The Journal of infection
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The Journal of infection · Jul 2017
Nasopharyngeal polymicrobial colonization during health, viral upper respiratory infection and upper respiratory bacterial infection.
We sought to understand how polymicrobial colonization varies during health, viral upper respiratory infection (URI) and acute upper respiratory bacterial infection to understand differences in infection-prone vs. non-prone patients. ⋯ The infection-prone patients more frequently have multiple potential bacterial pathogens in the NP than the non-prone patients. Polymicrobial interaction in the NP differs during health and at onset of infection.
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Lemierre's syndrome is a rare and feared complication of pharyngitis, occurring most commonly in adolescents and young adults. It is typically defined by the constellation of septic internal jugular vein thrombophlebitis, pulmonary and other septic emboli, and sterilesite infection by Fusobacterium necrophorum. The rarity and severity of Lemierre's syndrome has made it an attractive subject for case reports but there is a paucity of evidence to inform areas of persistent uncertainty. In recent years, heightened attention and controversy has focused upon speculation that a purported rise in the incidence of Lemierre's syndrome is due to reduced antibiotic prescribing for respiratory tract infections, that F. necrophorum is an under-appreciated cause of acute tonsillopharyngitis and that testing and targeted treatment would prevent cases of Lemierre's syndrome.
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Sepsis in children is a complex syndrome that develops from various infections and results in 15-30% mortality in high-income countries and up to 50% or higher in low-income countries. Worldwide, this represents an annual burden of 30 million cases resulting in 8 million deaths. ⋯ In this article, we review the important role of global advocacy to improve public awareness of sepsis; increase access to essential medicines and vaccines; improve use of evidence-based treatment guidelines; raise awareness of antimicrobial resistance and encourage antibiotic stewardship; and, develop resilient health systems that can cope with health crises. Advocacy in these areas can assist nations in reaching the United Nations sustainable development goals (UN SDGs) of low rates of neonatal and under-5 mortality.
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The Journal of infection · Apr 2017
Review Meta AnalysisEmpirical mono- versus combination antibiotic therapy in adult intensive care patients with severe sepsis - A systematic review with meta-analysis and trial sequential analysis.
To assess benefits and harms of empirical mono- vs. combination antibiotic therapy in adult patients with severe sepsis in the intensive care unit (ICU). ⋯ This systematic review of RCTs with meta-analysis and TSA demonstrated no differences in mortality or other patient-important outcomes between empirical mono- vs. combination antibiotic therapy in adult ICU patients with severe sepsis. The quantity and quality of data was low without firm evidence for benefit or harm of combination therapy.
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The Journal of infection · Apr 2017
ReviewAssociation of weekend effect with early mortality in severe sepsis patients over time.
The aim of this study is to investigate the "weekend effect" and early mortality of patients with severe sepsis. ⋯ Patients with severe sepsis are more likely to die in the hospital if they were admitted on weekends than if they were admitted on weekdays.