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Article: Vulvar pseudotumoral acyclovir-resistant herpes in an HIV-negative, non-immunosuppressed patient: A therapeutic challenge.

Hu, Jun / Krauss, John C / Moyal-Barracco, Micheline / Washer, Laraine L / Haefner, Hope K / Parker-Featherstone, Ebony

International journal of women's dermatology

2021 Volume 7, Issue 5Part B, Page(s) 731–736

Abstract: Background: Vulvar pseudotumoral herpes infections have been reported in HIV-positive patients. A 32-year-old HIV-negative woman presented with a 6-month history of a vulvar pseudotumor that had been unresponsive to oral acyclovir and valacyclovir, as ... ...

Abstract	Background: Vulvar pseudotumoral herpes infections have been reported in HIV-positive patients. A 32-year-old HIV-negative woman presented with a 6-month history of a vulvar pseudotumor that had been unresponsive to oral acyclovir and valacyclovir, as well as topical imiquimod. Objective: This study aimed to evaluate the therapeutic efficacy of a multidrug regimen for vulvar pseudotumor herpes infection in an HIV-negative patient. Methods: Histology revealed multinucleated giant cells, consistent with a herpes infection. The patient's herpes simplex virus type 2 was resistant to acyclovir. Immunomodulatory agents (thalidomide and topical imiquimod) were started. Results: The lesion enlarged after 6 weeks of treatment. Topical cidofovir 1% gel was added. There was gradual decrease in the pseudotumor size. After 7 months, the Pseudotumor had resolved. Conclusion: This is the first reported case of vulvar pseudotumoral herpes in an immunocompetent, HIV-negative patient. Oral thalidomide, in association with topical imiquimod and topical cidofovir, was effective in treating acyclovir-resistant pseudotumoral herpes of the vulva.
Language	English
Publishing date	2021-06-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2832233-2
ISSN	2352-6475
ISSN	2352-6475
DOI	10.1016/j.ijwd.2021.06.002
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Article: Detection of a Human Adenovirus Outbreak, Including Some Critical Infections, Using Multipathogen Testing at a Large University, September 2022-January 2023.

Montgomery, JoLynn P / Marquez, Juan Luis / Nord, Jennifer / Stamper, Aleksandra R / Edwards, Elizabeth A / Valentini, Nicholas / Frank, Christopher J / Washer, Laraine L / Ernst, Robert D / Park, Ji In / Price, Deanna / Collins, Jim / Smith-Jeffcoat, Sarah E / Hu, Fang / Knox, Christine L / Khan, Rebia / Lu, Xiaoyan / Kirking, Hannah L / Hsu, Christopher H

Open forum infectious diseases

2024 Volume 11, Issue 5, Page(s) ofae192

Abstract: Background: Human adenoviruses (HAdVs) can cause outbreaks of flu-like illness in university settings. Most infections in healthy young adults are mild; severe illnesses rarely occur. In Fall 2022, an adenovirus outbreak was identified in university ... ...

Abstract	Background: Human adenoviruses (HAdVs) can cause outbreaks of flu-like illness in university settings. Most infections in healthy young adults are mild; severe illnesses rarely occur. In Fall 2022, an adenovirus outbreak was identified in university students. Methods: HAdV cases were defined as university students 17-26 years old who presented to the University Health Service or nearby emergency department with flu-like symptoms (eg, fever, cough, headache, myalgia, nausea) and had confirmed adenovirus infections by polymerase chain reaction (PCR). Demographic and clinical characteristics were abstracted from electronic medical records; clinical severity was categorized as mild, moderate, severe, or critical. We performed contact investigations among critical cases. A subset of specimens was sequenced to confirm the HAdV type. Results: From 28 September 2022 to 30 January 2023, 90 PCR-confirmed cases were identified (51% female; mean age, 19.6 years). Most cases (88.9%) had mild illness. Seven cases required hospitalization, including 2 critical cases that required intensive care. Contact investigation identified 44 close contacts; 6 (14%) were confirmed HAdV cases and 8 (18%) reported symptoms but never sought care. All typed HAdV-positive specimens (n = 36) were type 4. Conclusions: While most students with confirmed HAdV had mild illness, 7 otherwise healthy students had severe or critical illness. Between the relatively high number of hospitalizations and proportion of close contacts with symptoms who did not seek care, the true number of HAdV cases was likely higher. Our findings illustrate the need to consider a wide range of pathogens, even when other viruses are known to be circulating.
Language	English
Publishing date	2024-04-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofae192
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Article ; Online: Breast implant infections.

Washer, Laraine L / Gutowski, Karol

Infectious disease clinics of North America

2012 Volume 26, Issue 1, Page(s) 111–125

Abstract: Infection after breast implant surgery occurs in 1.1% to 2.5% of procedures performed for augmentation and up to 35% of procedures performed for reconstruction after mastectomy. Most infections result from skin organisms and occur in the immediate ... ...

Abstract	Infection after breast implant surgery occurs in 1.1% to 2.5% of procedures performed for augmentation and up to 35% of procedures performed for reconstruction after mastectomy. Most infections result from skin organisms and occur in the immediate postoperative period, although infections can occasionally present after many years. Diagnosis of breast implant infection relies on the clinical presentation of breast pain, swelling, erythema, and drainage in conjunction with ultrasound-guided cultures of periprosthetic fluid. Management commonly involves implant removal, with device salvage attempted in select situations.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Breast Implantation/adverse effects ; Breast Implantation/methods ; Breast Implants/adverse effects ; Device Removal ; Female ; Humans ; Prosthesis-Related Infections/diagnosis ; Prosthesis-Related Infections/etiology ; Prosthesis-Related Infections/therapy ; Risk Factors
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2012-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1077676-x
ISSN	1557-9824 ; 0891-5520
ISSN (online)	1557-9824
ISSN	0891-5520
DOI	10.1016/j.idc.2011.09.003
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Article ; Online: Genomic Investigation of a Putative Endoscope-Associated Carbapenem-Resistant Enterobacter cloacae Outbreak Reveals a Wide Diversity of Circulating Strains and Resistance Mutations.

Hawken, Shawn E / Washer, Laraine L / Williams, Christopher L / Newton, Duane W / Snitkin, Evan S

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2017 Volume 66, Issue 3, Page(s) 460–463

Abstract: A genomic epidemiologic investigation of a putative carbapenem-resistant Enterobacter cloacae outbreak revealed few plausible instances of nosocomial transmission, highlighting instead the frequent importation of E. cloacae into our hospital. Searching ... ...

Abstract	A genomic epidemiologic investigation of a putative carbapenem-resistant Enterobacter cloacae outbreak revealed few plausible instances of nosocomial transmission, highlighting instead the frequent importation of E. cloacae into our hospital. Searching for genetic determinants of carbapenem resistance demonstrated that most resistance is due to convergent mutations in phylogenetically diverse E. cloacae.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/genetics ; Bacterial Typing Techniques ; Carbapenem-Resistant Enterobacteriaceae/drug effects ; Carbapenem-Resistant Enterobacteriaceae/genetics ; Carbapenems/pharmacology ; Cross Infection/etiology ; Cross Infection/microbiology ; Disease Outbreaks ; Drug Resistance, Bacterial/genetics ; Endoscopy/adverse effects ; Enterobacter cloacae/drug effects ; Enterobacter cloacae/genetics ; Enterobacteriaceae Infections/etiology ; Enterobacteriaceae Infections/transmission ; Equipment Contamination ; Genetic Variation ; Genomics ; Humans ; Microbial Sensitivity Tests ; Multilocus Sequence Typing ; Mutation ; beta-Lactamases/biosynthesis ; beta-Lactamases/genetics
Chemical Substances	Anti-Bacterial Agents ; Bacterial Proteins ; Carbapenems ; beta-Lactamases (EC 3.5.2.6)
Language	English
Publishing date	2017-11-14
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/cix934
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Article ; Online: A Model to Predict Central-Line-Associated Bloodstream Infection Among Patients With Peripherally Inserted Central Catheters: The MPC Score.

Herc, Erica / Patel, Payal / Washer, Laraine L / Conlon, Anna / Flanders, Scott A / Chopra, Vineet

Infection control and hospital epidemiology

2017 Volume 38, Issue 10, Page(s) 1155–1166

Abstract: BACKGROUND Peripherally inserted central catheters (PICCs) are associated with central-line-associated bloodstream infections (CLABSIs). However, no tools to predict risk of PICC-CLABSI have been developed. OBJECTIVE To operationalize or prioritize ... ...

Abstract	BACKGROUND Peripherally inserted central catheters (PICCs) are associated with central-line-associated bloodstream infections (CLABSIs). However, no tools to predict risk of PICC-CLABSI have been developed. OBJECTIVE To operationalize or prioritize CLABSI risk factors when making decisions regarding the use of PICCs using a risk model to estimate an individual's risk of PICC-CLABSI prior to device placement. METHODS Using data from the Michigan Hospital Medicine Safety consortium, patients that experienced PICC-CLABSI between January 2013 and October 2016 were identified. A Cox proportional hazards model with robust sandwich standard error estimates was then used to identify factors associated with PICC-CLABSI. Based on regression coefficients, points were assigned to each predictor and summed for each patient to create the Michigan PICC-CLABSI (MPC) score. The predictive performance of the score was assessed using time-dependent area-under-the-curve (AUC) values. RESULTS Of 23,088 patients that received PICCs during the study period, 249 patients (1.1%) developed a CLABSI. Significant risk factors associated with PICC-CLABSI included hematological cancer (3 points), CLABSI within 3 months of PICC insertion (2 points), multilumen PICC (2 points), solid cancers with ongoing chemotherapy (2 points), receipt of total parenteral nutrition (TPN) through the PICC (1 point), and presence of another central venous catheter (CVC) at the time of PICC placement (1 point). The MPC score was significantly associated with risk of CLABSI (P<.0001). For every point increase, the hazard ratio of CLABSI increased by 1.63 (95% confidence interval, 1.56-1.71). The area under the receiver-operating-characteristics curve was 0.67 to 0.77 for PICC dwell times of 6 to 40 days, which indicates good model calibration. CONCLUSION The MPC score offers a novel way to inform decisions regarding PICC use, surveillance of high-risk cohorts, and utility of blood cultures when PICC-CLABSI is suspected. Future studies validating the score are necessary. Infect Control Hosp Epidemiol 2017;38:1155-1166.
MeSH term(s)	Aged ; Bacteremia/epidemiology ; Catheter-Related Infections/epidemiology ; Catheter-Related Infections/microbiology ; Catheterization, Central Venous/adverse effects ; Catheterization, Peripheral/adverse effects ; Central Venous Catheters/microbiology ; Comorbidity ; Databases, Factual ; Decision Making ; Female ; Humans ; Male ; Michigan/epidemiology ; Middle Aged ; Proportional Hazards Models ; Risk Assessment/methods ; Risk Factors
Language	English
Publishing date	2017-08-15
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2017.167
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Article ; Online: COVID-19 Transmission to Health Care Personnel During Tracheostomy Under a Multidisciplinary Safety Protocol.

Standiford, Taylor C / Farlow, Janice L / Brenner, Michael J / Blank, Ross / Rajajee, Venkatakrishna / Baldwin, Noel R / Chinn, Steven B / Cusac, Jessica A / De Cardenas, Jose / Malloy, Kelly M / McDonough, Kelli L / Napolitano, Lena M / Sjoding, Michael W / Stoneman, Emily K / Washer, Laraine L / Park, Pauline K

American journal of critical care : an official publication, American Association of Critical-Care Nurses

2022 Volume 31, Issue 6, Page(s) 452–460

Abstract: Background: Tracheostomies are highly aerosolizing procedures yet are often indicated in patients with COVID-19 who require prolonged intubation. Robust investigations of the safety of tracheostomy protocols and provider adherence and evaluations are ... ...

Abstract	Background: Tracheostomies are highly aerosolizing procedures yet are often indicated in patients with COVID-19 who require prolonged intubation. Robust investigations of the safety of tracheostomy protocols and provider adherence and evaluations are limited. Objectives: To determine the rate of COVID-19 infection of health care personnel involved in COVID-19 tracheostomies under a multidisciplinary safety protocol and to investigate health care personnel's attitudes and suggested areas for improvement concerning the protocol. Methods: All health care personnel involved in tracheostomies in COVID-19-positive patients from April 9 through July 11, 2020, were sent a 22-item electronic survey. Results: Among 107 health care personnel (80.5%) who responded to the survey, 5 reported a positive COVID-19 test result (n = 2) or symptoms of COVID-19 (n = 3) within 21 days of the tracheostomy. Respondents reported 100% adherence to use of adequate personal protective equipment. Most (91%) were familiar with the tracheostomy protocol and felt safe (92%) while performing tracheostomy. Suggested improvements included creating dedicated tracheostomy teams and increasing provider choices surrounding personal protective equipment. Conclusions: Multidisciplinary engagement in the development and implementation of a COVID-19 tracheostomy protocol is associated with acceptable safety for all members of the care team.
MeSH term(s)	Humans ; COVID-19 ; Tracheostomy/adverse effects ; SARS-CoV-2 ; Personal Protective Equipment ; Delivery of Health Care
Language	English
Publishing date	2022-08-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	1130987-8
ISSN	1937-710X ; 1062-3264
ISSN (online)	1937-710X
ISSN	1062-3264
DOI	10.4037/ajcc2022538
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Article ; Online: Multidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms?

Mody, Lona / Washer, Laraine L / Kaye, Keith S / Gibson, Kristen / Saint, Sanjay / Reyes, Katherine / Cassone, Marco / Mantey, Julia / Cao, Jie / Altamimi, Sarah / Perri, Mary / Sax, Hugo / Chopra, Vineet / Zervos, Marcus

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2019 Volume 69, Issue 11, Page(s) 1837–1844

Abstract: Background: The impact of healthcare personnel hand contamination in multidrug-resistant organism (MDRO) transmission is important and well studied; however, the role of patient hand contamination needs to be characterized further.: Methods: Patients ...

Abstract	Background: The impact of healthcare personnel hand contamination in multidrug-resistant organism (MDRO) transmission is important and well studied; however, the role of patient hand contamination needs to be characterized further. Methods: Patients from 2 hospitals in southeast Michigan were recruited within 24 hours of arrival to their room and followed prospectively using microbial surveillance of nares, dominant hand, and 6 high-touch environmental surfaces. Sampling was performed on admission, days 3 and 7, and weekly until discharge. Paired samples of methicillin-resistant Staphylococcus aureus (MRSA) isolated from the patients' hand and room surfaces were evaluated for relatedness using pulsed-field gel electrophoresis and staphylococcal cassette chromosome mec, and Panton-Valentine leukocidin typing. Results: A total of 399 patients (mean age, 60.8 years; 49% male) were enrolled and followed for 710 visits. Fourteen percent (n = 56/399) of patients were colonized with an MDRO at baseline; 10% (40/399) had an MDRO on their hands. Twenty-nine percent of rooms harbored an MDRO. Six percent (14/225 patients with at least 2 visits) newly acquired an MDRO on their hands during their stay. New MDRO acquisition in patients occurred at a rate of 24.6/1000 patient-days, and in rooms at a rate of 58.6/1000 patient-days. Typing demonstrated a high correlation between MRSA on patient hands and room surfaces. Conclusions: Our data suggest that patient hand contamination with MDROs is common and correlates with contamination on high-touch room surfaces. Patient hand hygiene protocols should be considered to reduce transmission of pathogens and healthcare-associated infections.
MeSH term(s)	Adult ; Aged ; Bacteria/isolation & purification ; Bacterial Infections/microbiology ; Bacterial Infections/prevention & control ; Bacterial Infections/transmission ; Cross Infection/microbiology ; Cross Infection/prevention & control ; Cross Infection/transmission ; Drug Resistance, Multiple, Bacterial ; Equipment and Supplies, Hospital/microbiology ; Female ; Hand/microbiology ; Hospitals ; Humans ; Male ; Middle Aged ; Prospective Studies
Language	English
Publishing date	2019-06-20
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciz092
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Article ; Online: Impact of antimicrobial stewardship intervention on coagulase-negative Staphylococcus blood cultures in conjunction with rapid diagnostic testing.

Nagel, Jerod L / Huang, Angela M / Kunapuli, Anjly / Gandhi, Tejal N / Washer, Laraine L / Lassiter, Jessica / Patel, Twisha / Newton, Duane W

Journal of clinical microbiology

2014 Volume 52, Issue 8, Page(s) 2849–2854

Abstract: Rapid diagnostic testing with matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) decreases the time to organism identification by 24 to 36 h compared to the amount of time required by conventional methods. However, there are limited ... ...

Abstract	Rapid diagnostic testing with matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) decreases the time to organism identification by 24 to 36 h compared to the amount of time required by conventional methods. However, there are limited data evaluating the impact of MALDI-TOF with real-time antimicrobial stewardship team (AST) review and intervention on antimicrobial prescribing and outcomes for patients with bacteremia and blood cultures contaminated with coagulase-negative Staphylococcus (CoNS). A quasiexperimental study was conducted to analyze the impact of rapid diagnostic testing with MALDI-TOF plus AST review and intervention for adult hospitalized patients with blood cultures positive for CoNS. Antibiotic prescribing patterns and clinical outcomes were compared before and after implementation of MALDI-TOF with AST intervention for patients with CoNS bacteremia and CoNS contamination. A total of 324 patients with a positive CoNS blood culture were included; 246 were deemed to have contaminated cultures (117 in the preintervention group and 129 in AST the intervention group), and 78 patients had bacteremia (46 in the preintervention group and 32 in the AST intervention group). No differences in demographics were seen between the groups, and similar rates of contamination occurred between the preintervention and AST intervention groups (64.3% versus 72.6%, P = 0.173). Patients with bacteremia were initiated on optimal therapy sooner in the AST intervention group (58.7 versus 34.4 h, P = 0.030), which was associated with a similarly decreased mortality (21.7% versus 3.1%, P = 0.023). Patients with CoNS-contaminated cultures had similar rates of mortality, lengths of hospitalization, recurrent bloodstream infections, and 30-day hospital readmissions, but the AST intervention group had a decreased duration of unnecessary antibiotic therapy (1.31 versus 3.89 days, P = 0.032) and a decreased number of vancomycin trough assays performed (0.88 versus 1.95, P < 0.001). In patients with CoNS bacteremia, rapid pathogen identification integrated with real-time stewardship interventions improved timely organism identification and initiation of antibiotic therapy. Patients in the AST group with blood cultures contaminated with CoNS had decreased inappropriate antimicrobial prescribing and decreased unnecessary serum vancomycin trough assays.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/diagnosis ; Bacteremia/drug therapy ; Bacteremia/microbiology ; Bacteriological Techniques/methods ; Coagulase/deficiency ; Drug Utilization/standards ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods ; Staphylococcal Infections/diagnosis ; Staphylococcal Infections/drug therapy ; Staphylococcal Infections/microbiology ; Staphylococcus/drug effects ; Staphylococcus/isolation & purification ; Survival Analysis ; Treatment Outcome ; Young Adult
Chemical Substances	Anti-Bacterial Agents ; Coagulase
Language	English
Publishing date	2014-05-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	390499-4
ISSN	1098-660X ; 0095-1137
ISSN (online)	1098-660X
ISSN	0095-1137
DOI	10.1128/JCM.00682-14
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Article ; Online: Mycobacterium neoaurum bloodstream infection: report of 4 cases and review of the literature.

Washer, Laraine L / Riddell, James / Rider, Jennifer / Chenoweth, Carol E

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2007 Volume 45, Issue 2, Page(s) e10–3

Abstract: We describe a cluster of 4 bloodstream infections with Mycobacterium neoaurum and 5 additional cases from the literature. Infections occurred mainly in immunocompromised hosts who had central venous catheters. Fever was universal at presentation, but ... ...

Abstract	We describe a cluster of 4 bloodstream infections with Mycobacterium neoaurum and 5 additional cases from the literature. Infections occurred mainly in immunocompromised hosts who had central venous catheters. Fever was universal at presentation, but local signs of inflammation were rare. Combination antimicrobial therapy and catheter removal resulted in clinical cure.
MeSH term(s)	Anti-Bacterial Agents/administration & dosage ; Bacteremia/etiology ; Bacteremia/immunology ; Bacteremia/therapy ; Blood-Borne Pathogens/isolation & purification ; Catheterization, Central Venous/adverse effects ; Child, Preschool ; Cluster Analysis ; Combined Modality Therapy ; Device Removal ; Female ; Follow-Up Studies ; Humans ; Immunocompromised Host ; Infant ; Male ; Middle Aged ; Mycobacterium Infections, Nontuberculous/etiology ; Mycobacterium Infections, Nontuberculous/immunology ; Mycobacterium Infections, Nontuberculous/therapy ; Neoplasms/immunology ; Neoplasms/therapy ; Nontuberculous Mycobacteria/classification ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Treatment Outcome
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2007-07-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1086/518891
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Article ; Online: Managing antimicrobial resistance in intensive care units.

Gandhi, Tejal N / DePestel, Daryl D / Collins, Curtis D / Nagel, Jerod / Washer, Laraine L

Critical care medicine

2010 Volume 38, Issue 8 Suppl, Page(s) S315–23

Abstract: The challenges in managing patients with infection in the intensive care unit are increased in an era where there are dwindling antimicrobial choices for multidrug-resistant pathogens. Clinicians in the intensive care unit must balance between choosing ... ...

Abstract	The challenges in managing patients with infection in the intensive care unit are increased in an era where there are dwindling antimicrobial choices for multidrug-resistant pathogens. Clinicians in the intensive care unit must balance between choosing appropriate antimicrobial treatment for patients with suspected infection and utilizing antimicrobials in a judicious fashion. Improving antimicrobial utilization is a critical component to reducing antimicrobial resistance. Although providing effective antimicrobial therapy and improving antimicrobial utilization may seem to be competing goals, there are effective strategies to accomplish both. Antimicrobial stewardship programs provide an organized way to implement these strategies and can enhance the intensive care unit physician's success in improving patient outcomes and combating antimicrobial resistance in the intensive care unit.
MeSH term(s)	Anti-Bacterial Agents/administration & dosage ; Dose-Response Relationship, Drug ; Drug Resistance, Microbial ; Economics, Pharmaceutical ; Formularies, Hospital ; Humans ; Intensive Care Units ; Interprofessional Relations ; Microbial Sensitivity Tests ; Practice Guidelines as Topic
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2010-08
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0b013e3181e6a2a4
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