Large-size fattening calves’ lots fed with automatic milk feeders may have an increased risk for Mycoplasma bovis infection spread and for antibiotic use

Abstract Background Carbapenem-Resistant Enterobacteriales (CRE) bacteremia is associated with significant morbidity and mortality. CRE were assigned a threat level of “urgent” in the 2019 CDC report on antibiotic resistance in the United States. We attempted to identify predictors of 30-day mortality in patients with CRE bacteremia. Methods We performed a chart review of 146 patients with CRE bacteremia from January 2010 - July 2019. CRE was defined using the current CDC definition. Electronic medical records were reviewed to obtain clinical characteristics and outcomes including prior antibiotic use, comorbidities, prior location, treatment, hospital course, microbiological data and outcomes including in-hospital mortality. Results Of 146 patients included for analysis, the overall 30-day mortality rate was 36.3%. Patients admitted from a healthcare facility including outside hospitals, rehab, nursing homes, and LTACs had a 49.1% (29/59) 30-day mortality rate compared to 27.5% (24/87) for those admitted from home (RR=1.78, 95% CI 1.16–2.73, p=.0082). Patients with a Pitt bacteremia score ≥ 4 had a greater 30-day mortality rate (42.6%, 26/61) compared to those with a Pitt bacteremia score < 4 (17.6%, 15/85) (RR=2.92, 95% CI 1.40–4.16, p=.0015). Patients that received inactive empiric therapy had a 30-day mortality rate of 36% (36/100) compared to 36.9% (17/46) in those that received active empiric therapy (RR=.9741, 95% CI .6155-1.59, p=.9109). Patients with isolates determined to have a meropenem MIC ≥ 4 had a 30-day mortality rate of 40.2% (37/92) while those with an MIC < 4 had a 30-day mortality rate of 30.2% (16/53) (RR=1.33, 95% CI .8250–2.1513, p=.2408). A pulmonary source of bacteremia was associated with an increased risk of 30-day mortality (64.3%, 9/14) compared to all other sources of bacteremia (34.8%, 31/89) (RR=1.85, 95% CI 1.39–2.99, p=.0129). No other infection source was associated with an increased 30-day mortality rate. Conclusion Admission from a healthcare facility, Pitt bacteremia score ≥ 4, and pulmonary source of bacteremia were associated with increased risk of 30-day mortality. Interestingly, administration of active empiric therapy was not associated with a decreased mortality risk. Meropenem MIC was not predictive of 30-day mortality. Disclosures All Authors: No reported disclosures

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Study of antimicrobial use in paediatric inpatients in a tertiary care hospital in Ahmedabad, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20205430 ◽

2020 ◽

Vol 8 (1) ◽

pp. 35

Author(s):

Hetal N. Jeeyani ◽

Rutvik H. Parikh ◽

Sheena Sivanandan ◽

Harsh J. Muliya ◽

Shivam N. Badiyani ◽

...

Keyword(s):

Bacterial Resistance ◽

Tertiary Care ◽

Antibiotic Use ◽

Antibiotic Prescribing ◽

Care Hospital ◽

Antimicrobial Drugs ◽

Prescribing Indicators ◽

Inappropriate Use ◽

Increased Risk ◽

The Mean

Background: Inappropriate use and overuse of antibiotics are important factors leading to increased bacterial resistance apart from increased risk of adverse reactions. The aim of this study was to derive antibiotic use percentage, study its pattern and compare antibiotic prescribing indicators with standard indicators.Methods: This prospective observational study was conducted from 1st August 2018 to 31st July 2019 on paediatric inpatients from 1 month to 14 years. All the relevant data was taken from the case records of patients at the time of discharge. The data included: age, sex, hospital stay, clinical diagnosis and details of antimicrobial treatment.Results: From 989 patients, 85.9% were diagnosed with infectious illness, of which 60.1% had viral and 36.7% had bacterial infection. The use of antimicrobial drugs was 42.7% and antibiotics was 40.4%. The mean number of antibiotics received was 1.13±0.31. 90% patients received single antibiotic. 88.8% drugs were prescribed by generic name and 99% drugs were prescribed from essential drug formulary. 17 different antibiotics were used out of which ceftriaxone (62.5%) was the most commonly used. Groupwise, antibiotic use was cephalosporins (68.4%), penicillin (20.2%), aminoglycosides (4.31%), fluoroquinolones (0.9%) and macrolides (0.22%). The use of higher antibiotics like vancomycin (3.86%) and carbapenems (0.68%) was quite less.Conclusions: The antibiotic use in our hospital was higher than the WHO standard but less as compared to majority of other studies. Use of cephalosporins was more and penicillin was less as compared to other studies. This suggests that there is a need of implementing antibiotic stewardship programs to enhance rational antibiotic prescribing.

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Antibiotic use in children: another increased risk of asthma?

Breathe ◽

10.1183/18106838.0601.064 ◽

2009 ◽

Vol 6 (1) ◽

pp. 64-65

Author(s):

F Saretta ◽

M Canciani

Keyword(s):

Antibiotic Use ◽

Increased Risk

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Perinatal and Antibiotic Exposures and the Risk of Developing Childhood-Onset Inflammatory Bowel Disease: A Nested Case-Control Study Based on a Population-Based Birth Cohort

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17072409 ◽

2020 ◽

Vol 17 (7) ◽

pp. 2409 ◽

Cited By ~ 3

Author(s):

Cristina Canova ◽

Jonas F Ludvigsson ◽

Riccardo Di Domenicantonio ◽

Loris Zanier ◽

Claudio Barbiellini Amidei ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Birth Cohort ◽

Bowel Disease ◽

Antibiotic Use ◽

Case Control ◽

Childhood Onset ◽

Increased Risk ◽

Inflammatory Bowel ◽

Nested Case Control ◽

The Impact

The role of early-life environmental exposures on Inflammatory Bowel Disease (IBD) onset remains unclear. We aimed to quantify the impact of perinatal conditions and antibiotic use in the first 6 and 12 months of life, on the risk of childhood-onset IBD, in a birth cohort of the region Friuli-Venezia Giulia (Italy). A nested case-control design on a longitudinal cohort of 213,515 newborns was adopted. Conditional binomial regression models were used to estimate Odds Ratios (OR) with 95% confidence intervals (CI) for all analyzed risk factors. We identified 164 individuals with IBD onset before the age of 18 years and 1640 controls. None of the considered perinatal conditions were associated with IBD. Analyses on antibiotic exposure were based on 70 cases and 700 controls. Risks were significantly higher for children with ≥4 antibiotic prescriptions in the first 6 and 12 months of life (OR = 6.34; 95%CI 1.68–24.02 and OR = 2.91; 95%CI 1.31–6.45, respectively). This association was present only among patients with Crohn’s disease and those with earlier IBD onset. We found that perinatal characteristics were not associated to IBD, while the frequent use of antibiotics during the first year of life was associated to an increased risk of developing subsequent childhood-onset IBD.

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Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility: A Retrospective Cohort Study Among Primary Care Patients

Clinical Infectious Diseases ◽

10.1093/cid/ciz429 ◽

2019 ◽

Vol 69 (9) ◽

pp. 1517-1525 ◽

Cited By ~ 5

Author(s):

Casper D J den Heijer ◽

Christian J P A Hoebe ◽

Johanna H M Driessen ◽

Petra Wolffs ◽

Ingrid V F van den Broek ◽

...

Keyword(s):

Chlamydia Trachomatis ◽

Reproductive Health ◽

Ectopic Pregnancy ◽

Pelvic Inflammatory Disease ◽

Inflammatory Disease ◽

Antibiotic Use ◽

Female Infertility ◽

Dependent Manner ◽

Increased Risk ◽

Ct Test

Abstract Background We evaluated the risk of pelvic inflammatory disease (PID), ectopic pregnancy, and infertility in women with a previous Chlamydia trachomatis (CT) diagnosis compared with women who tested negative for CT and CT untested women, considering both targeted and incidental (ie, prescribed for another indication) use of CT-effective antibiotics. Methods This was a retrospective study of women aged 12–25 years at start of follow-up within the Clinical Practice Research Datalink GOLD database linked to index of multiple deprivation quintiles, 2000–2013. CT test status and antibiotic use were determined in a time-dependent manner. Risk of PID, ectopic pregnancy, or female infertility were evaluated using of Cox proportional hazard models. Results We studied 857 324 women, contributing 6 457 060 person-years. Compared with women who tested CT-negative, women who tested CT-positive had an increased risk of PID (adjusted hazard ratio [aHR], 2.36; 95% confidence interval [CI], 2.01–2.79), ectopic pregnancy (aHR, 1.87; 95% CI, 1.38–2.54), and infertility (aHR, 1.85; 95% CI, 1.27–2.68). The PID risk was higher for women with 2 or more positive CT tests than those with 1 positive test. PID risk increased with the number of previous antibiotic prescriptions, regardless of CT test status. Conclusions We showed an association between CT-positive tests and 3 adverse reproductive health outcomes. Moreover, this risk increased with repeat CT infections. CT-effective antibiotic use showed no decreased risks of subsequent PID regardless of CT history. Our results confirm the reproductive health burden of CT, which requires adequate public health interventions.

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Mitochondrial dysfunction-a link between antibiotic use and increased risk of severe mental disorders?

Acta Psychiatrica Scandinavica ◽

10.1111/acps.12727 ◽

2017 ◽

Vol 135 (5) ◽

pp. 499-499

Author(s):

William T. Regenold

Keyword(s):

Mental Disorders ◽

Mitochondrial Dysfunction ◽

Antibiotic Use ◽

Severe Mental Disorders ◽

Increased Risk

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Diarrhoea and preadmission antibiotic exposure in COVID-19: a retrospective cohort study of 1153 hospitalised patients

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2020-000593 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000593

Author(s):

Bilal Akhter Mateen ◽

Sandip Samanta ◽

Sebastian Tullie ◽

Sarah O’Neill ◽

Zillah Cargill ◽

...

Keyword(s):

Mortality Risk ◽

Antibiotic Use ◽

Prescribing Patterns ◽

Antibiotic Prescribing ◽

Antibiotic Exposure ◽

Test Results ◽

Risk Of Mortality ◽

Hospitalised Patients ◽

Increased Risk ◽

Residual Confounding

ObjectiveThe aims of this study were to describe community antibiotic prescribing patterns in individuals hospitalised with COVID-19, and to determine the association between experiencing diarrhoea, stratified by preadmission exposure to antibiotics, and mortality risk in this cohort.Design/methodsRetrospective study of the index presentations of 1153 adult patients with COVID-19, admitted between 1 March 2020 and 29 June 2020 in a South London NHS Trust. Data on patients’ medical history (presence of diarrhoea, antibiotic use in the previous 14 days, comorbidities); demographics (age, ethnicity, and body mass index); and blood test results were extracted. Time to event modelling was used to determine the risk of mortality for patients with diarrhoea and/or exposure to antibiotics.Results19.2% of the cohort reported diarrhoea on presentation; these patients tended to be younger, and were less likely to have recent exposure to antibiotics (unadjusted OR 0.64, 95% CI 0.42 to 0.97). 19.1% of the cohort had a course of antibiotics in the 2 weeks preceding admission; this was associated with dementia (unadjusted OR 2.92, 95% CI 1.14 to 7.49). After adjusting for confounders, neither diarrhoea nor recent antibiotic exposure was associated with increased mortality risk. However, the absence of diarrhoea in the presence of recent antibiotic exposure was associated with a 30% increased risk of mortality.ConclusionCommunity antibiotic use in patients with COVID-19, prior to hospitalisation, is relatively common, and absence of diarrhoea in antibiotic-exposed patients may be associated with increased risk of mortality. However, it is unclear whether this represents a causal physiological relationship or residual confounding.

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Twin pregnancy and perinatal outcomes: Data from ‘Birth in Brazil Study’

PLoS ONE ◽

10.1371/journal.pone.0245152 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245152

Author(s):

Ana Paula Esteves-Pereira ◽

Antônio José Ledo Alves da Cunha ◽

Marcos Nakamura-Pereira ◽

Maria Elisabeth Moreira ◽

Rosa Maria soares madeira Domingues ◽

...

Keyword(s):

Gestational Age ◽

Oxygen Therapy ◽

Negative Impact ◽

Age Groups ◽

Health Indicators ◽

Antibiotic Use ◽

Born Infant ◽

Low Middle Income Countries ◽

Increased Risk ◽

Maternity Hospitals

Background Twin pregnancies account for 0.5–2.0% of all gestations worldwide. They have a negative impact on perinatal health indicators, mainly owing to the increased risk for preterm birth. However, population-based data from low/middle income countries are limited. The current paper aims to understand the health risks of twins, compared to singletons, amongst late preterms and early terms. Methods Data is from “Birth in Brazil”, a national inquiry into childbirth care conducted in 2011/2012 in 266 maternity hospitals. We included women with a live birth or a stillborn, and excluded births of triplets or more, totalling 23,746 singletons and 554 twins. We used multiple logistic regressions and adjusted for potential confounders. Results Twins accounted for 1.2% of gestations and 2.3% of newborns. They had higher prevalence of low birth weight and intrauterine growth restriction, when compared to singletons, in all gestational age groups, except in the very premature ones (<34 weeks). Amongst late preterm’s, twins had higher odds of jaundice (OR 2.7, 95% CI 1.8–4.2) and antibiotic use (OR 1.8, 95% CI 1.1–3.2). Amongst early-terms, twins had higher odds of oxygen therapy (OR 2.7, 95% CI 1.3–5.9), admission to neonatal intensive care unit (OR 3.1, 95% CI 1.5–6.5), transient tachypnoea (OR 3.7, 95% CI 1.5–9.2), jaundice (OR 2.8, 95% CI 1.3–5.9) and antibiotic use (OR 2.2, 95% CI 1.14.9). In relation to birth order, the second-born infant had an elevated likelihood of jaundice, antibiotic use and oxygen therapy, than the first-born infant. Conclusion Although strongly mediated by gestational age, an independent risk remains for twins for most neonatal morbidities, when compared to singletons. These disadvantages seem to be more prominent in early-term newborns than in the late preterm ones.

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Maternal Antibiotic Use and Infections During Pregnancy and Offspring Asthma: The Norwegian Mother, Father and Child Cohort Study and a Nationwide Register Cohort

10.21203/rs.3.rs-1063914/v1 ◽

2021 ◽

Author(s):

Aino K. Rantala ◽

German Tapia ◽

Maria C Magnus ◽

Lars Christian Stene ◽

Jouni JK Jaakkola ◽

...

Keyword(s):

Cohort Study ◽

Antibiotic Use ◽

Population Based ◽

Prescription Database ◽

Upper Respiratory Tract ◽

Maternal Characteristics ◽

Increased Risk ◽

Norwegian Prescription Database ◽

Tract Infections

Abstract Maternal antibiotic use during pregnancy has been linked to asthma risk in children, but the role of underlying infections remains unclear. We investigated the association of maternal antibiotic use and infections during pregnancy with offspring risk of asthma. We used two population-based cohorts: the Norwegian Mother, Father and Child Cohort Study (MoBa) (n=53 417) and a register cohort (n=417 548). Asthma was defined based on dispensed asthma medications at 7 and 13 years from the Norwegian Prescription Database. Self-reported information on antibiotic use and infections during pregnancy was available in MoBa, while registrations of dispensed prescriptions was used to classify use of antibiotics in the register-based cohort. Maternal antibiotic use during pregnancy was associated with asthma at 7 years in both cohorts (aRR 1.23, 95% CI 1.11 - 1.37 in MoBa and aRR 1.21, 95% CI 1.16 - 1.25 in the register-based cohort) and asthma at 13 years in the register cohort (aRR 1.13, 95% CI 1.03-1.23) after adjusting for maternal characteristics. In MoBa, the estimate was attenuated after adjusting for infections during pregnancy. Maternal lower and upper respiratory tract infections (aRR 1.30, 95% CI 1.07 - 1.57 and aRR 1.19, 95% CI 1.09 - 1.30, respectively) and urinary tract infections (aRR 1.26, 95% CI 1.11 - 1.42) showed associations with asthma at 7 after adjusting for confounders, but estimates decreased after adjustment for antibiotics during pregnancy. Our findings suggest that both maternal antibiotic use and infections during pregnancy might be associated with an increased risk of asthma in childhood.

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