12 research outputs found

    Physiological aspects of sugar exchange between the gametophyte and the sporophyte of Polytrichum formosum

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    Staphylococcus aureus carriage at admission predicts early-onset pneumonia after burn trauma.

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    Early-onset pneumonia (EOP) is frequent after burn trauma, increasing morbidity in the critical resuscitation phase, which may preclude early aggressive management of burn wounds. Currently, however, preemptive treatment is not recommended. The aim of this study was to identify predictive factors for EOP that may justify early empirical antibiotic treatment. Data for all burn patients requiring ≥4 h mechanical ventilation (MV) who were admitted between January 2001 and October 2012 were extracted from the hospital's computerized information system. We reviewed EOP episodes (≤7 days) among patients who underwent endotracheal aspiration (ETA) within 5 days after admission. Univariate and multivariate analyses were performed to identify independent factors associated with EOP. Logistic regression was used to identify factors predicting EOP development. During the study period, 396 burn patients were admitted. ETA was performed within 5 days in 204/290 patients receiving ≥4 h MV. One hundred and eight patients developed EOP; 47 cases were caused by Staphylococcus aureus, 37 by Haemophilus influenzae, and 23 by Streptococcus pneumoniae. Among the 33 patients showing S. aureus positivity on ETA samples, 16 (48.5 %) developed S. aureus EOP. Among the 156 S. aureus non-carriers, 16 (10.2 %) developed EOP. Staphylococcus aureus carriage independently predicted EOP (p < 0.0001). We identified S. aureus carriage as an independent and strong predictor of EOP. As rapid point-of-care testing for S. aureus is readily available, we recommend testing of all patients at admission for burn trauma and the consideration of early preemptive treatment in all positive patients. Further studies are needed to evaluate this new strategy

    Antibiotic consumption to detect epidemics of Pseudomonas aeruginosa in a burn centre: A paradigm shift in the epidemiological surveillance of Pseudomonas aeruginosa nosocomial infections.

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    The control of antibiotic resistance and nosocomial infections are major challenges for specialized burn centres. Early detection of those epidemic outbreaks is crucial to limit the human and financial burden. We hypothesize that data collected by antibiotic consumption medico-economic surveys could be used as warning signal to detect early nosocomial outbreaks. A retrospective analysis was conducted that included all burn patients staying >48h on the Lausanne BICU (Burn Intensive Care Unit) between January 2001 and October 2012 who received systemic therapeutic antibiotics. Infection episodes were characterized according to predefined criteria. Antibiotic consumption data, obtained from the quarterly surveillance of drug consumption surveys, were translated into defined daily doses (DDDs). In total, 297 out of 414 burn patients stayed >48h, giving a total of 7458 'burn-days'. We identified 610 infection episodes (burn wound [32.0%], respiratory [31.1%], and catheter [21.8%]), from 774 microorganisms. Pseudomonas aeruginosa (26.2%), Staphylococcus aureus (11.5%), and Candida albicans (7.0%) were the main pathogens. We observed three distinct outbreaks of P. aeruginosa infections in 2002-2003, 2006, and 2009-2011. These outbreaks correlated with an increase in the DDDs of anti-Pseudomonas antibiotics. Our data support a paradigm shift in the epidemiological surveillance of nosocomial P. aeruginosa epidemics in burn centres, using the rise in antibiotic consumption as an early trigger to initiate the molecular typing of P. aeruginosa strains and the reinforcement of standard infection control procedures
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