scholarly journals Predictors for vancomycin resistant Enterococcus faecium transforming from colonization to infection: a case control study

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Pao-Yu Chen ◽  
Yu-Chung Chuang ◽  
Jann-Tay Wang ◽  
Wang-Huei Sheng ◽  
Yee-Chun Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Enterococcus Faecium ◽  
Case Control Study ◽  
Case Control ◽  
Control Measures ◽  
Fourth Generation ◽  
Surveillance Culture ◽  
Icu Admission ◽  
Vancomycin Resistant ◽  
Control Study

Abstract Background Little is known about risk factors for subsequent infections among vancomycin resistant Enterococcus faecium (VREfm) colonizers, especially characterized by concordant pulsotypes (CP) of paired colonization and infection-related isolates. Methods This case-control study was conducted at a teaching hospital between 2011 and 2014. Targeted patients received active surveillance culture for VREfm by anal swabs at admission. Cases were those who developed VREfm infection within 180 days after colonization of VREfm. Controls were those colonized with VREfm without subsequent VREfm infection. CP were defined by similarities ≥86.7% using pulsed-field gel electrophoresis between paired colonization and infection-related isolates. Results Ninety-seven cases and 194 controls were enrolled. By conditional multivariable logistic regression analysis, the risk factors for subsequent infection among VREfm colonizers were intensive care unit (ICU) admission (adjusted odds ratio [aOR], 9.32; 95% CI, 3.61–24.02), receipt of central venous catheters (CVC) (aOR, 3.38; 95% CI, 1.30–8.82), and utilization of third- and fourth-generation cephalosporins (aOR, 4.06; 95% CI, 1.79–9.20, and aOR, 5.32; 95% CI, 1.85– 10.29, respectively) (all P ≤ 0.01). Fifty-six (57.7%) of case patients belonged to the CP group, which were associated with ICU admission (aOR, 3.74; 95% CI, 1.38–10.13), and infection developing within 30 days after colonization (aOR, 3.34; 95% CI, 1.25–8.91). Conclusions Among VREfm colonizers, being admitted to ICU and receiving CVC or broad spectrum cephalosporins, were the risk factors for subsequent infections. These findings highlight the importance of conducting more strict infection control measures on specific groups of VREfm colonizers.

scholarly journals Risk factors for sporadic Campylobacter infection: an all-Ireland case-control study

2009 ◽  
Vol 14 (7) ◽  
Author(s):  
K Danis ◽  
M Di Renzi ◽  
W O’Neill ◽  
B Smyth ◽  
P McKeown ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Population Attributable Fraction ◽  
Case Control ◽  
Control Measures ◽  
Safety Education ◽  
First Case ◽  
The Republic ◽  
Campylobacter Infection ◽  
Control Study

We report the findings of the first case-control study conducted in both the Republic of Ireland and Northern Ireland to determine risk factors for sporadic Campylobacter infections. A total of 197 cases and 296 case-nominated controls matched for age, were included. Based on Population Attributable Fraction (PAF), the most important risk factors were consuming chicken [adjusted matched (am) OR 6.8; 95%CI 2.1-21.9], consuming lettuce (amOR 3.3; 95%CI 1.5-7.1) and eating in takeaways (amOR=3.1; 95%CI 1.4-6.6). Contact with sheep (amOR=11; 95%CI 1.6-78), peptic ulcer (amOR=19; 95%CI 3.8-93.7), hiatus hernia (amOR=20.3; 95%CI 2.3-183.3), lower bowel problems (amOR=4.5; 95%CI 1.2-16.8) were also independently associated with infection. Mains water supply showed protective effect (amOR=0.2; 95 CI 0.1-0.9). The findings highlight the continued need for consumer food safety education and further control measures throughout the food chain on the island of Ireland.

scholarly journals Determining the clinical significance of co-colonization of vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus in the intestinal tracts of patients in intensive care units: a case–control study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Young Kyung Yoon ◽  
Min Jung Lee ◽  
Yongguk Ju ◽  
Sung Eun Lee ◽  
Kyung Sook Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Clinical Outcomes ◽  
Intensive Care Units ◽  
Case Control Study ◽  
Case Control ◽  
Methicillin Resistant ◽  
Vancomycin Resistant ◽  
Control Study

Abstract Background The emergence of vancomycin-resistant Staphylococcus aureus (VRSA) has become a global concern for public health. The proximity of vancomycin-resistant enterococcus (VRE) and methicillin-resistant S. aureus (MRSA) is considered to be one of the foremost risk factors for the development of VRSA. This study aimed to determine the incidence, risk factors, and clinical outcomes of intestinal co-colonization with VRE and MRSA. Methods A case–control study was conducted in 52-bed intensive care units (ICUs) of a university-affiliated hospital from September 2012 to October 2017. Active surveillance using rectal cultures for VRE were conducted at ICU admission and on a weekly basis. Weekly surveillance cultures for detection of rectal MRSA were also conducted in patients with VRE carriage. Patients with intestinal co-colonization of VRE and MRSA were compared with randomly selected control patients with VRE colonization alone (1:1). Vancomycin minimum inhibitory concentrations (MICs) for MRSA isolates were determined by the Etest. Results Of the 4679 consecutive patients, 195 cases and 924 controls were detected. The median monthly incidence and duration of intestinal co-colonization with VRE and MRSA were 2.3/1000 patient-days and 7 days, respectively. The frequency of both MRSA infections and mortality attributable to MRSA were higher in the case group than in the control group: 56.9% vs. 44.1% (P = 0.011) and 8.2% vs. 1.0% (P = 0.002), respectively. Independent risk factors for intestinal co-colonization were enteral tube feeding (odds ratio [OR], 2.09; 95% confidence interval [CI] 1.32–3.32), metabolic diseases (OR, 1.75; 95% CI 1.05–2.93), male gender (OR, 1.62; 95% CI 1.06–2.50), and Charlson comorbidity index < 3 (OR, 3.61; 95% CI 1.88–6.94). All MRSA isolates from case patients were susceptible to vancomycin (MIC ≤ 2 mg/L). Conclusions Our study indicates that intestinal co-colonization of VRE and MRSA occurs commonly among patients in the ICU with MRSA endemicity, which might be associated with poor clinical outcomes.

Epidemiology of Vancomycin-Resistant Enterococci with Reduced Susceptibility to Daptomycin

2012 ◽  
Vol 33 (12) ◽  
pp. 1250-1254 ◽  
Author(s):  
Theresa Judge ◽  
Jason M. Pogue ◽  
Dror Marchaim ◽  
Kevin Ho ◽  
Srinivasa Kamatam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Case Control ◽  
Prior Exposure ◽  
Comorbid Conditions ◽  
Retrospective Case ◽  
Vancomycin Resistant Enterococci ◽  
Independent Risk Factors ◽  
Vancomycin Resistant ◽  
Control Study

A retrospective case–case control study was conducted, including 60 cases with daptomycin-nonsusceptible vancomycin-resistant enterococci (DNS-VRE) matched to cases with daptomycin-susceptible VRE and to uninfected controls (1:1:3 ratio). Immunosuppression, presence of comorbid conditions, and prior exposure to antimicrobials were independent predictors of DNS-VRE, although prior daptomycin exposure occurred rarely. In summary, a case–case control study identified independent risk factors for the isolation of DNS-VRE: immunosuppression, multiple comorbid conditions, and prior exposures to cephalosporines and metronidazole.

scholarly journals Another dengue fever outbreak in Eastern Ethiopia—An emerging public health threat

2021 ◽  
Vol 15 (1) ◽  
pp. e0008992
Author(s):  
Mulugeta Asefa Gutu ◽  
Alemayehu Bekele ◽  
Yimer Seid ◽  
Yusuf Mohammed ◽  
Fekadu Gemechu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Case Control Study ◽  
Larval Density ◽  
Case Control ◽  
Control Measures ◽  
Severe Dengue ◽  
Vector Surveillance ◽  
Eastern Ethiopia ◽  
Control Study

Background Dengue Fever (DF) is a viral disease primarily transmitted by Aedes (Ae.) aegypti mosquitoes. Outbreaks in Eastern Ethiopia were reported during 2014–2016. In May 2017, we investigated the first suspected DF outbreak from Kabridahar Town, Somali region (Eastern Ethiopia) to describe its magnitude, assess risk factors, and implement control measures. Methods Suspected DF cases were defined as acute febrile illness plus ≥2 symptoms (headache, fever, retro-orbital pain, myalgia, arthralgia, rash, or hemorrhage) in Kabridahar District residents. All reported cases were identified through medical record review and active searches. Severe dengue was defined as DF with severe organ impairment, severe hemorrhage, or severe plasma leakage. We conducted a neighborhood-matched case-control study using a subset of suspected cases and conveniently-selected asymptomatic community controls and interviewed participants to collect demographic and risk factor data. We tested sera by RT-PCR to detect dengue virus (DENV) and identify serotypes. Entomologists conducted mosquito surveys at community households to identify species and estimate larval density using the house index (HI), container index (CI) and Breteau index (BI), with BI≥20 indicating high density. Results We identified 101 total cases from May 12–31, 2017, including five with severe dengue (one death). The attack rate (AR) was 17/10,000. Of 21 tested samples, 15 (72%) were DENV serotype 2 (DENV 2). In the case-control study with 50 cases and 100 controls, a lack of formal education (AOR [Adjusted Odds Ratio] = 4.2, 95% CI [Confidence Interval] 1.6–11.2) and open water containers near the home (AOR = 3.0, 95% CI 1.2–7.5) were risk factors, while long-lasting insecticide treated-net (LLITN) usage (AOR = 0.21, 95% CI 0.05–0.79) was protective. HI and BI were 66/136 (49%) and 147 per 100 homes (147%) respectively, with 151/167 (90%) adult mosquitoes identified as Ae. aegypti. Conclusion The epidemiologic, entomologic, and laboratory investigation confirmed a DF outbreak. Mosquito indices were far above safe thresholds, indicating inadequate vector control. We recommended improved vector surveillance and control programs, including best practices in preserving water and disposal of open containers to reduce Aedes mosquito density.

scholarly journals Epidemiology, vaccine effectiveness, and risk factors for mortality for pneumococcal disease among hospitalised adults in Singapore: a case-control study

2020 ◽  
Author(s):  
Tyson Chan ◽  
Min Zhi Tay ◽  
Win Mar Kyaw ◽  
Angela Chow ◽  
Hanley J Ho
Keyword(s):  
Risk Factors ◽  
Pneumococcal Disease ◽  
Case Control Study ◽  
Pneumococcal Vaccination ◽  
Case Control ◽  
Vaccine Effectiveness ◽  
Adjusted Relative Risk ◽  
Factors Associated ◽  
Icu Admission ◽  
Control Study

Abstract Background: Streptococcus pneumoniae infections can lead to severe morbidity and mortality, especially in patients with invasive pneumococcal disease (IPD). This study evaluated factors associated with pneumococcal disease, pneumococcal vaccine effectiveness, and risk factors for all-cause mortality in hospitalised adults with pneumococcal disease in Singapore. Methods: Retrospective case-control study of patients tested for pneumococcal disease with streptococcal urinary antigen testing and at least one sterile site culture, during their admission to a tertiary hospital in Singapore from 2015-2017. Patients were defined as cases of IPD or non-IPD, or as controls, based on laboratory results and clinical diagnoses. Multivariable models were constructed to determine factors associated with IPD/non-IPD, and risk factors for mortality from pneumococcal disease. Vaccine effectiveness against IPD/non-IPD was estimated using a variation of the test-negative design. Results: We identified 496 pneumococcal disease cases, of whom 92 (18.5%) had IPD. The mean age of cases was 69.1±15.4yrs, and 65.5% were male. Compared with controls (N=9,181), IPD patients were younger (mean age 61.5±16.3yrs, vs 72.2±16.1yrs in controls; p<0.001) and with less co-morbidities [median Charlson’s score 1 (IQR 0-4), vs 3 (1-5) in controls; p<0.001]. IPD patients also had the highest proportions with intensive care unit (ICU) admission (20.7%), inpatient mortality (26.1%) and longest median length of stay [9 (IQR 8-17) days]. On multivariable analysis, IPD was negatively associated with prior pneumococcal vaccination (adjusted relative risk ratio=0.20, 95%CI 0.06–0.69; p=0.011). Risk factors for mortality among pneumococcal disease patients were ICU admission, diagnosis of IPD, age ≥85yrs and Charlson’s score >3.Conclusion: Patients with pneumococcal disease (especially IPD) were younger and had less co-morbidities than controls, but had higher risk of severe clinical outcomes and mortality. Pneumococcal vaccination effectiveness against IPD was estimated to be about 80%, and should be encouraged among high-risk patients.

Outbreak of Colonization and Infection With Vancomycin-ResistantEnterococcus faeciumin a French University Hospital

2006 ◽  
Vol 27 (9) ◽  
pp. 984-986 ◽  
Author(s):  
Olivier Lesens ◽  
L. Mihaila ◽  
F. Robin ◽  
O. Baud ◽  
J. P. Romaszko ◽  
...  
Keyword(s):  
Enterococcus Faecium ◽  
Odds Ratio ◽  
Case Control Study ◽  
Urinary Catheter ◽  
Generation Cephalosporin ◽  
Case Control ◽  
Prior Exposure ◽  
University Hospital ◽  
Vancomycin Resistant ◽  
Control Study

An outbreak of infection with vancomycin-resistantEnterococcus faeciumoccurred at Hôtel-Dieu Hospital (Clermont-Ferrand, France). A case-control study was performed in the infectious diseases and hematology units of the hospital. Urinary catheter use (odds ratio [OR], 12 [95% confidence interval {CI}, 1.5-90];P<.02), prior exposure to a third-generation cephalosporin (OR, 22 [95% CI, 3-152];P= .002), and prior exposure to antianaerobials (OR, 11 [95% CI, 1.5-88];P<.02) were independently predictive of vancomycin-resistantEnterococcus faeciumcarriage.

Risk Factors for Vancomycin-ResistantEnterococcus(VRE) Infection in Colonized Patients With Cancer

2002 ◽  
Vol 23 (2) ◽  
pp. 102-103 ◽  
Author(s):  
Rola Husni ◽  
Ray Hachem ◽  
Hend Hanna ◽  
Issam Raad
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Case Control Study ◽  
Case Control ◽  
Oral Vancomycin ◽  
Patients With Cancer ◽  
Neutropenic Patients ◽  
Vancomycin Resistant ◽  
Control Study ◽  
Significant Factors

AbstractTo determine the risk factors for vancomycin-resistantEnterococcus(VRE) infection in colonized patients with cancer, we conducted a case–control study. According to multivariate analysis, the only significant factors were neutropenia (< 500 cells/mm3) for more than 1 week and the use of oral vancomycin. Therefore, colonized neutropenic patients with cancer who have previously used oral vancomycin are most prone to VRE infection.

An Outbreak of Imipenem-ResistantAcinetobacter baumanniiin Critically Ill Surgical Patients

2001 ◽  
Vol 22 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Lisiane Fierobe ◽  
Jean-Christophe Lucet ◽  
Dominique Decré ◽  
Claudette Muller-Serieys ◽  
Arnaud Deleuze ◽  
...  
Keyword(s):  
Risk Factors ◽  
Therapeutic Intervention ◽  
Case Control Study ◽  
Severity Of Illness ◽  
Case Control ◽  
Control Measures ◽  
Surgical Intensive Care Unit ◽  
Safety Measures ◽  
Environmental Cleaning ◽  
Control Study

AbstractObjective:To describe an outbreak of imipenem-resistantAcinetobacter baumannii(IR-Ab) and the measures for its control, and to investigate risk factors for IR-Ab acquisition.Design:An observational and a case-control study.Setting:A surgical intensive care unit (ICU) in a university tertiary care hospital.Methods:After admission to the ICU of an IR-Ab-positive patient, patients were prospectively screened for IR-Ab carriage upon admission and then once a week. Environmental cleaning and barrier safety measures were used for IR-Ab carriers. A case-control study was performed to identify factors associated with IR-Ab acquisition. Cases were patients who acquired IR-Ab. Controls were patients who were hospitalized in the ICU at the same time as cases and were exposed to IR-Ab for a similar duration as cases. The following variables were investigated as potential risk factors: baseline characteristics, scores for severity of illness and therapeutic intervention, presence and duration of invasive procedures, and antimicrobial administration.Results:Beginning in May 1996, the outbreak involved 17 patients over 9 months, of whom 12 acquired IR-Ab (cases), 4 had IR-Ab isolates on admission to the ICU, and 1 could not be classified. Genotypic analysis identified two different IR-Ab isolates, responsible for three clusters. Ten of the 12 nosocomial cases developed infection. Control measures included reinforcement of barrier safety measures, limitation of the number of admissions, and thorough environmental cleaning. No new case was identified after January 1997. Eleven of the 12 cases could be compared to 19 controls. After adjustment for severity of illness, a high individual therapeutic intervention score appeared to be a risk factor for IR-Ab acquisition.Conclusion:The outbreak ended after strict application of control measures. Our results suggest that high work load contributes to IR-Ab acquisition.

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