scholarly journals 2283. The Incidence and Risk Factors for Neurotoxicity in Patients on Ertapenem Therapy: a Retrospective Case- Control Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S782-S782 ◽  
Author(s):  
Raymond K C Fong ◽  
Stephen G Donoghue ◽  
Humaira Shafi ◽  
Seow Yen Tan ◽  
Wee Boon Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Impairment ◽  
Univariate Analysis ◽  
Outpatient Setting ◽  
Retrospective Case ◽  
Neurotoxic Effects ◽  
Gram Negative Bacteremia ◽  
History Of ◽  
Baseline Characteristics ◽  
Control Study

Abstract Background Numerous reports have emerged about the neurotoxic effects of ertapenem. A recent study supports carbapenem use for the treatment of extended spectrum β-lactamase (ESBL)- producing Gram-negative bacteremia. This will likely bolster the use of ertapenem as it is a convenient choice to complete antibiotic treatment in an outpatient setting. This study aims to review the incidence of neurotoxicity with ertapenem and the risk factors associated with it. Methods A retrospective nested cohort study was conducted in Changi General Hospital in Singapore from January 2015 to Decemeber 2016. All patients who received at least 24 hours of ertapenem were identified. Those who exhibited ertapenem-associated neurotoxic effects were selected as cases while those who did not were included in the pool of controls and randomly selected at a 1:3 ratio. Results A total of 544 patients were treated with ertapenem in our hospital during this 2-year period. Twenty-five patients (incidence 4.6%) developed neurotoxic manifestations and 75 patients were included as controls. Acute confusion was the commonest reaction (n = 19, 76%) followed by hallucinations (n = 8, 32%) and seizures (n = 5, 20%). Baseline characteristics were similar in both groups; the median age of the cases was 79 years (IQR 71–83 years) and 14 (56%) were males. The median duration of ertapenem use before neurotoxicity occurred was 7 days (IQR 5–11days). The median Naranjo ADR probability score for cases was 7 (range 5 to 7) which suggests a probable relationship. Univariate analysis showed that renal impairment (with CrCl< 60 mL/minute) (OR 3.31, 95% CI 1.03–10.64), a history of a vulnerable brain (including stroke and epilepsy etc)(OR 2.61 95% CI 1.03–6.61) increased the risk of neurotoxicity. Neurotoxicity was also significantly associated with longer hospitalization (median 21 days, p = 0.03). Conclusion Our study suggests that renal impairment or a history of vulnerable brain may increase the risk for ertapenem-associated neurotoxicity. Hence, caution should be exercised when ertapenem is used to treat these individuals. Future prospective studies to further evaluate risk and to derive a prediction scoring system may help to reduce the incidence of neurotoxic adverse events with ertapenem use. Disclosures All authors: No reported disclosures.

Comparison of Hirschsprung Disease Characteristics between Those with a History of Postoperative Enterocolitis and Those without: Results from the Pediatric Colorectal and Pelvic Learning Consortium

2020 ◽  
Author(s):  
Mark A. Taylor ◽  
Brian T. Bucher ◽  
Ron W. Reeder ◽  
Jeffrey R. Avansino ◽  
Megan Durham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transition Zone ◽  
Private Insurance ◽  
Univariate Analysis ◽  
Hirschsprung Disease ◽  
Clinical Information ◽  
Retrospective Case ◽  
Disease Characteristics ◽  
History Of ◽  
Pull Through

Abstract Introduction The current understanding of Hirschsprung-associated enterocolitis (HAEC) is based mainly on single-center, retrospective studies. The aims of this study are to determine risk factors for postoperative HAEC using the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) database. Materials and Methods We performed a multicenter, retrospective, case–control study of children with Hirschsprung disease (HD) who had undergone a pull-through procedure and were evaluated at a PCPLC member site between February 2017 and March 2020. The cohort with a history of postoperative HAEC was compared with that without postoperative episodes of HAEC to determine relevant associations with postoperative HAEC. Results One-hundred forty of 299 (46.8%) patients enrolled had a history of postoperative HAEC. Patients with a rectosigmoid transition zone had a lower association with postoperative HAEC as compared with those with a more proximal transition zone (odds ratio [OR]: 0.46, 95% confidence interval [CI]: 0.26, 0.84, p < 0.01). Private insurance was protective against postoperative HAEC on univariate analysis (OR: 0.62, 95% CI: 0.38, 0.99, p = 0.047), but not on multivariate analysis (OR: 0.62, 95% CI: 0.37, 1.04, p = 0.07). Preoperative HAEC was not associated with the development of postoperative HAEC. Conclusion Patients with a rectosigmoid transition zone have less postoperative HAEC compared with patients with a more proximal transition zone. Multi-institutional collection of clinical information in patients with HD may allow for the identification of additional risk factors for HAEC and afford the opportunity to improve care.

Risk factors and outcomes of management of delayed suprachoroidal haemorrhage following Ahmed glaucoma valve implantation in children

2019 ◽  
Vol 104 (1) ◽  
pp. 115-120 ◽  
Author(s):  
Shantha Balekudaru ◽  
Tamonash Basu ◽  
Parveen Sen ◽  
Pramod Bhende ◽  
Vijaya Lingam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Univariate Analysis ◽  
Congenital Glaucoma ◽  
Ahmed Glaucoma Valve ◽  
Retrospective Case ◽  
Incidence Risk ◽  
Valve Implantation ◽  
Ahmed Glaucoma Valve Implantation ◽  
Control Study

AimsTo assess the incidence, risk factors and outcomes of management of delayed suprachoroidal haemorrhage (DSCH) in children who had undergone Ahmed glaucoma valve implantation.MethodsA retrospective case-control study of eyes which developed DSCH in children <18 years of age who underwent surgery between January 2009 and December 2017 with a follow-up of at least 2 months was performed. Nine cases were compared with 27 age, gender and surgeon matched controls who had undergone surgery during this period.ResultsThe incidence of DSCH was 4.7% (95% CL 1.5% to 7.7%, 9 eyes of 191 children). There were no significant differences between cases and controls in baseline details except for the number of intraocular pressure (IOP) lowering medications (p=0.01) and follow-up period (p=0.001). Risk factors identified on univariate analysis (p≤0.1) were axial length (p=0.02), diagnosis of primary congenital glaucoma (p=0.05), postoperative hypotony (p=0.07) and aphakia (p=0.1). None of them were found to be significant on multivariate analysis. Five eyes, three with retinal apposition and two with retinal detachment, underwent surgical drainage. There were no significant differences in the outcomes of eyes which underwent drainage compared with those which did not. Failures, defined as IOP>18 mm Hg despite use of medications, loss of light perception, phthisis or removal of the implant were more frequent in cases (three eyes, 33.3%) compared with controls (four eyes, 14.8%) (p=0.002).ConclusionsNone of the risk factors analysed in our series proved to be significant. Failures were more common in eyes with choroidal haemorrhage, despite surgical intervention.

scholarly journals The Wessex Recent In-Patient Suicide Study, 2

2001 ◽  
Vol 178 (6) ◽  
pp. 537-542 ◽  
Author(s):  
Elizabeth A. King ◽  
David S. Baldwin ◽  
Julia M. A. Sinclair ◽  
Michael J. Campbell
Keyword(s):  
Risk Factors ◽  
Care Delivery ◽  
Psychiatric Patients ◽  
Retrospective Case ◽  
Patient Suicide ◽  
Increased Risk ◽  
History Of ◽  
Self Harm ◽  
Low Sensitivity ◽  
Control Study

BackgroundPsychiatric patients have an elevated risk of suicide while in hospital.AimsTo compare social, clinical and health-care delivery factors in in-patient and out-patient suicides and their controls.MethodRetrospective case-control study of 59 in-patients and 106 controls, matched for age, gender, diagnosis and admission date. Odds ratios were calculated using conditional multiple logistic regression.ResultsThere were seven independent increased-risk factors: history of deliberate self-harm, admission under the Mental Health Act, involvement of the police in admission, depressive symptoms, violence towards property, going absent without leave and a significant care professional being on leave. When compared with out-patient suicides, in-patients were more often female and male in-patients had a psychotic illness. Unlike the out-patient suicides, social factors were not found to be significant.ConclusionsThe characteristics of inpatient and out-patient suicides differ. Identified risk factors have relatively low sensitivity and specificity.

scholarly journals Risk factors of acute confusional syndrome in elderly hospitalized in the Hospital Reina Sofía of Murcia. Retrospective case and controls

2018 ◽  
Author(s):  
Juan Rodado ◽  
Irine Aragon
Keyword(s):  
Risk Factors ◽  
Previous History ◽  
Source Population ◽  
Retrospective Case ◽  
Co Morbidity ◽  
History Of ◽  
Transversal Study ◽  
Special Relevance ◽  
Control Study

Background: Acute confusional syndrome is a current problem of special relevance among elderlypatients admitted to hospital medical services. The determination of its risk factors is an essential process in the development and implementation of programs to prevent this complication. Methods: With the mentioned aim we have carried out this case-control study as an analytical, observational, retrospective and transversal study, whose source population was integrated by 60 patients over age 65 according to inclusion and exclusion criteria and divided into two groups: with and without delirium. Discussion: Our analysis has confirmed the association between these factors and delirium: illness severity; previous history of Delirium (OR 10.6); mental status (OR 7.3); high risk medications (OR 6.9); renal failure (OR 6.5); medication at risk added (OR 6); physical status (OR 5.2); use of neuroleptics (OR5.1); anemia (OR 4.75); sodium alterations (OR 4.5); urinary catheter (OR 3.8); low albumin (OR 3.7); infection (OR 3.1). Conclusion: There is no relationship proved between acute confusional syndrom and the following factors: use of benzodiazepines, aggressive procedures, immobility, old age, dementia, diminished ADL skills, co-morbidity and polypharmacy, even if they have been identified as risk factors in previous studies. Hence, these results should be interpreted with caution.

scholarly journals Risk factors for cefotaxime resistance in children with pneumonia

2012 ◽  
Vol 52 (5) ◽  
pp. 255
Author(s):  
Anak Agung Made Sucipta ◽  
Ida Bagus Subanada ◽  
Samik Wahab
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Control Group ◽  
Case Group ◽  
Antimicrobial Use ◽  
Factors Associated ◽  
History Of ◽  
Culture Positive ◽  
Control Study

Background Pneumonia is a health problem in developingcountries, often caused by bacterial agents. The 'Widespreaduse of cefotaxime, a third􀁒generation of cephalosporin, may leadto increased incidence of resistance to this antibiotic. Severalstudies have reported on risk factors associated v.ith resistanceto cefotaxime.Objective To identify risk factors for cefotaxime resistance inchildren 'With pneumonia.Methods We performed a case􀁒control study at Sanglah Hospitalbetween January 2006􀁒December 2010. The case group includedchildren with blood culture􀁒positive pneumonia and resistanceto cefotaxime by sensitivity test. The control group was selectedfrom the same population as the case group, but the bacteriaisolated from these subjects were sensitive to cefotaxime. Wetested the folloMng risk factors for resistance to cefotaxime:age :53 years, microorganism species, history of antimicrobialuse, and history of hospitalization within the prior 3 months.Chi square test and logistic regression analysis were performedto determine any associations between the four potential riskfactors and resistance to cefotaxime. A P<0.05 was consideredto be statistically significant.Results Univariate analysis showed that the risk factors forresistance to cefotaxime were history of antimicrobial use in theprior 3 months (OR 2.79; 95%CI 1.40 to 5.55; P􀁓O.OOI) andhistory of hospitalization Mthin the prior 3 months (OR 5.57;95%CI 1.95 to 15.87; P=<O.OOOl). By multivariate analysis,risk factors associated Mth resistance to cefotaxime were historyof antimicrobial use in the prior 3 months (OR 2.4; 95%CI 1.18to 4.86; P=0.015), history of hospitalization within the prior 3months (OR 4.7; 95%CI 1.62 to 13.85; P􀁓0.004), and historyof breast feeding for less than 2 months (OR 2.3; 95%CI 1.0 to5.4; P􀁓0.042).Conclusion History of antimicrobial use and history ofhospitalization within the prior 3 monthsweresignificantrisk factors for resistance to cefotaxime in children Mth pneumonia.[Paediatr Indanes. 2012;52:255-9].

scholarly journals Epidemiology and Estimating the Risk Factors for the Transfer of Hepatitis B Virus Using Multivariate Analysis Model: A Retrospective Case-Control Study

2019 ◽  
Vol 6 (2) ◽  
pp. 70-75
Author(s):  
Mansour Bahardoust ◽  
Marjan Mokhtare ◽  
Arash Sarveazad ◽  
Shahdieh Karimi ◽  
Atefeh Talebi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Case Control Study ◽  
Case Control ◽  
Hbv Infection ◽  
Retrospective Case ◽  
B Virus ◽  
History Of ◽  
Control Study

Background and aims: Hepatitis B virus (HBV) is one of the important public health diseases in Iran. Therefore, to control the prevalence of the disease, knowledge is required regarding the risk factor of HBV. Accordingly, the aim of this study was to determine the risk factors of HB transmission. Methods: A retrospective case-control study was conducted on the possible risk factors of HBV transmission. To this end, a total of 171 patients with HBV infection and 171 controls from Rasoul-eAkram hospital were investigated during 2015-2018. All subjects were directly evaluated using a faceto-face questionnaire about demographic aspects. Finally, HBV infection and its risk factors among the subjects were detected using hepatitis B surface antigen test. Results: Overall, 171 HBV patients including 77 (42%) males and 93 (58%) females were evaluated. The mean age of the participants was 40 ± 13 years. Univariate logistic analysis showed that HBV infection in these cases was associated with addiction injection (odds ratio [OR] = 4.08, CI:1.3- 9.57), family history (OR = 4.52, CI: 1.27-10.7), and having a history of blood transfusion (OR = 3.16, CI: 1.52-5.37). There were no significant relationships between the liver function tests, alcohol consumption, the history of dental visits, and HBV participants. In addition, the logistic-regression model proved that patients with a history of HBV-infected parents (At least one of them) and addiction injection were severely subject to HB infection. In other words, there was a significant association between a history of HBV-infected parents and addiction injection and HB infection. Conclusion: In general, HBV infection was strongly related to having a family member infected with hepatitis B, suffering from addiction injection, and having blood injection.

Risk Factors for Necrotizing Enterocolitis in Infants Weighing More Than 2,000 Grams at Birth: A Case-Control Study

PEDIATRICS ◽  
1983 ◽  
Vol 71 (1) ◽  
pp. 19-22 ◽  
Author(s):  
Rickey Wilson ◽  
Madeline del Portillo ◽  
Emmet Schmidt ◽  
Roger A. Feldman ◽  
William P. Kanto
Keyword(s):  
Risk Factors ◽  
Respiratory Distress ◽  
Necrotizing Enterocolitis ◽  
Case Control Study ◽  
Case Control ◽  
Retrospective Case ◽  
Control Subjects ◽  
History Of ◽  
Control Study

A retrospective case-control study of necrotizing enterocolitis (NEC) was conducted among infants weighing &gt;2,000 g at birth. Twenty-three infants met the NEC criteria for inclusion in the study; 12 weighed 2,001 to 2,500 g at birth and 11 weighed &gt;2,500 g at birth. Hypoglycemia occurred in 7/12 (55%) infants weighing 2,001 to 2,500 g and in 4/35 (11%) control subjects (P &lt; .02). In infants weighing &gt;2,500 g at birth, polycythemia (occurring in 7/12 study infants (58%) and 5/32 (16%) control infants) and respiratory distress (3/11 study infants (27%) and 0 control subjects) were significantly associated with NEC (P &lt; .02). Larger infants with a history of perinatal stress and/or physiologic immaturity are likely to be at greater risk for NEC than their normal counterparts.

scholarly journals Evaluation of Risk Factors for Antibiotic Resistance in Patients with Nosocomial Infections Caused byPseudomonas aeruginosa

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Meliha Cagla Sonmezer ◽  
Gunay Ertem ◽  
Fatma Sebnem Erdinc ◽  
Esra Kaya Kilic ◽  
Necla Tulek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nosocomial Infection ◽  
Nosocomial Infections ◽  
Univariate Analysis ◽  
High Morbidity ◽  
Retrospective Case ◽  
Development Of Resistance ◽  
Independent Risk Factors ◽  
Imipenem Resistance ◽  
Control Study

Background.Pseudomonas aeruginosa(P. aeruginosa) is resistant to various antibiotics and can cause serious nosocomial infections with high morbidity and mortality. In this clinical study, we investigated the risk factors in patients who were diagnosed withP. aeruginosa-related nosocomial infection.Methods. A retrospective case control study including patients withP. aeruginosa-related nosocomial infection. Patients who were resistant to any of the six antibiotics (imipenem, meropenem, piperacillin-tazobactam, ciprofloxacin, amikacin, and ceftazidime) constituted the study group.Results. One hundred and twenty isolates were isolated. Various risk factors were detected for each antibiotic in the univariate analysis. In the multivariate analysis, previous cefazolin use was found as an independent risk factor for the development of imipenem resistance (OR = 3.33; CI 95% [1.11–10.0];p= 0.03), whereas previous cerebrovascular attack (OR = 3.57; CI 95% [1.31–9.76];p= 0.01) and previous meropenem use (OR = 4.13; CI 95% [1.21–14.07];p= 0.02) were independent factors for the development of meropenem resistance. For the development of resistance to ciprofloxacin, hospitalization in the neurology intensive care unit (OR = 4.24; CI 95% [1.5–11.98];p= 0.006) and mechanical ventilator application (OR = 11.7; CI 95% [2.24–61.45];p= 0.004) were independent risk factors.Conclusion. The meticulous application of contact measures can decrease the rate of nosocomial infections.

Investigation of an Outbreak of Gram-Negative Bacteremia Among Hematology-Oncology Outpatients

2000 ◽  
Vol 21 (9) ◽  
pp. 597-599 ◽  
Author(s):  
Scott R. Penzak ◽  
Paul O. Gubbins ◽  
Shawna L. Stratton ◽  
Elias J. Anaissie
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Venous Catheter ◽  
University Hospital ◽  
Retrospective Case ◽  
Oncology Patients ◽  
Gram Negative ◽  
Increased Risk ◽  
Gram Negative Bacteremia ◽  
Control Study

AbstractObjective:To identify risk factors associated with an outbreak of gram-negative bacteremia (GNB).Setting:A university hospital.Patients:Hematology-oncology outpatients.Design:Retrospective case-control study.Results:Thirty-eight patients developed GNB; 13 patients experienced more than one episode, and eight blood cultures grew more than one gram-negative organism. The most frequently isolated organisms were Stenotrophomonas maltophilia, Klebsiella pneumoniae, Acinetobacter baumannii, and Acinetobacter johnsonii. When the GNB patients (cases) were compared with randomly selected hematology-oncology patients (controls), central venous catheter (CVC) self-care (71% vs 39%; P=.02), and duration of recent hospital stay (median, 15 vs 4 days; P=.01) were identified as risk factors. In a logistic regression model, duration of recent hospital stay was the only risk factor significantly associated with GNB (odds ratio, 1.05; 95% confidence interval, 1.01-1.08; P<.02).Conclusions:Hematology-oncology patients providing their own CVC care who have recently been hospitalized for more than 2 weeks may be at increased risk of GNB. CVCs should be protected from possible environmental contamination in hematology-oncology patients. Patients providing their own CVC care should undergo continued rigorous education regarding proper CVC care.

scholarly journals Treating Critically Ill Patients Experiencing SARS-CoV-2 Severe Infection with Ig-M and Ig-A Enriched Ig-G Infusion

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 930
Author(s):  
Alberto Corona ◽  
Giuseppe Richini ◽  
Sara Simoncini ◽  
Marta Zangrandi ◽  
Monica Biasini ◽  
...  
Keyword(s):  
Immunoglobulin G ◽  
Standard Therapy ◽  
Severe Infection ◽  
Treated Group ◽  
Simplified Acute Physiology Score ◽  
Retrospective Case ◽  
Baseline Characteristics ◽  
Time Of Admission ◽  
Ig G ◽  
Control Study

SARS-CoV-2 in patients who need intensive care unit (ICU) is associated with a mortality rate ranging from 10 to 40–45%, with an increase in morbidity and mortality in presence of sepsis. We hypothesized that IgM and IgA enriched immunoglobulin G may support the sepsis-related phase improving patient outcome. We conducted a retrospective case–control study on 47 consecutive patients admitted to our ICU. At the time of admission, patients received anticoagulants (heparin sodium) together with the standard supportive treatment. We decided to add IgM and IgA enriched immunoglobulin G to the standard therapy. Patients receiving IgM and IgA enriched immunoglobulin G were compared with patients with similar baseline characteristics and treatment, receiving only standard therapy. The mortality resulted significantly higher in patients treated with standard therapy only (56.5 vs. 37.5%, p < 0.01) and, at day 7, the probability of dying was 3 times higher in this group. Variable life adjustment display (VLAD) was 2.4 and -2.2 (in terms of lives saved in relation with those expected and derived from Simplified Acute Physiology Score II) in the treated and not treated group, respectively. The treatment based on IgM and IgA enriched immunoglobulin G infusion seems to give an advantage on survival in SARS-CoV-2 severe infection.

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