Braswellforeman9618

Therefore, the results obtained demonstrated (i) the Pseudomonas aeruginosa isolates were highly sensitive to INTP in-vitro, (ii) CFU reduction of infectious Pseudomonas in wounds of diabetic mice after INTP treatment is far superior to that of non-treated infected wounds, and (iii) the application of INTP shows no indication of toxic effects. Our results are consistent with indirect non-thermal atmospheric plasma as a promising adjunct to disinfecting wounds.Introduction Veno arterial membrane oxygenation (VA ECMO) is increasingly used for cardiogenic failure. However, hemodynamic targets for adequate resuscitation remain a challenge. The PCO2 gap and the ratio between PCO2 gap and the arteriovenous difference in oxygen (PCO2 gap/Da-vO2) are marker of peripheral hypoperfusion. We hypothesized that the PCO2 gap and the PCO2 gap/Da-vO2 ratio might be useful parameters in VA ECMO patients. Materials and methods We conducted an observational prospective study between September 2015 and February 2017. All consecutive patients >18 years of age who had been treated with peripheral VA ECMO for cardiac failure were included. We compared 2 groups of patients patients who died of any cause under VA ECMO or in the 72 h following VA ECMO weaning (early death group) - and patients who survived VA ECMO weaning more than 72 h (surviving group). Blood samples were drawn from arterial and venous VA ECMO cannulas at H0, H6 and H24. The ability of PCO2 gap and PCO2 gap/Da-vO2 to discriminate between early mortality and surviving was studied using ROC curves analysis. Results We included 20 patients in surviving group and 29 in early death group. The PCO2 gap was higher in the early death group at H6 (7.4 mmHg [5.7-10.1] vs. see more 5.9 mmHg [3.8-9.2], p less then 0.01). AUC for PCO2 gap at H6 was 0.76 (0.61-0.92), with a cut-off of 6.2 mmHg. The PCO2 gap/Da-vO2 was higher in the early death group at H0 (2.1 [1.5-2.6] vs. 1.2 [0.9-2.4], p less then 0.01) and at H6 (2.1 [1.3-2.6] vs. 1.0 [0.8-1.7], p less then 0.01). AUC for PCO2 gap/Da-vO2 at H0 and H6 were 0.79 and 0.73 respectively; the cut-off value was 1.4. Conclusions Early PCO2 gap and PCO2 gap/Da-vO2 ratio are higher in the early death group in patients under VA ECMO.Background The routine use of empiric combination therapy with aminoglycosides during critical illness is associated with uncertain benefit and increased risk of acute kidney injury. This study aimed to assess the benefits of aminoglycosides in immunocompromised patients with suspected bacterial pneumonia and sepsis. Methods Secondary analysis of a prospective multicenter study. Adult immunocompromised patients with suspected bacterial pneumonia and sepsis or septic shock were included. Primary outcome was hospital mortality. Secondary outcomes were need for renal replacement therapy (RRT). Mortality was also assessed in neutropenic patients and in those with confirmed bacterial pneumonia. Results were further analyzed in a cohort matched on risk of receiving aminoglycosides combination. Results 535 patients were included in this analysis, of whom 187 (35%) received aminoglycosides in addition to another antibiotic effective against gram-negative bacteria. Overall hospital mortality was 59.6% (58.3% vs. 60.3% in patients receiving and not receiving combination therapy; P = 0.71). Lack of association between mortality and aminoglycosides was confirmed after adjustment for confounders and center effect (adjusted OR 1.14 [0.69-1.89]) and in a propensity matched cohort (adjusted OR = 0.89 [0.49-1.61]). No association was found between aminoglycosides and need for RRT (adjusted OR = 0.83 [0.49-1.39], p = 0.477), nor between aminoglycoside use and outcome in neutropenic patients or in patients with confirmed bacterial pneumonia (adjusted OR 0.66 [0.23-1.85] and 1.25 [0.61-2.57], respectively). Conclusion Aminoglycoside combination therapy was not associated with hospital mortality or need for renal replacement therapy in immunocompromised patients with pulmonary sepsis.Supplemental Digital Content is available in the text.A total of 714 pediatric cases of Staphylococcus aureus bacteremia were identified from 2008 to 2015 in Denmark; 98% were methicillin-susceptible S. aureus (MSSA). Fifteen isolates (2,1%) were Panton-Valentine leucocidin positive (0.17/100,000 children/year) and 87% MSSA. Eight cases (53%) were severe, including all pneumonia cases. Panton-Valentine leucocidin positive Staphylococcus aureus bacteremia is rare in our setting with high MSSA-prevalence. Half of the cases were uncomplicated.Malassezia sp. require exogenous lipid for growth and can cause disseminated infection in neonates requiring intravenous lipid infusions. Usually, Malassezia infection in neonates presents as fungemia or hematogenous dissemination into bone or lungs. We present a presumed case of Malassezia liver abscess associated with lipid infusion via a mispositioned umbilical venous catheter.Background In Western Europe, most pediatric tuberculosis (TB) cases occur among immigrants; however, data are rarely stratified by first/second-generation immigrants and many cases may be preventable. Methods This was a nationwide study of children less then 18 years with TB from 2009 to 2014 in Denmark. Demographic, clinical, microbiologic and treatment outcome data were obtained from registers and medical records. Results We identified 145 cases; 99 were immigrants (68%) of which 54 (55%) were second-generation immigrants. Most first-generation immigrants (73%) were diagnosed by passive case finding as was half the second-generation immigrants (52%), in contrast to Danish children who were mostly diagnosed by active case finding (70%). Symptoms were often nonspecific, and one-third of the children had normal blood tests at time of diagnosis. First-generation immigrants were most often infected abroad (84%) as opposed to Danish children (9%) and second-generation immigrants (30%). Approximately one-third of the children represented cases of TB disease that could possibly have been prevented by screening or rigorous contact tracing. The overall treatment success rate was 97%, and cases of unsuccessful treatment were restricted to immigrant adolescents. Conclusions The majority of pediatric TB in Denmark occurred among immigrant children with symptomatic TB, whereas more Danish children were diagnosed at earlier disease stages. Almost one-third of TB cases may represent missed opportunities to prevent TB disease. Improvements include enhanced adult case detection with comprehensive contact investigation among children, tailored screening and vaccination of immigrant children, and raised awareness of diagnosing and treating latent TB infection in children.