Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause for patients to present to a physicians office or emergency department. We observed increasing numbers of community-acquired MRSA infections in patients admitted to the hand surgery service at our suburban academic center. It is an important issue as unsuspected community-acquired MRSA hand infections can be admitted to the hospital, inadequately treated, and allowed for nosocomial spread. This study was performed to examine the trend in the incidence of community-acquired MRSA infections in patients admitted to the hand surgery service in order to sensitize practitioners to have a high index of suspicion for this entity and promote early recognition and treatment of this organism. A multihospital retrospective chart review was undertaken to compare the total number of community-acquired MRSA infections in our hospital as well as the number in patients admitted to the hand surgery service with community-acquired MRSA from 2000
BioAssay record AID 529821 submitted by ChEMBL: Bactericidal activity against community-acquired methicillin-resistant Staphylococcus aureus by broth microdilution method in presence of 50% human serum.
www.lung.org/assets/documents/research/pi-trend-report.pdf.. 5. Arnold FW, Wiemken TL, Peyrani P, et al. Mortality differences among hospitalized patients with community-acquired pneumonia in three world regions: results from the Community-Acquired Pneumonia Organization (CAPO) International Cohort Study. Respir Med 2013;107:1101-11.. 6. Mortensen EM, Coley CM, Singer DE, et al. Causes of death for patients with community-acquired pneumonia: results from the Pneumonia Patient Outcomes Research Team cohort study. Arch Intern Med 2002;162:1059-64.. 7. Bordon J, Wiemken T, Peyrani P, et al. Decrease in long-term survival for hospitalized patients with community-acquired pneumonia. Chest 2010;138:279-83.. 8. Mortensen EM, Halm EA, Pugh MJ, et al. Association of azithromycin with mortality and cardiovascular events among older patients hospitalized with pneumonia. JAMA 2014;311:2199-208.. 9. Aliberti S, Ramirez JA. Cardiac diseases complicating community-acquired pneumonia. Curr Opin Infect Dis ...
SUPPLEMENT ARTICLE Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults Lionel A. Mandell, 1,a Richard G. Wunderink,
Oxidative stress is an important part of host innate immune response to foreign pathogens. However, the impact of vitamin C on oxidative stress and inflammation remains unclear in community-acquired pneumonia (CAP). We aimed to determine the effect of vitamin C on oxidative stress and inflammation. CAP patients were enrolled. Reactive oxygen species (ROS), DNA damage, superoxide dismutases (SOD) activity, tumor necrosis factor-alpha (TNF-α), and IL-6 were analyzed in CAP patients and LPS-stimulated macrophages cells. MH-S cells were transfected with RFP-LC3 plasmids. Autophagy was measured in LPS-stimulated macrophages cells. Severe CAP patients showed significantly increased ROS, DNA damage, TNF-α, and IL-6. SOD was significantly decreased in severe CAP. Vitamin C significantly decreased ROS, DNA damage, TNF-α, and IL-6. Vitamin C inhibited LPS-induced ROS, DNA damage, TNF-α, IL-6, and p38 in macrophages cells. Vitamin C inhibited autophagy in LPS-induced macrophages cells.
References 1. Bartlett JG, Dowell SF, Mandell LA, et al; Infectious Diseases Society of America. Practice guidelines for the management of community-acquired pneumonia. Clin Infect Dis. 2000;31:347-382. 2. National Center for Health Statistics. Health, United States, 2006. Available at: www.cdc.gov/nchs/data/hus/hus06.pdf. Accessed June 6, 2007.3. DeFrances CJ, Podgornik MN. 2004 National hospital discharge survey. Adv Data. 2006;317:1-19. 4. Division of Epidemiology. National Heart Lung and Blood Institute. Morbidity and mortality: 2004 chartbook on cardiovascular, lung and blood diseases. May 2004. 5. Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44(suppl 2):S27-S72. 6. Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, PA: Churchill Livingstone; 2005:819-845. 7. Marrie TJ, ...
Distinguishing bacterial pneumonia from viral pneumonia is critical to providing effective treatment but remains a significant challenge. This issue provides guidance for the management of pediatric community-acquired pneumonia as well as associated complications including pleural effusion/empyema
Press Release Date: March 1, 2004. The Agency for Healthcare Research and Quality today announced its first clinical decision-support tool for personal digital assistants (PDAs) that is designed to help clinicians deliver evidence-based medicine at the point of care. AHRQs new Pneumonia Severity Index Calculator (which is available for download from the AHRQ Web site at http://pda.ahrq.gov), is an interactive application for Palm Pilots and other PDAs to help doctors quickly and easily determine whether patients with community-acquired pneumonia should be treated at home or in a hospital.. This new Pneumonia Severity Index Calculator is an example of how technology can support and facilitate the delivery of evidence-based medicine, said AHRQ Director Carolyn M. Clancy, M.D. AHRQ is striving to make decision support tools such as this available to clinicians. Community-acquired pneumonia contracted outside of a hospital or nursing home environment affects approximately 4 million Americans ...
There is no evidence supporting the use of de-escalation therapy (DET) among patients with community-acquired pneumonia (CAP). We assessed the outcomes associated with DET among bacteraemic CAP patients. We performed a secondary analysis of the Community-Acquired Pneumonia Organization database, which contains data on 660 bacteraemic patients hospitalized because of CAP in 35 countries (2001-2013). Exclusion criteria were death within 72h from admission and an inappropriate empirical antibiotic regimen. DET was defined as changing an appropriate empirical broad-spectrum regimen to a narrower-spectrum regimen according to culture results within 7 days from hospital admission. Two study groups were identified: patients whose antibiotic therapy was de-escalated (the DET group), and patients whose antibiotic therapy was not de-escalated (the N-DET group). The primary study outcome was 30-day mortality. Two hundred and sixty-one bacteraemic CAP patients were included. Gram-positive bacteria were ...
...WALTHAM Mass. Dec. 8 /- Decision Resources one of the ...The new Pharmacor report entitled Community-Acquired Pneumonia ... Two of the most clinically and commercially promising antibiotics in ...The report also finds that the community-acquired pneumonia market is ...,Patent,Expiries,of,Blockbuster,Antibiotics,Will,Fuel,a,Decline,of,More,Than,15,Percent,in,the,Community-Acquired,Pneumonia,Drug,Market,medicine,advanced medical technology,medical laboratory technology,medical device technology,latest medical technology,Health
Community-acquired pneumonia (CAP) has significant morbidity and mortality. The Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) guidelines recommend two antimicrobial regimens for hospitalized patients with CAP, one of which includes a macrolide, and one of which does not. Both regimens have antimicrobial properties, but macrolides also possess immunomodulatory properties. Macrolides, however, may also have potential arrhythmia adverse effects. The purpose of this review is to provide an update of studies evaluating outcomes for patients with CAP treated with or without a macrolide-based regimen. Two recent randomized controlled trials conflict with each other regarding the benefit versus noninferiority of including a macrolide for the treatment for CAP. Each have their respective limitations. Most prior observational studies and meta-analyses favor using a regimen with a macrolide. We do not recommend any different treatment strategy than the current IDSA/ATS guidelines for
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Plasma YKL-40 level has been reported as playing a significant role in community-acquired pneumonia (CAP). However, the correlation between plasma level of YKL-40 and the severity of CAP has not been reported. This study identifies the relationship between plasma level changes of the YKL-40 gene in adult patients hospitalized with CAP. The ELISA was used to measure the plasma YKL-40 level from 61 adult CAP patients before and after antibiotic treatment and from 60 healthy controls. The plasma YKL-40 levels were significantly increased in patients with CAP compared to normal controls. Moreover, the plasma concentration of YKL-40 correlated with the severity of CAP based on the pneumonia severity index (PSI) score (r = 0.630, p < 0.001), the CURB-65 (confusion, uremia, respiratory rate, BP, age 65 years) score (r = 0.640, p < 0.001), the Acute Physiology And Chronic Health Evaluation II (APACHE II) score (r = 0.539, p < 0.001) and length of hospital stay (r = 0.321, p = 0.011), respectively. In
Abdel-Rahman EM, 2000, DIAGN MICR INFEC DIS, V36, P203, DOI 10.1016-S0732-8893(99)00142-X; Ahmad S, 2009, JCPSP-J COLL PHYSICI, V19, P264, DOI 04.2009-JCPSP.264265; Ahmed K, 2000, EPIDEMIOL INFECT, V125, P573, DOI 10.1017-S0950268800004751; AHMED K, 1999, J INFECT CHEMOTHER, V5, P217, DOI 10.1007-s101560050039; Akala FA, 2006, LANCET, V367, P961, DOI 10.1016-S0140-6736(06)68402-X; Akbar DH, 2001, ACTA DIABETOL, V38, P77; ALALI MK, 2007, SAUDI MED J, V28, P813; Al-Ghamdi SM, 2003, SAUDI MED J, V24, P1073; Al-Ghizawi G. J., 2007, Eastern Mediterranean Health Journal, V13, P230; Al-Moyed K A, 2003, East Mediterr Health J, V9, P279; Al-Muhairi S, 2006, Monaldi Arch Chest Dis, V65, P13; Al-Muhairi SS, 2006, SAUDI MED J, V27, P1044; Alzeer A, 1998, J INFECTION, V36, P303, DOI 10.1016-S0163-4453(98)94315-8; Babay HA, 2000, SAUDI MED J, V21, P860; Balkhy HH, 2006, INT J INFECT DIS, V10, P326, DOI 10.1016-j.ijid.2005.06.013; Behbehani N, 2005, MED PRIN PRACT, V14, P235, DOI 10.1159-000085741; BISHAY FK, ...
Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging community-acquired pathogen among patients without established risk factors for MRSA infection (e.g., recent hospitalization, recent surgery, residence in a long-term-care facility [LTCF], or injecting-drug use [IDU]) (1). Since 1996, the Minnesota Department of Health (MDH) and the Indian Health Service (IHS) have investigated cases of community-acquired MRSA infection in patients without established risk factors. This report describes four fatal cases among children with community-acquired MRSA; the MRSA strains isolated from these patients appear to be different from typical nosocomial MRSA strains in antimicrobial susceptibility patterns and pulsed-field gel electrophoresis (PFGE) characteristics.. Case Reports. Case 1. In July 1997, a 7-year-old black girl from urban Minnesota was admitted to a tertiary-care hospital with a temperature of 103 F (39.5 C) and right groin pain. An infected right hip joint was diagnosed; she ...
Ekloef and Schmidt Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine2012, 20(Suppl 2):P10http://www.sjtrem.com/content/20/S2/P10 Community-acquired pneumonia: a comparisonof clinical treatment failure in patients treatedwith either penicillin or cefuroximeJosefin Ekloef*, Thomas A Schmidt From 4th Danish Emergency Medicine ConferenceRoskilde, Denmark. 25-26 November 2011 cefuroxime. Forty percent of the patients treated with National and local guidelines in the Emergency depart- penicillin experienced CTF compared to 17% in the ment (ED) at Holbaek hospital recommend penicillin as group treated with cefuroxime (p=0.347). Patients were first-line treatment of community-acquired pneumonia followed for 9 days. At 5 days, a survival rate without (CAP). Nevertheless, the use of cefuroxime seem to be CTF was estimated to 0,75 for cefuroxime and 0.54 for substantial when admitting patients with CAP ...
Our comprehensive search strategy identified 14 studies describing an association between kidney disease and acute community-acquired infection. Although between-study heterogeneity precluded meta-analysis, all studies were consistent with a positive direction of association. Four studies which reported estimates on more than one category of kidney disease found a graded association in which risk of infection increased with greater severity of CKD. These four studies excluded patients with ESRD, and three were at low risk of bias in all categories of quality assessment.22 ,23 ,26 ,27. To the best of our knowledge, this is the first review to address this research question systematically. We used a sensitive search strategy, with a broad definition of kidney disease, for a thorough and inclusive search. The results are consistent with the conclusion of previous narrative reviews: that an association between CKD and infection incidence is likely, but that there is a paucity of ...
Community-acquired pneumonia (CAP) is a common infection. Approximately 20 percent of all episodes of pneumonia result in hospitalization. It is the leading cause of community-acquired infection requiring intensive care unit (ICU) admission. In pulmonary infections, the release of cytokines and other inflammatory mediators from alveolar macrophages serves as a mechanism by which invading pathogens are eliminated. However, this reaction of the innate immune system can be potentially harmful when excessive release of circulating inflammatory cytokines causes damage to the patient, particularly the lung. Interest in the role of corticosteroids in the pathophysiology of critical illness has existed since the early part of the 20th century. On ICU, early treatment with corticosteroids to attenuate systemic inflammation is widespread. At the same time, outside the ICU little evidence is available on the effect of treatment with corticosteroids in patients diagnosed with CAP. Theoretically, early ...
Authors: Edberg M, Furebring M, Sjölin J, Enblad P.. BACKGROUND: Reports about neurointensive care of severe community-acquired meningitis are few. The aims of this retrospective study were to review the acute clinical course, management and outcome in a series of bacterial meningitis patients receiving neurointensive care.. METHODS: Thirty patients (median age 51, range 1-81) admitted from a population of 2 million people during 7 years were studied. The neurointensive care protocol included escalated stepwise treatment with mild hyperventilation, cerebrospinal fluid (CSF) drainage, continuous thiopentotal infusion and decompressive craniectomy. Clinical outcome was assessed using the Glasgow outcome scale.. RESULTS: Twenty-eight patients did not respond to commands on arrival, five were non-reacting and five had dilated pupils. Twenty-two patients had positive CSF cultures: Streptococcus pneumoniae (n=18), Neisseria meningitidis (n=2), β-streptococcus group A (n=1) and Staphylococcus aureus ...
4. "Genomics to Combact Resistance against Antibiotics in Community-acquired Lower Respiratory Tract Infections in Europe [GRACE]". Network of Excellence, Contract nº LSHM-CT-2005-518226. Funding: European Commission. Principal Contractor: University Hospital Antwerp, Belgium. Participating Institutions: ITQB and 23 others. March 2006/April 2010.. 5. "CONtrol of COmmunity-acquired MRSA: Rationale and Development of counteractions [CONCORD]". Project FP7-Health-F3-2008-222718. Funding: European Commission. Principal contractor: University Medical Centre Utrecht, The Netherlands. Participating institutions: ITQB and 8 others. January 2009/Junho 2012.. 6. "Translational Research on Combating Antimicrobial Resistance [TROCAR]". Project FP7-Health-F3-2008-223031. Funding: European Commission. Principal contractor: Institut Dinvestigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. Participating institutions: ITQB and 15 others. January 2009/Junho 2012.. 7. A comprehensive ...
Gatifloxacin is an 8-methoxy fluoroquinolone with broad activity against respiratory tract pathogens, including those commonly associated with community-acquired pneumonia (CAP). To evaluate the efficacy and safety of oral gatifloxacin 400 mg once daily for seven to 14 days, community-based physicians enrolled adult outpatients with confirmed or suspected CAP in a prospective, single-arm, open-label, noncomparative study. Of 1488 clinically evaluable patients with radiographically confirmed or clinically suspected CAP, 1417 (95.2%) were cured. All strains of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, the most commonly isolated pathogens, were susceptible to gatifloxacin. Penicillin nonsusceptibility was seen in 32.6% of S. pneumoniae isolates, and beta-lactamase production was detected in H. influenzae (26.9%) and M. catarrhalis (88%) isolates. Clinical cure rates of 91%, 94%, and 92% were achieved in patients with S. pneumoniae, H. influenzae, and M. catarrhalis,
Community-acquired pneumonia (CAP) refers to pneumonia (any of several lung diseases) contracted by a person with little contact with the healthcare system. The chief difference between hospital-acquired pneumonia (HAP) and CAP is that patients with HAP live in long-term care facilities or have recently visited a hospital. CAP is common, affecting people of all ages, and its symptoms occur as a result of oxygen-absorbing areas of the lung (alveoli) filling with fluid. This inhibits lung function, causing dyspnea, fever, chest pains and cough. CAP, the most common type of pneumonia, is a leading cause of illness and death worldwide. Its causes include bacteria, viruses, fungi and parasites. CAP is diagnosed by assessing symptoms, making a physical examination and on x-ray. Other tests, such as sputum examination, supplement chest x-rays. Patients with CAP sometimes require hospitalization, and it is treated primarily with antibiotics, antipyretics and cough medicine. Some forms of CAP can be ...
Community-acquired pneumonia substantially affects patient morbidity and mortality, and has significant health care costs. This type of pneumonia has more impact on elderly patients, who tend to have longer hospital stays and a higher cost per stay compared with younger patients. Multiple published guidelines provide physicians with information about when to admit patients with community-acquired pneumonia, which antibiotic therapy is appropriate, how long to treat, and when it is suitable to discharge patients from the hospital. These treatment strategies do not take into account the emergence of resistant organisms and the poorly understood impact of community-acquired pneumonia on younger patients. Although various studies have looked at combination antibiotic therapy, they rarely have been comparative. Brown and colleagues examined the effect of initial antibiotic therapy for community-acquired pneumonia on selected clinical outcomes.. The authors analyzed a hospital database of adult ...
Community-acquired pneumonia is diagnosed by clinical features (e.g., cough, fever, pleuritic chest pain) and by lung imaging, usually an infiltrate seen on chest radiography. Initial evaluation should determine the need for hospitalization versus outpatient management using validated mortality or severity prediction scores. Selected diagnostic laboratory testing, such as sputum and blood cultures, is indicated for inpatients with severe illness but is rarely useful for outpatients. Initial outpatient therapy should include a macrolide or doxycycline. For outpatients with comorbidities or who have used antibiotics within the previous three months, a respiratory fluoroquinolone (levofloxacin, gemifloxacin, or moxifloxacin), or an oral beta-lactam antibiotic plus a macrolide should be used. Inpatients not admitted to an intensive care unit should receive a respiratory fluoroquinolone, or a beta-lactam antibiotic plus a macrolide. Patients with severe community-acquired pneumonia or who are ...
The Outpatient Community-Acquired Pneumonia in Adults GUIDELINES Pocket Card is based on the latest guidelines of the Infectious Diseases Society of America
Community-acquired pneumonia (CAP) is defined as an acute infection of the pulmonary parenchyma in a patient who has acquired the infection in the community, as distinguished from hospital-acquired (nosocomial) pneumonia (HAP).CAP is a common and pot
ABSTRACTObjective:Community-acquired pneumonia (CAP) is a common presentation to the emergency department (ED) and has high mortality rates. The aim of our study is to investigate the risk stratification and prognostic prediction value of precalcitonin (PCT) and clinical severity scores on patients
Acute respiratory infections (ARIs) are responsible for high morbidity and mortality in pediatric patients, particularly in children less than five years old. Community-acquired pneumonia (CAP) is the most serious cause of ARI. Each year, from two to three million children die of pneumonia, predominantly in developing countries, and this is attributed to more severe clinical conditions, the involvement of bacteria as etiological agents, and less access to health care services and adequate therapy. This study aimed to compare clinical response to initial empirical treatment of Oxacillin associated with Ceftriaxone to Amoxicillin associated with Clavulanic Acid in children aged from two months to five years, diagnosed with severe community-acquired Pneumonia, who require hospitalization. It also aimed to evaluate the time for clinical recovery (fever and tachypnea) and the need for extending the antimicrobial spectrum in order to determine therapeutic failure in the proposed schemes. It is a ...
In a randomized clinical trial of antibiotic treatments for community-acquired pneumonia, researchers did not find that monotherapy with β-lactam alone was worse than a combination therapy with a macrolide in patients hospitalized with moderately severe pneumonia.
Introduction: Data describing real-life management and treatment of community-acquired pneumonia (CAP) in Europe are limited. The REtrospective Study to Assess the Clinical Management of Patients With Moderate-to-severe cSSTI or CAP Infections in the Hospital Setting (REACH) (NCT01293435) was an observational retrospective study that collected data on the management of European patients hospitalized with CAP in order to review current clinical practices and outcomes related to initial treatment failure, and to assess intercountry differences. Methods: Patients were aged ≥18 years, hospitalized with CAP between March 2010 and February 2011, and required in-hospital management and treatment with intravenous antibiotics. An electronic Case Report Form was used to collect a number of patient, disease and treatment variables, including type of CAP, medical history, treatment setting, antibiotic treatments and clinical outcomes, particularly treatment failure. Results: Patients (N=2039) were ...
Pneumonia is a type of lung infection. It can cause breathing problems and other symptoms. In community-acquired pneumonia (CAP), you get infected in a community setting. It doesnt happen in a hospital, nursing home, or other healthcare center.
Objective: To investigate the pathogens and antibiotic resistance of Community-Acquired Pneumonia (CAP) in children under 5 y old in our hospital duri..
TY - JOUR. T1 - Diagnostic accuracy of a serotype-specific antigen test in community-acquired pneumonia. AU - Huijts, S.M.. AU - Pride, M.W.. AU - Vos, J.M.. AU - Jansen, K.U.. AU - Webber, C.. AU - Gruber, W.. AU - Boersma, W.G.. AU - Snijders, D.. AU - Kluijtmans, J.A.J.W.. AU - van der Lee, I.. AU - Kuipers, B.A.. AU - van den Ende, A.. AU - Bonten, M.J.M.. PY - 2013. Y1 - 2013. U2 - 10.1183/09031936.00137412. DO - 10.1183/09031936.00137412. M3 - Article. C2 - 23397295. VL - 42. SP - 1283. EP - 1290. JO - European Respiratory Journal. JF - European Respiratory Journal. SN - 0903-1936. IS - 5. ER - ...
Edited by James D Chalmers Mathias W Pletz and Stefano Aliberti Community-acquired pneumonia remains the leading cause of hospitalisation for
Patients Receive Recommended Care for Community-Acquired Pneumonia For New Jersey to be a state in which all people live long, healthy lives. DSRIP LEARNING COLLABORATIVE PRESENTATION The Care you Trust!
We present the case of a patient with a necrotizing multilobar pneumonia caused by community-acquired methicillin-resistant Staphylococcus aureus (MRSA). The patient presented with shortness of breath and a productive cough of 3 days duration. On arrival to the emergency department she was intubated for increased work of breathing and given vasopressors for hypotension refractory to fluid resuscitation. Blood cultures taken at admission, sputum cultures from the patients endotracheal tube, and bronchoalveolar lavage cultures all grew S. aureus resistant to penicillinase-resistant penicillins. Over the following days the patients respiratory function deteriorated as she grew progressively hypoxemic and hypercarbic despite aggressive mechanical ventilation and intravenous antibiotics. On day 4 of her hospitalization a computed tomogram revealed extensive pulmonary necrosis consistent with necrotizing pneumonia. The patients family elected to withdraw support, and the patient rapidly died ...
PubMed comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
If the participating doctors think there is no definite need for antibiotics, participants will be asked to take a 7-day course of tablets to be taken three times a day. The tablets will be either amoxicillin, a very commonly used and safe penicillin-based antibiotic, or a placebo (a tablet without any medication in it). They will not be able to tell whether they will have the real antibiotic or the placebo. Random numbers are used to decide whether participants get antibiotic or placebo to make sure that they have an equal chance of getting either. This is the best way for us to show scientifically whether antibiotics really make a difference. If it is necessary to know whether participants are using an antibiotic or not, the participating doctors will be able to get that information at any time and change the participants medication. The participating doctors will also like to take one throat swab at day 8 (extra visit) and at the second study visit (day 28-35). The swab at day 8 will not be ...
WEDNESDAY, Oct. 11, 2017 (HealthDay News) - Statin use is associated with a decreased risk of community-acquired Staphylococcus aureus bacteremia (CA-SAB), particularly in long-term users, according to a study published in the October issue of Mayo Clinic Proceedings.. Jesper Smit, M.D., Ph.D., from Aalborg University Hospital in Denmark, and colleagues used population-based medical registries to identify 2,638 adults with first-time CA-SAB and 26,379 population controls matched for age, sex, and residence in northern Denmark (Jan. 1, 2000, through Dec. 31, 2011). Statin users were characterized as current users (new or long-term use), former users, and nonusers.. The researchers found that compared with nonusers, current statin users experienced markedly decreased risk of CA-SAB (adjusted odds ratio [OR], 0.73; 95 percent confidence interval, 0.63 to 0.84). The adjusted OR was 0.96 (95 percent confidence interval, 0.6 to 1.51) for new users, 0.71 (95 percent confidence interval, 0.62 to 0.82) ...
Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) should be considered the cause of this type of infection until definitive cultures are obtained? As crabwise cabergoline price part of a class of drugs called selective serotonin reuptake inhibitors, it works by helping to block the reuptake of a chemical in the brain called serotonin. Pharmacokinetics and pharmacodynamics of methylprednisolone in obesi. Then I went to Tomshardware, and one guy recommended wwwMicrosoftkeysalescom to me? During the entire course of treatment, it is recommended that patients consume plenty of water? Hypothyroidism, buy propecia online the chronic condition of an under-active thyroid, affects millions of Americans? Olympic hockey goals leader signs with Boston Bruins March 19, dostinex costo upwardly 2018 9:47 am Final World Cup Alpine skiing races canceled March 18, 2018 8:47 am Declan Farmer heroics lift US. Its a simple tool thats designed to perform a job, the tools for which you always ...
Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has increasingly been noted as an emerging pathogen worldwide
Hospital length of stay (LOS) and time for a patient to reach clinical stability (TCS) have increasingly become important outcomes when investigating ways in which to combat Community Acquired Pneumonia (CAP). Difficulties arise when deciding how to handle in-hospital mortality. Ad-hoc approaches that are commonly used to handle time to event outcomes with mortality can give disparate results and provide conflicting conclusions based on the same data. To ensure compatibility among studies investigating these outcomes, this type of data should be handled in a consistent and appropriate fashion. Using both simulated data and data from the international Community Acquired Pneumonia Organization (CAPO) database, we evaluate two ad-hoc approaches for handling mortality when estimating the probability of hospital discharge and clinical stability: 1) restricting analysis to those patients who lived, and 2) assigning individuals who die the worst outcome (right-censoring them at the longest recorded LOS or
S. Ewig, G. Höffken, W. V. Kern, G. Rohde, H. Flick, R. Krause, S. Ott, T. Bauer, K. Dalhoff, S. Gatermann, M. Kolditz, S. Krüger, J. Lorenz, M. Pletz, A. de Roux, B. Schaaf, T. Schaberg, H. Schütte, T.Welte; Behandlung von erwachsenen Patienten mit ambulant erworbener, Pneumonie und Prävention - Update 2016, Management of Adult Community-acquired Pneumonia and Prevention - Update 2016. Online-Publikation: 2016, Pneumologie, Georg Thieme Verlag KG - Stuttgart, New York, ISSN 0934-8387. Herzmann C, Sotgiu G, Schaberg T, Ernst M, Stenger S, Lange C; Consortium for the German TB or Not TB9. Early BCG vaccination is unrelated to pulmonary immunity against Mycobacterium tuberculosis in adults. Eur Respir J. 2014 Jun 25. pii: erj00865-2014. [Epub ahead of print] PubMed PMID: 24969658. Rose MA, Damm O, Greiner W, Knuf M, Wutzler P, Liese JG, Krüger H, Wahn U,Schaberg T, Schwehm M, Kochmann TF, Eichner M. The epidemiological impact ofchildhood influenza vaccination using live-attenuated influenza ...
Main hypothesis: microbiological diagnossis off severe community acquired pneumonia can be performed by non invasive or semi invasive microbiological tools, semi invasive tools including protected distal bronchial samplings by the mean of Fiber optic bronchoscopy (FOB). A microbiological diagnosis could improve antibiotic therapy efficacy and improve patients outcome.. These Two strategies have never been prospectivally evauated.. ...
After 7 days of treatment, 41.2% of patients in the monotherapy group had not reached clinical stability, compared with 33.6% of patients in the combination arm (P = .07), the researchers said. Kaplan-Meier curves showed that the difference between the two groups peaked on day 7 and persisted until day 30, but never reached statistical significance, they added. At the same time, patients with atypical infections were less likely to stabilize with monotherapy compared with dual treatment (hazard ratio, 0.33; 95% CI, 0.13 to 0.85), the researchers said. The superiority of dual therapy in these patients "may be explained by failure to provide timely coverage of the Legionella infection," the investigators said. Patients randomized to monotherapy whose urine tested positive went an average of almost 2 days before starting macrolides, they noted. "This long interval reflects real-life practice, with delays in collecting a urine sample for testing, receiving the results, and prescribing the ...
The results of our study suggest a higher adherence to the German guideline for the management of CAP patients after active implementation. The proportion of guideline conformity increased concerning the indicators "duration of antibiotic treatment in outpatients" (+9.2%), "antibiotic treatment in inpatients" (+5.6%) and its duration (+5.0%), whereas in the CG, a decrease could be observed in all the said indicators (−7.9%, −4.7% and −2.9%, respectively) except the "antibiotic treatment in outpatients" (+0.6%). Nevertheless, the logit loglinear analyses showed no effect of intervention or time period on the process of care. In addition, no significant effect could be observed on the 30-days overall mortality, the CAP-related mortality and the length of hospital stay.. Our study differs from previous investigations in this area in several aspects. We recruited patients not only in hospitals but also in sentinel practices, which allowed us to estimate the effect on the process of care in ...
The Pediatric Community-Acquired Pneumonia in Infants and Children |3 Months GUIDELINES Pocket Card is based on the latest guidelines of the Infectious
Brown and Lerner ask how Bartlett and Mundys review could be interpreted to mean that the ATS guidelines for CAP are appropriate. The Update clearly states that Bartlett and Mundy recommended routine diagnostic testing in CAP, a position that differs from the ATS guidelines. It then stated that on the basis of the pathogens causing CAP (and shown in Table 3 of the Update), the ATS guidelines were appropriate. In fact, the pathogens in the table were almost identical to the pathogens that were reported in the ATS guidelines to cause CAP in hospitalized patients. On the basis of these data, Bartlett and Mundy recommended empirical therapy (when necessary) for hospitalized patients that is identical to that recommended in the ATS guidelines [2]. This was the only point being made in the Update. However, in another paper not discussed in the Update, Bartlett and Mundy specifically stated that on the basis of the bacteriology of CAP seen in immunocompetent patients in their hospital, their findings ...
MRSA-methicillin resistant Staphylococcus aureus-is a serious problem: in the U.S., it kills more people annually than AIDS. Typically, the therapy used to treat MRSA is vancomycin, and strains resistant to vancomycin cant be treated on-label with any commercial antibiotics*. ST398 is a new clone of MRSA that is thought to be associated with agriculture-pigs in particular (hence, my designation of this as the piggy MRSA). In the Netherlands, in the course of a few years, it swept through pigs, and then colonized farmers, and recently has entered hospitals. In the U.S., its started to increase in pigs.. According to the article, two separate cases of community-acquired (i.e., they didnt pick it up at a hospital) ST398 were observed, and they were very persistent. Neither patient had any animal contact, which means that this strain has jumped from the agricultural setting into the broader human community. These strains also had PVL, which is a toxin that may increase the severity of ...
Although most events (89.1% in inpatients, 75% in outpatients) were diagnosed within the first week, more than half of them were recognized in the first 24 hours. Factors associated with their diagnosis included older age (odds ratio [OR],1.03; 95% confidence interval [CI], 1.02-1.04), nursing home residence (OR, 1.8; 95% CI, 1.2-2.9), history of heart failure (OR, 4.3; 95% CI, 3.0-6.3), prior cardiac arrhythmias (OR, 1.8; 95% CI, 1.2-2.7), previously diagnosed coronary artery disease (OR, 1.5; 95% CI, 1.04-2.0), arterial hypertension (OR, 1.5; 95% CI, 1.1-2.1), respiratory rate ≥30 breaths per minute (OR, 1.6; 95% CI, 1.1-2.3), blood pH ...