scholarly journals 1201. A Prolonged Multispecies Outbreak of Carbapenemase-Producing Enterobacteriaceae Due to Transmissible Plasmid With Carbapenemase Gene

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S363-S364
Author(s):  
Takuya Yamagishi ◽  
Mari Matsui ◽  
Tsuyoshi Sekizuka ◽  
Hiroaki Ito ◽  
Munehisa Fukusumi ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Clinical Samples ◽  
Care Hospital ◽  
Chromosomal Dna ◽  
Plasmid Analysis ◽  
Transmissible Plasmid ◽  
Carbapenemase Gene ◽  
Control Study ◽  
Pfge Profiles

Abstract Background In 2010, a multispecies outbreak of IMP type carbapenemase-producing Enterobacteriaceae (IMP-CPE) occurred at a large acute care hospital in Japan. The outbreak continued for years involving more than 100 patients mainly in surgical wards. Methods Because of the long period of the outbreak, investigation were focused on hospitalized patients whose clinical samples were positive for IMP-CPE between July 2013 and March 2014. A case–control study was conducted for cases who underwent abdominal surgery with controls from whom meropenem-susceptible Enterobacteriaceae were isolated. Pulsed-field gel electrophoresis (PFGE) was used for molecular typing. To evaluate genetic relationship among IMP-CPE isolates of different species, plasmid analysis using S1 nuclease to separate plasmid and chromosomal DNA followed by plasmid DNA extraction and whole-genome sequencing (WGS) was conducted. Results During the study period, 22 cases were identified and 22 IMP-CPE isolates which consisted of eight Escherichia coli, five Klebsiella oxytoca, five Enterobacter cloacae, three Klebsiella pneumoniae and one Enterobacter aerogenes were obtained. All five isolates of K. oxytoca had similar PFGE profiles which suggested clonal transmission. However, PFGE profiles of E. coli, E. cloacae and K. pneumoniae isolates were diverse. Plasmid analysis revealed that all 22 isolates shared ca. 50 kb IncN plasmid with blaIMP-6 which implies interspecies transmission of it The case–control study which adjusted by days of hospitalization with 11 cases and 24 controls revealed that pancreato-duodenectomy (adjusted odds ratio (aOR) = 6.4, 95% confidence interval (CI) 1.3–32.4) and enteric fistula (aOR = 8.0, 95% CI 1.5–41.9) were associated with IMP-CPE acquisition. Use of endoscopy within the past six months was not associated with IMP-CPE (aOR = 0.8 95% CI 0.2–4.2). With a bundled infection control with Osaka City Public Health Office, the outbreak was contained in July 2016. Conclusion Dissemination of carbapenemase gene by transmissible plasmid can play a critical role to complicate epidemiology of CPE outbreak and made it difficult to control. Plasmid analysis using WGS technology is a promising tool to untangle it. Disclosures All authors: No reported disclosures.

scholarly journals Comparison of maternal and perinatal outcome in pregnancy with altered thyroid profile and euthyroid patients: a prospective, observational and case control study in a tertiary care centre

2019 ◽  
Vol 8 (4) ◽  
pp. 1594
Author(s):  
Vandna Singh ◽  
Neeta Natu ◽  
Artika Sudhir Gupta
Keyword(s):  
Thyroid Dysfunction ◽  
Case Control Study ◽  
Tertiary Care ◽  
Case Control ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Altered Thyroid ◽  
Thyroid Profile ◽  
Control Study ◽  
In Pregnancy

Background: Thyroid disease is one of the commonest endocrine disorder affecting women of reproductive age, and when untreated during pregnancy is associated with an increased risk of complications. The objective of this review was to increase awareness and to provide a review on adverse effect of thyroid dysfunction on maternal and perinatal outcome.Methods: This prospective, observational hospital-based case-control study carried on women coming for antenatal check-up in a Tertiary Care Hospital in INDORE from May 2018-December 2018. 50 known booked antenatal (case) patient with established thyroid disorder, more than 32 week of gestation, and 50-matched euthyroid patients (control) were taken.Results: Women suffering from overt and subclinical hypothyroidism and hyperthyroidism are nulliparous in 72% cases as compared to 32% in euthyroid patient. Increased maternal age was associated with higher incidence of thyroid dysfunction. Normal vaginal delivery by spontaneous labour seen in 56% of euthyroid, while it is reduced with thyroid dysfunction. 38% of altered thyroid profile patient undergo induction of labour and 24% cases undergo caesarean section as compared to control (17%). Adverse fetal outcome like intrauterine growth retardation, preterm birth and ICU admission seen increased with thyroid dysfunction  as compared to euthyroid patients.Conclusions: Thyroid dysfunction in pregnancy, although has a low incidence, but is associated with adverse maternal and fetal implications. Thus, thyroid screening should be done in antenatal period to improve fetomaternal outcome.

scholarly journals Type D Personality and Myocardial Infarction: A Case-Control Study

2020 ◽  
pp. 025371762094715
Author(s):  
MT Manoj ◽  
KA Joseph ◽  
Govindan Vijayaraghavan
Keyword(s):  
Myocardial Infarction ◽  
Case Control Study ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Analysis ◽  
Developed Countries ◽  
Case Control ◽  
Type D Personality ◽  
Care Hospital ◽  
Type D ◽  
Control Study

Background: Coronary heart disease (CHD) is an impending global pandemic in developed countries as well as developing countries and economies in transition, such as India. A significant increase in the incidence of myocardial infarction (MI), one of the most common types of CHD, is being reported in India, and the incidence and severity of the disease are more among the youth in Kerala. Studies assessing the association between psychological factors and MI are few in India. Methods: We adopted a case-control study design. A total of 150 cases (with MI) and 150 controls (without MI and matched for age and gender) from a tertiary care hospital in Trivandrum, Kerala, India, were selected using convenient sampling method, between September 2016 and August 2017. Results: As compared to 33.3% of the controls, 50.7% of patients with MI had type D personality characteristics. Multivariate logistic regression analysis after adjusting for the confounders indicated a positive and statistically significant association between type D personality and MI: OR = 4.14, 95% CI = 2.19–8.85, P = 0.003. Conclusion: Type D personality is associated with MI.

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