scholarly journals Analysis of fungal bloodstream infection in intensive care units in the Meizhou region of China: species distribution and resistance and the risk factors for patient mortality

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Guangwen Xiao ◽  
Wanqing Liao ◽  
Yuenong Zhang ◽  
Xiaodong Luo ◽  
Cailing Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Species Distribution

scholarly journals Healthcare-Associated Infections in Pediatric and Neonatal Intensive Care Units: Impact of Underlying Risk Factors and Antimicrobial Resistance on 30-Day Case-Fatality in Italy and Brazil

2016 ◽  
Vol 37 (11) ◽  
pp. 1302-1309 ◽  
Author(s):  
Laura Folgori ◽  
Paola Bernaschi ◽  
Simone Piga ◽  
Michaela Carletti ◽  
Filippe Pirrone Cunha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Case Fatality ◽  
Neonatal Intensive Care Units ◽  
Healthcare Associated Infections ◽  
Day Case ◽  
Healthcare Associated

OBJECTIVESTo describe trends in the epidemiology of healthcare-associated Infections (HAIs) in pediatric/neonatal intensive care units (ICUs) and to evaluate risk factors and impact of multidrug resistance in children admitted to ICUs.DESIGNMulticenter, retrospective, cohort study with a nested case-control study conducted from January 1, 2010, through December 31, 2014.SETTINGThree tertiary care pediatric hospitals in Italy and Brazil with a total of 103 ICU beds.PATIENTSInclusion criteria were admission to ICU during the study period, age at onset less than 18 years, and microbiologically confirmed HAI.RESULTSA total of 538 HAIs in 454 children were included; 93.3% of patients had comorbidities. Bloodstream infections were the leading pattern (45.4%). The cumulative incidence of HAI was 3.6/100 ICU admissions and the crude 30-day fatality rate was 5.7/1,000 admissions. The most frequently isolated pathogens were Enterobacteriaceae, followed by Pseudomonas aeruginosa and Staphylococcus aureus. Forty-four percent of isolates were multidrug-resistant (MDR). Two multivariate logistic regressions were performed. Factors independently associated with an MDR-HAI were country, previous antibiotics, transplantation, major surgery, and colonization by an MDR strain. Factors independently associated with 30-day case fatality were country, previous transplantation, fungal infection, bloodstream infection, lower respiratory tract infection, and infection caused by MDR strains.CONCLUSIONSInfection control and prevention can limit the spread of MDR strains and improve outcomes. Targeted surveillance programs collecting neonatal and pediatric HAI/bloodstream infection data and outcomes would allow global benchmarking. The next step is to identify methods to monitor key HAIs and integrate these into affordable intervention programs.Infect Control Hosp Epidemiol 2016;1–8

Risk factors for noncatheter-related Candida bloodstream infections in intensive care units: A multicenter case-control study

2018 ◽  
Vol 57 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Ferhat Arslan ◽  
Hulya Caskurlu ◽  
Sema Sarı ◽  
Hayriye Cankar Dal ◽  
Sema Turan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Case Control Study ◽  
Absolute Risk ◽  
Subsequent Development ◽  
Bloodstream Infections ◽  
Case Control ◽  
Prior Exposure ◽  
Control Study

Abstract Candida bloodstream infections are associated with high mortality among critically ill patients in intensive care units (ICUs). Studies that explore the risk factors for candidemia may support better patient care in intensive care units. We conducted a retrospective, multicenter case-control study to investigate the risk factors for noncatheter-related Candida bloodstream infections (CBSI) in adult ICUs. Participants selected controls randomly on a 1:1 basis among all noncase patients stayed during the same period in ICUs. Data on 139 cases and 140 controls were deemed eligible. Among the controls, 69 patients died. The stratified Fine-Gray model was used to estimate the subdistribution Hazard ratios. The subdistribution hazards and 95% confidence intervals for final covariates were as follows: prior exposure to antimycotic agents, 2.21 (1.56–3.14); prior exposure to N-acetylcysteine, 0.11 (0.03–0.34) and prior surgical intervention, 1.26 (0.76–2.11). Of the patients, those exposed to antimycotic drugs, 87.1% (54/62) had breakthrough candidemia. Serious renal, hepatic, or hematologic side effects were comparable between patients those exposed and not-exposed to systemic antimycotic drugs. Untargeted administration of antimycotic drugs did not improve survival among candidemic patients (not-exposed, 63.6% [49/77]; exposed % 66.1 [41/62]; P = .899). This study documented that exposure to an antifungal agent is associated with increased the risk of subsequent development of CBSIs among nonneutropenic adult patients admitted to the ICU. Only two centers regularly prescribed N-acetylcysteine. Due to the limited number of subjects, we interpreted the positive effect of N-acetylcysteine on the absolute risk of CBSIs with caution.

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