Carbapenem-ResistantKlebsiella pneumoniaein Post-Acute-Care Facilities in Israel

2011 ◽  
Vol 32 (9) ◽  
pp. 845-853 ◽  
Author(s):  
Debby Ben-David ◽  
Samira Masarwa ◽  
Shiri Navon-Venezia ◽  
Hagit Mishali ◽  
Ilan Fridental ◽  
...  

Objective.To assess the prevalence of and risk factors for carbapenem-resistantKlebsiella pneumoniae(CRKP) carriage among patients in post-acute-care facilities (PACFs) in Israel.Design, Setting, and Patients.A cross-sectional prevalence survey was conducted in 12 PACFs. Rectal swab samples were obtained from 1,144 patients in 33 wards. Risk factors for CRKP carriage were assessed among the cohort. Next, a nested, matched case-control study was conducted to define individual risk factors for colonization. Finally, the cohort of patients with a history of CRKP carriage was characterized to determine risk factors for continuous carriage.Results.The prevalence of rectal carriage of CRKP among 1,004 patients without a history of CRKP carriage was 12.0%. Independent risk factors for CRKP carriage were prolonged length of stay (odds ratio [OR], 1.001;P< .001), sharing a room with a known carrier (OR, 3.09;P= .02), and increased prevalence of known carriers on the ward (OR, 1.02;P= .013). A policy of screening for carriage on admission was protective (OR, 0.41;P= .03). Risk factors identified in the nested case-control study were antibiotic exposure during the prior 3 months (OR, 1.66;P= .03) and colonization with other resistant pathogens (OR, 1.64;P= .03). Among 140 patients with a history of CRKP carriage, 47% were colonized. Independent risk factors for continued CRKP carriage were antibiotic exposure during the prior 3 months (OR, 3.05;P= .04), receipt of amoxicillin-clavulanate (OR, 4.18;P= .007), and screening within 90 days of the first culture growing CRKP (OR, 2.9;P= .012).Conclusions.We found a large reservoir of CRKP in PACFs. Infection-control polices and antibiotic exposure were associated with patient colonization.

2003 ◽  
Vol 131 (2) ◽  
pp. 907-914 ◽  
Author(s):  
M. V. CANO ◽  
G. F. PONCE-DE-LEON ◽  
S. TIPPEN ◽  
M. D. LINDSLEY ◽  
M. WARWICK ◽  
...  

Between 1992 and 1999, 93 cases of blastomycosis, including 25 laboratory confirmed cases, were identified in Missouri (annual incidence, 0·2/100000 population). Mississippi County in southeastern Missouri had the highest incidence (12/100000) with a much higher rate among blacks than whites in this county (43·2/100000). The mortality rate, 44% was also higher among blacks. To determine risk factors for endemic blastomycosis, a case-control study was conducted among southeastern Missouri residents. Independent risk factors for blastomycosis were black race and a prior history of pneumonia. No environmental exposures or socioeconomic factors were significantly associated with increased risk. The increased risk among blacks may possibly be related to genetic factors, but further studies are needed to clarify this. However, heightened awareness of the disease and a better understanding of the risk factors are important and may lead to earlier diagnosis and start of treatment, possibly improving outcome.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Arisara Poosari ◽  
Thitima Nutravong ◽  
Prakasit Sa-ngiamwibool ◽  
Wises Namwat ◽  
Supaporn Chatrchaiwiwatana ◽  
...  

Abstract Background Previous studies have shown the association between Campylobacter species infection and that environmental factors, poor oral hygiene in particular, are linked to an increased risk of esophageal cancer (EC). However, no study has reported on these factors in Thailand. Thus, this study’s objective was to evaluate the impact of the relationship between Campylobacter infection and environmental factors on EC incidence in the population of Thailand. Methods Data from a case–control study were collected from 105 newly diagnosed EC cases and 105 controls recruited from 2007 to 2017. Infection with Campylobacter spp. was detected in the formalin-fixed paraffin-embedded (FFPE) tissue of EC taken from gastroesophageal biopsy specimens obtained from the participants, and evaluated using TaqMan® real-time PCR. Multivariable logistic regression was performed to calculate the odds ratios (ORs) and perform data analysis. Results Smoking, alcohol use, a family history of cancer, history of gastroesophageal reflux disease, poor oral hygiene and Campylobacter spp. infection were shown to be significant risk factors for EC (p  <  0.05). The combination of poor oral hygiene and infection with Campylobacter spp. constituted significant risk for EC (p  <  0.001). In addition, the risk of EC in subjects co-infected with C. rectus and C. concisus that practiced poor oral hygiene was even higher and was significant (ORadj  =  4.7; 95% CI 2.41–9.98; p  =  0.003). Conclusions In Thailand, the major risk factors for EC are smoking status, alcohol drinking, family history of cancer, GERD, poor oral hygiene and Campylobacter spp. infection. This study found Campylobacter spp. prevalence to be associated with EC and appears to be enhanced by poor oral hygiene, suggesting that a combination of poor oral hygiene and Campylobacter species infection may together act as an important etiological risk factor for EC.


2014 ◽  
Vol 6 (2) ◽  
pp. 329-338
Author(s):  
N. Quraishi ◽  
U. Bhosale ◽  
R. Yegnanarayan ◽  
D. Devasthale

This study was conducted to assess and compare the cardiovascular risk and to explore the demography of CV risk of nonselective cyclooxygenase inhibitors (COX-Is) and selective COX-2-Is in arthritic patients. In this comparative matched case control study adult arthritic patients of either sex taking COX-Is for >1 yr; were included. Arthritic age and sex matched individuals with no history of COX-Is treatment were the controls. Patients those with history of any other disease (e.g. diabetes, hypertension, stroke, IHD etc.) were excluded. Patients were grouped into Control, nonselective COX-I and selective COX-2-I groups. The CV risk factors like blood pressure, blood sugar level(BSL), lipid profile, BMI(body mass index) etc. were assessed and compared; demography of CV risk factors i.e. age, sex, smoking, alcohol, heredity was also studied. Qualitative data was analyzed using Chi-square and quantitative data was analyzed by student’s‘t’-test. Study clearly revealed that all NSAIDs exhibit significant CV risk when taken over a period of time as in arthritis. However selective COX 2-Is found to exhibit more CV risk in this regard. Odds ratio (OR) for CV risk=10.3(95% CI: 1.45, 3.31) and OR for CV risk=5.2(95%CI: 1.05, 2.57) for nonselective COX-Is. BMI, BSL and lipid profile; the potential CV risk factors, showed significant impairment in selective COX 2-Is group; P<0.05, P<0.05 and P<0.01 (HDL), P<0.001 (cholesterol), respectively compared to controls and P<0.05 compared to nonselective COX-Is. This study portrays the potential CV risk of selective COX 2-Is and confirms and re-evaluate the results of earlier studies in this regard.  Keywords: Anti-arthritic agents; BMI; COX-Is; CV risk; Lipid profile.  © 2014 JSR Publications. ISSN: 2070-0237 (Print); 2070-0245 (Online). All rights reserved.  doi: http://dx.doi.org/10.3329/jsr.v6i2.17039 J. Sci. Res. 6 (2), 328-338 (2014)  


2016 ◽  
Vol 31 (2) ◽  
pp. 83
Author(s):  
Marina De Deus Moura Lima ◽  
Zacarias Soares Brito-Neto ◽  
Heylane Oliveira Amaral ◽  
Cacilda Castelo Branco Lima ◽  
Marcoeli Silva de Moura ◽  
...  

Objective: The aim of this study was to determine the risk factors associated with early childhood caries (ECC).Methods: It was an observational retrospective case-control study. The case group consisted of all patients diagnosed with ECC in the records of an active program of maternal and child care. The control group was composed of an equal number of children, matched for gender and age, who attended the program and did not have ECC. The process of data collection consisted of completing a pre-established schedule to analyse variables related to the mother/caregiver and child.Statisticalanalysis was performed using the chi-squared and odds ratio (OR), with alpha (α) = 0.05.Results: History of caries in the mother (OR=2.61; CI 95%=1.45-4.67) and father (OR=1.72; CI 95%=1.02-2.89) were key determinants in the child being diagnosed with ECC.Conclusions: The risk factors associated with ECC were the following: no oral hygiene acceptance, nocturnal feeding duration of more than 16 months, a daily intake of sugar greater than 4 times a day, a Baume type II maxillary arch, fewer than 3 consultations with the program, and a history of decay in the parents.


2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Jamila Haider ◽  
Ghosia Lutfullah ◽  
Irshad Ur Rehman ◽  
Irfan Khattak

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.


Author(s):  
Christa Kingston ◽  
Aravindan J. ◽  
Srikumar Walsalam

Background: Diabetic neuropathy is one among the most common complication in diabetes mellitus. Diabetic peripheral neuropathy hinders the quality of life causing morbidity and mortality. The purpose of this study was to find the risk factors associated with diabetic neuropathy.Methods: This case control study involved 100 diabetic patients attending the Dohnavur fellowship hospital, Dohnavur from October 2019 to March 2020. Sociodemographic profile and diabetic characteristics of the study group were obtained and analysed. Diagnosis of Diabetic Neuropathy was done by using the diagnostic method proposed by American Diabetic Association.Results: Of the total study population with mean age 59.43 years, 63% had family history of diabetes. Almost 70% had poor diabetic control. Statistically significant relationships were found between neuropathy and duration of diabetes, glycaemic control, history of hypertension, monofilament test and pinprick sensation.Conclusions: In this study, glycemic control, dyslipidemia and hypertension were modifiable risk factors for diabetic neuropathy. Early interventional programs to sensitize diabetics on these factors could improve the quality of life of Diabetic patients. 


2020 ◽  
Vol 58 (03) ◽  
pp. 234-240
Author(s):  
Bruno Neu ◽  
Georg Moessmer ◽  
Monther Bajbouj ◽  
Valentin Becker ◽  
Petra Barthel ◽  
...  

Abstract Objectives Angiodysplasia (AD) is a common source of gastrointestinal bleeding. Yet, little is known about factors forwarding bleeding in these vascular malformations. The presented study aims to determine risk factors for bleeding that occurs only in patients with symptomatic, but not with asymptomatic, AD. Methods Case-control study in patients with AD and either a positive or a negative history of gastrointestinal bleeding in Munich, Germany. Groups were compared by clinical, laboratory, and endoscopic features. Results 80 patients with (58, f 31, med. age 72) or without bleeding AD (22, f 12, med. age 61) were included. Bleeding from AD was significantly associated with the total number of AD (OR 1.4 (95 % CI 1.1–1.7) p = 0.01) and closure time in PFA/collagen-epinephrine test (OR 1.0 (95 % CI 1.0–1.0) p < 0.01). The total number of AD correlated significantly with age (r = 0.36; p = 0.01). AD were mainly detected in the upper small intestine (> 30 %). Although patients with aortic stenosis suffered not significantly more frequently from bleeding from AD, they demonstrated a loss of high molecular multimers of VWF. Conclusions The amount of AD is clearly correlated to the age of the patient. A higher number of ADs and inhibition of primary hemostasis increase the risk of bleeding.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Giuseppe La Torre ◽  
Antonella Sferrazza ◽  
Maria Rosaria Gualano ◽  
Chiara de Waure ◽  
Gennaro Clemente ◽  
...  

The aims of the present research are to investigate the possible predictors of pancreatic cancer, in particular smoking status, alcohol consumption, hypercholesterolemia, and diabetes mellitus, in patients with histologically confirmed pancreatic carcinoma and to examine the synergism between risk factors. A case-control study (80 patients and 392 controls) was conducted at the Teaching Hospital “Agostino Gemelli” in Rome. A conditional logistic regression was used for the statistical analysis and results were presented as odds ratio (OR) and 95% confidence intervals (95% CI). We also investigated the possible interactions between risk factors and calculated the synergism index (SI). The multivariate analysis revealed that hypercholesterolemia and alcohol consumption resulted in important risk factors for pancreatic cancer even after the adjustment for all variables (OR: 5.05, 95% CI: 2.94–8.66; OR: 2.25, 95% CI: 1.30–3.89, resp.). Interestingly, important synergistic interactions between risk factors were found, especially between ever smoking status and alcohol consumptions (SI = 17.61) as well as alcohol consumption and diabetes (SI = 17.77). In conclusion, the study confirms that hypercholesterolemia and alcohol consumption represent significant and independent risk factors for pancreatic cancer. Moreover, there is evidence of synergistic interaction between diabetes and lifestyle factors (drinking alcohol and eating fatty foods).


1994 ◽  
Vol 112 (3) ◽  
pp. 595-601 ◽  
Author(s):  
K. R. Neal ◽  
D. A. Jones ◽  
D. Killey ◽  
V. James

SUMMARYThe introduction of screening for hepatitis C virus (HCV) by the National Blood Transfusion Service identified donors who had acquired HCV infection. We undertook a case-control study amongst blood donors in the Trent Region to determine risks for HCV infection. A total of 74 blood donors confirmed positive for hepatitis C infection and 150 age, sex and donor venue matched controls were included in the study. Fifty-three percent of hepatitis C infected blood donors reported previous use of injected drugs compared to no controls; relative risk (RR) not estimatable (lower limit 95% CI = 20). Other risk factors were a history of: receipt of a blood transfusion or blood products RR = 3·6 (95% CI 1·5–8·3), having been a ‘health care worker’ RR = 2·8 (95% CI 1·1–7·6), tattooing RR = 3·3 (95% CI 1·2–8·7), and an association with having been born abroad RR = 3·2 (95% CI 1·1–9·5). No risk was shown for a history of multiple sexual partners, ear piercing or acupuncture. Injecting drug use explains more than 50% of hepatitis C infections in blood donors, a group who are less likely to have injected drugs than the general population.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S184-S184
Author(s):  
Patrick O’Neil ◽  
Patrick Ryscavage ◽  
Kristen A Stafford

Abstract Background The incidence of systemic hypertension (HTN) among perinatally-HIV-infected (PHIV) patients appears to increase as they enter adulthood. Among non-perinatally HIV-infected adults both traditional and HIV-associated risk factors have been found to contribute to HTN. Whether these same factors contribute to HTN in PHIV is unknown. The purpose of this study was to determine the socio-demographic, clinical, virologic, and immunologic factors associated with HTN among a cohort of PHIV adolescents and young adults, aged ≥18 years. Methods We conducted a case–control study among a population of 160 PHIV adults with and without HTN who were receiving care at the University of Maryland and aged 18–35 years as of December 31, 2017. Covariates assessed included traditional risk factors such as age, family history of HTN, and smoking, as well as HIV- and antiretroviral-associated covariates. Results We identified 49 HTN cases (30.6%) and 111 (69.4%) controls. There were no significant differences in the odds of most traditional (age, gender, race, family history of HTN, tobacco, alcohol, and/or other drug use) or HIV-associated (CD4 nadir <100 cells/mm3, individual ART exposure, ART interruption) risk factors among PHIV adults with HTN compared with those with no diagnosis of HTN. Cases had lower odds of a history of treatment with lopinavir/ritonavir (LPV/r). Cases had 3.7 (95% CI 1.11, 12.56) times the odds of a prior diagnosis of chronic kidney disease (CKD) compared with controls after controlling for CD4 nadir and ARV treatment history. Conclusion The results of this study suggest that most traditional and HIV-related risk factors do not appear to increase the odds of having HTN in this PHIV cohort. However, HTN among PHIV may be driven in part by CKD, and a focus on the prevention and early management of CKD in this group may be necessary to prevent the development of HTN. Additionally, there may be as yet unidentified risk factors for HTN among PHIV which require further exploration. Given the large and growing population of PHIV entering adulthood worldwide, it is imperative to explore risk factors for and effects of HTN in large, diverse PHIV populations. Disclosures All authors: No reported disclosures.


Sign in / Sign up

Export Citation Format

Share Document