3D
: three-dimensional
AIDS
: acquired immune deficiency syndrome
b.i.d.
: bis in die (twice daily)
BCNIE
: blood culture-negative infective endocarditis
CDRIE
: cardiac device-related infective endocarditis
CHD
: congenital heart disease
CIED
: cardiac implantable electronic device

/pdf/2015-esc-guidelines-for-the-management-of-infective-2z2r1c1flx.pdf

2015 ESC Guidelines for the management of infective endocarditis

Evidence-based guidelines for the management of patients with methicillin-resistant Staphylococcus aureus (MRSA) infections were prepared by an Expert Panel of the Infectious Diseases Society of America (IDSA). The guidelines are intended for use by health care providers who care for adult and pediatric patients with MRSA infections. The guidelines discuss the management of a variety of clinical syndromes associated with MRSA disease, including skin and soft tissue infections (SSTI), bacteremia and endocarditis, pneumonia, bone and joint infections, and central nervous system (CNS) infections. Recommendations are provided regarding vancomycin dosing and monitoring, management of infections due to MRSA strains with reduced susceptibility to vancomycin, and vancomycin treatment failures.

/pdf/clinical-practice-guidelines-by-the-infectious-diseases-3wgg73ktjz.pdf

Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections in Adults and Children

These guidelines were developed jointly by the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Surgical Infection Society (SIS), and the Society for Healthcare Epidemiology of America (SHEA). This work represents an update to the

/pdf/clinical-practice-guidelines-for-antimicrobial-prophylaxis-1gq1adk8ux.pdf

Clinical practice guidelines for antimicrobial prophylaxis in surgery

Functioning as the exterior interface of the human body with the environment, skin acts as a physical barrier to prevent the invasion of foreign pathogens while providing a home to the commensal microbiota. The harsh physical landscape of skin, particularly the desiccated, nutrient-poor, acidic environment, also contributes to the adversity that pathogens face when colonizing human skin. Despite this, the skin is colonized by a diverse microbiota. In this Review, we describe amplicon and shotgun metagenomic DNA sequencing studies that have been used to assess the taxonomic diversity of microorganisms that are associated with skin from the kingdom to the strain level. We discuss recent insights into skin microbial communities, including their composition in health and disease, the dynamics between species and interactions with the immune system, with a focus on Propionibacterium acnes, Staphylococcus epidermidis and Staphylococcus aureus.

/pdf/the-human-skin-microbiome-znvh6yxg29.pdf

The human skin microbiome

Prosthetic joint infection (PJI) is a tremendous burden for individual patients as well as the global health care industry. While a small minority of joint arthroplasties will become infected, appropriate recognition and management are critical to preserve or restore adequate function and prevent excess morbidity. In this review, we describe the reported risk factors for and clinical manifestations of PJI. We discuss the pathogenesis of PJI and the numerous microorganisms that can cause this devastating infection. The recently proposed consensus definitions of PJI and approaches to accurate diagnosis are reviewed in detail. An overview of the treatment and prevention of this challenging condition is provided.

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Prosthetic Joint Infection

Background Nasal carriers of Staphylococcus aureus are at increased risk for health care–associated infections with this organism. Decolonization of nasal and extranasal sites on hospital admission may reduce this risk. Methods In a randomized, double-blind, placebo-controlled, multicenter trial, we assessed whether rapid identification of S. aureus nasal carriers by means of a real-time polymerase-chain-reaction (PCR) assay, followed by treatment with mupirocin nasal ointment and chlorhexidine soap, reduces the risk of hospital-associated S. aureus infection. Results From October 2005 through June 2007, a total of 6771 patients were screened on admission. A total of 1270 nasal swabs from 1251 patients were positive for S. aureus. We enrolled 917 of these patients in the intention-to-treat analysis, of whom 808 (88.1%) underwent a surgical procedure. All the S. aureus strains identified on PCR assay were susceptible to methicillin and mupirocin. The rate of S. aureus infection was 3.4% (17 of 504 patients) in the mupirocin–chlorhexidine group, as compared with 7.7% (32 of 413 patients) in the placebo group (relative risk of infection, 0.42; 95% confidence interval [CI], 0.23 to 0.75). The effect of mupirocin–chlorhexidine treatment was most pronounced for deep surgical-site infections (relative risk, 0.21; 95% CI, 0.07 to 0.62). There was no significant difference in all-cause in-hospital mortality between the two groups. The time to the onset of nosocomial infection was shorter in the placebo group than in the mupirocin–chlorhexidine group (P = 0.005). Conclusions The number of surgical-site S. aureus infections acquired in the hospital can be reduced by rapid screening and decolonizing of nasal carriers of S. aureus on admission. (Current Controlled Trials number, ISRCTN56186788.)

/pdf/preventing-surgical-site-infections-in-nasal-carriers-of-2scawz93yr.pdf

Preventing Surgical-Site Infections in Nasal Carriers of Staphylococcus aureus

Preparatory Committee: Heiman F.L. Wertheim, MD, PhD (literature survey); Jan L. Nouwen (literature survey), MD, PhD; Prof. Marc J.M. Bonten, MD, PhD; Prof. Peterhans van den Broek, MD, PhD; Annet Troelstra, MD, PhD; Prof. Christina M.J.E. Vandenbroucke-Grauls, MD, PhD; Margreet C. Vos, MD, PhD; Prof. Andreas Voss, MD, PhD; Prof. Jan A. Kluytmans, MD, PhD (Chairman); Heidi S.M. Ammerlaan, MD, PhD (revision, February 2012).

Annet Troelstra

Papers

Preventing Surgical-Site Infections in Nasal Carriers of Staphylococcus aureus

Optimalization of the antibiotic policy in the Netherlands XI