From The Journal of Clinical Psychiatry:

Background Sepsis is one of the most significant healthcare concerns of the 21^st century. In the United States sepsis affect 1.7 million adults, with 270,000 fatal cases, according to the estimation of Centers for Disease Control and Prevention. The management of sepsis relies on early recognition, therefore the emergency departments have distinctive role in sepsis care, hence the need for early reliable risk stratification tools.Methods A retrospective, quantitative study was performed in Department of Emergency, University of Szeged. Hungary. Patients with suspected infection were enrolled to four subgroups based on the results of patient examination and laboratory results. In all cases (N=276), cell population data markers were analyzed along with ordinary infection biomarkers, such as CRP, PCT and WBC. Performance of cell population data parameters were investigated with ROC (Receiver Operating Curve) analysis.Results Almost all cell population biomarkers showed significant differences in the subgroup analysis. Remarkable performance was found in three markers (NE-SFL/M, MO-X/M and NE-WY/M) in patients having septic shock. Combining quick SOFA with these biomarkers (qS-Ne2Mo score) resulted in excellent diagnostic ability for septic shock (AUC 0.914, p<0.001), with good sensitivity (73.9%) and excellent specificity (89 %).Conclusions Since determination of cell population data requires complete blood count analysis, turn-around time of this novel indicator is significantly lower than other methods. qS-Ne2Mo score might be used as an initial screening tool to select only those patients that need more extensive laboratory investigations for their proper treatment and spare inadequate, time and money consuming laboratory requests.Trial Registration: University of Szeged, Ethical Committee ref. nr. 25/2016-SZTE

[Sudden cardiac arrest is a leading cause of death worldwide, claiming approximately 70 lives daily in Hungary. Survival often depends on the rapid intervention of lay bystanders, which requires basic resuscitation skills. ]

Background/Objectives: Surveillance of local antibiotic resistance plays a critical role in guiding empirical antibiotic therapies in emergency departments (EDs). This study aimed to collect and analyze a five-year period of prevalence and AMR rates among “ESKAPE” pathogens in a tertiary-care ED setting. Methods: This retrospective observational study included a complete census of microbiological specimens collected from patients presenting to the emergency department between 1 January 2019 and 31 December 2023. Data was retrieved from the MedBakter laboratory information system. Non relevant isolated and duplications were excluded. Only the first isolates per patient per phenotype were included in the final dataset. Results: The final dataset contained 6510 isolates. The most frequent isolates were E. coli (2717, 41.7%), K. pneumoniae (715, 11.0%), and P. mirabilis (696, 10.7%) followed by E. faecalis (662, 10.2%). Prevalence of multi-drug resistance (MDR) was 23.26% among “ESKAPE” pathogens, with highest prevalence in M. morganii (79.6%), P. stuartii (78.5%) and S. marcescens (77.1%). Difficult-to-treat resistance (DTR) was found in 32 isolates, while extensive drug resistance (XDR) was found in 5 isolates. The prevalence of other high-priority MDR bacteria was 12.4% for MRSA and 4.7% for VRE, while among Gram-negative bacteria the prevalence of carbapenem-resistant Enterobacterales was 0.52%. The prevalence of cephalosporin-resistant Enterobacterales varied greatly between 0 and 33%. Conclusions: Despite these important AMR trends, the cumulative antibiogram, according to the World Health Organization (WHO)-issued Access, Watch and Reserve (AWaRe) classification, revealed room for empirical antibiotic choices that spare Watch and Reserve agents. The results will aid the revision of the local antibiotic guidelines.