COVID-19 increased the risk of ICU-acquired bloodstream infections: a case–cohort study from the multicentric OUTCOMEREA network

Intensive Care Medicine, Год журнала: 2021, Номер 47(2), С. 180 - 187

Опубликована: Янв. 27, 2021

Язык: Английский

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Invasive candidiasis

Nature Reviews Disease Primers, Год журнала: 2024, Номер 10(1)

Опубликована: Март 21, 2024

Язык: Английский

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ICU-acquired infections in immunocompromised patients

Intensive Care Medicine, Год журнала: 2024, Номер 50(3), С. 332 - 349

Опубликована: Янв. 10, 2024

Язык: Английский

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Sepsis and Septic Shock

New England Journal of Medicine, Год журнала: 2024, Номер 391(22), С. 2133 - 2146

Опубликована: Дек. 4, 2024

Язык: Английский

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Clinical validation of a multiplex droplet digital PCR for diagnosing suspected bloodstream infections in ICU practice: a promising diagnostic tool

Critical Care, Год журнала: 2022, Номер 26(1)

Опубликована: Авг. 8, 2022

Droplet digital PCR (ddPCR) has emerged as a promising tool of pathogen detection in bloodstream infections (BSIs) critical care medicine. However, different ddPCR platforms have variable sensitivity and specificity for diverse microorganisms at various infection sites. There is still lack prospective clinical studies aimed validating interpreting the discrepant results diagnosing BSI intensive unit (ICU) practice.A diagnostic study multiplex panels was conducted general ICU from May 21, 2021, to December 22, 2021. Paired blood cultures (BCs) ddPCRs (2.5 h) were obtained synchronously detect 12 most common pathogens three antimicrobial resistance (AMR) genes. Firstly, performance compared definite BSI. Secondly, validation composite diagnosis. Sensitivity, specificity, positive negative predictive values calculated. Thirdly, rate AMR genes related analysis presented.A total 438 episodes suspected BSIs occurring 150 patients enrolled. BC targeted bacteria 40 (9.1%) 180 (41.1%) cases, respectively. 280 concordant 158 discordant. In comparison with BCs, ranged 58.8 86.7% an aggregate 72.5% species, corresponding ranging 73.5 92.2% 63.1%. Furthermore, ddPCR+/BC- 33.6% (147/438) 87.1% (128 147) cases associated probable (n = 108) or possible 20) BSIs. When clinically diagnosed used true positive, final increased 84.9% 92.5%, addition, blaKPC, 3blaNDM, 38 mecA detected, among which 90.5% definitely blaKPC. Further, 65.8% specimens predicted be mecA-positive Staphylococcus sp. according all microbiological analysis.The multiplexed flexible universal platform, can add-on complementary conventional BC. combined evidence, shows potential advantages rapidly practice.

Язык: Английский

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Antibiotic stewardship in the ICU: time to shift into overdrive

Annals of Intensive Care, Год журнала: 2023, Номер 13(1)

Опубликована: Май 6, 2023

Abstract Antibiotic resistance is a major health problem and will be probably one of the leading causes deaths in coming years. One most effective ways to fight against decrease antibiotic consumption. Intensive care units (ICUs) are places where antibiotics widely prescribed, multidrug-resistant pathogens frequently encountered. However, ICU physicians may have opportunities consumption apply antimicrobial stewardship programs. The main measures that implemented include refraining from immediate prescription when infection suspected (except patients with shock, administration essential); limiting empiric broad-spectrum (including anti-MRSA antibiotics) without risk factors for pathogens; switching monotherapy instead combination therapy narrowing spectrum culture susceptibility tests results available; use carbapenems extended-spectrum beta-lactamase-producing Enterobacteriaceae, new beta-lactams difficult-to-treat pathogen (when these news only available option); shortening duration treatment, procalcitonin being tool attain this goal. Antimicrobial programs should combine rather than applying single one. ICUs at frontline developing

Язык: Английский

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Bloodstream Infection in the Intensive Care Unit: Evolving Epidemiology and Microbiology

Antibiotics, Год журнала: 2024, Номер 13(2), С. 123 - 123

Опубликована: Янв. 26, 2024

Bloodstream infections (BSIs) arising in the intensive care unit (ICUs) present a significant challenge and we completed narrative review of emerging literature on this issue. Multiple reports document that these are associated with substantial morbidity mortality. Also, they can be caused by variety pathogens. Generally classified as either community or hospital onset, primary secondary origin, microbiology ICU BSIs varies across globe. Gram-positive pathogens predominate certain regions such United States while Gram-negative organisms occur more frequently Europe, Asia, Latin America. The incidence climbed during recent pandemic. complicating persons suffering from Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection significantly heighten risk for death compared to patients who develop but not infected SARS-CoV-2. Furthermore, rates antimicrobial resistance generally increasing BSIs. This fact complicates attempts ensure patient receives initially appropriate therapy is particular concern Methicillin-resistant Staphylococcus aureus, Carbapenem-resistant Enterobacterales, Acinetobacter baumannii. Fortunately, respect clinical application, preventive measures exist, analyses suggest increased collaboration between infectious disease specialists intensivists improve outcomes.

Язык: Английский

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Factors affecting the prolongation of mechanical ventilation in patients after cardiac surgery

Journal of Cardiothoracic Surgery, Год журнала: 2025, Номер 20(1)

Опубликована: Янв. 29, 2025

Abstract Background This study aimed to investigate the major predictive factors associated with prolonged mechanical ventilation(PMV) following cardiac surgery. Methods retrospective, cross-sectional, descriptive-analytical was conducted from September 2021 March 2022, involving 244 patients who underwent PMV defined as ventilation for more than 24 h. Potential risk before, during, and after surgery were examined recorded. Logistic regression analysis performed assess relationship between demographic, clinical variables, ventilation. A significance level of 0.05 used data analysis. Results The population consisted 68.4% male 31.6% female patients, 86.9% undergoing CABG observed in 13.1% patients. findings revealed that incidence postoperative pneumonia increased likelihood by 7 times [OR = 7.24, 95% CI=(5.12,8.14), P-value 0.001]. Similarly, respiratory failure a 7.5-fold increase odds 7.56, CI=(4.48,8.77), 0.042]. Drainage one liter blood on first day 2.2 2.21, CI=(1.98,2.46), 0.032], use epinephrine 2.73-fold 2.73, CI=(2.24,3.11), 0.022]. Risk had dysfunctin 2 times.[OR 2.58, 95%; CI (1.33.2.87); In need an Intra Aortic Balloon Pump(IABP) times. (OR 2.74,95%,CI 1.36,5.47: Pvalue 0.03). cerebrovascular accident(CVA) three 3.75, 1.26,4.84; 0.044]. For each unit Euro Score chance 1.38 TIMES. Furthermore ICU Mortality significant PMV.(Pvalue < 0.001). Conclusion identified complications, such pneumonia, failure, high drainage, IABP, higher EURO 2, Cardiac dysfunction, CVA epinephrine, independent

Язык: Английский

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Retrospective analysis of 300 microbial cell-free DNA sequencing results in routine blood stream infection diagnostics

Frontiers in Cellular and Infection Microbiology, Год журнала: 2025, Номер 15

Опубликована: Янв. 30, 2025

Introduction Bloodstream infections are a critical challenge worldwide due to the slow turnaround time of conventional microbiological tests for detecting bacteremia in septic patients. Noscendo GmbH (Duisburg, Germany) has developed CE/IVD pipeline DISQVER clinical metagenomics testing based on cell-free DNA (cfDNA) from blood samples address this issue. Methods We conducted retrospective study evaluate diagnostic utility methodological setup improving treatment decisions since it was introduced into our setting. Between January 2021 and June 2022, first 300 cases which applied at university hospital were collected analyzed. The results compared with routine microbiology test results, picture, associated decisions, course. Results Our findings demonstrate that where no pathogen reported effectively ruled out bacterial bloodstream infections, whereas positive varied their usefulness. While metagenomic approach proved highly valuable non-culturable rare pathogens, its limited detected microorganisms commonly microbiota. Discussion Performing on-site analysis might mitigate delays resulting logistical challenges help optimizing antibiotic stewardship. Once prompt can be obtained, relevance incorporating molecular resistograms will become more pronounced. Further, specific patient subgroups most benefit must worked out. Guiding clinicians identifying infection focus bacteria would significantly improve care. Lastly, evidence filamentous fungi diligently followed up.

Язык: Английский

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Predictive value of serum procalcitonin level for the diagnosis of bloodstream infections in hematological patients

BMC Infectious Diseases, Год журнала: 2025, Номер 25(1)

Опубликована: Фев. 3, 2025

Procalcitonin (PCT) is a critical diagnostic biomarker for bacterial infections in patients. Numerous studies have shown that PCT high sensitivity and specificity diagnosing bloodstream infection. However, the cut-off value of diagnosis patients with hematolgic diseases still unclear unreliable. We conducted retrospective study involving 2299 cases hematological who had been performed blood culture test within 24 h. For diseases, serum was slightly elevated BSI group. found most infection were stage severe neutropenia. The main infected strains Escherichia coli (n = 84, 21%), Klebsiella pneumoniae 61, 15.25%) Pseudomonas aeruginosa 65, 16.25%), increasing trend level more obvious Gram-negative bacteria. ROC analysis results showed area under receiver operating characteristic curve distinguishing from non-bacterial 0.554 (95%CI: 0.522–0.585) threshold (PCT > 0.5ng/mL). In our study, low levels better may be necessary to determine hematology

Язык: Английский

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