Neisseria meningitidis carriage and risk factors among teenagers in Suizhou city in China

Abstract Teenagers are important carriers of Neisseria meningitidis, which is a leading cause of invasive meningococcal disease. In China, the carriage rate and risk factors among teenagers are unclear. The present study presents a retrospective analysis of epidemiological data for N. meningitidis carriage from 2013 to 2017 in Suizhou city, China. The carriage rates were 3.26%, 2.22%, 3.33%, 3.53% and 9.88% for 2013, 2014, 2015, 2016 and 2017, respectively. From 2014 to 2017, the carriage rate in the 15- to 19-year-old age group (teenagers) was the highest and significantly higher than that in remain age groups. Subsequently, a larger scale survey (December 2017) for carriage rate and relative risk factors (population density, time spent in the classroom, gender and antibiotics use) were investigated on the teenagers (15- to 19-year-old age) at the same school. The carriage rate was still high at 33.48% (223/663) and varied greatly from 6.56% to 52.94% in a different class. Population density of the classroom was found to be a significant risk factor for carriage, and 1.4 persons/m2 is recommended as the maximum classroom density. Further, higher male gender ratio and more time spent in the classroom were also significantly associated with higher carriage. Finally, antibiotic use was associated with a significantly lower carriage rate. All the results imply that attention should be paid to the teenagers and various measures can be taken to reduce the N. meningitidis carriage, to prevent and control the outbreak of IMD.

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The 5-Factor Modified Frailty Index Predicts Complications and Worsening After Meningioma Surgery in Non-elderly Rather Than Elderly Patients: A Nationwide Registry Study

10.21203/rs.3.rs-411629/v1 ◽

2021 ◽

Author(s):

Fusao Ikawa ◽

Nobuaki Michihata ◽

Soichi Oya ◽

Toshikazu Hidaka ◽

Shingo Matsuda ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Elderly Patients ◽

Frailty Index ◽

Age Groups ◽

Significant Risk ◽

Significant Risk Factor ◽

Nationwide Registry ◽

Modified Frailty Index ◽

Meningioma Surgery

Abstract The simplified 5-factor modified frailty index (mFI-5) is a useful indicator of outcome for patients undergoing surgeries and considered as an important risk factor in elderly patients. However, its usefulness has not been validated based on age groups. We aimed to investigate the risk factors including the mFI-5 across age groups for complications and worse outcomes in meningioma surgery using data obtained from the nationwide database in Japan. We extracted data from the nationwide registry database in Japan between 2010 and 2015. Age (< 65, 65–74, and ≥ 75 years), sex, Barthel Index (BI), mFI-5 scores, and complications were evaluated. Multivariate logistic regression analyses identified risk factors across all age groups for worsening BI scores and complications after surgery. In 8,138 included cases, an mFI-5 score ≥ 2 items was a significant risk factor for worsening BI scores in patients aged < 65 years (odds ratio: 2.00; 95% confidence interval: 1.31-3.06), but not in patients aged 65-74 years and those aged ≥ 75 years. Similar results were noted for complications in patients aged < 65 years (2.40; 1.67–3.44), but not in patients aged 65-74 years and those aged ≥ 75 years. In conclusion, the mFI-5 scores can predict the risk of worsening outcome and complications in non-elderly patients aged < 65 years rather than in elderly patients aged ≥ 65 years. In meningioma surgeries, care must be taken when making decisions using the mFI-5 scores based on the patients’ age.Trial RegistrationName: Study on treatment method, age group, complications, and outcome of meningiomas and hemangioblastomas using DPC, URL: http://www.umin.ac.jp/ctr/index-j.htmID: UMIN000038486, No.: R000043856

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Risk factors for tuberculous empyema in pleural tuberculosis patients

Scientific Reports ◽

10.1038/s41598-019-56140-4 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Peng Wen ◽

Min Wei ◽

Chao Han ◽

Yu He ◽

Mao-Shui Wang

Keyword(s):

Risk Factors ◽

Protective Factor ◽

Significant Risk ◽

Multivariate Logistic Regression Analysis ◽

Epidemiological Data ◽

Significant Risk Factor ◽

Multidrug Resistant ◽

Mortality And Morbidity ◽

Pulmonary Tb ◽

Pleural Tuberculosis

AbstractTuberculous empyema (TE) is associated with high mortality and morbidity. In the retrospective cohort study, we aimed to find risk factors for TE among pleural tuberculosis (TB) patients. Between July 2011 and September 2015, all culture-confirmed pleural TB patients (474 cases) were enrolled in our study. Empyema was defined as grossly purulent pleural fluid. Demographic and epidemiological data were collected for further analysis. Multivariate logistic regression analysis was used to evaluate risk factors of TE in pleural TB, age–adjusted odds ratio (OR) and 95% confidence interval (CI) were calculated to show the risk. The mean age was 35.7 ± 18.1 years old, males comprised 79.1% of the participants (375 cases). Forty-seven patients (9.9%) were multidrug-resistant TB (MDR-TB), 29 (6.1%) had retreatment TB, 26 (5.5%) had diabetes mellitus. The percentage of empyema patients was 8.9% (42 cases). Multivariate analysis revealed that male (adjusted OR = 4.431, 95% CI: 1.411, 13.919), pleural adenosine deaminase (ADA, >88 U/L) (adjusted OR = 3.367, 95% CI: 1.533, 7.395) and white blood cell (WBC, >9.52 109/L) (adjusted OR = 5.763, 95% CI: 2.473, 13.431) were significant risk factors for empyema in pleural TB, while pulmonary TB (adjusted OR = 0.155, 95% CI: 0.072, 0.336) was the protective factor for the patients. TE remains a serious threat to public health in China. Male sex is a significant risk factor for TE while the presence of pulmonary TB is protective, and high levels of pleural ADA and WBC count could aid in early diagnosis of TE. This finding would help towards reducing the mortality and morbidity associated with TE.

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Risk factors for Clostridium difficile infection in C. difficile colonized ICU patients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.1007 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S403-S403

Author(s):

Yuan Zhou ◽

Larissa Lewis ◽

Michelle McIntosh ◽

Ferric C Fang ◽

Ronald Pergamit ◽

...

Keyword(s):

Risk Factors ◽

Clostridium Difficile ◽

Disease Transmission ◽

Significant Risk ◽

Retrospective Chart Review ◽

Signs And Symptoms ◽

Significant Risk Factor ◽

Antibiotic Use ◽

Research Support ◽

Icu Patients

Abstract Background Clostridium difficile is a major cause of healthcare-associated infections leading to significant morbidity and mortality; however, data-driven interventions to decrease C. difficile infections (CDI) are lacking due to an incomplete understanding of disease transmission and risk factors. Asymptomatic C. difficile carriers may be an important source of nosocomial transmission and disease but few studies have examined colonized patients who later develop CDI. We describe risk factors for the development of CDI in a critical care population screened for C. difficile colonization. Methods All patients admitted to our medical or trauma ICUs were screened for toxigenic C. difficile by PCR via rectal swab. Colonized patients were placed in contact enteric precautions for their entire hospitalization and monitored for signs and symptoms of CDI. Retrospective chart review assessed risk factors associated with development of CDI. Results 868 rectal swabs were collected from 4/01/16 to 10/31/16. 40 patients were colonized with C. difficile on ICU admission and 20 developed symptomatic CDI (Table 1). Risk factors for CDI in colonized patients include enteral feeding and exposure to antibiotics (Table 2). Conclusion 50% of C. difficile colonized ICU patients progressed to symptomatic CDI during their hospitalization. Antibiotic use was a significant risk factor for CDI. C. difficile carriers may be a particularly vulnerable population for CDI, warranting further investigation for early identification of colonized patients and strategies for infection prevention. Disclosures F. C. Fang, BioFire: Collaborator, Consultant and Scientific Advisor, Consulting fee, Research support and Speaker honorarium; Cepheid: Collaborator, Consultant and Scientific Advisor, Consulting fee, Educational grant, Research support and Speaker honorarium

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Etiological characteristic and risk factors of ESBL-Urinary Tract Infections: A nomogram had been built and Urologist should act in time

10.21203/rs.3.rs-31324/v1 ◽

2020 ◽

Author(s):

Yi Wei ◽

Chengjun Yu ◽

Tianxing Zhao ◽

Tao Lin ◽

Dawei He ◽

...

Keyword(s):

Risk Factors ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Significant Risk ◽

Significant Risk Factor ◽

Antibiotic Use ◽

Clinical Microbiology Laboratory ◽

Neurologic Disorder ◽

Extended Spectrum Beta Lactamase ◽

Tract Infections

Abstract Background: The presence of urinary tract infection (UTI) due to Extended-Spectrum Beta-Lactamase (ESBL)-producing bacteria is reported increased. Aim to study the most frequent uropathogens and the antibiotic susceptibility patterns of them in children and identify whether urodynamic change, underlying neurologic disorders and undernourishment were independent risk factors for ESBL positive UTI which is unclear. Methods: We retrospectively reviewed microbial etiologies and antimicrobial resistance among patients experiencing UTI events in the urology ward of Chongqing Medical University Afflicated Chlidren's Hospital from January 1994 and December 2019. All strains were cultured and identified by the Clinical Microbiology Laboratory. Results: A total of 854 patients with UTI over a 26-years period were evaluated and Escherichia coli was the most common pathogen. During the study period, the proportion of UTI cases attributed to Enterococci increased significantly. Susceptibilities to carbapenems and amikacin decreased significantly, indicating increased antibiotic resistance of pathogens associated with UTI. Interestingly, the susceptibilities to piperacillin/tazobactam have increased. 72.64% were caused by ESBL bacteria and ESBL-producing bacteria increased significantly. ESBL (+) and ESBL (-) UTI were compared and there were no significant differences in the clinical presentation between gender, side of the lesion and urodynamic results. Significant potential risk factors of ESBL-UTI were presence of congenital urological abnormalities, vesicoureteral reflux, neurologic disorder, age <12months, fever and previous use of antibiotics in the last 3 months. On logistic regression analysis, underlying neurologic disorder (OR =8, CI 1.845-34.695) and history of previous antibiotics administration in the last 3 months (OR =4.764, CI 3.114-7.289) were identified as an independent significant risk factor for ESBL- UTI. The nomogram generated was well calibrated for all predictions of ESBL+ probability, and the accuracy of the model nomogram measured by Harrell’s C statistic (C-index) was 0.741. Conclusions: The current situation of multiple bacterial antibiotic resistance has become a worrisome issue in UTI, and urologist should act timely. Our data will greatly assist physicians recognizing the risk factors of ESBL-UTI and optimising antibiotic use.

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Abstract 17276: Impact of Cardiovascular Comorbidities on COVID-19 Infection Risk

Circulation ◽

10.1161/circ.142.suppl_3.17276 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

David Tofovic ◽

Minji Seok ◽

Logan S Schwarzman ◽

Sreenivas Konda ◽

Noreen T Nazir

Keyword(s):

Risk Factors ◽

Cohort Analysis ◽

Age Groups ◽

Significant Risk ◽

Significant Risk Factor ◽

Age Group ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Patient Demographics ◽

The Impact

Introduction: A disproportionate amount of COVID-19 infections has occurred in minority populations and in individuals with comorbid disease. We sought to evaluate the impact of patient demographics, cardiovascular disease (CVD), and known CVD risk factors on the incidence of COVID-19 infection. Methods: Between April 1st to May 1st, 2020, 844 adult patients (mean age 51.4±17.7 years, mean BMI 29.6±8.3, 50% male) admitted for any reason and tested for COVID-19 based on CDC criteria were studied in this large, metropolitan, single-center retrospective cohort analysis. Bivariate and multivariate analysis between patient demographics, CVD, and CVD risk factors with COVID-19 were evaluated. The nonlinear effects of age on COVID-19 test results were further analyzed. Results: Prevalence of COVID-19 was 21.7%. African Americans, Latinos, and Caucasian were 463(55%), 216(25%), 165(20%) respectively. Unadjusted, diabetes mellitus (DM) was significantly related with the COVID-19 positivity (OR 1.83, 95% CI 1.30-2.58, P=0.0005), but age adjusted DM was insignificant (OR 1.35, 95% CI 0.93-1.97, P=0.12). Similar results were found with other CVD risk factors (see Tables 1,2). Stratified analysis by age groups (18-40 years, ≥40 years), DM in the younger age group was the most significant risk factor for the COVID-19 positivity (OR 4.52, 95% CI 1.95-10.52, P=0.0002) but not in older inpatients (OR 1.23, 95% CI 0.85-1.81, P=0.2763). In the older age group, Latinos were significantly higher risk for COVID-19 compared to Caucasian (OR 2.27, 95% CI 1.26-4.07, P=0.005). Conclusions: Increased resources for testing in younger individuals with DM and the Hispanic population may be merited.

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Determining the Prevalence of Nasal Community-acquired MRSA Carriage and Associated Risk Factors in the Turkish Cypriot Population

Flora the Journal of Infectious Diseases and Clinical Microbiology ◽

10.5578/flora.68821 ◽

2020 ◽

Vol 25 (3) ◽

pp. 339-346

Author(s):

Gizem Şanlıtürk ◽

Mümtaz Güran

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Marital Status ◽

Significant Risk ◽

Significant Risk Factor ◽

Nasal Carriage ◽

Developed Countries ◽

Carriage Rate ◽

Nasal Swab Sample ◽

Turkish Cypriot

Introduction: No studies have investigated Community-Acquired Methicillin-Resistant Staphylococcus aureus (CA-MRSA) nasal carriage rate in the Turkish Cypriot community up to now. The aim of this study was to investigate (i) The prevalence of CA-MRSA nasal carriage in the Turkish Cypriot community, (ii) The association of previously identified risk factors with CA-MRSA. Materials and Methods: Our study is a cross-sectional study conducted in Northern Cyprus in 2019 with 487 randomly selected and voluntary participants. In this study, a questionnaire was distributed, and the relationship between nasal CA-MRSA carriage and risk factors was investigated. In addition, the presence of CA-MRSA was determined by taking a nasal swab sample. Results: In this study, the prevalence of nasal CA-MRSA carriage in the Turkish Cypriot society was 6.98% (34/487). Marital status was found to be the only significant risk factor associated with CA-MRSA carriage (p= 0.035) in the study. However, it was found that individuals exposed to risk factors of “hospitalization during the previous year” and “using antibiotic during the last year” were 1.6 and 3.25 times higher than those who did not, respectively. Conclusion: In this study, “marital status” was the only statistically significant risk factor associated with CA-MRSA carriage. Furthermore, the prevalence of nasal CA-MRSA carriage in the Turkish Cypriot population was found to be higher than developed countries. In this context, it is essential to develop health strategies for the sustainability of TK-MRSA carriage surveillance and to reduce carriage.

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Evaluation of Hospital Room Assignment and Acquisition of Clostridium difficile Infection

Infection Control and Hospital Epidemiology ◽

10.1086/658669 ◽

2011 ◽

Vol 32 (3) ◽

pp. 201-206 ◽

Cited By ~ 203

Author(s):

Megan K. Shaughnessy ◽

Renee L. Micielli ◽

Daryl D. DePestel ◽

Jennifer Arndt ◽

Cathy L. Strachan ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Clostridium Difficile ◽

Tertiary Care ◽

Significant Risk ◽

Extended Period ◽

Significant Risk Factor ◽

Antibiotic Use ◽

Care Hospital ◽

Icu Discharge

Background and Objective.Clostridium difficile spores persist in hospital environments for an extended period. We evaluated whether admission to a room previously occupied by a patient with C. difficile infection (CDI) increased the risk of acquiring CDI.Design.Retrospective cohort study.Setting.Medical intensive care unit (ICU) at a tertiary care hospital.Methods.Patients admitted from January 1, 2005, through June 30, 2006, were evaluated for a diagnosis of CDI 48 hours after ICU admission and within 30 days after ICU discharge. Medical, ICU, and pharmacy records were reviewed for other CDI risk factors. Admitted patients who did develop CDI were compared with admitted patients who did not.Results.Among 1,844 patients admitted to the ICU, 134 CDI cases were identified. After exclusions, 1,770 admitted patients remained for analysis. Of the patients who acquired CDI after admission to the ICU, 4.6% had a prior occupant without CDI, whereas 11.0% had a prior occupant with CDI (P = .002). The effect of room on CDI acquisition remained a significant risk factor (P = .008) when Kaplan-Meier curves were used. The prior occupant's CDI status remained significant (P = .01; hazard ratio, 2.35) when controlling for the current patient's age, Acute Physiology and Chronic Health Evaluation III score, exposure to proton pump inhibitors, and antibiotic use.Conclusions.A prior room occupant with CDI is a significant risk factor for CDI acquisition, independent of established CDI risk factors. These findings have implications for room placement and hospital design.

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Risk factors of poor prognosis and impairment of activities of daily living in patients with hemorrhagic gastroduodenal ulcers

BMC Gastroenterology ◽

10.1186/s12876-020-01580-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Junya Arai ◽

Jun Kato ◽

Nobuo Toda ◽

Ken Kurokawa ◽

Chikako Shibata ◽

...

Keyword(s):

Risk Factors ◽

Activities Of Daily Living ◽

Daily Living ◽

Poor Prognosis ◽

Significant Risk ◽

Care Facility ◽

Significant Risk Factor ◽

Advanced Age ◽

Gastroduodenal Ulcers ◽

Poor Outcomes

Abstract Background Impairment of activities of daily living (ADL) due to hemorrhagic gastroduodenal ulcers (HGU) has rarely been evaluated. We analyzed the risk factors of poor prognosis, including mortality and impairment of ADL, in patients with HGU. Methods In total, 582 patients diagnosed with HGU were retrospectively analyzed. Admission to a care facility or the need for home adaptations during hospitalization were defined as ADL decline. The clinical factors were evaluated: endoscopic features, need for interventional endoscopic procedures, comorbidities, symptoms, and medications. The risk factors of outcomes were examined with multivariate analysis. Results Advanced age (> 75 years) was a significant predictor of poor prognosis, including impairment of ADL. Additional significant risk factors were renal disease (odds ratio [OR] 3.43; 95% confidence interval [CI] 1.44–8.14) for overall mortality, proton pump inhibitor (PPIs) usage prior to hemorrhage (OR 5.80; 95% CI 2.08–16.2), and heart disease (OR 3.05; 95% CI 1.11–8.43) for the impairment of ADL. Analysis of elderly (> 75 years) subjects alone also revealed that use of PPIs prior to hemorrhage was a significant predictor for the impairment of ADL (OR 8.24; 95% CI 2.36–28.7). Conclusion In addition to advanced age, the presence of comorbidities was a risk of poor outcomes in patients with HGU. PPI use prior to hemorrhage was a significant risk factor for the impairment of ADL, both in overall HGU patients and in elderly patients alone. These findings suggest that the current strategy for PPI use needs reconsideration.

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Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1344 ◽

2020 ◽

pp. 1-7

Author(s):

Stephanie M. Cabral ◽

Katherine E. Goodman ◽

Natalia Blanco ◽

Surbhi Leekha ◽

Larry S. Magder ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Risk Adjustment ◽

Community Hospital ◽

Significant Risk ◽

Significant Risk Factor ◽

Bivariate Analysis ◽

Patient Admissions ◽

Clostridioides Difficile ◽

Risk Adjustment Model

Abstract Objective: To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Patients: All patients at least 18 years of age admitted to 3 hospitals in Maryland between January 1, 2016, and January 1, 2018. Methods: Comorbid conditions were assigned using the Elixhauser comorbidity index. Multivariable log-binomial regression was conducted for each hospital using significant covariates (P < .10) in a bivariate analysis. Standardized infection ratios (SIRs) were computed using current Centers for Disease Control and Prevention (CDC) risk adjustment methodology and with the addition of Elixhauser score and individual comorbidities. Results: At hospital 1, 314 of 48,057 patient admissions (0.65%) had a HO-CDI; 41 of 8,791 patient admissions (0.47%) at community hospital 2 had a HO-CDI; and 75 of 29,211 patient admissions (0.26%) at community hospital 3 had a HO-CDI. In multivariable regression, Elixhauser score was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic use, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospital 1 and hospital 2. When Elixhauser score was included in the risk adjustment model, it was statistically significant (P < .01). Compared with the current CDC SIR methodology, the SIR of hospital 1 decreased by 2%, whereas the SIRs of hospitals 2 and 3 increased by 2% and 6%, respectively, but the rankings did not change. Conclusions: Electronically available patient comorbidities are important risk factors for HO-CDI and may improve risk-adjustment methodology.

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Designing a bed-side system for predicting length of stay in a neonatal intensive care unit

Scientific Reports ◽

10.1038/s41598-021-82957-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Harpreet Singh ◽

Su Jin Cho ◽

Shubham Gupta ◽

Ravneet Kaur ◽

S. Sunidhi ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care ◽

Length Of Stay ◽

Neonatal Intensive Care ◽

Financial Burden ◽

Significant Risk ◽

Model Performance ◽

Significant Risk Factor ◽

Validation Dataset ◽

Patient Records

AbstractIncreased length of stay (LOS) in intensive care units is directly associated with the financial burden, anxiety, and increased mortality risks. In the current study, we have incorporated the association of day-to-day nutrition and medication data of the patient during its stay in hospital with its predicted LOS. To demonstrate the same, we developed a model to predict the LOS using risk factors (a) perinatal and antenatal details, (b) deviation of nutrition and medication dosage from guidelines, and (c) clinical diagnoses encountered during NICU stay. Data of 836 patient records (12 months) from two NICU sites were used and validated on 211 patient records (4 months). A bedside user interface integrated with EMR has been designed to display the model performance results on the validation dataset. The study shows that each gestation age group of patients has unique and independent risk factors associated with the LOS. The gestation is a significant risk factor for neonates < 34 weeks, nutrition deviation for < 32 weeks, and clinical diagnosis (sepsis) for ≥ 32 weeks. Patients on medications had considerable extra LOS for ≥ 32 weeks’ gestation. The presented LOS model is tailored for each patient, and deviations from the recommended nutrition and medication guidelines were significantly associated with the predicted LOS.

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