scholarly journals Μελέτη του αποικισμού από Staphylococcus aureus ανθεκτικού στη μεθικιλλίνη (MRSA), στους ασθενείς που προσέρχονται στο νοσοκομείο

2013 ◽  
Author(s):  
Φανή Πλοιαρχοπούλου
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Mrsa Colonization ◽  
Valentine Leukocidin

Purpose: To determine the prevalence and to identify risk factors of MRSA colonization, among patients presenting for hospital admission.Methods: In a tertiary teaching hospital, surveillance cultures from the nares, axillae and inguinal areas were performed at the time of admission for all patients except those admitted in the oncology and hematology unit. Demographic and possible risk factors for colonization were recorded. Antibiotic susceptibility was tested with standard methods and methicillin resistance by the cefoxitin disc method and mec gene detection. Isolates were characterized as CA-MRSA according to their susceptibility pattern. MRSA isolates were tested for Panton Valentine leukocidin (pvl) gene.Results: Swab samples were collected from 2994 patients presenting for admission in two years. Mean patient age was 53 years (median 52) and the female to male ratio of 1.3:1. Staphylococcus aureus was isolated from 473 (15.8%) patients and MRSA from 88 (3%) of the patients (18.8% of colonizing isolates).Detection of colonization was (442/473) 93.4% in the nares, (128/279) 45.9% in the axilla and (157/279) 56.3% in the inguinal area. All the colonizing MRSA isolates, excluding three, exhibited in their sensitivity tests the pattern expected for CA-MRSA with the majority of them sensitive to cotrimoxazole, clindamycin, minocycline, rifampin and quinolones. Interestingly tetracycline and fucidic acid were inactive in the majority of strains. 64 MRSA isolates were tested for Pantone Valentine Leukocidin and 36 (56.25%) were positive. In the multivariate analysis comparing MRSA-colonized to MSSA-colonized or non-colonized patients, independent predictors of MRSA colonization were: residence at long term care facility (LTCF) (P <0.001, OR 12.05) and the presence of skin disease (p<0.001, OR 3.06)Conclusion: Colonization with MRSA of patients admitted to the hospital is low and appears to reflect the prevalence of colonization with CA-MRSA in the community. Risk factors for MRSA acquisition do not include previous contact with health-care facilities but instead the presence of skin diseases (affecting skin integrity) and residence in long term care facility.

scholarly journals Risk factors for COVID-19 diagnosis, hospitalization, and subsequent all-cause mortality in Sweden: a nationwide study

2021 ◽  
Vol 36 (3) ◽  
pp. 287-298
Author(s):  
Jonathan Bergman ◽  
Marcel Ballin ◽  
Anna Nordström ◽  
Peter Nordström
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Long Term Care ◽  
Care Facility ◽  
Prescription Medication ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
All Cause Mortality

AbstractWe conducted a nationwide, registry-based study to investigate the importance of 34 potential risk factors for coronavirus disease 2019 (COVID-19) diagnosis, hospitalization (with or without intensive care unit [ICU] admission), and subsequent all-cause mortality. The study population comprised all COVID-19 cases confirmed in Sweden by mid-September 2020 (68,575 non-hospitalized, 2494 ICU hospitalized, and 13,589 non-ICU hospitalized) and 434,081 randomly sampled general-population controls. Older age was the strongest risk factor for hospitalization, although the odds of ICU hospitalization decreased after 60–69 years and, after controlling for other risk factors, the odds of non-ICU hospitalization showed no trend after 40–49 years. Residence in a long-term care facility was associated with non-ICU hospitalization. Male sex and the presence of at least one investigated comorbidity or prescription medication were associated with both ICU and non-ICU hospitalization. Three comorbidities associated with both ICU and non-ICU hospitalization were asthma, hypertension, and Down syndrome. History of cancer was not associated with COVID-19 hospitalization, but cancer in the past year was associated with non-ICU hospitalization, after controlling for other risk factors. Cardiovascular disease was weakly associated with non-ICU hospitalization for COVID-19, but not with ICU hospitalization, after adjustment for other risk factors. Excess mortality was observed in both hospitalized and non-hospitalized COVID-19 cases. These results confirm that severe COVID-19 is related to age, sex, and comorbidity in general. The study provides new evidence that hypertension, asthma, Down syndrome, and residence in a long-term care facility are associated with severe COVID-19.

scholarly journals Risk factors for pneumonia and influenza hospitalizations in long-term care facility residents: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Patience Moyo ◽  
Andrew R. Zullo ◽  
Kevin W. McConeghy ◽  
Elliott Bosco ◽  
Robertus van Aalst ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals Risk factors for development of aminoglycoside resistance among gram-negative rods

2019 ◽  
Vol 76 (22) ◽  
pp. 1838-1847
Author(s):  
Stefan E Richter ◽  
Loren Miller ◽  
Jack Needleman ◽  
Daniel Z Uslan ◽  
Douglas Bell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Care Facility ◽  
Aminoglycoside Resistance ◽  
Term Care ◽  
Gram Negative ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
C Statistic

Abstract Purpose Development of scoring systems to predict the risk of aminoglycoside resistance and to guide therapy is described. Methods Infections due to aminoglycoside-resistant gram-negative rods (AR-GNRs) are increasingly common and associated with adverse outcomes; selection of effective initial antibiotic therapy is necessary to reduce adverse consequences and shorten length of stay. To determine risk factors for AR-GNR recovery from culture, cases of GNR infection among patients admitted to 2 institutions in a major academic hospital system during the period 2011–2016 were retrospectively analyzed. Gentamicin and tobramycin resistance (GTR-GNR) and amikacin resistance (AmR-GNR) patterns were analyzed separately. A total of 26,154 GNR isolates from 12,516 patients were analyzed, 6,699 of which were GTR, and 2,467 of which were AmR. Results In multivariate analysis, risk factors for GTR-GNR were presence of weight loss, admission from another medical or long-term care facility, a hemoglobin level of &lt;11 g/dL, receipt of any carbapenem in the prior 30 days, and receipt of any fluoroquinolone in the prior 30 days (C statistic, 0.63). Risk factors for AmR-GNR were diagnosis of cystic fibrosis, male gender, admission from another medical or long-term care facility, ventilation at any point prior to culture during the index hospitalization, receipt of any carbapenem in the prior 30 days, and receipt of any anti-MRSA agent in the prior 30 days (C statistic, 0.74). Multinomial and ordinal models demonstrated that the risk factors for the 2 resistance patterns differed significantly. Conclusion A scoring system derived from the developed risk prediction models can be applied by providers to guide empirical antimicrobial therapy for treatment of GNR infections.

A Norovirus Outbreak at a Long-Term-Care Facility: The Role of Environmental Surface Contamination

2005 ◽  
Vol 26 (10) ◽  
pp. 802-810 ◽  
Author(s):  
Henry M. Wu ◽  
Mary Fornek ◽  
Kellogg J. Schwab ◽  
Amy R. Chapin ◽  
Kristen Gibson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Care Facility ◽  
Rt Pcr ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Environmental Surface

AbstractBackground:The role of environmental surface contamination in the propagation of norovirus outbreaks is unclear. An outbreak of acute gastroenteritis was reported among residents of a 240-bed veterans long-term-care facility.Objectives:To identify the likely mode of transmission, to characterize risk factors for illness, and to evaluate for environmental contamination in this norovirus outbreak.Methods:An outbreak investigation was conducted to identify risk factors for illness among residents and employees. Stool and vomitus samples were tested for norovirus by reverse transcription polymerase chain reaction (RT-PCR). Fourteen days after outbreak detection, ongoing cases among the residents prompted environmental surface testing for norovirus by RT-PCR.Results:One hundred twenty-seven (52%) of 246 residents and 84 (46%) of 181 surveyed employees had gastroenteritis. Case-residents did not differ from non-case-residents by comorbidities, diet, room type, or level of mobility. Index cases were among the nursing staff. Eight of 11 resident stool or vomitus samples tested positive for genogroup II norovirus. The all-cause mortality rate during the month of the outbreak peak was significantly higher than the expected rate. Environmental surface swabs from case-resident rooms, a dining room table, and an elevator button used only by employees were positive for norovirus. Environmental and clinical norovirus sequences were identical.Conclusion:Extensive contamination of environmental surfaces may play a role in prolonged norovirus outbreaks and should be addressed in control interventions.

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