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Latest & greatest articles for infection
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Changes in Prevalence of Health Care-Associated Infections in U.S. Hospitals. BACKGROUND: A point-prevalence survey that was conducted in the United States in 2011 showed that 4% of hospitalized patients had a health care-associated infection. We repeated the survey in 2015 to assess changes in the prevalence of health care-associated infections during a period of national attention to the prevention of such infections. METHODS: At Emerging Infections Program sites in 10 states, we recruited up (...) to 25 hospitals in each site area, prioritizing hospitals that had participated in the 2011 survey. Each hospital selected 1 day on which a random sample of patients was identified for assessment. Trained staff reviewed medical records using the 2011 definitions of health care-associated infections. We compared the percentages of patients with health care-associated infections and performed multivariable log-binomial regression modeling to evaluate the association of survey year with the risk
Re-infection rates and clinical outcomes following arthrodesis with intramedullary nail and external fixator for infected knee prosthesis: a systematic review and meta-analysis 30301462 2018 11 14 1471-2474 19 1 2018 Oct 10 BMC musculoskeletal disorders BMC Musculoskelet Disord Re-infection rates and clinical outcomes following arthrodesis with intramedullary nail and external fixator for infected knee prosthesis: a systematic review and meta-analysis. 361 10.1186/s12891-018-2283-4 Knee (...) arthrodesis with intramedullary (IM) nail or external fixator (EF) is the most reliable therapeutic option to achieve definitive infection control in patients with septic failure of total knee arthroplasty (TKA). The first aim of this study was to compare re-infection rates following knee arthrodesis for periprosthetic joint infection (PJI) with IM nail or EF. The second aim was to compare rates of radiographic union, complication, and re-operation as well as clinical outcomes. A systematic search
Comparative risk of genital infections associated with sodium-glucose co-transporter-2 inhibitors 30207042 2018 10 12 1463-1326 2018 Sep 12 Diabetes, obesity & metabolism Diabetes Obes Metab Comparative risk of genital infections associated with sodium-glucose co-transporter-2 inhibitors. 10.1111/dom.13531 The extent to which sodium-glucose co-transporter-2 (SGLT2) inhibitors increase the risk of genital infections in routine clinical care, compared with other antidiabetic medications (...) was a composite of genital candidal infections, vaginitis or vulvovaginitis in women, and genital candidal infections, balanitis, balanoposthitis, phimosis or paraphimosis in men. Among propensity score-matched cohorts of 129 994 women and 156 074 men, the adjusted hazard ratio (HR) and excess risk per 1000 person-years for SGLT2 versus DPP-4 inhibitors was 2.81 (95% confidence interval [CI], 2.64, 2.99) and 87.4 (95% CI, 79.1, 96.2) respectively for women, and was 2.68 (95% CI, 2.31, 3.11) and 11.9 (95% CI
Guideline for the Management of Clostridium Difficile Infection in Children and Adolescents With Cancer and Pediatric Hematopoietic Stem-Cell Transplantation Recipients 30216124 2018 11 14 1527-7755 2018 Sep 14 Journal of clinical oncology : official journal of the American Society of Clinical Oncology J. Clin. Oncol. Guideline for the Management of Clostridium Difficile Infection in Children and Adolescents With Cancer and Pediatric Hematopoietic Stem-Cell Transplantation Recipients (...) . JCO1800407 10.1200/JCO.18.00407 Purpose The aim of this work was to develop a clinical practice guideline for the prevention and treatment of Clostridium difficile infection (CDI) in children and adolescents with cancer and pediatric hematopoietic stem-cell transplantation (HSCT) patients. Methods An international multidisciplinary panel of experts in pediatric oncology and infectious diseases with patient advocate representation was convened. We performed systematic reviews of randomized controlled
The Additive Value of Pelvic Examinations to History in Predicting Sexually Transmitted Infections for Young Female Patients With Suspected Cervicitis or Pelvic Inflammatory Disease 30251627 2018 09 25 1097-6760 2018 Jul 02 Annals of emergency medicine Ann Emerg Med The Additive Value of Pelvic Examinations to History in Predicting Sexually Transmitted Infections for Young Female Patients With Suspected Cervicitis or Pelvic Inflammatory Disease. S0196-0644(18)30413-X 10.1016/j.annemergmed (...) .2018.05.004 We evaluate the additive value of pelvic examinations in predicting sexually transmitted infection for young female patients with suspected cervicitis or pelvic inflammatory disease in a pediatric emergency department (ED). This was a prospective observational study of female patients aged 14 to 20 years who presented to an urban academic pediatric ED with a complaint of vaginal discharge or lower abdominal pain. Enrolled patients provided a urine sample for chlamydia, gonorrhea, and
HIV, Sexually Transmitted Infection, and Substance Use Continuum of Care Interventions Among Criminal Justice-Involved Black Men Who Have Sex With Men: A Systematic Review 30383433 2018 11 14 1541-0048 108 S4 2018 Nov American journal of public health Am J Public Health HIV, Sexually Transmitted Infection, and Substance Use Continuum of Care Interventions Among Criminal Justice-Involved Black Men Who Have Sex With Men: A Systematic Review. e1-e9 10.2105/AJPH.2018.304698 Because Black men who (...) have sex with men (BMSM) experience high rates of both HIV and incarceration relative to other groups, the various stages of criminal justice involvement may serve as important intervention points for addressing HIV and related conditions in this group. Although systematic reviews of HIV interventions targeting MSM in general and BMSM in particular exist, no review has explored the range and impact of HIV, sexually transmitted infection (STI), and substance use prevention and care continuum
Azithromycin for Early Pseudomonas Infection in Cystic Fibrosis. The OPTIMIZE Randomized Trial 29890086 2018 11 15 1535-4970 198 9 2018 Nov 01 American journal of respiratory and critical care medicine Am. J. Respir. Crit. Care Med. Azithromycin for Early Pseudomonas Infection in Cystic Fibrosis. The OPTIMIZE Randomized Trial. 1177-1187 10.1164/rccm.201802-0215OC New isolation of Pseudomonas aeruginosa (Pa) is generally treated with inhaled antipseudomonal antibiotics such as tobramycin (...) inhalation solution (TIS). A therapeutic approach that complements traditional antimicrobial therapy by reducing the risk of pulmonary exacerbation and inflammation may ultimately prolong the time to Pa recurrence. To test the hypothesis that the addition of azithromycin to TIS in children with cystic fibrosis and early Pa decreases the risk of pulmonary exacerbation and prolongs the time to Pa recurrence. The OPTIMIZE (Optimizing Treatment for Early Pseudomonas aeruginosa Infection in Cystic Fibrosis
Effect of Increased Daily Water Intake in Premenopausal Women With Recurrent Urinary Tract Infections: A Randomized Clinical Trial 30285042 2018 11 05 2168-6114 178 11 2018 Nov 01 JAMA internal medicine JAMA Intern Med Effect of Increased Daily Water Intake in Premenopausal Women With Recurrent Urinary Tract Infections: A Randomized Clinical Trial. 1509-1515 10.1001/jamainternmed.2018.4204 Increased hydration is often recommended as a preventive measure for women with recurrent cystitis, but (...) supportive data are sparse. To assess the efficacy of increased daily water intake on the frequency of recurrent cystitis in premenopausal women. Randomized, open-label, controlled, 12-month trial at a clinical research center (years 2013-2016). Among 163 healthy women with recurrent cystitis (≥3 episodes in past year) drinking less than 1.5 L of fluid daily assessed for eligibility, 23 were excluded and 140 assigned to water or control group. Assessments of daily fluid intake, urinary hydration
Follow-on RifAximin for the Prevention of recurrence following standard treatment of Infection with Clostridium Difficile (RAPID): a randomised placebo controlled trial 30254135 2018 10 27 1468-3288 2018 Sep 25 Gut Gut Follow-on RifAximin for the Prevention of recurrence following standard treatment of Infection with Clostridium Difficile (RAPID): a randomised placebo controlled trial. gutjnl-2018-316794 10.1136/gutjnl-2018-316794 Clostridium difficile infection (CDI) recurs after initial (...) , Nottingham University Hospitals NHS Trust, Nottingham, Nottinghamshire, UK. Spiller Robin C RC http://orcid.org/0000-0001-6371-4500 Nottingham Digestive Diseases Centre and NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, the University of Nottingham, Nottingham, Notts, UK. RAPID Collaboration Group eng Journal Article 2018 09 25 England Gut 2985108R 0017-5749 diarrhoea enteric infectionsinfective colitis inflammation Competing interests: GM, LB, KS, MD, NB, AM
A Meta-analysis of Prophylaxis of Surgical Site Infections with Topical Application of Povidone Iodine Before Primary Closure 30244376 2018 09 23 1432-2323 2018 Sep 22 World journal of surgery World J Surg A Meta-analysis of Prophylaxis of Surgical Site Infections with Topical Application of Povidone Iodine Before Primary Closure. 10.1007/s00268-018-4798-0 Povidone iodine (PVI) is a widely used antiseptic solution among surgeons. A meta-analysis based on randomized controlled trials (RCTs (...) ) was conducted to establish whether application of PVI before wound closure could reduce surgical site infection (SSI) rates. Systematic review of MEDLINE/PubMed, Scopus, CINAHL, and Web of Science databases from inception to September 2017, with no language restrictions. Only RCTs were retrieved. The primary outcome was the SSI rate. Meta-analysis was complemented with trial sequential analysis (TSA). A total of 7601 patients collected from 16 RCTs were analyzed. A reduction in overall SSI rate was found
Efficacies of Genotypic Resistance-Guided vs Empirical Therapy for Refractory Helicobacter pylori Infection 29964036 2018 10 23 2018 10 23 1528-0012 155 4 2018 10 Gastroenterology Gastroenterology Efficacies of Genotypic Resistance-Guided vs Empirical Therapy for Refractory Helicobacter pylori Infection. 1109-1119 S0016-5085(18)34689-4 10.1053/j.gastro.2018.06.047 We aimed to compare the efficacy of genotypic resistance-guided therapy vs empirical therapy for eradication of refractory (...) Helicobacter pylori infection in randomized controlled trials. We performed 2 multicenter, open-label trials of patients with H pylori infection (20 years or older) failed by 2 or more previous treatment regimens, from October 2012 through September 2017 in Taiwan. The patients were randomly assigned to groups given genotypic resistance-guided therapy for 14 days (n = 21 in trial 1, n = 205 in trial 2) or empirical therapy according to medication history for 14 days (n = 20 in trial 1, n = 205 in trial 2
Negative Pressure Wound Therapy for Surgical-site Infections: A Randomized Trial 30308616 2018 10 11 1528-1140 2018 Oct 10 Annals of surgery Ann. Surg. Negative Pressure Wound Therapy for Surgical-site Infections: A Randomized Trial. 10.1097/SLA.0000000000003056 This study seeks to evaluate the efficacy of negative pressure wound therapy for surgical-site infection (SSI) after open pancreaticoduodenectomy. Despite improvement in infection control, SSIs remain a common cause of morbidity after
Maternal-fetal transmission and adverse perinatal outcomes in pregnant women infected with Zika virus: prospective cohort study in French Guiana. OBJECTIVES: To estimate the rates of maternal-fetal transmission of Zika virus, adverse fetal/neonatal outcomes, and subsequent rates of asymptomatic/symptomatic congenital Zika virus infections up to the first week of life. DESIGN: Cohort study with prospective data collection and subsequent review of fetal/neonatal outcomes. SETTINGS: Referral (...) centre for prenatal diagnosis of the French Guiana Western Hospital. PARTICIPANTS: Pregnant women at any stage of pregnancy with a laboratory confirmed symptomatic or asymptomatic Zika virus infection during the epidemic period in western French Guiana. The cohort enrolled 300 participants and prospectively followed their 305 fetuses/newborns. MAIN OUTCOME MEASURES: Rate of maternal-fetal transmission of Zika virus (amniotic fluid, fetal and neonatal blood, urine, cerebrospinal fluid, and placentas
Harm reduction approaches predicted to reduce rates of new hepatitis C infection for people who inject drugs Signal - Harm reduction approaches predicted to reduce rates of new hepatitis C infection for people who inject drugs Dissemination Centre Discover Portal NIHR DC Discover Harm reduction approaches predicted to reduce rates of new hepatitis C infection for people who inject drugs Published on 5 December 2017 A combination of providing clean needles and syringes and offering safer oral (...) therapy, such as methadone, reduced the predicted risk of becoming infected with hepatitis C virus by 71%. Providing both services to people who inject drugs was likely to be cost-effective and has the potential to be cost-saving in some parts of the UK, depending on the size of the local population of people who inject drugs and underlying rates of infection. Current services are estimated to save up to £54 million in costs of treating hepatitis C infection. This is in addition to the savings made
A strategy of 'delayed antibiotic prescribing' for respiratory infections may reduce antibiotic use Signal - A strategy of 'delayed antibiotic prescribing' for respiratory infections may reduce antibiotic use Dissemination Centre Discover Portal NIHR DC Discover A strategy of 'delayed antibiotic prescribing' for respiratory infections may reduce antibiotic use Published on 19 December 2017 Delaying antibiotic prescribing made little difference to most symptoms of respiratory infection. It (...) reduced antibiotic use and did not affect patient satisfaction compared with immediate prescribing of antibiotics. Increasing antibiotic resistance is a global health concern. Many people don’t realise that viruses cause most respiratory infections and that antibiotics won’t help. The strategy allows some time for symptoms to improve naturally. This review of the latest evidence on delayed prescribing for self-limiting respiratory infections is in line with current guidance. On the whole delaying
Blood test reduces mortality and shortens antibiotic use among adults with chest infection Signal - Blood test reduces mortality and shortens antibiotic use among adults with chest infection Dissemination Centre Discover Portal NIHR DC Discover Blood test reduces mortality and shortens antibiotic use among adults with chest infection Published on 16 January 2018 It may be feasible to use procalcitonin blood levels to guide antibiotic treatment for adults in hospital with a suspected chest (...) infection. By measuring procalcitonin, an indicator of bacterial infection, clinicians could review their diagnosis earlier. This reduced antibiotic exposure by 2.5 days with fewer adverse effects and also less mortality. About 14 extra people in every 1,000 who had their management guided by the blood test would be expected to survive the first month, compared with those receiving standard care without this test. Antibiotics are commonly prescribed pre-emptively for a suspected respiratory infection
Biological therapies for psoriasis do not increase serious infection risk Signal - Biological therapies for psoriasis do not increase serious infection risk Dissemination Centre Discover Portal NIHR DC Discover Biological therapies for psoriasis do not increase serious infection risk Published on 23 January 2018 People with psoriasis who take an immune-modulating treatment are no more likely to get serious infections than people taking standard therapies. There are fears that these biological (...) therapies raise the risk of serious infections and this has discouraged their use. They are recommended by NICE for moderate to severe psoriasis. Previous studies have reached conflicting conclusions, making it hard to advise on the true risk. This study used a large database of people with psoriasis from the UK and Ireland. It compared serious infection risk of the biological therapies (etanercept, adalimumab or ustekinumab) with non-biological therapies, after accounting for factors such as other