Risk Factors for Nosocomial Bacteremia in a Large Spanish Teaching Hospital: A Case-Control Study

1991 ◽  
Vol 12 (3) ◽  
pp. 150-156 ◽  
Author(s):  
Antoni Trilla ◽  
Josep M. Gatell ◽  
Josep Mensa ◽  
Xavier Latorre ◽  
Manuel Almela ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Strong Support ◽  
Case Control ◽  
Control Measures ◽  
University Hospital ◽  
Stepwise Logistic Regression ◽  
Infection Control Measures ◽  
Nosocomial Bacteremia ◽  
Control Study

AbstractObjective:Identify independent risk factors associated with the development of nosocomial bacteremia.Design:Exploratory, unmatched, case-control study.Setting:A 970-bed Spanish university hospital.Patients:All non-neutropenic adult patients with nosocomial bacteremia admitted during a 12-month period were eligible as cases. All adult non-neutropenic patients without nosocomial bacteremia were eligible as controls.Results:The incidence of bacteremia in the study population was 6.9/1000 admissions/ year. One hundred eighty cases and 180 controls were analyzed. Multivariate analysis (stepwise logistic regression techniques) identified seven risk factors independently associated with nosocomial bacteremia: age above 65 years; prior admission (within six months) to the hospital; underlying diseases that were ultimately or rapidly fatal; indwelling urethral catheter in place for more than three days; intravenous central lines or peripheral venous lines (if in place for more than four days); “high-risk surgery” (i.e., lower abdominal, cardiac or thoracic); and admission to an intensive care unit.Conclusions:Although five variables are not modifiable, the remaining two relate to the use and duration of devices. Our data give strong support for the value of testing strict guidelines for limiting vascular catheters and evaluating the need for prolonged urethral catheterization. If effective infection control measures are identified, we could target hospital-wide surveillance to patients whose risk factors are amenable to intervention.

scholarly journals Risk factors for sporadic Campylobacter infection: an all-Ireland case-control study

2009 ◽  
Vol 14 (7) ◽  
Author(s):  
K Danis ◽  
M Di Renzi ◽  
W O’Neill ◽  
B Smyth ◽  
P McKeown ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Population Attributable Fraction ◽  
Case Control ◽  
Control Measures ◽  
Safety Education ◽  
First Case ◽  
The Republic ◽  
Campylobacter Infection ◽  
Control Study

We report the findings of the first case-control study conducted in both the Republic of Ireland and Northern Ireland to determine risk factors for sporadic Campylobacter infections. A total of 197 cases and 296 case-nominated controls matched for age, were included. Based on Population Attributable Fraction (PAF), the most important risk factors were consuming chicken [adjusted matched (am) OR 6.8; 95%CI 2.1-21.9], consuming lettuce (amOR 3.3; 95%CI 1.5-7.1) and eating in takeaways (amOR=3.1; 95%CI 1.4-6.6). Contact with sheep (amOR=11; 95%CI 1.6-78), peptic ulcer (amOR=19; 95%CI 3.8-93.7), hiatus hernia (amOR=20.3; 95%CI 2.3-183.3), lower bowel problems (amOR=4.5; 95%CI 1.2-16.8) were also independently associated with infection. Mains water supply showed protective effect (amOR=0.2; 95 CI 0.1-0.9). The findings highlight the continued need for consumer food safety education and further control measures throughout the food chain on the island of Ireland.

Association between Neuroleptics and Venous Thromboembolism: A Case-Control Study.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2601-2601
Author(s):  
Karine Lacut ◽  
Gregoire Le Gal ◽  
Emmanuel Oger ◽  
Dominique Mottier
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Antipsychotic Drugs ◽  
Case Control Study ◽  
Case Control ◽  
University Hospital ◽  
Number Of Patients ◽  
Increased Risk ◽  
Significant Difference ◽  
Control Study

Abstract Background: Preliminary reports suggest that use of antipsychotic drugs is associated with an increased risk of venous thromboembolism (VTE), but others did not confirm these results. Objective: To evaluate the relationship between antipsychotic drugs and VTE. Design: Case-control study (EDITH) designed to investigate genetic and environmental risk factors of VTE. Setting: Brest University Hospital. Participants: 857 patients consecutively hospitalized for a documented venous thromboembolic event were included between May 2000 and May 2004. Controls were matched on age, sex and the main risk factors of venous thromboembolism (cancer, surgery, pregnancy…). Results: The mean age of patients was 67.7 year. No significant difference was found between cases and controls concerning the main characteristics, except for smocking and body mass index. Among cases, 89 (10.4%) were current users of neuroleptics compared to 35 (4.8%) among controls. Current use of neuroleptics was associated with a significant increased risk of venous thromboembolism (OR = 2.32, 95% CI: 1.55–3.48). Excluding neuroleptics used for non psychiatric disorders, and after adjustment on the main confounding factors, this association remained significant (OR = 3.48, 95% CI: 2.00–6.04). No difference was found between the different chemical categories of neuroleptics, but the number of patients in some groups had limited statistical power to demonstrate significant differences. Biological mechanisms of action have been proposed to explain this relation. Analyses are ongoing for anti-phospholipid antibodies and homocysteine. Conclusion: In this case-control study of hospitalized patients, neuroleptics use was associated with a significant increased risk of venous thromboembolism. These results are concordant with previous reports. Nevertheless, further investigations are needed to explain wich mechanisms may be involved in such association and before use of neuroleptics can be definitely considered as risk factor for venous thromboembolism.

scholarly journals The Emergence ofClostridium difficileInfection among Peripartum Women: A Case-Control Study of aC. difficileOutbreak on an Obstetrical Service

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Jennifer A. Unger ◽  
Estella Whimbey ◽  
Michael G. Gravett ◽  
David A. Eschenbach
Keyword(s):  
Infection Control ◽  
Case Control Study ◽  
Clinical Manifestations ◽  
Antibiotic Use ◽  
Case Control ◽  
Control Measures ◽  
Multiple Infection ◽  
Infection Control Measures ◽  
Significant Independent Risk Factor ◽  
Control Study

Objective. An outbreak of 20 peripartumClostridium difficileinfections (CDI) occurred on the obstetrical service at the University of Washington Medical Center (UWMC) between April 2006 and June 2007. In this report, we characterize the clinical manifestations, describe interventions that appeared to reduce CDI, and determine potential risk factors for peripartum CDI.Methods. An investigation was initiated after the first three peripartum CDI cases. Based on the findings, enhanced infection control measures and a modified antibiotic regimen were implemented. We conducted a case-control study of peripartum cases and unmatched controls.Results. During the outbreak, there was an overall incidence of 7.5 CDI cases per 1000 deliveries. Peripartum CDI infection compared to controls was significantly associated with cesarean delivery (70% versus 34%;P=0.03), antibiotic use (95% versus 56%;P=0.001), chorioamnionitis (35% versus 5%;P=0.001), and the use of the combination of ampicillin, gentamicin, and clindamycin (50% versus 3%;P<0.001). Use of combination antibiotics remained a significant independent risk factor for CDI in the multivariate analysis.Conclusions. The outbreak was reduced after the implementation of multiple infection control measures and modification of antibiotic use. However, sporadic CDI continued for 8 months after these measures slowed the outbreak. Peripartum women appear to be another population susceptible to CDI.

scholarly journals Identification of risk factors for death from tetanus in Pernambuco, Brazil: a case-control study

2000 ◽  
Vol 42 (6) ◽  
pp. 333-339 ◽  
Author(s):  
Demócrito B. MIRANDA-FILHO ◽  
Ricardo A.A. XIMENES ◽  
Silvya N. BERNARDINO ◽  
Abelardo G. ESCARIÃO
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Case Control Study ◽  
Artificial Ventilation ◽  
Case Control ◽  
The State ◽  
University Hospital ◽  
State University ◽  
Neck Stiffness ◽  
Control Study

A case-control study was conducted to identify risk factors for death from tetanus in the State of Pernambuco, Brazil. Information was obtained from medical records of 152 cases and 152 controls, admitted to the tetanus unit in the State University Hospital, in Recife, from 1990 to 1995. Variables were grouped in three different sets. Crude and adjusted odds ratios, p-values and 95% confidence intervals were estimated. Variables selected in the multivariate analysis in each set were controlled for the effect of those selected in the others. All factors related to the disease progression - incubation period, time elapsed between the occurrence of the first tetanus symptom and admission, and period of onset - showed a statistically significant association with death from tetanus. Similarly, signs and/or symptoms occurring on admission or in the following 24 hours (second set): reflex spasms, neck stiffness, respiratory signs/symptoms and respiratory failure requiring artificial ventilation (third set) were associated with death from tetanus even when adjusted for the effect of the others.

Risk Factors for Nosocomial Bacteremia in a Large Spanish Teaching Hospital: A Case-Control Study

1991 ◽  
Vol 12 (3) ◽  
pp. 150-156 ◽  
Author(s):  
Antoni Trilla ◽  
Josep M. Gatell ◽  
Josep Mensa ◽  
Xavier Latorre ◽  
Manuel Almela ◽  
...  
Keyword(s):  
Risk Factors ◽  
Teaching Hospital ◽  
Case Control Study ◽  
Case Control ◽  
Nosocomial Bacteremia ◽  
Control Study

scholarly journals The spectrum of association in HLA region with rheumatoid arthritis in a diverse Asian population: evidence from the MyEIRA case-control study

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Lay Kim Tan ◽  
Chun Lai Too ◽  
Lina Marcela Diaz-Gallo ◽  
Sulaiman Wahinuddin ◽  
Ing Soo Lau ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Amino Acid ◽  
Fine Mapping ◽  
Case Control Study ◽  
Case Control ◽  
Caucasian Population ◽  
Stepwise Logistic Regression ◽  
Malaysian Population ◽  
Control Study

Abstract Background Fine-mapping of human leukocyte antigen (HLA) region for rheumatoid arthritis (RA) risk factors has identified several HLA alleles and its corresponding amino acid residues as independent signals (i.e., HLA-A, HLA-B, HLA-DPB1, and HLA-DQA1 genes), in addition to the well-established genetic factor in HLA-DRB1 gene. However, this was mainly performed in the Caucasian and East Asian populations, and data from different Asian regions is less represented. We aimed to evaluate whether there are independent RA risk variants in both anti-citrullinated protein antibody (ACPA)-positive and ACPA-negative RA patients from the multi-ethnic Malaysian population, using the fine-mapping of HLA region strategy. Methods We imputed the classical HLA alleles, amino acids, and haplotypes using the Immunochip genotyping data of 1260 RA cases (i.e., 530 Malays, 259 Chinese, 412 Indians, and 59 mixed ethnicities) and 1571 controls (i.e., 981 Malays, 205 Chinese, 297 Indians, and 87 mixed ethnicities) from the Malaysian Epidemiological Investigation of Rheumatoid Arthritis (MyEIRA) population-based case-control study. Stepwise logistic regression was performed to identify the independent genetic risk factors for RA within the HLA region. Results We confirmed that the HLA-DRB1 amino acid at position 11 with valine residue conferred the strongest risk effect for ACPA-positive RA (OR = 4.26, 95% CI = 3.30–5.49, PGWAS = 7.22 × 10−29) in the Malays. Our study also revealed that HLA-DRB1 amino acid at position 96 with histidine residue was negatively associated with the risk of developing ACPA-positive RA in the Indians (OR = 0.48, 95% CI = 0.37–0.62, PGWAS = 2.58 × 10−08). Interestingly, we observed that HLA-DQB1*03:02 allele was inversely related to the risk of developing ACPA-positive RA in the Malays (OR = 0.17, 95% CI = 0.09–0.30, PGWAS = 1.60 × 10−09). No association was observed between the HLA variants and risk of developing ACPA-negative RA in any of the three major ethnic groups in Malaysia. Conclusions Our results demonstrate that the RA-associated genetic factors in the multi-ethnic Malaysian population are similar to those in the Caucasian population, despite significant differences in the genetic architecture of HLA region across populations. A novel and distinct independent association between the HLA-DQB1*03:02 allele and ACPA-positive RA was observed in the Malays. In common with the Caucasian population, there is little risk from HLA region for ACPA-negative RA.

scholarly journals Predictors for vancomycin resistant Enterococcus faecium transforming from colonization to infection: a case control study

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Pao-Yu Chen ◽  
Yu-Chung Chuang ◽  
Jann-Tay Wang ◽  
Wang-Huei Sheng ◽  
Yee-Chun Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Enterococcus Faecium ◽  
Case Control Study ◽  
Case Control ◽  
Control Measures ◽  
Fourth Generation ◽  
Surveillance Culture ◽  
Icu Admission ◽  
Vancomycin Resistant ◽  
Control Study

Abstract Background Little is known about risk factors for subsequent infections among vancomycin resistant Enterococcus faecium (VREfm) colonizers, especially characterized by concordant pulsotypes (CP) of paired colonization and infection-related isolates. Methods This case-control study was conducted at a teaching hospital between 2011 and 2014. Targeted patients received active surveillance culture for VREfm by anal swabs at admission. Cases were those who developed VREfm infection within 180 days after colonization of VREfm. Controls were those colonized with VREfm without subsequent VREfm infection. CP were defined by similarities ≥86.7% using pulsed-field gel electrophoresis between paired colonization and infection-related isolates. Results Ninety-seven cases and 194 controls were enrolled. By conditional multivariable logistic regression analysis, the risk factors for subsequent infection among VREfm colonizers were intensive care unit (ICU) admission (adjusted odds ratio [aOR], 9.32; 95% CI, 3.61–24.02), receipt of central venous catheters (CVC) (aOR, 3.38; 95% CI, 1.30–8.82), and utilization of third- and fourth-generation cephalosporins (aOR, 4.06; 95% CI, 1.79–9.20, and aOR, 5.32; 95% CI, 1.85– 10.29, respectively) (all P ≤ 0.01). Fifty-six (57.7%) of case patients belonged to the CP group, which were associated with ICU admission (aOR, 3.74; 95% CI, 1.38–10.13), and infection developing within 30 days after colonization (aOR, 3.34; 95% CI, 1.25–8.91). Conclusions Among VREfm colonizers, being admitted to ICU and receiving CVC or broad spectrum cephalosporins, were the risk factors for subsequent infections. These findings highlight the importance of conducting more strict infection control measures on specific groups of VREfm colonizers.

scholarly journals Another dengue fever outbreak in Eastern Ethiopia—An emerging public health threat

2021 ◽  
Vol 15 (1) ◽  
pp. e0008992
Author(s):  
Mulugeta Asefa Gutu ◽  
Alemayehu Bekele ◽  
Yimer Seid ◽  
Yusuf Mohammed ◽  
Fekadu Gemechu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Case Control Study ◽  
Larval Density ◽  
Case Control ◽  
Control Measures ◽  
Severe Dengue ◽  
Vector Surveillance ◽  
Eastern Ethiopia ◽  
Control Study

Background Dengue Fever (DF) is a viral disease primarily transmitted by Aedes (Ae.) aegypti mosquitoes. Outbreaks in Eastern Ethiopia were reported during 2014–2016. In May 2017, we investigated the first suspected DF outbreak from Kabridahar Town, Somali region (Eastern Ethiopia) to describe its magnitude, assess risk factors, and implement control measures. Methods Suspected DF cases were defined as acute febrile illness plus ≥2 symptoms (headache, fever, retro-orbital pain, myalgia, arthralgia, rash, or hemorrhage) in Kabridahar District residents. All reported cases were identified through medical record review and active searches. Severe dengue was defined as DF with severe organ impairment, severe hemorrhage, or severe plasma leakage. We conducted a neighborhood-matched case-control study using a subset of suspected cases and conveniently-selected asymptomatic community controls and interviewed participants to collect demographic and risk factor data. We tested sera by RT-PCR to detect dengue virus (DENV) and identify serotypes. Entomologists conducted mosquito surveys at community households to identify species and estimate larval density using the house index (HI), container index (CI) and Breteau index (BI), with BI≥20 indicating high density. Results We identified 101 total cases from May 12–31, 2017, including five with severe dengue (one death). The attack rate (AR) was 17/10,000. Of 21 tested samples, 15 (72%) were DENV serotype 2 (DENV 2). In the case-control study with 50 cases and 100 controls, a lack of formal education (AOR [Adjusted Odds Ratio] = 4.2, 95% CI [Confidence Interval] 1.6–11.2) and open water containers near the home (AOR = 3.0, 95% CI 1.2–7.5) were risk factors, while long-lasting insecticide treated-net (LLITN) usage (AOR = 0.21, 95% CI 0.05–0.79) was protective. HI and BI were 66/136 (49%) and 147 per 100 homes (147%) respectively, with 151/167 (90%) adult mosquitoes identified as Ae. aegypti. Conclusion The epidemiologic, entomologic, and laboratory investigation confirmed a DF outbreak. Mosquito indices were far above safe thresholds, indicating inadequate vector control. We recommended improved vector surveillance and control programs, including best practices in preserving water and disposal of open containers to reduce Aedes mosquito density.

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