Antibiotic resistance in the intensive care unit: a primer in bacteriology.

Abstract:

:The clinical use of potent, well-tolerated, broad-spectrum antibiotics has been paralleled by the development of resistance in bacteria, and the prevalence of highly resistant bacteria in some intensive care units is despairingly commonplace. The intensive care community faces the realistic prospect of untreatable nosocomial infections and should be searching for new approaches to diagnose and manage resistant bacteria. In this review, we discuss some of the relevant underlying biology, with a particular focus on genetic transfer vehicles and the relationship of selection pressure to their movements. It is an attempt to demystify the relevant language and concepts for the anaesthetist and intensivist, to explain some of the reasons for the emergence of resistance in bacteria, and to provide a contextual basis for discussion of management approaches such as selective decontamination and antibiotic cycling.

journal_name

Anaesth Intensive Care

authors

Iredell J,Lipman J

doi

10.1177/0310057X0503300206

keywords:

subject

Has Abstract

pub_date

2005-04-01 00:00:00

pages

188-95

issue

2

eissn

0310-057X

issn

1448-0271

pii

2004171

journal_volume

33

pub_type

杂志文章,评审
  • Prone ventilation--it's time.

    abstract::Prone positioning to improve oxygenation in acute lung injury was first reported over 20 years ago. Although this and several subsequent studies have shown that prone positioning improved oxygenation in the majority of patients, it has failed to become common practice in intensive care units. This paper reviews the me...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,评审

    doi:10.1177/0310057X9902700213

    authors: Tobin A,Kelly W

    更新日期:1999-04-01 00:00:00

  • Eosinopenia as a predictor of unexpected re-admission and mortality after intensive care unit discharge.

    abstract::Predicting unexpected intensive care unit (ICU) re-admission and mortality after critical illness is difficult. This study assessed the associations between eosinopenia on the day of ICU discharge and outcomes after critical illness. This retrospective cohort study involved a total of 1446 critically ill patients who ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1304100130

    authors: Yip B,Ho KM

    更新日期:2013-03-01 00:00:00

  • Some prehistory of New Zealand intensive care medicine.

    abstract::In taking 1960 as the foundation year for the practice of intensive care medicine in New Zealand, this paper briefly looks into the previous two centuries for some interventions in life-threatening conditions. With the help of descriptions in early 19th century journals and books by perceptive observers, the author fo...

    journal_title:Anaesthesia and intensive care

    pub_type: 历史文章,杂志文章

    doi:10.1177/0310057X090370S105

    authors: Trubuhovich RV

    更新日期:2009-07-01 00:00:00

  • Graphic data representation in anaesthesiological journals: a proposed methodology for assessment of appropriateness.

    abstract::Few authors have addressed the topic of graphic data presentation. The purpose of our study was to combine several guidelines in order to evaluate three anaesthesiology journals listed in Index Medicus (Australian, American and Italian) in terms of the appropriateness and the quality of presentation of graphs. Our ana...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9702500612

    authors: De Amici D,Klersy C,Tinelli C

    更新日期:1997-12-01 00:00:00

  • Anaesthetic breathing circuit obstruction due to blockage of tracheal tube connector by a foreign body--two cases.

    abstract::Two cases are presented which illustrate the disastrous consequences possible when an anaesthetic breathing circuit is obstructed by a foreign body. Despite reports of previous similar cases, work practices and equipment manufacture or design continue to allow for such events to occur. The importance of both pre-anaes...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9902700116

    authors: Foreman MJ,Moyes DG

    更新日期:1999-02-01 00:00:00

  • The effect of halothane general anaesthesia on platelet function.

    abstract::Major craniofacial surgery has the potential for very large blood loss, frequently greater than one blood volume. In order that an assessment could be made of any deficiencies of platelet function or coagulation, tests were performed at intervals during the operation. None of the coagulation parameters showed variatio...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8701500306

    authors: Sweeney D,Williams V

    更新日期:1987-08-01 00:00:00

  • Surgery without pain--Part II: 1800-1847.

    abstract::This paper was commissioned to cover the beginning of anaesthesia: the transition from surgical operations with pain to those without. It reviews some previous pre-anaesthetic histories (Part I): it focuses upon attitudes to pain; and it seeks evidence from the one hundred years before the discovery of anaesthesia. Fi...

    journal_title:Anaesthesia and intensive care

    pub_type: 传,历史文章,杂志文章

    doi:10.1177/0310057X8601400214

    authors: Smith WD

    更新日期:1986-05-01 00:00:00

  • Prediction of the mediastinal drainage after coronary artery bypass surgery.

    abstract::Using multiple correlation and linear regression approaches, we investigated the association between the amount of mediastinal drainage for the first 24 postoperative hours and clinical variables as well as multiple haematological tests performed at three time points: before anaesthesia induction, 10 minutes after pro...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0002800411

    authors: Liu G,McNicol PL,McCall PR,Bellomo R,Connellan J,McInnes F,Przybylowski GM,Bowkett J,Choo F,Thurlow PJ

    更新日期:2000-08-01 00:00:00

  • The role of preoperative cervical spine X-rays in rheumatoid arthritis.

    abstract::The cervical spine is frequently involved in rheumatoid arthritis and yet there exists no consensus on the need to screen for cervical spine subluxations preoperatively. We reviewed retrospectively 77 patients who underwent 132 operations under general or regional anaesthesia over a 44-month period. We found that whil...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9802600604

    authors: Kwek TK,Lew TW,Thoo FL

    更新日期:1998-12-01 00:00:00

  • Cisatracurium and atracurium as antigens.

    abstract::Seventy-five consecutive patients referred to an anaesthetic allergy clinic were intradermally tested with atracurium and cisatracurium. With the exception of one patient the results were identical, suggesting that allergy to either drug is associated with allergy to the stereoisomer. For skin testing for allergy to n...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9902700406

    authors: Fisher MM

    更新日期:1999-08-01 00:00:00

  • Neural and neurochemical mechanisms of pain inhibition.

    abstract::Recent studies which suggest the existence of an endogenous neural substrate of pain inhibition are reviewed. Electrical stimulation of some areas of the medial brain stem in laboratory rats has produced a dramatic degree of analgesia. Such stimulation-produced analgesia is partially blocked by an opiate antagonist dr...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8201000209

    authors: Liebeskind JC,Sherman JE,Cannon T

    更新日期:1982-05-01 00:00:00

  • Immediate management of inadvertent dural puncture during insertion of a labour epidural: a survey of Australian obstetric anaesthetists.

    abstract::Immediate management of inadvertent dural puncture during insertion of an epidural needle during labour is controversial and evidence to guide clinical practice is limited. We surveyed Australian obstetric anaesthetists by anonymous postal questionnaire. Of the 671 surveys sent, 417 (62%) were returned. Following dura...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0803600117

    authors: Newman MJ,Cyna AM

    更新日期:2008-01-01 00:00:00

  • The prevention of gastric inflation--a neglected benefit of cricoid pressure.

    abstract::The ability of cricoid pressure to prevent inflation of the stomach during mask ventilation of a patient was studied. Fifty patients were randomly allocated to either have or not have cricoid pressure applied during a three-minute period of standardised mask ventilation. Patients who had had cricoid pressure applied h...

    journal_title:Anaesthesia and intensive care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1177/0310057X8801600202

    authors: Petito SP,Russell WJ

    更新日期:1988-05-01 00:00:00

  • Evaluation of a new blood warmer.

    abstract::Although some features are excellent, the Gorman-Rupp "dry heat' warmer has serious weaknesses which render part of the electrical circuit susceptible to water. Its heating ability is quite good but not completely adequate at flows of 150 ml/min. It creates a moderate resistance to blood flow and flow by gravity would...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8000800315

    authors: Russell WJ

    更新日期:1980-08-01 00:00:00

  • Congenital diaphragmatic hernia and the management of persistent foetal circulation.

    abstract::Twenty-two cases of diaphragmatic hernia, presenting from 1978 to 1982, were reviewed. Sixteen patients presented before 24 hours of life, of whom nine survived (56%). Six were late presenters who all did well. Seven babies had ten documented episodes of persistent foetal circulation (PFC) occurring as early as three ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8501300407

    authors: Fong LV,Pemberton PJ

    更新日期:1985-11-01 00:00:00

  • Incidence of ventricular fibrillation after aortic cross-clamp release using lignocaine cardioplegia.

    abstract::The occurrence of ventricular fibrillation after aortic de-clamping during cardiac surgery is common, and if prolonged may contribute to myocardial ischaemia. The use of lignocaine cardioplegia to minimize reperfusion ventricular fibrillation was studied in 141 patients undergoing first time coronary artery surgery in...

    journal_title:Anaesthesia and intensive care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1177/0310057X9402200420

    authors: Wallace SR,Baker AB

    更新日期:1994-08-01 00:00:00

  • Left ventricular outflow tract obstruction-be prepared!

    abstract::The current trend to treat hypotension in critically ill patients is to place a greater emphasis on inotropic support and less on fluid resuscitation in order to limit the potential harm from fluid overload. This combination may trigger left ventricular outflow tract obstruction (LVOTO) in susceptible patients. Althou...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1704500103

    authors: Evans JS,Huang SJ,McLean AS,Nalos M

    更新日期:2017-01-01 00:00:00

  • Prevalence and predictors of persistent post-surgical opioid use: a prospective observational cohort study.

    abstract::Post-surgical opioid prescribing intended for the short-term management of acute pain may lead to long-term opioid use. This study was undertaken to determine the prevalence of persistent post-surgical opioid use and patient-related factors associated with post-surgical opioid use. One thousand and thirteen opioid-naï...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1704500609

    authors: Stark N,Kerr S,Stevens J

    更新日期:2017-11-01 00:00:00

  • Pulmonary mechanics in patients with prolonged mechanical ventilation requiring tracheostomy.

    abstract::This study was performed to assess the changes in pulmonary mechanics before and after tracheostomy in patients with prolonged mechanical ventilation and to detect pre-tracheostomy physiologic factors that predict the outcome of weaning from mechanical ventilation. Pulmonary mechanics were recorded before and after tr...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9902700604

    authors: Lin MC,Huang CC,Yang CT,Tsai YH,Tsao TC

    更新日期:1999-12-01 00:00:00

  • Hours of work and fatigue-related error: a survey of New Zealand anaesthetists.

    abstract::A nationwide survey (70% response) documented anaesthetists' hours of work, their perceptions about safety limits and their recollection of fatigue-related errors in clinical practice. In the preceding six months, 71% of trainees and 58% of specialists had exceeded their self-defined safety limits for continuous anaes...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0002800209

    authors: Gander PH,Merry A,Millar MM,Weller J

    更新日期:2000-04-01 00:00:00

  • Shoulder manipulation to facilitate central vein catheterization from the external jugular vein.

    abstract::Manipulation of the shoulder to facilitate passage of J-wires past the clavicle during external jugular vein catheterization was tested prospectively in 111 adult patients undergoing cardiac surgery. On 10 of 25 occasions when the wire would not pass into the thorax, manipulation of the shoulder then allowed the wire ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9101900414

    authors: Sparks CJ,McSkimming I,George L

    更新日期:1991-11-01 00:00:00

  • Continuous tunnelled femoral nerve block for palliative care of a patient with metastatic osteosarcoma.

    abstract::An 18-year-old man with metastatic femoral osteosarcoma had inadequate pain control with gabapentin, naproxen and intravenous fentanyl. A tunnelled femoral nerve catheter was used to administer a continuous infusion of 0.2% ropivacaine and 4 microg/ml clonidine (10 ml/hour) until his death 88 days later During dischar...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1003800324

    authors: Pacenta HL,Kaddoum RN,Pereiras LA,Chidiac EJ,Burgoyne LL

    更新日期:2010-05-01 00:00:00

  • Pharmacokinetics and pharmacodynamics of suxamethonium.

    abstract::A study was undertaken to determine the time constants of elimination and effect compartment equilibration of suxamethonium and for the slope exponent of the Hill equation. Twelve patients were anaesthetized with thiopentone, fentanyl, and isoflurane in nitrous oxide and oxygen. After allowing conditions to become sta...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9702500312

    authors: Torda TA,Graham GG,Warwick NR,Donohue P

    更新日期:1997-06-01 00:00:00

  • Successful use of rocuronium and sugammadex in an anticipated difficult airway scenario.

    abstract::Neuromuscular blocking agents are often avoided in anticipated difficult airway scenarios. However to facilitate jet ventilation, muscle relaxants are useful. We report a case of a potentially threatened airway in a 21-year-old with a large infraglottic pedunculated polyp. In this case rocuronium was used on induction...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1003800226

    authors: McTernan CN,Rapeport DA,Ledowski T

    更新日期:2010-03-01 00:00:00

  • Attitudes and practices of New Zealand anaesthetists with regard to emergency drugs.

    abstract::A postal survey of anaesthetists practising in New Zealand assessed practices with regard to the preparation of pre-drawn syringes of emergency drugs in theatre, and attitudes towards the drawing up of drugs by non-medically qualified assistants. Opinion and practice varied widely; a quarter of respondents routinely d...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0002800616

    authors: Ducat CM,Merry AF,Webster CS

    更新日期:2000-12-01 00:00:00

  • A randomised comparison of parecoxib versus placebo for pain management following minor day stay gynaecological surgery.

    abstract::At therapeutic concentrations, parecoxib selectively inhibits the cyclo-oxygenase-2 enzyme. We investigated the impact of a single preoperative dose of parecoxib on pain relief following minor gynaecological surgery. Ninety women undergoing uterine dilatation and curettage, with or without hysteroscopy, were randomise...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0310057X1003800123

    authors: Luscombe KS,McDonnell NJ,Muchatuta NA,Paech MJ,Nathan EA

    更新日期:2010-01-01 00:00:00

  • 'Safe' methaemoglobin concentrations are a mortality risk factor in patients receiving inhaled nitric oxide.

    abstract::Inhaled nitric oxide (iNO) can reduce pulmonary arterial hypertension and improve oxygenation in some patients with severe respiratory or heart failure. Despite this, iNO has not been found to improve survival. This study aimed to perform a local practice audit to assess the mortality predictors of critically ill pati...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1103900519

    authors: Rolley L,Bandeshe H,Boots RJ

    更新日期:2011-09-01 00:00:00

  • The perioperative effects of oral premedication in children.

    abstract::The pre- and postoperative effects of oral diazepam (0.5 mg/kg), trimeprazine (4 mg/kg), pentobarbitone (3 mg/kg) and a placebo were compared in a randomized double-blind clinical trial in 149 children, aged one to ten years, undergoing adenotonsillectomy. The anaesthetic was standardised and each patient received int...

    journal_title:Anaesthesia and intensive care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1177/0310057X9001800102

    authors: van der Walt JH,Jacob R,Murrell D,Bentley M

    更新日期:1990-02-01 00:00:00

  • Granulocyte transfusions--a review for the intensive care physician.

    abstract::In order to achieve the maximum therapeutic benefit in the treatment of malignancies, doses of chemotherapeutic agents are pushed to the point of severe marrow toxicity. This aggressive therapy can lead to iatrogenic complications including haemorrhage and sepsis due to the depletion of platelets and granulocytes. Pri...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,评审

    doi:10.1177/0310057X9101900404

    authors: Tobias JD,Schleien C

    更新日期:1991-11-01 00:00:00

  • Continuous infusion of subcutaneous compared to intravenous insulin for tight glycaemic control in medical intensive care unit patients.

    abstract::The aim of this randomised controlled study was to compare continuous subcutaneous insulin infusion using an insulin pump with the traditional continuous intravenous infusion method for tight glycaemic control. Sixty patients admitted to our University Hospital medical intensive care unit with an initial blood glucose...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0310057X0803600421

    authors: Bodur HA,Saygili F,Saygili S,Doganay LH,Yesil S

    更新日期:2008-07-01 00:00:00