scholarly journals Effect of prior receipt of antibiotics on the pathogen distribution: a retrospective observational cohort study on 27,792 patients

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Leiqing Li ◽  
Lingcheng Xu ◽  
Rongsheng Zhu ◽  
Jiaojiao Song ◽  
Xuanding Wang
Keyword(s):  
Staphylococcus Aureus ◽  
Body Fluid ◽  
Antimicrobial Agents ◽  
Observational Cohort Study ◽  
Urine Samples ◽  
Separation Rate ◽  
Before And After ◽  
Fermenting Bacteria ◽  
Observational Cohort ◽  
Retrospective Observational Cohort Study

Abstract Background There have been no systematic studies of microbiological differences before and after antibiotics treatment. The aim of this study was to evaluate the effect of prior receipt of antibiotics on the microorganism distribution. Methods A retrospective, observational cohort study was conducted in a 3200-bed tertiary, referral, teaching hospital in eastern China. During a 2-year period, all hospitalized patients treated with antimicrobial agents were enrolled in this study. Among 48,692 patients evaluated, the 27,792 (57.1%) who were sampled within 2 days before or after administration of the first dose of antimicrobial agents were included. Distribution of clinical specimens and the microorganism were compared between before and after antibiotic drug treatment groups. Results Compared to specimens taken after antibiotics exposure, specimens taken before antibiotics exposure had a higher proportion of blood and urine specimens and a higher culture positive rate (all P < 0.001). Higher percentages of Staphylococcus aureus (9.9% vs. 8.5%, P = 0.041), non-fermenting bacteria (27.7% vs. 19.9%, P < 0.001), and fungi (8.4% vs. 4.0%, P < 0.001) were isolated from the group after antibiotics exposure, while the percentages of Streptococcus spp. (4.8% vs. 2.7%, P < 0.001), Haemophilus influenzae (2.3% vs. 0.8%, P < 0.001), and Moraxella catarrhalis (0.7% vs. 0.1%, P < 0.001) were higher in the group before antibiotics exposure. Further analysis found significant differences of microbes derived from respiratory secretions, blood or urine samples. We found, after antibiotics exposure, the separation rate of non-fermenting bacteria was significantly increased (all P < 0.05), and the separation rate of Candida spp. was higher, with statistical significance in airway secretion and urine samples (both P < 0.05), but the separation rate of Staphylococcus aureus among the three groups was not affected by antibiotics. In addition, the isolation rate of Streptococcus spp. in blood and urine samples decreased significantly (both P < 0.05) after antibiotics exposure. Interestingly, no statistical difference was found for microbes isolated from body fluid specimens between the two groups. Conclusions The outcome revealed that antibiotic-insensitive organisms such as non-fermentative bacteria and fungi were more frequently isolated after antibiotics exposure. However, this trend might be specimen dependent and was not obvious in body fluid specimens.

scholarly journals Effect of prior receipt of antibiotics on the pathogen distribution: a retrospective observational cohort study on 27 792 patients

2019 ◽  
Author(s):  
Leiqing Li ◽  
Lingcheng Xu ◽  
Rongsheng Zhu ◽  
Jiaojiao Song ◽  
Xuanding Wang
Keyword(s):  
Staphylococcus Aureus ◽  
Body Fluid ◽  
Antimicrobial Agents ◽  
Observational Cohort Study ◽  
Urine Samples ◽  
Separation Rate ◽  
Before And After ◽  
Fermenting Bacteria ◽  
Observational Cohort ◽  
Retrospective Observational Cohort Study

Abstract Background: There have been no systematic studies of microbiological differences before and after antibiotics treatment. The aim of this study was to evaluate the effect of prior receipt of antibiotics on the microorganism distribution. Methods: A retrospective, observational cohort study was conducted in a 3 200-bed tertiary, referral, teaching hospital in eastern China. During a 2-year period, all hospitalized patients treated with antimicrobial agents were enrolled in this study. Among 48 692 patients evaluated, the 27 792 (57.1%) who were sampled within two days before or after administration of the first dose of antimicrobial agents were included. Distribution of clinical specimens and the microorganism were compared between before and after antibiotic drug treatment groups. Results: Compared to specimens taken after antibiotics exposure, specimens taken before antibiotics exposure had a higher proportion of blood and urine specimens and a higher culture positive rate (all P<0.001). Higher percentages of Staphylococcus aureus (9.9% vs. 8.5%, P=0.041), non-fermenting bacteria (27.7% vs. 19.9%, P<0.001), and fungi 8.4% vs. 4.0%, P<0.001) were isolated from the group after antibiotics exposure, while the percentages of Streptococcus spp. (4.8% vs. 2.7%, P<0.001), Haemophilus influenzae (2.3% vs. 0.8%, P<0.001), and Moraxella catarrhalis (0.7% vs. 0.1%, P<0.001) were higher in the group before antibiotics exposure. Further analysis found significant differences of microbes derived from respiratory secretions, blood or urine samples. We found, after antibiotics exposure, the separation rate of non-fermenting bacteria was significantly increased (all P < 0.05), and the separation rate of Candida spp. was higher, with statistical significance in airway secretion and urine samples (both P < 0.05), but the separation rate of Staphylococcus aureus among the three groups was not affected by antibiotics. In addition, the isolation rate of Streptococcus spp. in blood and urine samples decreased significantly (both P < 0.05) after antibiotics exposure. Interestingly, no statistical difference was found for microbes isolated from body fluid specimens between the two groups. Conclusions: The outcome revealed that antibiotic-insensitive organisms such as non-fermentative bacteria and fungi were more frequently isolated after antibiotics exposure. However, this trend might be specimen dependent and was not obvious in body fluid specimens.

scholarly journals Association between visitation restriction during the COVID-19 pandemic and delirium incidence among emergency admission patients: a single-center retrospective observational cohort study in Japan

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Kenji Kandori ◽  
Yohei Okada ◽  
Wataru Ishii ◽  
Hiromichi Narumiya ◽  
Yoshiro Maebayashi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Emergency Services ◽  
Care Center ◽  
Emergency Admission ◽  
Primary Diagnosis ◽  
Observational Cohort Study ◽  
Single Center ◽  
Before And After ◽  
Observational Cohort ◽  
Retrospective Observational Cohort Study

Abstract Aim This study aimed to identify the association between total visitation restriction because of the coronavirus 2019 (COVID-19) pandemic and the incidence of delirium for emergency inpatients. Methods This was a single-center, retrospective, observational cohort study conducted at a tertiary critical care center in urban Kyoto, Japan. Adult emergency patients hospitalized between January 1, 2019, and June 30, 2020, were recruited. In response to the COVID-19 pandemic, the authors’ hospital began restricted visitation on March 28, 2020. This study defined before visitation restriction as January 1, 2019, through March 31, 2020, and after visitation restriction as April 1, 2020, through June 30, 2020. We did not restrict emergency services, and there were no changes in the hospital’s routine, except for visitation restrictions. The primary outcome was the incidence of delirium. The adjusted odds ratio (AOR) with 95% confidence interval (CI) for delirium incidence was calculated to compare the before and after visitation restriction periods, and the logistic model was used to adjust for seven variables: age, sex, ward type on admission, primary diagnosis, ventilator management, general anesthesia surgery, and dementia. Results Study participants were 6264 patients, median age 74 years (56–83), and 3303 men (52.7%). The total delirium incidence in entire research period was 2.5% (158 of 6264 patients), comprising 1.8% (95/5251) before visitation restriction and 6.2% (63/1013) after visitation restriction. The AOR for delirium incidence was 3.79 (95% CI, 2.70–5.31) after visitation restriction versus before visitation restriction. Subgroup analysis showed no apparent interaction for delirium incidence. Conclusion Visitation restriction was associated with an increased incidence of delirium in emergency inpatients.

scholarly journals The Effects of Aspergillus fumigatus Colonization on Lung Function in Patients with Cystic Fibrosis

2021 ◽  
Vol 7 (11) ◽  
pp. 944
Author(s):  
Mahasin Al Shakirchi ◽  
Kimmo Sorjonen ◽  
Lena Klingspor ◽  
Peter Bergman ◽  
Lena Hjelte ◽  
...  
Keyword(s):  
Lung Function ◽  
Aspergillus Fumigatus ◽  
Negative Impact ◽  
Forced Expiratory Volume ◽  
Observational Cohort Study ◽  
Before And After ◽  
Observational Cohort ◽  
The Impact ◽  
Retrospective Observational Cohort Study

Aspergillus fumigatus is commonly isolated from CF airways. However, the impact on CF lung progression is not completely understood. In this study, using a 16-year retrospective observational cohort study (2000–2015) that included 132 patients, we determined the annual lung function, measured as percent predicted forced expiratory volume in the first second (ppFEV1), decline before and after the first colonization with A. fumigatus. Further, in the same individual, the ratios of lung function when patients were colonized with A. fumigatus and when they were not were calculated. The impact of eradication, with antifungal treatment or spontaneously, was assessed. The annual ppFEV1 was significantly lower after the first colonization with A. fumigatus. Furthermore, within the same individual, colonization with A. fumigatus for two and three years in a row was associated with 4.3% and 7.9% lower ppFEV1, respectively, compared to when not colonized. Finally, patients who eradicated A. fumigatus the following two years after colonization exhibited 9.9% and 14.5% higher ppFEV1 compared to patients who continued to produce cultures with A. fumigatus for two and three years. Our study demonstrated that A. fumigatus colonization was associated with a negative impact on lung function in the long term and eradication, spontaneously or with treatment, was associated with a better pulmonary outcome.

scholarly journals Effect of prior receipt of antibiotics on the pathogen distribution: a retrospective observational study on 27 792 patients

2019 ◽  
Author(s):  
Leiqing Li ◽  
Lingcheng Xu ◽  
Rongsheng Zhu ◽  
Jiaojiao Song ◽  
Xuanding Wang
Keyword(s):  
Observational Study ◽  
Body Fluid ◽  
Antimicrobial Agents ◽  
Eastern China ◽  
Fermentative Bacteria ◽  
Antibiotic Drug ◽  
Before And After ◽  
Positive Rate ◽  
Fermenting Bacteria ◽  
Bacteria And Fungi

Abstract Background There have been no systematic studies of microbiological differences before and after antibiotics treatment. The aim of this study was to evaluate the effect of prior receipt of antibiotics on the microorganism distribution.Methods A retrospective, observational study patients was conducted in a 3,200-bed tertiary, referral, teaching hospital in eastern China. During a 2-year period, all hospitalized patients treated with antimicrobial agents were enrolled in this study. Among 48,692 patients evaluated, the 27,792 (57.1%) who were sampled within two days before or after administration of the first dose of antimicrobial agents were included. Distribution of clinical specimens and the microorganism were compared between before and after antibiotic drug treatment groups.Results Compared to specimens taken after antibiotics exposure, specimens taken before antibiotics exposure had a higher proportion of blood and urine specimens and a higher culture positive rate (all P <0.001). Higher percentages of Staphylococcus aureus (9.9% vs. 8.5%, P =0.041), non-fermenting bacteria (27.7% vs. 19.9%, P <0.001), and fungi (7.9% vs. 3.6%, P <0.001) were isolated from the group after antibiotics exposure, while the percentages of Streptococcus spp. (4.8% vs. 2.7%, P <0.001), Haemophilus influenzae (2.3% vs. 0.8%, P <0.001), and Moraxella catarrhalis (0.7% vs. 0.1%, P <0.001) were higher in the group before antibiotics exposure. Further analysis found significant differences or different rank orders of microbes derived from respiratory secretions, blood or urine samples, but no statistical difference was found for microbes isolated from body fluid specimens between the two groups.Conclusions The outcome revealed that antibiotic-insensitive organisms such as non-fermentative bacteria and fungi were more frequently isolated after antibiotics exposure. However, this trend might be specimen dependent and was not obvious in body fluid specimens.

scholarly journals Association between visitation restriction during COVID-19 pandemic and delirium incidence among emergency admission patients: a single-center retrospective observational cohort study in Japan

2020 ◽  
Author(s):  
Kenji Kandori ◽  
Yohei Okada ◽  
Wataru Ishii ◽  
Hiromichi Narumiya ◽  
Yoshiro Maebayashi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Emergency Services ◽  
Care Center ◽  
Emergency Admission ◽  
Primary Diagnosis ◽  
Observational Cohort Study ◽  
Single Center ◽  
Before And After ◽  
Observational Cohort ◽  
Retrospective Observational Cohort Study

Abstract Background: The purpose of this study was to identify the association between total visitation restriction because of the coronavirus 2019 (COVID-19) pandemic and the incidence of delirium for emergency inpatients.Methods: This was a single-center, retrospective, observational, cohort study that was carried out at a tertiary critical care center in urban Kyoto, Japan. Adult emergency patients hospitalized between January 1, 2019, and June 30, 2020 were recruited for this study. In response to the COVID-19 pandemic, the authors’ hospital began restricted visitation on March 28, 2020. This study defined before visitation restriction as January 1, 2019, through March 31, 2020, and after visitation restriction as April 1, 2020, through June 30, 2020. We did not restrict emergency services and there were no changes in the hospital’s routine, except for visitation restrictions. The primary outcome was the incidence of delirium. The adjusted odds ratio (AOR) with 95% confidence interval (CI) for delirium incidence was calculated to compare the before and after visitation restriction periods, and the logistic model was used to adjust for seven variables: age, sex, ward type on admission, primary diagnosis, ventilator management, general anesthesia surgery, and dementia. Results: Study participants were 6264 patients; median age 74 years (56–83); and 3303 men (52.7%). The total delirium incidence in entire research period was 2.5% (158 of 6264 patients), comprising 1.8% (95/5251) before visitation restriction and 6.2% (63/1013) after visitation restriction. The AOR for delirium incidence was 3.79 (95% CI, 2.70–5.31) after visitation restriction versus before visitation restriction. Subgroup analysis showed no apparent interaction for delirium incidence.Conclusion: Visitation restriction was associated with an increased incidence of delirium in emergency inpatients.

scholarly journals Disorders of placental villous maturation in fetal death

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Sunil Jaiman ◽  
Roberto Romero ◽  
Percy Pacora ◽  
Eunjung Jung ◽  
Gaurav Bhatti ◽  
...  
Keyword(s):  
Cohort Study ◽  
Fetal Death ◽  
Prevalence Ratio ◽  
Normal Pregnancy ◽  
Observational Cohort Study ◽  
Maturation Arrest ◽  
Inflammatory Lesions ◽  
Multiple Gestations ◽  
Observational Cohort ◽  
Retrospective Observational Cohort Study

Abstract Objective The aims of this study were to ascertain the frequency of disorders of villous maturation in fetal death and to also delineate other placental histopathologic lesions in fetal death. Methods This was a retrospective observational cohort study of fetal deaths occurring among women between January 2004 and January 2016 at Hutzel Women’s Hospital, Detroit, MI, USA. Cases comprised fetuses with death beyond 20 weeks’ gestation. Fetal deaths with congenital anomalies and multiple gestations were excluded. Controls included pregnant women without medical/obstetrical complications and delivered singleton, term (37–42 weeks) neonate with 5-min Apgar score ≥7 and birthweight between the 10th and 90th percentiles. Results Ninety-two percent (132/143) of placentas with fetal death showed placental histologic lesions. Fetal deaths were associated with (1) higher frequency of disorders of villous maturation [44.0% (64/143) vs. 1.0% (4/405), P < 0.0001, prevalence ratio, 44.6; delayed villous maturation, 22% (31/143); accelerated villous maturation, 20% (28/143); and maturation arrest, 4% (5/143)]; (2) higher frequency of maternal vascular malperfusion lesions [75.5% (108/143) vs. 35.7% (337/944), P < 0.0001, prevalence ratio, 2.1] and fetal vascular malperfusion lesions [88.1% (126/143) vs. 19.7% (186/944), P < 0.0001, prevalence ratio, 4.5]; (3) higher frequency of placental histologic patterns suggestive of hypoxia [59.0% (85/143) vs. 9.3% (82/942), P < 0.0001, prevalence ratio, 6.8]; and (4) higher frequency of chronic inflammatory lesions [53.1% (76/143) vs. 29.9% (282/944), P < 0.001, prevalence ratio 1.8]. Conclusion This study demonstrates that placentas of womem with fetal death were 44 times more likely to present disorders of villous maturation compared to placentas of those with normal pregnancy. This suggests that the burden of placental disorders of villous maturation lesions is substantial.

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