Accuracy of American Thoracic Society/Infectious Diseases Society of America criteria in predicting infection or colonization with multidrug-resistant bacteria at intensive-care unit admission.

The aim of this prospective observational study was to determine the accuracy of American Thoracic Society (ATS)/Infectious Diseases Society of America (IDSA) criteria in predicting infection or colonization related to multidrug-resistant (MDR) bacteria at intensive-care unit (ICU) admission. MDR bacteria were defined as methicillin-resistant Staphylococcus aureus, ceftazidime-resistant or imipenem-resistant Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia, and extended-spectrum β-lactamase-producing Gram-negative bacilli. Screening for MDR bacteria (using nasal and rectal swabs and tracheal aspirates from intubated patients) was performed at ICU admission.

Preliminary clinical study using a multiplex real-time PCR test for the detection of bacterial and fungal DNA directly in blood.

Early diagnosis of sepsis, rapid identification of the causative pathogen(s) and prompt initiation of appropriate antibiotic treatment have a combined impact on mortality due to sepsis. In this observational study, a new DNA-based system (LightCycler SeptiFast (LC-SF) test; Roche Diagnostics) allowing detection of 16 pathogens at the species level and four groups of pathogens at the genus level has been evaluated and compared with conventional blood cultures (BCs). One hundred BC and LC-SF results were obtained for 72 patients admitted to the intensive-care unit over a 6-month period for suspected sepsis.

Management of invasive aspergillosis in patients with COPD: rational use of voriconazole.

Invasive pulmonary aspergillosis (IPA) is an important cause of mortality in patients with hematologic malignancies. The reported incidence of IPA in the context of chronic obstructive pulmonary disease (COPD) seems to increase. Approximately 1%-2% of overall fatal cases of IPA occur in COPD patients.

Procalcitonin as a prognostic factor in severe acute exacerbation of chronic obstructive pulmonary disease.

Background And Objective: Little is known about the value of procalcitonin in predicting mortality in patients with an exacerbation of COPD. This study evaluated the clinical and biological predictors of intensive care unit (ICU) mortality in patients with a severe acute exacerbation of COPD.

Methods: A prospective observational cohort study was conducted of consecutive patients with severe acute exacerbation of COPD requiring intubation and mechanical ventilation.

Metformin-associated lactic acidosis: a prognostic and therapeutic study.

Objectives: Metformin-associated lactic acidosis is a rare and serious complication of biguanide treatment. It usually occurs when a precipitating disease induces an acute renal failure and an incidental overdose. Voluntary intoxication is rare.

Remifentanil discontinuation and subsequent intensive care unit-acquired infection: a cohort study.

Introduction: Recent animal studies demonstrated immunosuppressive effects of opioid withdrawal resulting in a higher risk of infection. The aim of this study was to determine the impact of remifentanil discontinuation on intensive care unit (ICU)-acquired infection.

Methods: This was a prospective observational cohort study performed in a 30-bed medical and surgical university ICU, during a one-year period.

Nosocomial tracheobronchitis.

Purpose Of Review: Nosocomial tracheobronchitis is common among intubated critically ill patients. Ventilator-associated tracheobronchitis (VAT) represents an intermediate process between lower respiratory tract colonization and ventilator-associated pneumonia. The aim of this review is to discuss recent findings on VAT.

Variations in endotracheal cuff pressure in intubated critically ill patients: prevalence and risk factors.

Background And Objective: An endotracheal cuff pressure of 20-30 cmH(2)O is recommended. Underinflation and overinflation are associated with complications such as aspiration and tracheal wall damage. The aim of this study was to identify prevalence of, and risk factors for, endotracheal cuff underinflation and overinflation.

Antibodies against glucan, chitin, and Saccharomyces cerevisiae mannan as new biomarkers of Candida albicans infection that complement tests based on C. albicans mannan.

Antibodies against Saccharomyces cerevisiae mannan (ASCA) and antibodies against synthetic disaccharide fragments of glucans (ALCA) and chitin (ACCA) are biomarkers of Crohn's disease (CD). We previously showed that Candida albicans infection generates ASCA. Here, we explored ALCA and ACCA as possible biomarkers of invasive C.

Factors predicting bacterial involvement in severe acute exacerbations of chronic obstructive pulmonary disease.

Background: Strategies aiming at reducing antibiotic use are required in the intensive care unit (ICU). Although antibiotic treatment is recommended in patients with severe exacerbation of chronic obstructive pulmonary disease (COPD), a bacterial etiology is found in only a half of these patients.

Objectives: The aim of this study was to determine factors predicting bacterial isolation in severe acute exacerbations of COPD.

Antimicrobial treatment for ventilator-associated tracheobronchitis: a randomized, controlled, multicenter study.

Introduction: Ventilator-associated tracheobronchitis (VAT) is associated with increased duration of mechanical ventilation. We hypothesized that, in patients with VAT, antibiotic treatment would be associated with reduced duration of mechanical ventilation.

Methods: We conducted a prospective, randomized, controlled, unblinded, multicenter study.

Risk factors for relapse of ventilator-associated pneumonia related to nonfermenting Gram negative bacilli: a case-control study.

Background: The aim of this study was to determine risk factors for relapse of ventilator-associated pneumonia (VAP) related to nonfermenting Gram negative bacilli (NF-GNB).

Methods: This is a retrospective case-control study based on prospectively collected data. Two hundred and seventy six patients with monobacterial VAP related to NF-GNB were eligible.

Prevalence and outcome of severe chronic obstructive pulmonary disease exacerbations caused by multidrug-resistant bacteria.

Purpose Of Review: A bacterial cause is found in about half of all severe chronic obstructive pulmonary disease exacerbations. The aim of this review is to discuss recent findings regarding prevalence, risk factors and outcome of severe chronic obstructive pulmonary disease exacerbations caused by multidrug-resistant bacteria.

Recent Findings: According to the results of recent studies, multidrug-resistant bacteria represented a large proportion of bacteria isolated in chronic obstructive pulmonary disease exacerbations.

[Ventilator-associated pneumonia and chronic obstructive pulmonary disease].

Introduction: Chronic obstructive pulmonary disease (COPD) is a common pulmonary and systemic inflammatory disease. Patients with COPD frequently require mechanical ventilation for acute exacerbations.

Background: The incidence of ventilator-associated pneumonia (VAP) in COPD patients varies from 6 to 33%.

Continuous control of endotracheal cuff pressure and tracheal wall damage: a randomized controlled animal study.

Background: Intubation is frequently performed in intensive care unit patients. Overinflation of the endotracheal tube cuff is a risk factor for tracheal ischemia and subsequent complications. Despite manual control of the cuff pressure, overinflation of the endotracheal cuff is common in intensive care unit patients.

[Pseudomonas aeruginosa and Candida albicans interaction in the respiratory tract: from pathophysiology to a therapeutic perspective].

Several studies evidenced a pathogenic interaction between P. aeruginosa and C. albicans.

Can dynamic indicators help the prediction of fluid responsiveness in spontaneously breathing critically ill patients?

Objective: To investigate whether the respiratory changes in arterial pulse (DeltaPP) and in systolic pressure (DeltaSP) could predict fluid responsiveness in spontaneously breathing (SB) patients. Because changes in intrathoracic pressure during spontaneous breathing (SB) might be insufficient to modify loading conditions of the ventricles, performances of indicators were also assessed during a forced respiratory maneuver.

Design: Prospective interventional study.

Relationship between immunosuppression and intensive care unit-acquired multidrug-resistant bacteria: a case-control study.

Objective: To determine the relationship between immunosuppression and intensive care unit (ICU)-acquired multidrug-resistant (MDR) bacteria.

Design: Retrospective case-control study based on prospectively collected data.

Setting: A 30-bed medical and surgical ICU.

Impact of antifungal treatment on Candida-Pseudomonas interaction: a preliminary retrospective case-control study.

Objective: A pathogenic interaction between Candida albicans and Pseudomonas aeruginosa has recently been demonstrated. In addition, experimental and clinical studies identified Candida spp. tracheobronchial colonization as a risk factor for P.

Intensive care unit-acquired Stenotrophomonas maltophilia: incidence, risk factors, and outcome.

Introduction: The aim of this study was to determine incidence, risk factors, and impact on outcome of intensive care unit (ICU)-acquired Stenotrophomonas maltophilia.

Methods: This prospective observational case-control study, which was a part of a cohort study, was conducted in a 30-bed ICU during a three year period. All immunocompetent patients hospitalised >48 hours were eligible.

Multiple-drug-resistant bacteria in patients with severe acute exacerbation of chronic obstructive pulmonary disease: Prevalence, risk factors, and outcome.

Objective: To determine prevalence, risk factors, and effect on outcome of multiple-drug-resistant (MDR) bacteria in patients with severe acute exacerbation of chronic obstructive pulmonary disease.

Design: Prospective, observational, cohort study.

Setting: Thirty-bed medical intensive care unit (ICU) in a university hospital.