Linezolid and clindamycin improve the outcome of severe, necrotizing pneumonia due to community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA).

The last decade has been characterized by the emergence of CA-MRSA strains associated with the production of Panton-Valentine leukocidin. We report a case of necrotizing pneumonia and septic shock caused by CA-MRSA, in which early recognition of the syndrome and appropriate treatment with two toxin-suppressing antibiotics improved the patient's outcome.

Rotation of antimicrobial therapy in the intensive care unit: impact on incidence of ventilator-associated pneumonia caused by antibiotic-resistant Gram-negative bacteria.

The development of antibiotic resistance is associated with high morbidity and mortality, particularly in the intensive care unit (ICU) setting. We evaluated the effect of an antibiotic rotation programme on the incidence of ventilator-associated pneumonia (VAP) caused by antibiotic-resistant Gram-negative bacteria. We conducted a 2-year before-and-after study at two medical-surgical ICUs at two different tertiary referral hospitals.

Epidemiology of nosocomial infection in 125 Italian intensive care units.

Aim: A continuous infection surveillance program was conducted by GiViTI throughout 2006 in Intensive Care Units (ICUs).

Methods: This was a prospective epidemiological study carried out in 125 Italian intensive care units. All patients have been included in the study.

Role of the infectious diseases specialist consultant on the appropriateness of antimicrobial therapy prescription in an intensive care unit.

Background: Use of routine microbiologic surveillance, antibiotic practice guidelines, and infectious diseases (ID) specialist consultation might contribute to achieve an early diagnosis and an appropriate antibiotic treatment of infections, particularly in an intensive care unit (ICU) setting.

Methods: We conducted a prospective cohort study in an ICU over a period of 4 years (2001-2004). We studied all patients with a possible or definite diagnosis of infection who received antimicrobial treatment, analyzing the appropriateness of antimicrobial therapy prescription before (P1) and after (P2) the implementation (January 1, 2003) of a systematic ID specialist consultation program.

Meticillin-resistant Staphylococcus aureus control in an intensive care unit: a 10 year analysis.

Data regarding the efficacy of programmes to control meticillin-resistant Staphylococcus aureus (MRSA) in intensive care units (ICUs) are limited. We performed an observational 'before-and-after' study to evaluate the search-and-destroy (S&D) strategy as compared with S&D and isolation (SDI), to control MRSA in a general ICU. S&D included active surveillance, contact precautions and treatment of carriers; in SDI, isolation or cohorting were added.

Antibiotic prophylaxis of early onset pneumonia in critically ill comatose patients. A randomized study.

Objective: To evaluate if a 3-day ampicillin-sulbactam prophylaxis can reduce the occurrence of early-onset pneumonia (EOP) in comatose mechanically-ventilated patients.

Design: This was a single-centre, prospective, randomised, open study.

Setting: A 10-bed general-neurological ICU in a 2,000-bed university hospital.

Surveillance of infections acquired in intensive care: usefulness in clinical practice.

Nosocomial infection surveillance is common in the USA and in some European countries but in Italy few hospitals use it. In order to evaluate its usefulness in clinical practice we performed a one year prospective epidemiological study that included 178 patients, admitted to an intensive care unit (ICU) for more than 48 h. Median ICU stay was 16 days.

Effects of high-dose IgG on survival of surgical patients with sepsis scores of 20 or greater.

Sixty-two consecutive septic surgical patients receiving standard multimodal intensive care unit treatment who developed a sepsis score of 20 or greater (day 0) were randomized to receive 0.4 g/kg of either intravenous IgG (29 patients) or human albumin (controls; 33 patients), repeated on days +1 and +5, in a prospective, double-blind, multicenter study. The two groups were similar in age, initial sepsis scores, and acute physiology and chronic health evaluation II score.

Free radical-induced lipoperoxidation and severe head injury. A clinical study.

Ten severely head injured patients (GCS less than or equal to 8), aged 17-62 years, were studied in order to investigate the role of lipoperoxidation in secondary brain damage. No patients had intracranial mass lesions, shock, hypoxemia, fever or sepsis. Blood samples were taken from the jugular bulb and from the right atrium, and thiobarbituric acid reacting substances (TBARS) were measured in plasma by spectrophotometry.