The incidence and outcomes of healthcare-associated respiratory tract infections in non-ventilated neurocritical care patients: Results of a 10-year cohort study

2022 ◽  
Vol 97 ◽  
pp. 32-41
Author(s):  
Ksenia Ershova ◽  
Ivan Savin ◽  
Oleg Khomenko ◽  
Darren Wong ◽  
Gleb Danilov ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Neurocritical Care ◽  
Tract Infections ◽  
Healthcare Associated

scholarly journals The Incidence and Outcomes of Healthcare-associated Respiratory Tract Infections in Non-ventilated Neurocritical Care Patients: Results of a 10-year Prospective Cohort Study

2021 ◽  
Author(s):  
Ksenia Ershova ◽  
Ivan Savin ◽  
Oleg Khomenko ◽  
Darren Wong ◽  
Gleb Danilov ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Tract ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Respiratory Tract Infections ◽  
Hospital Length Of Stay ◽  
P Value ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Abstract Background. The incidence of healthcare-associated respiratory tract infections in non-ventilated patients (NVA-HARTI) in neurosurgical intensive care units (ICU) is unknown. The impact of NVA-HARTI on patient outcomes and differences between NVA-HARTI and ventilator-associated healthcare-associated respiratory tract infections (VA-HARTI) are poorly understood. Our objectives were to report the incidence, hospital length of stay (LOS), ICU LOS, and mortality in neurosurgical ICU and compare these characteristics between NVA- and VA-HARTI.Methods. This prospective cohort study was conducted in a neurosurgical ICU in Moscow from 2011 to 2020. All patients with ICU LOS >48h were included. Time trends were analyzed for all outcomes. A competing risk model was used for survival and risk analysis.Results. A total of 3,937 ICU admissions were analyzed. NVA-HARTI vs VA-HARTI results were: cumulative incidence 7.2 (6.4-8.0) vs 15.4 (14.2-16.5) per 100 ICU admissions, incidence rate 4.2±2.0 vs 9.5±3.0 per 1000 patient-days in the ICU, median LOS 32 [21; 48.5] vs 46 [28; 76.5] days, median ICU LOS 15 [10; 28.75] vs 26 [17; 43] days, and mortality rates 12.3% (7.9-16.8) vs 16.7% (13.6-19.7). The incidence of VA-HARTI decreased in ten years while NVA-HARTI incidence did not change. VA-HARTI was found to be an independent risk factor of death, odds ratio 1.54 (1.11-2.14), p-value=0.009 while NVA-HARTI was not.Conclusion. Our findings suggest that NVA-HARTI in neurosurgical ICU patients represents a significant healthcare burden with relatively high incidence and associated poor outcomes. NVA-HARTI appeared to be different from VA-HARTI and persisted despite preventive measures; therefore, extrapolating VA-HARTI research findings to NVA-HARTI should be avoided.

scholarly journals Daycare attendance and respiratory tract infections: a prospective birth cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e014635 ◽  
Author(s):  
Linnea Schuez-Havupalo ◽  
Laura Toivonen ◽  
Sinikka Karppinen ◽  
Anne Kaljonen ◽  
Ville Peltola
Keyword(s):  
Cohort Study ◽  
Respiratory Tract ◽  
Birth Cohort ◽  
Day Care ◽  
Repeated Measures ◽  
Respiratory Tract Infections ◽  
Birth Cohort Study ◽  
Tract Infections ◽  
Prospective Birth Cohort ◽  
Prospective Birth Cohort Study

ObjectiveWe explored the burden of respiratory tract infections (RTIs) in young children with regard to day-care initiation.DesignLongitudinal prospective birth cohort study.Setting and methodsWe recruited 1827 children for follow-up until the age of 24 months collecting diary data on RTIs and daycare. Children with continuous daycare type and complete data were divided into groups of centre-based daycare (n=299), family day care (FDC) (n=245) and home care (n=350). Using repeated measures variance analyses, we analysed days per month with symptoms of respiratory tract infection, antibiotic treatments and parental absence from work for a period of 6 months prior to and 9 months after the start of daycare.ResultsWe documented a significant effect of time and type of daycare, as well as a significant interaction between them for all outcome measures. There was a rise in mean days with symptoms from 3.79 (95% CI 3.04 to 4.53) during the month preceding centre-based daycare to 10.57 (95% CI 9.35 to 11.79) at 2 months after the start of centre-based daycare, with a subsequent decrease within the following 9 months. Similar patterns with a rise and decline were observed in the use of antibiotics and parental absences. The start of FDC had weaker effects. Our findings were not changed when taking into account confounding factors.ConclusionsOur study shows the rapid increase in respiratory infections after start of daycare and a relatively fast decline in the course of time with continued daycare. It is important to support families around the beginning of daycare.

scholarly journals Lower Respiratory Tract Infections Associated with Rhinovirus during Infancy and Increased Risk of Wheezing during Childhood. A Cohort Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (7) ◽  
pp. e69370 ◽  
Author(s):  
Cristina O’Callaghan-Gordo ◽  
Quique Bassat ◽  
Núria Díez-Padrisa ◽  
Luis Morais ◽  
Sónia Machevo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Respiratory Tract Infections ◽  
Increased Risk ◽  
Tract Infections

scholarly journals Antibiotic exposure and ‘response failure’ for subsequent respiratory tract infections: an observational cohort study of UK preschool children in primary care

2019 ◽  
Vol 69 (686) ◽  
pp. e638-e646 ◽  
Author(s):  
Oliver van Hecke ◽  
Alice Fuller ◽  
Clare Bankhead ◽  
Sara Jenkins-Jones ◽  
Nick Francis ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Preschool Children ◽  
Respiratory Tract ◽  
Treatment Failure ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescription ◽  
Antibiotic Exposure ◽  
Tract Infections ◽  
Antibiotic Courses

BackgroundChildhood antibiotic exposure has important clinically relevant implications. These include disruption to the microbiome, antibiotic resistance, and clinical workload manifesting as treatment ‘failure’.AimTo examine the relationship between the number of antibiotic courses prescribed to preschool children for acute respiratory tract infections (RTI), in the preceding year, and subsequent RTIs that failed to respond to antibiotic treatment (‘response failures’).Design and settingA cohort study using UK primary care data from the Clinical Practice Research Datalink, 2009 to 2016.MethodChildren aged 12 to 60 months (1 to 5 years) who were prescribed an antibiotic for an acute RTI (upper and lower RTI or otitis media) were included. One random index antibiotic course for RTI per child was selected. Exposure was the number of antibiotic prescriptions for acute RTI up to 12 months before the index antibiotic prescription. The outcome was ‘response failure’ up to 14 days after index antibiotic prescription, defined as: subsequent antibiotic prescription; referral; hospital admission; death; or emergency department attendance within 3 days. The authors used logistic regression models to estimate the odds between antibiotic exposure and response failure.ResultsOut of 114 329 children who were prescribed an antibiotic course for acute RTI, children who received ≥2 antibiotic courses for acute RTIs in the preceding year had greater odds of response failure; one antibiotic course: adjusted odds ratio (OR) 1.03 (95% confidence interval [CI] = 0.88 to 1.21), P = 0.67, n = 230 children; ≥2 antibiotic courses: adjusted OR 1.32 (CI = 1.04 to 1.66), P = 0.02, n = 97.ConclusionChildhood antibiotic exposure for acute RTI may be a good predictor for subsequent response failure (but not necessarily because of antibiotic treatment failure). Further research is needed to improve understanding of the mechanisms underlying response failure.

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