688. Incidence and Risk Factors for Prosthetic Valve Endocarditis Following TAVR: 2015-2019

Abstract Background Transcatheter aortic valve replacement (TAVR) is increasingly used for lower risk patients. Incidence of TAVR endocarditis ranges from 0.2% to 3.3%. The purpose of this study was to determine local incidence and risk factors of prosthetic valve infective endocarditis (PVIE) in a contemporary cohort. Methods IRB approved retrospective, nested case-control study evaluated the 1-year incidence and risk factors for PVIE among TAVR recipients from 2015 to 2019. Inclusion: ≥ 18 years, TAVR procedure at Henry Ford Health System. Exclusion: repeat TAVR. PVIE cases were matched with controls who did not experience PVIE. PVIE defined as diagnosis documentation in the electronic medical record. Figure 1. Study Design Results 23/1266 patients were identified as cases corresponding to a 1-year incidence of 1.82%. The median time to PVIE was 127 days and 35% occurred within 60 days. The most frequently isolated organisms were streptococci (26%), MRSA (13%), and MSSA (13%). Baseline demographics and comorbidities for 23 PVIE cases and 161 controls are displayed in Table 1. Significant risk factors for PVIE in bivariate analysis included STS-PROM (Society of Thoracic Surgeons Predicted Risk of Mortality), median: 4.1 controls and 6.4 cases (p = 0.012). Age, BMI, and comorbidities were not significantly different. Diabetes was notably more frequent among cases (36% vs 48%, p = 0.274). Patients with PVIE had more post-op RBC transfusions (5% vs 21.7% p = 0.003), ECG changes (23% vs 43.5%, p = 0.035), heart block (15.5% vs 34.8%, p = 0.038), longer length of stay (2 days, range 1 to 4 vs 4 to 11, p = 0.004), and thirty-day readmission (10.6% vs 52.2%, p < 0.001). Results displayed in Table 2. Table 1. Patient Characteristics and Risk Factor Analysis Table 2. Additional Outcomes Conclusion The results from this study give insight to the local incidence, microbiology, and risk of PVIE following TAVR. Future directions include a larger evaluation of modifiable risks such as diabetes management and examining the heart block patients who received permanent pacemaker implants. Disclosures Rachel Kenney, PharmD, Medtronic, Inc. (Other Financial or Material Support, spouse is an employee and shareholder) Janet F. Wyman, DNP, CNS-BC, FACC, Edwards Lifesciences (Consultant) Dee Dee Wang, MD, Edwards LifeSciences (Consultant) Brian O'Neill, MD, Edwards Lifesciences (Consultant)

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Faculty Opinions recommendation of Prosthetic valve endocarditis after transcatheter aortic valve implantation.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725435873.793510604 ◽

2015 ◽

Author(s):

Bernard Prendergast

Keyword(s):

Aortic Valve ◽

Transcatheter Aortic Valve Implantation ◽

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

Transcatheter Aortic Valve ◽

Aortic Valve Implantation ◽

Valve Implantation

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Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1344 ◽

2020 ◽

pp. 1-7

Author(s):

Stephanie M. Cabral ◽

Katherine E. Goodman ◽

Natalia Blanco ◽

Surbhi Leekha ◽

Larry S. Magder ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Risk Adjustment ◽

Community Hospital ◽

Significant Risk ◽

Significant Risk Factor ◽

Bivariate Analysis ◽

Patient Admissions ◽

Clostridioides Difficile ◽

Risk Adjustment Model

Abstract Objective: To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Patients: All patients at least 18 years of age admitted to 3 hospitals in Maryland between January 1, 2016, and January 1, 2018. Methods: Comorbid conditions were assigned using the Elixhauser comorbidity index. Multivariable log-binomial regression was conducted for each hospital using significant covariates (P < .10) in a bivariate analysis. Standardized infection ratios (SIRs) were computed using current Centers for Disease Control and Prevention (CDC) risk adjustment methodology and with the addition of Elixhauser score and individual comorbidities. Results: At hospital 1, 314 of 48,057 patient admissions (0.65%) had a HO-CDI; 41 of 8,791 patient admissions (0.47%) at community hospital 2 had a HO-CDI; and 75 of 29,211 patient admissions (0.26%) at community hospital 3 had a HO-CDI. In multivariable regression, Elixhauser score was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic use, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospital 1 and hospital 2. When Elixhauser score was included in the risk adjustment model, it was statistically significant (P < .01). Compared with the current CDC SIR methodology, the SIR of hospital 1 decreased by 2%, whereas the SIRs of hospitals 2 and 3 increased by 2% and 6%, respectively, but the rankings did not change. Conclusions: Electronically available patient comorbidities are important risk factors for HO-CDI and may improve risk-adjustment methodology.

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Prevalence of Human Cystic Echinococcosis in Rio Negro Province, Argentina and Direct Risk Factors for Infection

10.21203/rs.3.rs-260421/v1 ◽

2021 ◽

Author(s):

Leonardo Uchiumi ◽

Guillermo Mujica ◽

Daniel Araya ◽

Juan Carlos Salvitti ◽

Mariano Sobrino ◽

...

Keyword(s):

Risk Factors ◽

Potential Risk ◽

Rural Areas ◽

Cystic Echinococcosis ◽

Significant Risk ◽

Prevalence Ratio ◽

Bivariate Analysis ◽

Rio Negro ◽

Potential Risk Factors ◽

Current Address

Abstract Background: Cystic echinococcosis (CE) is a parasitic zoonosis caused by infection with the larval stage of Echinococcus granulosus sensu lato This study investigated the prevalence and potential risk factors associated with human CE in the towns and rural areas of Ñorquinco and Ramos Mexia, Rio Negro province, Argentina. Methods: In order to detect abdominal CE cysts, we screened 892 volunteers by ultrasound and investigated potential risk factors for CE using a standardized questionnaire. Bivariate and multivariate analyses were used to estimate the Prevalence Ratio (PR) and their 95% CIs of the association between CE and the factors investigated. Results: Abdominal CE was detected in 42/892 screened volunteers (4.7%, CI 3.2-6.1), only two of who being under 15 years of age. Thirteen CE (30.9%) cases had 25 cysts in active stages (CE1, CE2, CE3) The most relevant risk factors identified in the bivariate analysis included: live in rural area (p=0.003), age >40 years (p=0.000), drinking always water of natural source (p=0.007), residing in rural areas during first five years of life (p=0.000) and live more than 20 years at your current address (p=0.013). In the multivariate model, statistically significant risk factors were: frequently touch dogs (p=0.012), residing in rural areas during first five years of life (p=0.004), smoking (p=0.000), age > 60 years (p=0.002) and live in rural areas (p=0.017).Conclusions: our results point toward infection with CE being acquired since childhood and with constant exposure throughout life, especially in rural areas with a general environmental contamination

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Analysis of risk factors associated with caesarean section surgical site infections: a case control study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205250 ◽

2020 ◽

Vol 9 (12) ◽

pp. 5075

Author(s):

Riya Rano ◽

Purvi K. Patel

Keyword(s):

Risk Factors ◽

Cesarean Section ◽

Subcutaneous Tissue ◽

White Blood Cells ◽

Significant Risk ◽

Surgical Site Infections ◽

Patient Characteristics ◽

Factors Associated ◽

Operative Care ◽

Duration Of Surgery

Background: Surgical site infection (SSI) is defined as infection occurring within 30 days after a surgical procedure and affecting either the incision or deep tissues at the operation site. SSIs are the most common nosocomial infections, accounting for 38% of hospital-acquired infections. Despite the advances in SSI control practices, SSIs remain common causes of morbidity and mortality among hospitalized patients. This study was undertaken with an objective to determine and analyze the risk factors associated with cesarean section SSIs.Methods: The study was carried out at Medical College and SSG Hospital, Baroda. After obtaining informed consent to be a part of the study, 140 subjects having cesarean section SSI as per the definition, were included as cases in the study. The controls (140) were also selected from the hospital subjects. The primary post-operative care was similar for the cases as well as controls. For patients who had SSI, samples of discharge from the cesarean section wound were collected and transported for culture. Antibiotics were given accordingly. Details about patient characteristics and outcomes were collected in the proforma for cases and controls and data analyzed.Results: The cesarean section SSI rate was 4.78%. Of the parameters studied, maternal age, parity, gestational age, HIV status, meconium stained amniotic fluid, amount of blood loss, previous surgery, duration of surgery were not associated with cesarean section SSI.Conclusions: Number of antenatal care (ANC) visits, haemoglobin, total white blood cells (WBC) count, pre eclampsia, premature rupture of membranes (PROM), non-progression in 2nd stage and subcutaneous tissue thickness were the independent significant risk factors associated with post-cesarean SSI.

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Prosthetic valve endocarditis secondary to Corynebacterium following transcatheter aortic valve implantation: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/yty109 ◽

2018 ◽

Vol 2 (4) ◽

Author(s):

Ramzi Moufarrej ◽

Nahla Aljaberi

Keyword(s):

Case Report ◽

Aortic Valve ◽

Transcatheter Aortic Valve Implantation ◽

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

Transcatheter Aortic Valve ◽

Aortic Valve Implantation ◽

Valve Implantation

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Prosthetic valve endocarditis after transcatheter aortic valve replacement: A case report and current review

Case Reports in Internal Medicine ◽

10.5430/crim.v4n2p10 ◽

2017 ◽

Vol 4 (2) ◽

pp. 10

Author(s):

Tarek Chami ◽

Guilherme Attizzani

Keyword(s):

Case Report ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Transcatheter Aortic Valve Replacement ◽

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

Transcatheter Aortic Valve ◽

Current Review

Prosthetic valve endocarditis (PVE) after transcatheter aortic valve replacement (TAVR) is a rare but very serious and often deadly complication. Despite that, data are scarce and limited. Here, we report a case of a patient who developed PVE three months following TAVR and review the literature.

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