Synergistic Meropenem/Vaborbactam Plus Fosfomycin Treatment of KPC Producing Septic Thrombosis Unresponsive to Ceftazidime/Avibactam: From the Bench to the Bedside.

Gram-negative bacilli septic thrombosis (GNB-ST) represents a subtle and often misleading condition, potentially fatal if not recognized early and requiring prolonged antimicrobial therapy and anticoagulation. Herein, reported for the first time, is a very challenging case of producing carbapenemase (KPC)-producing (KPC-Kp) ST unresponsive to ceftazidime/avibactam (CZA) relapsed first with meropenem/vaborbactam (MVB) monotherapy and subsequently cured with MVB plus fosfomycin (FOS) combination. The present case highlights the possibility of CZA underexposure on the infected thrombus and the risk of in vivo emergence of CZA resistance in the setting of persistent bacteremia and sub-optimal anticoagulation.

PTEN expression and its association with glucose control and calorie supplementation in critically ill patients.

Background & Aim: Phosphatase and tensin homologue (PTEN) reduces insulin sensitivity. Since critically ill patients present insulin resistance, we aimed at assessing the role of PTEN expression on glucose homeostasis and clinical outcome in patients admitted to an intensive care unit (ICU) and receiving artificial nutrition.

Methods: Observational, single-center study conducted in one ICU in Rome, Italy on adult patients hospitalized for trauma.

Noninvasive ventilation by helmet or face mask in immunocompromised patients: a case-control study.

Objective: To compare the efficacy of noninvasive positive pressure ventilation (NPPV) by helmet and face mask in immunocompromised patients with hypoxemic acute respiratory failure (ARF).

Design: Case-control study.

Setting: The general ICU of a university hospital.

A comparative evaluation of thermodilution and partial CO2 rebreathing techniques for cardiac output assessment in critically ill patients during assisted ventilation.

Objective: To evaluate the reliability and clinical value of partial noninvasive CO2 (NICO2) rebreathing technique for measuring cardiac output compared with standard thermodilution in a group of intensive care nonpostoperative patients.

Design And Setting: Clinical investigation in a university hospital ICU.

Patients: Twelve mechanically ventilated patients with high (n=6) and low (n=6) pulmonary shunt fractions.