Risk factors for hospital-acquired bacteraemia – an explorative case–control study of hospital interventions

2021 ◽  
pp. 1-8
Author(s):  
Viggo Holten Mortensen ◽  
Mette Søgaard ◽  
Brian Kristensen ◽  
Lone Hagens Mygind ◽  
Henrik Carl Schønheyder
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Case Control ◽  
Hospital Acquired ◽  
Control Study

scholarly journals Incidence, in-hospital mortality and risk factors for hospital-acquired pneumonia in patients with intra-abdominal surgical procedures hospitalized in a tertiary hospital in Belgrade, Serbia: A matched case- control study

2020 ◽  
Vol 77 (5) ◽  
pp. 525-531
Author(s):  
Djordje Tausan ◽  
Zoran Kostic ◽  
Damjan Slavkovic ◽  
Branimir Neskovic ◽  
Dubravko Bokonjic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Procedures ◽  
Case Control Study ◽  
Tertiary Hospital ◽  
Case Control ◽  
Hospital Acquired Pneumonia ◽  
Matched Case ◽  
Hospital Acquired ◽  
Matched Case Control Study ◽  
Control Study

Background/Aim. Hospital-acquired pneumonia (HAP) in a surgical population significantly increases morbidity and mortality, prolongs hospitalization and increases total treatment costs. In the present study, we aimed to determine incidence, in-hospital mortality and risk factors (RFs) of HAP in patients with intra-abdominal surgical procedures hospitalized in a tertiary hospital in Belgrade (Serbia). Methods. Through regular hospital surveillance of patients who underwent intra-abdominal surgical procedures, we prospectively identified postoperative HAP during five years. In the matched case-control study, every surgical patient with HAP was compared with four control patients without HAP. In the group of patients with HAP, those who died were compared with those who survived. Results. Overall 1.4% of all intra-abdominal surgical patients developed HAP in the postoperative period. The incidence of HAP (per 1,000 operative procedures) was greatest in patients undergoing exploratory laparotomy (102.6), followed by small bowel surgery (36.6), and gastric surgery (22.7). Multivariate logistic regression analysis (MLRA) identified three independent risk factors (RF) associated with HAP: multiple transfusion [p = 0.011; odds ratio (OR): 4.26; 95% confidence interval (CI): 1.59?11.33], length of hospital stay (p = 0.024; OR: 1.02; 95%CI: 1.00?1.03) and hospitalization in the Intensive care unit (ICU) (p = 0.043; OR: 2.83; 95%CI: 1.03?7.71). MLRA identified only surgical site infection as an independent RF associated with the poor outcome of HAP (p = 0.017; OR: 5.929; CI95%: 1.37?25.67). Conclusion. The results of the present study are valuable in documenting the relations between RFs and HAP in patients undergoing intra- abdominal surgical procedures.

scholarly journals Risk factors for hospital-acquired methicillin-resistant Staphylococcus aureus bacteraemia: a case-control study

2006 ◽  
Vol 134 (6) ◽  
pp. 1167-1173 ◽  
Author(s):  
D. CARNICER-PONT ◽  
K. A. BAILEY ◽  
B. W. MASON ◽  
A. M. WALKER ◽  
M. R. EVANS ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Case Control Study ◽  
Urinary Catheter ◽  
Central Line ◽  
Case Control ◽  
Site Infection ◽  
Hospital Acquired ◽  
Control Study

A case-control study was undertaken in an acute district general hospital to identify risk factors for hospital-acquired bacteraemia caused by methicillin-resistant Staphylococcus aureus (MRSA). Cases of hospital-acquired MRSA bacteraemia were defined as consecutive patients from whom MRSA was isolated from a blood sample taken on the third or subsequent day after admission. Controls were randomly selected from patients admitted to the hospital over the same time period with a length of stay of more than 2 days who did not have bacteraemia. Data on 42 of the 46 cases of hospital-acquired bacteraemia and 90 of the 92 controls were available for analysis. There were no significant differences in the age or sex of cases and controls. After adjusting for confounding factors, insertion of a central line [adjusted odds ratio (aOR) 35·3, 95% confidence interval (CI) 3·8–325·5] or urinary catheter (aOR 37·1, 95% CI 7·1–193·2) during the admission, and surgical site infection (aOR 4·3, 95% CI 1·2–14·6) all remained independent risk factors for MRSA bacteraemia. The adjusted population attributable fraction, showed that 51% of hospital-acquired MRSA bacteraemia cases were attributable to a urinary catheter, 39% to a central line, and 16% to a surgical site infection. In the United Kingdom, measures to reduce the incidence of hospital-acquired MRSA bacteraemia in acute general hospitals should focus on improving infection control procedures for the insertion and, most importantly, care of central lines and urinary catheters.

scholarly journals Prior Antimicrobial Therapy and Risk for Hospital-Acquired Candida glabrata and Candida krusei Fungemia: a Case-Case-Control Study

2005 ◽  
Vol 49 (11) ◽  
pp. 4555-4560 ◽  
Author(s):  
Michael Y. Lin ◽  
Yehuda Carmeli ◽  
Jennifer Zumsteg ◽  
Ernesto L. Flores ◽  
Jocelyn Tolentino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Candida Glabrata ◽  
Antimicrobial Agents ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Control ◽  
Candida Krusei ◽  
Case Group ◽  
Hospital Acquired ◽  
Control Study

ABSTRACT The incidence of infections caused by Candida glabrata and Candida krusei, which are generally more resistant to fluconazole than Candida albicans, is increasing in hospitalized patients. However, the extent to which prior exposure to specific antimicrobial agents increases the risk of subsequent C. glabrata or C. krusei candidemia has not been closely studied. A retrospective case-case-control study was performed at a university hospital. From 1998 to 2003, 60 patients were identified with hospital-acquired non-C. albicans candidemia (C. glabrata or C. krusei; case group 1). For comparison, 68 patients with C. albicans candidemia (case group 2) and a common control group of 121 patients without candidemia were studied. Models were adjusted for demographic and clinical risk factors, and the risk for candidemia associated with exposure to specific antimicrobial agents was assessed. After adjusting for both nonantimicrobial risk factors and receipt of other antimicrobial agents, piperacillin-tazobactam (odds ratio [OR], 4.15; 95% confidence interval [CI], 1.04 to 16.50) and vancomycin (OR, 6.48; CI, 2.20 to 19.13) were significant risk factors for C. glabrata or C. krusei candidemia. For C. albicans candidemia, no specific antibiotics remained a significant risk after adjusted analysis. Prior fluconazole use was not significantly associated with either C. albicans or non-C. albicans (C. glabrata or C. krusei) candidemia. In this single-center study, exposure to antibacterial agents, specifically vancomycin or piperacillin-tazobactam, but not fluconazole, was associated with subsequent hospital-acquired C. glabrata or C. krusei candidemia. Further studies are needed to prospectively analyze specific antimicrobial risks for nosocomial candidemia across multiple hospital centers.

scholarly journals Risk factors for the development of hospital-acquired pediatric venous thromboembolism—Dealing with potentially causal and confounding risk factors using a directed acyclic graph (DAG) analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242311
Author(s):  
Leonardo Rodrigues Campos ◽  
Maurício Petroli ◽  
Flavio Roberto Sztajnbok ◽  
Elaine Sobral da Costa ◽  
Leonardo Rodrigues Brandão ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nephrotic Syndrome ◽  
Directed Acyclic Graph ◽  
Case Control Study ◽  
Case Control ◽  
Final Model ◽  
Acyclic Graph ◽  
Potential Risk Factors ◽  
Hospital Acquired ◽  
Control Study

Introduction Hospital-acquired venous thromboembolism (HA-VTE) in children comprises multiple risk factors that should not be evaluated separately due to collinearity and multiple cause and effect relationships. This is one of the first case-control study of pediatric HA-VTE risk factors using a Directed Acyclic Graph (DAG) analysis. Material and methods Retrospective, case-control study with 22 cases of objectively confirmed HA-VTE and 76 controls matched by age, sex, unit of admission, and period of hospitalization. Descriptive statistics were used to define distributions of continuous variables, frequencies, and proportions of categorical variables, comparing cases and controls. Due to many potential risk factors of HA-VTE, a directed acyclic graph (DAG) model was created to identify confounding, reduce bias, and increase precision on the analysis. The final model consisted of a DAG-informed conditional logistic regression. Results In the initial conventional univariable model, the following variables were selected as potential risk factors for HA-VTE: length of stay (LOS, days), immobility, ICU admission in the last 30 days, LOS in ICU, infection, central venous catheter (CVC), number of CVCs placed, L-asparaginase, heart failure, liver failure, and nephrotic syndrome. The final model using the set of variables selected by DAG analysis revealed LOS (OR = 1.106, 95%CI = 1.021–1.198, p = 0.013), L-asparaginase (OR = 26.463, 95%CI = 1.609–435.342, p = 0.022), and nephrotic syndrome (OR = 29.127, 95%CI = 1.044–812.508, p = 0.004) as independent risk factors for HA-VTE. Conclusion The DAG-based approach was useful to clarify the influence of confounders and multiple causalities of HA-VTE. Interestingly, CVC placement—a known thrombotic risk factor highlighted in several studies—was considered a confounder, while LOS, L-asparaginase use and nephrotic syndrome were confirmed as risk factors to HA-VTE. Large confidence intervals are related to the sample size; however, the results were significant.

Risk factors for hospital-acquired pneumonia outside the intensive care unit: A case-control study

2014 ◽  
Vol 42 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Nieves Sopena ◽  
Eva Heras ◽  
Irma Casas ◽  
Jordi Bechini ◽  
Ignasi Guasch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Control Study ◽  
Case Control ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
Control Study

scholarly journals Risk factors for hospital-acquired ‘poor glycemic control’: a case–control study

2010 ◽  
Vol 23 (1) ◽  
pp. 44-51 ◽  
Author(s):  
Matthew D. Mchugh ◽  
Jingjing Shang ◽  
Douglas M. Sloane ◽  
Linda H. Aiken
Keyword(s):  
Risk Factors ◽  
Glycemic Control ◽  
Case Control Study ◽  
Case Control ◽  
Poor Glycemic Control ◽  
Hospital Acquired ◽  
Control Study

scholarly journals Risk factors for hospital-acquired influenza A and patient characteristics: A matched case-control study

2020 ◽  
Author(s):  
Kui Yang ◽  
Ni Zhang ◽  
Chunchen Gao ◽  
Hongyan Qin ◽  
Anhui Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Influenza A ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Patient Characteristics ◽  
Case Control ◽  
Hospitalized Patients ◽  
Hospital Acquired ◽  
Control Study

Abstract Background: While hospital-acquired influenza A results in an additional cost burden and considerable mortality in patients, its risk factors are unknown. We aimed to describe the characteristics of patients vulnerable to hospital-acquired influenza A and to identify its risk factors to assist clinicians control hospital-acquired infections and reduce the burden of treatment.Methods: A case-control study was conducted among hospitalized patients aged ≥18 years at a tertiary level teaching hospital during the 2018–2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient with no evidence of influenza A infection on admission. The controls without influenza A were selected among patients exposed to the same setting and time period. We identified risk factors using conditional logistic regression and described the characteristics of hospital-acquired influenza A by comparing the clinical data of infected patients and the controls.Results: Of the 412 hospitalized patients with influenza A from all the departments in the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%), and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P=0.027), hypoalbuminemia (78.5% vs 57.0%, P=0.002), and pleural effusion (26.9% vs 9.7%, P=0.002) than the matched controls. Infected patients also had longer hospital stays (18 days vs 14 days, P=0.002), and higher mortality rates (10.8% vs 2.2%, P=0.017) than the matched controls. Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24–7.80; P=0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10–4.57; P=0.027), and pleural effusion (OR: 3.09; 95% CI: 1.26–7.58; P=0.014) were independently associated with hospital-acquired influenza A.Conclusions: Lymphocytopenia, hypoalbuminemia and pleural effusion are independent risk factors that can help identify patients at high risk of hospital-acquired influenza A, which can extend hospital stay and is associated with a high mortality.

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