A Case-Control Study of Acute Respiratory Tract Infection in General Practice Patients in The Netherlands

Abstract Background Evidences regarding the associations between maternal upper respiratory tract infection/influenza during pregnancy and the risk of congenital heart disease (CHD) is still controversial. This study was specifically designed to examine the associations by a case-control study and a meta-analysis of the published evidences and our finding. Methods A hospital-based case-control study involving 262 children with simple CHD and 262 children with complex CHD, along with 262 control children, was conducted through June, 2016 to December, 2017. All children were aged 0–2 years old. Furthermore, a meta-analysis based on both previously published studies and our case-control study was performed. Results In the case-control study, after adjusting for possible confounders, maternal upper respiratory tract infection/influenza during early pregnancy was found to be related to an increased risk of CHD (OR = 3.40 and 95% CI: 2.05–5.62 for simple CHD; OR = 2.39 and 95% CI: 1.47–3.88 for complex CHD). After a meta-analysis, the adverse impact was still kept significant (OR = 1.47 and 95% CI: 1.28–1.67 for simple CHD; OR = 1.44 and 95% CI: 1.14–1.75 for complex CHD). The very similar associations were also observed among single type of CHD, herein, ventricular septal defects (VSD) and tetralogy of fallot (TOF) in the case-control study. In the subsequent meta-analysis, however, the significant association only existed in VSD. Conclusions Although there is still conflicting in TOF, the results are overall consistent, which provide new enforced evidence that maternal upper respiratory tract infection/influenza during early pregnancy, in general, play an important role in the occurrence of CHD.

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Burkholderia cepaciaLower Respiratory Tract Infection Associated With Exposure to a Respiratory Therapist

Infection Control and Hospital Epidemiology ◽

10.1086/501928 ◽

2001 ◽

Vol 22 (7) ◽

pp. 423-426 ◽

Cited By ~ 28

Author(s):

Alan H. Ramsey ◽

Patrice Skonieczny ◽

Diane T. Coolidge ◽

Terry A. Kurzynski ◽

Mary E. Proctor ◽

...

Keyword(s):

Intensive Care ◽

Tract Infection ◽

Respiratory Tract ◽

Infection Control ◽

Respiratory Tract Infection ◽

Case Control Study ◽

Respiratory Therapy ◽

Case Control ◽

Respiratory Therapist ◽

Control Study

AbstractObjective:To investigate and control a nosocomial outbreak ofBurkholderia cepacialower respiratory tract infection.Design:Outbreak investigation and case-control study.Setting:A 260-bed community hospital.Patients:Participants were mechanically ventilated intensive care patients without cystic fibrosis. A case was defined as a hospitalized patient with a sputum culture positive forB cepaciabetween January 1 and November 6, 1998.Methods:Respiratory therapy infection control policies and practices were reviewed; laboratory and environmental studies and a retrospective case-control study were conducted. Case-patients were matched with control-patients on age, gender, diagnosis, and type of intensive care unit.Results:Nine case-patients were identified;B cepacialikely caused pneumonia in seven and colonization in two. Two respiratory therapy practices probably contributed to the transmission ofB cepacia:multidose albuterol vials were used among several patients, and nebulizer assemblies often were not dried between uses.B cepaciawas grown from cultures of three previously opened multidose vials; pulsed-field gel electrophoresis patterns ofB cepaciafrom seven case-patients and two multidose vials were indistinguishable. Case-patients had longer durations of heated humidified mechanical ventilation (mean, 9.8 days vs 4.4 days;P=.03) and were more likely to have exposure to one particular respiratory therapist than controls (odds ratio, undefined; 95% confidence interval, 4.7-∞P=.001). The association with the respiratory therapist, a temporary employee, persisted after controlling for duration of heated humidified ventilation. No newB cepaciainfections were identified after control measures were implemented.Conclusions:B cepaciaprobably was transmitted among patients through use of extrinsically contaminated multidose albuterol vials. Respiratory therapy departments must pay close attention to infection control practices, particularly among new or temporary staff.

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