Difficult-to-Treat Resistance in Gram-negative Bacteremia at 173 US Hospitals: Retrospective Cohort Analysis of Prevalence, Predictors, and Outcome of Resistance to All First-line Agents.
Sameer S Kadri,Sameer S Kadri,Jennifer Adjemian,Jennifer Adjemian,Yi Ling Lai,Alicen B Spaulding,Emily Ricotta,D. Rebecca Prevots,Tara N. Palmore,Chanu Rhee,Chanu Rhee,Michael Klompas,Michael Klompas,John P. Dekker,John H. Powers,Anthony F. Suffredini,David C. Hooper,Scott K. Fridkin,Robert L. Danner +18 more
TLDR
Nonsusceptibility to first-line antibiotics is associated with decreased survival in GNBSIs and DTR is a simple bedside prognostic measure of treatment-limiting coresistance.Abstract:
Background
Resistance to all first-line antibiotics necessitates the use of less effective or more toxic “reserve” agents Gram-negative bloodstream infections (GNBSIs) harboring such difficult-to-treat resistance (DTR) may have higher mortality than phenotypes that allow for ≥1 active first-line antibioticread more
Citations
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Infectious Diseases Society of America Guidance on the Treatment of Extended-Spectrum β-lactamase Producing Enterobacterales (ESBL-E), Carbapenem-Resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with Difficult-to-Treat Resistance (DTR-P. aeruginosa).
Pranita D. Tamma,Samuel L. Aitken,Robert A. Bonomo,Amy J. Mathers,David van Duin,Cornelius J. Clancy +5 more
TL;DR: A panel of six infectious diseases specialists with expertise in managing antimicrobial resistant infections formulated common questions about the treatment of ESBL-E, CRE, and DTR-P.
Journal ArticleDOI
Treatment of Infections Due to MDR Gram-Negative Bacteria.
TL;DR: Treatment of severe MDR-GNB infections in critically ill patients in the near future will require an expert and complex clinical reasoning, of course taking into account the peculiar characteristics of the target population, but also the need for adequate empirical coverage and the more and more specific enzyme-level activity of novel antimicrobials with respect to the different resistance mechanisms.
Journal ArticleDOI
Prevalence of Antibiotic-Resistant Pathogens in Culture-Proven Sepsis and Outcomes Associated With Inadequate and Broad-Spectrum Empiric Antibiotic Use.
Chanu Rhee,Chanu Rhee,Sameer S Kadri,John P. Dekker,Robert L. Danner,Huai-Chun Chen,David Fram,Fang Zhang,Rui Wang,Michael Klompas,Michael Klompas +10 more
TL;DR: In this study, broad-spectrum antibiotics were frequently administered to patients with community-onset sepsis without resistant organisms, and these therapies were associated with worse outcomes.
Journal ArticleDOI
Bloodstream infections in critically ill patients: an expert statement
TL;DR: Initial antimicrobial dosing should take into account the pharmacokinetic alterations commonly observed in ICU patients, with a loading dose in case of sepsis or septic shock, with up-to-date expert statements.
Journal ArticleDOI
OUP accepted manuscript
TL;DR: The Infectious Diseases Society of America (IDSA) is committed to providing up-to-date guidance on the treatment of antimicrobial-resistant infections as discussed by the authors , including those caused by extended-spectrum β-lactamase producing Enterobacterales (ESBL-E), carbapenem-resistant enterobactorales (CRE), and Pseudomonas aeruginosa with difficultto-treat resistance (DTR-P).
References
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Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance
A-P Magiorakos,Arjun Srinivasan,R B Carey,Yehuda Carmeli,Matthew E. Falagas,Matthew E. Falagas,Christian G. Giske,Stéphan Juergen Harbarth,Janet F. Hindler,Gunnar Kahlmeter,Barbro Olsson-Liljequist,David L. Paterson,Louis B. Rice,John Stelling,Marc Struelens,Alkiviadis Vatopoulos,J T Weber,Dominique L Monnet +17 more
TL;DR: A group of international experts came together through a joint initiative by the European Centre for Disease Prevention and Control and the Centers for Disease Control and Prevention, to create a standardized international terminology with which to describe acquired resistance profiles in Staphylococcus aureus, Enterococcus spp.
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Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data.
Hude Quan,Vijaya Sundararajan,Patricia Halfon,Andrew Fong,Bernard Burnand,Jean-Christophe Luthi,L. Duncan Saunders,Cynthia A. Beck,Thomas E Feasby,William A. Ghali +9 more
TL;DR: A multistep process to develop ICD-10 coding algorithms to define Charlson and Elixhauser comorbidities in administrative data and assess the performance of the resulting algorithms found these newly developed algorithms produce similar estimates ofComorbidity prevalence in administrativeData, and may outperform existing I CD-9-CM coding algorithms.
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From the Centers for Disease Control and Prevention
TL;DR: This report summarizes the clinical features of these cases and the epidemiologic investigations by the Texas Department of Health and the New Jersey State Department of health and Senior Services, which indicated that a bat-associated variant of the rabies virus was responsible for infection in both cases.
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Global spread of Carbapenemase-producing Enterobacteriaceae.
TL;DR: These resistance traits have been identified among nosocomial and community-acquired infections and are being investigated for use in drug discovery and development.
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