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NU610 Unit 3 Case Studies, Exams of Nursing

NU610 Unit 3 Case StudiesNU610 Unit 3 Case Studies

Typology: Exams

Available from 04/29/2023

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WJEC UNIT 3 CRIMINOLOGY - Relevant case studies research activity

Subject: Sociology

Age range: 16+

Resource type: Lesson (complete)

Last updated

19 October 2021

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A Powerpoint featuring all of the relevant cases to support the content in unit 3. Including activities linked to the following cases

AMANDA KNOX
BARRY GEORGE
COLIN STAGG
SALLY CLARK
ANTHONY HARDY
COLIN PITCHFORK
RONALD COTTON
STEPHEN DOWNING

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PMAL 106 UNIT 7 CASE STUDY 3

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Stenotrophomonas maltophilia : the landscape in critically ill patients and optimising management approaches.

1. Introduction

2. relevant sections, 2.1. commensal vs. pathogenic status of sm: relevant aspects, 2.1.1. why should we consider highlighting the importance of colonisation by sm, 2.1.2. why and when should we consider sm as a real-life pathogen in the icu the importance of vap cases in the critically ill, 2.2. antibiotic resistance traits and microbiological diagnostic challenges: clinical impact on the icu population, 2.2.1. basis of sm antibiotic resistance, 2.2.2. considerations for empirical antimicrobial decision-making, 2.2.3. related microbiological diagnostic challenges, 2.3. best evidence-based approach to sm severe infections. antimicrobial stewardship in the critically ill, 2.4. preventive measures: theoretical basis for clinical formulation of prevention and control strategies to reduce the morbidity and mortality of sm infection in the icu, 3. discussion and future directions, 4. conclusions, author contributions, conflicts of interest.

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Diagnostic Test	Pathogen/ Resistance	Sample Type	Time Required to Detection (Hours)	Detection Limit	Sensitivity (%)	Specificity (%)	Robustness	Reference
Unyvero A50 System HPN (Curetis, Holzgerlingen, Germany)	21 Gram-negative and Gram-positive bacteria/17 antibiotic-resistant markers	Sputum, bronchoalveolar lavage, tracheal and bronchial secretions	<5 h	NR	84	98	NR	Sun et al., 2021 [ ]
Unyvero A50 System BCU (Curetis)	34 Pathogens, 16 antibiotic resistance markers	Positive blood culture	<5 h	NR	96.8	99.8	NR	Burrack-Lange et al., 2018 [ ]
Biofire®Filmarray® BCID2 (bioMeriéux, Craponne, France)	33 Gram-negative, Gram-positive bacteria, Candida spp., and 10 antibiotic-resistant markers	Positive blood culture	1 h	NR	>80 for SM	99.8	NR	Peri et al., 2022 [ ]
Sepsis Flow Chip (VITRO Master Diagnóstica, Granada, Spain)	17 Gram-negative and Gram-positive bacteria, 1 yeast, and 19 antibiotic-resistant markers	Positive blood culture	3 h	NR	100 for SM	100	NR	Galiana et al., 2017 [ ]
hemoFISH (Miacom Diagnostics, Düsseldorf, Germany)	19 Gram-negative and Gram-positive bacteria	Positive blood culture	>5 h	NR	<80–90 for SM	>95	NR	Reitz et al., 2018 [ ]
Magicplex Sepsis Real-Time (Seegene, Seoul, Republic of Korea)	73 Gram-positive, 12 Gram-negative, 6 fungal, and 3 antibiotic-resistant markers	Whole blood	3–6 h	NR	65	92	NR	Carrara et al., 2013 [ ]
MALDI Biotyper System (Bruker, Billerica, MA, USA)	Bacterial and fungal species or species groups	A single colony from isolate positive culture or positive whole blood cultures	minutes	-	73 for SM	99	NR	Gautam et al., 2017 [ ]
LiDia-SEQ NGS (DNA Electronics Ltd., Carlsbad, CA, USA)	Bacterial and fungal pathogens	Whole blood	>4 h	1 CFU/mL	NR	NR	NR	Not found

Scenario	Clinical Evidence
Epidemiology	Recent surveillance data indicate that SM accounts for less than 3% of all strains of healthcare-associated infections, a percentage that doubles in the case of VAP [ , , ]. Crude 28-day mortality is 54.8% [ ], increasing to 90% if hemorrhagic pneumonia is present [ ], and it is further increased with co-infection by Pseudomonas aeruginosa [ ]
Risk factors	Importance of stratification strategy: pre-existing medical conditions (COPD, malignancy); length of ICU stay; invasive procedures and antimicrobial agents, especially CP [ ]. StenoSCORE2 for SM bacteriemia prediction [ ]
Colonisation	Oral SM relative abundance of 36% predicts infection [ ]. Previous SM colonisation was found in 80% of patients with pneumonia and 67% of patients with bacteremia caused by SM [ , ]
Antibiotic resistance	SM is intrinsically resistant to a wide range of commonly used antibiotics [ ]. The resistance surveillance data reflect an increase, especially for cotrimoxazole and tigecycline [ , , ]
Diagnostic challenges	There is no consensus among antimicrobial susceptibility testing guidelines [ , ]. An ICU-ASP for guiding an adjustment of empirical antimicrobial therapy based on rapid microbiological testing seems imperative [ , ]
Empirical therapy	SM predicts initially inappropriate antibiotic therapy [ ]
Directed therapy	Combination therapy is recommended until clinical improvement [ , ]
Prevention measures	SM establishes ambiental ICU reservoirs and is related to patient infection [ , ]. Optimisation of infection control policies deserves special attention [ ]

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Carbonell, N.; Oltra, M.R.; Clari, M.Á. Stenotrophomonas maltophilia : The Landscape in Critically Ill Patients and Optimising Management Approaches. Antibiotics 2024 , 13 , 577. https://doi.org/10.3390/antibiotics13070577

Carbonell N, Oltra MR, Clari MÁ. Stenotrophomonas maltophilia : The Landscape in Critically Ill Patients and Optimising Management Approaches. Antibiotics . 2024; 13(7):577. https://doi.org/10.3390/antibiotics13070577

Carbonell, Nieves, María Rosa Oltra, and María Ángeles Clari. 2024. " Stenotrophomonas maltophilia : The Landscape in Critically Ill Patients and Optimising Management Approaches" Antibiotics 13, no. 7: 577. https://doi.org/10.3390/antibiotics13070577

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