Risk factors for major infections in Wegener granulomatosis: analysis of 113 patients

2008 ◽  
Vol 68 (5) ◽  
pp. 658-663 ◽  
Author(s):  
C Charlier ◽  
C Henegar ◽  
O Launay ◽  
C Pagnoux ◽  
A Berezné ◽  
...  
Keyword(s):  
Risk Factors ◽  
Herpes Zoster ◽  
Infectious Complications ◽  
Wegener Granulomatosis ◽  
Medicine Department ◽  
Cotrimoxazole Prophylaxis ◽  
Viral Hepatitis B ◽  
Potential Risk Factors ◽  
Tract Infections ◽  
Oesophageal Candidiasis

Objective:To characterise major infectious complications and analyse potential risk factors in patients with Wegener granulomatosis (WG).Methods:Data from 113 patients with WG (69 male) followed at least once between January 1984 and March 2006 in our internal medicine department, were analysed retrospectively.Results:A total of 35 patients (mean (SD) age at WG diagnosis: 50.2 (13.05) years) developed 53 major infections. Infections were: bronchopneumonias (n = 19), herpes zoster recurrences (n = 9), cellulitis (n = 4), prostatitis (n = 4), spondylodiscitis and septic arthritis (n = 3), digestive tract infections (n = 2), Enterococcus faecalis or Staphylococcus aureus septicaemia (n = 2), viral hepatitis B reactivations (n = 2), post transfusion HIV infection with fatal cerebral toxoplasmosis, oesophageal candidiasis, disseminated herpes simplex and cytomegalovirus infection, cytomegalovirus retinitis, herpetic keratitis, herpetic stomatitis, Serratia sp. node suppuration and fever resolving under broad spectrum antibiotics (n = 1 each). Half of the major infectious episodes occurred within 3 years after WG diagnosis. Eight (7%) patients died, with two (2%) infection-related deaths. Patients diagnosed with WG before 1996 had a significantly higher rate of infection than those diagnosed later (48% vs 24%, p = 0.02). Cyclophosphamide and corticosteroids were independently associated with significantly higher risk of major infection (p<0.05 and <0.001, respectively). All patients treated since 1993 received antipneumocystosis prophylaxis.Conclusion:Cyclophosphamide and corticosteroids were associated with higher risk of infection. Despite systematic cotrimoxazole prophylaxis, major infections, mostly bronchopneumonias and herpes zoster recurrences, were still common in the course of WG.

scholarly journals Predictive Risk Factors of Urinary Tract Infection Following Semirigid Ureteroscopic Lithotripsy

2020 ◽  
Author(s):  
Mehmet Çağlar Çakıcı ◽  
Özgür Kazan ◽  
Ayberk İplikçi ◽  
Muhammet Çiçek ◽  
Özgür Efiloğlu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Infectious Complications ◽  
Ureteral Stones ◽  
P Value ◽  
Ureteroscopic Lithotripsy ◽  
Increased Risk ◽  
Predictive Risk ◽  
Tract Infections ◽  
Residual Fragments

INTRODUCTION: The aim of this study is to determine the frequency and predictive factors of postoperative UTI in patients who underwent URS regarding ureteral stones. METHODS: Data from 425 patients undergoing semi-rigid ureteroscopic lithotripsy between December 2015 and December 2019 at a single center were reviewed to detect factors predicting postoperative urinary tract infections. RESULTS: Of the 425 patients, 35 were infective (8.2%). Proximal ureteral stones were the majority in infective group (48.5%); distal ureteral stones were the majority in non-infective group (42.6%)(p=0.026). Stone number and stone size were also higher in the postoperative infective group (p<0.05). UTI history and preoperative DJS insertion were higher in Group 1 (p <0.001, p = 0.001, respectively). Multivariate regression analyses revealed that history of UTI (OR=5.513, 95% CI; 2.622–11.591, p value <0.001) and presence of residual fragments (OR=4.274, 95% CI; 1.892–9.657, p value <0.001) were independent risk factors for infectious complications after URS. DISCUSSION AND CONCLUSION: Even if URS is considered an innocuous procedure, the probability of postoperative infectious complications is far from negligible. Our results showed that the presence of UTI history and residual fragments were associated with an increased risk of subsequent UTI after URS. These infectious complications also have significant morbidity, mortality and expenditure if not treated timely. Therefore, to avoid this preventable complication, all variables should be reviewed and more careful.

Risk Factors for Urinary Lithotripsy-Associated Sepsis

1993 ◽  
Vol 14 (8) ◽  
pp. 469-472 ◽  
Author(s):  
Robert Orenstein ◽  
James E. Bross ◽  
Mary Dahlmann
Keyword(s):  
Risk Factors ◽  
Infectious Complications ◽  
Control Groups ◽  
Retrospective Case ◽  
Stone Size ◽  
Extracorporeal Shock Wave ◽  
Tract Infections ◽  
Regional Referral Center ◽  
Control Study

AbstractObjectives:To identify risk factors for sepsis following urinary extracorporeal shock wave lithotripsy (ESWL).Design:Retrospective case-control study with two control groups.Setting:A rural, 570-bed, regional referral center.Results:Six cases (four bacteremias and two fungemias) were compared with two sets of 18 controls. Cases had a higher frequency and number of urinary tract infections prior to the procedure and tended to have larger stone size.Conclusions:Patients undergoing ESWL who are at high risk for infectious complications may be identified by preprocedure evaluation. Such patients may require alternative prophylactic regimens and close postprocedure follow-up.

Healthcare-Associated Bacteremia and Urinary Tract Infections in Wards A and B of Medicine Department, CNHU-HKM of Cotonou: Characteristics and Risk Factors

2018 ◽  
Vol 08 (01) ◽  
pp. 42-53
Author(s):  
Angèle Azon-Kouanou ◽  
Kouessi Anthelme Agbodande ◽  
Faridath Abèni Tatiane Massou ◽  
Dissou Affolabi ◽  
Roberto Dossou Torès Kouassi Prudencio ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Medicine Department ◽  
Tract Infections ◽  
Healthcare Associated

scholarly journals Predictive Clinical Rule for Readmissions in OPAT. Improving in Security

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S335-S335 ◽  
Author(s):  
Itsaso Bengoetxea ◽  
Miren J Onaindia ◽  
Antonio Apezetxea ◽  
Montserrat Gomez ◽  
Muskilda Goyeneche ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Area Under The Curve ◽  
Time Factors ◽  
Venous Access ◽  
Potential Risk Factors ◽  
L Value ◽  
Clinical Tools ◽  
Tract Infections ◽  
At Home

Abstract Background Outpatient Parenteral Antibiotic Therapy (OPAT) is a safe, effective and beneficial practice but studies report 10–20% of readmissions rate. The risk factors for readmissions in OPAT have been investigated, although there are no clinical tools that allow us to predict these situations. The main goal of this study is to develop and validate a predictive model for readmission in OPAT patients. Methods Prospective study was conducted during 1 year (10/2012–09/2013), 1488 patients with OPAT were recruited at 8 units of Hospital at Home in Spain. Potential risk factors related to patient demographics, lead-time factors, clinical and microbiologic features were collected. We developed the prediction model in a derivation sample and after that, we validated this model in the validation sample. Sensitivity, specificity and area under the curve were obtained and the calibration capacity of the models were evaluated using the Hosmer-Lemeshow test (H-L). Results The mean age of patients was 63 years (range 11–102), 58.74% men and most common diagnoses were urinary tract infections (23%). Our readmission rate during OPAT episode at home was 8.67% and the 30-days readmissions were 12.29%. The 72% of the readmissions during OPAT episode was related to the infectious pathology and 27.90% to the the patient’s comorbidity. The leading indicators for readmission were: gender, age, presence of caregivers, risk factor for infection, Charlsonand Barthel Index, microorganisme number, presence of multirresistent or micotic infection, venous access, antibiotic type and creatinine, proteine and leucocyte level at admissions. Finally, those factors included in the model were: antibiotic type (OR 3.93; IC 95% 1.90–8.11; P = 0.0002), presence of infection risk factor (OR 2.53; IC 95% 1.47–4.38; P = 0.001) and leucocytosis at admission (OR 2.21; IC 95% 1.32–3.71; P = 0.003). The AUC for the model was 0.72 (IC 95% 0.66–0.78) and the H-L value was 0.23. After the validation the AUC was 0.71 (IC 95% 0.64–0.78) and H-L value 0.9. Conclusion Patients at high risk of readmission during OPAT may be identified using predictive rules. This will allow us to implement measures that reduce the rate of readmissions and contribute to increase the safety of this therapy. Disclosures All authors: No reported disclosures.

scholarly journals Study of clinical profile of acute lower respiratory tract infection in children aged 2 months to 5 years

2018 ◽  
Vol 5 (4) ◽  
pp. 1322
Author(s):  
Dhivyanarayani M. ◽  
Raju V. ◽  
Jeyachandran P.
Keyword(s):  
Risk Factors ◽  
Respiratory Tract ◽  
Environmental Risk ◽  
Potential Risk ◽  
Lower Respiratory Tract ◽  
Environmental Risk Factors ◽  
Clinical Profile ◽  
Nutritional Risk ◽  
Potential Risk Factors ◽  
Tract Infections

Background: Acute respiratory infections are a leading cause of morbidity and mortality in under-five chil-dren in developing countries. Hence, the present study was undertaken to study the various risk factors, clinical profile and outcome of acute lower respiratory tract infections (ALRI) in children aged 2 months to 5 years. To study the risk factors associated with ALRI in these children. To ascertain the association of the various cultural practices prevalent in this area with ALRI.Methods: 100 ALRI cases fulfilling WHO criteria for pneumonia, in the age group of 2 months to 5 years were evaluated for potential risk factors, clinical profile and outcome as per a predesigned proforma in a rural medical college.Results: Socio-demographic risk factors like parental illiteracy, overcrowding, partial immunization and low socioeconomic status were potential risk factors; similarly, nutritional risk factors like early and late weaning, anemia, and malnutrition were associated with ALRI. Significant environmental risk factors were the use of biomass fuels, inadequate ventilation at home, and lack of separate kitchen.Conclusions: The present study has identified various socio-demographic, nutritional and environmental risk factors for ALRI which can be tackled by effective health education of the community and effective training of peripheral health personnel.

scholarly journals SAT0265 RISK FACTORS FOR INFECTIOUS COMPLICATIONS FOLLOWING RITUXIMAB TREATMENT – MULTICENTER POLISH EXPERIENCE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1076.2-1076
Author(s):  
A. Masiak ◽  
M. Ziętkiewicz ◽  
K. Wójcik ◽  
K. Wawrzycka-Adamczyk ◽  
M. Madej ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Respiratory Tract ◽  
Soft Tissues ◽  
Infectious Complications ◽  
Prolonged Treatment ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Mean Time

Background:Rituximab (RTX) is a B cell depleting monoclonal antibody with proven efficacy in the treatment of ANCA-associated vasculitis (AAV). The infectious complications occur in 15-25%.Objectives:We aimed to assess the frequency and risk factors of infections in patients with AAV receiving RTX among Polish patients.Methods:7 tertiary referral centers experienced in the treatment of vasculitis completed a questionnaire regarding AAV patients treated with RTX.Results:Among 49 patients included in the analysis (47 with GPA, 2 with MPA; 36/73% men; mean age at diagnosis 42,45±14,9 yrs., mean age on RTX initiation 46,14±14,72 yrs.,) at least one infection occurred in 20 patients (40.82%) after mean time of 16,65±16,01 weeks since the administration of RTX. Patients were followed for a mean time of 26,88±21,94 months. There were no differences in the incidence of infectious complications by gender, age, BMI, smoking status, severity of the disease, activity of the disease (BVAS), time from diagnosis to RTX initiation, carriage of staphylococcus aureus in the upper respiratory tract, total dose of CYC before RTX treatment. We didn’t observe severe hypogammaglobulinemia or neutropenia after RTX treatment. 40% of the observed infections occurred during the first month, 35% between second and sixth month of follow-up, while 25% were observed between 6 and 12 months after the RTX initiation. Of the 20 patients who developed infection, 12 (24.5%) had further infections. Antibiotic prophylaxis with trimethoprim–sulfamethoxazole was administered in 40 out of 49 (81.63%). Upper respiratory tract infection was the most common infectious complication (n=11), followed by lower respiratory tract (n=4), soft tissues (n=4) and urinary tract infections (n=4), lacrimal gland abscess (n=2) and abdomen (n=1). In cases with a positive microbial result Staphylococcus aureus (n=4), Klebsiella pneumoniae (n=2), Pseudomonas aeruginosa (n=1), Candida (n=1) and others (n=6) were identified. No fatalities were recorded and only 3 patients had severe infection with the necessity of prolonged treatment.Conclusion:Despite the high number of infections in our group treated with RTX, most of them were not severe. Upper respiratory tract was the most common site of infection.Disclosure of Interests:None declared

scholarly journals Study of risk factors for urinary colonization in patients with the double J catheter

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Amine Saouli ◽  
Tarik Karmouni ◽  
Khalid El Khader ◽  
Abdellatif Koutani ◽  
Ahmed Iben Attya Andaloussi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Predictive Factors ◽  
Univariate Analysis ◽  
Infectious Complications ◽  
Ureteral Stent ◽  
Continuous Variables ◽  
Qualitative Variables ◽  
Tract Infections ◽  
Jj Stent

Abstract Background The aim of this study is to evaluate the prevalence of urinary colonization in patients with the JJ stent and to define the predictive factors associated with this colonization. Methods This is a monocentric prospective study (between January 2013 and April 2017), conducted in the department of Urology B of Ibn Sina Hospital in Rabat. One hundred and forty-five double ureteral stents carried by 120 patients, 25 of which had bilateral double ureteral stent, were examined. The bacteriological profile of the urine of our patients was followed by the completion of an initial urine examination and another at the time of the removal of the JJ. The comparison of the means was made by the Student's test and the Mann–Whitney test for continuous variables and by the KHI-2 test and Fisher's test for qualitative variables. The threshold of significance is set at 0.05. Results The rate of colonization of JJ stent was 35.8% (43 out of 120). The urinary colonization rate was 31.7% (38 out of 120). Average time of indwelling of JJ stent was 90 days. On double ureteral stent culture, we identified Escherichia Coli as the most predominant colonizing pathogen (47.3% of probes) followed by Enterococcus faecalis and Klebsiella pneumoniae (18.4% and 15.8%, respectively). 11.5% of colonized patients developed infectious complications (5 out of 43) and have been treated successfully except a patient who died from septic shock. In univariate analysis, diabetes mellitus (p = 0.007, OR = 4.1, CI = 1.46–11.48), urgent establishment of JJ (p = 0.03, OR = 4.61; IC = 1.08–19.6) and time of indwelling of the JJ (p = 0.05, OR = 1.89, CI = 0.95–3.77) were the predictive factors for urinary colonization in patients with JJ. In multivariate analysis, these three factors were statistically associated with this risk: diabetes mellitus (p = 0.005, OR = 0.23, CI = 0.08–0.64), the urgent establishment of JJ (p = 0.05, OR = 0.26, CI = 0, 06–1.04) and time of indwelling of the JJ more than 30 days (p = 0.007, OR = 4.29, CI = 1.49–12.37). Conclusion The prevalence of urinary colonization in patients with the double J stent was 31.7%. Diabetes mellitus, time of indwelling of the JJ more than 30 days and urgent JJ ​​ establishment are associated with a higher risk of these urinary colonizations. Strict monitoring is therefore recommended in patients with these risk factors. These results should be confirmed by multicenter and randomized studies to analyze the development of urinary tract infections in colonized patients.

scholarly journals Community studies on hepatitis B in Rajahmundry town of Andhra Pradesh, India, 1997–8: unnecessary therapeutic injections are a major risk factor

2000 ◽  
Vol 125 (2) ◽  
pp. 367-375 ◽  
Author(s):  
J. SINGH ◽  
R. BHATIA ◽  
S. K. PATNAIK ◽  
S. KHARE ◽  
D. BORA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis B ◽  
Viral Hepatitis ◽  
Hepatitis A ◽  
Community Studies ◽  
Viral Hepatitis B ◽  
Potential Risk Factors ◽  
History Of ◽  
Hepatitis B Transmission ◽  
Viral Hepatitis A

In Rajahmundry town in India, 234 community cases of jaundice were interviewed for risk factors of viral hepatitis B and tested for markers of hepatitis A–E. About 41% and 1·7% of them were positive for anti-HBc and anti-HCV respectively. Of 83 cases who were tested within 3 months of onset of jaundice, 5 (6%), 11 (13·3%), 1 (1·2%), 5 (6%) and 16 (19·3%) were found to have acute viral hepatitis A–E, respectively. The aetiology of the remaining 60% (50/83) of cases of jaundice could not be established. Thirty-one percent (26/83) were already positive for anti-HBc before they developed jaundice. History of therapeutic injections before the onset of jaundice was significantly higher in cases of hepatitis B (P = 0·01) or B–D (P = 0·04) than in cases of hepatitis A and E together. Other potential risk factors of hepatitis B transmission were equally prevalent in two groups. Subsequent studies showed that the majority of injections given were unnecessary (74%, 95% CI 66–82%) and were administered by both qualified and unqualified doctors.

Frequency of Postherpetic Neuralgia In Herpes Zoster Patients

2021 ◽  
Vol 15 (6) ◽  
pp. 1305-1308
Author(s):  
A. Malik ◽  
F. F Jang ◽  
M. Moosa ◽  
A. Iqbal ◽  
S. A. A. Hassan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Age Group ◽  
Male Population ◽  
Female Population ◽  
Number Of Patients ◽  
Co Morbidity ◽  
Incidence Risk ◽  
Potential Risk Factors

Aim: To estimate the incidence ofpostherpetic neuralgia after being infected by herpes zoster virus. Place and duration of study: This study was conducted in Sharif Medical & Dental College, Lahore from August 2019 to August 2020. Methodology: A number of 126 patients was included in this research who had history of herpes zoster. Demographic information, medical diagnosis, treatment and symptoms were included in the data collected. Patients with unclear diagnosis regarding herpes zoster were not included in this study. From patient’s history, we comprehended the number of patients who developed postherpetic neuralgia after herpes zoster. Severity of pain was judged by the medications prescribed to the patients. Risk factors like age, gender, co-morbidity and localization were also analyzed. We used multivariate logistic regression to analyze potential risk factors. Risk factors were analyzed in order to determine the frequency of postherpetic neuralgia in herpes zoster patients extensively. This gave us a better idea about postherpetic neuralgia occurrence. Results: Percentage of patients developing postherpetic neuralgia after one month of herpes zoster was 12.7% for age group 50-60. For age group 75-85, this percentage increased up to 26.8%. Neuralgia with severe pain persisted from 9 to 12 months. Mostly patients suffered mild to moderate pain up till 8 months. Patients with ophthalmic localization had 7.6% more chance of developing postherpetic neuralgia than the patients with no localization, after one month of herpes zoster. So, did the patients with co-morbidity. Conclusion: As the results show, postherpetic neuralgia in herpes zoster patients is a frequently occurring condition. The incidence of postherpetic neuralgia increases with age. As the age increases, so does the chance of postherpetic neuralgia in herpes zoster patients. Ophthalmic localization and co-morbidity, i.e. diabetes mellitus and rheumatoid arthritis, are also related to high prevalence of postherpetic neuralgia. Female population also tend to get more postherpetic neuralgia than male population does. Keywords: Postherpetic Neuralgia, Herpes Zoster, Incidence, Risk Factors.

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