scholarly journals Using Patient Risk Factors to Identify Whether Carbapenem-Resistant Enterobacteriaceae Infections Are Caused by Carbapenemase-Producing Organisms

2018 ◽  
Vol 5 (5) ◽  
Author(s):  
Patricia J Simner ◽  
Katherine E Goodman ◽  
Karen C Carroll ◽  
Anthony D Harris ◽  
Jennifer H Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Acute Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Patient Risk ◽  
Acute Care Facility ◽  
Carbapenem Resistant ◽  
Enterobacteriaceae Infections ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Evaluating all inpatient carbapenem-resistant Enterobacteriaceae (CRE) infections over a 1-year period, 47% were caused by carbapenemase-producing (CP) organisms. Compared with non-CP-CRE patients, patients with CP-CRE had an 18-fold greater odds of a recent stay in a foreign health care facility and a 3-fold greater odds of transfer from a post–acute care facility.

scholarly journals Risk factors for death in patients with severe asthma

2014 ◽  
Vol 40 (4) ◽  
pp. 364-372 ◽  
Author(s):  
Andréia Guedes Oliva Fernandes ◽  
Carolina Souza-Machado ◽  
Renata Conceição Pereira Coelho ◽  
Priscila Abreu Franco ◽  
Renata Miranda Esquivel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Asthma Control ◽  
Severe Asthma ◽  
Airflow Obstruction ◽  
Care Facility ◽  
Health Care Facility ◽  
Control Program ◽  
Male Gender ◽  
Respiratory Causes

OBJECTIVE: To identify risk factors for death among patients with severe asthma. METHODS: This was a nested case-control study. Among the patients with severe asthma treated between December of 2002 and December of 2010 at the Central Referral Outpatient Clinic of the Bahia State Asthma Control Program, in the city of Salvador, Brazil, we selected all those who died, as well as selecting other patients with severe asthma to be used as controls (at a ratio of 1:4). Data were collected from the medical charts of the patients, home visit reports, and death certificates. RESULTS: We selected 58 cases of deaths and 232 control cases. Most of the deaths were attributed to respiratory causes and occurred within a health care facility. Advanced age, unemployment, rhinitis, symptoms of gastroesophageal reflux disease, long-standing asthma, and persistent airflow obstruction were common features in both groups. Multivariate analysis showed that male gender, FEV1 pre-bronchodilator < 60% of predicted, and the lack of control of asthma symptoms were significantly and independently associated with mortality in this sample of patients with severe asthma. CONCLUSIONS: In this cohort of outpatients with severe asthma, the deaths occurred predominantly due to respiratory causes and within a health care facility. Lack of asthma control and male gender were risk factors for mortality.

Evaluation of patient risk factors for infection with carbapenem-resistant Enterobacteriaceae

2020 ◽  
Vol 48 (9) ◽  
pp. 1028-1031 ◽  
Author(s):  
Marko Predic ◽  
John P. Delano ◽  
Elizabeth Tremblay ◽  
Nicole Iovine ◽  
Scott Brown ◽  
...  
Keyword(s):  
Risk Factors ◽  
Patient Risk ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

scholarly journals A prospective study of treatment of carbapenem-resistant Enterobacteriaceae infections and risk factors associated with outcome

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Claudia M. D. de Maio Carrilho ◽  
Larissa Marques de Oliveira ◽  
Juliana Gaudereto ◽  
Jamile S. Perozin ◽  
Mariana Ragassi Urbano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Factors Associated ◽  
Carbapenem Resistant ◽  
Enterobacteriaceae Infections ◽  
A Prospective Study ◽  
Carbapenem Resistant Enterobacteriaceae

Risk Factors for Atherothrombotic Brain Infarction in Persons Over 62 Years of Age in a Long-Term Health Care Facility

1987 ◽  
Vol 35 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Wilbert S. Aronow ◽  
Laurence Starling ◽  
Fritzner Etienne ◽  
Peter D'Alba ◽  
Mildred Edwards ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Brain Infarction ◽  
Care Facility ◽  
Health Care Facility

scholarly journals Risk Factors for Development of Carbapenem Resistance Among Gram-Negative Rods

2019 ◽  
Vol 6 (3) ◽  
Author(s):  
Stefan E Richter ◽  
Loren Miller ◽  
Jack Needleman ◽  
Daniel Z Uslan ◽  
Douglas Bell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Carbapenem Resistance ◽  
High Morbidity ◽  
Index Hospitalization ◽  
Hospital System ◽  
Gram Negative ◽  
C Statistic

Abstract Background Infections due to carbapenem-resistant Gram-negative rods (CR-GNR) are increasing in frequency and result in high morbidity and mortality. Appropriate initial antibiotic therapy is necessary to reduce adverse consequences and shorten length of stay. Methods To determine risk factors for recovery on culture of CR-GNR, cases were retrospectively analyzed at a major academic hospital system from 2011 to 2016. Ertapenem resistance (ER-GNR) and antipseudomonal (nonertapenem) carbapenem resistance (ACR-GNR) patterns were analyzed separately. A total of 30951 GNR isolates from 12370 patients were analyzed, 563 of which were ER and 1307 of which were ACR. Results In multivariate analysis, risk factors for ER-GNR were renal disease, admission from another health care facility, ventilation at any point before culture during the index hospitalization, receipt of any carbapenem in the prior 30 days, and receipt of any anti-methicillin-resistant Staphylococcus aureus (anti-MRSA) agent in the prior 30 days (c-statistic, 0.74). Risk factors for ACR-GNR were male sex, admission from another health care facility, ventilation at any point before culture during the index hospitalization, receipt of any carbapenem in the prior 30 days, and receipt of any anti-MRSA agent in the prior 30 days (c-statistic, 0.76). Conclusions A straightforward scoring system derived from these models can be applied by providers to guide empiric antimicrobial therapy; it outperformed use of a standard hospital antibiogram in predicting infections with ER-GNR and ACR-GNR.

Risk Factors for Colonization due to Carbapenem-Resistant Enterobacteriaceae among Patients: Exposed to Long-Term Acute Care and Acute Care Facilities

2014 ◽  
Vol 35 (4) ◽  
pp. 398-405 ◽  
Author(s):  
Ashish Bhargava ◽  
Kayoko Hayakawa ◽  
Ethan Silverman ◽  
Samran Haider ◽  
Krishna Chaitanya Alluri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Admission ◽  
Acute Care ◽  
Entire Cohort ◽  
Carbapenem Resistant ◽  
Increased Risk ◽  
Surveillance Programs ◽  
Acute Care Facilities ◽  
Carbapenem Resistant Enterobacteriaceae

Background.This study aimed to identify risk factors associated with carbapenem-resistant Enterobacteriaceae (CRE) colonization among patients screened with rectal cultures upon admission to a hospital or long-term acute care (LTAC) center and to compare risk factors among patients who were screen positive for CRE at the time of hospital admission with those screen positive prior to LTAC admission.Methods.A retrospective nested matched case-control study was conducted from June 2009 to December 2011. Patients with recent LTAC exposure were screened for CRE carriage at the time of hospital admission, and patients admitted to a regional LTAC facility were screened prior to LTAC admission. Cases were patients with a positive CRE screening culture, and controls (matched in a 3:1 ratio to cases) were patients with negative screening cultures.Results.Nine hundred five cultures were performed on 679 patients. Forty-eight (7.1%) cases were matched to 144 controls. One hundred fifty-eight patients were screened upon hospital admission and 521 prior to LTAC admission. Independent predictors for CRE colonization included Charlson's score greater than 3 (odds ratio [OR], 4.85 [95% confidence interval (CI), 1.64–14.41]), immunosuppression (OR, 3.92 [95% CI, 1.08–1.28]), presence of indwelling devices (OR, 5.21 [95% CI, 1.09–2.96]), and prior antimicrobial exposures (OR, 3.89 [95% CI, 0.71–21.47]). Risk factors among patients screened upon hospital admission were similar to the entire cohort. Among patients screened prior to LTAC admission, the characteristics of the CRE-colonized and noncolonized patients were similar.Conclusions.These results can be used to identify patients at increased risk for CRE colonization and to help target active surveillance programs in healthcare settings.

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