scholarly journals Epidemiology, species distribution, and outcome of nosocomial Candida spp. bloodstream infection in Shanghai: an 11-year retrospective analysis in a tertiary care hospital

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yan-Jun Zheng ◽  
Ting Xie ◽  
Lin Wu ◽  
Xiao-Ying Liu ◽  
Ling Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Antifungal Therapy ◽  
Species Distribution ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Severity ◽  
Severe Neutropenia ◽  
Care Hospital ◽  
The Impact

Abstract Background The incidence of Candida bloodstream infections (BSIs), has increased over time. In this study, we aimed to describe the current epidemiology of Candida BSI in a large tertiary care hospital in Shanghai and to determine the risk factors of 28-day mortality and the impact of antifungal therapy on clinical outcomes. Methods All consecutive adult inpatients with Candida BSI at Ruijin Hospital between January 1, 2008, and December 31, 2018, were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and their impact on the outcomes were analyzed. Results Among the 370 inpatients with 393 consecutive episodes of Candida BSI, the incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients. Of the 393 cases, 299 (76.1%) were treated with antifungal therapy (247 and 52 were treated with early appropriate and targeted antifungal therapy, respectively). The overall 28-day mortality rate was 28.5%, which was significantly lower in those who received early appropriate (25.5%) or targeted (23.1%) antifungal therapy than in those who did not (39.4%; P = 0.012 and P = 0.046, respectively). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, and severe neutropenia were found to be independent risk factors of the 28-day mortality rate. Patients who received antifungal therapy had a lower mortality risk than did those who did not. Conclusions The incidence of Candida BSI has increased steadily in the past 11 years at our tertiary care hospital in Shanghai. Antifungal therapy influenced short-term survival, but no significant difference in mortality was observed between patients who received early appropriate and targeted antifungal therapy.

scholarly journals Epidemiology, species distribution, and outcome of nosocomial Candida spp. bloodstream infection in Shanghai — An 11-year retrospective analysis in a tertiary care hospital

2021 ◽  
Author(s):  
Yanjun Zheng ◽  
Ting Xie ◽  
Lin Wu ◽  
Xiaoying Liu ◽  
Ling Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Antifungal Therapy ◽  
Species Distribution ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Severity ◽  
Severe Neutropenia ◽  
Care Hospital ◽  
The Impact

Abstract Background The incidence of Candida bloodstream infections (BSIs), has increased over time. In this study, we aimed to describe the current epidemiology of Candida BSI in a large tertiary care hospital in Shanghai and to determine the risk factors of 28-day mortality and the impact of antifungal therapy on clinical outcomes. Methods All consecutive adult inpatients with Candida BSI at Ruijin Hospital between January 1, 2008 and December 31, 2018 were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and their impact on the outcomes were analyzed. Results Among the 370 inpatients with 393 consecutive episodes of Candida BSI, the incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients. Of the 393 cases, 299 (76.1%) were treated with antifungal therapy (247 and 52 were treated with early appropriate and targeted antifungal therapy, respectively). The overall 28-day mortality rate was 28.5%, which was significantly lower in those who received early appropriate (25.5%) or targeted (23.1%) antifungal therapy than in those who did not (39.4%; P=0.012 and P=0.046, respectively). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, and severe neutropenia were found to be independent risk factors of 28-day mortality rate. Patients who received antifungal therapy had a lower mortality risk than did those who did not.Conclusions The incidence of Candida BSI has increased steadily in the past 11 years at our tertiary care hospital in Shanghai. Antifungal therapy influenced short-term survival, but no significant difference in mortality was observed between patients who received early appropriate and targeted antifungal therapy.

scholarly journals Epidemiology, Species Distribution, and Outcome of Nosocomial Candida spp. Bloodstream Infection in Shanghai — An 11-year Retrospective Analysis in a Tertiary Care Hospital

2021 ◽  
Author(s):  
Yan-Jun ZHENG ◽  
Ting XIE ◽  
Lin WU ◽  
Xiao-Ying LIU ◽  
Ling ZHU ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Antifungal Therapy ◽  
Species Distribution ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Severity ◽  
Care Hospital ◽  
Significant Difference ◽  
The Impact

Abstract BackgroundThe incidence of Candida bloodstream infections (BSIs), has increased over time. In this study, we aimed to describe the current epidemiology of Candida BSI in a large tertiary care hospital in Shanghai and to determine the risk factors of 28-day mortality and the impact of antifungal therapy on clinical outcomes. MethodsAll consecutive adult inpatients with Candida BSI at Ruijin Hospital from 2008.1 to 2018.12 were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and their impact on the outcomes were analyzed. ResultsAmong the 370 inpatients with 393 consecutive episodes of Candida BSI, the incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients. Of the 393 cases, 299 (76.1%) were treated with antifungal therapy (247 and 52 were treated with early appropriate and targeted antifungal therapy, respectively). The overall 28-day mortality rate was 28.5%, which was significantly lower in those who received early appropriate (25.5%) or targeted (23.1%) antifungal therapy than in those who did not (39.4%; P=0.012 and P=0.046, respectively). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, and neutropenia were found to be independent risk factors of 28-day mortality rate. Patients who received antifungal therapy had a lower mortality risk than did those who did not.ConclusionsThe incidence of Candida BSI has increased steadily in the past 11 years at our tertiary care hospital in Shanghai. Antifungal therapy influenced short-term survival, but no significant difference in mortality was observed between those who received early appropriate and targeted antifungal therapy.

scholarly journals Epidemiology, species distribution and outcome of nosocomial Candida spp. bloodstream infection in Shanghai — A retrospective of 11-year clinical analysis in a shanghai tertiary hospital

2020 ◽  
Author(s):  
yanjun Zheng ◽  
xie Ting ◽  
lin Wu ◽  
xiaoying Liu ◽  
ling Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Antifungal Therapy ◽  
Species Distribution ◽  
Clinical Severity ◽  
Care Hospital ◽  
Short Term ◽  
Candida Spp ◽  
Term Survival ◽  
Short Term Survival

Abstract Background: Candida spp. are important opportunist pathogens causing bloodstream infections (BSIs). The present study aims to describe the current epidemiology of Candida BSI in a large Shanghai Tertiary-care Hospital from 2008 to 2018, and to identify the risk factors and the impact of antifungal therapy on clinical outcome.Methods: From January 2008 to December 2018, all consecutive patients who developed Candida BSI at Ruijin Hospital were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy and its impact on the outcome were analyzed.Results: The incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients, and overall 30-day mortality rate was 28.5%. Among the 393 cases of Candida BSI, 299 cases (76.1%) received antifungal therapy. 247 received appropriate antifungal therapy, and 52 received delayed antifungal therapy (5 days after onset of Candida BSI). The 30-day mortality rate was significantly lower in those who received appropriate antifungal therapy or delayed antifungal therapy compared with those who did not receive antifungal therapy (25.5% and 23.1% vs. 39.4%，P=0.012 and P=0.046). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, neutropenia were independent risk factors for the 30-day mortality rate, while antifungal therapy was a protective factor for short-term survival rate.Conclusion: The epidemiology of Candida BSI in Shanghai differed from that observed in Western countries. Antifungal therapy did influence the short-term survival, while there was no significant difference between the mortality for those who received appropriate antifungal therapy and for those who received delayed antifungal therapy.

scholarly journals Epidemiology, species distribution, and outcome of nosocomial Candida spp. bloodstream infection in Shanghai — A retrospective of 11-year clinical analysis in a shanghai tertiary hospital

2020 ◽  
Author(s):  
Yan-Jun ZHENG ◽  
Ting XIE ◽  
Lin WU ◽  
Xiao-Ying LIU ◽  
Ling ZHU ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Antifungal Therapy ◽  
Species Distribution ◽  
Clinical Severity ◽  
Care Hospital ◽  
Short Term ◽  
Candida Spp ◽  
Term Survival ◽  
Short Term Survival

Abstract Background: Candida spp. are important opportunist pathogens causing bloodstream infections (BSIs). The present study aims to describe the current epidemiology of Candida BSI in a large Shanghai Tertiary-care Hospital from 2008 to 2018 and to identify the risk factors and the impact of antifungal therapy on clinical outcomes. Methods: From January 2008 to December 2018, all consecutive patients who developed Candida BSI at Ruijin Hospital were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and its impact on the outcome were analyzed. Results: The incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients, and the overall 28-day mortality rate was 28.5%. Among the 393 cases of Candida BSI, 299 cases (76.1%) received antifungal therapy. 247 received early appropriate antifungal therapy (an appropriate drug with adequate dosage was started before the subsequent in vitro susceptibility results), and 52 received target antifungal therapy (appropriate target treatment started after susceptibility results, regardless of whether the inappropriate antifungal treatment has been initialed or not). The 28-day mortality rate was significantly lower in those who received early appropriate antifungal therapy or target antifungal therapy compared with those who did not receive antifungal therapy (25.5% and 23.1% vs. 39.4%,P = 0.012 and P = 0.046). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, neutropenia were independent risk factors for the 28-day mortality rate, while antifungal therapy was a protective factor for short-term survival rate. Conclusions: The epidemiology of Candida BSI in Shanghai differed from that observed in Western countries. Antifungal therapy did influence the short-term survival, while there was no significant difference between the mortality for those who received early appropriate antifungal therapy and for those who received target antifungal therapy.

scholarly journals Clinical Symptoms, Pathogen Spectrum, Risk Factors and Antibiogram of Suspected Neonatal Sepsis Cases in Tertiary Care Hospital of Southern Part of Nepal: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (232) ◽  
Author(s):  
Bijay Raj Pandit ◽  
Ashish Vyas
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Neonatal Sepsis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Neonatal Mortality Rate ◽  
Cross Sectional

Introduction: Neonatal mortality rate is highest in sub-Saharan Africa and Southern Asia region. The present study is undertaken to find out prevalence of neonatal sepsis, recognize bacterial pathogens, neonatal risk factors, major symptoms, and their antibiotic sensitivity pattern in neonates in tertiary care hospital in southern Nepal. Methods: A descriptive cross-sectional study was carried out in a tertiary care hospital from 2nd January 2017 to 20th February 2018 after approval (Ref: 125/2016-17). The sample size was calculated and convenience sampling was done. Data were collected from hospital records and microbiology laboratory and analyzed by Statistical Package for Social Sciences. Results: Out of 1200 clinically suspected cases, early-onset neonatal sepsis was seen in 290 (79.89%). A positive culture was seen in 363 (30.25%) where maximum bacterial growth was found in 254 (69.98%) males. Preterm gestational age was seen in 265 (73%), low birth weight 284 (78.23%), a vaginal delivery mode in 279 (76.90%), and delivery in hospital in 232 (63.91%). Likewise, Staphylococcus aureus in 229 (63.08%) was found maximum followed by Klebsiella pneumoniae in 48(13.22%). The major symptom observed was Respiratory distress in 245 (20.41%) while culture positive was seen in poor cry in 94 (53.10%). Mainly effective antibiotics against Gram-positive and gram-negative organisms were Linezolid in 250 (94%) and Imipenem in 46 (90.19%), whereas Penicillin-G in 254 (99.21%) and Ampicillin in 38 (94.74%) found resistance towards organisms respectively. Conclusions: The high prevalence of neonatal sepsis in our study reflects a huge challenge to reduce the neonatal mortality rate to 12 by 2030 of Sustainable Development Goals. Bacterial isolates exhibited higher resistance towards commonly used antibiotics.

scholarly journals Frequency, risk factors and materno-foetal outcomes among cases of Placenta previa at a tertiary care hospital: a two year study

2019 ◽  
Vol 8 (6) ◽  
pp. 2240
Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Early Date

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.

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