Nosocomial infections continue to pose a significant burden on the healthcare system. The most recent summary of data reported to the National Healthcare Safety Network (NHSN) showed that gram-positive organisms remained a leading cause of healthcare–associated infections (HAIs) between 2015…
Gram-negative bacteria are ubiquitous microorganisms of particular concern, especially the gram-negative bacilli (GNB), because of the fast spread of multidrug resistance (MDR). GNBs have intrinsic abilities to find new pathways of resistance and to transmit genetic material that allows other…
Pneumonia causes 79% of all infectious deaths in the United States and is a leading cause of death around the world. Although community-acquired pneumonia (CAP) causes most of these deaths, nosocomial pneumonia, both hospital-acquired pneumonia (HAP) in general and the…
Antimicrobial stewardship is an important concept that is pertinent to virtually every clinician. Its goals are to combat the emergence of resistance, improve clinical outcomes, and decrease healthcare costs ( Fig. 105.1 ). In this chapter, we will focus on…
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Over half of all critically ill patients develop some degree of acute kidney injury (AKI), and nearly 5% require renal replacement therapy (RRT). For those patients with severe AKI requiring RRT, mortality can be as high as 70%, and up…
Iodinated contrast agents, which are administered intravascularly for medical imaging, are widely used pharmaceutical agents: more than 80 million doses were estimated to be administered annually over a decade ago. Although vital for diagnostic and therapeutic purposes, their use can…
A patent urinary tract is necessary for optimal kidney function. Under normal circumstances, urine passes unimpeded from the renal pelvises to the tip of the urethra. Obstruction can occur anywhere along this pathway and may lead to both acute and…
Acute kidney injury (AKI) is recognized as one of the most serious complications in critically ill patients. It is strongly associated with higher short- and long-term mortality, increased resource utilization, and a higher risk for the development of chronic kidney…
The goals of fluid administration are to optimize tissue oxygenation by augmenting intravascular volume, improving left ventricular preload, and increasing cardiac output. This chapter reviews the timing and considerations for choice of therapy in volume repletion and the effects of…