Ten papers for teachers of evidence-based medicine and health care: Sicily workshop 2019

A previous article sought to signpost papers that were considered helpful when starting on the journey of practicing evidence-based medicine (EBM). The lead author was invited to run a workshop at the Eighth Conference of the International Society for Evidence-Based Health Care run in collaboration with the Gruppo Italiano per la Medicina Basata sulle Evidenze from 6 November to 9 November 2019. The aim of the workshop was to challenge a group of teachers and educators to consider useful papers for the teaching of EBM/evidence-based healthcare (EBHC). The second aim was to start a database of such studies. The third aim was to share learning and foster discussion from the workshop through journal publication. EBM and EBHC are used interchangeably throughout this article

Community‐acquired Stenotrophomonas maltophilia bacteremia in liver cirrhosis: A case report

Abstract Stenotrophomonas maltophilia is a Gram‐negative bacterium, usually considered a nosocomial pathogen. Its role in community‐acquired infections has been reported, but it is still not typically included in differential diagnoses of patients not exposed to the healthcare system. Recently, some reports suggested that liver diseases might also act as a possible risk factor for community‐acquired S. maltophilia bloodstream infection. We report a case of a 77‐year‐old woman with a history of cirrhosis who was diagnosed with community‐acquired S. maltophilia bloodstream infection. S. maltophilia not only causes hospital‐acquired infections but is also emerging as a pathogen in community settings. Although community‐onset infection is still rare and might have lower mortality, this antibiotic‐resistant bacterial species should be considered a possible pathogen in patients with liver cirrhosis. Although trimethoprim‐sulfamethoxazole is considered the first‐line treatment, a study in vitro and a 4‐year review of S. maltophilia susceptibility in our institution found that the bacteria were more susceptible to minocycline than to trimethoprim‐sulfamethoxazole. Therefore, minocycline might become the first‐line treatment in the future