Susceptibility profiles and clinical efficacy of antifungals against candida bloodstream isolates from critically ill patients: Focus on intravenous itraconazole.

In vitro and clinical data were analysed to evaluate the susceptibility profile of itraconazole in light of the new cut-off points. The in vitro activity of itraconazole was compared with that of eight comparators against 119 Candida bloodstream isolates from 2015 to 2018. Minimum inhibitory concentrations (MICs) were measured by the colorimetric MICRONAUT-S assay.

Characteristics, risk factors and outcomes of Clostridium difficile infections in Greek Intensive Care Units.

Background: Clostridium difficile is one of the major causes of diarrhoea among critically ill patients and its prevalence increases exponentially in relation to the use of antibiotics and medical devices. We sought to investigate the incidence of C. difficile infection in Greek units, and identify potential risk factors related to C.

Soluble urokinase plasminogen activator receptor informs on the progression course after multiple injuries.

Purpose: The purpose of this study is to study the use of soluble urokinase plasminogen activator receptor (suPAR) for the prognosis of multiple organ dysfunction (MOF) after multiple traumas.

Methods: Serum suPAR was measured within the first 24 h after multiple injuries in 85 patients. Measurements were repeated after 4 d or at sepsis onset.

Defective cytokine production early after multiple traumas: Modulation in severe sepsis.

The exact time frame of multiple trauma-induced immunosuppression and the immune mechanisms mediating transition to severe sepsis are largely unknown. Peripheral blood mononuclear cells were isolated from 69 patients with multiple injuries within the first 24h from injury and from 36 healthy volunteers and stimulated for cytokine production. Circulating endotoxins were measured by the kinetic LAL assay.

Early administration of hydrocortisone replacement after the advent of septic shock: impact on survival and immune response*.

Objectives: To investigate the impact of early initiation of hydrocortisone therapy on the clinical course of septic shock and on cytokine release.

Design: Prospective study in patients with septic shock treated with low doses of hydrocortisone.

Setting: ICUs and general wards.

Polymicrobial bloodstream infections: Epidemiology and impact on mortality.

The aim of this study was to investigate the impact of polymicrobial bloodstream infections (pBSIs) on the outcome of sepsis in an area where antimicrobial resistance is of concern. This was a retrospective analysis of data collected prospectively from patients developing BSI outside of an intensive care unit (non-ICU patients) or after ICU admission. Demographics and clinical characteristics were compared for patients with pBSI versus monomicrobial BSI (mBSI) and following stratification by ICU or non-ICU and severity of sepsis status.

Risk assessment in sepsis: a new prognostication rule by APACHE II score and serum soluble urokinase plasminogen activator receptor.

Introduction: Early risk assessment is the mainstay of management of patients with sepsis. APACHE II is the gold standard prognostic stratification system. A prediction rule that aimed to improve prognostication by APACHE II with the application of serum suPAR (soluble urokinase plasminogen activator receptor) is developed.

Genetic polymorphisms within tumor necrosis factor gene promoter region: a role for susceptibility to ventilator-associated pneumonia.

Debatable findings exist among various studies regarding the impact of single nucleotide polymorphisms (SNPs) within the promoter region of the tumor necrosis factor (TNF) gene for susceptibility to infections. Their impact was investigated in a cohort of mechanically ventilated patients who developed ventilator-associated pneumonia (VAP). Two-hundred and thirteen mechanically ventilated patients who developed VAP were enrolled.

Early alterations of the innate and adaptive immune statuses in sepsis according to the type of underlying infection.

Introduction: Although major changes of the immune system have been described in sepsis, it has never been studied whether these may differ in relation to the type of underlying infection or not. This was studied for the first time.

Methods: The statuses of the innate and adaptive immune systems were prospectively compared in 505 patients.

Should procalcitonin be introduced in the diagnostic criteria for the systemic inflammatory response syndrome and sepsis?

Purpose: To define whether procalcitonin should be introduced in the diagnostic criteria of sepsis.

Methods: Procalcitonin was estimated in sera of 105 critically ill patients by an immunochemiluminometric assay. Diagnosis was settled by 3 types of criteria: A, the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) 1992 criteria; B, the ACCP/SCCM criteria and concentrations of procalcitonin above 1.

Health-related quality of life and disability in survivors of multiple trauma one year after intensive care unit discharge.

Objective: To evaluate health-related quality of life and disability in multiple-trauma patients requiring intensive care unit management.

Design: A total of 87 survivors of multiple trauma, with a median age of 31 yrs and a median Injury Severity Score of 22, were enrolled in the present study. The Nottingham Health Profile, Glasgow Outcome Scale, and Rosser Disability Scale were used to assess the functional consequences of trauma 1 yr after intensive care unit discharge.

Massive rupture of a hepatic hydatid cyst associated with mechanical ventilation.

Unlabelled: An 80-yr-old woman with a complicated Echinococcus cyst of the liver underwent endotracheal intubation with a simple endotracheal tube and conventional mechanical ventilation that led to massive rupture of the cyst into the bronchi followed by fatal anaphylactic shock. We believe that the currently recommended use of a double-lumen endotracheal tube during surgery in the pulmonary hydatid cysts should be extended to hydatid cysts of the liver with thoracic involvement.

Implications: We present a case of massive rupture of hepatic Echinococcus cyst associated with mechanical ventilation.

Prediction of prolonged ventilatory support in blunt thoracic trauma patients.

Objective: To identify predictors of prolonged (>7 days) mechanical ventilation (MV) in patients with blunt thoracic trauma.

Design: Prospective analysis of consecutive patients.

Setting: Adult intensive care unit (ICU) in a teaching, tertiary-care hospital.

High prevalence of decreased cortisol reserve in brain-dead potential organ donors.

Objective: To investigate the adrenocortical function in brain-dead patients, potential organ donors.

Design: Prospective study.

Setting: Intensive care units in two teaching hospitals.