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Urinary tract infections in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
For asymptomatic women, bacteriuria is diagnosed by quantitative urine culture: two consecutive voided specimens with isolation of the same bacterial strain in quantitative counts ‡105 bacteria/mL or a single catheterized urine specimen containing ‡102 bacteria/mL (36). Although only approximately 80% of women with a positive initial screening culture would have that confirmed on subsequent sampling, the detection of ‡105 bacteria/mL in a single voided midstream urine is generally accepted as an adequate and more practical alternative to the requirement for serial positive samples (37). The bacteria identified in ASB are generally similar to those of other UTIs, except that group B streptococcus is more common in this UTI, present in approximately one-quarter of positive screening cultures (8,38).
Antibiotic Treatment Failure
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Consider if the source of infection could have a polymicrobial flora that the current antibiotics may only be partially covering. Review old culture results and see if there are any bacteria that are resistant to the current antibiotic therapy. This could be clinical cultures or screening cultures.
Understanding and Diagnosing Herpes Simplex Virus
Published in Marie Studahl, Paola Cinque, Tomas Bergström, Herpes Simplex Viruses, 2017
In newborns without clinical symptoms but with risk factors for neonatal HSV, such as premature rupture of membranes or the presence of genital lesions during vaginal delivery, viral serology will help to prove whether baby has protective maternally transferred HSV IgG. Screening cultures and/or HSV PCR of throat, urine, stool, nasopharynx, and conjunctiva can be used to monitor such babies.
Is pandrug-resistance in A. baumannii a transient phenotype? Epidemiological clues from a 4-year cohort study at a tertiary referral hospital in Greece
Published in Journal of Chemotherapy, 2021
Stamatis Karakonstantis, Evangelos I. Kritsotakis, Achilleas Gikas
The potential for emergence of PDRAB from non-PDRAB has important clinical implications. PDRAB infections can result in significant excess mortality14 and treatment options are very limited.15 Furthermore, transient emergence of PDRAB could be missed in the absence of screening cultures but may have the potential to result in PDRAB outbreaks, which has important infection control implications. Another important implication of our hypothesis is that PDRAB may be outcompeted by fitter non-PDRAB in the absence of continued antimicrobial pressure. Therefore, limiting unnecessary use of last resort antibiotics can result in reduction of the PDRAB burden. However, the isolation of PDRAB in 2 outpatients, suggests that some PDRAB strains may persist without exposure to last resort antimicrobials.
Multidrug-resistant Klebsiella pneumoniae: challenges for treatment, prevention and infection control
Published in Expert Review of Anti-infective Therapy, 2018
Matteo Bassetti, Elda Righi, Alessia Carnelutti, Elena Graziano, Alessandro Russo
Asymptomatic rectal carriage of MDR-KP is currently considered the main reservoir for ongoing transmission and represents a key point for the implementation of infection control measures [9]. For this reason, European guidelines strongly recommend the adoption of active screening cultures (ASC) programs based on local epidemiology in epidemic settings with MDR-KP outbreaks. Specifically, screening swabs at hospital admission [particularly when risk factors for MDR-KP colonization are present and in high-risk wards, such as oncology-hematology and intensive care unit (ICU)] followed by weekly surveillance swabs in patients at high-risk for MDR-GNB carriage (e.g. patients with prolonged hospitalization, prolonged antibiotic therapy and the ones with indwelling devices, undergoing surgery or admitted to ICU) are recommended. Conversely, in endemic settings ASC should not be considered a basic measure to control the spread of MDR-GNB [10]**. Both in epidemic and in endemic settings, however, the implementation of targeted screening cultures in high-risk patients and active surveillance of patients with epidemiological links to a case of MDR-GNB colonization or infection are suggested [10]. Gagliotti et al. evaluated the effect of implementation of an active screening strategy in a tertiary Italian hospital. A rectal swab was performed at hospital admission in all patients transferred from other hospitals or long-term health facilities, in patients hospitalized in the previous 60 days and in the ones admitted to intensive care and post-acute units. Overall, 1687 patients were screened and 65 (3.9%) tested positive for MDR-KP. Interestingly, 5.1% of case contacts tested positive for MDR-KP, confirming that case contacts screening represents an essential surveillance component for detecting asymptomatic carriers of MDR-KP [11].