scholarly journals Risk Factors for Fluconazole-Resistant Candidemia

2010 ◽  
Vol 54 (8) ◽  
pp. 3149-3154 ◽  
Author(s):  
José Garnacho-Montero ◽  
Ana Díaz-Martín ◽  
Emilio García-Cabrera ◽  
Maite Ruiz Pérez de Pipaón ◽  
Clara Hernández-Caballero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Renal Disease ◽  
Fluconazole Resistance ◽  
Factors Associated ◽  
Patient Demographics ◽  
Resistant Species ◽  
Empirical Antifungal Therapy ◽  
Fluconazole Resistant ◽  
A Prospective Study ◽  
Underlying Diseases

ABSTRACT Previous studies have sought to determine the risk factors associated with candidemia caused by non-albicans Candida spp. or with potentially fluconazole-resistant Candida spp. (C. glabrata and C. krusei). Non-albicans Candida strains are a heterogeneous group that includes species with different levels of virulence, and only a limited number of C. glabrata isolates are resistant to fluconazole. We set out to identify the risk factors associated with microbiologically proven fluconazole-resistant candidemia. A prospective study including adult patients with candidemia was performed. Data were collected on patient demographics; underlying diseases; exposure to corticosteroids, antibiotics, or fluconazole; and invasive procedures. Risk factors associated either with non-albicans Candida spp. or potentially fluconazole-resistant Candida spp. (C. glabrata or C. krusei) or with Candida spp. with microbiologically confirmed fluconazole resistance were assessed using logistic regressions. We included 226 candidemia episodes. Non-albicans Candida isolates accounted for 53.1% of the fungal isolates, but only 18.2% of the cases were caused by potentially fluconazole-resistant organisms. Thirty isolates exhibited microbiologically confirmed fluconazole resistance. The multivariate analysis revealed that independent predictors associated with fluconazole-resistant Candida spp. were neutropenia (odds ratio [OR] = 4.94; 95% confidence interval [CI] = 1.50 to 16.20; P = 0.008), chronic renal disease (OR = 4.82; 95% CI = 1.47 to 15.88; P = 0.01), and previous fluconazole exposure (OR = 5.09; 95% CI = 1.66 to 15.6; P = 0.004). Independently significant variables associated with non-albicans Candida bloodstream infection or with potentially fluconazole-resistant Candida spp. did not include previous fluconazole exposure. We concluded that prior fluconazole treatment is an independent risk factor only for candidemia caused by microbiologically confirmed fluconazole resistant species. Our findings may be of value for selecting empirical antifungal therapy.

scholarly journals RISK FACTORS ASSOCIATED WITH TEMPORARY CATHETER-RELATED INFECTION IN PATIENTS ON DIALYSIS TREATMENT

2015 ◽  
Vol 24 (3) ◽  
pp. 680-685 ◽  
Author(s):  
Palmiane de Rezende Ramim Borges ◽  
João Bedendo
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Renal Failure ◽  
Dialysis Treatment ◽  
Catheter Related Infection ◽  
Hemodialysis Catheter ◽  
Factors Associated ◽  
Independent Variables ◽  
Hemodialysis Session ◽  
A Prospective Study

ABSTRACTThis study aims to identify risk factors associated with temporary hemodialysis catheter-related infection, in patients on dialysis treatment in a teaching hospital. This is a prospective study performed from November of 2012 to May of 2013, with 129 patients. Sociodemographic, clinical and biochemical data were collected from patient charts. In patients with a catheter,, 48.8% had catheter-related infection, 65% were male, 65% were 60 years of age or older, 85.3% had the catheter because they were diagnosed with acute renal failure, and 88% were hospitalized in an intensive care unit. There was a significant correlation between the independent variables and the outcome of infection. The risk factors associated with temporary hemodialysis catheter-related infection were: length of time of catheter use, the change of device, death, and complications during a hemodialysis session.

scholarly journals Survival and factors predicting mortality after major and minor lower-extremity amputations among patients with diabetes: a population-based study using health information systems

2020 ◽  
Vol 8 (1) ◽  
pp. e001355
Author(s):  
Silvia Cascini ◽  
Nera Agabiti ◽  
Marina Davoli ◽  
Luigi Uccioli ◽  
Marco Meloni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Renal Disease ◽  
High Mortality ◽  
Chronic Renal Disease ◽  
Mortality Rates ◽  
Population Based ◽  
Term Survival ◽  
Factors Associated ◽  
Patients With Diabetes

IntroductionThe aim of the study was to identify the sociodemographic and clinical factors associated with death after the first lower-extremity amputation (LEA), minor and major separately, using data from regional health administrative databases.Research design and methodsWe carried out a population-based cohort study including patients with diabetes residing in the Lazio region and undergoing a primary amputation in the period 2012–2015. Each individual was followed up for at least 2 years. Kaplan-Meier analysis was used to evaluate long-term survival; Cox proportional regression models were applied to identify factors associated with all-cause mortality.ResultsThe cohort included 1053 patients, 72% were male, 63% aged ≥65 years, and 519 (49%) died by the end of follow-up. Mortality rates at 1 and 4 years were, respectively, 33% and 65% for major LEA and 18% and 45% for minor LEA. Significant risk factors for mortality were age ≥65, diabetes-related cardiovascular complications, and chronic renal disease for patients with minor LEA, and age ≥75 years, chronic renal disease and antidepressant drug consumption for subjects with major LEA.ConclusionsThe present study confirms the high mortality rates described in patients with diabetes after non-traumatic LEA. It shows differences between minor and major LEA in terms of mortality rates and related risk factors. The study highlights the role of depression as specific risk factor for death in patients with diabetes after major LEA and suggests including its definition and management in strategies to reduce the high mortality rate observed in this group of patients.

scholarly journals Candida norvegensis: a fluconazole-resistant species.

1997 ◽  
Vol 41 (6) ◽  
pp. 1375-1376 ◽  
Author(s):  
P Sandven ◽  
K Nilsen ◽  
A Digranes ◽  
T Tjade ◽  
J Lassen
Keyword(s):  
Fluconazole Resistance ◽  
Resistant Species ◽  
Fluconazole Resistant

Candida norvegensis has been an unusual cause of infections in humans. In Norway this species was isolated from eight patients from 1990 to 1996 and was of probable pathogenic significance in four of them. All isolates were resistant to fluconazole. The same was true for two C. norvegensis isolates from before 1940, and it is therefore assumed that the fluconazole resistance is inherent.

A prospective study of transmission by transfusion of HTLV-I and risk factors associated with seroconversion

1992 ◽  
Vol 51 (6) ◽  
pp. 886-891 ◽  
Author(s):  
Angela Manns ◽  
Rainford J. Wilks ◽  
Edward L. Murphy ◽  
Grace Haynes ◽  
J. Peter Figueroa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Factors Associated ◽  
A Prospective Study

scholarly journals Incidence and risk factors associated with human albumin administration following total joint arthroplasty: a multicenter retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shaoyun Zhang ◽  
Haibo Si ◽  
Jinwei Xie ◽  
Yuangang Wu ◽  
Qinsheng Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Enhanced Recovery ◽  
Human Albumin ◽  
Albumin Level ◽  
Factors Associated ◽  
Patient Demographics ◽  
Colloidal Fluids ◽  
Risk Patients ◽  
Goal Directed Fluid Therapy ◽  
Independent Risk Factors

Abstract Background Enhanced recovery after surgery (ERAS) program advocates implementation of perioperative goal-directed fluid therapy and reduced application of colloidal fluids. It should be used reasonably selectively in high-risk patients despite the clear efficacy of human albumin (HA). Therefore, it is vital to identify the risk factors for the use of HA. This study aims to determine the incidence and risk factors of HA administration in patients undergoing total hip or knee arthroplasty (THA, TKA). Methods We identified patients undergoing THA or TKA in multiple institutions from 2014 to 2016 and collected patient demographics and perioperative variables. The criterion of HA administration was defined as a postoperative albumin level < 32 g/L or 32 to 35 g/L for at-risk patients. We compared 14 variables between patients who received HA administration and those who did not after stratification by the preoperative albumin (pre-ALB) level. Multivariable regressions identified the independent risk factors associated with HA administration. Results In total, 958 (20.3%) of 4713 patients undergoing THA and 410 (9.7%) of 4248 patients undergoing TKA received HA administration. In addition to pre-ALB < 35 g/L, preoperative anemia (odds ratio [OR] 2.12, P = 0.001; OR 1.39, P < 0.001) and drain use (OR 3.33, P = 0.001; OR 4.25, P < 0.001) were also independent risk factors for HA administration after THA regardless pre-ALB < 35 g/L or not, and patients undergoing TKA diagnosed of rheumatoid arthritis or ankylosing spondylitis tended to receive HA administration regardless pre-ALB < 35 g/L or not (OR 3.67, P = 0.002; OR 2.06, P < 0.001). Conclusions The incidence of HA administration was high in patients undergoing THA or TKA, and several variables were risk factors for HA administration. This finding may aid surgeons in preoperatively identifying patients requiring HA administration and optimizing perioperative managements.

scholarly journals Surgical Site Infections (SSI) and factors associated in a private tertiary care teaching hospital in Raichur, Karnataka, India

2018 ◽  
Vol 5 (8) ◽  
pp. 2899
Author(s):  
Prashanta Swami Pujar ◽  
K. B. Phuleker ◽  
Nagaraj Bhalki
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Research Centre ◽  
Chi Square ◽  
College Hospital ◽  
Factors Associated ◽  
Duration Of Surgery ◽  
Chi Square Test ◽  
A Prospective Study

Background: Prevention of Surgical site infection (SSI) remains a focus of attention because wound infections continue to be a major source of expense, morbidity, and even mortality. Three quarters of deaths of surgical patients with SSIs are attributed to nosocomial infections, nearly all of which are organ/space infections. The objective of the present study was to estimate the incidence of SSI and to study the various risk factors associated with SSI.Methods: This is a prospective study of 180 eligible cases eligible subjects, who underwent various surgeries in the department of General Surgery after applying inclusion and exclusion criteria. The study conducted at the Navodaya Medical College Hospital and Research Centre, Raichur. The tenure for the study was April 2017 to June 2017. Data was collected using pretested proforma. Data was analysed using SPSS version 16. Chi -square test and multiple logistic regression was applied to know the association between various risk factors and occurrence of SSI.Results: Among 180 patients 33 (18.33%) developed surgical site infections (SSI). Among 33 SSIs 25 (75.76%) were grade 3 and 8 (24.24%) were grade 4 infections. SSIs were found more commonly among patients over 50 years, diabetics, HIV infected patients, patients with longer duration of surgery and associations with these factors were found statistically significant.Conclusions: The incidence rate of SSI was quite high, and its end results will have a greater impact on patients as well as on healthcare systems. Prevention of SSI requires multipronged approach targeting both patient related and procedure related risk factors in pre- operative, intra-operative, and post-operative period.

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