Infection and Sepsis- June 2011

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June 2011 - Issue 1



Infections or Sepsis in elderly patients

This fact sheet provides an overview of recent evidence relevant to Infections and sepsis in elderly patients;  Health  surveillance   models   currently  used  and  Delays   in  treatment   -  antibiotics  and information on how the “Outreach Librarian Service” can support you to keep up-to-date .


Selected Evidence

Electronic Books (available through your Athens account—MD Consult)

Diagnosis of systemic inflammatory response syndrome

Walsh: Palliative Medicine, 1st ed. Chapter 90—Emergencies in Palliative Medicine—Sepsis .

..Liver function tests Helpful in localizing sepsis; consider biliary sepsis, especially in elderly patients with

no obvious localizing signs...cultures Part of the diagnostic workup for sepsis Lumbar puncture and

cerebrospinal fluid examination...


Bope: Conn's Current Therapy 2011, 1st ed.; Section 2 - The Infectious Diseases >> Severe Sepsis and

sceptic shock

remarkable aspect of sepsis, severe sepsis, and septic shock is the relatively...of gram-negative and

candidal sepsis in patients with hematologic malignancies. Although sepsis is most typically a disease of

the elderly, the immune suppressed, and those...


Significance of Screening Bacteriuria

Wein: Campbell-Walsh Urology, 9th ed.; Chapter 8 - Infections of the Urinary Tract >> Bacteriuria in the


...Bacteriuria that leads to UTIs in elderly subjects in the presence of underlying...lead to severe renal

damage. Sepsis and its sequel (sepsis syndrome and septic shock) are increasingly common in the

elderly. This is in part due to the aggressive...



Delirium: Diagnosis, prevention and management

NICE clinical guideline 103 July 2010

Guidelines on Urological Infections (Sepsis)

M. Grabe (Chairman), T.E. Bjerklund-Johansen, H. Botto, M. Çek, K.G. Naber, P. Tenke, F. Wagenlehner

European Association of Urology    2010

Management of patients with Dementia -     A National Clinical Guideline

Scottish Intercollegiate Guidelines Network -      Sign (86) 2011





Abad, CL; Kumar, A and Safdar, N

Antimicrbial therapy of sepsi and septic shock—When are two drugs better than one? (Review article)

Critical Care Clinics April 2011: 27(2) e1-e27

Ahmed NN, Pearce SE (2010)

Acute care for the elderly: a literature review.

Population Health Management 2010 Aug; 13(4):219-25.


Alejandra, MM; Lansang, MAD; Dans, LF and Mantaring III JB

Intravenous immunoglobulin for treating sepsis, severe sepsis and septic shock

(Intervention Review)

The Cochrane Library Review 2010: Issue 2


Angus, DC

The lingering consequences of sepsis: A hidden public health disaster?

Journal of the American Medical Association (JAMA) June 2011: 305(21) 2145-2244


Casserly, B; Read, R and Levy MM

Hemodynamic monitoring in sepsis

Critical Care Nursing Clinics of North America March 2011: 23(1) 149-169


Caterino, JM; Jalbuena, T and Bogucki, B

Predictors of acute decomposition after admission in ED patients with sepsis

American Journal of Emergency Medicine June 2010: 28(5) 631-636


Coen, D; Vaccaro, A; Cazzaniga, M; Cortellaro, F; Monti, G and Tombini, V

Toward a noninvasive approach to early goal-directed therapy

Chest March 2011: 139(3) 726-7


Crowe, CA; Mistry, CD; Rzechula, K and Kulstad, CE

Evaluation of a modified early goal-directed therapy protocol

American Journal of Emergency Medicine July 2010: 28(6) 689-693


Daniels, R; Nutbeam, T; McNamara, G and Galvin, C

The sepsis six and the severe sepsis resuscitation bundle: A prospective observational cohort study

Emergency Medicine Journal June 2011: 28: 507-512


Francis, M; Rich, T; Williamson, T and Peterson, D

Effect of an emergency department sepsis protocol on time to antibiotics in severe sepsis

Canadian Journal of Emergency Medical Care (CEJM) July 2010: 12(4) 303-310


Gaieski, DF; Mikkelsen, ME; Band, RA; Pines, JM; Massone, R and Furia, FF

Impact of time to antibiotics on survival of patients with severe sepsis or septic shock in whom

goal-directed therapy was initiated in the emergency department

Critical Care Medicine April 2010: 38(4) 1045-1053


Gomes Silva, BN; Andriolo, RB; Atallah, AN and Salomao, R

De-escalation of antimicrobial treatment for adults with sepsis, severe sepsis or septic shock

(Intervention Review)

The Cochrane Library Review 2010: Issue 2


Goyal, M; Pines, JM; Byron, C; Drumheller, DF and Gaeski, DF

Point-of-care testing at triage decreases time to lactate level in septic patients

Journal of Emergency Medicine June 2010: 38(5) 578-581

Kouroumichakis, I; Papanas, N; Proikaki, S; Zarogoulidis, P and Maltezos, E

Statins in prevention and treatment of severe sepsis and septic shock

European Journal of Internal Medicine April 2011: 22(2) 125-133


Kumar, A; Safdar, N; Kethireddy, S and Chateau, D

A survival benefit of combination antibiotic therapy for serious infections associated with sepsis and

septic shock is contingent only on risk of death: A meta-analytic/meta-regression study

Critical Care Medicine 2010: 38(8) 1651-1664


Marti-Carvajal, AJ; Sola, I; Lathyris, D and Cardona, AF

Human recombinant activated protein C for severe sepsis

Intervention Review)

The Cochrane Library Review 2010: Issue 4


Meurer, WJ; Losman, ED; Smith, BL; Malani, PN and Younger, JG

Short-term functional decline of older adults admitted for suspected sepsis

The American Journal of Emergency Medicine 2010: (E Pub ahead of print)


Mikkelsen, ME; Gaieski, DF; Goyal, M; Miltiades, AN; Munson, JC; Pines, JM and Fuchs, BD

Factors associated with nonadherence to early goal-directed therapy in the ED

Chest September 2010: 138(3) 551-558


Nee, PA and Rivers, EP

The end of the line for the surviving sepsis campaign, but not for early goal-directed therapy

Emergency Medicine Journal January 2011: 28(3-4) 1472-0213


Nelson, JL; Smith, BL; Jared, JD and Younger, JG

Prospective trial of real-time electronic surveillance to expedite early care of severe sepsis

Annals of Emergency Medicine May 2011: 57(5) 500-504


Powell, ES; Khare, RK; Courtney, DM and Feinglass, J

Volume of emergency department admissions for sepsis is related to inpatient mortality: Results of a

nationwide cross-sectional analysis

Critical Care Medicine November 2010: 38(11) 2161-2168


Schorr, C

Performance improvement in the management of sepsis (Review article)

Critical Care Nursing Clinics of North America March 2011: 23(1) 203-213


Shorr, AF; Micek, ST; Welch, EC; Doherty, JA; Reichley, RM, Kollef, MH

Inappropriate antibiotic therapy in Gram-negative sepsis increases hospital length of stay

Critical Care Medicine January 2011: 39(1) 46-51


Seymour, CW; Cooke, CR; Mikklesen, ME; Hylton, J; Rea, TD; Goss, CH; Gaeski, DF and Band, RA

Out-of-hospital fluid in severe sepsis: Effect on early resuscitation in the emergency department

Prehospital Emergency Care April 2010: 14(2) 145-152


Siddiqui, S and Razzack, J

Early versus late pre-intensive care unit admission broad spectrum antibiotics for severe sepsis in

adults (Intervention Review)

The Cochrane Library Review 2010: Issue 10

Sweet, DD; Jaswal, D; Bouchard, M; Sivapalan, P; Rachel, J and Chittock, D

Effect of an emergency department sepsis protocol on the care of septic patients admitted to the

Intensive care unit

Canadian Journal of Emergency Medical Care (CJEM) September 2010: 12(5) 414-420

Tiruvoipati, R; Ong, K; Gangopadhyay, H; Arora, S and Botha, J

Hypothermia predicts mortality in critically ill elderly patients with sepsis

BMC Geriatrics 2010: 10(70) 1471-2318


Wang, HE; Weaver, MD; Shapiro, NI and Yealy, DM

Opportunities for emergency medical services care of sepsis

Resuscitation February 2010: 81(2) 193-197


Yang, Y; Yang, KS; Hsann, YM; Lim, V and Ong, BC

The effect of comorbidity and age on hospital mortality and length of stay in patients with sepsis

Journal of Critical Care September 2010: 25(3) 398-405


Zubert, S; Funk, DJ and Kumar, A

Antibiotics in sepsis and septic shock: Like everything else in life, timing is everything

Critical Care Medicine April 2010:38(4) 1211-1212




How can I help you?


Literature search service

I can offer an expert, in-depth literature search service to help you locate the evidence on any health

related topic.



If you want to learn to navigate the wealth of available online healthcare information and how to search

databases more effectively, the ‘Trust trainer’ can offer timetabled hands-on training sessions or can

provide customised one-to-one support. Telephone: 0121 424 0583 or email:

[email protected]


Current awareness services

If you need to keep up-to-date on a particular topic I can advise on suitable RSS feeds and help you set

up article alerts from the major healthcare databases.


Online resources

Whilst many good quality resources are freely available, most full-text journals and the main biblio-

graphic databases (e.g. Medline and CINAHL) require an Athens username and password. To register

for an Athens login go to


The Library web pages contain detailed information about library services and training opportunities,

online request and registration forms and several guides on key online resources and evidence-based

websites at



The Outreach Librarian is located in the education centre at Heartlands Hospital, on the first floor, next

to the Library.

Telephone 0121 424 2583 (42583) or email: [email protected]