Nationwide surveillance of bacterial respiratory pathogens conducted by the surveillance committee of Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in 2010: General view of the pathogens\u27 antibacterial susceptibility

The nationwide surveillance on antimicrobial susceptibility of bacterial respiratory pathogens from patients in Japan, was conducted by Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases and Japanese Society for Clinical Microbiology in 2010.The isolates were collected from clinical specimens obtained from well-diagnosed adult patients with respiratory tract infections during the period from January and April 2010 by three societies. Antimicrobial susceptibility testing was conducted at the central reference laboratory according to the method recommended by Clinical and Laboratory Standard Institutes using maximum 45 antibacterial agents.Susceptibility testing was evaluable with 954 strains (206 Staphylococcus aureus, 189 Streptococcus pneumoniae, 4 Streptococcus pyogenes, 182 Haemophilus influenzae, 74 Moraxella catarrhalis, 139 Klebsiella pneumoniae and 160 Pseudomonas aeruginosa). Ratio of methicillin-resistant S.aureus was as high as 50.5%, and those of penicillin-intermediate and -resistant S.pneumoniae were 1.1% and 0.0%, respectively. Among H.influenzae, 17.6% of them were found to be β-lactamase-non-producing ampicillin (ABPC)-intermediately resistant, 33.5% to be β-lactamase-non-producing ABPC-resistant and 11.0% to be β-lactamase-producing ABPC-resistant strains. Extended spectrum β-lactamase-producing K.pneumoniae and multi-drug resistant P.aeruginosa with metallo β-lactamase were 2.9% and 0.6%, respectively.Continuous national surveillance of antimicrobial susceptibility of respiratory pathogens is crucial in order to monitor changing patterns of susceptibility and to be able to update treatment recommendations on a regular basis

Effect of the McGRATH MAC® Video Laryngoscope on Hemodynamic Response during Tracheal Intubation: A Retrospective Study.

BACKGROUND:Hypertension often occurs after tracheal intubation using a Macintosh laryngoscope and may lead to rare but serious complications. The Macintosh laryngoscope may increase the incidence of hypertension because it requires forced alignment of the oral and pharyngeal axes in order to view the glottis. In contrast, the McGRATH MAC video laryngoscope does not require this manipulation. The objective of this study was to evaluate the incidence of hypertension after tracheal intubation using a McGRATH laryngoscope compared with a Macintosh laryngoscope. METHODS:Data of 360 consecutive patients who underwent general anesthesia with tracheal intubation by Macintosh laryngoscope or McGRATH video laryngoscope were obtained retrospectively. A total of 16 variables including patient characteristics, anesthetic drug used, and intubation techniques were extracted as potential factors affecting the incidence of hypertension after intubation. The incidence of hypertension after tracheal intubation was defined as an increase in systolic blood pressure (SBP) >20% of values immediately before intubation. Propensity scoring with inverse probability weighting was used to calculate the odds ratio for the incidence of hypertension after intubation with a McGRATH video laryngoscope as the primary outcome. The mean difference in SBP change between the two laryngoscopes was also calculated. RESULTS:A McGRATH laryngoscope was used in 68 of 360 patients (18%). The numbers of patients who increase in systolic blood pressure of more than 20% was 189 patients (53%). The odds ratio for the use of a McGRATH laryngoscope was 0.43 (95% confidence interval (CI), 0.19-0.96; P = 0.04). The mean difference in SBP change between the two laryngoscopes was -8.6 mmHg (95% CI, -17.4 to 0.2; P = 0.06). CONCLUSIONS:The use of a McGRATH laryngoscope may reduce the incidence of hypertension after tracheal intubation compared to the Macintosh laryngoscope

Anesthetic factors of patients with McGRATH laryngoscope and with Macintosh laryngoscope.

<p>Anesthetic factors of patients with McGRATH laryngoscope and with Macintosh laryngoscope.</p

Results of blood pressure change, time to measure blood pressure, and EtCO₂.

<p>Results of blood pressure change, time to measure blood pressure, and EtCO₂.</p

Characteristics of patients with McGRATH laryngoscope and with Macintosh laryngoscope.

<p>Characteristics of patients with McGRATH laryngoscope and with Macintosh laryngoscope.</p