Rapid Identification of Staphyloccocus aureus in Positive-Testing Blood Cultures by Slidex Staph Plus Agglutination Test (original) (raw)
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Evaluation of Current Treatment for Severe Sepsis (SS) in a University-Associated Teaching Hospital
Critical Care Medicine, 2004
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einstein (São Paulo), 2019
Objective: To describe the clinical and epidemiological features of patients with and without sepsis at critical care units of a public hospital. Methods: A cross-sectional study was carried out from May 2012 to April 2013. Clinical and laboratory data of patients with and without sepsis in the intensive care units were reviewed of medical records. Results: We evaluated 466 patients, 58% were men, median age was 40 years, and 146 (31%) of them were diagnosed with sepsis. The overall mortality was 20% being significantly higher for patients with sepsis (39%). The factors associated with intensive care unit mortality were the presence of sepsis (OR: 6.1, 95%CI: 3.7-10.5), age (OR: 3.6, 95%CI: 1.4-7.2), and length of hospital stay (OR: 0.96, 95%CI: 0.94-0.98). Pulmonary (49%) and intra-abdominal (20%) infections were most commonly identified sites, and coagulase-negative staphylococci and enteric Gram negative bacilli the most frequent (66%) pathogens isolated. Conclusion: Although the impact of sepsis on mortality is related to patients’ clinical and epidemiological characteristics, a critical evaluation of these data is important since they will allow the direct implementation of local policies for managing this serious public health problem.
Prevalence and incidence of severe sepsis in Dutch intensive care units
Critical care (London, England), 2004
Severe sepsis is a dreaded consequence of infection and necessitates intensive care treatment. Severe sepsis has a profound impact on mortality and on hospital costs, but recent incidence data from The Netherlands are not available. The purpose of the present study was to determine the prevalence and incidence of severe sepsis occurring during the first 24 hours of admission in Dutch intensive care units (ICUs). Forty-seven ICUs in The Netherlands participated in a point prevalence survey and included patients with infection at the time of ICU admission. Clinical symptoms of severe sepsis during the first 24 hours of each patient's ICU stay were recorded and the prevalence of severe sepsis was calculated. Then, the annual incidence of severe sepsis in The Netherlands was estimated, based on the prevalence, the estimated length of stay, and the capacity of the participating ICUs relative to the national intensive care capacity. The participating ICUs had 442 beds available for ad...
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Antibiotics
Bloodstream infections (BSIs) are among the leading causes of morbidity and mortality worldwide, among infectious diseases. Local knowledge of the main bacteria involved in BSIs and their associated antibiotic susceptibility patterns is essential to rationalize the empiric antimicrobial therapy. The aim of this study was to define the incidence of infection and evaluate the antimicrobial resistance profile of the main pathogens involved in BSIs. This study enrolled patients of all ages and both sexes admitted to the University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy between January 2015 to December 2019. Bacterial identification and antibiotic susceptibility testing were performed with Vitek 2. A number of 3.949 positive blood cultures were included out of 24,694 total blood cultures from 2015 to 2019. Coagulase-negative staphylococci (CoNS) were identified as the main bacteria that caused BSI (17.4%), followed by Staphylococcus aureus (12.3%), Escherichia c...
Retrospective study of the incidence and outcomes of sepsis in a Center
2019
Background: sepsis is the common cause of death in immunocompromised patients and those suffering from malignant diseases. The mortality can be significantly reduced when early and correct diagnosis is given and the appropriate therapy is administered. Here we set to determine the incidence, sources and outcomes of sepsis and to resolve which bacteria, based on Gram staining, are more often the cause of sepsis. Patients and methods: we conducted a retrospective study of medical history in a two-year period, from April 2014 to April 2016. Diagnosis was given based on patients’ blood culture findings or their clinical presentation. Results: during a two-year period 1663 patients were treated. Sepsis was diagnosed in 35 patients (2.10%). The median age was 73 years and 22 patients (63%) were male. Sepsis was the primary cause of death in 10 patients (29%). Gram-positive bacteria were isolated in 21 patients (60%), and Gram-negative bacteria in 10 patients (31%). Conclusion: in our retr...
Sepsis in European intensive care units: Results of the SOAP study*
Critical Care Medicine, 2006
R ecent years have seen several studies providing important national and international epidemiologic data on the frequency, associated factors, and even costs of sepsis (1-7). Angus and coworkers (1) analyzed Ͼ6 million hospital discharge records from seven states in the United States and estimated that 751,000 cases of severe sepsis occur annually in the United States, with a mortality rate of 28.6% and leading to average costs per case of $22,100. Using the National Hospital Discharge Survey database, Martin et al. (2) identified 10,319,418 cases of sepsis from an estimated 750 million hospitalizations in the United States over a 22-yr period, with an increase in frequency from 82.7 cases per 100,000 population in 1979 to 240.4 cases per 100,000 population in 2000. Alberti and colleagues (3) examined 14,364 patients in six European countries and Canada with Ͼ4,500 documented infectious episodes and reported a hospital mortality rate of 16.9% for noninfected patients and 53.6% for patients who had repeated courses of infection while in the intensive care unit (ICU). The European Prevalence of Infection in intensive Care (EPIC) study (8), now Ͼ10 yrs old, demonstrated how international collaboration can succeed in providing valuable information regarding disease prevalence and demographics of critically ill patients. In that prevalence Objective: To better define the incidence of sepsis and the characteristics of critically ill patients in European intensive care units. Design: Cohort, multiple-center, observational study. Setting: One hundred and ninety-eight intensive care units in 24 European countries. Patients: All new adult admissions to a participating intensive care unit between May 1 and 15, 2002. Interventions: None. Measurements and Main Results: Demographic data, comorbid diseases, and clinical and laboratory data were collected prospectively. Patients were followed up until death, until hospital discharge, or for 60 days. Of 3,147 adult patients, with a median age of 64 yrs, 1,177 (37.4%) had sepsis; 777 (24.7%) of these patients had sepsis on admission. In patients with sepsis, the lung was the most common site of infection (68%), followed by the abdomen (22%). Cultures were positive in 60% of the patients with sepsis. The most common organisms were Staphylococcus aureus (30%, including 14% methicillin-resistant), Pseudomonas species (14%), and Escherichia coli (13%). Pseudomonas species was the only microorganism independently associated with increased mortality rates. Patients with sepsis had more severe organ dysfunction, longer intensive care unit and hospital lengths of stay, and higher mortality rate than patients without sepsis. In patients with sepsis, age, positive fluid balance, septic shock, cancer, and medical admission were the important prognostic variables for intensive care unit mortality. There was considerable variation between countries, with a strong correlation between the frequency of sepsis and the intensive care unit mortality rates in each of these countries. Conclusions: This large pan-European study documents the high frequency of sepsis in critically ill patients and shows a close relationship between the proportion of patients with sepsis and the intensive care unit mortality in the various countries. In addition to age, a positive fluid balance was among the strongest prognostic factors for death. Patients with intensive care unit acquired sepsis have a worse outcome despite similar severity scores on intensive care unit admission. (Crit Care Med 2006; 34:344-353) *See also p. 552.
Sepsis in Intensive Care Unit Patients: Worldwide Data From the Intensive Care over Nations Audit
Open Forum Infectious Diseases, 2018
Background. There is a need to better define the epidemiology of sepsis in intensive care units (ICUs) around the globe. Methods. The Intensive Care over Nations (ICON) audit prospectively collected data on all adult (>16 years) patients admitted to the ICU between May 8 and May 18, 2012, except those admitted for less than 24 hours for routine postoperative surveillance. Data were collected daily for a maximum of 28 days in the ICU, and patients were followed up for outcome data until death, hospital discharge, or for 60 days. Participation was entirely voluntary. Results. The audit included 10 069 patients from Europe (54.1%), Asia (19.2%), America (17.1%), and other continents (9.6%). Sepsis, defined as infection with associated organ failure, was identified during the ICU stay in 2973 (29.5%) patients, including in 1808 (18.0%) already at ICU admission. Occurrence rates of sepsis varied from 13.6% to 39.3% in the different regions. Overall ICU and hospital mortality rates were 25.8% and 35.3%, respectively, in patients with sepsis, but it varied from 11.9% and 19.3% (Oceania) to 39.5% and 47.2% (Africa), respectively. After adjustment for possible confounders in a multilevel analysis, independent risk factors for in-hospital death included older age, higher simplified acute physiology II score, comorbid cancer, chronic heart failure (New York Heart Association Classification III/IV), cirrhosis, use of mechanical ventilation or renal replacement therapy, and infection with Acinetobacter spp. Conclusions. Sepsis remains a major health problem in ICU patients worldwide and is associated with high mortality rates. However, there is wide variability in the sepsis rate and outcomes in ICU patients around the globe.
Clinical Microbiology and Infection, 2008
This study describes the development of a method for rapid preliminary species identification of bacteria from positive blood culture vials. The method yielded preliminary identification results for 496 (92%) of 541 positive blood cultures within 5 h. The method was capable of identifying the most frequently isolated bacteria (i.e., Staphylococcus aureus, coagulase-negative staphylococci, Escherichia coli, Streptococcus pneumoniae and Enterococcus spp.) to the species level. The method can be established easily, with a materials cost of 2-5 Euros per sample.
The importance of pathogens in sepsis: Staphylococcus aureus story
Scandinavian Journal of Infectious Diseases, 2010
Different pathogens cause different outcomes for patients with sepsis. They infl uence intensive care unit (ICU) mortality, ICU length of stay (ICU LOS) and the need for mechanical ventilation (MV). We undertook a retrospective data-based analysis over a 6-y period. Seventy-eight patients with methicillin-sensitive Staphylococcus aureus (MSSA) and 74 patients with Escherichia coli (EC) sepsis were included in the study. ICU mortality for the MSSA group was 32 (41.0%) vs 26 (35.1%) for the EC group (p = 0.506; OR 1.28, 95% CI 0.67-2.48). There was no signifi cant difference in ICU LOS (MSSA group: median 7.5, interquartile range (IQR) 4-14 days and EC: median 5, IQR 3-13.5 days; p = 0.214). Need for MV in the MSSA group was present in 45 (57.7%) patients vs 43 (58.1%) in the EC group. Univariate analysis did not show that MSSA was independently associated with ICU mortality (p = 0.506). Logistic regression analysis showed that after adjustment for APACHE II, the chance of ICU death doubled in the MSSA group (odds ratio 2.166; 95% confi dence interval 1.004-4.858). The odds for ICU admission were 8 times higher in MSSA patients. MSSA sepsis should be considered as an independent factor for ICU mortality after adjustment for APACHE II.