Abstract:
BACKGROUND:Procalcitonin (PCT)-protocols to guide antibiotic treatment in severe infections are known to be effective. But less is known about the long-term effects of such protocols on antibiotic consumption under real life conditions. This retrospective study analyses the effects on antibiotic use in patients with severe sepsis and septic shock after implementation of a PCT-protocol. METHODS:We conducted a retrospective ICU-database search for adult patients between 2005 and 2009 with sepsis and organ dysfunction who where treated accordingly to a PCT-guided algorithm as follows: Daily measurements of PCT (BRAHMS PCT LIA(®); BRAHMS Aktiengesellschaft, Hennigsdorf, Germany). Antibiotic therapy was discontinued if 1) clinical signs and symptoms of infection improved and PCT decreased to ≤1 ng/ml, or 2) if the PCT value was >1 ng/ml, but had dropped to 25-35% of the initial value within three days. The primary outcome parameters were: antibiotic days on ICU, ICU re-infection rate, 28-day mortality rate, length of stay (LOS) in ICU, mean antibiotic costs (per patient) and ventilation hours. Data from 141 patients were included in our study. Primary outcome parameters were analysed using covariance analyses (ANCOVA) to control for effects by gender, age, SAPS II, APACHE II and effective cost weight. RESULTS:From baseline data of 2005, duration of antibiotic therapy was reduced by an average of 1.0 day per year from 14.3 ±1.2 to 9.0 ±1.7 days in 2009 (p=0.02). ICU re-infection rate was decreased by yearly 35.1% (95% CI -53 to -8.5; p=0.014) just as ventilation hours by 42 hours per year (95% CI -72.6 to -11.4; p=0.008). ICU-LOS was reduced by 2.7 days per year (p<0.001). Trends towards an average yearly reduction of 28-day mortality by -22.4% (95% CI -44.3 to 8.1; p=0.133) and mean cost for antibiotic therapy/ patient by -14.3 Euro (95% CI -55.7 to 27.1) did not reach statistical significance. CONCLUSIONS:In a real-life clinical setting, implementation of a PCT-protocol was associated with a reduced duration of antibiotic therapy in septic ICU patients without compromising clinical or economical outcomes. GERMAN CLINICAL TRIALS REGISTER: DRKS00003490.
journal_name
BMC Infect Disjournal_title
BMC infectious diseasesauthors
Hohn A,Schroeder S,Gehrt A,Bernhardt K,Bein B,Wegscheider K,Hochreiter Mdoi
10.1186/1471-2334-13-158subject
Has Abstractpub_date
2013-04-01 00:00:00pages
158issn
1471-2334pii
1471-2334-13-158journal_volume
13pub_type
杂志文章abstract:BACKGROUND:Worldwide Helicobacter pylori (H.pylori) treatment is of great challenge due to increased antibiotic resistance. The burden of H. pylori antibiotic resistance in Africa is high with unclear information regarding the real magnitude. This systematic review and meta-analysis was conducted to investigate the mag...
journal_title:BMC infectious diseases
pub_type: 杂志文章,meta分析
doi:10.1186/s12879-018-3099-4
更新日期:2018-04-24 00:00:00
abstract::Following publication. ...
journal_title:BMC infectious diseases
pub_type: 杂志文章,已发布勘误
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更新日期:2019-03-04 00:00:00
abstract:BACKGROUND:Blastocystis sp. are among the most commonly observed intestinal parasites in routine clinical parasitology. Blastocystis in humans consists of at least 9 genetic subtypes. Different subtypes of Blastocystis may be associated with differences in pathogenicity and symptomatology. METHODS:Advanced microscopy ...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-13-389
更新日期:2013-08-23 00:00:00
abstract:BACKGROUND:This case report emphasizes the need to recognize cryptococcus as a possible cause of meningitis in non-HIV patients in Sub-Saharan Africa and to highlight the possibility of grave outcomes due to the paradoxical immune response in diabetic patients with cryptococcus meningitis. It also highlights the need f...
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pub_type: 杂志文章
doi:10.1186/s12879-018-3625-4
更新日期:2019-01-03 00:00:00
abstract:BACKGROUND:The identification and differentiation of strains of Mycobacterium tuberculosis by DNA fingerprinting has provided a better understanding of the epidemiology and tracing the transmission of tuberculosis. We set out to determine if there was a relationship between the risk of belonging to a group of tuberculo...
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pub_type: 杂志文章
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journal_title:BMC infectious diseases
pub_type: 杂志文章,评审
doi:10.1186/s12879-020-05459-9
更新日期:2020-10-14 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-015-1199-y
更新日期:2015-10-22 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12879-017-2217-z
更新日期:2017-02-03 00:00:00
abstract:BACKGROUND:Dengue has global importance as a dreaded arboviral infection. It has 4 serotypes of epidemiological imporatnce. The classification denotes two clinical spectrums- dengue fever (DF) and dengue haemorragic fever (DHF). Most cases are stereotype and amenable to fluid resuscitation. However, unusual manifestati...
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pub_type: 杂志文章
doi:10.1186/s12879-018-3596-5
更新日期:2018-12-18 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12879-017-2193-3
更新日期:2017-01-31 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-018-3637-0
更新日期:2018-12-29 00:00:00
abstract:BACKGROUND:Implant-related infections, including those of peri-prosthetic joint (PJIs), osteosynthesis and other biomaterials, are biofilm-related. Pathogen identification is considered the diagnostic benchmark; however, the presence of bacterial biofilms makes pathogen detection with traditional microbiological techni...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-018-3050-8
更新日期:2018-04-02 00:00:00
abstract:BACKGROUND:Screening for benign or malignant process of pelvis in young females is a challenge for a physician in a limited resource country. Tuberculosis should be always considered in the differential diagnosis of a pelvic mass in countries with high prevalence of tuberculosis. Negative results of analysis of periton...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-017-2237-8
更新日期:2017-02-07 00:00:00
abstract:BACKGROUND:Hepatitis B virus (HBV) infection is a high-risk factor of hepatocellular carcinoma (HCC). Cellular immune responses are essential for HCC development, and the CD4+ and CD8+ T subtypes are identified as the primary anti-tumor immune cells. In the study, we investigated the effect and mechanism of amygdalin i...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-020-05713-0
更新日期:2021-01-12 00:00:00
abstract:BACKGROUND:In Ethiopia, measles case-based surveillance was introduced in 2004 as one strategy for measles control by laboratory confirmation of suspected cases. In this article, epidemiological distribution of laboratory-confirmed measles cases were reported from the Southern Nation Nationalities and Peoples Region (S...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-017-2183-5
更新日期:2017-01-19 00:00:00
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journal_title:BMC infectious diseases
pub_type: 临床试验,杂志文章
doi:10.1186/s12879-017-2470-1
更新日期:2017-06-07 00:00:00
abstract:BACKGROUND:Bedaquiline was recently introduced into World Health Organization (WHO)-recommended regimens for treatment of drug resistant tuberculosis. There is limited data on the long-term safety of bedaquiline. Because bedaquiline prolongs the QT interval, there are concerns regarding cardiovascular safety. The Weste...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-019-4197-7
更新日期:2019-06-20 00:00:00
abstract:BACKGROUND:Studies report serious adherence problems among youth (individuals age 15-24 years of age) in Uganda. Recent growth in mobile phone ownership has highlighted the potential of using text-based interventions to improve antiretroviral treatment (ART) adherence among Ugandan youth. We piloted a randomized contro...
journal_title:BMC infectious diseases
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12879-020-4896-0
更新日期:2020-02-24 00:00:00
abstract:BACKGROUND:Mycobacterium goodii is a rare cause of significant infection. M. goodii has mainly been associated with lymphadenitis, cellulitis, osteomyelitis, and wound infection. CASE PRESENTATION:A case of a 76-year-old Caucasian female is presented. The patient developed a prosthetic valve endocarditis caused by M. ...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-12-301
更新日期:2012-11-14 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12879-020-05205-1
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pub_type: 杂志文章
doi:10.1186/s12879-020-05611-5
更新日期:2020-11-24 00:00:00
abstract:BACKGROUND:Raoultella planticola(R.planticola) is a very rare opportunistic pathogen and sometimes even associated with fatal infection in pediatric cases. Recently,the emergence of carbapenem resistance strains are constantly being reported and a growing source of concern for pediatricians. CASE PRESENTATION:We repor...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-020-05409-5
更新日期:2020-09-16 00:00:00
abstract:BACKGROUND:Streptococcus pneumoniae is a commensal of the human upper respiratory tract and a major cause of morbidity and mortality worldwide. This paper presents the distribution of serotypes and antimicrobial resistance in commensal S. pneumoniae strains cultured from healthy carriers older than four years of age in...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-018-3341-0
更新日期:2018-08-29 00:00:00
abstract:BACKGROUND:Community-acquired pneumonia (CAP) is a serious cause of morbidity among children in developed countries. The real impact of 7-valent pneumococcal conjugate vaccine (PCV7) on pneumococcal pneumonia is difficult to assess accurately. METHODS:Children aged ≤16 years with clinical and radiological pneumonia we...
journal_title:BMC infectious diseases
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2334-13-357
更新日期:2013-07-31 00:00:00
abstract:BACKGROUND:A two-stage surgical strategy (debridement-negative pressure therapy (NPT) and flap coverage) with prolonged antimicrobial therapy is usually proposed in pressure ulcer-related pelvic osteomyelitis but has not been widely evaluated. METHODS:Adult patients with pressure ulcer-related pelvic osteomyelitis tre...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-018-3076-y
更新日期:2018-04-10 00:00:00
abstract:BACKGROUND:Yeasts, mostly Candida, are important causes of bloodstream infections (BSI), responsible for significant mortality and morbidity among hospitalized patients. The epidemiology and species distribution vary from different regions. The goals of this study were to report the current epidemiology of Candida BSI ...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-14-241
更新日期:2014-05-06 00:00:00
abstract:BACKGROUND:In Ethiopia a tiebreaker algorithm using 3 rapid diagnostic tests (RDTs) in series is used to diagnose HIV. Discordant results between the first 2 RDTs are resolved by a third 'tiebreaker' RDT. Médecins Sans Frontières uses an alternate serial algorithm of 2 RDTs followed by a confirmation test for all doubl...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-015-0769-3
更新日期:2015-02-03 00:00:00
abstract:BACKGROUND:Various viruses are known to be associated with pneumonia. However, the impact of viral infections on adult pneumonia mortality remains unclear. This study aimed to clarify the effect of virus infection on pneumonia mortality among adults stratified by virus type and patient comorbidities. METHODS:This mult...
journal_title:BMC infectious diseases
pub_type: 杂志文章,多中心研究
doi:10.1186/s12879-017-2858-y
更新日期:2017-12-06 00:00:00
abstract:BACKGROUND:Preliminary results suggest that pertussis infection might be considered in infants during a seasonal respiratory syncytial virus (RSV) outbreak. METHODS:In order to analyze clinical features and laboratory findings in infants with pertussis hospitalized for acute respiratory symptoms during a seasonal RSV ...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-13-526
更新日期:2013-11-08 00:00:00
abstract:BACKGROUND:To better understand potential transmission risks from contact with the body fluids of children, we monitored the presence and amount of CMV shedding over time in healthy CMV-seropositive children. METHODS:Through screening we identified 36 children from the Atlanta, Georgia area who were CMV-seropositive, ...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-014-0569-1
更新日期:2014-11-13 00:00:00