scholarly journals The Risk Factors and the Characteristics of Fungal Endophthalmitis Following Candida Blood Stream Infection, a Case–Control Study

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S85-S85
Author(s):  
Hideaki Kato ◽  
Kayoko Sano ◽  
Yoshifumi Sugiyama ◽  
Risa Sakai ◽  
Sei Samukawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Significant Risk ◽  
Venous Catheter ◽  
Significant Risk Factor ◽  
Blood Stream ◽  
Bivariate Analysis ◽  
Fungal Endophthalmitis ◽  
Failure Assessment ◽  
Control Study

Abstract Background Fungal endophthalmitis is one of the severe complications following Candida blood stream infection (Candidemia). Methods To analyze the risk factors of Candidemia-related fungal endophthalmitis, total 50 Candidemia cases underwent ophthalmology examination between April 2011 and March 2016 were retrospectively collected from the medical records. Ten Candidemia with endophthalmitis cases were compared with 40 Candidemia cases without endophthalmitis were reviewed to analyze the risk factors and characteristics; patients’ age, gender, causative Candida species, the presence of shock, the highest sequential organ failure assessment (SOFA) score and the predisposing factors including diabetes, steroid use, hematological malignancy, cancer, central venous catheter (CVC) placement and neutropenia. Results By bivariate analysis, candidemia caused by C. albicans (40% vs. 6.7%, P = 0.009), the presence of shock (36.4% vs. 15.4%, P = 0.197), CVC placement (25.7% vs. 0%, P = 0.092), and neutropenia (40% vs. 15%, P = 0.097) were found higher endophthalmitis group. By logistic regression analysis, C. albicans candidemia was only found to be a significant risk factor (adjusted odds ratio 9.41 [95% CI, 1.42–64.76]). Conclusion C. albicans is most responsible causative agent for candidemia-related endophthalmitis. Candidemia cases with the presence of shock, CVC placement, and neutropenia should be closely monitored to early detect Candidemia-related endophthalmitis. Disclosures All authors: No reported disclosures.

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

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.

scholarly journals Evaluation of Specific Risk Factors and Outcomes of Colistin-Resistant Klebsiella pneumoniae Infections in a Tertiary Care Centre - An Observational Study

2021 ◽  
Vol 4 (2) ◽  
pp. 1-6
Author(s):  
Prakash Shastri ◽  
Shamanth A Shankarnarayan
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Venous Catheter ◽  
Blood Stream ◽  
Central Line ◽  
Multidrug Resistant ◽  
Automated System ◽  
Tertiary Care Centre ◽  
Broth Microdilution Method

Background: Incidence of multidrug resistant Klebsiella pnumoniae infections are increasing globally especially in ICUs. Aim: We evaluated the burden of colistin resistant K. pneumoniae (ColR KP) and the risk factors associated with the outcome of these patients. Methods: Consecutive patients developing K. pneumoniae infections were included. K. pneumoniae from endotracheal tube and catheterized urine sample, having cell count <105 cfu/ml, and which did not necessitate a change in antibiotics as per the treating physicians was considered as colonizer. Demographic and clinical details were collected and samples were processed as per standard protocol. Any growth was identified and its antimicrobial susceptibility was carried out by using Vitek 2 automated system. Minimum inhibitory concentration of >4 μg/ml for Colistin was considered as resistant. The resistant isolates were confirmed with Broth microdilution method. Risk factor associated with the outcome of ColR KP was analyzed. Findings: Burden of K. pneumoniae infection was 50.02 per 1000 admissions. K. pneumonie (n=155) was isolated from patients with ventilator associated pneumonia (84, 54.2%), followed by blood stream infection (49, 31.6%) and urinary tract infection (22, 14.2%). ColR KP and intermediate (ColI KP) isolates were 58 (37.41%) and 97 (62.6%) respectively. Among ColR KP infected patients 32 (55.1%) died whereas 26 (44.8%) patients were discharged. Higher mortality was witnessed in ColI KP cases (75, 77.3%) compared to ColR-KP cases (32, 55.1%) (p=0.004; OR=2.77; 95% CI=1.37 to 5.59). Colistin resistance and presence of central line were independently associated with mortality. Conclusion: Colistin resistant K. pneumoniae infections among ICU patients are on rise. Presence of central venous catheter and resistance to colistin were independent predictors of mortality.

scholarly journals Hemodialysis Catheter-Related Infection in a Teaching Hospital of Central Nepal

2019 ◽  
Vol 41 (2) ◽  
pp. 11-16
Author(s):  
Arun Sedhain ◽  
Abja Sapkota ◽  
Narayan B Mahotra
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Antibiotic Sensitivity ◽  
Major Complication ◽  
Venous Catheter ◽  
Blood Stream ◽  
Recent Change ◽  
Catheter Related Infection ◽  
Hemodialysis Catheter ◽  
A Prospective Study

Introduction: Infection of the central venous catheter (CVC) is a major complication seen among patients undergoing hemodialysis. Identifying CVC related infection (CRI) and its risk factors and causative organisms is important for better implementation of preventive strategies. Methods: A prospective study was conducted at Chitwan Medical College for duration of 2 years from January 2017to December 2018 among the patients undergoing hemodialysis via CVC. The data collected were related to patients’ demographics, site of catheter insertion, and duration, microbiological data including cultures from catheter sites, blood, and catheters’ tips and antibiotic sensitivity. Catheter related infection was divided into catheter related local infection (CRLI) and catheter related blood stream infection (CRBSI). Data was analyzed using IBM SPSS Statistics version 21.0. Results: A total of 41 cases of CVC related infection (CRI) were documented with an incidence rate of 6.94 episodes per 1000 catheter days at risk. Out of the total CRI, 39.02% were CRLI and 60.98% were CRBSI. Fever with chills and rigor were the most common clinical presentation. Risk factors for the development of CRI were duration of catheter in situ, repeated change of CVC and the use of CVC for indications other than hemodialysis (HD).Staphylococci and Klebsiella were the most common organisms isolated in culture. Conclusion: The rate of CRI among Nepalese patients undergoing hemodialysis is high. Prolonged duration of CVC usage, recent change of catheter and the use of the HD catheter for the purpose of institution of intravenous medication have been found as the risk factors for CRI.

scholarly journals Peripheral venous catheter related blood stream infection in intensive care unit

2018 ◽  
Vol 5 (3) ◽  
pp. 668 ◽  
Author(s):  
Satish Kumar Dalai ◽  
Sanghamitra Padhi ◽  
Abhishek Padhi ◽  
Banojini Parida
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Signs And Symptoms ◽  
Venous Catheter ◽  
Blood Stream ◽  
Sensitivity Testing ◽  
Klebsiella Species ◽  
Blood Stream Infections ◽  
Peripheral Venous Catheter ◽  
Microbial Profile

Background: Peripheral venous catheter related blood stream infections (PVC-BSI) are a common cause of morbidity and mortality in hospitals. Most of the catheter related blood stream infections occurs due to lack of proper aseptic measures. This study points out the risk factors microbial profile and antimicrobial susceptibility of isolates associated with PVC-BSI. The common organisms causing Catheter related BSI are Staphylococcus aureus (41.1%), and Klebsiella species (17.6%) followed by CONS and Enterococcus species. Objective of present study was to isolate and identify the organisms causing PCV-BSI, perform antimicrobial sensitivity testing of isolated organisms and to identify the associated risk factors and preventive measures that should be used.Methods: The study was conducted over a period of one year from August 2015 to July 2016 in the Department of Microbiology. Study group comprised of all the patients with peripheral venous catheterization who developed signs and symptoms of septicemia after 48 hrs of insertion of PVC. These patients were followed up from the time of catheterization till discharge. Peripheral venous catheter tip was collected under aseptic condition along with peripheral blood samples from a site other than the catheterized one. Samples were collected from patients at any point of time who developed signs and symptoms of septicemia after 48 hrs of catheter insertion. The length of time for which the PVC was in place was recorded.Results: In total, 87 cases were included in the study with mean catheter duration of 4.8 days accounting for 418 catheter days. Out of these 87 cases, 17 cases developed PVC-BSI (19.5%) and 34 cases developed colonization (24.1%). Staphylococcus species (41.1%) was the most common isolate.Conclusions: PVC-BSI has a significant role in hospital acquired infections and more studies are needed to establish this.

Hub colonization of central line catheters in children with cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18530-18530 ◽  
Author(s):  
R. Norville ◽  
B. Horvath ◽  
D. Lee ◽  
A. Hyde ◽  
M. Gregurich ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Blood Stream Infection ◽  
Significant Risk ◽  
Venous Catheter ◽  
Blood Stream ◽  
Coagulase Negative Staphylococcus ◽  
Urban Hospital ◽  
Central Venous ◽  
Children With Cancer ◽  
Convenience Sample

18530 Background: Central venous catheter (CVC) hub sites provide bacterial access to the blood stream through migration along the external and internal surfaces of the catheter. Hub colonization rates vary from 29–38% in the adult literature. While pediatric studies were not found, one study reported the incidence of blood stream infections in neonates to be 30 times higher in catheters with hub colonization compared to catheter hubs that were not colonized. The purpose of this descriptive study was to obtain baseline cultures of CVC hubs to determine the incidence of colonization. Methods: Fifty-one catheter hub cultures were obtained from a convenience sample of 27 children with cancer. The mean age of the patients was 8.2 years (range 0.5–16.2 years); 77% were diagnosed with leukemia and 23% with solid tumors. Cultures were obtained by swabbing the threaded area of the catheter hub after removing the injection cap. A semi-quantitative culture for bacteria and fungus was obtained using standard laboratory procedures by a microbiologist. This study was conducted in a large urban hospital in the Southwest. Results: Fifty-seven percent of the hubs were culture positive. Of those positive cultures, 69%, 24%, 10% and 7% were colonized with 2, 3, 4 and 5 organisms, respectively. The most common organism cultured was coagulase negative staphylococcus. The only significant risk factor for this population was previous central venous catheter infections (p = 0.025). Sixty-nine percent of the lines were tunneled catheters. Central venous catheters were in place on an average of 75.3 days but this was not a factor in the colonization rate. Conclusions: The majority (57%) of the 51 central venous catheter hubs cultured were colonized with at least one organism. This study is the first to evaluate the rate of central venous catheter hub colonization in children with cancer. These findings support the need for more stringent guidelines for central venous catheter care. Further research evaluating the relationship between hub colonization and subsequent blood stream infection is needed. No significant financial relationships to disclose.

Prevention of Recurrent Thrombotic Events in Children with Central Venous Catheter-Associated Venous Thrombosis

Blood ◽  
2021 ◽  
Author(s):  
Helen Havens Clark ◽  
Lance Ballester ◽  
Hilary B Whitworth ◽  
Leslie Raffini ◽  
Char Witmer
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Venous Catheter ◽  
Significant Risk Factor ◽  
Bleeding Risk ◽  
Secondary Prophylaxis ◽  
Central Venous ◽  
Full Dose ◽  
Increased Risk ◽  
Recurrent Vte

Central venous catheters (CVC) are the most significant risk factor for pediatric venous thromboembolism (VTE). After an index CVC-associated VTE (CVC-VTE), the role of secondary prophylaxis for subsequent CVC placement is uncertain. Aims of this single center retrospective study were to evaluate the efficacy of secondary prophylaxis for patients with a prior CVC-VTE and identify risk factors associated with recurrent VTE in patients less than 19 years with an index CVC-VTE between 2003 and 2013. Data collection included clinical and demographic factors, subsequent CVC placement, secondary prophylaxis strategy, recurrent VTE, and bleeding. Risk factors for recurrence and effectiveness of secondary prophylaxis were evaluated using survival and binomial models. Among 373 patients with an index CVC-VTE, 239 (64.1%) had subsequent CVC placement. 17.4% (65/373) of patients had recurrent VTE, 90.8% (59/65) were CVC-associated. On multivariable survival analysis, each additional CVC (HR 12.00; 95% CI 2.78 - 51.91), congenital heart disease (HR 3.70; 95% CI 1.97 - 6.95), and total parenteral nutrition dependence (HR 4.02; 95% CI 2.23 - 7.28) were associated with an increased hazard of recurrence. Full dose anticoagulation for secondary prophylaxis was associated with decreased odds of recurrent CVC-VTE (OR 0.35; 95% CI 0.19 - 0.65) but not prophylactic dosing (OR 0.61; 95% CI 0.28 - 1.30). Only 1.3% of CVCs experienced major bleeding with prophylactic or full dose anticoagulation. In summary, children with CVC-VTE are at increased risk for recurrent VTE. Secondary prophylaxis with full dose anticoagulation was associated with a 65% reduction in odds of thrombotic events.

scholarly journals A case–control study of risk factors for sporadic campylobacter infections in Denmark

2003 ◽  
Vol 130 (3) ◽  
pp. 353-366 ◽  
Author(s):  
J. NEIMANN ◽  
J. ENGBERG ◽  
K. MØLBAK ◽  
H. C. WEGENER
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Case Control Study ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Case Control ◽  
Final Model ◽  
Unpasteurized Milk ◽  
Frequent Consumption ◽  
Control Study

A case control study comprising 282 cases and 319 matched controls was conducted in Denmark during 1996–7. Two estimates of the odds ratio (OR) were determined for each risk factor with and without ‘protective factors’ fitted into the final model. Consumption of undercooked poultry (OR 4·5; 8·2), consumption of red meat at a barbecue (OR 2·3; 4·1), consumption of grapes (OR 1·6; 2·8) and drinking unpasteurized milk (OR 2·3; 11·8) were identified as risk factors in both models. Frequent consumption of pork chops (OR 4·4) and daily contact with domestic animals and pets were identified as risk factors in one of the two models only. Finally, foreign travel was found to be a significant risk factor (OR 2·5). Seasonal and regional interaction was observed for several risk factors and the time elapsed from interviewing of cases to interviewing of controls seemed to influence the effect of certain seasonal dependent risk factors.

scholarly journals Risk Factors for Mortality in Children with Hospital-Acquired Pneumonia in Dr. Soetomo General Hospital Surabaya

2021 ◽  
Vol 7 (2) ◽  
pp. 46
Author(s):  
Diska Hanifah Nurhayati ◽  
Retno Asih Setyoningrum ◽  
Arie Utariani ◽  
Ira Dharmawati
Keyword(s):  
Risk Factors ◽  
General Hospital ◽  
Treatment Strategies ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Response To Therapy ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Introduction: Hospital-Acquired Pneumonia (HAP) is a nosocomial pneumonia that brings negative impacts, such as prolonged hospital stay and increased cost. Previous studies often discussed about the risk factors of HAP mortality in adult patients rather than in children. This study aimed to analyze the risk factors of mortality in children with HAP.Methods: This was a retrospective observational analytic study using cross sectional method with total sampling. A total of 73 children were enrolled in this study, consisted of inpatients at Pediatric Inpatient Room Dr. Soetomo General Hospital Surabaya who met the inclusion and exclusion criteria. Independent variables were gender, age, onset of HAP, length of stay (LOS), comorbidities, birth weight, type of breastfeeding, the use of mechanical ventilation (MV), and response to therapy. Dependent variable was mortality. The data were collected from medical records, which later were analyzed by bivariate and multivariate analysis.Results: The mortality of children with HAP was 23.3%. Bivariate analysis showed that age (p = 0.009), the use of MV (p = 0.029), and response to therapy (p = 0.036) were proven to affect mortality in children with HAP in Dr. Soetomo General Hospital Surabaya. In addition, the use of MV was the significant risk factor (p = 0.023) given by the multivariate analysis. Gender, onset of HAP, LOS, comorbidities, and type of breastfeeding were not proven to be the risk factors for mortality.Conclusion:Mortality in children with HAP in Dr. Soetomo General Hospital Surabaya was significantly affected by children’s age, the use of MV, and response to therapy. This information might be used as early signs and treatment strategies for children with HAP which lead to the decrease of hospital mortality. 

scholarly journals Risk factors associated with the recent cholera outbreak in Yemen: a case-control study

2019 ◽  
Vol 41 ◽  
pp. e2019015
Author(s):  
Fekri Dureab ◽  
Albrecht Jahn ◽  
Johannes Krisam ◽  
Asma Dureab ◽  
Omer Zain ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Control ◽  
Bivariate Analysis ◽  
Common Source ◽  
Source Water ◽  
Cholera Outbreak ◽  
History Of ◽  
Control Study

OBJECTIVES: The cholera outbreak in Yemen has become the largest in the recent history of cholera records, having reached more than 1.4 million cases since it started in late 2016. This study aimed to identify risk factors for cholera in this outbreak.METHODS: A case-control study was conducted in Aden in 2018 to investigate risk factors for cholera in this still-ongoing outbreak. In total, 59 cholera cases and 118 community controls were studied.RESULTS: The following risk factors were associated with being a cholera case in the bivariate analysis: a history of travelling and having had visitors from outside Aden Province; eating outside the house; not washing fruit, vegetables, and khat (a local herbal stimulant) before consumption; using common-source water; and not using chlorine or soap in the household. In the multivariate analysis, not washing khat and the use of common-source water remained significant risk factors for being a cholera case.CONCLUSIONS: Behavioural factors and unsafe water appear to be the major risk factors in the recent cholera outbreak in Yemen. In order to reduce the risk of cholera, hygiene practices for washing khat and vegetables and the use and accessibility of safe drinking water should be promoted at the community level.

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