Article
Medical Laboratory Technology
Philipp Schuetz
Summary: PCT can help differentiate bacterial from non-bacterial infections and inflammation states, particularly in respiratory illness. PCT-guided antibiotic stewardship has been shown to reduce antibiotic exposure and associated side-effects in patients with respiratory infection and sepsis. Patient-specific decisions regarding antibiotic usage should consider clinical situation, pretest probability for bacterial infection, severity of presentation, and PCT test results.
CLINICAL CHEMISTRY AND LABORATORY MEDICINE
(2023)
Article
Infectious Diseases
Elsa Harte, Sharuha Kumarasamysarma, Benjamin Phillips, Olivia Mackay, Zohra Rashid, Natalya Malikova, Abdullah Mukit, Saraswathi Ramachandran, Anna Biju, Kate Brown, Rosie Watts, Charlie Hodges, William Tuckwell, Nick Wetherall, Henry Breen, Shannon Price, Tamas Szakmany
Summary: The development of secondary bacterial infections in COVID-19 patients is associated with increased mortality and worse clinical outcomes. Empirical antibiotic therapies have been used, potentially worsening the antimicrobial resistance crisis. Procalcitonin testing was unable to identify secondary infections in COVID-19 patients.
Article
Infectious Diseases
Jose Knuesli, Loic Lhopitallier, Andreas Kronenberg, Jean-Yves Meuwly, Onya Opota, Marc-Antoine Perrenoud, Marie-Anne Page, Kevin C. Kain, Aline Mamin, Valerie D'Acremont, Nicolas Senn, Yolanda Mueller, Isabella Locatelli, Noemie Boillat-Blanco
Summary: In a clinical trial in Switzerland, one-third of patients with low procalcitonin level received antibiotics, which was associated with the socio-demographic characteristics of the physicians. This highlights the importance of continuous medical education and communication training for successful implementation of procalcitonin point-of-care tests for antibiotic stewardship.
Article
Medicine, Research & Experimental
Ashok Kumar Pannu, Abhishek Kumar, Ravindran Kiran, Mandip Bhatia, Saurabh Chandrabhan Sharda, Atul Saroch, Archana Angrup, Pinaki Dutta, Navneet Sharma
Summary: This study aimed to evaluate the diagnostic performance of procalcitonin in identifying bacterial infections in patients with diabetic ketoacidosis (DKA). The researchers reviewed the case records of 303 DKA patients and found that 49.8% of them had infection precipitations. Although the median value of procalcitonin was higher in patients with bacterial infections, its diagnostic performance was low.
CLINICAL AND EXPERIMENTAL MEDICINE
(2023)
Article
Infectious Diseases
Johan Van Laethem, Stephanie Wuyts, Sven Van Laere, Silke Dirkx, Lucie Seyler, Rembert Mertens, Bart Ilsen, Patrick Lacor, Denis Pierard, Sabine D. Allard
Summary: Although bacterial co- and superinfections are rarely present in patients with COVID-19, overall antibiotic prescribing in admitted patients is high. This study conducted a comprehensive evaluation of antibiotic prescriptions in patients admitted to a COVID-19 ward in a Belgian university hospital, finding that the antibiotic consumption for a (presumed) bacterial respiratory tract co-/superinfection was low in the studied population with confirmed COVID-19 diagnosis. The study emphasizes the importance of thoughtful antibiotic use and the crucial role of antibiotic stewardship programmes in countering unnecessary and inappropriate antibiotic use in hospitalized patients with COVID-19.
INFECTIOUS DISEASES AND THERAPY
(2021)
Article
Microbiology
Michael May, Michelle Chang, Donald Dietz, Sherif Shoucri, Justin Laracy, Magdalena E. Sobieszczyk, Anne-Catrin Uhlemann, Jason Zucker, Christine J. Kubin
Summary: The role of procalcitonin in identifying community-associated bacterial infections among patients with coronavirus disease 2019 is not yet established. Procalcitonin did not reliably identify bacterial coinfections, but may be useful in excluding bacterial infection.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2021)
Article
Multidisciplinary Sciences
Melissa Ross, Ricardo Henao, Thomas W. Burke, Emily R. Ko, Micah T. McClain, Geoffrey S. Ginsburg, Christopher W. Woods, Ephraim L. Tsalik
Summary: The study compared three host response strategies to distinguish bacterial and viral etiologies of acute respiratory illness. The gene expression signature was found to be the most accurate strategy for classifying subjects with bacterial, viral, or non-infectious ARI.
Article
Critical Care Medicine
Cedric Daubin, Francois Fournel, Fabrice Thiolliere, Fabrice Daviaud, Michel Ramakers, Andrea Polito, Bernard Flocard, Xavier Valette, Damien Du Cheyron, Nicolas Terzi, Muriel Fartoukh, Stephane Allouche, Jean-Jacques Parienti
Summary: Procalcitonin levels showed limited accuracy in predicting bacterial infection in severe AECOPD patients, despite higher levels in those with bacterial infection. PCT may not be reliable as a standalone marker for initiating antibiotic treatment in this population.
ANNALS OF INTENSIVE CARE
(2021)
Article
Respiratory System
Shengchen Duan, Xiaoying Gu, Guohui Fan, Fei Zhou, Guangfa Zhu, Bin Cao
Summary: The study aimed to assess the ability of PCT or CRP combined with clinical characteristics to distinguish between viral and bacterial infections in hospitalized non-ICU adults with LRTI. The findings suggest that combining CRP or PCT with clinical symptoms, particularly rhinorrhea, can improve the discrimination between viral and bacterial infections in LRTI patients.
BMC PULMONARY MEDICINE
(2021)
Review
Infectious Diseases
Faiza Morado, Darren W. Wong
Summary: Urinary tract infection is a common bacterial infection with challenges in diagnosis. To limit unnecessary testing and antibiotic use, various diagnostic stewardship initiatives involving multidisciplinary approaches and education of healthcare providers are effective in decreasing inappropriate testing and prescribing.
Review
Infectious Diseases
P. Naucler, A. Huttner, C. H. Van Werkhoven, M. Singer, P. Tattevin, S. Einav, T. Tangden
Summary: The study explored the impact of time to antibiotic treatment on clinical outcomes in patients presenting to the emergency department with bacterial infections of different severity of illness and source of infection. Most articles supported prompt administration of effective antibiotics for septic shock and bacterial meningitis, but there is no clear evidence showing that a delayed start of therapy is associated with worse outcome for less severe infectious syndromes.
CLINICAL MICROBIOLOGY AND INFECTION
(2021)
Article
Public, Environmental & Occupational Health
Anna S. C. Conlon, Zoey Chopra, Shannon Cahalan, Sandro Cinti, Krishna Rao
Summary: This study aims to describe the natural course of procalcitonin (PCT) in COVID-19 patients and its correlation with antimicrobial prescribing, providing insights into PCT data utilization in antimicrobial stewardship. The results show that PCT trends are associated with antibiotic initiation and duration of treatment, independent of pneumonia status and comorbidities.
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY
(2023)
Review
Infectious Diseases
Brian W. C. A. Tian, Vanni Agnoletti, Luca Ansaloni, Federico Coccolini, Francesca Bravi, Massimo Sartelli, Carlo Vallicelli, Fausto Catena
Summary: Patients with intra-abdominal sepsis face high mortality and morbidity. The main treatment strategies include source control and early administration of antibiotics, but the duration of antibiotic therapy is still debated. Prolonged antibiotic use can lead to increased resistance and nosocomial infections. The value of procalcitonin (PCT) as a biomarker in managing intra-abdominal infections has been a focus of recent research.
Article
Pediatrics
Jennifer Zihlmann-Ji, Christian Braun, Michael Buettcher, Markus Hodel, Dirk Lehnick, Martin Stocker
Summary: This study analyzed the duration of antibiotic therapy for suspected EOS in neonates and found that PCT-guided therapy can shorten the course of antibiotic treatment. The duration of antibiotic therapy was found to be independent of gestational age, but was influenced by abnormal laboratory measurements.
FRONTIERS IN PEDIATRICS
(2021)
Review
Pediatrics
Matti Korppi
Summary: This mini review summarizes the available data on the implementation and impact of antibiotic stewardship programs (ASP) for acute respiratory tract infections (ARTI) in pediatric outpatients. The results suggest that ASPs have a low impact on overall antibiotic prescription rates and a modest impact on prescribing broad-spectrum antibiotics. However, the implementation of ASP protocols needs further development, and more research is necessary on barriers to complying with ASPs.
Article
Immunology
Kasper S. Moestrup, Joanne Reekie, Adrian G. Zucco, Tomas O. Jensen, Jens Ulrik S. Jensen, Lothar Wiese, Sisse R. Ostrowski, Carsten U. Niemann, Cameron MacPherson, Jens Lundgren, Marie Helleberg
Summary: In this study, it was found that the rates of readmissions and deaths after hospital discharge in COVID-19 patients were substantial. This suggests that a 28-day follow-up period, focusing only on recovery, might be too short, especially for critically ill patients.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Medical Laboratory Technology
Philipp Schuetz
Summary: PCT can help differentiate bacterial from non-bacterial infections and inflammation states, particularly in respiratory illness. PCT-guided antibiotic stewardship has been shown to reduce antibiotic exposure and associated side-effects in patients with respiratory infection and sepsis. Patient-specific decisions regarding antibiotic usage should consider clinical situation, pretest probability for bacterial infection, severity of presentation, and PCT test results.
CLINICAL CHEMISTRY AND LABORATORY MEDICINE
(2023)
Article
Health Care Sciences & Services
Christoph Becker, Sebastian Gross, Martina Gamp, Katharina Beck, Simon A. Amacher, Jonas Mueller, Chantal Bohren, Rene Blatter, Rainer Schaefert, Philipp Schuetz, Joerg Leuppi, Stefano Bassetti, Sabina Hunziker
Summary: This study investigated the association between patients' decisional control preference (DCP) and their medical knowledge, ward round performance measures, and perceived quality of care measures. The findings demonstrate that patients with an active DCP have lower trust in physicians and nurses and are less satisfied with their hospital stay.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2023)
Article
Respiratory System
Charlotte Sandau, Ejvind Frausing Hansen, Lars Pedersen, Jens Ulrik Staehr Jensen
Summary: The occurrence of hypoxemia within the first 24 hours of admission in patients with acute exacerbation of COPD is associated with a significantly increased risk of poor prognosis.
EUROPEAN CLINICAL RESPIRATORY JOURNAL
(2023)
Letter
Cardiac & Cardiovascular Systems
Mats C. Hojbjerg Lassen, Daniel Modin, Kristoffer Grundtvig Skaarup, Niklas Dyrby Johansen, Brian Claggett, Scott D. Solomon, Michael Fralick, Jens Ulrik Staehr Jensen, Pradeesh Sivapalan, Muthiah Vaduganathan, Manan Pareek, Morten Schou, Tyra Grove Krause, Anders Hviid, Lars Kober, Christian Torp-Pedersen, Gunnar Gislason, Tor Biering-Sorensen
Article
Geriatrics & Gerontology
Jennifer Siegwart, Umberto Spennato, Nathalie Lerjen, Beat Mueller, Philipp Schuetz, Daniel Koch, Tristan Struja
Summary: A retrospective cohort study in a Swiss tertiary care hospital assessed the predictive ability of different clinical scores for fall risk and developed a new fall risk score. The scores showed fair accuracy in predicting fall risk, which could help in establishing preventive strategies.
Article
Critical Care Medicine
Romain Sonneville, Etienne de Montmollin, Damien Contou, Ricard Ferrer, Mohan Gurjar, Kada Klouche, Benjamine Sarton, Sophie Demeret, Pierre Bailly, Daniel da Silva, Etienne Escudier, Loic Le Guennec, Russel Chabanne, Laurent Argaud, Omar Ben Hadj Salem, Martial Thyrault, Aurelien Frerou, Guillaume Louis, Gennaro De Pascale, Janneke Horn, Raimund Helbok, Guillaume Geri, Fabrice Bruneel, Ignacio Martin-Loeches, Fabio Silvio Taccone, Jan De Waele, Stephane Ruckly, Quentin Staiquly, Giuseppe Citerio, Jean-Francois Timsit, EURECA Investigator Study Grp
Summary: This study aimed to characterize the outcomes of severe meningoencephalitis patients requiring intensive care. A multicenter international cohort study was conducted from 2017 to 2020 in 68 centers across 7 countries. Among the enrolled patients, 50.5% had a poor functional outcome at 3 months, and the independent factors associated with this outcome included age > 60 years, immunodepression, delayed ICU admission, low Glasgow Coma Scale score, motor deficits, respiratory and cardiovascular complications, while administration of certain medications on ICU admission was protective.
INTENSIVE CARE MEDICINE
(2023)
Article
Critical Care Medicine
Alexis Tabah, Niccolo Buetti, Quentin Staiquly, Stephane Ruckly, Murat Akova, Abdullah Tarik Aslan, Marc Leone, Andrew Conway Morris, Matteo Bassetti, Kostoula Arvaniti, Jeffrey Lipman, Ricard Ferrer, Haibo Qiu, Jose-Artur Paiva, Pedro Povoa, Liesbet De Bus, Jan De Waele, Farid Zand, Mohan Gurjar, Adel Alsisi, Khalid Abidi, Hendrik Bracht, Yoshiro Hayashi, Kyeongman Jeon, Muhammed Elhadi, Francois Barbier, Jean-Francois Timsit
Summary: This study investigated hospital-acquired bloodstream infections (HA-BSI) in 2600 adult patients from 333 ICUs in 52 countries. HA-BSI were frequently caused by Gram-negative, carbapenem-resistant, and difficult-to-treat pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy, resulting in high mortality rates.
INTENSIVE CARE MEDICINE
(2023)
Review
Critical Care Medicine
Elio Antonucci, Tania Polo, Manuela Giovini, Massimo Girardis, Ignacio Martin-Loeches, Nathan D. Nielsen, Francisco Jose Chacon Lozsan, Ricard Ferrer, Ines Lakbar, Marc Leone
Summary: Background: This study reviews different studies on refractory septic shock and/or catecholamine resistance and/or high dose norepinephrine, highlighting the heterogeneity in the definitions used by authors. Method: A systematic review of papers reporting data on refractory septic shock was conducted. Results: Out of 276 papers reviewed initially, 8 studies were included, comprising of 3 randomized controlled trials, 3 prospective studies, and 2 retrospective studies, with a total of 562 patients with septic shock. Catecholamine resistance was generally defined as decreased vascular responsiveness to catecholamine regardless of the administered norepinephrine dose. Refractory septic shock was broadly defined as a clinical condition characterized by persistent hyperdynamic shock despite adequate fluid resuscitation (individualized doses) and high doses of norepinephrine (>= 1 mu g/kg/min). Reported high doses of norepinephrine were often >= 1 mu g/kg/min. However, there was significant variability in the usage of these terms throughout the literature. Discussion: The usage of terms for refractory septic shock showed marked inconsistencies. Consensus definitions are urgently needed to establish a common language in the medical literature and to harmonize future studies.
JOURNAL OF CRITICAL CARE
(2023)
Article
Cardiac & Cardiovascular Systems
Jordi Riera, Laura Domenech, Sonia Garcia, Alba Pau, Manuel Sosa, Josep Domenech, Clara Palmada, Pau Torrella, Ariadna Sanchez, Anna Lamora, Elisabet Gallart, Pilar Giron, Xavier Nuvials, Ricard Ferrer
Summary: In this study, we investigated the pharmacokinetics of cefiderocol in a critically ill patient receiving ECMO support.
Article
Respiratory System
Sarah Altaraihi, Peter Kamstrup, Josefin Eklof, Niklas Dyrby Johansen, Tor Biering-Sorensen, Pradeesh Sivapalan, Jens-Ulrik Jensen
Summary: This study aimed to evaluate whether the use of prophylactic oral anticoagulation prior to COVID-19 infection could reduce the risk of all-cause mortality, hospital admission, and ICU admission in COVID-19 patients. The results showed that the use of oral anticoagulants did not provide any prophylactic benefits in terms of reducing the risk of all-cause mortality, but slightly increased the risk of hospital admission.
Article
Medicine, General & Internal
Marin Gergics, Greta Pham-Dobor, Csilla Kurdi, Gergely Montsko, Krisztina Mihalyi, Gabor Banfai, Peter Kanizsai, Tamas Koszegi, Emese Mezosi, Laszlo Bajnok
Summary: In this prospective observational study, the researchers investigated the prognostic role of apelin-13 in critically ill patients and explored its correlations with free cortisol, aldosterone, CRH, and copeptin. The results showed a strong positive correlation between apelin-13 and CRH concentrations, and apelin-13 was significantly higher in non-septic patients. Multivariate Cox regression analysis revealed that apelin-13 and free cortisol were independent determinants of survival.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Geriatrics & Gerontology
Marco Falcone, Michael Bauer, Ricard Ferrer, Gaetan Gavazzi, Juan Gonzalez del Castillo, Alberto Pilotto, Philipp Schuetz
Summary: The optimal treatment of infections in the elderly population is challenging due to less specific clinical symptoms and signs. Elderly patients have a weaker immune response to infection and may be at risk of both over- and undertreatment. The use of biomarkers, particularly procalcitonin (PCT), has shown potential in assessing the risk of septic complications and guiding antibiotic treatment decisions in elderly patients.
AGING CLINICAL AND EXPERIMENTAL RESEARCH
(2023)
Article
Public, Environmental & Occupational Health
J. Wilson, H. Griffin, A. Gorzig, J. Prieto, K. Saeed, M. I. Garvey, E. Holden, A. Tingle, H. Loveday
Summary: This study developed a prognostic screening tool (PRHAPs) based on routine admission data to identify patients at high risk of NV-HAP, enabling targeted preventive interventions and reducing antimicrobial agent usage.
JOURNAL OF HOSPITAL INFECTION
(2023)
Article
Medicine, General & Internal
Adam Watson, Ryan Beecham, Michael P. W. Grocott, Kordo Saeed, Ahilanandan Dushianthan
Summary: Little is known about PIV infection in adult ICU patients. This study found that PIV infection in adult ICU patients is associated with significant mortality and morbidity. The infection requires respiratory and cardiovascular support, and there are differences in respiratory failure types.
JOURNAL OF CLINICAL MEDICINE
(2023)