Preoperative Risk Factors for Nasal Carriage of Staphylococcus aureus

2004 ◽  
Vol 25 (6) ◽  
pp. 481-484 ◽  
Author(s):  
Loreen A. Herwaldt ◽  
Joseph J. Cullen ◽  
Pamela French ◽  
Jianfang Hu ◽  
Michael A. Pfaller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Cerebrovascular Accident ◽  
Antimicrobial Agents ◽  
Nasal Carriage ◽  
Male Gender ◽  
Stepwise Logistic Regression ◽  
Stepwise Logistic Regression Analysis ◽  
Surgical Specialty ◽  
History Of

AbstractBackground:Staphylococcus aureus nasal carriage is a risk factor for surgical-site infections (SSIs) caused by S. aureus, and eradication of carriage reduces postoperative nosocomial infections caused by it. No study has compared large groups of preoperative carriers and non-carriers to identify factors that are linked to S. aureus nasal carriage.Methods:While conducting a clinical trial evaluating whether mupirocin prevented S. aureus SSIs, we prospectively collected data on 70 patient characteristics that might be associated with S. aureus carriage. We performed stepwise logistic regression analysis.Results:Of the 4,030 patients, 891 (22%) carried S. aureus. Independent risk factors for S. aureus nasal carriage were obesity (odds ratio [OR], 1.29; 95% confidence interval [CI95], 1.11-1.50), male gender (OR, 1.29; CI95,1.11-1.51), and a history of a cerebrovascular accident (OR, 1.53; CI95, 1.03-2.25) for all patients. Factors associated with nasal carriage varied somewhat by surgical specialty. In all groups, preoperative use of antimicrobial agents was independently associated with a lower risk of carrying S. aureus in the nares. Previously identified risk factors were not significantly associated with S. aureus nasal carriage in this large group of surgical patients.Conclusion:Male gender, obesity, and a history of a cerebrovascular accident were identified as risk factors for S. aureus nasal carriage. It remains to be seen whether preoperative weight loss would reduce the rate of nasal carriage. In addition, the value of screening this patient population for S. aureus nasal carriage merits further investigation.

Staphylococcus aureus nasal colonization among Vietnamese adults: prevalence, risk factors and antibiotic susceptibility profile

MedPharmRes ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 21-31
Author(s):  
Nguyen Phan ◽  
Hien Pham ◽  
Thuc Nguyen ◽  
Hoai Nguyen
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Nasal Carriage ◽  
Resistance Rate ◽  
High Rate ◽  
Weight History ◽  
Potential Risk Factors ◽  
History Of ◽  
Vietnamese Community

Staphylococcus aureus (S. aureus) has long been recognized as an important human pathogen causing many severe diseases. It is also a part of human normal flora with its ecological niche in the human anterior nares. This study focused on screening S. aureus nasal carriage in community and its relationship to human physiological and pathological factors which have not been studied in Vietnam previously. Two hundred and five volunteers in Ho Chi Minh City from 18 to 35 and over 59 years old both male and female participated in the study. Result showed that the prevalence of S. aureus nasal carriage in southern Vietnamese community was relatively low, only 11.2% (23/205), much lower than that in other international reports on human S. aureus. In addition, nasal carriage of the older age group (> 59 years old, 13.7%) was higher than that of younger age (18-35 years old, 10.4%). Other potential risk factors such as gender, career, height, weight, history of antibiotic usage, daily nasal wash, use of nasal medication sprays, acne problems, smoking and nasal problems showed no significant impact on S. aureus carriage. The obtained S. aureus nasal isolates were all sensitive to vancomycin. Lincomycin and tetracycline had low resistance rate with 4.3 % and 17.4 %, respectively. However, the isolates showed particularly high rate of multidrug resistance (54.2%) In summary, our data provided researchers an overview on S. aureus nasal carriage and antibiotic susceptibility profile of the community- isolated S. aureus in Vietnam. This would serve as valuable information on assessing risk of community-acquired S. aureus infections.

scholarly journals Risk Factors for Acute Respiratory Infections in Hospitalized Under Five Children in Central Nepal

2013 ◽  
Vol 33 (1) ◽  
pp. 39-44 ◽  
Author(s):  
S Yadav ◽  
Y Khinchi ◽  
A Pan ◽  
SK Gupta ◽  
GS Shah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family Member ◽  
Respiratory Infections ◽  
Vitamin A Deficiency ◽  
Male Gender ◽  
Stepwise Logistic Regression ◽  
Under Five ◽  
Factors Associated ◽  
Rural Residency ◽  
History Of

Introduction: Acute respiratory infection is a leading cause of morbidity and mortality in under 5 children in developing countries. There are various modifiable risk factors associated with Acute Respiratory Tract Infection (ARI). Hence, identification of associated risk factors for ARI may be helpful to reduce the burden of disease. The aims of this study were to study the risk factors for ARI in under five hospitalized children and to correlate risk factors with ARI related morbidity. It was a hospital- based prospective study. Materials and Methods: Children of less than 5 years admitted in ward with diagnosis of ARI were enrolled in the study as cases. Control included children under 5 years of age attending to Well Baby Clinic, Immunization Clinic and siblings or relatives under 5 years who came with patients in the Paediatric outpatient department of the same institution during the same period. Various risk factors, demographic and clinical data of each child were recorded in a pre-designed proforma of both groups. Results: A total of 200 cases and 200 controls were enrolled. The various risk factors associated with ARI on stepwise logistic regression were male gender, rural residency, overcrowding, history of ARI in any family member within two weeks and undernutrition. The statistically insignificant risk factors were infancy, economic status, illiterate parents, cooking fuel other than LPG, low birth weight, prematurity, lack of exclusive breast feeding, vitamin A deficiency and incomplete immunization. Conclusion: The various risk factors for ARI identified in this study were male gender, rural residency, overcrowding, history of ARI in any family member within two weeks and undernutrition. DOI: http://dx.doi.org/10.3126/jnps.v33i1.7358 J Nepal Paediatr Soc. 2013;33(1):39-44

scholarly journals Risk factors and outcome of placenta previa: accrete in a tertiary health care center of Punjab, India

2019 ◽  
Vol 8 (2) ◽  
pp. 658
Author(s):  
Davinder Pal ◽  
Nisha Bhagat ◽  
Ritu Arora
Keyword(s):  
Risk Factors ◽  
Placenta Previa ◽  
Care Center ◽  
Significant Risk ◽  
Stepwise Logistic Regression ◽  
Stepwise Logistic Regression Analysis ◽  
Health Care Center ◽  
Exposure Variable ◽  
History Of ◽  
Uterine Curettage

Background: The aim of this study was to identify and evaluate risk factors associated with placenta accrete (PA) and its clinical outcome.Methods: A descriptive, case control study was conducted in department of obstetrics and gynecology, GMC Amritsar in which authors retrospectively reviewed data of 180 patients of placenta previa (PP) over 5 years, categorized as PA (cases; n=23) or no PA (control; n=157). Furthermore, these groups were compared as to maternal demographics, intrapartum and postpartum complications and neonatal outcomes. Stepwise logistic regression analysis was done to evaluate the extent to which exposure variable contributed to the incidence of PA including advanced maternal age (AMA), parity, location of placenta and previous caesarian section (CS).  Primary aim was to identify and quantify the various risk factors of PA and secondary aim measured incidences of PP, PA and fetomaternal outcome.Results: The cumulative incidence of PA over 5 years was 2.98 per 1000 deliveries. Accrete rate increased with number of CSs at 4.76% in patients with no previous CS versus 45.94% in ≥1 CS (p < 0.003). Anterior PP (AOR 10.128  CI 2.406 -42.632; p <0.001) and number of previous CSs (AOR 36.405, 95% CI 2.743 -483.24, p =0.006) were significant risk factors for PA. AMA (OR >30 years: 4.326 95% CI 0.724 -25.856; p =0.108), parity (AOR 1 vs 0: 2.526 95% CI 0.242-26.41; p=0.439), prior uterine curettage (AOR ≥1 vs 0: 11.143 95% CI 0.522-9.726; p=0.278) although had association with PA but was not statistical significant. Caesarian hysterectomy was done in 95.65% patients of PA while only 1 patient of PP required hysterectomy (p<0.001). Neonatal outcome was similar in both groups.Conclusions: Prior caesarian and anterior PP emerged out as significant predictors of PA. Other risk factors like AMA, multiparous, history of prior uterine curettage, central PP have incremental risk of having PA and such patients should be managed diligently to lower feto-maternal morbidities and mortalities. 

Risk Factors for Nonunion Following Ankle Arthrodesis: A Systematic Review and Meta-analysis

2021 ◽  
pp. 193864002199849
Author(s):  
Sumit Patel ◽  
Lauren Baker ◽  
Jose Perez ◽  
Ettore Vulcano ◽  
Jonathan Kaplan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Avascular Necrosis ◽  
Strong Evidence ◽  
Meta Analysis ◽  
Ankle Arthrodesis ◽  
Male Gender ◽  
Site Infection ◽  
Open Injury ◽  
History Of

Background Nonunion is a postoperative complication after ankle arthrodesis (AA), which leads to increased morbidity and revision rates. Previous studies have identified risk factors for nonunion following AA, but no meta-analysis has been performed to stratify risk factors based on strength of evidence. Methods Abstracts and full-text articles were screened by 2 independent reviewers. Relevant data were extracted from the included studies. Random effects meta-analyses were summarized as forest plots of individual study and pooled random effect results. Results Database search yielded 13 studies involving 987 patients were included, and 37 potential risk factors for nonunion. Meta-analysis found 5 significant risk factors for nonunion post-AA. Strong evidence supports male gender (OR: 1.96; 95% CI: 1.13-3.41), smoking (OR: 2.89; 95% CI: 1.23-6.76), and history of operative site infection prior to arthrodesis (OR: 2.40; 95% CI: 1.13-5.09) as predictors for nonunion following AA. There was moderate evidence supporting history of open injury (OR: 5.95; 95% CI: 2.31-15.38) and limited evidence for preoperative avascular necrosis (OR: 13.16; 95% CI: 2.17-79.61) as possible risk factors for nonunion. Conclusion The results of our meta-analysis suggest that male gender, smoking, and history of operative site infection have strong evidence and that history of open injury and avascular necrosis also have evidence as risk factors for nonunion. Surgeons should be cognizant of these risks when performing AA and closely follow up with patients with the aforementioned risk factors to ensure postoperative success. Levels of Evidence: Level V: Systematic review of cohort and case-control studies

scholarly journals Methicillin-resistant Staphylococcus aureus bloodstream infection: risk factors and clinical outcome in non-intensive-care units

2012 ◽  
Vol 45 (2) ◽  
pp. 189-193 ◽  
Author(s):  
Karinne Spirandelli Carvalho Naves ◽  
Natália Vaz da Trindade ◽  
Paulo Pinto Gontijo Filho
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Bloodstream Infection ◽  
Antimicrobial Agents ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Methicillin Resistant ◽  
Staphylococcus Aureus Bloodstream Infection

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) is spread out in hospitals across different regions of the world and is regarded as the major agent of nosocomial infections, causing infections such as skin and soft tissue pneumonia and sepsis. The aim of this study was to identify risk factors for methicillin-resistance in Staphylococcus aureus bloodstream infection (BSI) and the predictive factors for death. METHODS: A retrospective cohort of fifty-one patients presenting bacteraemia due to S. aureus between September 2006 and September 2008 was analysed. Staphylococcu aureus samples were obtained from blood cultures performed by clinical hospital microbiology laboratory from the Uberlândia Federal University. Methicillinresistance was determined by growth on oxacillin screen agar and antimicrobial susceptibility by means of the disk diffusion method. RESULTS: We found similar numbers of MRSA (56.8%) and methicillin-susceptible Staphylococcus aureus (MSSA) (43.2%) infections, and the overall hospital mortality ratio was 47%, predominantly in MRSA group (70.8% vs. 29.2%) (p=0.05). Age (p=0.02) was significantly higher in MRSA patients as also was the use of central venous catheter (p=0.02). The use of two or more antimicrobial agents (p=0.03) and the length of hospital stay prior to bacteraemia superior to seven days (p=0.006) were associated with mortality. High odds ratio value was observed in cardiopathy as comorbidity. CONCLUSIONS: Despite several risk factors associated with MRSA and MSSA infection, the use of two or more antimicrobial agents was the unique independent variable associated with mortality.

scholarly journals Allogeneic Red Blood Cell Transfusion Rate and Risk Factors in Elderly Patients With Femoral Neck Fracture After Hemiarthroplasty

2020 ◽  
Author(s):  
Rui Yue ◽  
Minghui Yang ◽  
Xiaohui Deng ◽  
Ping Zhang
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Blood Cell ◽  
Stepwise Logistic Regression ◽  
Stepwise Logistic Regression Analysis ◽  
Neck Fracture ◽  
Multivariate Stepwise Logistic Regression

Abstract Objective: To determine the rate and risk factors of allogeneic red blood cell transfusions (ABT) in elderly patients with femoral neck fracture (FNF) after hemiarthroplasty (HA). Methods: We conducted a study on elderly patients (≥65 years old) who were admitted to the geriatric trauma orthopedics ward of Beijing Jishuitan Hospital for HA treatment from March 2018 to February 2019 due to FNF. The perioperative data were collected retrospectively, and univariate and multivariate stepwise logistic regression analysis were performed to determine the postoperative ABT rate and its risk factors. Results: 343 patients were included in the study, of which 151 (44.0%) received ABT after surgery. Multivariate stepwise logistic regression analysis showed that preoperative low hemoglobin (Hb), high intraoperative blood loss (IBL), advanced age, and low body mass index (BMI) are independent risk factors of ABT after HA in elderly FNF patients. Conclusion: ABT after HA is a common phenomenon in elderly patients with FNF. Their postoperative ABT needs are related to preoperative low Hb, high IBL, advanced age, and low BMI. Therefore, ABT can be reduced from the above aspects.

scholarly journals Identification of risk factors for human immunodeficiency virus-1 infection in Khyber Pakhtunkhwa population: A case control study

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Jamila Haider ◽  
Ghosia Lutfullah ◽  
Irshad Ur Rehman ◽  
Irfan Khattak
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Case Control Study ◽  
Case Control ◽  
Male Gender ◽  
Khyber Pakhtunkhwa ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Control Study ◽  
Human Immunodeficiency Virus 1

Objectives: The present study aims to identify the risk factors for Human Immunodeficiency Virus-1(HIV-1) infection in Khyber Pakhtunkhwa (KP) population by comparing HIV-antibody positive cases with HIV-antibody-negative controls. Methods: The study was designed at the Family Care Centre (FCC), Hayatabad Medical Centre (HMC) Peshawar from February 2015 to December 2016. A total of 280 individuals were selected randomly for the study as cases and control. Data was collected on a structured questionnaire with informed oral consent. The collected data was analysed statistically using SPSS version 20. Results: Out of 280 individuals, 56% were males, 44% were females, and 53.21% belonged to the urban areas. The literacy rate was 48.6%, and 75.4% were married. The statistical analysis of risk factors revealed the following factors as of significance value (p < 0.05). Family history of HIV (OR = 9.46), spouse status of HIV (OR=22.22), injection drug users (IDUs), migrants (OR=2.234), use of therapeutic injections (OR= 2.791), employment (OR=2.545), male gender (OR=2.35), tattooing (OR=7.667) and history of blood transfusion (OR= 2.69). Conclusion: The present study revealed spouse status of HIV, tattooing, migrants, IDUs, use of therapeutic injections, history of blood transfusion, male gender and employment as significant risk factors for HIV infection in the population of KP. doi: https://doi.org/10.12669/pjms.35.5.258 How to cite this:Haider J, Lutfullah G, Irshad ur Rehman, Khattak I. Identification of risk factors for human immunodeficiency virus-1 infection in Khyber Pakhtunkhwa population: A case control study. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.258 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract P014: Cardiovascular Risk Factors Associated with Low Dehydroepiandrosterone Sulfate

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Monik C Jimenez ◽  
JoAnn E Manson ◽  
Kathryn M Rexrode
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Heart Disease ◽  
Dehydroepiandrosterone Sulfate ◽  
Stepwise Logistic Regression ◽  
Postmenopausal Hormone ◽  
Reactive Protein ◽  
Unit Increase ◽  
History Of ◽  
Hormone Use

Introduction: Low dehydroepiandrosterone sulfate (DHEAS) levels recently have been related to elevated risk of ischemic stroke. However, the association between DHEAS and traditional cardiovascular risk factors remains unclear. Methods: Blood samples were collected in 1989-1990 among 32,826 participants of the Nurses’ Health Study. Samples were assayed for DHEAS, lipids, and other biomarkers as part of a nested case control study evaluating risk of ischemic stroke and 340 stroke-free controls with complete data were available. Lifestyle covariates were ascertained in 1988. Stepwise logistic regression models were used to evaluate the association of between CVD risk factors and low DHEAS (<42 μ g/dL), while stepwise linear regression was used to evaluate the association with continuous DHEAS. Stepwise models utilized an entry threshold of α=0.20 and exit criterion of α=0.10. Results: The mean level of DHEAS was 78.38 μ g/dL (s.d. 50.02; median=67.03) in this population of women aged 43-69 years (median=62). Age was strongly associated with lower DHEAS. Women with history of heart disease and higher total/HDL cholesterol were more likely to have low DHEAS. In stepwise logistic regression analyses, age (OR=2.94; 95%CI: 1.73-5.00 for 10 yrs) and history of heart disease (OR=1.84; 95% CI: 0.91-3.70) were identified as risk factors for low DHEAS. In stepwise linear regression modeling, age, postmenopausal hormone use, history of heart disease and C-reactive protein (CRP) were associated with lower DHEAS levels while alcohol use was associated with higher DHEAS levels (Table 1). Body mass index, smoking, diabetes, glycosylated hemoglobin and lipids were not associated with low DHEAS. Conclusions: In this population of healthy women, lower levels of DHEAS were associated with older age, history of heart disease, postmenopausal hormone use, higher CRP and lower levels of alcohol consumption. Further research is needed to explore these associations. Table 1 Multivariable * adjusted estimates for DHEAS by cardiovascular disease risk factors DHEAS (continuous μ g/dL) β † 95%CI Age ‡ −28.40 −36.75, -20.05 History of Heart disease −18.76 −39.23, 1.71 Postmenopausal Hormone Therapy Use & −12.01 −21.99, -2.04 CRP £ (mg/L) −0.66 −1.37, 0.04 Alcohol # (g/day) 2.95 0.46, 5.45 * All variables mutually adjusted for one another † Estimated from stepwise logistic regression model ‡ per 10 year increase in age & Ref = No use of postmenopausal hormone therapy £ per 1 unit increase in C-reactive protein (CRP- mg/L) # per 5 unit increase in alcohol consumption (g/day)

scholarly journals 1240. Evaluation of Preoperative Staphylococcus aureus (SA) Decolonization with Nasal Iodine for Hips/Knees and Fusion Surgeries

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S446-S447
Author(s):  
Anupama Neelakanta ◽  
Kristi Clutts ◽  
Stephanie Strollo ◽  
Catherine Passaretti
Keyword(s):  
Staphylococcus Aureus ◽  
Large Scale ◽  
Nasal Carriage ◽  
Pcr Screening ◽  
Total Knee Replacements ◽  
Alternative Approach ◽  
Hip Replacements ◽  
Intranasal Mupirocin ◽  
History Of ◽  
Total Knee

Abstract Background Preoperative decolonization for patients with known nasal carriage of Staphylococcus aureus is recommended in some surgical site infection (SSI) guidelines, however, meaningful implementation is often challenging with poor compliance. We evaluated utilization of nasal iodine with S. aureus polymerase chain reaction (PCR) screening on the day of surgery as an alternative approach. Methods For all total hip replacements (THR), total knee replacements (TKR) and fusion patients in a 250-bed community hospital, we implemented day of surgery S. aureus PCR for all patients who had not been screened in the 2 weeks prior in August 2018. Those known to have S. aureus colonization in the 2 weeks prior to surgery as well as those who had no screen in the 2 weeks prior were treated with nasal iodine and received a chlorhexidine (CHG) bath in the preoperative area. Postoperatively any patient found to have (methicillin-resistant S. aureus) MRSA from preoperative screen or who had a history of MRSA in the past year were automatically decolonized with 5 days of intranasal mupirocin and CHG baths in addition. Compliance with S. aureus screening in preoperative area, results of screens and rates of THR, TKR and fusion SSI per National Health Safety Network (NHSN) definitions were monitored throughout the study period. SSI standardized infection ratios (SIR) during the study were compared with data 1 year prior to intervention date. Results Between August 2018 and January 2019, 694 THR, TKR and fusion surgeries were performed. Preoperative nursing compliance with completing the SA screen was 79. 2% and percent compliance with administering/documenting nasal iodine was 77.8%. Of those screened 21.7% (126/578) were found to have SA. Only 15% (n = 19) of SA positive PCRs were positive for MRSA. SSIs decreased in intervention period compared with preintervention (August 2017–July 2018) as shown in Table 1. Conclusion Preoperative nasal iodine has been effective and helped reduce our infection SIR to below 1. These results could be confounded by the presence of other initiatives but looks promising and large-scale studies would be helpful to make these results generalizable. Disclosures All authors: No reported disclosures.

Sign in / Sign up

Export Citation Format

Share Document