Independent risk factors associated with hospital-acquired pneumonia in an adult ICU: 4-year prospective cohort study in a university reference hospital

2015 ◽  
Vol 38 (2) ◽  
pp. 378-383 ◽  
Author(s):  
Bernardo Guzmán-Herrador ◽  
Carmen Díaz Molina ◽  
Mohamed Farouk Allam ◽  
Rafael Fernández-Crehuet Navajas
2009 ◽  
Vol 181 (4S) ◽  
pp. 142-142
Author(s):  
Charles R Vincent ◽  
Mary Brown ◽  
Leticia Reyes ◽  
Benjamin K Canales ◽  
Keith Muller ◽  
...  

2018 ◽  
Vol 45 (4) ◽  
pp. 521-528 ◽  
Author(s):  
Akinori Hara ◽  
Takashi Wada ◽  
Ken-ei Sada ◽  
Koichi Amano ◽  
Hiroaki Dobashi ◽  
...  

Objective.The aim was to elucidate the prognosis and risk factors associated with relapse during longterm remission maintenance therapy for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).Methods.Patients with newly diagnosed AAV (n = 156) were registered in the Remission Induction Therapy in Japanese patients with ANCA-associated Vasculitides (RemIT-JAV) study, and among them, 83 patients who achieved remission were enrolled and followed up for 24 additional months in our nationwide, prospective cohort study (Co-RemIT-JAV; registration number UMIN 000006373). Patterns of maintenance therapy, effectiveness, and safety were evaluated from months 25 to 48 after the RemIT-JAV. The primary outcome measure was the rate of relapse. Secondary outcome measures included overall and renal survival, risk factors associated with relapse, and incidence rates of serious infections.Results.The patients comprised 35 men and 48 women aged 65.3 ± 12.6 years. Between months 25 and 48, the survival rate was 95% (79/83). Causes of death included 1 thyroid cancer, 1 infection, and 2 unknown reasons. Four patients had developed endstage renal disease (ESRD) by Month 24; 1 developed ESRD beyond Month 25. The relapse rate was 24% (20/83) from months 25 to 48. Multivariable analysis revealed that oral prednisolone ≤ 2.5 mg/day at Month 24 was a significant risk factor for relapse between months 25 and 48 (HR = 3.1, 95% CI 1.1–8.5).Conclusion.One-quarter of patients with AAV relapsed during maintenance therapy, and relapse was associated with the dose of oral prednisolone 24 months after the initiation of remission induction therapy in Japan.


2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S345-S346
Author(s):  
Min Hyung Kim ◽  
Su Jin Jeong ◽  
Seong Gyu Lee ◽  
Ki Sook Kim ◽  
Yoon Ji Heo ◽  
...  

Abstract Background Hand hygiene and isolation precaution are often difficult to sustain, requiring additional measure to control multidrug-resistant organisms (MDRO) transmission. It was suggested that continuously antimicrobial surfaces could offer superior control of surface bioburden.Thus, we sought to decide the efficacy of photocatalyst antimicrobial coating in reducing MDRO acquisition in high incidence setting. Methods At an institute where used to have high incidence rate of methicillin-resistant Staphylococcus aureus (MRSA), we performed prospective cohort study involving patients hospitalized in medical intensive care unit. Five months of preintervention (where routine infection control measures were maintained) data were compared with 5 months of postintervention (after titanium dioxide-based photocatalyst were coated on high touch surfaces) data. The acquisition rate of MDROs and the rates of hospital acquired blood stream infection (BSI), pneumonia, urinary tract infection (UTI), and Clostridium difficile-associated disease (CDAD) were compared using Cox proportional hazards regression analysis. Results A total of 621 patients were included. There was significant decrease in MRSA acquisition rate after photocatalyst antimicrobial coating. (hazard ratio, 0.37; 95% CI, 0.14–0.99; P = 0.04.) However, acquisition rates of vancomycin-resistant Enterococcus spp. and multidrug-resistant Acinetobacter baunmannii had not significantly decreased. The hazard of acquiring hospital acquired pneumonia during intervention period compared with baseline period was 0.46 (95% CI, 0.23–0.94; P = 0.03). There were not significant reduction in hospital acquired BSI, UTI, and CDAD, after photocatalyst antimicrobial coating. Conclusion MRSA acquisition rate and hospital acquired pneumonia were significantly reduced after photocatalyst antimicrobial coating. This study provides evidence that photocatalyst antimicrobial disinfection can be an adjunctive measure to control MRSA acquisition in high incidence setting. Disclosures All authors: No reported disclosures.


2013 ◽  
Vol 189 (3) ◽  
pp. 904-910 ◽  
Author(s):  
Charles R. Vincent ◽  
Tami L. Thomas ◽  
Leticia Reyes ◽  
C. LeAnn White ◽  
Benjamin K. Canales ◽  
...  

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