The Impact of Rapid Molecular Diagnostics for Influenza on Antibiotic Stewardship in the Emergency Department-An Observational Retrospective Study.

Objective: The clinical diagnosis of respiratory tract infections (RTIs) may result in unnecessary antibiotic treatment due to clinical exams' low sensitivity and specificity to differentiate viral from bacterial infections and costly diagnostic work-ups. Unnecessary antibiotic consumption drives antibiotic resistance. We explored whether a rapid influenza-specific polymerase chain reaction (PCR) assay reduced antibiotic use in an emergency room before the COVID-19 pandemic.

Enhancing interprofessional ward rounds by identifying factors associated with low satisfaction and efficiency: a quantitative and qualitative national survey of Swiss healthcare professionals.

Aims Of The Study: Interprofessional ward rounds are a cornerstone of patient-centred care for medical inpatients and offer opportunities to discuss and coordinate patient treatment and further management. We aimed to identify factors associated with lower satisfaction and efficiency of interprofessional ward rounds, as reported by physicians and nurses.

Methods: An anonymous Swiss nationwide online survey of physicians and nurses was conducted in 28 Swiss internal medicine inpatient departments between 9 August and 19 October 2023.

Monitoring low-value care in medical patients from Swiss university hospitals using a Findable, Accessible, Interoperable, Reusable (FAIR) national data stream and patient and public involvement: LUCID study protocol.

Introduction: Healthcare practices providing minimal or no benefit to recipients have been estimated to represent 20% of healthcare costs. However, defining, measuring and monitoring low-value care (LVC) and its downstream consequences remain a major challenge. The purpose of the National Data Stream (LUCID NDS) is to identify and monitor LVC in medical inpatients using routinely collected hospital data.

Multicenter Evaluation of the QIAstat-Dx and the BioFire Multiplex Panel Tests for the Detection of Respiratory Pathogens.

Syndromic multiplex panel testing enables simultaneous detection of multiple respiratory pathogens, but limited data is available on the comparative diagnostic performance of different testing systems. In this multicenter prospective study, we aimed to compare the QIAstat-Dx Respiratory Panel 2.0 (QIAstat-Dx-RP2.

Effects of a scoring aid on glasgow coma score assessment and physicians' comprehension: a simulator-based randomized clinical trial.

Purpose: Examining the impact of scoring aids on the accuracy of assessing the Glasgow Coma Score (GCS) in a standardized trauma scenario (primary outcome). Evaluating physicians' understanding of the GCS assessment and clinical application (secondary outcome).

Materials And Methods: This randomized trial was performed at the simulator center of a Swiss tertiary academic medical hospital.

[Clinical reasoning, the art of medicine and artificial intelligence].

"Clinical reasoning" refers to all the thought processes that physicians use to make a diagnosis and determine a treatment and care plan. Artificial intelligence (AI) will enhance, improve, and accelerate human clinical diagnostic thinking, but it is unlikely to replace it. Its application in medicine has the potential to drastically reduce medical diagnostic errors and give doctors more time to care for their patients.

Target Attainment and Population Pharmacokinetics of Cefazolin in Patients with Invasive Infections: A Prospective Cohort Study.

This study aimed to determine cefazolin target attainment in patients with invasive () infections and to develop a population pharmacokinetic (PK) model. Adult patients with invasive infections treated with cefazolin bolus infusions were included. Unbound and total trough and mid-dose cefazolin concentrations were measured, and strain-specific MICs were determined.

Secondary attack rate following on-site isolation of patients with suspected COVID-19 in multiple-bed rooms.

The implementation of isolation precautions for patients with suspected Coronavirus Disease 2019 (COVID-19) and pending test results is resource intensive. Due to the limited availability of single-bed rooms at our institution, we isolated patients with suspected COVID-19 together with patients without suspected COVID-19 on-site in multiple-bed rooms until SARS-CoV-2-test results were available. We evaluated the likelihood of SARS-CoV-2 transmission to individuals sharing the room with patients isolated on-site.

Syncope or seizure: that is the question-case report of a young patient with convulsive cardioinhibitory syncope treated with cardioneuroablation.

Background: Differentiation of syncope from seizure is challenging and has therapeutic implications. Cardioinhibitory reflex syncope typically affects young patients where permanent pacing should be avoided whenever possible. Cardioneuroablation may obviate the need for a pacemaker in well-selected patients.

The association of vaccination status with perceived discrimination in patients with COVID-19: results from a cross-sectional study.

Study Aims: During the COVID-19 pandemic, there was increasing pressure to be vaccinated to prevent further spread of the virus and improve outcomes. At the same time, part of the population expressed reluctance to vaccination, for various reasons. Only a few studies have compared the perceptions of vaccinated and non-vaccinated patients being treated in hospitals for COVID-19.

Bacterial genome-wide association study substantiates papGII of Escherichia coli as a major risk factor for urosepsis.

Background: Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, often caused by uropathogenic Escherichia coli. Multiple bacterial virulence factors or patient characteristics have been linked separately to progressive, more invasive infections. In this study, we aim to identify pathogen- and patient-specific factors that drive the progression to urosepsis by jointly analysing bacterial and host characteristics.

Identification of microorganisms by a rapid PCR panel from positive blood cultures leads to faster optimal antimicrobial therapy - a before-after study.

Background: The BioFire® FilmArray® Blood Culture Identification Panel 1 (BF-FA-BCIP) detects microorganisms with high accuracy in positive blood cultures (BC) - a key step in the management of patients with suspected bacteraemia. We aimed to compare the time to optimal antimicrobial therapy (OAT) for the BF-FA-BCIP vs. standard culture-based identification.

Occurrence of sensitive topics during ward round: an ancillary analysis of the BEDSIDE-OUTSIDE trial.

Objective: Discussing sensitive topics (eg, medical uncertainty, social issues, non-adherence) during ward rounds is challenging and may negatively impact patient satisfaction with the healthcare they are receiving. In the previous multicentre randomised BEDSIDE-OUTSIDE trial focusing on communication during ward rounds, we investigated the interplay between sensitive topics and low reported satisfaction with care.

Design: Pre-planned secondary analysis of a randomised controlled trial.

Evaluation of the clinical relevance of the Biofire FilmArray pneumonia panel among hospitalized patients.

Purpose: Panel PCR tests provide rapid pathogen identification. However, their diagnostic performance is unclear. We assessed the performance of the Biofire FilmArray pneumonia (PN)-panel against standard culture in broncho-alveolar lavage (BAL) samples.

Factors associated with non-carbapenemase mediated carbapenem resistance of Gram-negative bacteria: a retrospective case-control study.

Infections with carbapenemase-producing Gram-negative bacteria are related to increased morbidity and mortality, yet little is known regarding infections caused by non-beta-lactamase mediated carbapenem-resistant bacteria. Our objective was to identify risk factors for, and the clinical impact of infections caused by carbapenem-resistant carbapenemase-negative Enterobacterales and Pseudomonas aeruginosa. This retrospective matched case-control study was performed at the University Hospital of Basel, Switzerland, in 2016.

A long-term retrospective observational study at a medium-sized medical oncology service in Switzerland: comparison of overall survival with a national cohort and adherence to treatment guidelines.

Aims: There is a lack of national and international publicly available long-term survival outcome data from individual healthcare providers in medical oncology. In this study, the overall survival at a medium-sized medical oncology service at Olten Cantonal Hospital was evaluated and compared as a local benchmark report with national data from the Swiss Cancer Registries. Furthermore, adherence to treatment guidelines was investigated as an additional quality indicator.

A systematic outbreak investigation of SARS-CoV-2 transmission clusters in a tertiary academic care center.

Background: We sought to decipher transmission pathways in healthcare-associated infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within our hospital by epidemiological work-up and complementary whole genome sequencing (WGS). We report the findings of the four largest epidemiologic clusters of SARS-CoV-2 transmission occurring during the second wave of the pandemic from 11/2020 to 12/2020.

Methods: At the University Hospital Basel, Switzerland, systematic outbreak investigation is initiated at detection of any nosocomial case of SARS-CoV-2 infection, as confirmed by polymerase chain reaction, occurring more than five days after admission.

Factors impacting the pre-analytical quality of blood cultures-Analysis at a tertiary medical center.

Background: Blood cultures (BC) are critical for the diagnosis of bloodstream infections, pathogen identification, and resistance testing. Guidelines recommend a blood volume of 8-10 mL per bottle as lower volumes result in decreased sensitivity. We aimed to evaluate factors for non-adherence to recommended volumes and assess the effects on diagnostic performance.

Free-living core body temperature monitoring using a wrist-worn sensor after COVID-19 booster vaccination: a pilot study.

Core body temperature (CBT) is a key vital sign and fever is an important indicator of disease. In the past decade, there has been growing interest for vital sign monitoring technology that may be embedded in wearable devices, and the COVID-19 pandemic has highlighted the need for remote patient monitoring systems. While wrist-worn sensors allow continuous assessment of heart rate and oxygen saturation, reliable measurement of CBT at the wrist remains challenging.

PorinPredict: Identification of OprD Loss from WGS Data for Improved Genotype-Phenotype Predictions of P. aeruginosa Carbapenem Resistance.

The increasing integration of genomics into routine clinical diagnostics requires reliable computational tools to identify determinants of antimicrobial resistance (AMR) from whole-genome sequencing data. Here, we developed PorinPredict, a bioinformatic tool that predicts defects of the Pseudomonas aeruginosa outer membrane porin OprD, which are strongly associated with reduced carbapenem susceptibility. PorinPredict relies on a database of intact OprD variants and reports inactivating mutations in the coding or promoter region.

Gastrointestinal bleeding during anticoagulation with direct oral anticoagulants compared to vitamin K antagonists.

Patients receiving oral anticoagulants with vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) have an increased risk of gastrointestinal bleeding (GIB). We compared cases of GIB associated with VKAs and DOACs in terms of risk factors, scores, timing, location, severity, and outcome. Data from patients treated at a university hospital in Switzerland for GIB under VKA and DOACs between 2012 and 2018 were analyzed in this investigator-driven, retrospective, single-center study.

[Better Late than Never - Fever of Unknown Origin in a Patient with a Prosthetic Valve].

Better Late than Never - Fever of Unknown Origin in a Patient with a Prosthetic Valve A patient presents with worsening of his general condition, chills and dyspnoea on exertion. With a history of aortic valve replacement, infective endocarditis is suspected, but due to negative imaging by transesophageal echocardiography and negative blood cultures cannot be confirmed. Finally, prosthetic valve endocarditis is diagnosed after culture of C.