scholarly journals Risk Factors for Healthcare-Associated Extensively Drug-Resistant Acinetobacter baumannii Infections: A Case-Control Study

PLoS ONE ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e85973 ◽  
Author(s):  
Ming-Chin Chan ◽  
Sheng-Kang Chiu ◽  
Po-Ren Hsueh ◽  
Ning-Chi Wang ◽  
Chih-Chien Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acinetobacter Baumannii ◽  
Case Control Study ◽  
Case Control ◽  
Drug Resistant ◽  
Extensively Drug Resistant ◽  
Healthcare Associated ◽  
Control Study

A Multicenter Case-Case Control Study for Risk Factors and Outcomes of Extensively Drug-Resistant Acinetobacter baumannii Bacteremia

2014 ◽  
Vol 35 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Tat Ming Ng ◽  
Christine B. Teng ◽  
David C. Lye ◽  
Anucha Apisarnthanarak
Keyword(s):  
Risk Factors ◽  
Acinetobacter Baumannii ◽  
Case Control Study ◽  
Polymyxin B ◽  
Case Control ◽  
Case Group ◽  
Drug Resistant ◽  
Extensively Drug Resistant ◽  
Group 2 ◽  
Control Study

Objective.Extensively drug resistant (XDR) Acinetobacter baumannii infections are increasing. Knowledge of risk factors can help to prevent these infections.Methods.We designed a 1: 1: 1 case-case-control study to identify risk factors for XDR A. baumannii bacteremia in Singapore and Thailand. Case group 1 was defined as having infection due to XDR A. baumannii, and case group 2 was defined as having infection due to non-XDR A. baumannii. The control group comprised patients with blood cultures obtained to determine possible infection.Results.There were 93 patients in each group. Pitt bacteremia score (adjusted odds ratio [aOR], 2.570 [95% confidence interval (CI), 1.528–4.322]), central venous catheters (CVCs; aOR, 12.644 [95% CI, 2.143–74.620]), use of carbapenems (aOR, 54.391 [95% CI, 3.869–764.674]), and piperacillin-tazobactam (aOR, 55.035 [95% CI, 4.803–630.613]) were independently associated with XDR A. baumannii bacteremia. In case group 2, Pitt bacteremia score (aOR, 1.667 [95% CI, 1.265–2.196]) and third-generation cephalosporins (aOR, 2.965 [95% CI, 1.224–7.182]) were independently associated with non-XDR A. baumannii bacteremia. Concurrent infections (aOR, 3.527 [95% CI, 1.479–8.411]), cancer (aOR, 3.172 [95% CI, 1.135–8.865]), and respiratory source (aOR, 2.690 [95% CI, 1.160–6.239]) were associated with an increased risk of 30-day mortality. Survivors received more active empirical therapy (16.7% vs 9.6%; P = .157), had fewer cases of XDR bacteremia (45.8% vs 52.6%; P = .452), and received higher median definitive polymyxin B doses (840,000 units vs 700,000 units; P = .339)Conclusions.Use of CVC and broad spectrum antibiotics were unique risk factors of XDR A. baumannii bacteremia. Effective antimicrobial stewardship together with use of a CVC bundle may reduce the incidence of these infections. Risk factors of acquisition and mortality may help identify patients for early initiation of polymyxin B therapy.

scholarly journals Risk Factors of Extensive Drug Resistant Typhoid Fever among Children in Karachi: A Case-Control Study Extensively Drug-Resistant Typhoid Fever (XDR-TF) was responsible for a continuing outbreak in Pakistan that began in November 2016. (Preprint)

2021 ◽  
Author(s):  
Anum Vighio ◽  
Muhammad Asif Syed ◽  
Ishfaque Hussain ◽  
Syed Masroor Zia ◽  
Munaza Fatima ◽  
...  
Keyword(s):  
Risk Factors ◽  
Typhoid Fever ◽  
Case Control Study ◽  
Case Control ◽  
Drug Resistant ◽  
Street Vendors ◽  
Community Water ◽  
Extensively Drug Resistant ◽  
Control Study ◽  
Age And Sex

BACKGROUND Extensively Drug-Resistant Typhoid Fever (XDR-TF) was responsible for a continuing outbreak in Pakistan that began in November 2016. OBJECTIVE This study aimed to determine the risk factors associated with XDR-TF. METHODS Age and sex-matched case-control study (75 cases and 75 Controls) was conducted during May-October 2018 in Karachi. All patients with XDR-TF were identified from the lab-based surveillance system data. Cases were defined as patients aged < 15 years living in Karachi with culture positive Salmonella enterica serovar who are resistant to chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole, fluoroquinolones and third generation cephalosporins. Age and sex-matched controls were defined as children free from symptoms of typhoid fever, under 15 years, and resident of Karachi. All controls were recruited from those attending outpatient clinics. RESULTS A total of 75 cases and 75 controls were included in this study. In the univariate analysis, the odds of having XDR-TF in participants who used piped municipal water were 13 times higher as compared to those who did not (OR=12.6, 95% CI: 4.1 – 38.6). Use of bore water was significantly associated with XDR-TF (OR=5.1, 95% CI: 1.4-19.0). Cases were more likely to report eating French fries with sauce (OR=13.5, 95% CI: 3.9 –47.0) and poppadum (OR=3.4, 95% CI: 1.7 – 6.7) from street vendors. Boiling water at home was negatively associated with with XDR-TF (OR=0.3, 95% CI: 0.2 – 0.7). In the multivariate analysis, two factors were independently associated with XDR-TF. Using piped municipal water (OR=10.3, 95% CI: 3.4 – 30.4) and eating French fries with sauce from street vendors (OR=8.8, 95% CI: 2.1 – 36.2) were significantly associated with increased odds of XDR-TF. CONCLUSIONS Community water supply and street vendor eating habits were implicated in the spread of the superbug S typhi outbreak that continues to grow in Karachi. Therefore, it is recommended to improve community water supply to meet recommended standards and develop a policy to improve safety of street food. In addition, health department should conduct mass vaccination in high-risk group against typhoid fever.

scholarly journals Risk Factors of Extensive Drug Resistant Typhoid Fever among Children in Karachi: A Case-Control Study (Preprint)

10.2196/27276 ◽  
2021 ◽  
Author(s):  
Anum Vighio ◽  
Muhammad Asif Syed ◽  
Ishfaque Hussain ◽  
Syed Masroor Zia ◽  
Munaza Fatima ◽  
...  
Keyword(s):  
Risk Factors ◽  
Typhoid Fever ◽  
Case Control Study ◽  
Case Control ◽  
Drug Resistant ◽  
Control Study

scholarly journals Risk Factors for rectal colonization with carbapenem-resistant Acinetobacter baumannii in hospital: a matched case-control study

2021 ◽  
Author(s):  
marianna meschiari ◽  
Shaniko Kaleci ◽  
Gabriella Orlando ◽  
Silvia Selmi ◽  
Antonella Santoro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Acinetobacter Baumannii ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Control ◽  
Carbapenem Resistant ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

Abstract Background During the last decade carbapenem-resistant Acinetobacter baumannii (CRAB) became hyper-endemic in hospitals due to difficult to control spreading. Our aim is to identify risk factors for nosocomial rectal CRAB colonization in an endemic hospital. Methods A retrospective matched case-control study (ratio 1:2) with a prospective inclusion of cases and concurrent selection of controls was conducted from January 2017 to December 2018 in a tertiary-care hospital. Universal active surveillance for CRAB was implemented. Univariate and multivariate logistic regression was carried out using a stepwise selection method to compare prognostic factors between cases and controls. A sub-analysis was carried out according to the type of department. Results Forty-five cases with nosocomial rectal CRAB colonization and 90 controls were included. One hundred and two (75%) patients were hospitalized in medical departments. At multivariable analysis significant risk factors associated with CRAB colonization were: use of permanent devices (OR: 10.15, 95%CI: 2.27–45.39; P = 0.002), mechanical ventilation (OR: 40.01, 95%CI: 4.05–395.1; P = 0.002), urinary catheters (OR: 4.9, 95%CI:1.52–16.19; P = 0.008), McCabe score (OR: 5.45, 95%CI: 1.87–15.89; P = 0.002), length of stay (OR: 1.03, 95%CI: 1.01–1.05; P = 0.002), carbapenem use (OR: 5.39, 95%CI: 1.14–25.44; P = 0.033). The sub-analysis showed that patients admitted to different departments had different risk factors. In geriatric department a fatal disease and a longer hospital stay represented significant risk factors both in univariate and multivariate analysis, while in internal medicine department the use of permanent devices, current antibiotic therapy and antibiotic polytherapy represented significant risk factors for CRAB at the univariate analysis, also confirmed in multivariate analysis. Conclusions Our data suggest that active surveillance for rectal CRAB colonization should be addressed to patients with an unfavourable prognosis, longer hospitalizations and carriers of multiple devices. To counter CRAB spreading in endemic settings, clinicians must limit the use of carbapenems, and reinforce interventions aimed at proper use of devices.

scholarly journals Risk Factors for Acquisition of Imipenem-Resistant Acinetobacter baumannii: a Case-Control Study

2004 ◽  
Vol 48 (3) ◽  
pp. 1070-1070
Author(s):  
Sang-Oh Lee ◽  
Nam Joong Kim ◽  
Sang-Ho Choi ◽  
Tae Hyong Kim ◽  
Jin-Won Chung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acinetobacter Baumannii ◽  
Case Control Study ◽  
Case Control ◽  
Control Study
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