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Effect of cytomegalovirus reactivation on the time course of systemic host response biomarkers in previously immunocompetent critically ill patients with sepsis: a matched cohort study

Cytomegalovirus (CMV) reactivation in previously immunocompetent critically ill patients is associated with increased mortality, which has been hypothesized to result from virus-induced immunomodulation. Therefore, we studied the effects of CMV reactivation on the temporal course of host response biomarkers in patients with sepsis. In this matched cohort study, each sepsis...

Risk prediction for Staphylococcus aureus surgical site infection following cardiothoracic surgery; A secondary analysis of the V710-P003 trial

. Flaminia Olearo (Geneva) for her contributions to the project. Author Contributions Conceptualization: Fleur P. Paling, Karina Olsen, Hasan S. Jafri, Frangiscos Sifakis, Marc J. M. Bonten, Stephan J ... . Funding acquisition: Marc J. M. Bonten. Investigation: Vance G. Fowler, Jr., Mark J. DiNubile. Methodology: Fleur P. Paling, Karina Olsen, Kristin Ohneberg, Martin Wolkewitz, Frangiscos Sifakis, Marc J

Risk factors for ESBL-producing Escherichia coli on pig farms: A longitudinal study in the context of reduced use of antimicrobials

The presence of extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-E. coli) in food animals is a public health concern. This study aimed to determine prevalence of ESBL-E. coli on pig farms and to assess the effect of reducing veterinary antimicrobial use (AMU) and farm management practices on ESBL-E. coli occurrence on pig farms. During 2011–2013, 36 Dutch...

Development and first evaluation of a novel multiplex real-time PCR on whole blood samples for rapid pathogen identification in critically ill patients with sepsis

Molecular tests may enable early adjustment of antimicrobial therapy and be complementary to blood culture (BC) which has imperfect sensitivity in critically ill patients. We evaluated a novel multiplex real-time PCR assay to diagnose bloodstream pathogens directly in whole blood samples (BSI-PCR). BSI-PCR included 11 species- and four genus-specific PCRs, a molecular Gram-stain...

Hospitalization costs for community-acquired pneumonia in Dutch elderly: an observational study

Community-acquired pneumonia (CAP) is one of the most common infections, especially in the elderly (≥65 years). The aim of this study was to quantify hospitalization costs for CAP in different age groups and in patients with different CAP risk profiles. Secondary objectives were to assess disease severity differences between placebo and vaccine receiving participants and identify...

Isoniazid Prophylactic Therapy for the Prevention of Tuberculosis in HIV Infected Adults: A Systematic Review and Meta-Analysis of Randomized Trials

Background Infection with Human Immunodeficiency virus (HIV) is an important risk factor for Tuberculosis (TB). Anti-Retroviral Therapy (ART) has improved the prognosis of HIV and reduced the risk of TB infected patients. Isoniazid Preventive Therapy (IPT) aims to reduce the development of active TB in patients with latent TB. Objective Systematically review and synthesize effect...

Predictors of Bacteraemia in Patients with Suspected Community-Acquired Pneumonia

Introduction The diagnostic yield of blood cultures is limited in patients with community-acquired pneumonia (CAP). Yet, positive blood culture results provide important information for antibiotic treatment and for monitoring epidemiologic trends. We investigated the potential of clinical predictors to improve the cost-benefit ratio of obtaining blood cultures. Methods Data from...

Oral mucosal adverse events with chlorhexidine 2 % mouthwash in ICU

Christian Brun‑Buisson 5 Marc J. M. Bonten 0 3 4 0 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht , P.O. Box 85500, 3508 GA Utrecht , The Netherlands Full author

Cost and Effects of Different Admission Screening Strategies to Control the Spread of Methicillin-resistant Staphylococcus aureus

Nosocomial infection rates due to antibiotic-resistant bacteriae, e.g., methicillin-resistant Staphylococcus aureus (MRSA) remain high in most countries. Screening for MRSA carriage followed by barrier precautions for documented carriers (so-called screen and isolate (S&I)) has been successful in some, but not all settings. Moreover, different strategies have been proposed, but...

Within-Host and Population Transmission of blaOXA-48 in K. pneumoniae and E. coli

During a large hospital outbreak of OXA-48 producing bacteria, most K. pneumoniaeOXA-48 isolates were phenotypically resistant to meropenem or imipenem, whereas most E. coliOXA-48 isolates were phenotypically susceptible to these antibiotics. In the absence of molecular gene-detection E. coliOXA-48 could remain undetected, facilitating cross-transmission and horizontal gene...

Successful Veterans Affairs Initiative to Prevent Methicillin-Resistant Staphylococcus aureus Infections Revisited

In 2011 Jain et al reported a 62% reduction of healthcare-associated methicillin-resistant Staphylococcus aureus infections that resulted from an intervention bundle. Here we present a mathematical model and prove, using parameters from the study by Jain et al, that the universal screen and isolate strategy can have contributed only marginally to the reduction in infections.

Duration of colonization with antimicrobial-resistant bacteria after ICU discharge

Manon R. Haverkate Lennie P. G. Derde Christian Brun-Buisson Marc J. M. Bonten Martin C. J. Bootsma 0 1 0 Take-home message: To gain insight into the role of readmitted patients in the nosocomial

The Dilemma of Assessment Bias in Infection Control Research

Infection control studies often rely on infection endpoints to determine whether interventions are effective. However, many infection outcomes, including those defined by standardized surveillance criteria, involve some subjective judgment for determination. Studies that use unblinded ascertainment of subjective infection endpoints are at risk of assessment bias. Unfortunately...

Ventilator-Associated Pneumonia: Preventing the Inevitable

Marc J. M. Bonten () 0 0 Department of Medical Microbiology, Julius Center for Public Health and Primary Care, University Medical Center Utrecht , Heidelberglaan, the Netherlands Ventilator

A LacI-Family Regulator Activates Maltodextrin Metabolism of Enterococcus faecium

Enterococcus faecium is a gut commensal of humans and animals. In the intestinal tract, E. faecium will have access to a wide variety of carbohydrates, including maltodextrins and maltose, which are the sugars that result from the enzymatic digestion of starch by host-derived and microbial amylases. In this study, we identified the genetic determinants for maltodextrin...

Cytomegalovirus reactivation and mortality in patients with acute respiratory distress syndrome

Purpose Cytomegalovirus (CMV) reactivation occurs frequently in patients with the acute respiratory distress syndrome (ARDS) and has been associated with increased mortality. However, it remains unknown whether this association represents an independent risk for poor outcome. We aimed to estimate the attributable effect of CMV reactivation on mortality in immunocompetent ARDS...

Chlorhexidine body washing to control antimicrobial-resistant bacteria in intensive care units: a systematic review

Lennie P. G. Derde Mirjam J. D. Dautzenberg Marc J. M. Bonten lderde@umcutrecht.nl 0 0 L. P. G. Derde M. J. D. Dautzenberg M. J. M. Bonten P.O. Box 85500, 3508 GA Utrecht, The Netherlands Purpose