Abstract:
Background:Risk-based guidelines aid empiric antibiotic selection for critically ill adults with suspected infection with Gram-negative bacilli with high potential for antibiotic resistance (termed high-risk GNRs). Neither evidence-based guidelines for empiric antibiotic selection nor validated risk factors predicting high-risk GNR growth exist for critically ill children. We developed and validated a model for predicting high-risk GNR growth in critically ill children with suspected infection. Methods:This is a retrospective cohort study involving 2 pediatric cohorts admitted to a pediatric intensive care unit (ICU) with suspected infection. We developed a risk model predicting growth of high-risk GNRs using multivariable regression analysis in 1 cohort and validated it in a separate cohort. Results:In our derivation cohort (556 infectious episodes involving 489 patients), we identified the following independent predictors of high-risk GNR growth: hospitalization >48 hours before suspected infection, hospitalization within the past 4 weeks, recent systemic antibiotics, chronic lung disease, residence in a chronic care facility, and prior high-risk GNR growth. The model sensitivity was 96%, the specificity was 48%, performance using the Brier score was good, and the area under the receiver operator characteristic curve (AUROC) was 0.722, indicating good model performance. In our validation cohort (525 episodes in 447 patients), model performance was similar (AUROC, 0.733), indicating stable model performance. Conclusions:Our model predicting high-risk GNR growth in critically ill children demonstrates the high sensitivity needed for ICU antibiotic decisions, good overall predictive capability, and stable performance in 2 separate cohorts. This model could be used to develop risk-based empiric antibiotic guidelines for the pediatric ICU.
journal_name
Open Forum Infect Disjournal_title
Open forum infectious diseasesauthors
Karsies T,Moore-Clingenpeel M,Hall Mdoi
10.1093/ofid/ofy278subject
Has Abstractpub_date
2018-10-24 00:00:00pages
ofy278issue
11issn
2328-8957pii
ofy278journal_volume
5pub_type
杂志文章abstract::Background. Cryptococcal meningitis is a leading cause of death in people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome. The World Health Organizations recommends pre-antiretroviral treatment (ART) cryptococcal antigen (CRAG) screening in persons with CD4 below 100 cells/µL. We as...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofv046
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abstract:Background:Bolstered by the high efficacy of hepatitis C virus (HCV) treatment, the World Health Organization has called for HCV elimination by 2030. People with HIV (PWH) have been identified as a population in which elimination should be prioritized. Methods:We examined progress in HCV elimination through the HCV ca...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz426
更新日期:2019-09-30 00:00:00
abstract:Background:Inpatient HIV care often requires specialized laboratory testing with which practitioners may not be familiar. In addition, computerized physician order entry allows for ordering tests without understanding test indications, but it can also provide a venue for education and diagnostic stewardship. Methods:A...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
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更新日期:2019-03-29 00:00:00
abstract:Background:In 2012, the US Food and Drug Administration (FDA) required drug manufacturers to give advance notice of impending drug shortages. A survey of infectious diseases (ID) physicians was undertaken to determine the impact of this requirement and to follow-up on prior perceptions of ID physicians on shortages of ...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy068
更新日期:2018-04-23 00:00:00
abstract:: Background. Many human immunodeficiency virus (HIV)-infected patients remain on nevirapine-based antiretroviral therapy (ART) despite safety and efficacy concerns. Switching to a rilpivirine-based regimen is an alternative, but there is little experience with rilpivirine ...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofw141
更新日期:2016-07-01 00:00:00
abstract:Background:Hydatid disease is a severe health problem in endemic areas. In recent years, the incidence of this disease in China has been increasing. As the imaging characteristics of pancreatic echinococcosis (PE) are similar to those of cystic diseases, such as cysts, tuberculosis, and tumors, PE is often misdiagnosed...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
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更新日期:2020-04-03 00:00:00
abstract:Background:In December 2018, a large, tertiary, university-affiliated hospital in the Philippines discovered that their legitimate supply chain was infiltrated with counterfeit rabies vaccines. Methods:All vials suspected to be counterfeit were quarantined and surrendered to the Philippine Food and Drug Administration...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa313
更新日期:2020-07-22 00:00:00
abstract:Background:Identification of HIV infection at the early stage is valuable for patient management, for prevention, and for research purposes. In practice, identification of a recent HIV infection at diagnosis proves challenging after HIV antibody seroconversion but can be suspected using Western blots (WBs) or immunoblo...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa140
更新日期:2020-04-21 00:00:00
abstract::We describe a case of fetal parvovirus B19 infection resulting in preterm birth and leading to hydrops fetalis requiring multiple in utero transfusions. The infant developed chronic postnatal anemia responsive to intravenous immunoglobulin therapy. Serum viral load decreased after immunoglobulin treatment but remained...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofv049
更新日期:2015-04-15 00:00:00
abstract::People living with human immunodeficiency virus frequently use dietary supplements, including probiotics, but concern exists about ingesting live organisms. We performed a systematic review of the benefits of probiotics and a meta-analysis of sepsis risk. We undertook a protocol-driven, comprehensive review to identif...
journal_title:Open forum infectious diseases
pub_type: 杂志文章,评审
doi:10.1093/ofid/ofw164
更新日期:2016-07-29 00:00:00
abstract:Background:Hematogenous dissemination of Talaromyces marneffei can result in multiorgan involvement (skin, lung, and reticuloendothelial system involvement); however, few studies have reported intestinal T marneffei infections. We investigated clinical features, management, and patient outcomes concerning Talaromyces-r...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa128
更新日期:2020-04-27 00:00:00
abstract:BACKGROUND:Endothelial activation and dysfunction play a central role in the pathogenesis of sepsis and viral hemorrhagic fevers. Hantaviral disease is a viral hemorrhagic fever and is characterized by capillary dysfunction, although the underlying mechanisms for hantaviral disease are not fully elucidated. METHODS:Th...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofu027
更新日期:2014-05-29 00:00:00
abstract:BACKGROUND:Ombitasvir, paritaprevir with ritonavir, and dasabuvir (OBV/PTV/r ± DSV) ±ribavirin (RBV) are approved to treat hepatitis C virus (HCV) genotype 1 and 4 infection. Here, we investigate the safety and efficacy of OBV/PTV/r + DSV ±RBV for HCV genotype 1, and OBV/PTV/r + RBV for HCV genotype 4, in human immunod...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx154
更新日期:2017-07-22 00:00:00
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journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy102
更新日期:2018-05-03 00:00:00
abstract:Background:The diagnosis of cellulitis is made clinically without a gold standard diagnostic test, and cellulitis has many disease mimics. There is currently no consensus for optimal antimicrobial treatment duration or method of antimicrobial delivery. Methods:This was a randomized controlled open-label multicenter tr...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz335
更新日期:2019-07-20 00:00:00
abstract::International guidelines recommend using local susceptibility data to direct empiric therapy for acute uncomplicated cystitis. We evaluated outpatient urinary isolate susceptibility trends in New York State. Nitrofurantoin had the lowest resistance prevalence whereas trimethoprim-sulfamethoxazole and fluoroquinolones ...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy297
更新日期:2018-11-16 00:00:00
abstract::We assessed the impact of a rapid molecular assay for influenza detection whether outsourced or performed onsite 24/7 in a University Hospital in Paris, France. Shorter median time-to-results (16.8 vs 2.3 hours, P < .05) and an increased rate of adequate prescription of oseltamivir (76.6% vs 95.3%, P < .05) were obser...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa374
更新日期:2020-08-25 00:00:00
abstract:Background:To determine the effectiveness of implementing a locally developed clinical practice guideline (CPG) for antibiotic treatment in adults with community-acquired cellulitis at Siriraj Hospital in Bangkok, Thailand. Methods:The CPG for antibiotic treatment of community-acquired cellulitis was developed based o...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa411
更新日期:2020-09-07 00:00:00
abstract::Persistent viral activity may cause enduring seropositivity and inflammation in treated people with HIV (PWH). We compared inflammatory biomarkers between early treated PWH who remained seronegative or seroconverted and found similar levels of D-dimer, soluble cluster of differentiation 14, C-reactive protein, and int...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa383
更新日期:2020-08-26 00:00:00
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journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx213
更新日期:2017-10-03 00:00:00
abstract::Elimination of a rifamycin from the treatment regimen for tuberculosis negatively impacts outcomes. Cross-reactivity between the rifamycins after drug eruptions is unclear. We report 6 consecutive human immunodeficiency virus-infected patients with rifampicin-associated drug rash with eosinophilia and systemic symptom...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofw130
更新日期:2016-06-20 00:00:00
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journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy137
更新日期:2018-06-16 00:00:00
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journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofaa236
更新日期:2020-06-19 00:00:00
abstract:Background:Post-kala-azar dermal leishmaniasis (PKDL) is a sequel to visceral leishmaniasis (VL), which is found in VL-endemic countries including Bangladesh. Because of these enigmatic cases, the success of the National Kala-azar Elimination Program is under threat. To date, diagnostic methods for PKDL cases in endemi...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofy234
更新日期:2018-09-15 00:00:00
abstract:Background:Malaria transmission through blood transfusion is an accidental but preventable cause of malaria infection and is increasingly becoming a matter of concern for blood transfusion services. This systematic review was conducted to provide a summary of evidence about the prevalence of Plasmodium infection in asy...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofz283
更新日期:2019-06-11 00:00:00
abstract:Background:Clinical features of Lyme disease (LD) range from localized skin lesions to serious disseminated disease. Information on risk factors for Lyme arthritis, facial palsy, carditis, and meningitis is limited but could facilitate disease recognition and elucidate pathophysiology. Methods:Patients from high-incid...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx254
更新日期:2017-11-18 00:00:00
abstract:Background:Mismanagement of asymptomatic patients with positive urine cultures (referred to as asymptomatic bacteriuria [ASB] in the literature) promotes antimicrobial resistance and results in unnecessary antimicrobial-related adverse events and increased health care costs. Methods:We conducted a systematic review an...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx207
更新日期:2017-11-20 00:00:00
abstract::Microvascular function and oxygen consumption affect oxygen homeostasis but have not been assessed in African children with malaria. Microvascular function in Tanzanian children with severe malaria (SM) or uncomplicated malaria were 39% and 72%, respectively, of controls (P < .001). Uncomplicated malaria (P = .04), no...
journal_title:Open forum infectious diseases
pub_type: 杂志文章
doi:10.1093/ofid/ofx079
更新日期:2017-04-22 00:00:00
abstract::Surveillance represents an important informational tool for planning actions to monitor emerging antimicrobial resistance. Antimicrobial resistance surveillance (ARS) programs may have many different designs and can be grouped in 2 major categories based on their main objectives: (1) public health ARS programs and (2)...
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pub_type: 杂志文章
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更新日期:2019-03-15 00:00:00
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journal_title:Open forum infectious diseases
pub_type: 杂志文章
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更新日期:2018-08-29 00:00:00