department of Microbiology and Infectious Diseases, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
[Ti] Título:Failure of daptomycin ß-Lactam combination therapy to prevent resistance emergence in Enterococcus faecium.
[So] Source:Diagn Microbiol Infect Dis;90(2):120-122, 2018 Feb.
[Is] ISSN:1879-0070
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Daptomycin ß-Lactam combination therapy offers "protection" against daptomycin non-susceptibility (DNS) development in Enterococcus faecium. We report failure of this strategy and the importance of source control. Mutations were detected in the LiaF and cls genes in DNS isolates. A single DNS isolate contained an unrecognized mutation, which requires confirmation.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Daptomicina/uso terapêutico
Enterococcus faecium/efeitos dos fármacos
Infecções por Bactérias Gram-Positivas/tratamento farmacológico
beta-Lactamas/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Antibacterianos/farmacologia
Daptomicina/farmacologia
Farmacorresistência Bacteriana/genética
Quimioterapia Combinada
Enterococcus faecium/genética
Infecções por Bactérias Gram-Positivas/microbiologia
Seres Humanos
Masculino
Testes de Sensibilidade Microbiana
Mutação/genética
beta-Lactamas/farmacologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (beta-Lactams); NWQ5N31VKK (Daptomycin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171203
[St] Status:MEDLINE


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[PMID]:29245276
[Au] Autor:Chen CH; Lin LC; Chang YJ; Chang CY
[Ad] Endereço:aCenter of Infection Prevention and ControlbDivision of Infectious Diseases, Department of Internal Medicine, Yuanlin Christian Hospital, ChanghuacDepartment of Nursing, College of Medicine & Nursing, Hung Kuang University, Sha-lu District, TaichungdEpidemiology and Biostatics Center, Changhua Christian HospitaleDepartment of Internal Medicine,Yuanlin Christian Hospital, Changhua, Taiwan.
[Ti] Título:Clinical and microbiological characteristics of vancomycin-resistant Enterococcus faecium bloodstream infection in Central Taiwan.
[So] Source:Medicine (Baltimore);96(49):e9000, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Bloodstream infections (BSIs) due to vancomycin-resistant Enterococcus faecium (VREfae) remain a therapeutic challenge. This study aimed to evaluate mortality from BSIs due to VREfae in Central Taiwan.We retrospectively analyzed patients with significant VREfae BSIs in the Changhua Christian Hospital System between January 1, 2010 and December 31, 2014.Of the 152 patients with Enterococcal BSI, 56 patients (36.8%) were admitted to intensive care units (ICUs) at the onset of BSI and 20 (13.2%) patients were associated with polymicrobial bacteremia. VREfae BSI was observed in 36 (23.7%) patients. Van A (100%) is the prevalence genotype, and ST 17 (41.7%) is the predominant ST type among 36 VREfae isolates during the study period. The 30-day mortality rate was 13.2% (20/152). The multivariate logistic regression analysis showed that the onset of VREfae BSI in the ICU (odds ratio [OR] = 4.2, 95% confidence interval [CI] = 1.7-10.0, P = .002) was a significant risk factor for 30-day mortality, whereas an appropriate antimicrobial therapy was a protective factor for 30-day mortality (OR = 0.33, 95% CI = 0.14-0.79, P = .013).Our results underscore the need to assist patients who are admitted to ICUs with VREfae BSIs. We emphasize the use of an appropriate antimicrobial therapy for VREfae BSI with the aim to treat more patients with these infections.
[Mh] Termos MeSH primário: Bacteriemia/microbiologia
Enterococcus faecium
Infecções por Bactérias Gram-Positivas/fisiopatologia
Resistência a Vancomicina
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Antibacterianos/uso terapêutico
Bacteriemia/tratamento farmacológico
Bacteriemia/epidemiologia
Técnicas Bacteriológicas
Feminino
Genótipo
Infecções por Bactérias Gram-Positivas/tratamento farmacológico
Infecções por Bactérias Gram-Positivas/epidemiologia
Seres Humanos
Masculino
Meia-Idade
Fatores de Risco
Taiwan/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009000


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[PMID]:29245306
[Au] Autor:Chen D; Dong M; Zhao K; Sun F; Wang H; Liu Z
[Ad] Endereço:aThe First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, ZhejiangbKey Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou, China.
[Ti] Título:Unusual synchronous liver and brain abscesses infected by rare Aerococcus viridians in a patient with pulmonary arteriovenous malformations on FDG PET/CT: A case report and literature review.
[So] Source:Medicine (Baltimore);96(49):e9048, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Pulmonary arteriovenous malformations (PAVMs) complicated with multiple organ abscesses is an uncommon manifestation. Because of the low incidence of the disease, F-18 fluorodeoxyglucose positron emission tomography with computed tomography (F-FDG PET/CT) imaging studies for PAVMs complicated with multiple organ abscesses are scarce. PATIENT CONCERNS: We report a case of a 54-year-old man presenting with PAVMs complicated with synchronous multiple organ abscesses founded by F-FDG PET/CT. F-FDG PET/CT revealed tortuous stripes and mass opacities with no significant FDG uptake in the left upper lung lobe. However, hypermetabolic lesions located in the anterior inferior segment of right hepatic lobe [with maximum standardized uptake value (SUVmax) of 10.7], and in the right basal ganglia with SUVmax of 14.1 were found by F-FDG PET/CT. DIAGNOSES: A diagnosis of synchronous liver and brain abscesses infected by rare Aerococcus viridans was determined by tissue culture. INTERVENTIONS: Vancomycin was provided intravenously, and oral linezolidate tablets were prescribed for anti-inflammatory treatment for 1 month. Liver and head magnetic resonance imaging was performed during the follow-up. OUTCOMES: The lesion in the right basal ganglia was reduced, and the lesion in the right liver had disappeared, indicating the lesions were abscesses. LESSONS: The present case indicated that the possibility of abscesses should be considered with patients with PAVMs, and whole-body F-FDG PET/CT is suggested to identify possible accompanying abscesses in multiple organs for PAVMs patients.
[Mh] Termos MeSH primário: Abscesso Encefálico/diagnóstico por imagem
Fluordesoxiglucose F18
Infecções por Bactérias Gram-Positivas/diagnóstico por imagem
Abscesso Hepático/diagnóstico por imagem
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos
Compostos Radiofarmacêuticos
[Mh] Termos MeSH secundário: Aerococcus
Malformações Arteriovenosas/diagnóstico por imagem
Malformações Arteriovenosas/microbiologia
Abscesso Encefálico/microbiologia
Infecções por Bactérias Gram-Positivas/microbiologia
Seres Humanos
Abscesso Hepático/microbiologia
Masculino
Meia-Idade
Artéria Pulmonar/anormalidades
Artéria Pulmonar/diagnóstico por imagem
Artéria Pulmonar/microbiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Radiopharmaceuticals); 0Z5B2CJX4D (Fluorodeoxyglucose F18)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009048



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