Articles: bacterial-infections.
-
Multicenter Study Pragmatic Clinical Trial
Implementation of a rapid host-protein diagnostic test for distinguishing bacterial and viral infections in adults presenting to urgent care centers: a pragmatic cohort study.
Urgent care centers (UCCs) are a growing segment of healthcare with high rates of inappropriate antibiotic use. MeMed BV® (MMBV) is a blood test that differentiates bacterial from viral infections. Between April 2022 and March 2023, we introduced MMBV into routine care at ten UCCs. The primary objective was to assess MMBV's impact on antibiotic use; the secondary objective was to assess whether MMBV aided in patient management. ⋯ Implementing MMBV aided urgent care center physicians in their clinical decision-making and may have contributed to appropriate antibiotic use, better resource utilization, and patient management.
-
Patients with suspected infections account for 15% to 35% of hospital emergency department (ED) caseloads in Spain and Latin America. The main objective of this systematic review was to compare evidence supporting the safety and efficacy of early (3 hours after triage) vs deferred ($ 3-6 hours) antibiotic therapy prescribed in EDs for adults with serious infections or sepsis. Efficacy and improved clinical course were defined by reduced progression to septic shock and short- and long-term mortality. ⋯ Early initiation of antibiotic therapy, preferably within 3 hours of triage, can be recommended in cases of serious infection (sepsis or serious sepsis that do not meet the criteria for septic shock). In fact, based on a tendency for higher short- and long-term mortality associated with delay and a higher probability of developing septic shock with each hour of delay, therapy should start as soon as possible if infection is confirmed or suspected in the absence of an alternative diagnosis.
-
Semin Respir Crit Care Med · Jan 2025
State of the Art and Emerging Technologies in Vaccine Design for Respiratory Pathogens.
In this review, we present the efforts made so far in developing effective solutions to prevent infections caused by seven major respiratory pathogens: influenza virus, respiratory syncytial virus (RSV), the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Bordetella pertussis, Streptococcus pneumoniae (pneumococcus), Mycobacterium tuberculosis, and Pseudomonas aeruginosa. Advancements driven by the recent coronavirus disease 2019 (COVID-19) crisis have largely focused on viruses, but effective prophylactic solutions for bacterial pathogens are also needed, especially in light of the antimicrobial resistance (AMR) phenomenon. Here, we discuss various innovative key technologies that can help address this critical need, such as (a) the development of Lung-on-Chip ex vivo models to gain a better understanding of the pathogenesis process and the host-microbe interactions; (b) a more thorough investigation of the mechanisms behind mucosal immunity as the first line of defense against pathogens; (c) the identification of correlates of protection (CoPs) which, in conjunction with the Reverse Vaccinology 2.0 approach, can push a more rational and targeted design of vaccines. By focusing on these critical areas, we expect substantial progress in the development of new vaccines against respiratory bacterial pathogens, thereby enhancing global health protection in the framework of the increasingly concerning AMR emergence.
-
Accuracy of pathogen diagnostic codes for acute hematogenous musculoskeletal infections in children.
Administrative databases are powerful tools for pediatric research but lack patient-level microbiology results. This study aimed to determine the accuracy of pathogen discharge diagnosis codes for children hospitalized with acute hematogenous musculoskeletal infections (MSKIs). Medical records for 244 children hospitalized with acute hematogenous MSKIs were manually reviewed to determine which bacterial pathogen, if any, was identified for each MSKI based on microbiology results obtained during the hospitalization. ⋯ Discharge diagnostic codes correctly matched the microbiology results in 89.3% of encounters. Sensitivity and specificity for Staphylococcus aureus discharge diagnostic codes were 88.6% and 96.4% respectively for methicillin-susceptible S. aureus and 92.9% and 99.5% for methicillin-resistant S. aureus. Pathogen discharge codes are reliable surrogates that accurately reflect the microbiology results for children with MSKIs.