Chloramphenicol Resistance in Vancomycin-Resistant Enterococcal Bacteremia: Impact of Prior Fluoroquinolone Use?

2004 ◽  
Vol 25 (2) ◽  
pp. 138-145 ◽  
Author(s):  
Carolyn V. Gould ◽  
Neil O. Fishman ◽  
Irving Nachamkin ◽  
Ebbing Lautenbach
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Medical Center ◽  
Tertiary Care ◽  
Case Control ◽  
Close Monitoring ◽  
Chi Square ◽  
Chloramphenicol Resistance ◽  
Vancomycin Resistant ◽  
Control Study

AbstractObjective:The prevalence of vancomycin-resistant enterococci (VRE) has increased markedly during the past decade. Few data exist regarding the epidemiology of resistance of VRE to chloramphenicol, one of the few therapeutic options.Design:Survey and case-control study.Setting:A 725-bed, tertiary-care academie medical center and a 344-bed urban community hospital.Patients:Hospitalized patients with blood cultures demonstrating VRE.Methods:We examined the trends in the prevalence of chloramphenicol resistance in VRE blood isolates at our institution from 1991 through 2002 and conducted a case-control study to identify risk factors for chloramphenicol resistance among these isolates.Results:From 1991 through 2002, the annual prevalence of chloramphenicol-resistant VRE increased from 0% to 12% (P < .001, chi-square test for trend). Twenty-two case-patients with chloramphenicol-resistant VRE bloodstream isolates were compared with 79 randomly selected control-patients with chloramphenicol-susceptible VRE. Independent risk factors for chloramphenicol-resistant VRE were prior chloramphenicol use (odds ratio [OR], 10.9; 95% confidence interval [CI95], 1.72-68.91; P = .01) and prior fluoroquinolone use (OR, 4.74; CI95, 1.15-19.42; P = .03). Chloramphenicol-resistant VRE isolates were more likely to be susceptible to beta-lactams and resistant to tetracycline than were chloramphenicol-susceptible VRE isolates.Conclusions:Significant increases in the prevalence of chloramphenicol-resistant VRE may limit the future utility of chloramphenicol in the treatment of VRE infections, and close monitoring of susceptibility trends should continue. The association between fluoroquinolone use and chloramphenicol-resistant VRE, reflecting possible co-selection of resistance, suggests that recent dramatic increases in fluoroquinolone use may have broader implications than previously recognized.

scholarly journals Risk Factors for Resistance to β-Lactam/β-Lactamase Inhibitors and Ertapenem in Bacteroides Bacteremia

2015 ◽  
Vol 59 (8) ◽  
pp. 5049-5051 ◽  
Author(s):  
Janessa M. Smith ◽  
Edina Avdic ◽  
Pranita D. Tamma ◽  
Long Zhang ◽  
Karen C. Carroll ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Medical Center ◽  
Tertiary Care ◽  
Case Control ◽  
Retrospective Case ◽  
Content Type ◽  
Development Of Resistance ◽  
Tertiary Care Medical Center ◽  
Control Study

ABSTRACTThe objective of this study was to determine risk factors for the development of resistance to β-lactams/β-lactamase inhibitors (βL/βLIs) and ertapenem amongBacteroidesspecies bacteremia. We conducted a retrospective case-control study of 101 adult patients withBacteroidesspecies bacteremia at a 1,051-bed tertiary care medical center. The duration of exposure to βL/βLIs (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.08 to 2.31) was the only independent risk factor for resistance.

scholarly journals Neonatal Candidemia: Clinical Presentation, Laboratory Profile, Risk Factors and Immediate Outcome in a Tertiary Hospital in Kerala- A Case-Control Study

2020 ◽  
pp. 33-38
Author(s):  
Dr. Jayaram Sankar. KR ◽  
Dr. Sunil Daniel ◽  
Dr. Rekha Rachel Philip
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Tertiary Care ◽  
Binary Logistic Regression ◽  
Tertiary Hospital ◽  
Case Control ◽  
Chi Square ◽  
Chi Square Test ◽  
Laboratory Profile ◽  
Control Study

Objective: To identify the clinical and laboratory profile and risk factors of bloodstream candida infection in newborns and to assess the immediate outcome of candidemia in newborns. Design: Case -control study. Setting: Tertiary care NICU of Govt. T.D. Medical College, Alappuzha, Kerala from 1st January 2010 to 31st December 2014. Methods: Through consecutive sampling, we got 94 cases and 188 controls. For comparison, chi-square test was used, and for strength association Odds ratio was used. Analysis was done using SPSS V18. Binary logistic regression has been used to identify independent risk factors.

Descriptive Epidemiology and Case-Control Study of Patients Colonized With Vancomycin-Resistant Enterococcus and Methicillin-ResistantStaphylococcus aureus

2006 ◽  
Vol 27 (9) ◽  
pp. 913-919 ◽  
Author(s):  
Bryndis Sigurdardottir ◽  
Jeffery Vande Berg ◽  
Jianfang Hu ◽  
Josiah Alamu ◽  
Louise-Anne McNutt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Insufficiency ◽  
Active Surveillance ◽  
Case Control Study ◽  
Tertiary Care ◽  
Case Control ◽  
Vancomycin Resistant Enterococcus ◽  
Methicillin Resistant ◽  
Vancomycin Resistant ◽  
Control Study

Background.Patients colonized or infected with vancomycin-resistant enterococcus and methicillin-resistantStaphylococcus aureusmay be at risk of acquiring vancomycin-resistantS. aureusif the vanA gene is transferred from vancomycin-resistant enterococcus to methicillin-resistantS. aureus..Objective.Our goal was to identify risk factors for cocolonization or coinfection (CC/CI) with vancomycin-resistant enterococcus and methicillin-resistantS. aureus.Design.We conducted a descriptive, epidemiologic study of all patients with CC/CI identified from January 1998 to May 2003 and a nested case-control study of a cohort of patients hospitalized in the burn and wound unit.Setting.We conducted our study in a 813-bed tertiary care university teaching hospital.Population.The study population consisted of patients found to have CC/CI during the study period.Methods.Descriptive epidemiologic data were collected from hospital records of all patients identified as having CC/CI. A subset of patients hospitalized in the burn and wound unit were included in a case-control study.Results.CC/CI was detected in 71% of the patients during a single hospital stay. The burn and wound unit, which does active surveillance for both organisms, and the general medicine unit, which does not do active surveillance for either organism, cared for more than one-half of these patients. Among patients being cared for in the burn and wound unit, having exposure to 2 or more invasive devices (central venous catheters, indwelling urinary catheters, and enteral feeding tubes) and renal insufficiency were independent risk factors for CC/CI.Conclusions.Patients with CC/CI are the population at greatest risk for vancomycin-resistantS. aureuscolonization or infection. The number of invasive devices to which patients are exposed and, thus, possibly the patients' underlying severity of illness, as well as renal insufficiency, appear to be risk factors for CC/CI.

scholarly journals Analisis Faktor Fetus dan Tali Pusat terhadap Risiko Asphyxia Perinatal di Surakarta

2020 ◽  
Vol 3 (1) ◽  
pp. 16
Author(s):  
Siti Lestari ◽  
Dyah Dwi Astuti ◽  
Fachriza Malika Ramadhani
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Perinatal Asphyxia ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
Retrospective Case ◽  
Chi Square ◽  
Fetal Position ◽  
Control Study

Asfiksia perinatal merujuk pada kekurangan oksigen selama persalinan, sehingga berpotensi menyebabkan kematian dan kecacatan. WHO memperkirakan  4 juta anak terlahir dengan asfiksia setiap tahun, dimana 1 juta di antaranya meninggal dan 1 juta anak bertahan hidup dengan gejala sisa neurologis yang parah. Penelitian ini bertujuan untuk menganalisis faktor risiko fetal dan tali pusat pada asfiksia neonatal.Penelitian dilakukan di lakukan di RS Dr Moewardi Surakarta dengan pendekatan  quantitative retrospective case control study. Data diambil dari rekam medis antara  tahun 2013-2018. Penelitan ini melibatkan  264 neonatal yang terdiri dari 88 kelompok kasus dan 176  kelompok control. Kelompok kasus adalah bayi dengan diagnosa  asfiksia yang  dilakukan analisis terhadap faktor risiko fetal, sedangkan bayi yang tidak mengalami asfiksia dijadikan  kelompok kontrol. Hasil analisis statistik uji Chi-Square dan Fisher Exact ditemukan bahwa  kelahiran prematur (OR 2,07 CI 95% P 0,02), persalinan dengan tindakan (OR 3,61 CI 95% P 0,00), berat bayi (OR 2,85 CI 95% P 0,00), posisi janin (OR 2,37 CI 95% P 0,05), tali pusat ( QR 3,071 CI 95%  P 0,01)  berisiko terhadap insiden asfiksia perinatal. Air ketuban yang bercampur meconium (OR 1,51 CI 95% P 0,16) tidak memiliki risiko  dengan Asfiksia perinatal. Kesimpulan: Risiko terhadap insiden asfiksia perinatal  meliputi kelahiran prematur, persalinan dengan tindakan, berat bayi, posisi janin,  dan tali pusat.Perinatal asphyxia refers to a lack of oxygen during labor, which has the potential to cause death and disability. WHO estimates  4 million children born with asphyxia each year, in  which 1 million dies and 1 million survive with severe neurological sequelae. This study aims to analyze fetal and umbilical risk factors in neonatal asphyxia.This research is a quantitative retrospective case-control study, which was conducted at The Dr. Moewardi  hospital,  Surakarta. Data was taken from  medical records from 2013-2018. The case group was patients diagnosed  asphyxia, while those who did not experience asphyxia were treated as a control group.  A total of 264  samples, consisting of 88 case group respondents and 176 control group respondents. Statistical analysis Chi- Square and Fisher Exact found that preterm birth (OR 2.07 CI 95% P 0.02), labor with instrument or complication (OR 3.61 CI 95% P 0.00), infant weight (OR 2.85 CI 95% P 0, 00), fetal position (OR 2.37 CI 95% P 0.05), umbilical cord (QR 3.071 CI 95% P 0.01) are at risk for the incidence of perinatal Asphyxia. The amniotic fluid mixed with meconium (OR 1.51 CI 95% P 0.16) has no risk with perinatal asphyxia.The risk factors of incidences of perinatal asphyxia were  preterm birth, labor with instrument or complication, baby weight, fetal position and umbilical cord. 

scholarly journals Determining the clinical significance of co-colonization of vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus in the intestinal tracts of patients in intensive care units: a case–control study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Young Kyung Yoon ◽  
Min Jung Lee ◽  
Yongguk Ju ◽  
Sung Eun Lee ◽  
Kyung Sook Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Clinical Outcomes ◽  
Intensive Care Units ◽  
Case Control Study ◽  
Case Control ◽  
Methicillin Resistant ◽  
Vancomycin Resistant ◽  
Control Study

Abstract Background The emergence of vancomycin-resistant Staphylococcus aureus (VRSA) has become a global concern for public health. The proximity of vancomycin-resistant enterococcus (VRE) and methicillin-resistant S. aureus (MRSA) is considered to be one of the foremost risk factors for the development of VRSA. This study aimed to determine the incidence, risk factors, and clinical outcomes of intestinal co-colonization with VRE and MRSA. Methods A case–control study was conducted in 52-bed intensive care units (ICUs) of a university-affiliated hospital from September 2012 to October 2017. Active surveillance using rectal cultures for VRE were conducted at ICU admission and on a weekly basis. Weekly surveillance cultures for detection of rectal MRSA were also conducted in patients with VRE carriage. Patients with intestinal co-colonization of VRE and MRSA were compared with randomly selected control patients with VRE colonization alone (1:1). Vancomycin minimum inhibitory concentrations (MICs) for MRSA isolates were determined by the Etest. Results Of the 4679 consecutive patients, 195 cases and 924 controls were detected. The median monthly incidence and duration of intestinal co-colonization with VRE and MRSA were 2.3/1000 patient-days and 7 days, respectively. The frequency of both MRSA infections and mortality attributable to MRSA were higher in the case group than in the control group: 56.9% vs. 44.1% (P = 0.011) and 8.2% vs. 1.0% (P = 0.002), respectively. Independent risk factors for intestinal co-colonization were enteral tube feeding (odds ratio [OR], 2.09; 95% confidence interval [CI] 1.32–3.32), metabolic diseases (OR, 1.75; 95% CI 1.05–2.93), male gender (OR, 1.62; 95% CI 1.06–2.50), and Charlson comorbidity index < 3 (OR, 3.61; 95% CI 1.88–6.94). All MRSA isolates from case patients were susceptible to vancomycin (MIC ≤ 2 mg/L). Conclusions Our study indicates that intestinal co-colonization of VRE and MRSA occurs commonly among patients in the ICU with MRSA endemicity, which might be associated with poor clinical outcomes.

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