Hospital-Acquired Candidemia in HIV-Infected Patients. Incidence, Risk Factors and Predictors of Outcome

OBJECTIVEClostridium difficile infection (CDI) is a common hospital-acquired infection. Previous reports on the incidence, risk factors, and impact of CDI on resources in the surgical population are limited. In this context, we study CDI across diverse surgical settings.METHODSWe prospectively identified patients with laboratory-confirmed postoperative CDI after 40 different general, vascular, or gynecologic surgeries at 52 academic and community hospitals between July 2012 and September 2013. We used multivariable regression models to identify CDI risk factors and to determine the impact of CDI on resource utilization.RESULTSOf 35,363 patients, 179 (0.51%) developed postoperative CDI. The highest rates of CDI occurred after lower-extremity amputation (2.6%), followed by bowel resection or repair (0.9%) and gastric or esophageal operations (0.7%). Gynecologic and endocrine operations had the lowest rates (0.1% and 0%, respectively). By multivariable analyses, older age, chronic immunosuppression, hypoalbuminemia (≤3.5 g/dL), and preoperative sepsis were associated with CDI. Use of prophylactic antibiotics was not independently associated with CDI, neither was sex, body mass index (BMI), surgical priority, weight loss, or comorbid conditions. Three procedure groups had higher odds of postoperative CDI: lower-extremity amputations (adjusted odds ratio [aOR], 3.5; P=.03), gastric or esophageal operations (aOR, 2.1; P=.04), and bowel resection or repair (aOR, 2; P=.04). Postoperative CDI was independently associated with increased length of stay (mean, 13.7 d vs 4.5 d), emergency department presentations (18.9 vs 9.1%) and readmissions (38.9% vs 7.2%, all P<.001).CONCLUSIONSIncidence of postoperative CDI varies by surgical procedure. Postoperative CDI is also associated with higher rates of extended length of stay, emergency room presentations, and readmissions, which places a potentially preventable burden on hospital resources.Infect Control Hosp Epidemiol 2015;36(1): 40–46

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Pneumonia in patients with severe head injury: incidence, risk factors, and outcomes

Journal of Neurosurgery ◽

10.3171/2012.10.jns127 ◽

2013 ◽

Vol 118 (2) ◽

pp. 358-363 ◽

Cited By ~ 10

Author(s):

Kuo-Wei Wang ◽

Han-Jung Chen ◽

Kang Lu ◽

Po-Chou Liliang ◽

Chun-Kai Huang ◽

...

Keyword(s):

Risk Factors ◽

Head Injury ◽

Nasogastric Tube ◽

Bacterial Pneumonia ◽

Severe Head Injury ◽

Injury Incidence ◽

Tube Insertion ◽

Incidence Risk ◽

Hospital Acquired ◽

Nasogastric Tube Insertion

Object The reported incidence of hospital-acquired bacterial pneumonia in critically ill trauma patients varies from as low as 4% to as high as 87%, with fatality rates varying from 6% to 59%. Clinical studies have identified the risk factors for pneumonia. The authors undertook this retrospective study to evaluate the incidence, risk factors, and outcomes of hospital-acquired bacterial pneumonia in a group of patients with severe head injuries. Methods This was a retrospective review of consecutive adult patients admitted to the neurosurgical ICU in the authors' hospital because of severe head injury (Glasgow Coma Scale scores ≤ 8) between January 2008 and December 2010. Results During the study period, 290 patients were admitted to the neurosurgical ICU. Multivariate Cox regression analysis showed that age (HR 1.01, 95% CI 1.001–1.02), nasogastric tube insertion (HR 4.56, 95% CI 1.11–18.64), and hemiplegia or hemiparesis (HR 3.79, 95% CI 2.01–7.17) were significantly associated with the development of pneumonia. Conclusions The authors identified 3 risk factors (age, nasogastric tube insertion, and hemiplegia or hemiparesis) associated with the development of pneumonia in patients with severe head injury. This finding constituted the basis for developing a simple screening tool that can be used to assess the risk of occurrence of pneumonia in such patients.

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Hospital-acquired pneumonia in critically ill children: Incidence, risk factors, outcome and diagnosis with insight on the novel diagnostic technique of multiplex polymerase chain reaction

Egyptian Journal of Medical Human Genetics ◽

10.1016/j.ejmhg.2012.01.002 ◽

2012 ◽

Vol 13 (1) ◽

pp. 99-105 ◽

Cited By ~ 1

Author(s):

Mervat Gamal Eldin Mansour ◽

Sherin Bendary

Keyword(s):

Risk Factors ◽

Multiplex Polymerase Chain Reaction ◽

Diagnostic Technique ◽

Critically Ill Children ◽

The Novel ◽

Chain Reaction ◽

Incidence Risk ◽

Hospital Acquired Pneumonia ◽

Polymerase Chain ◽

Hospital Acquired

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Incidence, Risk Factors, and Mortality From Hospital-Acquired Infections at a Hospital in Mauritius

Cureus ◽

10.7759/cureus.19962 ◽

2021 ◽

Author(s):

Dooshanveer C Nuckchady

Keyword(s):

Risk Factors ◽

Hospital Acquired Infections ◽

Incidence Risk ◽

Hospital Acquired

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Surveillance of surgical site infections to determine incidence, risk factors and microbiologic spectrum following obstetric and gynaecological surgeries

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184124 ◽

2018 ◽

Vol 7 (10) ◽

pp. 4029

Author(s):

Seetha Panicker ◽

T. V. Chitra

Keyword(s):

Risk Factors ◽

Operating Time ◽

Surgical Site Infections ◽

Multidrug Resistant ◽

E Coli ◽

Incidence Risk ◽

Resistant Strains ◽

Prolonged Hospital ◽

Drug Resistant Strains ◽

Hospital Acquired

Background: Surgical site infections (SSI) are one of the major health problems throughout the world with an incidence of 3%-16%. Hospital acquired surgical site infection is further complicated by the emergence of multi drug resistant strains. SSI surveillance is an established monitoring tool and has been shown to reduce infection rates. The importance of preventing surgical site infections is well recognized since they lead to increased morbidity, prolonged hospital stay, need for readmission, high end antibiotic treatment and re-surgery. This study was undertaken to determine the incidence, risk factors, and microbiological spectrum of surgical site infections and to identify the multidrug resistant strains. Analysis of the effectiveness of the existing surveillance methods was also done.Methods: This retrospective study was done for a period of 1-year form Jan 2016 to Dec 2016. All patients with infection following caesarean section and abdominal and vaginal hysterectomy were included. Laparoscopic surgery and patients with preexisting infection were excluded.Results: Incidence of SSI in present study is 5.27%. The major risk factors identified were obesity, diabetes and prolonged operating time. The commonest infective organism was Klebsiella Pneumoniae in 37% of which 19% were ESBL producing and 3.8% were carbapenemase producing. E. coli was identified in 20% of isolates. The incidence of ESBL in both isolates was higher.Conclusions: Regular audit of SSIs is a very effective tool to analyse risk factors, identify causes and plan strategies to prevent infection.

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Incidence, risk factors, and predictors of outcome of candidemia. Survey in 2 Italian university hospitals

Diagnostic Microbiology and Infectious Disease ◽

10.1016/j.diagmicrobio.2007.01.005 ◽

2007 ◽

Vol 58 (3) ◽

pp. 325-331 ◽

Cited By ~ 72

Author(s):

Matteo Bassetti ◽

Enrico Maria Trecarichi ◽

Elda Righi ◽

Maurizio Sanguinetti ◽

Francesca Bisio ◽

...

Keyword(s):

Risk Factors ◽

Predictors Of Outcome ◽

University Hospitals ◽

Incidence Risk

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Incidence, Risk Factors and Impact on Clinical Outcomes of Bloodstream Infections in Patients Hospitalised with COVID-19: A Prospective Cohort Study

Antibiotics ◽

10.3390/antibiotics10091031 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1031

Author(s):

Andrea Cona ◽

Alessandro Tavelli ◽

Andrea Renzelli ◽

Benedetta Varisco ◽

Francesca Bai ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Bloodstream Infections ◽

Corticosteroid Treatment ◽

Risk Of Mortality ◽

Increased Risk ◽

Incidence Risk ◽

Observational Cohort ◽

Healthcare Associated ◽

Hospital Acquired

With the aim of describing the burden and epidemiology of community-acquired/healthcare-associated and hospital-acquired bloodstream infections (CA/HCA-BSIs and HA-BSIs) in patients hospitalised with COVID-19, and evaluating the risk factors for BSIs and their relative impact on mortality, an observational cohort study was performed on patients hospitalised with COVID-19 at San Paolo Hospital in Milan, Italy from 24 February to 30 November 2020. Among 1351 consecutive patients hospitalised with COVID-19, 18 (1.3%) had CA/HCA-BSI and 51 (3.8%) HA-BSI for a total of 82 episodes of BSI. The overall incidence of HA-BSI was 3.3/1000 patient-days (95% CI 2.4–4.2). Patients with HA-BSI had a longer hospital stay compared to CA/HCA-BSI and no-BSI groups (27 (IQR 21–35) vs. 12 (7–29) vs. 9 (5–17) median-days, p < 0.001) but a similar in-hospital mortality (31% vs. 33% vs. 25%, p = 0.421). BSI was not associated with an increased risk of mortality (CA/HCA-BSI vs. non-BSI aOR 1.27 95% CI 0.41–3.90, p = 0.681; HA-BSI vs. non-BSI aOR 1.29 95% CI 0.65–2.54, p = 0.463). Upon multivariate analysis, NIMV/CPAP (aOR 2.09, 95% CI 1.06–4.12, p = 0.034), IMV (aOR 5.13, 95% CI 2.08–12.65, p < 0.001) and corticosteroid treatment (aOR 2.11, 95% CI 1.06–4.19, p = 0.032) were confirmed as independent factors associated with HA-BSI. Development of HA-BSI did not significantly affect mortality. Patients treated with corticosteroid therapy had double the risk of developing BSI.

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