scholarly journals A hospital-based matched case–control study to identify clinical outcome and risk factors associated with carbapenem-resistant Klebsiella pneumoniae infection

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Luci Correa ◽  
Marines Dalla Valle Martino ◽  
Itacy Siqueira ◽  
Jacyr Pasternak ◽  
Ana Cristina Gales ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Clinical Outcome ◽  
Case Control Study ◽  
Case Control ◽  
Factors Associated ◽  
Carbapenem Resistant ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

Outcomes of Carbapenem-Resistant Klebsiella pneumoniae Infection and the Impact of Antimicrobial and Adjunctive Therapies

2008 ◽  
Vol 29 (12) ◽  
pp. 1099-1106 ◽  
Author(s):  
Gopi Patel ◽  
Shirish Huprikar ◽  
Stephanie H. Factor ◽  
Stephen G. Jenkins ◽  
David P. Calfee
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Case Control Study ◽  
Patient Survival ◽  
Case Control ◽  
Factors Associated ◽  
Carbapenem Resistant ◽  
Matched Case ◽  
The Impact ◽  
Control Study

Background.Carbapenem-resistant Klebsiella pneumoniae is an emerging healthcare-associated pathogen.Objective.To describe the epidemiology of and clinical outcomes associated with carbapenem-resistant K. pneumoniae infection and to identify risk factors associated with mortality among patients with this type of infection.Setting.Mount Sinai Hospital, a 1,171-bed tertiary care teaching hospital in New York City.Design.Two matched case-control studies.Methods.In the first matched case-control study, case patients with carbapenem-resistant K. pneumoniae infection were compared with control patients with carbapenem-susceptible K. pneumoniae infection. In the second case-control study, patients who survived carbapenem-resistant K. pneumoniae infection were compared with those who did not survive, to identify risk factors associated with mortality among patients with carbapenem-resistant K. pneumoniae infection.Results.There were 99 case patients and 99 control patients identified. Carbapenem-resistant K. pneumoniae infection was independently associated with recent organ or stem-cell transplantation (P = .008), receipt of mechanical ventilation (P = .04), longer length of stay before infection (P = .01), and exposure to cephalosporins (P = .02) and carbapenems (P < .001). Case patients were more likely than control patients to die during hospitalization (48% vs 20%; P < .001) and to die from infection (38% vs 12%; P < .001). Removal of the focus of infection (ie, debridement) was independently associated with patient survival (P = .002). The timely administration of antibiotics with in vitro activity against carbapenem-resistant K. pneumoniae was not associated with patient survival.Conclusions.Carbapenem-resistant K. pneumoniae infection is associated with numerous healthcare-related risk factors and with high mortality. The mortality rate associated with carbapenem-resistant K. pneumoniae infection and the limited antimicrobial options for treatment of carbapenem-resistant K. pneumoniae infection highlight the need for improved detection of carbapenem-resistant K. pneumoniae infection, identification of effective preventive measures, and development of novel agents with reliable clinical efficacy against carbapenem-resistant K. pneumoniae.

scholarly journals Risk factors of carbapenem-resistant Klebsiella pneumoniae infections: a matched case control study

2007 ◽  
Vol 60 (5) ◽  
pp. 1124-1130 ◽  
Author(s):  
M. E. Falagas ◽  
P. I. Rafailidis ◽  
D. Kofteridis ◽  
S. Virtzili ◽  
F. C. Chelvatzoglou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Case Control Study ◽  
Case Control ◽  
Carbapenem Resistant ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

Risk factors associated with the isolation of colistin-resistant Gram-negative bacteria: A matched case-control study

2008 ◽  
Vol 36 (3) ◽  
pp. 807-811 ◽  
Author(s):  
Dimitrios K. Matthaiou ◽  
Argyris Michalopoulos ◽  
Petros I. Rafailidis ◽  
Drosos E. Karageorgopoulos ◽  
Vassiliki Papaioannou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Case Control ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Factors Associated ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

scholarly journals Risk Factors for Acute Respiratory Infections in Children Between 0 and 23 Months of Age in a Peri-Urban District in Pakistan: A Matched Case–Control Study

2022 ◽  
Vol 9 ◽  
Author(s):  
Fatima Mir ◽  
Shabina Ariff ◽  
Maria Bhura ◽  
Suhail Chanar ◽  
Apsara Ali Nathwani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Case Control Study ◽  
Case Control ◽  
Childhood Mortality ◽  
Urban District ◽  
Factors Associated ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

Background: Acute respiratory infection (ARI) accounts for nearly 15% of all childhood mortality in South Asia, with children from rural areas at higher risk due to inaccessibility to healthcare facilities. We therefore aimed to identify risk factors associated with ARI in children under 2 years of age in rural Pakistan.Methods: A retrospective 1:2 matched case–control study was conducted between October and December 2018 in Taluka Kotri, Jamshoro District of Pakistan. Cases were identified as children between 0 and 23 months of age with a history of fever, cough, sore throat, fast breathing, difficulty breathing, or chest indrawing in the 2 weeks prior to the survey. Controls were participants without symptoms of ARI, matched based on age in months. Data analysis was conducted using STATA version 15. Univariate and multivariable conditional logistic regression analyses were used to identify factors associated with ARI, and p &lt; 0.05 was considered statistically significant.Results: We identified 1,071 cases of ARI who were matched with 2,142 controls. Multivariable analysis revealed that female gender [odds ratio (OR) 0.78, 95% confidence interval (CI): 0.67–0.91], exclusive breastfeeding (OR 0.81, 95% CI: 0.69–0.97), and comorbidity with diarrhea (OR: 1.64, 95% CI: 1.40–1.91) were significantly associated with ARI.Conclusion: Pakistan continues to progress toward reducing childhood mortality, particularly ARI-related deaths, for which it bears a great burden. This study identifies risk factors such as the male gender, breastfeeding, and comorbidities with diarrhea, which could open grounds for further programmatic implications in targeting a multifaceted approach to reducing incidences of ARI in rural areas of the country.

scholarly journals Risk Factors for rectal colonization with carbapenem-resistant Acinetobacter baumannii in hospital: a matched case-control study

2021 ◽  
Author(s):  
marianna meschiari ◽  
Shaniko Kaleci ◽  
Gabriella Orlando ◽  
Silvia Selmi ◽  
Antonella Santoro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Acinetobacter Baumannii ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Control ◽  
Carbapenem Resistant ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

Abstract Background During the last decade carbapenem-resistant Acinetobacter baumannii (CRAB) became hyper-endemic in hospitals due to difficult to control spreading. Our aim is to identify risk factors for nosocomial rectal CRAB colonization in an endemic hospital. Methods A retrospective matched case-control study (ratio 1:2) with a prospective inclusion of cases and concurrent selection of controls was conducted from January 2017 to December 2018 in a tertiary-care hospital. Universal active surveillance for CRAB was implemented. Univariate and multivariate logistic regression was carried out using a stepwise selection method to compare prognostic factors between cases and controls. A sub-analysis was carried out according to the type of department. Results Forty-five cases with nosocomial rectal CRAB colonization and 90 controls were included. One hundred and two (75%) patients were hospitalized in medical departments. At multivariable analysis significant risk factors associated with CRAB colonization were: use of permanent devices (OR: 10.15, 95%CI: 2.27–45.39; P = 0.002), mechanical ventilation (OR: 40.01, 95%CI: 4.05–395.1; P = 0.002), urinary catheters (OR: 4.9, 95%CI:1.52–16.19; P = 0.008), McCabe score (OR: 5.45, 95%CI: 1.87–15.89; P = 0.002), length of stay (OR: 1.03, 95%CI: 1.01–1.05; P = 0.002), carbapenem use (OR: 5.39, 95%CI: 1.14–25.44; P = 0.033). The sub-analysis showed that patients admitted to different departments had different risk factors. In geriatric department a fatal disease and a longer hospital stay represented significant risk factors both in univariate and multivariate analysis, while in internal medicine department the use of permanent devices, current antibiotic therapy and antibiotic polytherapy represented significant risk factors for CRAB at the univariate analysis, also confirmed in multivariate analysis. Conclusions Our data suggest that active surveillance for rectal CRAB colonization should be addressed to patients with an unfavourable prognosis, longer hospitalizations and carriers of multiple devices. To counter CRAB spreading in endemic settings, clinicians must limit the use of carbapenems, and reinforce interventions aimed at proper use of devices.

Sign in / Sign up

Export Citation Format

Share Document