scholarly journals Differential Effects of Levofloxacin and Ciprofloxacin on the Risk for Isolation of Quinolone-Resistant Pseudomonas aeruginosa

2006 ◽  
Vol 50 (6) ◽  
pp. 2192-2196 ◽  
Author(s):  
Keith S. Kaye ◽  
Zeina A. Kanafani ◽  
Ashley E. Dodds ◽  
John J. Engemann ◽  
Stephen G. Weber ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Case Control Study ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Clinical Strain ◽  
Control Group ◽  
Multivariable Analyses ◽  
Control Study

ABSTRACT Due to the greater in vitro activity of ciprofloxacin than that of levofloxacin against Pseudomonas aeruginosa, the likelihood of isolating a clinical strain of quinolone-resistant (QR) P. aeruginosa might be greater after exposure to levofloxacin than ciprofloxacin. We examined the risk of isolating QR P. aeruginosa in association with prior levofloxacin or ciprofloxacin exposure. A case-case-control study was conducted. Two groups of cases, one with nosocomial QR P. aeruginosa infections and one with nosocomial quinolone-susceptible (QS) P. aeruginosa infections, were compared to a control group of hospitalized patients without P. aeruginosa infections. Bivariable and multivariable analyses were used to determine risk factors for isolation of QR P. aeruginosa and QS P. aeruginosa. One hundred seventeen QR P. aeruginosa and 255 QS P. aeruginosa cases were identified, and 739 controls were selected. Exposures to ciprofloxacin were similar among all three groups (8% for controls, 9.4% for QR P. aeruginosa cases, and 7.5% for QS P. aeruginosa cases; P ≥ 0.6). Levofloxacin use was more frequent in the QR P. aeruginosa cases than in the controls (35.9% and 22.1%, respectively; odds ratio [OR] = 2.0; 95% confidence interval [CI] = 1.3 to 3.0) and less frequent in QS P. aeruginosa cases (14.1% of QS P. aeruginosa cases; OR = 0.6; 95% CI = 0.4 to 0.9). In multivariable analysis, levofloxacin, but not ciprofloxacin, was a significant risk factor for isolation of QR P. aeruginosa (OR for levofloxacin = 1.7 [95% CI = 1.0 to 2.9]; OR for ciprofloxacin = 1.2 [95% CI = 0.6 to 2.5]). Levofloxacin was associated with a reduced risk of isolation of QS P. aeruginosa (OR = 0.6; 95% CI = 0.4 to 0.9), whereas ciprofloxacin had no significant effect (OR = 1.0; 95% CI = 0.6 to 1.8). In conclusion, the use of levofloxacin, but not ciprofloxacin, was associated with isolation of QR P. aeruginosa.

scholarly journals Influence of prior antibiotic use on risk of rheumatoid arthritis: case control study in general practice

Rheumatology ◽  
2019 ◽  
Vol 59 (6) ◽  
pp. 1281-1287 ◽  
Author(s):  
David Armstrong ◽  
Alex Dregan ◽  
Mark Ashworth ◽  
Patrick White ◽  
Chris McGee ◽  
...  
Keyword(s):  
Case Control Study ◽  
Significant Risk ◽  
Immunological Response ◽  
Significant Risk Factor ◽  
Antibiotic Use ◽  
Case Control ◽  
Control Group ◽  
Centre Database ◽  
New Diagnosis ◽  
Control Study

Abstract Objectives To test the hypothesis that prior antibiotics influences the risk of developing RA. Methods A case–control study was conducted over 15 years using the UK’s Royal College of General Practitioners Research and Surveillance Centre database. The frequency and type of antibiotic prescription for patients who subsequently developed RA were compared with antibiotic prescriptions in a control group of patients who remained free of RA. Cases, defined as patients with a new diagnosis of RA made between 2006 and 2018, were matched with up to four RA-free controls on practice, age, gender and date of diagnosis. Exposure was measured by the number and type of prescriptions for antibiotics prior to the RA diagnosis or to the index date in controls. Results A total of 8482 patients with a new diagnosis of RA between 2006 and 2018 were compared with 22 661 controls. There was a higher likelihood of an RA diagnosis after antibiotic prescriptions within 1 year, 5 years and ever with a strong dose–response. Patients receiving >10 antibiotics in a 5 year period were more than twice as likely to receive an RA diagnosis as controls [adjusted odds ratio 2.65 (CI 2.40, 2.93)]. Conclusion Exposure to antibiotics prior to the diagnosis was a significant risk factor for RA. This could reflect an immunological response to a compromised microbiome. Alternatively, patients with pre-symptomatic or early undiagnosed RA may have been more likely to present to their general practitioner with infections due to an unrecognized effect of RA.

An Outbreak of Pyodermas Among Neonates Caused by Ultrasound Gel Contaminated With Methicillin-SusceptibleStaphylococcus Aureus

2000 ◽  
Vol 21 (12) ◽  
pp. 761-764 ◽  
Author(s):  
Klaus Weist ◽  
Constanze Wendt ◽  
Lyle R. Petersen ◽  
Hans Versmold ◽  
Henning Rüden
Keyword(s):  
Hip Joint ◽  
Case Control Study ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Case Control ◽  
University Hospital ◽  
Good Physical Condition ◽  
Rapd Pcr ◽  
Control Study

Objective:To investigate an outbreak of methicillin-susceptibleStaphylococcus aureus(MSSA); infections in a neonatal clinic.Design:Prospective chart review, environmental sampling, and genotyping by two independent methods: pulsed-field gel electrophoresis (PFGE) and randomly amplified polymorphic DNA polymerase chain reaction (RAPD-PCR). A case-control study was performed with 31 controls from the same clinic.Setting:A German 1,350-bed tertiary-care teaching university hospital.Results:There was a significant increase in the incidence of pyodermas with MSSA 10 neonates in good physical condition with no infection immediately after birth developed pyodermas. A shared spatula and ultrasound gel were the only identified infection sources. The gel contained MSSA and was used for hip-joint sonographies in all neonates. PFGE and RAPD-PCR patterns from 6 neonates and from the gel were indistinguishable and thus genetically related clones. The case-control study revealed no significant risk factor with the exception of cesarean section (P=.006). The attack rate by days of hip-joint sonography between April 15 and April 27, 1994, was 11.8% to 40%.Conclusions:Inappropriate hygienic measures in connection with lubricants during routine ultrasound scanning may lead to nosocomialS aureusinfections of the skin. To our knowledge this source ofS aureusinfections has not previously been described.

scholarly journals Non-PSEUDO-AntiBiotiCs Score—A Predictor of Bacteraemia Caused by Pseudomonas aeruginosa: A Case-control Study

2021 ◽  
Author(s):  
Kaori Iwami ◽  
Takahiro Matsuo ◽  
Kuniyoshi Hayashi ◽  
Nobuyoshi Mori
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Bloodstream Infection ◽  
Broad Spectrum ◽  
Case Control Study ◽  
Characteristic Curve ◽  
Multivariable Analysis ◽  
Case Control ◽  
Resistant Bacteria ◽  
Multivariable Logistic Regression Analysis ◽  
Control Study

Abstract Background: Immoderate use of broad-spectrum antimicrobials could lead to emergence of resistant bacteria. The purpose of this study was to identify factors associated with Pseudomonas aeruginosa bacteraemia and develop an exclusion scoring system to help clinicians select an appropriate antimicrobial treatment. Methods: This single-centre case-control study recruited inpatients and outpatients (age ≥ 20 years) with P. aeruginosa or Escherichia coli bacteraemia at St. Luke’s International Hospital in Tokyo from April 2005 to March 2020. Bivariate associations were assessed using χ2 test, Fisher's exact test, or Mann–Whitney U test, and the relationship between P. aeruginosa bacteraemia and other variables was determined using multivariable logistic regression analysis. Results: A total of 1562 patients (208 patients with P. aeruginosa bacteraemia and 1354 patients with E. coli bacteraemia) were included. Multivariable analysis revealed 11 variables associated with P. aeruginosa bacteraemia: Nosocomial infections, Pneumonia, Sex (males), Exposure to antibiotics within 90 days, Urinary tract infection, Urinary catheterization, abDOminal infection, Age < 77 years, Body mass index < 19, presence of Central venous catheter, and Central line-associated bloodstream infection/peripheral line-associated bloodstream infection; these variables were used to develop the Non-PSEUDO-AntiBiotiCs score. The area under the receiver operating characteristic curve was 0.89 (95% confidence interval: 0.88–­0.92), and the best cut-off-point was 5; a score of ≥ 5 had a sensitivity of 80% and a specificity of 83%. Conclusion: We developed the Non-PSEUDO-AntiBiotiCs score. This score may allow clinicians to rule out the possibility of P. aeruginosa bacteraemia and prevent the abuse of broad-spectrum antimicrobials.

Abstract 126: Importance of Untreated Hypertension for Intracerebral Hemorrhage

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Kyle B Walsh ◽  
Opeolu Adeoye ◽  
Padmini Sekar ◽  
Jennifer Osborne ◽  
Charles J Moomaw ◽  
...  
Keyword(s):  
Risk Factor ◽  
Ethnic Groups ◽  
Case Control Study ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Case Control ◽  
Insurance Status ◽  
Race Ethnicity ◽  
Untreated Hypertension ◽  
Control Study

Introduction: Hypertension (HTN), particularly untreated HTN, has been found to be a significant risk factor for ICH in predominately white ICH populations. We evaluated the risk of treated and untreated HTN on ICH in a multi-ethnic case-control study. Hypothesis: Treated and untreated HTN confer variable risk for ICH by race/ethnicity. Methods: The Ethnic/Racial Variations of ICH (ERICH) study is a prospective, multicenter, case-control study of ICH among whites, blacks, and Hispanics. Cases were enrolled from 42 recruitment centers using hot-pursuit. Controls matched to cases 1:1 by age (±5 years), sex, race/ethnicity, and metropolitan area were recruited by random-digit dialing. Subjects were interviewed to determine whether they had a history of HTN and if they took medications to reduce blood pressure. Results: Between 9/2010 and 6/2015, 891 white, 833 black, and 599 Hispanic case/control pairs were enrolled. Higher proportions of black and Hispanic ICH with HTN were untreated, compared with whites (43.3% and 48.3% vs. 33.2%; p=.0002 and p<.0001, respectively). When adjusted for medical insurance status, a significant difference persisted for whites vs. Hispanics (p=.002), but not whites vs. blacks (p=.197). In multivariate analyses adjusted for alcohol use, anticoagulation, hypercholesterolemia, education, and insurance status, treated HTN was a significant risk factor for ICH in whites (OR=1.72, 95% CI 1.33-2.22, p<.0001), blacks (3.04, 2.13-4.34, <.0001), and Hispanics (2.57, 1.64-4.00, <.0001). Untreated HTN was a substantially greater risk factor for ICH for all three racial/ethnic groups: whites (9.53, 5.88-15.45, <.0001), blacks (11.10, 7.06-17.47, <.0001), Hispanics (9.65, 5.49-16.95, <.0001). In the subtype analyses of deep, lobar, and infratentorial ICH, untreated HTN resulted in ORs of 3.50 to 24.81, with statistical significance for all subtypes and ethnic groups. Conclusion: Treatment of HTN reduces the risk of ICH conferred by HTN markedly, but not completely. Untreated hypertension, which is significantly more prevalent among black and Hispanic ICH cases than among white cases, confers at least a 9-fold risk of ICH regardless of race. Treatment of hypertension is expected to have substantial impact on risk of ICH.

scholarly journals A case–control study of risk factors for sporadic campylobacter infections in Denmark

2003 ◽  
Vol 130 (3) ◽  
pp. 353-366 ◽  
Author(s):  
J. NEIMANN ◽  
J. ENGBERG ◽  
K. MØLBAK ◽  
H. C. WEGENER
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Case Control Study ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Case Control ◽  
Final Model ◽  
Unpasteurized Milk ◽  
Frequent Consumption ◽  
Control Study

A case control study comprising 282 cases and 319 matched controls was conducted in Denmark during 1996–7. Two estimates of the odds ratio (OR) were determined for each risk factor with and without ‘protective factors’ fitted into the final model. Consumption of undercooked poultry (OR 4·5; 8·2), consumption of red meat at a barbecue (OR 2·3; 4·1), consumption of grapes (OR 1·6; 2·8) and drinking unpasteurized milk (OR 2·3; 11·8) were identified as risk factors in both models. Frequent consumption of pork chops (OR 4·4) and daily contact with domestic animals and pets were identified as risk factors in one of the two models only. Finally, foreign travel was found to be a significant risk factor (OR 2·5). Seasonal and regional interaction was observed for several risk factors and the time elapsed from interviewing of cases to interviewing of controls seemed to influence the effect of certain seasonal dependent risk factors.

scholarly journals Well-managed gestational diabetes mellitus is no longer a risk factor for neonatal RDS — a case-control study

2020 ◽  
Author(s):  
Guannan Xi ◽  
Qian Ying ◽  
Xuefeng Wang ◽  
Fei Luo ◽  
Chengqiu Lu ◽  
...  
Keyword(s):  
Risk Factor ◽  
Gestational Diabetes ◽  
Subgroup Analysis ◽  
Case Control Study ◽  
Diabetes Management ◽  
Significant Risk ◽  
Case Control ◽  
Control Group ◽  
Control Study ◽  
Hba1c Levels

Abstract Abstract BACKGROUND Diabetes in pregnancy used to be considered associated with a higher risk of respiratory distress syndrome(RDS) in neonates. However, as antenatal examinations have improved, whether well-managed gestational diabetes remains an independent risk factor is unclear. This study was to determine the associations of well-managed gestational diabetes with morbidity and complications of RDS. Method This was a case-control study conducted at the Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China. We collected data from 101 RDS infants and 101 RDS infants from among 1749 infants, through a standardized protocol with predefined inclusion and exclusion criteria. Assessment of diabetes management was based on HbA1c and random blood glucose measurements. Univariable and multivariable logistic regression was performed to calculate the odds ratio (OR). An intergroup analysis was conducted between RDS infants and those without RDS, and a subgroup analysis was conducted between RDS neonates born to women with gestational diabetes and those born to women without gestational diabetes. RESULTS The mean (±SD) gestational age of the RDS infants was 35.9 (1.9) weeks, which was similar to that of the non-RDS infants (35.7 (±1.3) weeks). The HbA1c levels at diabetes diagnosed, the HbA1c levels right before delivery and the RBG levels before delivery had no significant differences, and all of them were below a well-controlled level. In the intergroup analysis, the morbidity of gestational diabetes between the two groups showed no significant differences in the adjusted analyses (adjusted OR 1.40, 95% CI 0.59-3.36). However, the case group had significantly more placental abnormalities (adjusted OR 3.61, 95% CI 1.63-8.00), fetal distress (adjusted OR 4.20, 95% CI 1.87-9.46), and asphyxia (adjusted OR 3.74, 95% CI 1.59-8.81) than the control group. In the subgroup analysis, the total dose of the PS applications, incidence of complications, and need for respiratory support (total and separate) were not significantly different between the two groups. CONCLUSIONS Well managed gestational diabetes is no longer a significant risk factor for RDS, while acute or chronic ischemia factors are. With regards to most GDM, diet and exercise are sufficient for maintaining an HbA1c below 6.5%

scholarly journals A Case-Control Study of Real-Life Experience with Ceftolozane-Tazobactam in Patients with Hematologic Malignancy and Pseudomonas aeruginosa Infection

2018 ◽  
Vol 63 (2) ◽  
pp. e02340-18 ◽  
Author(s):  
Ana Fernández-Cruz ◽  
Natalia Alba ◽  
María Auxiliadora Semiglia-Chong ◽  
Belén Padilla ◽  
Gabriela Rodríguez-Macías ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Case Control Study ◽  
Life Experience ◽  
Hematologic Malignancy ◽  
Real Life ◽  
Case Control ◽  
Control Group ◽  
Content Type ◽  
Hospital Acquired ◽  
Control Study

ABSTRACT We present our experience in patients with hematologic malignancy and Pseudomonas aeruginosa infection treated with ceftolozane-tazobactam. We performed a single-center case-control study comparing patients with hematologic malignancy and P. aeruginosa infection treated with ceftolozane-tazobactam (study group) with similar patients not treated with ceftolozane-tazobactam (control group) to assess safety and efficacy. Nineteen cases and 38 controls were analyzed. Cases were younger (45.6 years versus 57.6 years; P = 0.012) and less frequently had bacteremia (52.6% versus 86.8%; P = 0.008). They also had worse Multinational Association for Supportive Care in Cancer (MASCC) scores (10.2 versus 16.1; P = 0.0001), more hospital-acquired infections (78.9% versus 47.4%; P = 0.013), and more extremely drug-resistant (XDR) P. aeruginosa infections (47.4% versus 21.1%; P = 0.015). Cases received a median of 14 days (7 to 18 days) of ceftolozane-tazobactam (monotherapy in 11 cases [57.9.6%]). Ceftolozane-tazobactam was mostly used as targeted therapy (16 cases; 84.2%) because of resistance (9 cases; 47.4%), failure (4 cases; 21.1%), and toxicity (3 cases; 15.8%). Ten cases had bacteremia (52.6%). The sources were pneumonia (26.3%), catheter-related bacteremia (21.1%), primary bacteremia (21.1%), and perianal/genital (15.7%), urinary (10.5%), and skin/soft tissue (5.3%) infection. No toxicity was attributed to ceftolozane-tazobactam. More than 60% had neutropenia, and 15.8% fulfilled the criteria for sepsis. There were no significant differences in clinical cure at day 14 (89.5% versus 71.1%; P = 0.183) or recurrence (15.8% versus 10.5%; P = 0.675). Thirty-day mortality was lower among cases (5.3% versus 28.9%; P = 0.045). Ceftolozane-tazobactam was well tolerated and at least as effective as other alternatives for P. aeruginosa infection in patients with hematologic malignancy, including neutropenic patients with sepsis caused by XDR strains.

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