Impact of Infectious Disease Consultation in Patients With Candidemia: A Retrospective Study, Systematic Literature Review, and Meta-analysis

Abstract Background Morbidity and mortality from candidemia remain unacceptably high. While infectious disease consultation (IDC) is known to lower the mortality from Staphylococcus aureus bacteremia, little is known on the impact of IDC in candidemia. Methods We conducted a retrospective observational cohort study of candidemia patients at a large tertiary care hospital between 2015 and 2019. All patients aged ≥18 years with blood cultures positive for Candida species were included. We only included the first episode of candidemia. Exclusion criteria were death or transfer to the palliative care unit within 48 hours from the time cultures became positive. The crude mortality rate was compared between those with IDC and without IDC. Then, we systematically searched five publication-databases through February 2020 and performed a meta-analysis of the impact of IDC on mortality of patients with candidemia. The study protocol has been submitted to the International Prospective Register for Systematic Reviews (PROSPERO) database (ID 156939) on April 2020. Results A total of 151 patients at our institution met the inclusion criteria, 129 (85%) of whom received IDC. Thirty-day, and 90-day mortality rates were significantly lower in the IDC group (18% vs 50%, P = .002; 23% vs 50%, P = .0022, respectively). Our systematic literature review returned 216 reports, of which, 13 studies including ours fulfilled the inclusion criteria. Among the 13 studies with a total 3687 patients, IDC was performed in 49% of patients. Mortality numbers were available in 10 studies. Overall mortality was 38.2% with a significant difference in favor of the IDC group (28.4% and 47.6%) with a pooled relative risk of 0.41 [95% Cl 0.35-0.49]. Ophthalmology referral (61%; 790/1279 and 21%; 273/1304, P < 0.001), echocardiogram (54%; 662/1219 and 28%; 369/1296, P < 0.001), and central line removal (78%; 830/1069 and 61%; 686/1116, P < 0.02) were performed more frequently among patients receiving IDC. Overall mortality Conclusion This study is the first systematic literature review and meta-analysis to evaluate the association between IDC and candidemia mortality. IDC was associated with a lower mortality and should be standard of care in all patients with candidemia. Disclosures Dimitrios Farmakiotis, MD, Astellas (Grant/Research Support) Paul Auwaerter, Collidion (Consultant)DiaSorin (Consultant)Johnson and Johnson (Shareholder)MicroB-Plex (Research Grant or Support)Shionogi (Consultant) Daniel Diekema, bioMerieux, Inc (Grant/Research Support)JMI Laboratories (Consultant)

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The impact of infectious disease consultation in candidemia in a tertiary care hospital in Japan over 12 years

PLoS ONE ◽

10.1371/journal.pone.0215996 ◽

2019 ◽

Vol 14 (4) ◽

pp. e0215996 ◽

Cited By ~ 5

Author(s):

Masahiro Ishikane ◽

Kayoko Hayakawa ◽

Satoshi Kutsuna ◽

Nozomi Takeshita ◽

Norio Ohmagari

Keyword(s):

Infectious Disease ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Infectious Disease Consultation ◽

The Impact

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Complications of transradial versus transfemoral access for neuroendovascular procedures: a meta-analysis

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2021-018032 ◽

2021 ◽

pp. neurintsurg-2021-018032

Author(s):

Derrek Schartz ◽

Sajal Medha K Akkipeddi ◽

Nathaniel Ellens ◽

Redi Rahmani ◽

Gurkirat Singh Kohli ◽

...

Keyword(s):

Literature Review ◽

Meta Analysis ◽

Final Analysis ◽

Case Control ◽

Random Effects Model ◽

Inclusion Criteria ◽

Access Site ◽

Lower Odds ◽

Significant Difference ◽

Study Heterogeneity

BackgroundTransradial access (TRA) has gained increased usage among neurointerventionalists. However, the overall safety profile of access site complications (ASCs) and non-access site complications (NASCs) of TRA versus transfemoral access (TFA) for neuroendovascular procedures remains unclear.MethodsA systematic literature review and meta-analysis using a random effects model was conducted to investigate the pooled odds ratios (OR) of ASCs and NASCs. Randomized, case–control, and cohort studies comparing access-related complications were analyzed. An assessment of study heterogeneity and publication bias was also completed.ResultsSeventeen comparative studies met the inclusion criteria for final analysis. Overall, there was a composite ASC rate of 1.8% (49/2767) versus 3.2% (168/5222) for TRA and TFA, respectively (P<0.001). TRA was associated with a lower odds of ASC compared with TFA (OR 0.42; 95% CI 0.25 to 0.68, P<0.001, I2=31%). There was significantly lower odds of complications within the intervention and diagnostic subgroups. For NASC, TRA had a lower composite incidence of complications than TFA at 1.2% (31/2586) versus 4.2% (207/4909), P<0.001). However, on meta-analysis, we found no significant difference overall between TRA and TFA for NASCs (OR 0.79; 95% CI 0.51 to 1.22, P=0.28, I2=0%), which was also the case on subgroup analysis.ConclusionOn meta-analysis, the current literature indicates that TRA is associated with a lower incidence of ASCs compared with TFA, but is not associated with a lower rate of NASCs.

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Acute kidney injury requiring dialysis in obstetric patients: management and clinical outcome in case series of 30 patients in a tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172923 ◽

2017 ◽

Vol 6 (7) ◽

pp. 2997

Author(s):

Molina U. Patel ◽

Yuvraj Jadeja ◽

Niket Patel ◽

Nayana Patel ◽

Smruti Vaishnav ◽

...

Keyword(s):

Acute Kidney Injury ◽

Tertiary Care ◽

Case Series ◽

Kidney Injury ◽

Therapeutic Interventions ◽

Risk Category ◽

Care Hospital ◽

Tertiary Care Centre ◽

Significant Difference ◽

The Impact

Background: Acute Kidney Injury is a common medical problem affecting approximately 5% of all hospitalized and 30% of critically ill patients. The incidence in obstetric patients ranges from 1 in 2000 to 1 in 25000 pregnancies. In India till date, the impact of AKI on fetomaternal outcome and pertaining therapeutic interventions is only sparsely studied.Methods: It is a retrospective cross-sectional study. All obstetric patients with AKI on dialysis, admitted to Shree Krishna Hospital, a tertiary care hospital in Karamsad village in Gujarat from January 2013 to August 2015. Multivariate statistical analysis of clinical and laboratory parameters was performed using SPSS program to obtain the results.Results: The incidence of dialysis was 1.6%. HELLP syndrome and pre-eclampsia (80%) was found to be the most common etiology of AKI followed by Congestive cardiac failure (34.5%), hemorrhage and sepsis in 30% resp. All patients were admitted to ICU care. No significant difference was found between SAP II and SOFA monitoring system. Mechanical ventilation was done to support 53.3% and inotropic support was needed by 56.7% patients. According to the RIFLE criteria, majority of the patients fall under risk category followed by injury. 18% of the patients developed End Stage Renal Disease.Conclusions: In view of the multifaceted etiologies and complexity of management of AKI, a multi-disciplinary approach involving nephrologist, intensivists, obstetricians and neonatologists is extremely important.

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Non-lesional treatment options for tremor in idiopathic Parkinson syndrome: a protocol for a systematic literature review

BMJ Open ◽

10.1136/bmjopen-2020-048367 ◽

2021 ◽

Vol 11 (8) ◽

pp. e048367

Author(s):

Anna Julia Pedrosa Carrasco ◽

Felicitas Mügge ◽

David José Pedrosa

Keyword(s):

Literature Review ◽

Systematic Literature Review ◽

Meta Analysis ◽

Treatment Options ◽

Inclusion Criteria ◽

Parkinson Syndrome ◽

Registration Number ◽

Future Publication ◽

Rich Data ◽

Improve Patient

IntroductionIdiopathic Parkinson syndrome (iPS) is one of the most common neurodegenerative disorders characterised by the triad of bradykinesia, rigidity and tremor. Tremor at rest predominantly at one side is often perceived by patients as severely disabling and yet ranges among the most difficult symptoms to treat. In medically refractory cases, lesional approaches have proven to be effective alternatives. However, to date, there is no comprehensive analysis of non-surgical therapies to manage iPS-patients’ tremor. We therefore present a detailed study protocol for a systematic literature review assessing efficacy/effectiveness and safety of non-lesional treatments for tremor in iPS.Methods and analysisWe will search three electronic databases (MEDLINE, EMBASE and PsycINFO) using a combination of title/abstract keywords. Additionally, hand-searched reference and citation lists of key reviews identified through the search strategy will be screened. Eligible studies should investigate the efficacy/effectiveness and safety of therapeutic options for tremor in iPS excluding lesional interventions. Publications will be independently assessed for inclusion criteria by two investigators and study information summarised using a standardised template including quality assessment according to the QualSyst tool. We will provide a narrative synthesis of results and conduct a meta-analysis whenever possible.Ethics and disseminationWe commit to present contemporary evidence on the efficacy/effectiveness and safety of non-lesional interventions for tremor in iPS in a future publication. We aim to compile rich data of published studies to inform healthcare professionals in order to ultimately improve patient outcomes.PROSPERO registration numberCRD42020202911).

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The Impact of Automated Brief Messages Promoting Lifestyle Changes Delivered Via Mobile Devices to People with Type 2 Diabetes: A Systematic Literature Review and Meta-Analysis of Controlled Trials

Journal of Medical Internet Research ◽

10.2196/jmir.5425 ◽

2016 ◽

Vol 18 (4) ◽

pp. e86 ◽

Cited By ~ 79

Author(s):

Carukshi Arambepola ◽

Ignacio Ricci-Cabello ◽

Pavithra Manikavasagam ◽

Nia Roberts ◽

David P French ◽

...

Keyword(s):

Type 2 Diabetes ◽

Literature Review ◽

Mobile Devices ◽

Systematic Literature Review ◽

Meta Analysis ◽

Lifestyle Changes ◽

Controlled Trials ◽

The Impact

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The Impact of Hospital Accreditation on the Patients Satisfaction of Haemodialysis Department Services

International Journal of Emerging Research in Management and Technology ◽

10.23956/ijermt.v6i8.170 ◽

2018 ◽

Vol 6 (8) ◽

pp. 384

Author(s):

Zuber Mujeeb Shaikh

Keyword(s):

Patient Satisfaction ◽

Health Care Quality ◽

Tertiary Care ◽

Care Quality ◽

Care Hospital ◽

Significant Difference ◽

Before And After ◽

The Impact ◽

Survey Questionnaires

The quality of hospital Haemodialysis Department Service is one of the most relevant items of health care quality perceived by patients and by their families. Patient satisfaction is considered a way of measuring the quality of services provided. Objectives: To study the impact of National Accreditation Board for Hospitals & Healthcare Providers (NABH) Accreditation, India on Haemodialysis Department Service patient satisfaction. Methods: It is a quantitative, descriptive and inferential research based case study in which sample of a population was studied by structured satisfaction survey questionnaires (before and after the accreditation) in a private tertiary care hospital at Secunderabad, Telangana State, India to determine its characteristics, and it is then inferred that the population has the same or different characteristics. Significance of Research: It was observed initially before the accreditation that there was a lower patient satisfaction rate of the hospital Haemodialysis Department Services, which was affecting the study hospitals’ business. Hypothesis: Null Hypothesis (Ho) and Alternative Hypothesis (H1) were used and tested to compare the before and after impact of accreditation by applying to each question in the questionnaire. Study Design: The closed ended questionnaire was developed considering the Haemodialysis Department Services and incorporated the six dimensions of quality Safe, Timely, Effective, Efficient, Equitable, and Patient-centred (STEEP) and tested prior to implementing. Questionnaires were given to the patients' families for completion upon using the Haemodialysis Department Services two months before and two months after the accreditation. The data were collected in order to cover all three shifts of the Haemodialysis Department Services. Study Population: Simple random sampling method was selected, the researcher had involved all conscious patients (clinical conditions) from all age groups. Data Collections: Primary data were collected from the survey questionnaires. Secondary data were collected from relevant published journals, articles, research papers, academic literature and web portals. Conclusion: At the 5 % level of significance, the t-test results indicate that there is a significant difference in the responses between before (M=51.11, SD=21.89) and after accreditation (M=58.56, SD=17.28) with p-value <0.001. The mean satisfaction score has improved from before accreditation compared to after accreditation.

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Nurse Leader Rounds: Effect on Nurse - Related Patient Satisfaction Scores on Two Post-Surgical Units in an Acute Care Facility

Medical & Clinical Research ◽

10.33140/mcr.02.03.02 ◽

2017 ◽

Vol 2 (3) ◽

Keyword(s):

Patient Satisfaction ◽

Tertiary Care ◽

Healthcare Delivery ◽

Patient Perception ◽

Inpatient Setting ◽

Care Hospital ◽

Nurse Leader ◽

Surgical Units ◽

Significant Difference ◽

The Impact

Background and Significance: The best possible inpatient experience is a priority for many hospitals in today’s model of healthcare delivery. Achieving and sustaining measurable success is a key challenge. Nurse leader rounds (NLR) has been revealed to be an effective improvement strategy in some hospitals. The purpose of this DNP project was to analyze the impact of implementing daily NLR on patient satisfaction (PS) scores in two postsurgical units at Mount Sinai Beth Israel (MSBI) hospital in New York. Methods: This study used descriptive comparison to analyze existing survey data before and after NLR was implemented. The study took place in an academic, urban, tertiary care hospital in two postsurgical units. Data were collected using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey reflecting questions to measure patient’s perceptions of care, specifically, assessing the nurse related communication to examine if there was a relationship between NLR and PS scores. Results: Patient perception data summarized in this study suggested that the implementation of NLR was associated with increased levels of patient satisfaction with communication (SC) with nurses following NLR in the inpatient setting on two post-surgical units. The results indicated significant difference between the pre and post scores of SC in nurse related questions referring to communication (Appendix A). Conclusion: Effective implementation of NLR can improve patient perception of care. Improvements in nurse communica

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Evaluation of an infectious disease consultation programme in a German tertiary care hospital

Infection ◽

10.1007/s15010-013-0512-1 ◽

2013 ◽

Vol 41 (6) ◽

pp. 1121-1128 ◽

Cited By ~ 11

Author(s):

J. J. Vehreschild ◽

G. Morgen ◽

O. A. Cornely ◽

P. Hartmann ◽

S. Koch ◽

...

Keyword(s):

Infectious Disease ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Infectious Disease Consultation

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Epidemiology, Species Distribution, and Outcome of Nosocomial Candida spp. Bloodstream Infection in Shanghai — An 11-year Retrospective Analysis in a Tertiary Care Hospital

10.21203/rs.3.rs-212048/v1 ◽

2021 ◽

Author(s):

Yan-Jun ZHENG ◽

Ting XIE ◽

Lin WU ◽

Xiao-Ying LIU ◽

Ling ZHU ◽

...

Keyword(s):

Risk Factors ◽

Mortality Rate ◽

Antifungal Therapy ◽

Species Distribution ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Clinical Severity ◽

Care Hospital ◽

Significant Difference ◽

The Impact

Abstract BackgroundThe incidence of Candida bloodstream infections (BSIs), has increased over time. In this study, we aimed to describe the current epidemiology of Candida BSI in a large tertiary care hospital in Shanghai and to determine the risk factors of 28-day mortality and the impact of antifungal therapy on clinical outcomes. MethodsAll consecutive adult inpatients with Candida BSI at Ruijin Hospital from 2008.1 to 2018.12 were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and their impact on the outcomes were analyzed. ResultsAmong the 370 inpatients with 393 consecutive episodes of Candida BSI, the incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients. Of the 393 cases, 299 (76.1%) were treated with antifungal therapy (247 and 52 were treated with early appropriate and targeted antifungal therapy, respectively). The overall 28-day mortality rate was 28.5%, which was significantly lower in those who received early appropriate (25.5%) or targeted (23.1%) antifungal therapy than in those who did not (39.4%; P=0.012 and P=0.046, respectively). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, and neutropenia were found to be independent risk factors of 28-day mortality rate. Patients who received antifungal therapy had a lower mortality risk than did those who did not.ConclusionsThe incidence of Candida BSI has increased steadily in the past 11 years at our tertiary care hospital in Shanghai. Antifungal therapy influenced short-term survival, but no significant difference in mortality was observed between those who received early appropriate and targeted antifungal therapy.

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