Aditya Kotecha

Cardiorenal syndrome in sepsis: A narrative review

&NA; Multi‐organ dysfunction is seen in nearly 40–60% of all patients presenting with sepsis, including renal and cardiac dysfunction. Cardiorenal syndrome type‐5 reflects concomitant cardiac and renal dysfunction secondary to a systemic condition that primarily affects both organs, such as sepsis. There are limited data on the etiology, pathogenesis and clinical implications of cardiorenal syndrome in sepsis. Cardiac dysfunction and injury can be measured with cardiac biomarkers, echocardiographic dysfunction, and hemodynamic parameters. Acute kidney injury is systematically evaluated using serum creatinine and urine output criteria. This review seeks to systematically describe the epidemiology, risk factors, pathogenesis, diagnosis and management of cardiorenal syndrome type‐5 in the setting of sepsis. Highlights:There are limited data on cardiorenal syndrome type‐5 in sepsisCardiorenal syndrome is associated with higher mortality and morbidityThis review describes the epidemiology, diagnosis and management of cardiorenal syndrome type‐5

Prevalence of Clostridium difficile infection in acute care hospitals, long-term care facilities, and outpatient clinics: Is Clostridium difficile infection underdiagnosed in long-term care facility patients?

HighlightsPrevalence of Clostridium difficile infection [CDI] using microbiologic data.8 acute care hospitals [ACHs], 16 long‐term care facilities [LTCFs], 45 clinicsLTCFs [33%] had higher CDI prevalence compared to ACHs [15%] and clinics [12%].CDI testing less frequent in LTCFs than ACHs [2 vs 50‐100 tests/month per facility]Low CDI prevalence [12%] in one LTCF which tested more frequently [26 tests/month]. &NA; Clostridium difficile infection is a common cause of diarrhea in long‐term care facility (LTCF) patients. The high prevalence of C difficile infection in LTCFs noted in our study calls for a critical need to educate LTCF staff to send diarrheal stool for C difficile testing to identify more cases and prevent transmission.