Search results for "Intensive Care Unit"

showing 10 items of 459 documents

Use of Cepheid Xpert Carba-R® for Rapid Detection of Carbapenemase-Producing Bacteria in Abdominal Septic Patients Admitted to Intensive Care Unit.

2016

Abstract Early institution of effective antibiotic therapy and source control are pivotal to improve survival of abdominal septic patients. Xpert® Carba-R is a real time polymerase chain reaction assay for rapid detection and differentiation of five genes (blaKPC, blaVIM, blaOXA-48, blaIMP-1, blaNDM) responsible for carbapenem resistance. We performed an observational study investigating the clinical usefulness and applicability of Xpert® Carba-R to detect carbapenem resistance in abdominal septic patients admitted to intensive care unit. We compared the results of Xpert® Carba-R with standard microbiological culture. We collected a set of two rectal/stomia swabs and two swabs from abdomina…

0301 basic medicineMaleMicrobiological cultureAntibioticslcsh:MedicineArtificial Gene Amplification and ExtensionPathology and Laboratory MedicinePolymerase Chain Reactionlaw.inventionKlebsiella Pneumoniae0302 clinical medicinelawAntibioticsKlebsiellaEpidemiologymultidrug resistance sepsis intensive care unitAbdomenMedicine and Health SciencesMedicine030212 general & internal medicinelcsh:ScienceMultidisciplinaryAntimicrobialsCepheid Xpert Carba-R®DrugsMicrobial CulturesMiddle AgedIntensive care unitHospitalsBacterial PathogensIntensive Care UnitsAbdominal SurgeryMedical MicrobiologyFemaleBiological CulturesPathogensResearch ArticleDNA Bacterialmedicine.medical_specialtymedicine.drug_class030106 microbiologySurgical and Invasive Medical ProceduresResearch and Analysis MethodsReal-Time Polymerase Chain ReactionRapid detectionMicrobiologySensitivity and Specificitybeta-Lactamases03 medical and health sciencesAntibiotic resistanceBacterial ProteinsEnterobacteriaceaeDiagnostic MedicineInternal medicineIntensive careMicrobial ControlSepsisDrug Resistance BacterialHumansMED/41 - ANESTESIOLOGIAMolecular Biology TechniquesMicrobial PathogensMolecular BiologyAgedPharmacologyBacteriabusiness.industrylcsh:ROrganismsRectumBiology and Life SciencesSurgeryHealth CareCarbapenemsHealth Care FacilitiesAntibiotic Resistancelcsh:QAntimicrobial ResistanceReagent Kits DiagnosticbusinessAbdominal surgery
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Intersociety policy statement on the use of whole-exome sequencing in the critically ill newborn infant.

2017

Abstract The rapid advancement of next-generation sequencing (NGS) technology and the decrease in costs for whole-exome sequencing (WES) and whole-genome sequening (WGS), has prompted its clinical application in several fields of medicine. Currently, there are no specific guidelines for the use of NGS in the field of neonatal medicine and in the diagnosis of genetic diseases in critically ill newborn infants. As a consequence, NGS may be underused with reduced diagnostic success rate, or overused, with increased costs for the healthcare system. Most genetic diseases may be already expressed during the neonatal age, but their identification may be complicated by nonspecific presentation, esp…

0301 basic medicineMaleNeonatal intensive care unitDiseaseReview030105 genetics & heredityPediatricsWhole Exome SequencingNeonateNeonatalOutcome Assessment Health CareDiagnosisPolicy MakingExome sequencingSanger sequencingGenomelcsh:RJ1-570Perinatology and Child HealthSettore MED/38Intensive Care UnitsItalyWhole-exome sequencingPractice Guidelines as TopicsymbolsWESFemaleHumanDiagnosiNICUmedicine.medical_specialtyMendelian03 medical and health sciencessymbols.namesakeOutcome Assessment (Health Care)Neonatal ScreeningNeonatal intensive care unitGeneticIntensive Care Units NeonatalExome SequencingmedicineDiagnosis; Genetic; Genome; Mendelian; Neonatal intensive care unit; Neonate; NICU; WES; WGS; Whole-exome sequencing; Pediatrics Perinatology and Child HealthHumansGenetic TestingIntensive care medicineSettore MED/06 - ONCOLOGIA MEDICAGenetic heterogeneityCritically illbusiness.industryGenome HumanInfant NewbornInfantlcsh:PediatricsNewbornInfant newborn030104 developmental biologyDiagnosis; Genetic; Genome; Mendelian; NICU; Neonatal intensive care unit; Neonate; WES; WGS; Whole-exome sequencing; Female; Genetic Testing; Genome Human; Humans; Infant; Infant Newborn; Intensive Care Units Neonatal; Italy; Male; Neonatal Screening; Outcome Assessment (Health Care); Policy Making; Whole Exome Sequencing; Practice Guidelines as TopicPediatrics Perinatology and Child HealthDifferential diagnosisbusinessWGS
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Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic an…

2016

Objectives: We utilized the database of the Defining Antibiotic Levels in Intensive care unit patients (DALI) study to statistically compare the pharmacokinetic/pharmacodynamic and clinical outcomes between prolonged- infusion and intermittent-bolus dosing of piperacillin/tazobactam and meropenem in critically ill patients using inclusion criteria similar to those used in previous prospective studies. Methods: This was a post hoc analysis of a prospective, multicentre pharmacokinetic point-prevalence study (DALI), which recruited a large cohort of critically ill patients from 68 ICUs across 10 countries. Results: Of the 211 patients receiving piperacillin/tazobactam and meropenem in the DAL…

0301 basic medicineMalePenicillanic Acidintensive care unitlaw.inventionthienamycin derivative abdominal infection[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseaseslawcentral nervous system infectioncreatinine clearancePharmacology (medical)Infusions IntravenouProspective StudiesInfusions IntravenousProspective cohort studyTazobactam Drug CombinationAged; Anti-Bacterial Agents; Blood Chemical Analysis; Critical Illness; Female; Humans; Infusions Intravenous; Intensive Care Units; Male; Meropenem; Microbial Sensitivity Tests; Middle Aged; Penicillanic Acid; Piperacillin; Piperacillin Tazobactam Drug Combination; Prospective Studies; Thienamycins; Treatment Outcome; Pharmacology; Microbiology (medical); Pharmacology (medical); Infectious Diseasescritical illneMicrobial Sensitivity TestadultRespiratory infectionclinical trialMiddle Agedcontinuous infusionanalogs and derivativeIntensive care unit3. Good healthAnti-Bacterial Agentsantiinfective agentintravenous drug administrationIntensive Care Units[SDV.MP]Life Sciences [q-bio]/Microbiology and ParasitologyTreatment OutcomeInfectious DiseasesPiperacillin/tazobactammulticenter study (topic)SOFA scoreFemaletreatment outcome AgedIntravenousprospective studyHumanmedicine.drugsurvival rateMicrobiology (medical)medicine.medical_specialtyInfusionspost hoc analysirespiratory tract infectionCritical IllnessAged; Anti-Bacterial Agents; Blood Chemical Analysis; Critical Illness; Female; Humans; Infusions Intravenous; Intensive Care Units; Male; Microbial Sensitivity Tests; Middle Aged; Penicillanic Acid; Piperacillin; Prospective Studies; Thienamycins; Treatment Outcome; Pharmacology; Pharmacology (medical); Infectious Diseases030106 microbiologybloodstream infectionMicrobial Sensitivity Testsminimum inhibitory concentrationpiperacillin plus tazobactamMeropenemTazobactamArticle03 medical and health sciencescritically ill patientInternal medicineAnti-Bacterial AgentmedicineSequential Organ Failure Assessment ScoreHumansThienamycinsurvival timeblood analysiAgedPiperacillinPharmacologybusiness.industryBlood Chemical AnalysiMeropenemmajor clinical studySurgeryProspective Studiemulticenter studyPharmacology; Pharmacology (medical); Infectious Diseases[SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/PharmacologyThienamycinspiperacillin tazobactam drug combinationurinary tract infectionbusinessBlood Chemical AnalysisPiperacillin
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Genetic justification of severe COVID-19 using a rigorous algorithm

2021

Recent studies suggest excessive complement activation in severe coronavirus disease-19 (COVID-19). The latter shares common characteristics with complement-mediated thrombotic microangiopathy (TMA). We hypothesized that genetic susceptibility would be evident in patients with severe COVID-19 (similar to TMA) and associated with disease severity. We analyzed genetic and clinical data from 97 patients hospitalized for COVID-19. Through targeted next-generation-sequencing we found an ADAMTS13 variant in 49 patients, along with two risk factor variants (C3, 21 patients; CFH,34 patients). 31 (32%) patients had a combination of these, which was independently associated with ICU hospitalization (…

0301 basic medicineMaleThrombomodulinSeverity of Illness Index0302 clinical medicineRisk FactorsImmunology and AllergyMedicineComplement ActivationRigorous algorithmmedicine.diagnostic_testHigh-Throughput Nucleotide SequencingComplement C3EculizumabEculizumabMiddle AgedHospitalizationSettore ICAR/09 - Tecnica Delle CostruzioniIntensive Care UnitsFactor HComplement Factor HFemaleAlgorithmsmedicine.drugmedicine.medical_specialtyThrombotic microangiopathyCritical CareImmunologyComplementADAMTS13 Protein03 medical and health sciencesInternal medicineFull Length ArticleSeverity of illnessGenetic predispositionGenetic susceptibilityHumansGenetic Predisposition to DiseaseGenetic TestingRisk factorGenetic testingAgedbusiness.industryThrombotic MicroangiopathiesCOVID-19medicine.diseaseComplement system030104 developmental biologySARS-CoV2business030215 immunologyClinical Immunology (Orlando, Fla.)
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Predicting invasive fungal disease due to Candida species in non-neutropenic, critically ill, adult patients in United Kingdom critical care units.

2016

BACKGROUND: Given the predominance of invasive fungal disease (IFD) amongst the non-immunocompromised adult critically ill population, the potential benefit of antifungal prophylaxis and the lack of generalisable tools to identify high risk patients, the aim of the current study was to describe the epidemiology of IFD in UK critical care units, and to develop and validate a clinical risk prediction tool to identify non-neutropenic, critically ill adult patients at high risk of IFD who would benefit from antifungal prophylaxis. METHODS: Data on risk factors for, and outcomes from, IFD were collected for consecutive admissions to adult, general critical care units in the UK participating in t…

0301 basic medicineMalemedicine.medical_specialtyAntifungal AgentsLetterCritical Illness030106 microbiologyPopulationRisk Assessmentlaw.invention03 medical and health sciences0302 clinical medicineMedical microbiologylawRisk FactorsInvasive fungal infectionsSepsisEpidemiologyCandida albicansmedicineHumansCandidiasis InvasiveeducationIntensive care medicineAgedCandidaCandida sppeducation.field_of_studyAdult patientsCritically illbusiness.industryIncidence (epidemiology)IncidenceCandidiasisCandidemia030208 emergency & critical care medicineAntibiotic ProphylaxisMiddle AgedIntensive care unitUnited KingdomIntensive Care UnitsInfectious DiseasesInvasive fungal diseaseFemalebusinessBMC infectious diseases
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(1,3)-β-d-Glucan-based antifungal treatment in critically ill adults at high risk of candidaemia: an observational study.

2016

OBJECTIVES To determine the effects of a strategy that uses serum (1,3)-β-d-glucan (BDG) results for antifungal treatment of ICU patients at high risk of invasive candidiasis. PATIENTS AND METHODS Adult patients admitted to the ICU from January 2012 to June 2014 were included if they exhibited sepsis at the time of BDG testing and they met Candida score components ≥3. A retrospective analysis of collected data was performed. RESULTS In total, 198 patients were studied. Of 63 BDG-positive patients, 47 with candidaemia and 16 with probable Candida infection, all [31.8% (63/198)] received antifungal therapy. Of 135 BDG-negative patients, 110 [55.5% (110/198)] did not receive antifungal therapy…

0301 basic medicineMicrobiology (medical)AntifungalAdultMalemedicine.medical_specialtyAntifungal AgentsAntigens Fungalbeta-GlucansLetterAdolescentMedicine (all); Pharmacology; Infectious Diseases; Pharmacology (medical)medicine.drug_classCritical Illness030106 microbiologyAntifungal drugSettore MED/17 - MALATTIE INFETTIVESettore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICAlaw.inventionSepsis03 medical and health sciencesYoung AdultlawInternal medicineSepsismedicineHumansPharmacology (medical)Candidiasis InvasiveMedical prescriptionYoung adultCandidaAgedRetrospective StudiesPharmacologyAged 80 and overbusiness.industryMedicine (all)Retrospective cohort studyMiddle Agedmedicine.diseaseIntensive care unitSurgeryInfectious DiseasesObservational studyFemaleProteoglycansbusinessThe Journal of antimicrobial chemotherapy
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Outbreak of ST395 KPC-Producing Klebsiella pneumoniae in a Neonatal Intensive Care Unit in Palermo, Italy

2018

0301 basic medicineMicrobiology (medical)Klebsiella pneumoniae Neonatal Intensive Care Unit Carbapenem resistance KPC Outbreakmedicine.medical_specialtyNeonatal intensive care unitEpidemiologyKlebsiella pneumoniae030106 microbiologySettore MED/42 - Igiene Generale E Applicatabeta-Lactam ResistanceDisease Outbreaks03 medical and health sciencesIntensive Care Units NeonatalmedicineHumansBacteriological TechniquesInfection ControlbiologyOutbreakbiology.organism_classificationKlebsiella InfectionsKlebsiella pneumoniae030104 developmental biologyInfectious DiseasesCarbapenemsItalyEmergency medicineBeta lactam antibiotics
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Efficacy of a coordinated strategy for containment of multidrug-resistant Gram-negative bacteria carriage in a Neonatal Intensive Care Unit in the co…

2021

AbstractBackgroundAntimicrobial resistance in neonatal intensive care unit (NICU) patients is a threat, due to the frequent use of antimicrobial treatment and invasive devices in fragile babies. Since 2014 an active surveillance program of multidrug-resistant Gram-negative bacteria (MDR-GNB) carriage has been in place in the five NICUs of Palermo, Italy. In 2017 an increase in the prevalence of MDR-GNB, and in particular of extended-spectrum β-lactamases-producingKlebsiella pneumoniae(ESBL-KP), was observed in “Civico” hospital NICU.AimTo assess the impact of a coordinated intervention strategy in achieving long-lasting reduction of MDR-GNB prevalence in the NICU.MethodsRectal swabs were ob…

0301 basic medicineMicrobiology (medical)Malemedicine.medical_specialtyNeonatal intensive care unit030106 microbiologyExtended spectrum β lactamases producing klebsiella pneumoniaeContext (language use)Drug resistanceMicrobial Sensitivity TestsAntimicrobial resistancelcsh:Infectious and parasitic diseases03 medical and health sciences0302 clinical medicineAntibiotic resistanceMedical microbiologyNeonatal intensive care unitInternal medicineDrug Resistance Multiple BacterialIntensive Care Units NeonatalGram-Negative BacteriamedicineHumansPharmacology (medical)lcsh:RC109-216030212 general & internal medicineNeonatal intensive care unit.Cross InfectionInfection ControlActive surveillance programbusiness.industryResearchPublic Health Environmental and Occupational HealthInfant NewbornAntimicrobialMulti-drug resistant gram-negative bacteriaElectrophoresis Gel Pulsed-FieldInfectious DiseasesCarriageItalyIntervention strategyCarrier StateFemaleSample collectionbusinessGram-Negative Bacterial Infections
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A Snapshot on MRSA Epidemiology in a Neonatal Intensive Care Unit Network, Palermo, Italy

2016

Objectives. We performed a one-year prospective surveillance study on MRSA colonization within the five NICUs of the metropolitan area of Palermo, Italy. The purpose of the study was to assess epidemiology of MRSA in NICU from a network perspective. Methods. Transfer of patients between NICUs during 2014 was traced based on the annual hospital discharge records. In the period February 2014 – January 2015, in the NICU B, at the University teaching hospital, nasal swabs from all infants were collected weekly, whereas in the other four NICUs (A, C, D, E) at four week-intervals of time. MRSA isolates were submitted to antibiotic susceptibility testing, SCCmec typing, PCR to detect lukS-PV and l…

0301 basic medicineMicrobiology (medical)medicine.medical_specialtyNeonatal intensive care unithealth care facilities manpower and services030106 microbiologylcsh:QR1-502MRSAMicrobiologylcsh:Microbiology03 medical and health sciencesInternal medicineEpidemiologyMedicineInfection controlnetwork approachOriginal ResearchNICuActive surveillance; Molecular typing; MRSA; Network approach; NICu; Microbiology; Microbiology (medical)business.industryMRSA colonizationactive surveillancemolecular typingSequence typesVariable number tandem repeat030104 developmental biologyMultilocus sequence typingUniversity teachingbusinessFrontiers in Microbiology
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Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis

2016

Twin pregnancies are at increased risk of stillbirth. Uncomplicated twin pregnancies are commonly delivered earlier to prevent stillbirth; however, there is a risk of neonatal complications associated with being born prior to 39 weeks’ gestation. The optimal gestational age for delivery in twin pregnancies is unknown and likely varies by chorionicity. The present study aimed to determine the prospective risk of stillbirth in women with uncomplicated monochorionic and dichorionic twin pregnancies, and neonatal mortality risks, when delivered beyond 34 weeks of gestation. Data on twin pregnancies that reported rates of stillbirth were obtained from MEDLINE, EMBASE, and Cochrane Library. Separ…

0301 basic medicinePediatricsNeonatal intensive care unitPerinatal DeathCochrane LibraryInfant Newborn Diseases0302 clinical medicineObstetrics and gynaecologyPregnancyRisk FactorsTwins DizygoticMedicineProspective StudiesProspective cohort studyreproductive and urinary physiologyTwin Pregnancyhealth care economics and organizations030219 obstetrics & reproductive medicineObstetricsIncidence (epidemiology)Absolute risk reductionObstetrics and GynecologyGestational ageProspective riskGeneral MedicineStillbirthfemale genital diseases and pregnancy complicationsMeta-analysisGestationFemalemedicine.medical_specialtyeducationGestational AgeTwin-to-twin transfusion syndrome03 medical and health sciences030225 pediatricsJournal ArticleHumansGynecologyPregnancybusiness.industryResearchInfant NewbornTwins Monozygoticmedicine.diseaseConfidence interval030104 developmental biologyIntensive Care NeonatalPregnancy TwinbusinessBMJ (Clinical research ed.)
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