scholarly journals Umbilical catheters as vectors for generalized bacterial infection in premature infants regardless of antibiotic use

2019 ◽  
Vol 68 (9) ◽  
pp. 1306-1313
Author(s):  
Alina Sobczak ◽  
Joanna Klepacka ◽  
Dalia Amrom ◽  
Iwona Żak ◽  
Piotr Kruczek ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Premature Infants ◽  
Antibiotic Use ◽  
Umbilical Catheters

Procalcitonin Testingreduce Unnecessary Antibiotic Use in Bacterial Infection

2019 ◽  
Vol 2 (1) ◽  
pp. 1-3
Author(s):  
Attabak Toofani Milani ◽  
Mahshid Mohammadian ◽  
Sadegh Rostaminasab ◽  
Roghayeh Paribananaem ◽  
Zohre Ahmadi ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Diagnostic Test ◽  
Bacterial Infections ◽  
Intervention Studies ◽  
Antibiotic Use ◽  
Clinical Suspicion ◽  
Diagnostic Biomarker ◽  
Clinical Routine ◽  
Initial Rise

Conventional diagnostic test have limitations to deferential diagnosis in clinical suspicion ofbacterial infection cases, that in some cases lead to inappropriate antibiotic therapy and increases antibiotic resistance. A new diagnostic insight is procalcitonin (PCT) test to improve diagnosis of bacterial infections and to guide antibiotic therapy. Serum PCT levels are of useful test as a biomarker in patients with bacterial infections for several reasons. Initial rise of PCT levels due to bacterial infection, subsequent sequential PCT levels can be used to assess the effectiveness and duration of antibiotic therapy. Based on clinical researches results, in bacterial infections, promising good results obtained when use of PCT used as differential diagnostic test. But further intervention studies are needed before use of PCT in clinical routine tests. The goal of this review is to study the PCT reliability as infections diagnostic biomarker.

scholarly journals Implementation of a Pragmatic Biomarker-Driven Algorithm to Guide Antibiotic Use in the Pediatric Intensive Care Unit: the Optimizing Antibiotic Strategies in Sepsis (OASIS) II Study

2018 ◽  
Vol 9 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Kevin J Downes ◽  
Julie C Fitzgerald ◽  
Emily Schriver ◽  
Craig L K Boge ◽  
Michael E Russo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bacterial Infection ◽  
Pediatric Intensive Care Unit ◽  
Bacterial Infections ◽  
Pediatric Intensive Care ◽  
Antibiotic Use ◽  
Antibiotic Administration ◽  
Period 2 ◽  
Rate Ratios

Abstract Background Biomarkers can facilitate safe antibiotic discontinuation in critically ill patients without bacterial infection. Methods We tested the ability of a biomarker-based algorithm to reduce excess antibiotic administration in patients with systemic inflammatory response syndrome (SIRS) without bacterial infections (uninfected) in our pediatric intensive care unit (PICU). The algorithm suggested that PICU clinicians stop antibiotics if (1) C-reactive protein <4 mg/dL and procalcitonin <1 ng/mL at SIRS onset and (2) no evidence of bacterial infection by exam/testing by 48 hours. We evaluated excess broad-spectrum antibiotic use, defined as administration on days 3–9 after SIRS onset in uninfected children. Incidence rate ratios (IRRs) compared unadjusted excess length of therapy (LOT) in the 34 months before (Period 1) and 12 months after (Period 2) implementation of this algorithm, stratified by biomarker values. Segmented linear regression evaluated excess LOT among all uninfected episodes over time and between the periods. Results We identified 457 eligible SIRS episodes without bacterial infection, 333 in Period 1 and 124 in Period 2. When both biomarkers were below the algorithm’s cut-points (n = 48 Period 1, n = 31 Period 2), unadjusted excess LOT was lower in Period 2 (IRR, 0.53; 95% confidence interval, 0.30–0.93). Among all 457 uninfected episodes, there were no significant differences in LOT (coefficient 0.9, P = .99) between the periods on segmented regression. Conclusions Implementation of a biomarker-based algorithm did not decrease overall antibiotic exposure among all uninfected patients in our PICU, although exposures were reduced in the subset of SIRS episodes where biomarkers were low.

scholarly journals Safety of meningococcal group B vaccination in hospitalised premature infants

2018 ◽  
Vol 104 (2) ◽  
pp. F171-F175 ◽  
Author(s):  
Alison Kent ◽  
Kazim Beebeejaun ◽  
Serena Braccio ◽  
Seilesh Kadambari ◽  
Paul Clarke ◽  
...  
Keyword(s):  
Adverse Events ◽  
Premature Infants ◽  
Antibiotic Use ◽  
Neurological Status ◽  
Serious Adverse Events ◽  
Historical Cohort ◽  
Protein Levels ◽  
Reactive Protein ◽  
Before And After ◽  
Group B

ObjectivesTo assess the risk of significant adverse events in premature infants receiving the novel 4-component group B meningococcal vaccine (4CMenB) with their routine immunisations at 2 months of age.Participants, design and settingIn December 2015, Public Health England requested neonatal units across England to voluntarily participate in a national audit; 19 units agreed to participate. Anonymised questionnaires were completed for infants receiving 4CMenB alongside their routine immunisations. For comparison, a historical cohort of premature infants receiving their primary immunisations without 4CMenB or paracetamol prophylaxis was used.Main outcome measuresParacetamol use; temperature, cardiovascular, respiratory and neurological status before and after vaccination; and management and investigations postvaccination, including serum C reactive protein levels, infection screens and antibiotic use.ResultsComplete questionnaires were returned for 133 premature infants (<35 weeks’ gestation) who received their first dose of 4CMenB at 8 weeks of age, including 108 who received prophylactic paracetamol according to national recommendations. Overall, 7% (8/108) of infants receiving 4CMenB with paracetamol had fever (>38°C) after vaccination compared with 20% (5/25) of those receiving 4CMenB without paracetamol (P=0.06) and none of those in the historical cohort. There were no significant differences between cohorts in the proportion of infants with apnoea, bradycardia, desaturation and receiving respiratory support after vaccination.Conclusions4CMenB does not increase the risk of serious adverse events in hospitalised premature infants. This audit supports the current national recommendations to offer 4CMenB with other routine vaccinations and prophylactic paracetamol to premature infants at their chronological age.

scholarly journals A novel method to detect bacterial infection in premature infants: Using a combination of inflammatory markers in blood and saliva

2020 ◽  
Vol 53 (6) ◽  
pp. 892-899 ◽  
Author(s):  
I-Lun Chen ◽  
Hsin-Chun Huang ◽  
Mei-Chen Ou-Yang ◽  
Feng-Shun Chen ◽  
Mei-Yung Chung ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Premature Infants ◽  
Inflammatory Markers ◽  
Novel Method

scholarly journals 226. Evaluating the Unnecessary Use of Intravenous Broad-Spectrum Antibiotics in Patients Based on Systemic Inflammatory Response Syndrome Criteria in the Emergency Department (ED)

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S114-S114
Author(s):  
Esther Y Bae ◽  
Marguerite Monogue ◽  
Tiffeny T Smith
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Bacterial Infection ◽  
Broad Spectrum ◽  
Bacterial Infections ◽  
Antibiotic Use ◽  
Systemic Inflammatory Response ◽  
Broad Spectrum Antibiotic ◽  
Suspected Sepsis ◽  
Broad Spectrum Antibiotics

Abstract Background Recognition of sepsis frequently occurs in the ED. To demonstrate the need to optimize antibiotic use for suspected sepsis and evaluate the reliability of systemic inflammatory response syndrome (SIRS) criteria in predicting bacterial infection, we quantified the rate of unnecessary intravenous (IV) broad-spectrum antibiotic use for suspected sepsis in the ED at an academic medical center. Methods Adult patients who were admitted to the ED between January 2018 and June 2018 with suspected sepsis (≥ 2 SIRS) and received ≥ 1 dose of IV broad-spectrum antibiotic were included in this retrospective study. The presence of bacterial infection was determined using Centers for Disease Control and Prevention (CDC)/National Healthcare Safety Network (NHSN) definitions, microbiologic, radiographic, and laboratory findings. Suspected infections lacked microbiologic data. The primary outcome was the percentage of confirmed and suspected infections. Secondary outcomes included 90-day Clostridioides difficile infection (CDI) and 90-day drug-resistant organism (DRO) infections. Results A total of 218 patients were included. The percentages of confirmed/suspected and absence of bacterial infections were 63.8% and 36.2%, respectively. Elevated SIRS (≥ 2) and Quick Sequential Organ Failure Assessment (qSOFA; ≥ 2) scores were not associated with the presence of bacterial infections. 82% of patients were discharged from the ED. Antibiotic exposure in days of therapy in the ED and/or hospital admission did not significantly vary between patients with confirmed/suspected bacterial infection and those with absence of bacterial infections. Among patients who lacked evidence of bacterial infections, 44% were prescribed outpatient antibiotics after being discharged from the ED. 90-day CDI and DRO infections were identified in 7 and 6 patients, respectively, regardless of the presence of bacterial infections. Table 1. Baseline demographics of patients admitted to the ED with suspected sepsis Conclusion A third of the patients with suspected sepsis received IV broad-spectrum antibiotics in the ED but ultimately lacked bacterial infection. Our findings suggest that identification of bacterial infection and patients with sepsis using SIRS or qSOFA lack specificity and can lead to the overuse of unnecessary antibiotics in the ED. Disclosures All Authors: No reported disclosures

scholarly journals Antibiotic Use and Bacterial Infection Among Inpatients in the First Wave of COVID-19: A Retrospective Cohort Study of 64,691 Patients

2021 ◽  
Author(s):  
Jonathan D. Baghdadi ◽  
KC Coffey ◽  
Timileyin Adediran ◽  
Katherine E. Goodman ◽  
Lisa Pineles ◽  
...  
Keyword(s):  
Cohort Study ◽  
Bacterial Infection ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Bacterial Infections ◽  
Secondary Infection ◽  
Antibiotic Use ◽  
Healthcare Database ◽  
Secondary Infections ◽  
Present On Admission

Background: Hospitalized patients with SARS-CoV-2 infection (COVID-19) often receive antibiotics for suspected bacterial co-infection. We estimated the incidence of bacterial co-infection and secondary infection in COVID-19 using clinical diagnoses to determine how frequently antibiotics are administered when bacterial infection is absent. Methods: We performed a retrospective cohort study of inpatients with COVID-19 present on admission to hospitals in the Premier Healthcare Database between April – June 2020. Bacterial infections were defined using ICD-10-CM diagnosis codes and associated “present on admission” coding. Co-infections were defined by bacterial infection present on admission, while secondary infections were defined by bacterial infection that developed after admission. Co-infection and secondary infection were not mutually exclusive. Results: 18.5% of 64,961 COVID-19 patients (n=12,040) presented with bacterial infection at admission, 3.8% (n=2,506) developed secondary infection after admission, and 0.9% (n=574) had both. 76.3% (n=49,551) received an antibiotic while hospitalized, including 71% of patients who had no diagnosis of bacterial infection. Secondary bacterial infection occurred in 5.7% patients receiving steroids in the first 2 days of hospitalization, 9.9% receiving tocilizumab in the first 2 days of hospitalization, and 10.3% patients receiving both. After adjusting for patient and hospital characteristics, bacterial co-infection (aRR 1.15; 95% CI, 1.11 – 1.20) and secondary infection (aRR 1.93; 95% CI, 1.82 – 2.04) were both independently associated with increased mortality. Conclusions: Though 1 in 5 inpatients with COVID-19 present with bacterial infection, secondary infections in the hospital are uncommon. Most inpatients with COVID-19 receive antibiotic therapy, including 71% of those not diagnosed with bacterial infection.

Reply to Casalini et al., “Bacterial Coinfections in COVID-19 Patients without a Positive Microbiologic Result: a Word of Caution”

2022 ◽  
Author(s):  
Jonathan Baghdadi ◽  
Sarah Bejo ◽  
Anthony Harris
Keyword(s):  
Bacterial Infection ◽  
Antibiotic Use ◽  
Hospitalized Patients ◽  
Letter To The Editor ◽  
Microbiologic Result

We thank Casalini et al. for their letter to the editor and interest in our recent publication, Antibiotic use and bacterial infection among inpatients in the first wave of covid-19 ,(1) and appreciate the opportunity to extend the conversation related to antibiotic use among hospitalized patients with COVID-19.…

Investigations of Bacterial Infection Rate and Bacterial Flora of Premature Infants during no Gowning Period

1975 ◽  
Vol 17 (1) ◽  
pp. 31-31 ◽  
Author(s):  
Akira Shirahata ◽  
Yutaka Nozaki ◽  
Takeshi Horiuchi ◽  
Kazuo Ishikawa ◽  
Masayuki Muto ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Infection Rate ◽  
Premature Infants ◽  
Bacterial Flora
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