Journal of chemotherapy
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Journal of chemotherapy · Oct 2007
Rapid control of two outbreaks of Serratia marcescens in a Northern Italian neonatal intensive care unit.
Serratia marcescens is a recognized cause of outbreaks in neonatal intensive care units (NICUs). The aim of the present study was to investigate two nosocomial outbreaks of S. marcescens that occurred in an NICU in Northern Italy. ⋯ Containment of the outbreaks was achieved by means of strict hygienic measure and cohort nursing of the infected and/or colonized infants. We experimented with the use of probiotics as an infection control measure.
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Journal of chemotherapy · Oct 2007
ReviewBiochemical markers for the early assessment of neonatal sepsis: the role of procalcitonin.
Procalcitonin (PCT) is the precursor of calcitonin, normally synthesized in the C-cells of the thyroid gland. Systemic inflammation and sepsis induce PCT production by various cell types, including hepatocytes, nephrons, monocytes. PCT begins to rise four hours after exposure to bacterial endotoxins, peaking at six to eight hours, and remaining raised for at least 24 hours with a half-life of 25-30 hours. ⋯ By using a cut-off limit of 0,5 microg/L, the PCT positive likelihoud ratio was found of 12.5. PCT has a theoretical advantage as a marker of systemic induction in sepsis and its half-life suitable for daily monitoring of disease progress. PCT may be useful in assessing the severity of infection, following the progress of treatment, and predicting outcomes.
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Journal of chemotherapy · Oct 2007
Management and prevention strategies for community-acquired pneumonia in the Gulf Corporation Council.
Risk factors identify likelihood and severity of community-acquired pneumonia (CAP) and may allow prognostication. Prognostic factors can focus resources and efforts on those who may need special observation. Several risk assessment tools are used to estimate the severity of CAP and whether these tools can be used to predict outcomes, to determine disposition or even used to determine ICU level of care is hotly under debate. ⋯ The current guidelines for managing CAP categorize patients with CAP into the healthy outpatient, the outpatient with modifying factors or comorbidities, the inpatient with CAP and patients requiring intensive care unit admission. These guidelines took into account regional bacteriology, antibiotic resistance data and available antibiotics to formulate recommendations. Preventive strategies for CAP include the administration of pneumococcal and influenza vaccine in selected populations at risk.