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Iskalni niz: "ključne besede" (chlorhexidine) .

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1.
Decontamination strategies and bloodstream infections with antibiotic-resistant microorganisms in ventilated patients : a randomized clinical trial
Bastiaan H. Wittekamp, Nienke L. Plantinga, Ben S. Cooper, Joaquin Lopez-Contreras, Pere Coll, Jordi Mancebo, Matt P. Wise, Matt P. G. Morgan, Pieter Depuydt, Jerina Boelens, Viktorija Tomič, Franc Šifrer, 2018, izvirni znanstveni članek

Povzetek: Importance: The effects of chlorhexidine (CHX) mouthwash, selective oropharyngeal decontamination (SOD), and selective digestive tract decontamination (SDD) on patient outcomes in ICUs with moderate to high levels of antibiotic resistance are unknown. Objective: To determine associations between CHX 2%, SOD, and SDD and the occurrence of ICU-acquired bloodstream infections with multidrug-resistant gram-negative bacteria (MDRGNB) and 28-day mortality in ICUs with moderate to high levels of antibiotic resistance. Design, setting, and participants: Randomized trial conducted from December 1, 2013, to May 31, 2017, in 13 European ICUs where at least 5% of bloodstream infections are caused by extended-spectrum [beta]-lactamase-producing Enterobacteriaceae. Patients with anticipated mechanical ventilation of more than 24 hours were eligible. The final date of follow-up was September 20, 2017. Interventions: Standard care was daily CHX 2% body washings and a hand hygiene improvement program. Following a baseline period from 6 to 14 months, each ICU was assigned in random order to 3 separate 6-month intervention periods with either CHX 2% mouthwash, SOD (mouthpaste with colistin, tobramycin, and nystatin), or SDD (the same mouthpaste and gastrointestinal suspension with the same antibiotics), all applied 4 times daily. Main outcomes and measures: The occurrence of ICU-acquired bloodstream infection with MDRGNB (primary outcome) and 28-day mortality (secondary outcome) during each intervention period compared with the baseline period. Results: A total of 8665 patients (median age, 64.1 years; 5561 men [64.2%]) were included in the study (2251, 2108, 2224, and 2082 in the baseline, CHX, SOD, and SDD periods, respectively). ICU-acquired bloodstream infection with MDRGNB occurred among 144 patients (154 episodes) in 2.1%, 1.8%, 1.5%, and 1.2% of included patients during the baseline, CHX, SOD, and SDD periods, respectively. Absolute risk reductions were 0.3% (95% CI, -0.6% to 1.1%), 0.6% (95% CI, -0.2% to 1.4%), and 0.8% (95% CI, 0.1% to 1.6%) for CHX, SOD, and SDD, respectively, compared with baseline. Adjusted hazard ratios were 1.13 (95% CI, 0.68-1.88), 0.89 (95% CI, 0.55-1.45), and 0.70 (95% CI, 0.43-1.14) during the CHX, SOD, and SDD periods, respectively, vs baseline. Crude mortality risks on day 28 were 31.9%, 32.9%, 32.4%, and 34.1% during the baseline, CHX, SOD, and SDD periods, respectively. Adjusted odds ratios for 28-day mortality were 1.07 (95% CI, 0.86-1.32), 1.05 (95% CI, 0.85-1.29), and 1.03 (95% CI, 0.80-1.32) for CHX, SOD, and SDD, respectively, vs baseline. Conclusions and relevance: Among patients receiving mechanical ventilation in ICUs with moderate to high antibiotic resistance prevalence, use of CHX mouthwash, SOD, or SDD was not associated with reductions in ICU-acquired bloodstream infections caused by MDRGNB compared with standard care.
Ključne besede: anti-infective agents -- therapeutic use, bacteremia -- prevention and control, chlorhexidine -- therapeutic use, cross infection -- prevention and control, disinfection -- methods, bacterial drug resistance, gastrointestinal tract -- microbiology, Gram-negative bacterial infections -- prevention and control, hospital mortality, intensive care units, mouthwashes -- therapeutic use, oropharynx -- microbiology, artificial respiration, multicenter study, randomized controlled trial
Objavljeno v DiRROS: 09.11.2020; Ogledov: 1164; Prenosov: 376
URL Povezava na datoteko

2.
Comparative epidemiology of suspected perioperative hypersensitivity reactions
Paul Michel Mertes, Didier G. Ebo, Tomaz Garcez, Michael Rose, Vito Sabato, Tomonori Takazawa, Peter J. Cooke, Russel C. Clarke, Pascale Dewachter, Lene Heise Garvey, Anne Berit Guttormsen, David L. Hepner, Philip M. Hopkins, David A. Khan, Peter Kopač, Peter R. Platt, Louise C. Savic, 2019, pregledni znanstveni članek

Povzetek: Suspected perioperative hypersensitivity reactions are rare but contribute significantly to the morbidity and mortality of surgical procedures. Recent publications have highlighted the differences between countries concerning the respective risk of different drugs, and changes in patterns of causal agents and the emergence of new allergens. This review summarises recent information on the epidemiology of perioperative hypersensitivity reactions, with specific consideration of differences between geographic areas for the most frequently involved offending agents.
Ključne besede: anaphylaxis, anti-bacterial agents, blood, chlorhexidine, latex, neuromuscular blocking agents, hypersensitivity, drug hypersensitivity, sugammadex, antibiotics, blood products, perioperative anaphylaxis, perioperative hypersensitivity
Objavljeno v DiRROS: 16.10.2020; Ogledov: 1354; Prenosov: 339
URL Povezava na datoteko

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