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Sepsis Management: What We Think We Know

In the Protocolized Resuscitation in Sepsis Meta-Analysis (PRISM), 3,723 patients’ outcomes from the ProCESS, ARISE, and ProMISe randomized, controlled trials of early goal-directed therapy (EGDT) were evaluated. EGDT did not result in better outcomes than usual care and was associated with higher costs. The authors of a second study looked at outcomes of 49,331 patients with sepsis treated in New York from April 2014 to June 2016. More rapid completion of the three-hour sepsis bundle and antibiotic administration (but not rapid bolus administration of IV fluids) was associated with reduced in-hospital mortality.

Bug Bytes From Barcelona: Report of the 15th Conference of the International Society of Travel Medicine

In addition to issues of malaria, vaccination, and trauma in travelers, viral diseases and the management of diarrhea were key topics at the biannual meeting of the International Society of Travel Medicine in Barcelona, Spain, during May 2017.

Not Just Ebola — Lassa Fever Rears its Ugly Head Once Again

Outbreaks of Lassa fever are occurring in Nigeria and several other West African nations, some of which also are endemic for Ebola virus infections.

Dual Antibiotic Therapy Is Not Routinely Necessary for Uncomplicated Cellulitis

A randomized, multicenter, placebo-controlled clinical trial that enrolled patients presenting to emergency departments with uncomplicated cellulitis found the addition of trimethoprim-sulfamethoxazole to cephalexin did not lead to better outcomes.

Infectious Disease Alert Updates

Colistin Resistance in Action; PK-tailored High-dose Colistin May Not Be Beneficial; ‘Dragon’s Blood’ Yields Possible Antibacterial

Oral Cholera Vaccine and Travelers

The new oral cholera vaccine is recommended for adults 18-64 years of age who are planning to travel to areas at risk.

Surviving Sepsis Campaign Guidelines Bundle: Studying How Improved Compliance Might Affect Outcomes

Improved compliance with the Surviving Sepsis Campaign guidelines bundle was associated with a non-statistically significant decrease in the in-hospital mortality of severe sepsis patients.

Ready for Dengue in the United States?

Dengue is increasingly recognized in the southern United States. When recently surveyed, however, clinicians in Texas seemed incompletely prepared to understand and manage patients with dengue.

Bambi Strikes Again — Encephalitis Due to the ‘Deer Tick Virus’ (Powassan Virus) May Be Increasing in Frequency

Powassan virus is transmitted by the same tick that carries the etiologic agent of Lyme disease and several other pathogens. The number of cases of encephalitis caused by this virus may be increasing in the endemic areas.

Current Trends and Outcomes for Infective Endocarditis

Using large databases from New York and California, investigators found the overall incidence of infective endocarditis remained stable between 1998 and 2013, and 90-day mortality declined. Changes were noted in pathogen etiology and patient characteristics over time.