Research Digest: UNMC Investigates Blood Stream Infections

Blood stream infections are one of the most feared type of infections in the infectious disease world. And for good reason- if left untreated they can quickly develop into serious complications such as septic shock. Luckily, researchers are constantly exploring the risk factors and treatments for this infection, including many UNMC ID faculty. Read on for a digest of 3 recent articles authored by UNMC faculty exploring the diagnosis and treatment of sepsis.

Sepsis is of particularly high concern for cancer patients, as various cancers as well as their treatments can interfere with the immune system’s ability to fight off infection. Unfortunately, there is a shortage of up-to-date data about the epidemiology of sepsis and antibiotic resistance in this population, making adjusting best practice guidelines difficult. In a new article, our own Dr. Andrea Zimmer and Dr. Erica Stohs led a cross-sectional study assessing these very variables in hundreds of high-risk febrile neutropenic patients with blood stream infections. They found that the current standard of care, cefepime or piperacillin-tazobactam, remains effective in this population and has excellent results. Read on for the details, including resistance rates to many common antibiotics. Study here.

Dr. Cortés-Penfield, co-author of a recent article exploring the use of imaging in sepsis diagnosis.

Treatment of sepsis first relies on an accurate diagnosis. Bettering our ability to do that is the focus of this next article. Staphylococcus aureus bacteremia is a serious type of blood stream infection which requires heightened clinical attention, as this pathogen is capable of infecting visually any tissue in the body. The use of newer imaging modalities to better detect infection is a promising idea, but the implementation remains controversial. This paper presents a metanalysis examining the efficacy of using 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT) to identify this infection. Combining the analysis of 7 studies, Dr. Nicolás Cortés-Penfield co-authored the analysis showing there is promising evidence that this imaging technique could help detect infection and prevent mortality at evidence levels comparable to those currently used as standard practice. Read the study here for the full analysis and conclusions.

Dr. Cawcutt, co-author of an article exploring sepsis in the VV-ECMO population.

Sepsis is also a big concern for the patient population utilizing venous-venous extracorporeal membrane oxygenation (VV-ECMO), including right ventricular assist devices. But, just as in cancer patients, current data surrounding this problem is sparse. This study also aimed to investigate the rate of infection in these patients to better understand the risks involved. The article, co-authored by Dr. Kelly Cawcutt, confirmed that infection rate in this population is moderately low, sitting at 2.7%. The authors suggest that this low rate of infection may be owed to the use of preoperative antimicrobial medication as most cannulations occur in the OR. Read the full details here.

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