scholarly journals Frequency of Antimicrobial Resistance in Shiga Toxin-Producing Escherichia coli (STEC) and Non-Typhoidal Salmonella (NTS) Clinical Infections and Association with Epidemiological Factors

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S366-S366
Author(s):  
Sanjana Mukherjee ◽  
Rebekah Mosci ◽  
Chase Anderson ◽  
Brian Snyder ◽  
James Collins ◽  
...  
Keyword(s):  
Continuous Monitoring ◽  
Antibiotic Prescription ◽  
Epidemiological Data ◽  
Chi Square ◽  
Surveillance Network ◽  
High Frequencies ◽  
Drug Classes ◽  
The Us ◽  
Prescription Rates ◽  
Foodborne Infections

Abstract Background STEC and NTS are leading causes of foodborne infections in the US. Monitoring resistance in these pathogens is essential to understand the distribution of resistance profiles and because of the high likelihood of horizontal transfer of resistance genes to other pathogens. Data involving resistance in clinical STEC and NTS isolates from Michigan is lacking. Methods Clinical STEC (n = 353) and NTS (n = 148) isolates from the MDHHS (2010–2014) were examined for resistance using disk diffusion, E-test or broth microdilution. Case information and epidemiological data for STEC isolates was extracted and associations with resistant infections were determined using chi square tests in SAS 9.3 and EpiInfo™ 7. Results Overall, 31 (8.8%, n = 353) STEC isolates were resistant to at least one antibiotic; high frequencies of resistance were observed for ampicillin (7.4%) and trimethoprim-sulfamethoxazole (4.0%). Resistance to ciprofloxacin (0.28%) and all three drug classes (0.28%) was less common. Preliminary results indicate that O157 resistance to ampicillin (4.8%) and trimethoprim-sulfamethoxazole (3.4%) was higher in Michigan compared with national frequencies (ampicillin = 2.7%, trimethoprim-sulfamethoxazole= 1.5%). Higher resistance frequencies were also observed in counties with high (11.3%) vs. low (7.7%) antibiotic prescription rates. For NTS, 23 (15.5%) isolates were resistant to ≥1 antibiotic. Resistance varied by serotype with high frequencies in Typhimurium (20%, n = 20), Newport (17.6%, n = 17) and Enteritidis (4.8%, n = 42); 11 (7.4%) NTS isolates were resistant to ≥3 antimicrobial classes. Conclusion Continuous monitoring of resistance in clinical STEC and NTS is warranted due to their importance as food pathogens. The identification of risk factors for resistance is crucial to develop alternative prevention practices to reduce the health burden of resistant infections in Michigan, which is not part of the FoodNet surveillance network. Disclosures All authors: No reported disclosures.

Trends in the incidence and mortality of oral cancer in Nevada (Preprint)

2020 ◽  
Author(s):  
Kevin Foote ◽  
Karl Kingsley
Keyword(s):  
Public Health ◽  
Oral Cancer ◽  
Cancer Incidence ◽  
Cancer Control ◽  
Cancer Registries ◽  
Public Health Research ◽  
Chi Square ◽  
Incidence And Mortality ◽  
The Us ◽  
Chi Square Analysis

BACKGROUND Reviews of national and state-specific cancer registries have revealed differences in rates of oral cancer incidence and mortality that have implications for public health research and policy. Many significant associations between head and neck (oral) cancers and major risk factors, such as cigarette usage, may be influenced by public health policy such as smoking restrictions and bans – including the Nevada Clean Indoor Act of 2006 (and subsequent modification in 2011). OBJECTIVE Although evaluation of general and regional advances in public policy have been previously evaluated, no recent studies have focused specifically on the changes to the epidemiology of oral cancer incidence and mortality in Nevada. METHODS Cancer incidence and mortality rate data were obtained from the National Cancer Institute (NCI) Division of Cancer Control and Population Sciences (DCCPS) Surveillance, Epidemiology and End Results (SEER) program. Most recently available rate changes in cancer incidence and mortality for Nevada included the years 2012 – 2016 and are age-adjusted to the year 2000 standard US population. Comparisons of any differences between Nevada and the overall US population were evaluated using Chi square analysis. RESULTS This analysis revealed that the overall rates of incidence and mortality from oral cancer in Nevada differs from that observed in the overall US population. For example, although the incidence of oral cancer among Caucasians is increasing in Nevada and the US overall, it is increasing at nearly twice that rate in Nevada, P=0.0002. In addition, although oral cancer incidence among Minorities in the US is declining, it is increasing in Nevada , P=0.0001. Analysis of reported mortality causes revealed that mortality from oral cancer increased in the US overall but declined in Nevada during the same period (2012-2016). More specifically, mortality among both Males and Females in the US is increasing, but is declining in Nevada, P=0.0027. CONCLUSIONS Analysis of the epidemiologic data from Nevada compared with the overall US revealed significant differences in rates of oral cancer incidence and mortality. More specifically, oral cancer incidence increased in Nevada between 2012-2016 among all groups analyzed (Males, Females, White, Minority), while decreases were observed nationally among Females and Minorities. Although mortality in Nevada decreased over this same time period (in contrast to the national trends), the lag time between diagnosis (incidence) and mortality suggests that these trends will change in the near future. CLINICALTRIAL Not applicable

scholarly journals Patterns of dental antibiotic prescribing in 2017: Australia, England, United States, and British Columbia (Canada)

2021 ◽  
pp. 1-8
Author(s):  
Wendy Thompson ◽  
Leanne Teoh ◽  
Colin C. Hubbard ◽  
Fawziah Marra ◽  
David M. Patrick ◽  
...  
Keyword(s):  
United States ◽  
British Columbia ◽  
Broad Spectrum ◽  
Antibiotic Prescription ◽  
Population Level ◽  
The United States ◽  
Antibiotic Prescribing ◽  
Prescribing Behavior ◽  
The Us ◽  
Amoxicillin Clavulanic Acid

Abstract Objective: Our objective was to compare patterns of dental antibiotic prescribing in Australia, England, and North America (United States and British Columbia, Canada). Design: Population-level analysis of antibiotic prescription. Setting: Outpatient prescribing by dentists in 2017. Participants: Patients receiving an antibiotic dispensed by an outpatient pharmacy. Methods: Prescription-based rates adjusted by population were compared overall and by antibiotic class. Contingency tables assessed differences in the proportion of antibiotic class by country. Results: In 2017, dentists in the United States had the highest antibiotic prescribing rate per 1,000 population and Australia had the lowest rate. The penicillin class, particularly amoxicillin, was the most frequently prescribed for all countries. The second most common agents prescribed were clindamycin in the United States and British Columbia (Canada) and metronidazole in Australia and England. Broad-spectrum agents, amoxicillin-clavulanic acid, and azithromycin were the highest in Australia and the United States, respectively. Conclusion: Extreme differences exist in antibiotics prescribed by dentists in Australia, England, the United States, and British Columbia. The United States had twice the antibiotic prescription rate of Australia and the most frequently prescribed antibiotic in the US was clindamycin. Significant opportunities exist for the global dental community to update their prescribing behavior relating to second-line agents for penicillin allergic patients and to contribute to international efforts addressing antibiotic resistance. Patient safety improvements will result from optimizing dental antibiotic prescribing, especially for antibiotics associated with resistance (broad-spectrum agents) or C. difficile (clindamycin). Dental antibiotic stewardship programs are urgently needed worldwide.

Risk Factors for Typhoid Fever Occurrence and Recurrence in Gombe Metropolis, Gombe State, Nigeria

2021 ◽  
Vol 23 (11) ◽  
pp. 381-401
Author(s):  
Umar Abdullahi Tawfiq ◽  
◽  
Shohaimi Shamarina ◽  
Syafinaz Amin Nordin ◽  
Mohd Noor Hisham Mohd Nadzir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Epidemiological Data ◽  
Simple Random Sampling ◽  
Chi Square ◽  
Long Time ◽  
Chi Square Test ◽  
The Government ◽  
Set Up ◽  
Associated Risk Factors ◽  
At Home

Typhoid is a life-threatening disease that has remained endemic in parts of Africa and Asia where its burden is elevated by the inefficiency of control efforts which have been hampered by lack of epidemiological data, among others. In Nigeria, such data is absent in most of the States like Gombe where the disease has been rife for a long time, hence, to bridge that knowledge gap, this study was set up to determine the host-associated risk factors for typhoid occurrence and recurrence in Gombe. A questionnaire that was designed and validated for this location was used to obtain data from 663 respondents using simple random sampling and analyzed using the Chi-square test for association and binomial logistic regression to obtain risk factors for typhoid occurrence and recurrence, respectively. The study revealed that occurrences were statistically significantly associated with the variables for vaccination (χ2 = 39.729, p < 0.01), having houseboy/girl (χ2 = 16.909, p < 0.01), typhoid patient at home (χ2 = 13.393, p < 0.01), hand washing before handling food (χ2 = 22.856, p < 0.01), consuming iced/frozen items (χ2 = 16.805, p < 0.01), boiling drinking water (χ2 = 49.633, p < 0.01), and eating commercially available foods/drinks (χ2 = 27.864, p < 0.01), while recurrences were statistically significantly predicted by „not sure of been vaccinated‟ (OR = 2.962, CI = 1.290 to 6.802, p < 0.01), „not having another typhoid patient at home‟ (OR = 1.799, CI = 0.998 to 3.244, p < 0.01), and „drinking unboiled water sometimes‟ (OR = 2.130, CI = 1.023 to 4.434, p < 0.01). It is believed that these findings will guide efforts by the Government for health interventions against typhoid in the study area, thus improving the quality of life for the population.

scholarly journals Adherence to Vaccine Requirements among Hajj Pilgrims in Saudi Arabia, 2017-2019

2021 ◽  
Vol 3 (2) ◽  
pp. 86-97
Author(s):  
Adel Alotaibi ◽  
Sami S Almudarra ◽  
Homoud S Algarni ◽  
Yasser Bakhsh ◽  
Zahir Mohamed Elamin Dafaalla ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Infectious Diseases ◽  
Yellow Fever ◽  
Vaccine Coverage ◽  
Compliance Rate ◽  
Adherence Rate ◽  
P Value ◽  
Chi Square ◽  
Surveillance Network ◽  
Polio Vaccination

Hajj pilgrims must have certain vaccines for pilgrimage; these requirements aim to reduce the spread of infectious diseases. This study analyzed the trends in vaccine adherence for meningitis, yellow fever, and polio from January 2017- December 2019. These trends can help in guiding future policymaking to prevent outbreaks during Hajj and similar mass gatherings. We analyzed data using descriptive statistics for Hajj pilgrims and Hajj seasonal workers arriving in Saudi Arabia over three years (2017–2019). Health Control Centers (HCCs) collected data at points-of-entry (PoE) and entered it into Saudi Arabia’s Health Electronic Surveillance Network (HESN). We reviewed HESN data to collect information on total passengers arriving per country and the number of passengers vaccinated for: meningococcal meningitis, poliomyelitis, and yellow fever. We compared data to identify the difference in vaccination by region.  We used chi-square tests to assess differences in compliance rate among these travelers by year and country of origin. The number of participating countries increased from 113 to 132. Meningitis vaccine coverage increased by 5% from 2017–2019. The increase was not statistically significant. Asia had the lowest overall adherence rate (83%). Yellow fever adherence decreased significantly using a difference of mean adherence between 2017 and 2019 (p-value 0.01). Polio vaccination adherence decreased by 5% from 2017 to 2019; this was not significant (p-value = 0.08). The vaccine coverage increased for meningitis and decreased for yellow fever and polio. Less than 100% vaccine adherence among Hajj travelers creates the potential for the spread of infectious diseases. Proof of vaccination should be required in submitted visa applications. Countries of origin and Saudi Arabia must work together to ensure that all Hajjis are adequately vaccinated before departure.

scholarly journals Inappropriate prescribing of antibiotics to patients with acute bronchitis

2019 ◽  
Vol 76 (7) ◽  
pp. 684-689
Author(s):  
Marijana Petrovic ◽  
Roland Antonic ◽  
Bojan Bagi ◽  
Irena Ilic ◽  
Aleksandar Kocovic ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Antibiotic Prescription ◽  
Inappropriate Prescribing ◽  
Acute Bronchitis ◽  
Beta Lactams ◽  
Number Of Patients ◽  
Frequent Event ◽  
Prescription Rates ◽  
Attending Physician ◽  
To Receive

Background/Aim. Inappropriate prescribing of antibiotics to the patients with acute bronchitis is frequent event in clinical practice with potentially serious consequences, although majority of treatment guidelines do not recommend it. The aim of this study was to reveal risk factors associated with inappropriate prescribing of antibiotics to the patients with acute bronchitis in primary healthcare. Methods. This case/control study included the adult patients with acute bronchitis during the initial encounter with a general practitioner. Prescription of an antibiotic was an event that defined the case, and patients without prescribed antibiotic served as controls. Results. Antibiotics (mostly macrolides and beta-lactams) were prescribed to the majority of patients with diagnosis of acute bronchitis (78.5%). A significant association was found between antibiotic prescription rates and patient age, whether an attending physician is a specialist or not and the average number of patients a physician sees per day [ORadjustedwas 1.029 (1.007?1.052), 0.347 (0.147?0.818) and 0.957 (0.923?0.992), respectively]. Conclusion. When there is primary care encounter with patients suffering from acute bronchitis, older patients are more likely to receive inappropriate antibiotic prescription, especially if their physician is without specialist training and has less patient encounters in his/her office daily.

scholarly journals A Retrospective study on the dynamics of the clinical and Demographical evolution of Cutaneous Leishmaniasis in the Yazd province, Iran

2020 ◽  
Vol 3 (3) ◽  
pp. 80-83
Author(s):  
Ali Fattahi Bafghi ◽  
◽  
Elham Rezaee ◽  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Epidemiological Study ◽  
Age Groups ◽  
Epidemiological Data ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Personal Hygiene ◽  
Chi Square ◽  
Cross Sectional ◽  
The Past

Leishmaniasis is considered as an important health problem in the world. Cutaneous Leishmaniasis is epidemic in all of places of Iran, this disease begins as small swells and then they gradually grow and turn into wounds. Since the epidemiological study of this problem is effective in preventing and controlling it. The current research was conducted to study the epidemiological study of Cutaneous Leishmaniasis in Yazd province during the past 5(2014-2018) years. This cross-sectional study has been conducted on registered information and documents of the patients having problem in Yazd province remedial and health care centers over the past 5 years. First, the registered demographic and epidemiological data of the patients were extracted and then they were analyzed by using SPSS 18 software with chi-square test and descriptive statistics.897 patients included 457 males (51.06%) and 439 females (48.94%). The majority of the patients were between nine 20-29 years old and the minority of them were over the range of 5-9 years old. Most lesions were on the hand and leg of the patients. It was also found that there was a significant relationship between age groups and types of Leishmaniasis (P<0.05) as well as gender and type Leishmaniasis (P<0.05). According to our study, there has been an ascending trend in disease frequency in Yazd province from 2014 to 2018. This increase in diseases due to lack of health and educational status of the people-is also a lack of personal hygiene.

scholarly journals Medications' Prescribing Pattern in the General Surgery Outpatient Department

2021 ◽  
pp. 1-4
Author(s):  
Nehad J. Ahmed
Keyword(s):  
General Surgery ◽  
Public Hospital ◽  
Continuous Monitoring ◽  
Outpatient Surgery ◽  
Outpatient Department ◽  
Prescribing Pattern ◽  
Drug Classes ◽  
Amoxicillin Clavulanic Acid ◽  
Surgery Department ◽  
Pharmacy Prescriptions

Aim: The aim of this study was to evaluate the drugs’ prescribing pattern in general surgery department of a public hospital in Alkharj. Methodology: The present retrospective study included collecting data from the general surgery outpatient pharmacy prescriptions from a public hospital in Alkharj from 1st of June 2018 to 31th December 2018. Results: The total number of outpatients who received prescriptions from general surgery outpatient department was 319. Most of them were males (52.35%) and aged less than 50 years (79.31%). Most of the prescriptions were written by residents (47.02). The most prescribed medication was paracetamol (21.32%) followed by amoxicillin/clavulanic acid (12.85%), ciprofloxacin (12.85%), and metronidazole (6.27%). Conclusion: The study showed that antibiotics and analgesics were the most commonly prescribed drug classes in outpatient surgery department. Continuous monitoring for the prescribing of these drugs is essential to increase the wise use of these medications. More awareness workshops and educational programs for surgeons are needed for the prescribing of these drugs.

Abstract 16088: Mortality Trend Among Patients With Atrial Fibrillation on Long Term Anticoagulation Who Developed Intracranial Hemorrhage: Insights From the National Inpatient Database From 2006 to 2014

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Karol Quelal ◽  
Andrea Torres ◽  
Christian Torres ◽  
Alfonso Tafur
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Mortality ◽  
Intracranial Hemorrhage ◽  
Vitamin K Antagonists ◽  
Hospital Death ◽  
Chi Square ◽  
Fda Approval ◽  
The Us ◽  
Inpatient Database

Introduction: Intracranial hemorrhage (ICH), is a potential complication of anticoagulation use in atrial fibrillation (AF). During the last decade, guidelines have evolved from recommending vitamin K antagonists to a preference for DOACs in the case of non-valvular AF after FDA approval in 2010. Data have reported that DOACs have a lower rate of ICH and an overall better clinical profile when compared to VKA. Aim: We sought to describe the rate of ICH and its associated mortality h with the increment in the use of DOACs over the period of 2006 to 2014 in the US population with AF. Methods: We queried the NIS database 2006-2014. AF patients, patients using long term anticoagulation, and intracranial hemorrhage admissions were selected using the appropriate ICD-9 codes. Time trend was analyzed using Chi-square. In-hospital mortality was evaluated by binomial logistic regression. Results: We found a 30740346 weighted population with AF between 2006 and 2014. 16.8 % were long term users of anticoagulants. Of them, 1.1% (n: 56400) were admitted due to ICH. Long term anticoagulation use in AF went from 13.3% in 2006 to 17.3% in 2010 (p<0.001). Among AF patients, 30.7% of patients had in-hospital death when admitted for ICH using long term anticoagulation. Long term anticoagulation was associated with increased in-hospital death in ICH patients aOR 1.31 (95% CI 1.24 - 1.39) when compared to those not using long term anticoagulation. Patients with AF and long term use of anticoagulants showed an increased frequency of in-hospital mortality from 32.7% in 2006 to 34.2% in 2007 and a decrease to 30.9% up to 2010. The decrease in mortality rate was more notorious from 2010 to 2014 going to 25.8% (p< 0.001). Conclusions: The rate of ICH diagnosis among anticoagulated atrial fibrillation patients has remained stable after the introduction of DOACs. Rates of inpatient death have decreased from 2006 to 2014 having the most notorious inflection point in 2010 after the progressive introduction of DOACs .

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