This case reviews the clinical course of an elderly woman on chronic total parenteral nutrition who developed sepsis secondary to a rare, newly described gram-negative rod known as The patient noticed a leak in her Hickman catheter when infusing her nutrition. 24 hours after a new catheter was replaced, the patient developed fevers, chills and weakness. She presented to the hospital with hypotension and tachycardia, meeting shock criteria. Blood cultures grew and the diagnosis of septic shock was confirmed. Susceptibilities informed antibiotic coverage, and she ultimately improved within the next 48 hours.
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http://dx.doi.org/10.1136/bcr-2023-258384 | DOI Listing |
Background And Aim: Large number of studies proved undisputable role of procalcitonin (PCT) in sepsis diagnosis. Moreover, potential of procalcitonin to predict blood culture results according to Gram staining, different types of pathogens and foci of infection is discussed lately. The primary aim of our study was to compare the PCT levels in septic patients with documented Gram-positive and Gram-negative bacteraemia.
View Article and Find Full Text PDFJAMA Netw Open
December 2024
School of Pharmacy, University of Maryland, Baltimore.
Importance: Initiating effective therapy early is associated with improved survival among patients hospitalized with gram-negative bloodstream infections; furthermore, providing early phenotype-desirable antimicrobial therapy (PDAT; defined as receipt of a β-lactam antibiotic with the narrowest spectrum of activity to effectively treat the pathogen's phenotype) is crucial for antimicrobial stewardship. However, the timing of targeted therapy among patients hospitalized with gram-negative bloodstream infections is not well understood.
Objective: To compare the clinical outcomes between patients who were hospitalized with Enterobacterales bloodstream infections receiving early vs delayed PDAT.
J Intensive Care Med
December 2024
Department of Critical Care and Anaesthesiology, All India Institute of Medical Sciences, Jodhpur, India.
Nosocomial bloodstream infections with multidrug-resistant microorganisms have become a common health threat in intensive care settings worldwide. Understanding antimicrobial resistance and the outcomes of these infections is crucial for addressing this issue. This study aimed to investigate the burden, antimicrobial resistance, and 28-day outcomes of nosocomial bloodstream infections in the intensive care unit.
View Article and Find Full Text PDFJ Biol Chem
December 2024
Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR.
Lipopolysaccharide (LPS) is the primary pathogenic factor in Gram-negative sepsis. While the presence of LPS in the bloodstream during infection is associated with disseminated intravascular coagulation, the mechanistic link between LPS and blood coagulation activation remains ill-defined. The contact pathway of coagulation-a series of biochemical reactions that initiates blood clotting when plasma factors XII (FXII) and XI (FXI), prekallikrein (PK) and high molecular weight kininogen (HK) interact with anionic surfaces-has been shown to be activated in Gram-negative septic patients.
View Article and Find Full Text PDFMedicine (Baltimore)
December 2024
Heart Surgery Department, Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey.
In this study, the blood culture results of patients aged >65 years who were admitted to the cardiology intensive care unit in a training and research hospital and who had positive blood cultures within the first 48 hours were evaluated. This was a retrospective, observational and nonrandomized study. Patient data at the time of the blood culture were included in the study.
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