K B Laupland

..We sought to describe the epidemiological profile of S. aureus bacteremia and to assess whether the incidence and severity of and the antimicrobial resistance rates associated with this bacteremia are increasing...

..The objective of this study was to assess effect of timing of admission to and discharge from ICUs and subsequent risk for death...

..We sought to determine the occurrence and relation of hyperlactatemia with ICU mortality in all patients admitted to four ICUs in a large regional critical care system...

..The objective of this study was to investigate whether kinetic bed therapy reduces the incidence of nosocomial pneumonia and improves outcomes in critically ill mechanically ventilated patients...

..Severe acute renal failure (sARF) is associated with considerable morbidity, mortality and use of healthcare resources; however, its precise epidemiology and long-term outcomes have not been well described in a non-specified population...

..To compare the discriminative ability of the SOFA and MOD scoring systems with respect to hospital mortality and unfavorable neurologic outcome in patients with severe traumatic brain injury admitted to intensive care...

..We describe a case of DDS-induced cerebral edema that resulted in irreversible brain injury and death following acute HD and review the relevant literature of the association of DDS and HD...

..The objective of this study was to develop a health-related quality of life questionnaire (HRQL) for patients with extremity soft tissue infections (ESTI) for future use in clinical trials...

..Metastatic malignant melanoma to the liver resulting in fulminant hepatic failure is a rare occurrence...

..The objective of this study was to describe the occurrence of fever in the critically ill and assess its effect on ICU outcome...

..coli bacteraemia and identifies groups at increased risk for acquiring and dying from these infections. The emergence of ciprofloxacin resistance and its adverse effect on patient outcome is a major concern...

..Differences in the seasonal occurrence and focus of infection occurred between the different groups...

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..There are a number of potential biases that should be considered in the methodological design and interpretation of antimicrobial-resistant organism surveillance...

..The occurrence, demographical risk-factors and microbiology of Proteeae isolates varied according to the individual species...

..They usually arise as complications of otogenic, oropharyngeal, or paranasal sinus infections, and management involves an aggressive combined medical-surgical approach...

..Clinical trials specifically comparing fever management strategies in neurologically intact critically ill medical patients are needed...

..Although trauma is associated with major acute morbidity and mortality, its long-term outcome is less well defined. We sought to define the rate of readmission to hospital and long-term mortality of victims of major trauma...

..The objective of this study was to describe the occurrence and factors predictive of prolonged ICU stay at admission, and to define the long-term (>/= 1 year) mortality outcome...

..These data support expenditures on infection prevention and control programmes and further research into reducing the impact of these infections...

..Our objective was to evaluate the potential magnitude of bias in reporting of etiologic agents and their resistance rates associated with inclusion of multiple patient samples and non-random timing and location of sampling...

..Four hundred and sixty patients died in hospital for a case-fatality rate of 13%. Community-onset BSI is common and has a major patient and societal impact. These data support further efforts to reduce the burden of community-onset BSI...

..The aim of the study is to determine the incidence, demographic risk factors, and outcomes of critical illness among all adult status Aboriginal Canadians (SACs) admitted to intensive care units (ICUs)...

..We therefore conducted population-based laboratory surveillance in order to define the incidence, demographic risk factors, etiology, and antimicrobial susceptibilities of community onset UTI in a large Canadian region...

..Serratia species isolation is most commonly of community onset and older patients and males are at increased risk. Despite reports of increasing resistance among Serratia species, the incidence in our region remains at a low stable rate...

..Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli have emerged as significant causes of community-onset disease. We sought to identify risk factors for acquiring community-onset ESBL-producing E. coli...

..Hospital-based series have characterized Hafnia alvei primarily as an infrequent agent of polymicrobial nosocomial infections in males with underlying illness...

..We report a previously healthy adult patient who had acute bacteraemic S. pyogenes mastoiditis complicated by intra-cranial air. This novel report adds pneumocephaly to the currently recognized list of complications of acute mastoiditis...

..The objective of this study was to define the occurrence of, risk factors for, and antifungal susceptibilities of invasive Candida species infections in a large Canadian health region...

..To survey the opinions of Canadian critical care medicine and infectious disease specialists about the use of intravenous immunoglobulin (IVIG) for the treatment of severe infections...

..0001) Development of an ICU-acquired BSI was an independent risk factor for death (OR 1.79; 95% CI 1.3-2.5) and increases the risk of dying from critical illness...

..The objective of this study was to evaluate the potential effects of inclusion of nonresidents in population-based studies in intensive care...

..However, population-based data are limited. The objective of this study was to define the occurrence of S. enterica bacteremia in a large international population and to evaluate temporal and regional differences...

..Haemophilus influenzae is an important cause of invasive infection but contemporary data in non-selected populations is limited...

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..The objective of this study was to define the early (≤28 days) and late (>28 days) mortality and assess determinants of late death following community-onset bloodstream infection...

..The objectives of this study were to describe the occurrence, microbiology, and risk factors for acquiring UTIs in the ICU and to determine whether these infections independently increase mortality...

..Although mupirocin is effective at reducing nasal carriage, routine use of topical intranasal mupirocin for infection prophylaxis is not supported by the currently available evidence...

..Clinical and outcome information was obtained from regional databases. Weekends were defined as anytime Saturday or Sunday, evenings as 18:00-22:59, and nights as 23:00-07:59...

..CONCLUSION: Future studies from this collaborative should lead to a better understanding of the epidemiology of bloodstream infections...

..However, the low yield may limit their usefulness, particularly in low-risk populations. This study was conducted to assess the utility of blood cultures drawn from ambulatory outpatients...

..99, 95% confidence interval 0.83-1.16; p = 0.88). Admission with community-onset bloodstream infection during the after hours is not associated with adverse outcome in this region...

..We sought to evaluate clinical equipoise by surveying Canadian surgeons regarding the use of temporary abdominal closure strategies in damage control and emergency situations...

..To define the incidence, risk factors for acquisition, and outcomes associated with clostridial bacteremia in a large Canadian health region...

..CONCLUSION: Knowledge of the epidemiology of these syndromes is important for assessing the burden of disease and providing background information for investigating new therapies...

..We sought to describe the incidence rate, risk factors, and outcomes associated with P. aeruginosa bacteremia in a large Canadian health region...

..Identification of risk factors for severe bloodstream infection may allow targeting of preventive efforts to individuals at greatest potential benefit...

..45). Further prospective studies are warranted to determine the optimal treatment of MBL-producing P. aeruginosa infections...

..The purpose was to (1) determine whether perceived OPTXs were truly occult or simply missed and (2) address factors that contribute to the poor sensitivity of the supine CXR...

..Our data provide justification to support efforts to reduce the adverse impact of BSI in trauma victims...

..In this large Canadian region, AmpC beta-lactamase-producing E. coli is an emerging community pathogen that commonly causes urinary tract infections in older women...

..In our region, multiple antibiotic-resistant organisms are uncommon causes of bloodstream infections, suggesting that it may be safe to use narrower spectrum empirical treatment regimens than current guidelines recommend...

..2; 95% confidence interval, 3.69-54.84). Strains of E. coli with blaCTX-M genes commonly cause community-onset infections, and women and older patients are at highest risk...

..The in-hospital case-fatality rate was 13%. Community-onset BSI is associated with a major burden of illness. These data support ongoing and future preventative and research efforts aimed at reducing the major impact of these infections...

..CONCLUSIONS: Nosocomial UTIs develop commonly in the critically ill and women and those with an extended ICU stay are at increased risk. Although ICU-acquired UTIs are markers of morbidity, they do not significantly increase mortality...

..We sought to assess the adequacy of empirical therapy and its effect on mortality in invasive Candida species infections...

..This study provides important data on the burden of ISA disease and identifies risk groups that may potentially benefit from preventive efforts...

..Males and the elderly are at the highest risk for acquiring sTBI and may represent target groups for preventive efforts...

..Systematic population-based data to guide clinicians with respect to this risk are, however, lacking...

..Further studies are warranted to investigate whether community-onset diseases caused by ESBL-producing E. coli are related to a point source or transmission within the community...

..However, their epidemiology has not been well defined in non-selected populations. We sought to describe the incidence of, risk factors for, and outcomes associated with anaerobic bacteremia...

..There is limited information about renal recovery to independence from renal replacement therapy (RRT) and about factors associated with its occurrence after severe acute renal failure (ARF)...

..CONCLUSION: OSB is more common than reported and can be treated successfully in ambulatory settings with sequential intravenous therapy followed by oral therapy and drainage in selected cases...

..Basic markers available early in resuscitation are highly predictive for OPTXs and may guide management before CT scanning. Further study of OPTX detection and management is required...

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..A combined negative rapid test consisting of Gram's stain/bacterial ATP assay rules out significant bacteria in BAL samples with a high degree of certainty. Future studies are needed to clinically validate these observations...

..CONCLUSIONS: Non-neurologic organ dysfunction is common in patients with severe traumatic brain injury and is independently associated with worse outcome...

..To systematically review the literature to assess whether adjunctive therapy with polyclonal intravenous immunoglobulin (ivIg) reduces mortality among critically ill adults with severe sepsis and septic shock...

..Few population-based studies have evaluated pyogenic liver abscess (PLA) in North America. We assessed the incidence of PLA and evaluated predictors of mortality...

..To survey surgeon opinion regarding the management of the open abdomen (OA) and abdominal compartment syndrome (ACS) to assess current practice and direct future prospective clinical studies...

..Although hand-held US equipment is now commercially available and may expand the availability and speed of US in assessing the trauma patient, it has not been subjected to controlled evaluation in early trauma care...

..An additional goal was to define the relationship of ventilator-associated pneumonia (VAP) with nonneurological organ dysfunction...

..It is hoped that ongoing work in this area will be useful in the development of effective injury prevention and health resource allocation strategies...

..Patient care may be inconsistent during off hours. We sought to determine whether adults admitted to or discharged from intensive care units (ICUs) on evenings and weekends have increased mortality rates...

..coli. We recommend that laboratories using Vitek should employ alternative susceptibility testing methods for TZP before reporting the activity of this agent against ESBL-producing E. coli...

..This study describes the relationship between TTP and clinical outcome in all patients with Staphylococcus aureus bacteremia (SAB) in a large Canadian health region...

..An evaluation of hand-held ultrasonography (US) in the assessment of penetrating torso trauma has not yet been reported...

..Population-based laboratory surveillance was subsequently conducted that identified an annual incidence of invasive C. perfringens disease of 0.83 per 100,000 population with a striking age-related increased risk for acquisition...

..This study illustrates the importance of molecular surveillance in tracking CTX-M-producing E. coli strains in the community and investigating their influx into hospitals...

..coli isolates; and this is the first study to identify CTX-M-14 in E. coli clone ST131...

..However, the diagnostic utility of hand-held US has not been previously evaluated in this role...

..There is a relative paucity of research on nosocomial urinary tract infection specifically acquired in the intensive care unit and further studies are needed to better define the epidemiology and management of these infections...

..aeruginosa strains were associated with a higher case-fatality rate and invasive disease. Our study highlights the potential importance of molecular laboratory techniques in infection control and patient care...

..Thus, more rapid diagnostic testing of ESBL-producing bacteria and the possible modification of guidelines for community-onset bacteraemia associated with UTIs are required...

..Our study suggested that clone ST131 coproducing CTX-M-15, OXA-1, TEM-1, and AAC(6')-Ib-cr and clonally unrelated CTX-M-14 producers have emerged as important causes of community-acquired, travel-related infections...

..To determine the rate of Staphylococcus aureus nasal colonization at admission to intensive care units (ICU) and assess its effect on the development of an ICU-acquired S aureus infection...

..We sought to describe the incidence of, risk factors for, and outcomes associated with K. pneumoniae bacteremia...

..Electronic surveillance has moderate to excellent utility compared with conventional methods for nosocomial infections. Future studies are needed to refine electronic algorithms further, especially with community-onset infections...

..Studies evaluating administrative database ascertainment of co-morbidities specifically in infectious diseases research are needed...

..CONCLUSIONS: CXR missed over half of all PTXs. OPTXs had a greater anterior versus lateral (nearly 4-fold) and both basal and apical versus lateral (2-fold) distribution. OPTXs are often located at easily accessible sonographic windows...

..Despite greater societal attention, medical admission after MVC results in avoidance of legal consequences. We sought to determine characteristics of, and consequences to, injured alcohol-impaired drivers (IAIDs)...

..This study reports a fatal case of bacteremic P. multocida empyema without pneumonia associated with refractory septic shock in a patient with both cirrhosis and asplenia...

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..4 per 1 million people annually. CONCLUSION: This population-based study demonstrates that severe electrocution is rare but is associated with death in the majority of cases in this large Canadian region...

..We evaluated a new technique for continuous monitoring of intra-abdominal pressure (CIAP) using a standard three-way bladder catheter in a diverse group of intensive care unit patients...

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..22 per 100,000 population. CONCLUSIONS: This study provides important data on the burden of PLA and identifies risk groups that might potentially benefit from preventive efforts...

..Kidney dysfunction in the intensive care unit (ICU) results in increased morbidity, mortality, and health care costs; however, long-term mortality has not been described across strata of severity in kidney dysfunction...

..This article highlights the need for randomized clinical trials and economic evaluations of therapies in critical care medicine for which the effect of the therapy on health outcomes and/or costs are unknown...