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Emergence of antibiotic resistance Pseudomonas aeruginosa in intensive care unit;a critical review

Genes & Diseases 2019年第2期6卷 109-119页

作者： Preeti Pachori Ragini Gothalwal Puneet Gandhi Department of Biotechnology Barkatullah UniversityBhopal 462026Madhya PradeshIndia Department of Research Bhopal Memorial Hospital and Research Centre(BMHRC)Bhopal 462037Madhya PradeshIndia

The emergence of antibiotic resistant bacteria in the healthcare is a serious *** the Healthcare premises precisely intensive care unit are major sources of microbial *** findings have demonstrated not only microbial diversity but also drug resistant microbes largely habitat in *** aeruginosa found as a part of normal intestinal flora and a significant pathogen responsible for wide range of ICU acquired infection in critically ill *** infection associated with this organism including gastrointestinal infection,urinary tract infections and blood stream *** caused by this organism are difficult to treat because of the presence of its innate resistance to many antibiotics(b-lactam and penem group of antibiotics),and its ability to acquire further resistance mechanism to multiple class of antibiotics,including Beta-lactams,aminoglycosides and *** the molecular evolution microbes adopted several mechanism to maintain genomic *** tool microbe use for its survival is mainly biofilm formation,quorum sensing,and horizontal gene transfer and enzyme *** genomic plasticity provide an ideal habitat to grow and survive in hearse environment mainly antibiotics *** review focus on infection caused by Pseudomonas aeruginosa,its mechanisms of resistance and available treatment *** present study provides a systemic review on major source of Pseudomonas aeruginosa in ***,study also emphasizes virulence gene/s associated with Pseudomonas aeruginosa genome for extended drug *** gives detailed overview of antibiotic drug resistance mechanism.

关键词： Antibiotics blood stream infections Infection Pathogen Resistance Urinary tract infections

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Bacterial Spectrum and Antimicrobial Profile of Pediatric blood stream Infection at a Tertiary Care Hospital in Pakistan

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Chinese Medical Sciences Journal 2020年第4期35卷 315-322页

作者： Anees Muhammad Sadiq Noor Khan Tahir Jamal Irshad Ul Haq Abdul Jabbar Ihsan Ali Department of Medical Laboratory Technology University of HaripurHaripurKhyber Pathtunkhwa(KPK)22620Pakistan Rehman Medical Institute(RMI) PeshawarKPK 22620Pakistan Department of Microbiology University of HaripurHaripurKPK 22620Pakistan College of Medical Technology Bacha Khan Medical CollegeMardanKPK 23200Pakistan lnstitute of Paramedical Sciences Khyber Medical UniversityPeshawarKPK 22620Pakistan

Objectives blood stream infections(BSIs)are the main cause of morbidity and mortality in children *** present study was carried out to determine the prevalence of BSI with a focus on the identification of the causative agent of BSI,and to further evaluate the antibiotic susceptibility profile of the causing bacterial *** A cross-section study was carried out at the tertiary care hospital in Peshawar,Pakistan from January to December,*** samples were collected in BACTEC™botdes and standard microbiological protocols were applied for the isolation and identification of bacterial *** antibiotic susceptibility tests were performed using disc diffusion method as per the 2014 guideline of Clinical Laboratory Standard Institute(CLSI).Results Of 567 blood cultures in total,111(19.6%)were positive for *** children were 64%(71/111)and female children were 36%(40/111).For the causative predominant group of microorganisms,Gramnegative bacteria were identified in 79(71.1%)isolates,and Gram-positive bacteria in 32(28.9%)*** common bacteria of isolates were ***(n=35,31.5%),***(n=19,17.1%),***(n=18,16.2%),***(n=12,10.8%),and Enterococcus species(n=7,6.3%).The 36.7%(29/79)isolates of Gram-negative bacteria were ESBL producers,and 61.1%(11/18)of *** isolates were methicillin ***,72.9%isolates were multidrug *** Gram-negative bacteria were the main cause of pediatric BSIs,where the predominant microorganism was S.卯***,majority of the *** isolates were resistant to ciprofloxacin.

关键词： antibiotic resistance blood stream infections pediatric Pakistan

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The Slippery Slope of Sepsis

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Open Journal of Emergency Medicine 2023年第3期11卷 126-154页

作者： Lawrence W. Gernon Global & National Security Policy Institute University of New Mexico Albuquerque NM USA Department of Emergency Medicine Presbyterian Health System Albuquerque NM USA Burrell College of Osteopathic Medicine Las Cruces NM USA

Mortality, morbidity, early recognition, and treatment of sepsis remain a diagnostic dilemma for clinicians, in addition, the timely diagnosis of sepsis represents an ongoing clinical challenge. This review looks at the challenges of early recognition, the scope of the problem, the immunologic basis of the sepsis cascade, new frontiers related to interventions, and the role of antibiotics in an era of antimicrobial resistance. In Figure 1, once a patient is on the slippery slope of sepsis, the ability to reverse the momentum is challenging;hoping antibiotics, fluid resuscitation, vasopressors may buy time for the immunologic cascade to equilibrate to its homeostatic balance. While the development of septic shock is much more complex than pathogen proliferation, our understanding of the pathogenesis and ability to therapeutically intervene is in its infancy. Patients with sepsis frequently present for urgent medical care with undifferentiated infection and nonspecific symptoms. As 80% of patients with sepsis are initially treated in an Emergency Department, the burden of early recognition and intervention falls squarely on the shoulders of Emergency Department Clinicians. [1] This is an entity that occurs in all age groups, without regard to race, geography, or health status. Survival and mortality related to this clinical entity are poorly understood. Our understanding of sepsis needs to expand beyond the downstream effects and collateral damage of multiorgan dysfunction and failure. Immunologically, the antigenic triggers, be it invasive infection, severe injury, and systemic inflammation without concomitant infection, elicit similar pattern recognition receptors and innate host responses. If you are lucky enough to have survived an acute episode of sepsis, patients with sepsis often develop new adverse sequelae after treatment, a concept called persistent critical illness or post sepsis syndrome, characterized by long-term disability, and worsening chronic health

关键词： Sepsis Antibiotics Antimicrobial Resistance Immunology blood Cultures PCR Diagnostics Septic Shock Antimicrobial Stewardship blood stream infections Persistent Critical Illness Post Sepsis Syndrome SIRS blood stream infections Sepsis Biomarkers Endothelial Dysfunction Persistent Critical Illness

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