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Healthcare-associated Infections — Better, But Not There Yet

One-day prevalence studies demonstrated that there has been a 16% reduction in the risk of healthcare-associated infections from 2011 to 2015.

Oral Linezolid for Staphylococcus aureus Bacteremia

Investigators evaluated 135 patients with Staphylococcus aureus bacteremia (SAB) in a prospective cohort study comparing early switch to oral linezolid to continued treatment with standard parenteral therapy (SPT). Patients with complicated SAB and osteoarticular infection were excluded. Early switch to oral therapy yielded similar outcomes to continued SPT and allowed earlier hospital discharge.

Factors Associated With Urinary Tract Infections Caused by Multidrug-resistant Gram-negative Bacteria

A multicenter, retrospective, cohort study from southern and eastern Europe identified predictive factors for multidrug-resistant complicated urinary tract infections (cUTI), which included male sex, cUTI acquisition in a healthcare facility, presence of a Foley catheter, having a UTI in the previous year, and receiving an antibiotic in the preceding 30 days.

Blastomycosis (But Not That Blastomycosis) in the Western United States

Blastomycosis occurs in western Canada and in the United States well outside the known endemic area, but it is due to Blastomyces helicus, not Blastomyces dermatitidis.

Optimal Treatment of Vivax Malaria

In glucose-6-phosphate-dehydrogenase-sufficient individuals in Southeast Asia, combined treatment with chloroquine and primaquine provides much more lasting relief from vivax malaria than either chloroquine alone or artesunate.

Finding a Consensus on ARDS Diagnostics and Determining a Relationship to Hospital Mortality

Critical care physicians reviewed more than 700 mechanically ventilated patients with acute hypoxemia and reached a consensus on the presence of acute respiratory distress syndrome (ARDS) in 15% of patients and nonconsensus on the presence of ARDS in an additional 14% of cases. Hospital mortality was not different between these cohorts (37% and 35%, respectively).

Preventive Tactics and Management of Acute Kidney Injury in the ICU

Acute kidney injury (AKI) is a sudden decline in renal function due to nephron dysfunction and/or damage that results in nitrogenous waste product accumulation and acid-base, electrolyte, and fluid disturbances. It is estimated to occur in 16-67% of critically ill patients admitted to the ICU. Common inciting causes include major surgery, iatrogenic interventions, and sepsis. Advanced age and comorbidities increase kidney susceptibility to various exposures and insults. Severe AKI requiring renal replacement therapy (RRT) is associated with a 10-fold increase in mortality and increases length of stay an average of 5.7 days. Preventive tactics and RRT remain the cornerstones of AKI management in critically ill patients.

Identify 4 Major Findings in New-onset Chest Pain Patient

The ECG in the figure was obtained from a patient with new-onset chest pain. He was hemodynamically stable at the time the tracing was obtained. In addition to the artifact that is most pronounced in the lateral chest leads, there are four major findings. Admittedly, two findings are subtle. How many findings can you identify?

Human Papillomavirus Vaccine (Gardasil 9)

The FDA has approved a supplemental application to expand the indication for human papillomavirus 9-valent vaccine (HPV-9) to include men and women 27-45 years of age.

Who Really Needs Intensive Blood Pressure Control?

A patient baseline characteristics level analysis of the SPRINT and ACCORD trials resulted in the creation of a simple algorithm for identifying high-risk patients who experienced fewer major cardiac events without increased serious adverse events from intensive blood pressure therapy.