PGI1 PREVALENCE AND RISK FACTORS FOR DIARRHEA AT A LARGE TERTIARY CARE MEDICAL CENTER

Objectives.To identify risk factors for infection with imipenem-resistant Pseudomonas aeruginosa and determine the impact of imipenem resistance on clinical and economic outcomes among patients infected with P. aeruginosa.Designs.An ecologic study, a case-control study, and a retrospective cohort study.Setting.A 625-bed tertiary care medical center.Patients.All patients who had an inpatient clinical culture positive for P. aeruginosa between January 1, 1999, and December 31, 2000.Results.From 1991 through 2000, the annual prevalence of imipenem resistance among P. aeruginosa isolates increased significantly (P<.001 by the χ2 test for trend). Among 879 patients infected with P. aeruginosa during 1999-2000, a total of 142 had imipenem-resistant P. aeruginosa infection (the case group), whereas 737 had imipenem-susceptible P. aeruginosa infection (the control group). The only independent risk factor for imipenem-resistant P. aeruginosa infection was prior fluoroquinolone use (adjusted odds ratio, 2.52 [95% confidence interval {CI}, 1.61-3.92]; P<.001). Compared with patients infected with imipenem-susceptible P. aeruginosa, patients infected with imipenem-resistant P. aeruginosa had longer subsequent hospitalization durations (15.5 days vs 9 days; P = .02) and greater hospital costs ($81,330 vs $48,381; P<.001). The mortality rate among patients infected with imipenem-resistant P. aeruginosa was 31.1%, compared with 16.7% for patients infected with imipenem-susceptible P. aeruginosa (relative risk, 1.86 [95% CI, 1.38-2.51]; P<.001). In multivariable analyses, there remained an independent association between infection with imipenem-resistant P. aeruginosa and mortality.Conclusions.The prevalence of imipenem resistance among P. aeruginosa strains has increased markedly in recent years and has had a significant impact on both clinical and economic outcomes. Our results suggest that curtailing use of other antibiotics (particularly fluoroquinolones) may be important in attempts to curb further emergence of imipenem resistance.

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Extended-Spectrum β-Lactamase–ProducingEscherichia coliandKlebsiellaSpecies: Risk Factors for Colonization and Impact of Antimicrobial Formulary Interventions on Colonization Prevalence

Infection Control and Hospital Epidemiology ◽

10.1086/502045 ◽

2002 ◽

Vol 23 (5) ◽

pp. 254-260 ◽

Cited By ~ 51

Author(s):

Gregory Bisson ◽

Neil O. Fishman ◽

Jean Baldus Patel ◽

Paul H. Edelstein ◽

Ebbing Lautenbach

Keyword(s):

Risk Factors ◽

Medical Center ◽

Tertiary Care ◽

Healthcare Facility ◽

System A ◽

Extended Spectrum ◽

Tertiary Care Medical Center ◽

Duration Of Hospitalization ◽

Third Generation Cephalosporins ◽

Control Study

Objective:The incidence of extended-spectrum β-lactamase (ESβL)–mediated resistance has increased markedly during the past decade. Risk factors for colonization with ESβL-producingEscherichia coliand Klebsiella species(ESβL-EK) remain unclear, as do methods to control their further emergence.Design:Case–control study.Setting:Two hospitals within a large academic health system: a 725-bed academic tertiary-care medical center and a 344-bed urban community hospital.Patients:Thirteen patients with ESβL-EK fecal colonization were compared with 46 randomly selected noncolonized controls.Results:Duration of hospitalization was the only independent risk factor for ESβL-EK colonization (odds ratio, 1.11; 95% confidence interval, 1.02 to 1.21). Of note, 8 (62%) of the patients had been admitted from another healthcare facility. In addition, there was evidence for dissemination of a singleK. oxytocaclone. Finally, the prevalence of ESβL-EK colonization decreased from 7.9% to 5.7% following restriction of third-generation cephalosporins (P= .51).Conclusions:ESβL-EK colonization was associated only with duration of hospitalization and there was no significant reduction following antimicrobial formulary interventions. The evidence for nosocomial spread and the high percentage of patients with ESβL-EK admitted from other sites suggest that greater emphasis must be placed on controlling the spread of such organisms within and between institutions.

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Risk Factors for Otolaryngological Foreign Bodies in Eastern Poland

Otolaryngology ◽

10.1177/0194599812455297 ◽

2012 ◽

Vol 147 (5) ◽

pp. 889-893 ◽

Cited By ~ 3

Author(s):

Beata Rybojad ◽

Artur Niedzielski ◽

Grażyna Niedzielska ◽

Paweł Rybojad

Keyword(s):

Risk Factors ◽

Foreign Body ◽

Elementary Education ◽

Urban Areas ◽

Foreign Bodies ◽

Medical Center ◽

Tertiary Care ◽

Case Series ◽

Psychomotor Development ◽

Tertiary Care Medical Center

Objective To identify the sociodemographic characteristics and risk factors associated with suspected foreign bodies in the ear, nose, throat, airway, and esophagus among Polish children. Study Design Case series with chart review. Setting Tertiary care medical center. Subjects and Methods A retrospective analysis of the medical records of patients hospitalized for a suspected foreign body (FB) between 1998 and 2008 was conducted. Data regarding place of residence, presence of siblings, parents’ educational status, seasonality, psychomotor development, age, and sex were collected and statistically analyzed. Results Of the 1011 patients with suspected foreign body insertion, 849 (84%) had a positive diagnosis. Of the confirmed foreign bodies, 96 were found in the tracheobronchial tree, 142 were found in the esophagus, and 611 were located in the external auditory canals, nasopharyngeal passage, tonsils, auricles, or lips. Sociodemographically, 596 of the children came from urban areas, with a preponderance of males (55%). Objects were removed more frequently in summer and autumn (60%). Children with siblings (53%) predominated. The majority of patients (52%) had parents with an elementary education. Food was the most frequent foreign body in children under 3 years of age. Patients with delayed psychomotor development constituted 1.6% of the analyzed population. Conclusions Being male, 1 to 3 years of age, belonging to an urban family with siblings, and having parents with an elementary education increased the risk of foreign body insertion. Training caregivers about proper nutrition and safety rules when playing with children can reduce the risk of accidents related to foreign body insertion.

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Frequency of and risk factors for medication errors by pharmacists during order verification in a tertiary care medical center

American Journal of Health-System Pharmacy ◽

10.2146/ajhp140673 ◽

2015 ◽

Vol 72 (17) ◽

pp. 1471-1474 ◽

Cited By ~ 11

Author(s):

Christy Gorbach ◽

Linda Blanton ◽

Beverly A. Lukawski ◽

Alex C. Varkey ◽

E. Paige Pitman ◽

...

Keyword(s):

Risk Factors ◽

Medication Errors ◽

Medical Center ◽

Tertiary Care ◽

Tertiary Care Medical Center

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Early Clinical Experience with Anidulafungin at a Large Tertiary Care Medical Center

Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy ◽

10.1592/phco.28.1.64 ◽

2008 ◽

Vol 28 (1) ◽

pp. 64-73 ◽

Cited By ~ 39

Author(s):

Benjamin D Brielmaier ◽

Ed Casabar ◽

Christine M Kurtzeborn ◽

Peggy S McKinnon ◽

David J Ritchie

Keyword(s):

Clinical Experience ◽

Medical Center ◽

Tertiary Care ◽

Early Clinical Experience ◽

Tertiary Care Medical Center ◽

Large Tertiary Care

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Multivariate analysis of risk factors for deep and superficial sternal infection after coronary artery bypass grafting at a tertiary care medical center

Seminars in Thoracic and Cardiovascular Surgery ◽

10.1053/j.semtcvs.2004.01.009 ◽

2004 ◽

Vol 16 (1) ◽

pp. 53-61 ◽

Cited By ~ 97

Author(s):

Traves D Crabtree ◽

John E Codd ◽

Victoria J Fraser ◽

Marci S Bailey ◽

Margaret A Olsen ◽

...

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Medical Center ◽

Artery Bypass ◽

Tertiary Care ◽

Bypass Grafting ◽

Tertiary Care Medical Center

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A fully automated inpatient transport system

Technology and Health Care ◽

10.3233/thc-212880 ◽

2021 ◽

pp. 1-8

Author(s):

Joseph Mendlovic ◽

Eli Gargir ◽

David E. Katz

Keyword(s):

Adverse Events ◽

Transport System ◽

Medical Center ◽

Tertiary Care ◽

Transport Systems ◽

Case Review ◽

Patient Identification ◽

Retrospective Case ◽

Tertiary Care Medical Center ◽

Large Tertiary Care

BACKGROUND: The transport of the inpatients to and from locations inside the hospital can vary in complexity depending on the patient location, status, and logistical needs. Most transport systems have not developed at the same speed as other medically related technologies. We conducted a pilot study of a new automated transport system for patients within the hospital. METHODS: Our innovative system was introduced in January 2020. We present a retrospective case review of all in-patient transport request during April 15, 2020 through May 30, 2020 at the Shaare Zedek Medical Center, Jerusalem, Israel. The system is fully automated and works via smartphone and electronic medical record integration. Transfer requests are processed on the basis of priority, proximity, and availably. RESULTS: During the study period there were 15, 581 transfer requests. Mean times to hospital destinations ranged from 9:25 to 28:02 minutes. Overall, mean times were quicker for emergency and surgical services. Trip times by priority code were likely influence by unmeasured confounders. There were no reported patient identification adverse events. Peak requests occurred during 0900-1500, and at the beginning of the week. CONCLUSION: Our automated in-patient transfer system appears to be efficient, safe, well received, and capable of servicing our large tertiary care medical center. Future controlled studies are needed to assess efficacy, adverse events, and clinical outcomes.

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