scholarly journals Evaluation of Risk Factors for Antibiotic Resistance in Patients with Nosocomial Infections Caused byPseudomonas aeruginosa

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Meliha Cagla Sonmezer ◽  
Gunay Ertem ◽  
Fatma Sebnem Erdinc ◽  
Esra Kaya Kilic ◽  
Necla Tulek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nosocomial Infection ◽  
Nosocomial Infections ◽  
Univariate Analysis ◽  
High Morbidity ◽  
Retrospective Case ◽  
Development Of Resistance ◽  
Independent Risk Factors ◽  
Imipenem Resistance ◽  
Control Study

Background.Pseudomonas aeruginosa(P. aeruginosa) is resistant to various antibiotics and can cause serious nosocomial infections with high morbidity and mortality. In this clinical study, we investigated the risk factors in patients who were diagnosed withP. aeruginosa-related nosocomial infection.Methods. A retrospective case control study including patients withP. aeruginosa-related nosocomial infection. Patients who were resistant to any of the six antibiotics (imipenem, meropenem, piperacillin-tazobactam, ciprofloxacin, amikacin, and ceftazidime) constituted the study group.Results. One hundred and twenty isolates were isolated. Various risk factors were detected for each antibiotic in the univariate analysis. In the multivariate analysis, previous cefazolin use was found as an independent risk factor for the development of imipenem resistance (OR = 3.33; CI 95% [1.11–10.0];p= 0.03), whereas previous cerebrovascular attack (OR = 3.57; CI 95% [1.31–9.76];p= 0.01) and previous meropenem use (OR = 4.13; CI 95% [1.21–14.07];p= 0.02) were independent factors for the development of meropenem resistance. For the development of resistance to ciprofloxacin, hospitalization in the neurology intensive care unit (OR = 4.24; CI 95% [1.5–11.98];p= 0.006) and mechanical ventilator application (OR = 11.7; CI 95% [2.24–61.45];p= 0.004) were independent risk factors.Conclusion. The meticulous application of contact measures can decrease the rate of nosocomial infections.

Risk factors and outcomes of management of delayed suprachoroidal haemorrhage following Ahmed glaucoma valve implantation in children

2019 ◽  
Vol 104 (1) ◽  
pp. 115-120 ◽  
Author(s):  
Shantha Balekudaru ◽  
Tamonash Basu ◽  
Parveen Sen ◽  
Pramod Bhende ◽  
Vijaya Lingam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Univariate Analysis ◽  
Congenital Glaucoma ◽  
Ahmed Glaucoma Valve ◽  
Retrospective Case ◽  
Incidence Risk ◽  
Valve Implantation ◽  
Ahmed Glaucoma Valve Implantation ◽  
Control Study

AimsTo assess the incidence, risk factors and outcomes of management of delayed suprachoroidal haemorrhage (DSCH) in children who had undergone Ahmed glaucoma valve implantation.MethodsA retrospective case-control study of eyes which developed DSCH in children <18 years of age who underwent surgery between January 2009 and December 2017 with a follow-up of at least 2 months was performed. Nine cases were compared with 27 age, gender and surgeon matched controls who had undergone surgery during this period.ResultsThe incidence of DSCH was 4.7% (95% CL 1.5% to 7.7%, 9 eyes of 191 children). There were no significant differences between cases and controls in baseline details except for the number of intraocular pressure (IOP) lowering medications (p=0.01) and follow-up period (p=0.001). Risk factors identified on univariate analysis (p≤0.1) were axial length (p=0.02), diagnosis of primary congenital glaucoma (p=0.05), postoperative hypotony (p=0.07) and aphakia (p=0.1). None of them were found to be significant on multivariate analysis. Five eyes, three with retinal apposition and two with retinal detachment, underwent surgical drainage. There were no significant differences in the outcomes of eyes which underwent drainage compared with those which did not. Failures, defined as IOP>18 mm Hg despite use of medications, loss of light perception, phthisis or removal of the implant were more frequent in cases (three eyes, 33.3%) compared with controls (four eyes, 14.8%) (p=0.002).ConclusionsNone of the risk factors analysed in our series proved to be significant. Failures were more common in eyes with choroidal haemorrhage, despite surgical intervention.

Epidemiology of Vancomycin-Resistant Enterococci with Reduced Susceptibility to Daptomycin

2012 ◽  
Vol 33 (12) ◽  
pp. 1250-1254 ◽  
Author(s):  
Theresa Judge ◽  
Jason M. Pogue ◽  
Dror Marchaim ◽  
Kevin Ho ◽  
Srinivasa Kamatam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Case Control ◽  
Prior Exposure ◽  
Comorbid Conditions ◽  
Retrospective Case ◽  
Vancomycin Resistant Enterococci ◽  
Independent Risk Factors ◽  
Vancomycin Resistant ◽  
Control Study

A retrospective case–case control study was conducted, including 60 cases with daptomycin-nonsusceptible vancomycin-resistant enterococci (DNS-VRE) matched to cases with daptomycin-susceptible VRE and to uninfected controls (1:1:3 ratio). Immunosuppression, presence of comorbid conditions, and prior exposure to antimicrobials were independent predictors of DNS-VRE, although prior daptomycin exposure occurred rarely. In summary, a case–case control study identified independent risk factors for the isolation of DNS-VRE: immunosuppression, multiple comorbid conditions, and prior exposures to cephalosporines and metronidazole.

scholarly journals 2283. The Incidence and Risk Factors for Neurotoxicity in Patients on Ertapenem Therapy: a Retrospective Case- Control Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S782-S782 ◽  
Author(s):  
Raymond K C Fong ◽  
Stephen G Donoghue ◽  
Humaira Shafi ◽  
Seow Yen Tan ◽  
Wee Boon Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Impairment ◽  
Univariate Analysis ◽  
Outpatient Setting ◽  
Retrospective Case ◽  
Neurotoxic Effects ◽  
Gram Negative Bacteremia ◽  
History Of ◽  
Baseline Characteristics ◽  
Control Study

Abstract Background Numerous reports have emerged about the neurotoxic effects of ertapenem. A recent study supports carbapenem use for the treatment of extended spectrum β-lactamase (ESBL)- producing Gram-negative bacteremia. This will likely bolster the use of ertapenem as it is a convenient choice to complete antibiotic treatment in an outpatient setting. This study aims to review the incidence of neurotoxicity with ertapenem and the risk factors associated with it. Methods A retrospective nested cohort study was conducted in Changi General Hospital in Singapore from January 2015 to Decemeber 2016. All patients who received at least 24 hours of ertapenem were identified. Those who exhibited ertapenem-associated neurotoxic effects were selected as cases while those who did not were included in the pool of controls and randomly selected at a 1:3 ratio. Results A total of 544 patients were treated with ertapenem in our hospital during this 2-year period. Twenty-five patients (incidence 4.6%) developed neurotoxic manifestations and 75 patients were included as controls. Acute confusion was the commonest reaction (n = 19, 76%) followed by hallucinations (n = 8, 32%) and seizures (n = 5, 20%). Baseline characteristics were similar in both groups; the median age of the cases was 79 years (IQR 71–83 years) and 14 (56%) were males. The median duration of ertapenem use before neurotoxicity occurred was 7 days (IQR 5–11days). The median Naranjo ADR probability score for cases was 7 (range 5 to 7) which suggests a probable relationship. Univariate analysis showed that renal impairment (with CrCl< 60 mL/minute) (OR 3.31, 95% CI 1.03–10.64), a history of a vulnerable brain (including stroke and epilepsy etc)(OR 2.61 95% CI 1.03–6.61) increased the risk of neurotoxicity. Neurotoxicity was also significantly associated with longer hospitalization (median 21 days, p = 0.03). Conclusion Our study suggests that renal impairment or a history of vulnerable brain may increase the risk for ertapenem-associated neurotoxicity. Hence, caution should be exercised when ertapenem is used to treat these individuals. Future prospective studies to further evaluate risk and to derive a prediction scoring system may help to reduce the incidence of neurotoxic adverse events with ertapenem use. Disclosures All authors: No reported disclosures.

scholarly journals Risk factors for postoperative meningitis after microsurgery for vestibular schwannoma

2019 ◽  
Author(s):  
Bowen Huang ◽  
Yanming Ren ◽  
Chenghong Wang ◽  
Zhigang Lan ◽  
Xuhui Hui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vestibular Schwannoma ◽  
Univariate Analysis ◽  
High Morbidity ◽  
Intraoperative Bleeding ◽  
Bleeding Volume ◽  
Independent Risk Factors ◽  
Postoperative Meningitis ◽  
Prolonged Hospital ◽  
Duration Of Operation

AbstractOBJECTIVEMeningitis after microsurgery for vestibular schwannoma (VS) is a severe complication and result in high morbidity. But few studies have focused on meningitis after VS surgery alone. The purpose of this study was to identify the risk factors for meningitis after VS surgery.METHODSWe undertook a retrospective analysis of all VS patients, who underwent microsurgery of VS and at least live for 7 days after surgery, between 1st June 2015 and 30st November 2018 at West China Hospital of Sichuan University. Univariate and multivariate analyses were performed to identify the risk factors for postoperative meningitis (POM).RESULTSWe collected 410 patients, 27 of whom had POM. Through univariate analysis, hydrocephalus (p=0. 018), Koos grade IV (p=0.04), The operative duration (> 3 hours p=0.03) and intraoperative bleeding volume (≥ 400ml p=0. 02) were significantly correlated to POM. Multivariate analysis showed that Koos grade IV (p=0.04; OR=3.19; 95% CI 1.032-3.190), operation duration (> 3 hours p=0.03 OR= 7.927; 95% CI 1.043-60.265), and intraoperative bleeding volume (≥ 400ml p=0.02; OR=2.551; 95% CI 1.112-5.850) are the independent influencing factors of POM.CONCLUSIONSKoos grade IV, the duration of operation, and the amount of bleeding were identified as independent risk factors for POM after microsurgery of VS. POM caused a prolonged hospital stay.

scholarly journals Pathophysiology and Risk Factors for Cholelithiasis in Patients with Crohn’s Disease

2019 ◽  
pp. S173-S182
Author(s):  
I. STURDIK ◽  
A. KRAJCOVICOVA ◽  
Y. JALALI ◽  
M. ADAMCOVA ◽  
M. TKACIK ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Parenteral Nutrition ◽  
Univariate Analysis ◽  
Abdominal Ultrasound ◽  
Control Group ◽  
Healthy Population ◽  
Retrospective Case ◽  
Independent Risk Factors

Cholelithiasis is more common in patients with Crohn’s disease (CD) than in the healthy population. The aim here was to examine risk factors for cholelithiasis in a cohort of CD patients and to compare the prevalence of cholelithiasis in a cohort of CD patients with that in a control group. This was a single-center retrospective case-control study. The cohort comprised all consecutive CD patients who underwent abdominal ultrasound from January 2007 to January 2018. The control group comprised age- and gender-matched non-CD patients referred for upper gastrointestinal tract dyspepsia. The study included 238 CD patients and 238 controls. The prevalence of cholelithiasis in the CD and control groups was 12.6 % and 9.2 %, respectively (risk ratio (RR), 1.36; p=0.24). Univariate analysis revealed that cholelithiasis was associated with multiple risk factors. Multivariate analysis identified age (OR, 1.077; 95 % CI, 1.043–1.112; p<0.001) and receipt of parenteral nutrition (OR, 1.812; 95 % CI, 1.131–2.903; p=0.013) as independent risk factors for cholelithiasis in CD patients. The prevalence of cholelithiasis in CD patients was higher than that in the control group; however, the difference was not statistically significant. Age and receipt of parenteral nutrition were independent risk factors for cholelithiasis in CD patients.

scholarly journals Risk factors of carbapenem-resistant Enterobacteriaceae infection and colonisation: a Malaysian tertiary care hospital based case-control study

2021 ◽  
Vol 51 (1) ◽  
pp. 24-30
Author(s):  
Chuan Chuah ◽  
◽  
Yasmin Gani ◽  
Benedict Sim ◽  
Suresh Chidambaram
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Case Control ◽  
High Morbidity ◽  
Care Hospital ◽  
Carbapenem Resistant ◽  
Control Study ◽  
Carbapenem Resistant Enterobacteriaceae

Background Carbapenem-resistant Enterobacteriaceae (CRE) infection has become a major challenge to clinicians. The aim of this study is to identify the risk factors of acquiring CRE to guide more targeted screening for hospital admissions. Methods This is a retrospective case-control study (ratio 1:1) where a patient with CRE infection or colonisation was matched with a control. The control was an individual who tested negative for CRE but was a close contact of a patient testing positive and was admitted at the same time and place. Univariate and multivariate statistical analyses were done. Results The study included 154 patients. The majority of the CRE was Klebsiella species (83%). From univariate analysis, the significant risk factors were having a history of indwelling devices (OR: 2.791; 95% CI: 1.384–5.629), concomitant other MDRO (OR: 2.556; 95% CI: 1.144–5.707) and hospitalisation for more than three weeks (OR: 2.331; 95% CI: 1.163–4.673). Multivariate analysis showed that being unable to ambulate on admission (adjusted OR: 2.345; 95% CI: 1.170–4.699) and antibiotic exposure (adjusted OR: 3.515; 95% CI: 1.377–8.972) were independent predictors. The in-hospital mortality rate of CRE infection was high (64.5%). CRE acquisition resulted in prolonged hospitalisation (median=35 days; P<0.001). Conclusion CRE infection results in high morbidity and mortality. On top of the common risk factors, patients with mobility restriction, prior antibiotic exposures and hospitalisation for more than three weeks should be prioritised in the screening strategy to control the spread of CRE.

scholarly journals Risk factors of nosocomial infections caused by piperacillin-tazobactam resistant Pseudomonas aeruginosa

2013 ◽  
Vol 141 (9-10) ◽  
pp. 640-647 ◽  
Author(s):  
Zorana Djordjevic ◽  
Olgica Gajovic ◽  
Zeljko Mijailovic ◽  
Aleksandra Ilic ◽  
Radojica Stolic
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Nosocomial Infections ◽  
Hospitalized Patients ◽  
Serious Infections ◽  
Clinical Centre ◽  
Independent Risk Factors ◽  
Hospital Morbidity ◽  
Tract Infections ◽  
Control Study

Introduction. Pseudomonas aeruginosa is a common cause of serious infections in hospitalized patients and is associated with high rates of hospital morbidity and mortality. Objective. The aim of this study was to identify the risk factors of nosocomial infections caused by piperacillin?tazobactam? resistant P. aeruginosa (PT?RPA). Methods. A case?control study was conducted in the Clinical Centre Kragujevac from January 2010 to December 2011. Results. In the observed period, 79 (38.16%) patients had PT? RPA infections, while 128 (61.84%) patients had infections caused by piperacillin?tazobactam?sensitive P. aeruginosa (PT?SPA). Pneumonia was more frequently found in the PT?RPA group (55.70%) (p<0.05), whereas urinary tract infections were more frequent in the group of patients with PT?SPA infections (26.56%) (p<0.01). Multivariate analysis was used to identify an injury on admission (OR=3.089; 95%CI=1.438?6.635; p=0.004), administration of imipenem (OR=15.027; 95%CI=1.778? 127.021; p=0.013), meropenem (OR=2.618; 95%CI=1.030? 6.653; p=0.043), ciprofloxacin (OR=3.380; 95%CI=1.412?8.090; p=0.006), vancomycin (OR=4.294; 95%CI=1.477?12.479; p=0.007), piperacillin?tazobactam (OR=4.047; 95%CI=1.395?11.742; p=0. 010) as independent risk factors associated with PT?RPA infection. Conclusion. In hospitalized patients, the risk of PT?RPA infections is associated with previous administration of imipenem, meropenem, ciprofloxacin, vancomycin, piperacillin?tazobactam, and the presence of injury on admission.

scholarly journals Risk Factors for Resistance to β-Lactam/β-Lactamase Inhibitors and Ertapenem in Bacteroides Bacteremia

2015 ◽  
Vol 59 (8) ◽  
pp. 5049-5051 ◽  
Author(s):  
Janessa M. Smith ◽  
Edina Avdic ◽  
Pranita D. Tamma ◽  
Long Zhang ◽  
Karen C. Carroll ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Medical Center ◽  
Tertiary Care ◽  
Case Control ◽  
Retrospective Case ◽  
Content Type ◽  
Development Of Resistance ◽  
Tertiary Care Medical Center ◽  
Control Study

ABSTRACTThe objective of this study was to determine risk factors for the development of resistance to β-lactams/β-lactamase inhibitors (βL/βLIs) and ertapenem amongBacteroidesspecies bacteremia. We conducted a retrospective case-control study of 101 adult patients withBacteroidesspecies bacteremia at a 1,051-bed tertiary care medical center. The duration of exposure to βL/βLIs (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.08 to 2.31) was the only independent risk factor for resistance.

scholarly journals Risk factors for suicidal tendency in people with epilepsy in China: a case–control study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mintao Lin ◽  
Jiani Chen ◽  
Sisi Li ◽  
Yingjie Qin ◽  
Xuruan Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Case Control Study ◽  
Univariate Analysis ◽  
Case Control ◽  
Conditional Inference ◽  
Suicidal Tendency ◽  
Patients With Epilepsy ◽  
Nested Case Control ◽  
Control Study

AbstractPeople with epilepsy (PWE) have an increased suicide prevalence. This study aimed to identify the risk factors for suicidal tendency among PWE in West China. A nested case–control study was designed in a cohort of patients with epilepsy (n = 2087). In total, 28 variates were calculated. In the univariate analysis, unemployment, low income, seizure frequency, seizure-free time, infectious or structural etiology, levetiracetam or phenobarbital use, anxiety, depression, and stigma were associated with suicidal tendency. A multivariate analysis indicated that unemployment (odds ratio [OR] 5.74, 95% confidence interval [CI] 2.13–15.48), levetiracetam use (OR 2.80, 95%CI 1.11–7.05), depression (C-NDDI-E score ≥ 13; OR 3.21, 95%CI 1.26–8.21), and stigma (SSCI score ≥ 16; OR 6.67, 95%CI 1.80–24.69) were independently associated with suicidal tendency. Conditional inference tree analysis indicated that SSCI and C-NDDI-E scores could effectively identify patients with suicidal tendency. Thus, this study suggests that unemployment, levetiracetam use, depression, and stigma are independent risk factors for suicidal tendency in PWE in China.

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