Risk Factors for Nosocomial Infective Endocarditis in Patients with Methicillin-Resistant Staphylococcus Aureus Bacteremia

2005 ◽  
Vol 26 (7) ◽  
pp. 654-657 ◽  
Author(s):  
Ron-Bin Hsu
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Liver Disease ◽  
Infective Endocarditis ◽  
Chronic Liver Disease ◽  
Tertiary Care ◽  
Chronic Liver ◽  
Control Group ◽  
Care Hospital ◽  
Methicillin Resistant

AbstractBackground and Objective:Nosocomial infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are increasing. Only a few studies of MRSA infective endocarditis have been conducted, and none have reported its risk factors. We sought to determine the host-related risk factors for infective endocarditis in patients with nosocomial MRSA bacteremia.Setting:A 2,000-bed, university-affiliated, tertiary-care hospital.Patients:Thirty-one patients with nosocomial MRSA infective endocarditis between October 1996 and May 2003.Design:A retrospective chart review was conducted. Data were compared with those from a control group of patients with nosocomial MRSA bacteremia. Logistic regression was used to identify independent risk factors for nosocomial infective endocarditis.Results:Compared with patients who had nosocomial MRSA bacteremia and no infective endocarditis, patients who had infective endocarditis had a higher incidence of chronic liver disease and a lower incidence of immunodeficiency. The risk of developing infective endocarditis was approximately 10% for patients with nosocomial MRSA bacteremia.Conclusion:Patients with MRSA bacteremia and underlying chronic liver disease were prone to infective endocarditis. (Infect Control Hosp Epidemiol 2005;26:654-657)

scholarly journals An audit of indoor morbidity and mortality in a medical ward at a Tertiary Care Hospital

2016 ◽  
Vol 11 (1) ◽  
Author(s):  
Abeer Qadir ◽  
Muhammad Arif Nadeem ◽  
Atif Munir ◽  
Zafar Ullah Khan
Keyword(s):  
Heart Disease ◽  
Liver Disease ◽  
Ischemic Heart Disease ◽  
Chronic Liver Disease ◽  
Tertiary Care ◽  
Chronic Liver ◽  
Ischemic Heart ◽  
Care Hospital ◽  
Cerebrovascular Accidents ◽  
Number Of Patients

There is a great geographical variation in disease burden around the world, which is due primarily to environmental, genetic, social and economic factors. Similar variations exist in worldwide mortality figures from a particular disease that can be attributed almost entirely to the access and efficacy of healthcare facilities. We did this audit to identify the major causes of morbidity and mortality in patients admitted in a medical unit of a tertiary care hospital and to highlight the importance of primary prevention. The audit was carried out in West Medical Ward Mayo Hospital Lahore, Pakistan from 1st January 2004 to 31st December 2004. All patients admitted with medical problems from the Outpatient and Emergency Departments were included. During the year 2004, a total of 2045 patients were admitted, out of which maximum number of patients admitted in the ward were suffering from chronic liver disease (17%) followed by ischemic heart disease (14.4%) cerebrovascular accidents (10.4%) and renal diseases. Total number of deaths were 321 with male mortality was 167 (14.40%) and female mortality 154 (17.40%). Chronic liver disease also had the highest mortality (16.8%) followed by cerebrovascular accidents (14%), renal disease (11.5%) and ischemic heart disease (7.8%). Even the mortality due to chronic liver disease was significantly higher (p <0.01) than ischernic heart disease. The number of patients having the four common diseases having age 45 years or more (770) was significantly greater (p <0.0001) then the number of patients (279) in the age range of 15 to 44 years. It was observed that significantly greater number of male patients (595) had morbidity than females (462), (p <0.0001), while mortality has no difference. Chronic liver disease, ischemic heart disease and cerebrovascular accidents are the diseases putting maximum burden on our health resources and disabling our productive population. This audit highlights the fact that all these three groups of diseases can be prevented and thus obviates the need of primary prevention of these major killers.

Hematological, Biochemical and Etiological factors of Chronic Liver Disease in a tertiary care Hospital of Lahore

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Sami Ullah Mumtaz ◽  
Amna Akbar ◽  
Humaira Waseem ◽  
Tayyeba Komal ◽  
Somia Iqtadar ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Hepatitis C ◽  
Chronic Liver Disease ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Chronic Liver ◽  
Care Hospital ◽  
Alcoholic Fatty Liver ◽  
Etiological Factors

Chronic Liver Disease (CLD) progresses from hepatocyte inammation to brosis, regeneration, cirrhosis and in some cases to Hepatocellular Carcinoma (HCC). In general, the main etiologies of Liver Cirrhosis (LC) are viral infections (hepatitis C and B viruses), chronic alcohol abuse and Non-Alcoholic Fatty Liver Disease (NAFLD), including Non-Alcoholic Steato Hepatitis (NASH). Major complications of CLD are ascites, upper gastrointestinal bleeding, jaundice (acute or chronic) and hepatic encephalopathy. Abstract:Study Design: Cross-sectional.Conclusions: This study assesses the etiological factors and complications of CLD in a tertiary care hospital of Lahore, Pakistan. Objectives: Methods: Study was carried out in indoor and Accident & Emergency Departments of Mayo Hospital Lahore. 100 clinically diagnosed CLD cases were chosen through “Convenient Sampling” technique during 3 months. Observations: Most common complications of CLD were upper GI variceal Bleeding (48%) & hepatic encephalopathy (34%) and acute or chronic hepatitis (AVH) (33%). Other less common complications observed were hepatorenal syndrome (10%), Spontaneous bacterial peritonitis (15%), Ascites (5%) and HCC (10%). Hepatitis C was found as main etiological factor of CLD. Bleeding and hepatic encephalopathy are the common complications. Awareness programmes regarding CLD and its complications are mandatory in our society to improve human health.

A Study on Haematological Manifestations in Patients with Chronic Liver Disease in a Tertiary Care Hospital of North India

2021 ◽  
Vol 8 (25) ◽  
pp. 2222-2228
Author(s):  
Jasmine Kaur ◽  
Navjot Kaur ◽  
Jasleen Kaur ◽  
Navjot Kaur Layal ◽  
Gurkiran Kaur
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Prothrombin Time ◽  
Chronic Liver Disease ◽  
Tertiary Care ◽  
Meld Score ◽  
Chronic Liver ◽  
Care Hospital ◽  
End Stage Liver Disease ◽  
End Stage

BACKGROUND Chronic liver diseases frequently are associated with haematological abnormalities. Anaemia occurs in about 75% of patients with chronic liver disease. The most common type of anaemia seen in liver cirrhosis is normocytic normochromic anaemia, due to the chronic inflammatory state, blood loss from oesophageal and rectal varices. The purpose of this study was to study the haematological manifestations in patients with chronic liver disease. METHODS A cross-sectional observational study was conducted at Sri Guru Ram Das Institute of Medical Sciences and Research (March 2019 - March 2020). Total of 90 patients with chronic liver disease were included in the study. The population was divided into 2 groups based on the model for end-stage liver disease (MELD) score and the various haematological abnormalities were assessed in these 2 groups. Similarly, haemoglobin (Hb) levels were assessed in 3 groups based on the ChildTurcotte-Pugh (CTP) classification. RESULTS There was a significant correlation between hemoglobina and CTP class (P < 0.001), with the lowest haemoglobin levels in CTP class C group. The correlation coefficient of MELD score and haemoglobin was -0.504 which was significant statistically. Thus, confirming the fact that haemoglobin levels decreases with the progress in the severity of liver cirrhosis. Of 39 patients with haemoglobin < 8 g/dl, 5 (12.8 %) had a MELD score of < 12, whereas 34 patients (87.2 %) had a MELD score of > 12 and was statistically significant (P < 0.0001). Leukocytosis was observed in 41 patients and leucopoenia in 14 patients. The mean prothrombin time was 20.4 seconds and 80 % of the patients had prothrombin time prolonged by more than 6 sec indicating liver damage alters coagulation profile. CONCLUSIONS We found an association between anaemia and indicators of advanced liver disease such as a higher MELD and CPS scores. This study inferred that levels of haemoglobin decrease as the severity of liver disease progresses. Thus, this measure can be used in the initial assessment of cirrhosis patients that needs urgent identification and correction to reduce morbidity and mortality. KEYWORDS Anaemia, Liver Cirrhosis, Model for End-Stage Liver Disease Score, Child-TurcottePugh Class

scholarly journals Incidence and Risk Factors of Ocular Infection Caused by Staphylococcus aureus Bacteremia

2016 ◽  
Vol 60 (4) ◽  
pp. 2012-2017 ◽  
Author(s):  
Jiwon Jung ◽  
Junyeop Lee ◽  
Shi Nae Yu ◽  
Yong Kyun Kim ◽  
Ju Young Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Tertiary Care ◽  
Ocular Infection ◽  
Ocular Involvement ◽  
Care Hospital ◽  
Content Type ◽  
Ocular Infections ◽  
Metastatic Infection

ABSTRACTStaphylococcus aureusbacteremia (SAB) often leads to ocular infections, including endophthalmitis and chorioretinitis. However, the incidence, risk factors, and outcomes of ocular infections complicated by SAB are largely unknown. We retrospectively analyzed the incidence and risk factors of ocular involvement in a prospective cohort of patients with SAB at a tertiary-care hospital. Ophthalmologists reviewed the fundoscopic findings and classified the ocular infections as endophthalmitis or chorioretinitis. During the 5-year study period, 1,109 patients had SAB, and data for 612 (55%) who underwent ophthalmic examinations within 14 days after SAB onset were analyzed. Of those 612 patients, 56 (9% [95% confidence interval [CI], 7 to 12%]) had ocular involvement, including 15 (2.5%) with endophthalmitis and 41 (6.7%) with chorioretinitis. In a multivariate analysis, infective endocarditis (adjusted odds ratio [aOR], 5.74 [95% CI, 2.25 to 14.64]) and metastatic infection (aOR, 2.38 [95% CI, 1.29 to 4.39]) were independent risk factors for ocular involvement. Of the 47 patients with ocular involvement who could communicate, only 17 (36%) had visual disturbances. Two-thirds of the patients with endophthalmitis (10/15 patients) were treated with intravitreal antibiotics combined with parenteral antibiotics, whereas all of the patients with chorioretinitis were treated only with systemic antibiotics. No patients became blind. Among 42 patients for whom follow-up assessments were available, the ocular lesions improved in 29 (69%) but remained the same in the others. Ocular involvement was independently associated with death within 30 days after SAB onset. Ocular involvement is not uncommon among patients with SAB. Routine ophthalmic examinations should be considered for patients with infective endocarditis or metastatic infections caused by SAB.

Methicillin Resistance and Risk Factors for Embolism inStaphylococcus aureusInfective Endocarditis

2007 ◽  
Vol 28 (7) ◽  
pp. 860-866 ◽  
Author(s):  
Ron-Bin Hsu ◽  
Fang-Yue Lin
Keyword(s):  
Risk Factors ◽  
Infective Endocarditis ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Neurological Involvement ◽  
Hospital Death ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Independent Risk Factors

Objective.Infective endocarditis caused byStaphylococcus aureusis an ominous prognosis associated with a high prevalence of embolic episodes and neurological involvement. Whether methicillin resistance decreases the risk of embolism in infective endocarditis is unclear. We sought to assess the association between methicillin resistance and risk factors for embolism in S.aureusinfective endocarditis.Design.Retrospective chart review. Data from patients with infective endocarditis due to methicillin-resistantS. aureus werecompared with data from patients with endocarditis due to methicillin-susceptibleS. aureus.Logistic regression was used to identify independent risk factors for embolism.Setting.A 2,000-bed, university-affiliated tertiary care hospital.Patients.Between 1995 and 2005, 123 patients withS. aureusinfective endocarditis were included in the study. There were 74 male patients and 49 female patients, with a median age of 54 years (range, 0-89 years).Results.Of 123 infections, 30 (24%) were nosocomial infections, and 14 (11%) were prosthetic valve infections. Of 123S. aureusisolates, 48 (39%) were methicillin resistant. In total, embolism occurred in 45 (37%) of these patients: pulmonary embolism in 22 (18%), cerebral embolism in 21 (17%), and peripheral embolism in 6 (5%). The independent risk factors for an embolism were injection drug use, presence of a cardiac vegetation with a size of 10 mm or greater, and absence of nosocomial infection. For 83 patients with aortic or mitral infective endocarditis, independent risk factors for an embolism were the presence of a cardiac vegetation with a size of 10 mm or greater and endocarditis due to methicillin-susceptibleS. aureus.Overall, in-hospital death occurred for 32 (26%) of 123 Patients. Methicillin-resistant infection was not an independent risk factor for death.Conclusions.Methicillin-resistant S.aureusinfection was associated with decreased risk of embolism in left-side endocarditis, but was not associated with in-hospital death.

Evaluation of association of relevant past history, symptoms, signs, complication profile and sero prevalence of HBV and HCV among the patients presenting with chronic liver disease and its complications: A Tertiary Care Hospital Based Study

2020 ◽  
pp. 9-18
Author(s):  
Richmond Ronald Gomes ◽  
Akmat Ali
Keyword(s):  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Chronic Liver Disease ◽  
Health Problem ◽  
Tertiary Care ◽  
Chronic Liver ◽  
Care Hospital ◽  
Major Health

Background: Now-a-days chronic liver disease is one of the major health problems in the world. In developing countries, chronic liver disease due to hepatitis virus (like hepatitis B and hepatitis C virus) is increasing day by day. It is rapidly emerging as a major health problem. So the present study was conducted to document the hepatitis B and hepatitis C virus in patient with chronic liver disease by an easy and simple marker like HBsAg, Anti HBc (total) and Anti HCV in a tertiary hospital. Methods: Serum samples were collected from 100 selected cases who were diagnosed as a case of chronic liver disease in medicine and gastroenterology department of DMCH. Study period was from April 01, 2016 to September 30, 2018. For detection of HBsAg, Anti HBc (total) and Anti HCV, Immunochromatographic test (ICT) was done in every case. Results: Out of 100 cases, HBsAg seropositive with negative Anti HCV was found in 64% cases, Anti HCV positive with negative HBsAg was found in 16% cases, both HBsAg and anti HCV positive was found in 4% cases, both HBsAg and anti HCV negative was found in 16% cases. Among these cases, 74% were male and 26% were female. Here male: female was 3:1 and among them, 75% male was seropositive for either HBsAg or Anti HCV. Conclusion: The high frequency of seropositivity in patients with chronic liver disease with male predominance is found in tertiary care settings. The number of Anti HCV seropositive patient indicates that it is an emerging health problem in our country. Keywords: Chronic liver disease; HBsAg; Anti HCV; ICT

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