Journal of infection and public health
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J Infect Public Health · Sep 2015
Community- versus nosocomial-acquired severe sepsis and septic shock in patients admitted to a tertiary intensive care in Saudi Arabia, etiology and outcome.
Sepsis syndrome is a major worldwide cause of morbidity and mortality. While community-acquired severe sepsis and septic shock constitutes a major cause of admission to the intensive care unit, hospital-acquired severe sepsis and septic shock remain major preventable causes of ICU admission. This study evaluates the rate, etiology, complication and outcome of community- and hospital-acquired sepsis in a tertiary care hospital in Saudi Arabia. ⋯ Both community and hospital-acquired infections carry high mortality. Hospital-acquired severe sepsis is frequent in medical wards and ICUs, and measures to further evaluate risk factors are prudent.
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J Infect Public Health · Jul 2015
Observational StudyObservational clinical study on the effects of different dosing regimens on vancomycin target levels in critically ill patients: Continuous versus intermittent application.
Different dosing regimens for vancomycin are in clinical use: intermittent infusion and continuous administration. The intention of using these different dosing regimens is to reduce toxicity, to achieve target levels faster and to avoid treatment failure. The aim of this phase IV study was to compare safety and effectiveness in both administration regimens. ⋯ Acute renal failure during the ICU stay occurred in 35% of patients with intermittent infusion versus 26% of patients with continuous application (p=0.324). In conclusion, continuous administration of vancomycin allowed more rapid achievement of targeted drug levels with fewer sub-therapeutic vancomycin levels observed. This might indicate that patients with more severe infections or higher variability in renal function could benefit from this form of administration.
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J Infect Public Health · May 2015
ReviewUse of the surgical safety checklist to improve communication and reduce complications.
Existing evidence suggests that communication failures are common in the operating room, and that they lead to increased complications, including infections. Use of a surgical safety checklist may prevent communication failures and reduce complications. ⋯ A growing body of literature points out that while the physical act of "checking the box" may not necessarily prevent all adverse events, the checklist is a scaffold on which attitudes toward teamwork and communication can be encouraged and improved. Recent evidence reinforces the fact the compliance with the checklist is critical for the effects on patient safety to be realized.
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J Infect Public Health · Mar 2015
Observational StudyIncidence and attributable costs of ventilator-associated pneumonia (VAP) in a tertiary-level intensive care unit (ICU) in northern India.
Ventilator-associated pneumonia (VAP) is the most common nosocomial infection acquired by patients in the intensive care unit (ICU). However, the economic effects of such infections remain unclear particularly in developing countries. ⋯ We conclude that VAP significantly increases the costs of treatment in low-income developing countries. This study highlights the need to implement urgent measures to reduce the incidence of this disease in ICUs.
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J Infect Public Health · Mar 2015
The evaluation of Clostridium difficile infection (CDI) in a community hospital.
Clostridium difficile is a serious reemerging pathogen in Europe and North America. C. difficile infection (CDI) has been of concern over the last decade in view of its significant morbidity and mortality, as well as the high health care costs involved with each case. Although multiple risk factors are known to be associated with CDI, a number of patients develop severe infection even in the absence of known risk factors. CDI is diagnosed by the detection of the toxin A/B in stools by enzyme immunoassay (EIA) or by polymerase chain reaction (PCR). There is conflicting literature regarding whether any particular group of antibiotics is associated with higher risk for CDI. There is also a tendency to perform repeated stool tests for toxin A/B if the first test is negative. We evaluated 100 consecutive hospitalized patients who tested positive for C. difficile over a one-year period. ⋯ Elderly patients are especially vulnerable to CDI when exposed to antibiotics, and higher mortality and morbidity is observed in this age group. PPI use was common in our patients. Metronidazole was used as the first line agent in the majority of patients. We also determined a tendency to test for the C. difficile toxin in more than one stool sample. All of these practices need to be modified based on the current guidelines.