International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
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Int. J. Infect. Dis. · Aug 2019
Meta AnalysisIneffectiveness of procalcitonin-guided antibiotic therapy in severely critically ill patients: A meta-analysis.
Optimizing antibiotic therapy has an important impact on the management of critically ill patients. Procalcitonin (PCT) is considered to be of possible use in the guidance of antibiotic stewardship; however, its efficacy remains controversial. Thus, a meta-analysis was performed to determine the efficacy of PCT-guided antibiotic therapy in critically ill patients. ⋯ PCT-guided antibiotic therapy fails to decrease the mortality or LOS of critically ill patients with suspected or confirmed sepsis. PCT-guided cessation of antibiotic therapy could reduce the mortality in patients with an average SOFA score of <8, but not in those with an average SOFA score of >8.
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Int. J. Infect. Dis. · Aug 2019
Multicenter StudyThe prognosis of streptococcal prosthetic bone and joint infections depends on surgical management-A multicenter retrospective study.
The optimal treatment of streptococcal prosthetic joint infections (PJIs) is unclear. ⋯ Streptococcal PJIs managed with DAIR have a poor prognosis and S. agalactiae seems to be an independent factor of treatment failure.
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Int. J. Infect. Dis. · Jul 2019
Efficacy and accuracy of qSOFA and SOFA scores as prognostic tools for community-acquired and healthcare-associated pneumonia.
The Japanese Respiratory Society recently updated its prognostic guidelines for pneumonia, recommending that pneumonia severity be evaluated using the sequential organ failure assessment (SOFA) and quick SOFA (qSOFA) scoring systems in a therapeutic strategy flowchart. However, the efficacy and accuracy of these tools are still unknown. ⋯ qSOFA and SOFA scores were able to correctly evaluate the severity of CAP and HCAP.
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Int. J. Infect. Dis. · Jun 2019
Contribution of the FilmArray Respiratory Panel in the management of adult and pediatric patients attending the emergency room during 2015-2016 influenza epidemics: An interventional study.
To evaluate the contribution of a multiplex PCR for respiratory viruses on antibiotic and antiviral prescription, ancillary test prescription, admission and length of stay of patients. ⋯ Results from the FilmArray Respiratory Panel do not appear to impact admission or antibiotic prescription, with the exception of a lower admission rate for children who tested positive for influenza B. Parameters that account for the clinical decisions evaluated are CRP level, white blood cell count, suspected or proven bacterial infection and, for adult patients only, signs of respiratory distress. Length of stay is also not significantly different between patients with a positive and a negative result. A rapid influenza test result permits a more appropriate prescription of oseltamivir.
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Int. J. Infect. Dis. · May 2019
Cytomegalovirus encephalitis in immunocompetent infants: A 15-year retrospective study at a single center.
Cytomegalovirus (CMV) encephalitis is a disease that primarily affects immunocompromised hosts. Only a few cases have been reported in immunocompetent individuals, especially in children. The aim of this study was to investigate the clinical characteristics of immunocompetent children with CMV encephalitis attending a single medical center in southwest China over a 15-year period. ⋯ The possibility of CMV encephalitis in the immunocompetent child should be kept in mind, especially in those younger than 6 months of age. Suspicion for a diagnosis of CMV encephalitis is needed in the presence of unexplained prominent seizure, fever, poor feeding, and a marked elevation of protein level in the CSF. CMV PCR assays of CSF are necessary to determine the etiology. Furthermore, measurement of the CMV load in CSF and urine may be useful for evaluating the response to treatment and the outcome. Ganciclovir may lead to clinical improvement with limited ADR. CMV encephalitis in the immunocompetent infant does not necessarily indicate a poor short-term prognosis.