Difficulties in assessing community-acquired infection as a risk factor for nosocomial infection at an intensive care unit

1994 ◽  
Vol 10 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Aurora Bueno-Cavanillas ◽  
Miguel Delgado-Rodríguez ◽  
Pablo Lardelli-Claret ◽  
Alfredo López-Luque ◽  
Ramón Gálvez-Vargas
Keyword(s):  
Intensive Care Unit ◽  
Risk Factor ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Community Acquired Infection

Screening for Multidrug-Resistant Bacteria as a Predictive Test for Subsequent Onset of Nosocomial Infection

2006 ◽  
Vol 27 (11) ◽  
pp. 1233-1241 ◽  
Author(s):  
L. Galoisy-Guibal ◽  
J. L. Soubirou ◽  
G. Desjeux ◽  
J. Y. Dusseau ◽  
O. Eve ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Risk Factor ◽  
Intensive Care ◽  
Propensity Score ◽  
Nosocomial Infection ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria ◽  
Test Result ◽  
Subsequent Onset

Objective.To investigate whether carriage of multidrug-resistant bacteria is a risk factor for nosocomial infection and whether detection of carriage is predictive of subsequent onset of nosocomial infection.Methods.In this observational cohort (study period, June 1998 through October 2002), nasal and rectal swab specimens from 412 consecutive patients admitted to the intensive care unit were tested for carriage of multidrug-resistant bacteria. Concomitantly, the bacteria responsible for any subsequent nosocomial infection, the date of infection, and some of the known clinical risk factors for nosocomial infection were noted. These factors were adjusted for potential confounders, using a Cox model stratified on the propensity score of multidrug-resistant bacteria carriage. The diagnostic characteristics of a carriage test, including the positive and negative diagnostic likelihood ratios, were calculated for all strata of the propensity score.Results.Forty-two patients were carrying multidrug-resistant bacteria. Nosocomial infection occurred in 95 patients, of whom 16 (38%) were carriers, and 79 (83%) were noncarriers (P= .01). After adjustment for potential confounders, statistical analysis revealed that carriage remained a risk factor for nosocomial infection (relative risk, 2.08 [95% confidence interval {CI}, 1.13-3.81]). Receipt of antibiotic treatment at the time of intensive care unit admission was found to be protective against nosocomial infection. A positive result of test for detection of carriage seemed to be an efficient predictor of subsequent nosocomial infection (positive diagnostic likelihood ratio, 2.05 [95% CI, 1.15-3.66]), although a negative test result was not a predictor of subsequent nosocomial infection (negative likelihood ratio, 0.91 [95% CI, 0.73-1.11]).Conclusion.Carriage proved to be a risk factor for subsequent nosocomial infection. However, the carriage test was useful as a predictive tool only for patients with a positive test result.

scholarly journals Contamination of Propofol Infusions in the Intensive Care Unit: Incidence and Clinical Significance

1998 ◽  
Vol 26 (2) ◽  
pp. 162-164 ◽  
Author(s):  
S. A. R. Webb ◽  
B. Roberts ◽  
F. X. Breheny ◽  
C. L. Golledge ◽  
P. D. Cameron ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Nosocomial Infection ◽  
Wound Infection ◽  
Clinical Significance ◽  
Low Grade ◽  
Clinical Infection ◽  
Icu Patients

Epidemics of bacteraemia and wound infection have been associated with the infusion of bacterially contaminated propofol administered during anaesthesia. We conducted an observational study to determine the incidence and clinical significance of administration of potentially contaminated propofol to patients in an ICU setting. One hundred patients received a total of 302 infusions of propofol. Eighteen episodes of possible contamination of propofol syringes were identified, but in all cases contamination was by a low-grade virulence pathogen. There were no episodes of clinical infection or colonization which could be attributed to the administration of contaminated propofol. During the routine use of propofol to provide sedation in ICU patients the risk of nosocomial infection secondary to contamination of propofol is extremely low.

scholarly journals Candidemia in an intensive care unit

Medicina ◽  
2008 ◽  
Vol 45 (5) ◽  
pp. 351
Author(s):  
Dalia Adukauskienė ◽  
Aida Kinderytė ◽  
Asta Dambrauskienė ◽  
Astra Vitkauskienė
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Risk Factor ◽  
Intensive Care ◽  
Urinary Bladder ◽  
Intensive Care Units ◽  
Severe Disease ◽  
Candida Spp ◽  
Lethal Outcome ◽  
Bladder Catheter

Candidemia is becoming more actual because of better survival of even critically ill patients, wide use of antimicrobials, and increased numbers of invasive procedures and manipulations. Diagnosis of candidemia remains complicated, and costs of treatment and mortality rates are increasing. Objective. To evaluate the pathogens of candidemia, risk factors and their influence on outcome. Material and methods. Data of 41 patients with positive blood culture for Candida spp., who were treated in the intensive care units at the Hospital of Kaunas University of Medicine, were analyzed retrospectively. Results. Candidemia was caused by Candida albicans (C. albicans) in 48.8% (n=20) of patients and by non-albicans Candida in 51.2% (n=21) of patients. The main cause of candidemia was C. albicans in 2004 (83.3%, n=5), but in 2005 (63.6%, n=7), in 2006 (57.1%, n=4), and in 2007 (52.9%, n=9), the main cause was non-albicans Candida spp. The number of candidemia cases caused by C. albicans was decreased in 2005, 2006, and 2007 as compared with 2004, and the number of candidemia caused by non-albicans Candida spp. was decreased, respectively (P<0.05). More than 65% (n=34) of patients had severe disease (P<0.05). Lethal outcome was recorded in 58.5% of patients with candidemia. Mechanical ventilation was used in 76.9% (n=20) and urinary bladder catheter in 72.1% (n=19) of non-survivors and in 23.1% (n=6) and 26.9% (n=7) of survivors, respectively (P<0.05). Conclusions. There is an increase in the prevalence of candidemia in the intensive care units during the 4-year period; half of candidemia cases were caused by non-albicans Candida spp., and patients with candidemia caused by non-albicans Candida spp. are at higher risk of mortality. Therefore, for the empirical treatment of septic conditions in an intensive care unit, when invasive fungal infection is suspected, we recommend using an antifungal agent of non-azole class until a pathogen of candidemia is determined. Severe disease is evaluated as a risk factor for candidemia. Patients with oncological diseases are at significantly higher risk for candidemia caused by non-albicans Candida spp. Use of mechanical ventilation and urinary bladder catheter is a risk factor for lethal outcome.

Brain Injury as a Risk Factor for Fever Upon Admission to the Intensive Care Unit and Association With In-Hospital Case Fatality

2013 ◽  
Vol 30 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Fred Rincon ◽  
Utkal Patel ◽  
Christa Schorr ◽  
Elizabeth Lee ◽  
Steven Ross ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Risk Factor ◽  
Intensive Care ◽  
Brain Injury ◽  
Case Fatality ◽  
Hospital Case

scholarly journals The Predictive Role of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio on Intensive Care Unit Admission and Mortality of COVID-19 Patients in Iran

2021 ◽  
Author(s):  
Peiman Foroughi ◽  
Mojtaba Varshochi ◽  
Mehdi Hassanpour ◽  
Meisam Amini ◽  
Behnam Amini ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Risk Factor ◽  
Intensive Care ◽  
Independent Risk Factor ◽  
Multivariate Logistic Regression Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Icu Admission ◽  
Inflammatory Index

Abstract Since the outbreak of COVID-19 several studies conducted to identify predictive factors which are associated with prognosis of COVID-19. In this study we aimed to determine whether the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) could help the clinicians to predict intensive care unit (ICU) admission and mortality of COVID-19 patients. This retrospective cohort study involved examining the medical records of 311 Iranian COVID-19 patients from 22 July 2020 to 22 August 2020. All characteristic data and laboratory results were recorded. The receiver operating characteristic (ROC) curve was used to identify the predictive value of studied parameters for ICU admission and death. Comparison of data revealed that some factors were jointly higher in non-survivors and ICU admitted patients than survivors and non-ICU admitted patients, such as: age, hemoglobin (HB), NLR, derived neutrophil-to-lymphocyte ratio (dNLR), PLR, systemic inflammatory index (SII), lactate dehydrogenase (LDH), Respiratory diseases, ischemic heart disease (IHD). Multivariate logistic regression analysis showed that only hypertension (OR 3.18, P=0.02) is an independent risk factor of death in COVID-19 patients, and also PLR (OR 1.02, P=0.05), hypertension (OR 4.00, P=0.002) and IHD (OR 5.15, P=0.008) were independent risk factor of ICU admission in COVID-19 patients. This study revealed that the NLR, PLR, platelet-to-white blood Cell ratio (PWR), dNLR and SII are valuable factors for predicting ICU admission and mortality of COVID-19 patients.

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