Influence of antibiotic pressure on multi-drug resistant colonisation in critically ill patients.

Background: The aim of this study is to evaluate the risk factors for colonisation by multidrug resistant (MDR) in a critical care unit and the relationship between colonisation and the antibiotic pressure exerted by the antimicrobial treatments received by patients.

Methods: A prospective observational was designed. Patients admitted for more than 48 h to an intensive care unit were included.

Impact of an antimicrobial stewardship program on critical haematological patients.

Objective: Antimicrobial Stewardship Programs (ASPs) have appeared as very useful tools in order to improve the use of antimicrobial agents. The objective of this study is to assess the impact of an ASP on haematological patients hospitalized in an Intensive Care Unit (ICU).

Methods: A quasi-experimental pre-post intervention study, which included haematological patients admitted to an ICU and assessed by the ASP program during 3 years.

Association between recurrence of acute kidney injury and mortality in intensive care unit patients with severe sepsis.

Background: Acute kidney injury (AKI) occurs in more than half critically ill patients admitted in intensive care units (ICU) and increases the mortality risk. The main cause of AKI in ICU is sepsis. AKI severity and other related variables such as recurrence of AKI episodes may influence mortality risk.

Cost-effectiveness analysis of implementing an antimicrobial stewardship program in critical care units.

Aims: To evaluate the cost-effectiveness of antimicrobial stewardship (AS) program implementation focused on critical care units based on assumptions for the Spanish setting.

Materials And Methods: A decision model comparing costs and outcomes of sepsis, community-acquired pneumonia, and nosocomial infections (including catheter-related bacteremia, urinary tract infection, and ventilator-associated pneumonia) in critical care units with or without an AS was designed. Model variables and costs, along with their distributions, were obtained from the literature.

A comparison of acute kidney injury classification systems in sepsis.

Background: Since 2004, various criteria have been proposed to define and stage acute kidney injury (AKI). Nevertheless, fixed criteria for assessing severe sepsis-related AKI have not yet been established.

Objectives: To assess the ability of the different AKI classification methods to predict mortality in a cohort of patients with sepsis.

Spinal muscular atrophy type I mimicking critical illness neuropathy in a paediatric intensive care neonate: electrophysiological features.

We report the case of a neonate with spinal muscular atrophy type I (SMA type I or Werdnig-Hoffman disease) who was initially misdiagnosis as having critical illness neuropathy. Electromyography (EMG) showed a moderate loss of voluntary and motor unit potentials of both neurogenic and myopathic appearance. Nerve conduction studies revealed the presence of a severe sensory-motor axonal neuropathy.

Necrotizing fasciitis after cesarean section.

We report a case of monomicrobial necrotizing fasciitis affecting a healthy woman after caesarean section. On day 1 post-partum she started taking a non-steroidal anti-inflammatory drug. The patient developed an acute fulminant infection and died from sepsis.