scholarly journals Outcomes of UTI and bacteriuria caused by ESBL vs. non-ESBL Enterobacteriaceae isolates in pregnancy: a matched case–control study

2018 ◽  
Vol 146 (6) ◽  
pp. 771-774 ◽  
Author(s):  
Y. Yagel ◽  
H. Nativ ◽  
K. Riesenberg ◽  
L. Nesher ◽  
L. Saidel-Odes ◽  
...  

AbstractInfections caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) have become increasingly prevalent, posing a serious public threat worldwide. It is commonly believed that untreated urinary tract infections (UTI) and asymptomatic bacteriuria (ABU) during pregnancy are associated with poor obstetric outcomes. Currently, there is a paucity of data regarding the outcomes or risk factors of such ESBL-E infections in pregnant women. We conducted a retrospective 1:2 matched case–control study of hospitalised pregnant women with ESBL-E- vs. non-ESBL-producing Enterobacteriaceae-positive urine cultures obtained between 2004 and 2015, and compared risk factors for the development of resistant bacteria, clinical course and outcomes. In total, 87 pregnant women with ESBL-E-positive urine cultures were matched to 174 controls by decade of age, ethnicity and pregnancy trimester. Significant risk factors for acquisition of ESBL-E included prior UTI/ABU episodes (50.6% vs. 26.3%, P < 0.001), previous isolation of ESBL-E in urine cultures (12.6% vs. 0.6%, P < 0.001) and prior antibiotic exposure (71.3% vs. 54%, P = 0.002). Previous hospitalisation, however, was not found to be a risk factor. No significant difference was found in adverse obstetric outcomes. We conclude that prior urinary infections and antibiotic exposure were significant risk factors for the isolation of ESBL-E pathogens from the urine of pregnant women; however, this was not associated with worse obstetric outcomes compared with non-ESBL-E pathogens.

2021 ◽  
Author(s):  
marianna meschiari ◽  
Shaniko Kaleci ◽  
Gabriella Orlando ◽  
Silvia Selmi ◽  
Antonella Santoro ◽  
...  

Abstract Background During the last decade carbapenem-resistant Acinetobacter baumannii (CRAB) became hyper-endemic in hospitals due to difficult to control spreading. Our aim is to identify risk factors for nosocomial rectal CRAB colonization in an endemic hospital. Methods A retrospective matched case-control study (ratio 1:2) with a prospective inclusion of cases and concurrent selection of controls was conducted from January 2017 to December 2018 in a tertiary-care hospital. Universal active surveillance for CRAB was implemented. Univariate and multivariate logistic regression was carried out using a stepwise selection method to compare prognostic factors between cases and controls. A sub-analysis was carried out according to the type of department. Results Forty-five cases with nosocomial rectal CRAB colonization and 90 controls were included. One hundred and two (75%) patients were hospitalized in medical departments. At multivariable analysis significant risk factors associated with CRAB colonization were: use of permanent devices (OR: 10.15, 95%CI: 2.27–45.39; P = 0.002), mechanical ventilation (OR: 40.01, 95%CI: 4.05–395.1; P = 0.002), urinary catheters (OR: 4.9, 95%CI:1.52–16.19; P = 0.008), McCabe score (OR: 5.45, 95%CI: 1.87–15.89; P = 0.002), length of stay (OR: 1.03, 95%CI: 1.01–1.05; P = 0.002), carbapenem use (OR: 5.39, 95%CI: 1.14–25.44; P = 0.033). The sub-analysis showed that patients admitted to different departments had different risk factors. In geriatric department a fatal disease and a longer hospital stay represented significant risk factors both in univariate and multivariate analysis, while in internal medicine department the use of permanent devices, current antibiotic therapy and antibiotic polytherapy represented significant risk factors for CRAB at the univariate analysis, also confirmed in multivariate analysis. Conclusions Our data suggest that active surveillance for rectal CRAB colonization should be addressed to patients with an unfavourable prognosis, longer hospitalizations and carriers of multiple devices. To counter CRAB spreading in endemic settings, clinicians must limit the use of carbapenems, and reinforce interventions aimed at proper use of devices.


Author(s):  
Marianna Meschiari ◽  
Shaniko Kaleci ◽  
Gabriella Orlando ◽  
Silvia Selmi ◽  
Antonella Santoro ◽  
...  

Abstract Background During the last decade carbapenem-resistant Acinetobacter baumannii (CRAB) became hyper-endemic in hospitals due to difficult to control spreading. Our aim is to identify risk factors for nosocomial rectal CRAB colonization in an endemic hospital. Methods A retrospective matched case–control study (ratio 1:2) with a prospective inclusion of cases and concurrent selection of controls was conducted from January 2017 to December 2018 in a tertiary-care hospital. Universal active surveillance for CRAB was implemented. Univariate and multivariate logistic regression was carried out using a stepwise selection method to compare prognostic factors between cases and controls. A sub-analysis was carried out according to the type of department. Results Forty-five cases with nosocomial rectal CRAB colonization and 90 controls were included. One hundred and two (75%) patients were hospitalized in medical departments. At multivariable analysis significant risk factors associated with CRAB colonization were: use of permanent devices (OR 10.15, 95% CI 2.27–45.39; P = 0.002), mechanical ventilation (OR 40.01, 95% CI 4.05–395.1; P = 0.002), urinary catheters (OR 4.9, 95% CI 1.52–16.19; P = 0.008), McCabe score (OR 5.45, 95% CI 1.87–15.89; P = 0.002), length of stay (OR 1.03, 95% CI 1.01–1.05; P = 0.002), carbapenem use (OR 5.39, 95% CI 1.14–25.44; P = 0.033). The sub-analysis showed that patients admitted to different departments had different risk factors. In geriatric department a fatal disease and a longer hospital stay represented significant risk factors both in univariate and multivariate analysis, while in internal medicine department the use of permanent devices, current antibiotic therapy and antibiotic polytherapy represented significant risk factors for CRAB at the univariate analysis, also confirmed in multivariate analysis. Conclusions Our data suggest that active surveillance for rectal CRAB colonization should be addressed to patients with an unfavourable prognosis, longer hospitalizations and carriers of multiple devices. To counter CRAB spreading in endemic settings, clinicians must limit the use of carbapenems, and reinforce interventions aimed at proper use of devices.


2021 ◽  
pp. 1-26
Author(s):  
Xue-min Huang ◽  
Yan-hua Liu ◽  
Han Zhang ◽  
Yuan Cao ◽  
Wei-feng Dou ◽  
...  

Abstract The effect of vitamin D (VD) on the risk of preeclampsia (PE) is uncertain. Few of previous studies focused on the relationship between dietary VD intake and PE risk. Therefore, we conducted this 1:1 matched case-control study to explore the association of dietary VD intake and serum VD concentrations with PE risk in Chinese pregnant women. A total of 440 pairs of participants were recruited during March 2016 to June 2019. Dietary information was obtained using a 78-item semi-quantitative food frequency questionnaire. Serum concentrations of 25(OH)D2 and 25(OH)D3 were measured by liquid chromatography–tandem mass spectrometry. Multivariate conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic splines (RCS) were plotted to evaluate the dose-response relationship of dietary VD intake and serum VD concentrations with PE risk. Compared with the lowest quartile, the ORs of the highest quartile were 0.45 (95%CI: 0.29-0.71, Ptrend = 0.001) for VD dietary intake and 0.26 (95%CI: 0.11-0.60, Ptrend = 0.003) for serum levels after adjusting for confounders. In addition, the RCS analysis suggested a reverse J-shaped relationship between dietary VD intake and PE risk (P-nonlinearity = 0.02). A similar association was also found between serum concentrations of total 25(OH)D and PE risk (P-nonlinearity = 0.02). In conclusion, this study provides evidence that higher dietary intake and serum levels of VD are associated with the lower risk of PE in Chinese pregnant women.


2020 ◽  
Vol 20 (3) ◽  
pp. 321-328
Author(s):  
Junichi Kushioka ◽  
Shota Takenaka ◽  
Takahiro Makino ◽  
Yusuke Sakai ◽  
Masafumi Kashii ◽  
...  

2021 ◽  
Vol 223 ◽  
pp. 140-148
Author(s):  
Ken-Kuo Lin ◽  
Jiahn-Shing Lee ◽  
Chiun-Ho Hou ◽  
Wei-Min Chen ◽  
Ching-Hsi Hsiao ◽  
...  

2014 ◽  
Vol 6 (2) ◽  
pp. 329-338
Author(s):  
N. Quraishi ◽  
U. Bhosale ◽  
R. Yegnanarayan ◽  
D. Devasthale

This study was conducted to assess and compare the cardiovascular risk and to explore the demography of CV risk of nonselective cyclooxygenase inhibitors (COX-Is) and selective COX-2-Is in arthritic patients. In this comparative matched case control study adult arthritic patients of either sex taking COX-Is for >1 yr; were included. Arthritic age and sex matched individuals with no history of COX-Is treatment were the controls. Patients those with history of any other disease (e.g. diabetes, hypertension, stroke, IHD etc.) were excluded. Patients were grouped into Control, nonselective COX-I and selective COX-2-I groups. The CV risk factors like blood pressure, blood sugar level(BSL), lipid profile, BMI(body mass index) etc. were assessed and compared; demography of CV risk factors i.e. age, sex, smoking, alcohol, heredity was also studied. Qualitative data was analyzed using Chi-square and quantitative data was analyzed by student’s‘t’-test. Study clearly revealed that all NSAIDs exhibit significant CV risk when taken over a period of time as in arthritis. However selective COX 2-Is found to exhibit more CV risk in this regard. Odds ratio (OR) for CV risk=10.3(95% CI: 1.45, 3.31) and OR for CV risk=5.2(95%CI: 1.05, 2.57) for nonselective COX-Is. BMI, BSL and lipid profile; the potential CV risk factors, showed significant impairment in selective COX 2-Is group; P<0.05, P<0.05 and P<0.01 (HDL), P<0.001 (cholesterol), respectively compared to controls and P<0.05 compared to nonselective COX-Is. This study portrays the potential CV risk of selective COX 2-Is and confirms and re-evaluate the results of earlier studies in this regard.  Keywords: Anti-arthritic agents; BMI; COX-Is; CV risk; Lipid profile.  © 2014 JSR Publications. ISSN: 2070-0237 (Print); 2070-0245 (Online). All rights reserved.  doi: http://dx.doi.org/10.3329/jsr.v6i2.17039 J. Sci. Res. 6 (2), 328-338 (2014)  


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