About: Bloodstream infections in critically ill patients: an expert statement

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An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Bloodstream infections in critically ill patients: an expert statement
Creator	Timsit, Jean-François Bassetti, Matteo Barbier, François Ruppé, Etienne Tabah, Alexis
Source	PMC
abstract	Bloodstream infection (BSI) is defined by positive blood cultures in a patient with systemic signs of infection and may be either secondary to a documented source or primary—that is, without identified origin. Community-acquired BSIs in immunocompetent adults usually involve drug-susceptible bacteria, while healthcare-associated BSIs are frequently due to multidrug-resistant (MDR) strains. Early adequate antimicrobial therapy is a key to improve patient outcomes, especially in those with criteria for sepsis or septic shock, and should be based on guidelines and direct examination of available samples. Local epidemiology, suspected source, immune status, previous antimicrobial exposure, and documented colonization with MDR bacteria must be considered for the choice of first-line antimicrobials in healthcare-associated and hospital-acquired BSIs. Early genotypic or phenotypic tests are now available for bacterial identification and early detection of resistance mechanisms and may help, though their clinical impact warrants further investigations. Initial antimicrobial dosing should take into account the pharmacokinetic alterations commonly observed in ICU patients, with a loading dose in case of sepsis or septic shock. Initial antimicrobial combination attempting to increase the antimicrobial spectrum should be discussed when MDR bacteria are suspected and/or in the most severely ill patients. Source identification and control should be performed as soon as the hemodynamic status is stabilized. De-escalation from a broad-spectrum to a narrow-spectrum antimicrobial may reduce antibiotic selection pressure without negative impact on mortality. The duration of therapy is usually 5–8 days though longer durations may be discussed depending on the underlying illness and the source of infection. This narrative review covers the epidemiology, diagnostic workflow and therapeutic aspects of BSI in ICU patients and proposed up-to-date expert statements.
has issue date	2020-02-11(xsd:dateTime)
bibo:doi	10.1007/s00134-020-05950-6
bibo:pmid	32047941
has license	no-cc
sha1sum (hex)	16faae89aa50c2728c6c3d63e4c30742176f25cd
schema:url	https://doi.org/10.1007/s00134-020-05950-6
resource representing a document's title	Bloodstream infections in critically ill patients: an expert statement
has PubMed Central identifier	PMC7223992
has PubMed identifier	32047941
schema:publication	Intensive Care Med
resource representing a document's body	covid:16faae89aa50c2728c6c3d63e4c30742176f25cd#body_text
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