scholarly journals Gastrointestinal carriage of Klebsiella pneumoniae in a general adult population in Norway: a cross-sectional study of risk factors and bacterial genomic diversity

2021 ◽  
Author(s):  
Niclas Raffelsberger ◽  
Marit Andrea Klokkhammer Hetland ◽  
Kristian Svendsen ◽  
Lars Småbrekke ◽  
Iren H. Löhr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Population Structure ◽  
General Population ◽  
Klebsiella Pneumoniae ◽  
Representative Sample ◽  
Adult Population ◽  
Antibiotic Use ◽  
Genomic Diversity ◽  
Prescription Database ◽  
Hospitalised Patients

SummaryBackgroundKlebsiella pneumoniae is a leading public health threat due to its increasing prevalence of antibiotic resistance. Gastrointestinal carriage of K. pneumoniae is a risk factor for subsequent infections in hospitalised patients. We determined risk factors for gastrointestinal carriage and the genomic population structure of K. pneumoniae colonising humans in a representative sample of a general population.Methods2,975 individuals (54% women) ≥40y participating in the population-based Tromsø Study 7 (2015-2016) were included. Faecal samples were screened for K. pneumoniae which were characterised using whole-genome sequencing. Risk factors for carriage were analysed using data from the Norwegian Prescription Database and questionnaires, using multivariable logistic regression.FindingsPrevalence of K. pneumoniae gastrointestinal carriage was 16·3% (95% CI 15·0-17·7%) with no gender difference. Risk factors associated with carriage included age ≥60y, travel to Greece or Asia past 12 months (adjusted odds ratio 1·49, 95% CI 1·11-2·00), Crohn’s disease/ulcerative colitis (2·26, 1·20-4·27), use of protein pump inhibitors (1·62, 1·18-2·22) and non-steroidal anti-inflammatory drugs past six months (1·38, 1·04-1·84), and antibiotic use last month (1·73, 1·05-2·86). Prevalence was higher among those having used combinations of drug classes and decreased over time with respect to preceding antibiotic use. The K. pneumoniae population was diverse with 300 sequence types among 484 isolates distributed across four phylogroups. Among the isolates, 5·2% and 11·6% harboured acquired resistance and virulence factors, respectively.InterpretationIdentification of risk factors for gastrointestinal carriage in a representative sample of a general population allows for identification of individuals that may have a higher risk of extraintestinal infection during hospitalisation. The diverse population structure of K. pneumoniae carriage isolates reflects the ecologically adaptive capacity of the bacterium, and the low antibacterial consumption probably contributes to the low prevalence of resistance in clinical isolates in Norway.

scholarly journals Gastrointestinal carriage of Klebsiella pneumoniae in a general adult population: a cross-sectional study of risk factors and bacterial genomic diversity

Gut Microbes ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 1939599
Author(s):  
Niclas Raffelsberger ◽  
Marit Andrea Klokkhammer Hetland ◽  
Kristian Svendsen ◽  
Lars Småbrekke ◽  
Iren Høyland Löhr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Adult Population ◽  
Cross Sectional Study ◽  
Genomic Diversity ◽  
Sectional Study ◽  
Cross Sectional ◽  
General Adult Population

Prevalence of hepatitis C virus infection and risk factor analysis in Changsha, central China, about population undergoing routine check-up, 2013–2015

2019 ◽  
Author(s):  
Shaohui Liu ◽  
Chang Zeng ◽  
Xintong Kang ◽  
Ying Tan ◽  
Wei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
General Population ◽  
Rural Areas ◽  
Adult Population ◽  
Hcv Infection ◽  
Central China ◽  
Major Public Health Problem

Abstract Background Currently, Hepatitis C virus (HCV) infection remains a major public health problem. The aim of current study wanted to determine the prevalence of HCV virus infections, and to explore the risk factors for HCV infection in the general adult population undergoing routine check-ups in Changsha City. Methods We collected 59688 blood samples from the adult population undergoing routine check-ups in 2013–2015 and obtained relevant information using a standardized questionnaire. We then conducted association and logistic regression analyses. We used the enzyme immunoassay method to test for anti-HCV antibodies in the serum samples. Results The positivity rate of anti-HCV was about 0.57% (340/59688) in the general population. Participants from rural areas showed significantly higher HCV seroprevalence rates than did those from the urban area (0.83% vs 0.19%, p < 0.001). HCV seropositivity increased progressively with age, peaking at 55–64 years (1.23%), and decreasing in participants aged 65 and older. The positivity rate of anti-HCV for males was slightly higher than that of females (0.67% vs 0.48%, p = 0.002). The results of multiple logistic regression showed that history of blood transfusion, surgery, living in rural areas, and transmission in families were the main risk factors for HCV infection. Conclusions: The prevalence of HCV infection is low in the general population in Changsha. This information vital for healthcare settings and health education entities in public, especially in rural areas.

EXTENDED-SPECTRUM BETA-LACTAMASES PRODUCING KLEBSIELLA PNEUMONIAE (ESBL-KP) INFECTION, RISK FACTORS, ANTIBIOTIC USE AND BACKGROUND

CHEST Journal ◽  
2005 ◽  
Vol 128 (4) ◽  
pp. 136S
Author(s):  
Frew H. Gebreab ◽  
Nasser Saad ◽  
Liziamma George ◽  
Teena Abraham ◽  
Imran Aurangzeb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Antibiotic Use ◽  
Infection Risk ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Infection Risk Factors

scholarly journals Cost-effectiveness of Comprehensive screening of general population for hypertension: Can it save money and Life? Systematic review of Pharmacoeconomic Studies

2020 ◽  
Author(s):  
Majid Davari ◽  
Mende Mensa Sorato ◽  
Shekoufeh Nikfar
Keyword(s):  
Risk Factors ◽  
Cost Effectiveness ◽  
General Population ◽  
Adult Population ◽  
Cost Effective ◽  
Arterial Disease ◽  
Population Based ◽  
Delayed Presentation ◽  
Early Screening ◽  
Peripheral Arterial

Abstract Background: Hypertension is one of major modifiable risk factors contributing for development of ischemic heart disease, diabetes, kidney disease, cerebrovascular disease and peripheral arterial disease. Silent nature of the disease, delayed presentation of patients to health system after development of significant cardiovascular events and poor access to comprehensive health care are major challenge of hypertension control. Early screening, detection and treatment of hypertension is effective for control of the disease progression. However, there is no robust evidence on whether screening general population for hypertension is cost-effective or not. Therefore, this review was conducted t o generate evidence on cost effectiveness of population-based hypertension screening for asymptomatic individuals as early detection strategy for the primary prevention of cardiovascular diseases. Methods: PubMed/Medline , Scopus, Web of sciences and Google Scholar were searched from January 2000 to 11 December 2019. Two investigators independently selected and reviewed fair and good-quality pharmacoeconomic studies for the cost-effectiveness of asymptomatic screening for hypertension in the community. Quality of selected literatures are evaluated by authors based on comprehensive tool developed for critical appraisal of pharmacoeconomic studies. Results: Eleven included Pharmacoeconomic studies reported favorable results for screening asymptomatic adults for hypertension. Most of studies agreed on cost-effectiveness of screening adults aged 40 years and older. Screening of general adult population for hypertension is not-cost effective. Conclusion: Screening population 40 years and older with or without additional risk factors is cost-effective in reducing hypertension and associated cardiovascular disease morbidity and mortality in developed and developing countries.

scholarly journals Psychosocial and clinical correlates of suicidal acts: Results from a national population survey

2008 ◽  
Vol 192 (4) ◽  
pp. 279-284 ◽  
Author(s):  
Emma Robertson Blackmore ◽  
Sarah Munce ◽  
Iris Weller ◽  
Brandon Zagorski ◽  
Stephen A. Stansfeld ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Adult Population ◽  
Female Gender ◽  
Epidemiological Survey ◽  
Health Condition ◽  
Psychosocial Risk Factors ◽  
Psychosocial Risk ◽  
Clinical Samples ◽  
General Adult Population

BackgroundClinical samples have identified a number of psychosocial risk factors for suicidal acts but it is unclear if these findings relate to the general population.AimsTo describe the prevalence of and psychosocial risk factors for suicidal acts in a general adult population.MethodData were obtained from a Canadian epidemiological survey of 36 984 respondents aged 15 years and older (weighted sample n=23 662 430).ResultsOf these respondents, 0.6% (weighted n=130 143) endorsed a 12-month suicidal act. Female gender (OR=4.27, 95% CI 4.05–4.50), being separated (OR=37.88, 95% CI 33.92–42.31) or divorced (OR=7.79, 95% CI 7.22–8.41), being unemployed (OR=1.70, 95% CI 1.50–1.80), experiencing a chronic physical health condition (OR=1.70, 95% CI 1.67–1.86) and experiencing a major depressive episode in the same 12-month period as the act (OR=9.10, 95% CI 8.65–9.59) were significantly associated with a suicidal act.ConclusionsThe psychosocial correlates of suicidal acts in this sample are consistent with those previously reported in clinical and general population samples. These findings reinforce the importance of the determination of suicide risk and its prevention not only of psychiatric illness but of physical and psychosocial factors as well.

scholarly journals Klebsiella pneumoniae carriage in low-income countries: antimicrobial resistance, genomic diversity and risk factors

Gut Microbes ◽  
2020 ◽  
Vol 11 (5) ◽  
pp. 1287-1299 ◽  
Author(s):  
Bich-Tram Huynh ◽  
Virginie Passet ◽  
Andriniaina Rakotondrasoa ◽  
Thierno Diallo ◽  
Alexandra Kerleguer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Low Income ◽  
Genomic Diversity ◽  
Low Income Countries

scholarly journals Epidemiology and risk factors for ESBL-producing Klebsiella pneumoniae: a case control study

2010 ◽  
Vol 4 (11) ◽  
pp. 717-722 ◽  
Author(s):  
Kutbettin Demirdag ◽  
Salih Hosoglu
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Surgical Intervention ◽  
Univariate Analysis ◽  
Antibiotic Use ◽  
Case Control ◽  
University Hospital ◽  
Stepwise Logistic Regression ◽  
Invasive Infection ◽  
Stepwise Logistic Regression Analysis

Introduction: Increased production of extended-spectrum β-lactamases (ESBLs) has become an important issue for treatment of severe Klebsiella pneumoniae (K. pneumoniae) infections. This study aimed to evaluate risk factors of infection from ESBL-producing K. pneumoniae (ESBL-KP). Methodology: Risk factors were evaluated using a retrospective case control design. Fifty-two patients admitted to Firat University Hospital (FUH) with invasive infections from ESBL-KP were employed as cases. Patients admitted to FUH with non-ESBL-producing K. pneumoniae invasive infection were chosen as controls. Potential risk factors of the cases and controls were evaluated using hospital charts. Pulsed-field Gel Electrophoresis (PFGE) was used to show the relatedness of ESBL-KP strains. Results: In univariate analysis, the following factors were found significant for ESBL-KP: pre-infection hospital stay, nosocomial origin, central venous catheterization, surgical intervention, antibiotic use longer than one week, and previous hospitalization. In contrast, stepwise logistic regression analysis showed that two variables, previous antibiotic use (p = 0.000) and surgical intervention (p = 0.006), remained significantly associated with risk for infection with an ESBL-KP. Molecular epidemiology identified several clusters among the ESBL-producing isolates. Conclusions: Antibiotic use and surgical intervention were significant associated factors for infections with ESBL-KP.

scholarly journals A retrospective study of risk factors for carbapenem-resistant Klebsiella pneumoniae acquisition among ICU patients

2016 ◽  
Vol 10 (03) ◽  
pp. 208-213 ◽  
Author(s):  
Yangmin Hu ◽  
Yanting Ping ◽  
Leiqing Li ◽  
Huimin Xu ◽  
Xiaofeng Yan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Klebsiella Pneumoniae ◽  
Independent Risk Factor ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Clinical Factor ◽  
Icu Patients ◽  
Carbapenem Resistant ◽  
Bivariable Analysis

Introduction: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is rapidly emerging as a life-threatening nosocomial infection. In this study, we aim to identify risk factors, especially antibiotic use, for CRKP infection among intensive care unit (ICU) patients. Methodology: This was a matched case-control study of a 67-bed ICU in a tertiary care teaching hospital from 1 January 2011 through 30 June 2013. The control cases were selected among the patients with carbapenem-susceptible Klebsiella pneumoniae (CSKP) and were matched with CRKP cases for year of ICU admission and site of infection. The clinical outcomes and antibiotic treatments were analyzed. Results: One hundred and thirty patients were included in the study (65 cases and 65 controls). Bivariable analysis showed that age of patients (p = 0.044), number of antibiotic groups (p = 0.001), and exposure to carbapenems (p < 0.001) were associated with CRKP infection. Using multivariate analysis adjusted for age, prior hospitalization, number of antibiotic groups, and previous exposure to carbapenems, previous carbapenem exposure (p < 0.001) was identified as an independent risk factor for CRKP infection. Conclusions: These data suggest that exposure to carbapenems is an independent risk factor for CRKP infection. Patients with this clinical factor should be targeted for interventions to reduce the subsequent risk of infection.

scholarly journals Differences Between Dietary, Drinking Habits and Physical Activity of the Adult Population Living in Two Distinct Geographic Areas of Romania

2018 ◽  
Vol 69 (11) ◽  
pp. 3100-3105
Author(s):  
Iosif Balint ◽  
Sandor Pal ◽  
Lorand Ferencz ◽  
Zoltan Abram
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Body Mass Index ◽  
Alcohol Consumption ◽  
General Population ◽  
Body Mass ◽  
Dietary Habits ◽  
Adult Population ◽  
Modern Society ◽  
Significant Difference

The constantly and intensely changing modern society has a negative influence on the the general population�s health status. Risk factors being deeply inserted in the structure of the modern society can hardly be influenced and corrected. The aim of the study was the lifestyle- and diet-related comparison of two distinct adult populations from Romania: Bacau and Tirgu Mures. Material and methods: We evaluated the dietary habits, alcohol consumption and physical activity by a complex, validated questionnaire. Body mass index was also determined. The adult population from Tirgu Mures numbered 352 subjects, who were compared to the adults from Bacau, numbering 231 individuals. The considered threshold of significance was 0.05. Body mass index is over the normal range in more than 2/3 of the subjects. The overweight occurrence was 37.95%. The majority of the subjects (77.5%) has regular daily exercise (30 minutes or more). Daily alcohol consumption was present in 42.42% of the cases. Dietary habits were also analyzed: 61.9% of the subjects consume breakfast daily, and 46.94% of them consumes snacks between meals 2-3 times per week. A statistical difference could be observed regarding the frequency of breakfast consumption and body mass index (p-0.042): 2/3 of the studied adults from Tirgu Mures who eat breakfast sometimes having their body mass index over 25 kg/m2. Regarding physical activity a significant difference could be observed in case of those who responded rarely or never (p-0.027) (76.0% of Mures county with this response vs. only 24.0% in Bacau). The frequency of alcohol consumption is higher in Tirgu Mures and surroundings in case of once or several times per week consumption (p-0.005). Instructional and educational interventions targeting the development of healthier lifestyle habits in general population are worthy and needed to reduce the risk factors associated with the development of cardiovascular and metabolic diseases and reducing the burden upon the society of these diseases.

scholarly journals Changes in the rate of cardiometabolic and pulmonary events during the COVID-19 pandemic

2021 ◽  
Author(s):  
Alex J Walker ◽  
John Tazare ◽  
George Hickman ◽  
Christopher T Rentsch ◽  
Elizabeth J Williamson ◽  
...  
Keyword(s):  
Heart Failure ◽  
General Population ◽  
Adult Population ◽  
Clinical Event ◽  
Clinical Events ◽  
Respiratory Events ◽  
Hospitalised Patients ◽  
Respiratory Event ◽  
Hospital Acquired ◽  
The Relationship

AbstractBackgroundThere has been extensive speculation about the relationship between COVID-19 and various cardiometabolic and pulmonary conditions. This a complex question: COVID-19 may cause a cardiometabolic or respiratory event; admission for a clinical event may result in hospital-acquired SARS-CoV-2 infection; both may contribute to a patient surpassing the threshold for presenting to services; and the presence of a pandemic may change whether patients present to services at all. To inform analysis of these questions, we set out to describe the overall rate of various key clinical events over time, and their relationship with COVID-19.MethodsWorking on behalf of NHS England, we used data from the OpenSAFELY platform containing data from approximately 40% of the population of England. We selected the whole adult population of 17m patients and within this identified two further mutually exclusive groups: patients who tested positive for SARS-CoV-2 in the community; and patients hospitalised with COVID-19. We report counts of death, DVT, PE, ischaemic stroke, MI, heart failure, AKI and diabetic ketoacidosis in each month between February 2019 and October 2020 within each of: the general population, community SARS-CoV-2 cases, and hospitalised patients with COVID-19. Outcome events were defined using hospitalisations, GP records and cause of death data.ResultsFor all outcomes except death there was a lower count of events in April 2020 compared to April 2019. For most outcomes the minimum count of events was in April 2020, where the decrease compared to April 2019 in events ranged from 5.9% (PE) to 40.0% (heart failure). Despite hospitalised COVID-19 patients making up just 0.14% of the population in April 2020, these patients accounted for an extremely high proportion of cardiometabolic and respiratory events in that month (range of proportions 10.3% (DVT) to 33.5% (AKI)).InterpretationWe observed a substantial drop in the incidence of cardiometabolic and pulmonary events in the non-COVID-19 general population, but high occurrence of COVID-19 among patients with these events. Shortcomings in routine NHS secondary care data, especially around the timing and order of events, make causal interpretations challenging. We caution that the intermediate findings reported here should be used to inform the design and interpretation of any studies using a general population comparator to evaluate the relationship between COVID-19 and other clinical events.

Sign in / Sign up

Export Citation Format

Share Document