Epidemiology of Methicillin-ResistantStaphylococcus aureusBloodstream Coinfection Among Adults With Candidemia in Atlanta, GA, 2008–2012

2015 ◽  
Vol 36 (11) ◽  
pp. 1298-1304 ◽  
Author(s):  
Jessica Reno ◽  
Saumil Doshi ◽  
Amy K. Tunali ◽  
Betsy Stein ◽  
Monica M. Farley ◽  
...  
Keyword(s):  
Nursing Home ◽  
Medical Records ◽  
Odds Ratio ◽  
Nursing Home Residents ◽  
Population Based ◽  
Emerging Infections ◽  
Multivariate Logistic Regression ◽  
Factors Associated ◽  
Active Population ◽  
Invasive Infections

BACKGROUNDPatients with candidemia are at risk for other invasive infections, such as methicillin-resistantStaphylococcus aureus(MRSA) bloodstream infection (BSI).OBJECTIVETo identify the risk factors for, and outcomes of, BSI in adults withCandidaspp. and MRSA at the same time or nearly the same time.DESIGNPopulation-based cohort study.SETTINGMetropolitan Atlanta, March 1, 2008, through November 30, 2012.PATIENTSAll residents withCandidaspp. or MRSA isolated from blood.METHODSThe Georgia Emerging Infections Program conducts active, population-based surveillance for candidemia and invasive MRSA. Medical records for patients with incident candidemia were reviewed to identify cases of MRSA coinfection, defined as incident MRSA BSI 30 days before or after candidemia. Multivariate logistic regression was performed to identify factors associated with coinfection in patients with candidemia.RESULTSAmong 2,070 adult candidemia cases, 110 (5.3%) had coinfection within 30 days. Among these 110 coinfections, MRSA BSI usually preceded candidemia (60.9%; n=67) or occurred on the same day (20.0%; n=22). The incidence of coinfection per 100,000 population decreased from 1.12 to 0.53 between 2009 and 2012, paralleling the decreased incidence of all MRSA BSIs and candidemia. Thirty-day mortality was similarly high between coinfection cases and candidemia alone (45.2% vs 36.0%,P=.10). Only nursing home residence (odds ratio, 1.72 [95% CI, 1.03–2.86]) predicted coinfection.CONCLUSIONSA small but important proportion of patients with candidemia have MRSA coinfection, suggesting that heightened awareness is warranted after 1 major BSI pathogen is identified. Nursing home residents should be targeted in BSI prevention efforts.Infect. Control Hosp. Epidemiol.2015;36(11):1298–1304

Odds of Venous Thromboembolims (VTE) Associated with Hospitalization, Surgery, and Cancer Among Nursing Home Residents: A Population-Based Study.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2984-2984
Author(s):  
Cynthia L. Leibson ◽  
John A. Heit ◽  
Kent R. Bailey ◽  
Tanya M. Petterson ◽  
Aneel Ashrani
Keyword(s):  
Nursing Home ◽  
Symptom Onset ◽  
Odds Ratio ◽  
Conflicts Of Interest ◽  
Conditional Logistic Regression ◽  
Nursing Home Residents ◽  
Population Based ◽  
Olmsted County ◽  
Increased Risk ◽  
Active Cancer

Abstract Abstract 2984 Poster Board II-960 In previous studies of venous thromboembolism (VTE) among all residents of Olmsted County, MN, the odds of VTE associated with surgery, medical hospitalization, or active cancer were extremely high (Univariate odds ratio [OR] =14.6; 4.6, and 8.4 respectively). We also showed that nursing home (NH) residency was an independent risk factor for VTE (OR =5.6). From a clinical practice perspective, it is important to identify which NH residents are at risk of VTE. While it might be assumed that, similar to estimates for the population generally, surgery, medical hospitalization, and cancer are associated with increased risk of VTE within the NH population, the answer remains unclear. We took advantage of the previous identification of all Olmsted County, MN residents who met research criteria for incident VTE 1998-2005 (N=1168). We then determined which individuals were resident of a local NH at time of symptom onset, regardless of location of symptom onset (i.e., for purposes of this study, individuals whose VTE occurred in-hospital having been admitted from a NH were considered NH residents). For each such NH VTE case (N=96), we identified 2 same sex Olmsted County residents of similar age and duration-of-medical-history who were resident of a local NH at the time of the case's VTE event (i.e., index date) (N=192). The detailed provider-linked medical records of NH VTE cases and NH non-VTE controls were reviewed for 3 months before index for surgery or medical hospitalization and for 6 months surrounding index for active cancer. Using conditional logistic regression, we tested and estimated the odds ratio associated with each of these potential risk factors. The proportions of NH VTE cases and NH non-VTE controls with surgery (33%, 28%), medical hospitalization (44%, 46%), and active cancer (12%, 9%) were similar. Univariate odds ratios (95% confidence intervals) and p values for surgery, medical hospitalization, and active cancer were 1.5 (0.7-3.1), p=0.30; 1.1 (0.6-2.1), p=0.74; and 1.4 (0.6-3.2), p=0.46 respectively. Compared to the entire Olmsted County population, the odds of VTE associated with surgery, hospitalization, and cancer are surprisingly much lower for NH residents. Additional investigation is needed to characterize the subset of NH residents at increased risk of VTE. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Factors associated with the development of ocular candidiasis and ocular prognosis with echinocandin therapy for candidemia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Daiki Sakai ◽  
Wataru Matsumiya ◽  
Sentaro Kusuhara ◽  
Makoto Nakamura
Keyword(s):  
Candida Albicans ◽  
Medical Records ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Patient Characteristics ◽  
Antifungal Drugs ◽  
Factors Associated ◽  
Logistic Analysis ◽  
Multivariate Logistic Analysis ◽  
Systemic Antifungal Therapy

Abstract Purpose To evaluate the factors associated with the development of ocular candidiasis (OC) and ocular prognosis with echinocandin therapy for candidemia. Methods The medical records of 56 consecutive patients with a positive blood culture for Candida species between November 2016 and October 2019 were retrospectively reviewed. Information on patient characteristics, isolated Candida species, treatment details for candidemia, and ocular findings were extracted to identify factors associated with OC development. Results The leading pathogen of candidemia was Candida albicans (C.albicans) (41.1%). Of 56 patients, 18 (32.1%) were diagnosed with chorioretinitis, categorized as either probable (8 patients) or possible OC (10 patients). There was no case of endophthalmitis with vitritis. The incidence of probable OC was not significantly different between the groups treated with echinocandins and other antifungal drugs (15.2% vs. 11.1%, p = 1.00). In all probable OC cases, systemic antifungal therapy was switched from echinocandins to azoles, and no case progressed to endophthalmitis. A multivariate logistic analysis revealed that female sex (adjusted odds ratio [aOR], 8.93; 95% confidence interval [CI], 1.09–72.9) and C. albicans (aOR, 23.6; 95% CI, 1.8–281) were independent factors associated with the development of probable OC. Conclusion One-seventh of patients with candidemia developed probable OC. Given the evidence of female and C. albicans as the factors associated with OC development, careful ophthalmologic management is required with these factors, especially in candidemia. Although echinocandins had no correlation with OC development and did not lead to the deterioration of ocular prognosis, further investigation is required.

Readmission after Adult Uvulopalatopharyngoplasty: A Population-Based Inpatient Cohort Study in Taiwan

2018 ◽  
Vol 160 (3) ◽  
pp. 559-566 ◽  
Author(s):  
Ying-Shuo Hsu ◽  
Wei-Chung Hsu ◽  
Jenq-Yuh Ko ◽  
Te-Huei Yeh ◽  
Chia-Hsuan Lee ◽  
...  
Keyword(s):  
Odds Ratio ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Factors Associated ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
Classification Of Diseases ◽  
Insurance Database ◽  
Population Based Survey

Objective To investigate readmissions among adult inpatients who underwent uvulopalatopharyngoplasty (UPPP) in Taiwan. Design Population-based survey. Setting Retrospective study with the National Health Insurance Database. Methods All cases of inpatient adult UPPP (age >20 years) from 1997 to 2012 were identified through International Classification of Diseases, Ninth Revision, Clinical Modification. Factors associated with readmission within 30 days after surgery were analyzed. Results A total of 38,839 adults with UPPP were identified (mean age, 39.3 years; men, 73.7%). The incidence of UPPP was 14.6 per 100 000 adults, which increased from 1997 to 2012 (6.7 to 16.7 per 100,000, Ptrend < .001). The rates of readmission for any reason, readmission for bleeding, reoperation for bleeding, and 30-day mortality were 4.2%, 1.7%, 1.0%, and 0.14%, respectively. Young age increased the risk of reoperation for bleeding, and old age increased the risk of readmission for any reason and mortality. Men had an increased risk of readmission and reoperation. Hypertension was associated with an increased risk of readmission for any reason (odds ratio [OR], 1.29; 95% CI, 1.10-1.51), bleeding-related readmission (OR, 1.89; 95% CI, 1.52-2.36), and reoperation (OR, 2.47; 95% CI, 1.84-3.30). Concurrent hypopharyngeal surgery was associated with an increased risk of readmission for any reason (OR, 1.34; 95% CI, 1.07-1.66) and bleeding-related readmission (OR, 1.69; 95% CI, 1.25-2.27). Finally, the use of steroids was associated with an increased risk of bleeding-related readmission and reoperation. Conclusions The incidence of adult UPPP increased from 1997 to 2012 in Taiwan. Age, sex, comorbidity, concurrent hypopharyngeal surgery, and drug administration were associated with readmission after inpatient UPPP.

Prevalence and potentially reversible factors associated with anorexia among older nursing home residents: Results from the ULISSE Project

2013 ◽  
Vol 4 ◽  
pp. S45 ◽  
Author(s):  
G. Dell’Aquila ◽  
F. Landi ◽  
P. Eusebi ◽  
B. Gasperini ◽  
R. Liperoti ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Home Residents ◽  
Factors Associated

scholarly journals Factors Associated With Deprescribing Acetylcholinesterase Inhibitors in Older Nursing Home Residents With Severe Dementia

2019 ◽  
Vol 67 (9) ◽  
pp. 1871-1879 ◽  
Author(s):  
Joshua D. Niznik ◽  
Xinhua Zhao ◽  
Meiqi He ◽  
Sherrie L. Aspinall ◽  
Joseph T. Hanlon ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Home Residents ◽  
Acetylcholinesterase Inhibitors ◽  
Severe Dementia ◽  
Factors Associated

scholarly journals Antimicrobial Use in US Hospitals: Comparison of Results From Emerging Infections Program Prevalence Surveys, 2015 and 2011

2020 ◽  
Author(s):  
Shelley S Magill ◽  
Erin O’Leary ◽  
Susan M Ray ◽  
Marion A Kainer ◽  
Christopher Evans ◽  
...  
Keyword(s):  
Medical Records ◽  
Generation Cephalosporin ◽  
Fourth Generation ◽  
Antimicrobial Use ◽  
Emerging Infections ◽  
Prevalence Survey ◽  
Factors Associated ◽  
Binomial Regression ◽  
Healthcare Associated ◽  
Critical Care Patients

Abstract Background In the 2011 US hospital prevalence survey of healthcare-associated infections and antimicrobial use 50% of patients received antimicrobial medications on the survey date or day before. More hospitals have since established antimicrobial stewardship programs. We repeated the survey in 2015 to determine antimicrobial use prevalence and describe changes since 2011. Methods The Centers for Disease Control and Prevention’s Emerging Infections Program sites in 10 states each recruited ≤25 general and women’s and children’s hospitals. Hospitals selected a survey date from May–September 2015. Medical records for a random patient sample on the survey date were reviewed to collect data on antimicrobial medications administered on the survey date or day before. Percentages of patients on antimicrobial medications were compared; multivariable log-binomial regression modeling was used to evaluate factors associated with antimicrobial use. Results Of 12 299 patients in 199 hospitals, 6084 (49.5%; 95% CI, 48.6–50.4%) received antimicrobials. Among 148 hospitals in both surveys, overall antimicrobial use prevalence was similar in 2011 and 2015, although the percentage of neonatal critical care patients on antimicrobials was lower in 2015 (22.8% vs 32.0% [2011]; P = .006). Fluoroquinolone use was lower in 2015 (10.1% of patients vs 11.9% [2011]; P &lt; .001). Third- or fourth-generation cephalosporin use was higher (12.2% vs 10.7% [2011]; P = .002), as was carbapenem use (3.7% vs 2.7% [2011]; P &lt; .001). Conclusions Overall hospital antimicrobial use prevalence was not different in 2011 and 2015; however, differences observed in selected patient or antimicrobial groups may provide evidence of stewardship impact.

Risk factors associated with accidental falls among Italian nursing home residents: A longitudinal study (FRAILS)

2020 ◽  
Vol 41 (2) ◽  
pp. 75-80
Author(s):  
Anna Castaldo ◽  
Andrea Giordano ◽  
Raffaele Antonelli Incalzi ◽  
Maura Lusignani
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Longitudinal Study ◽  
Accidental Falls ◽  
Nursing Home Residents ◽  
Factors Associated
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