scholarly journals Growth Patterns of Clostridium difficile – Correlations with Strains, Binary Toxin and Disease Severity: A Prospective Cohort Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (9) ◽  
pp. e0161711 ◽  
Author(s):  
Sarah Tschudin-Sutter ◽  
Olivier Braissant ◽  
Stefan Erb ◽  
Anne Stranden ◽  
Gernot Bonkat ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clostridium Difficile ◽  
Disease Severity ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Growth Patterns ◽  
Binary Toxin

Underlying Disease Severity as a Major Risk Factor for Nosocomial Clostridium difficile Diarrhea

2002 ◽  
Vol 23 (11) ◽  
pp. 653-659 ◽  
Author(s):  
Lorraine Kyne ◽  
Stavros Sougioultzis ◽  
Lynne V. McFarland ◽  
Ciarán P. Kelly
Keyword(s):  
Cohort Study ◽  
Clostridium Difficile ◽  
Disease Severity ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Severe Disease ◽  
Underlying Disease ◽  
Hospitalized Patients ◽  
Antibiotic Prescribing ◽  
Predictive Values

Objective:To determine the diagnostic accuracy of an index of underlying disease severity (Horn's index) in identifying patients with a high probability of having nosocomial Clostridium difficile diarrhea as a complication of antimicrobial therapy.Design:A prospective cohort study of 252 adult patients admitted to the hospital and receiving antibiotics. Risk factors for C. difficile diarrhea were first determined retrospectively in a different cohort of 300 hospitalized patients (primary cobort) and then prospectively in this cohort of 252 hospitalized patients receiving antibiotics (secondary cohort). At the time of hospital admission, disease was rated by clinicians as mild (1), moderate (2), severe (3), or extremely severe (4) using a modified Horn's index. Multivariable logistic regression analysis was used to determine the odds ratio (OR) for C. difficile diarrhea associated with increasing levels of disease severity.Setting:An urban teaching hospital affiliated with a medical school in Boston, Massachusetts.Results:The incidence of nosocomial C. difficile diarrhea was 8.7% in the primary cohort and 11% in the secondary cohort. In the prospective cohort study (secondary cohort), the OR for C. difficile diarrhea associated with extremely severe disease was 17.6 (95% confidence interval, 5.8 to 53.5). The sensitivity, specificity, and positive and negative predictive values of a Horn's index score of 3 or more (severe to extremely severe disease) as a predictor of nosocomial C. difficile diarrhea were 79%, 73%, 27%, and 96%, respectively.Conclusions:These findings provide a means of early stratification of hospitalized patients receiving antibiotics according to their risk for nosocomial C. difficile diarrhea. Patients with severe to extremely severe disease at the time of admission may benefit from careful monitoring of antibiotic prescribing and early attention to infection control issues. In the future, these “high-risk” patients may benefit from prophylaxis studies of novel agents being developed to prevent C. difficile diarrhea.

A prospective cohort study on hospital mortality due to Clostridium difficile infection

Infection ◽  
2012 ◽  
Vol 40 (5) ◽  
pp. 479-484 ◽  
Author(s):  
J. M. Wenisch ◽  
D. Schmid ◽  
G. Tucek ◽  
H.-W. Kuo ◽  
F. Allerberger ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clostridium Difficile ◽  
Hospital Mortality ◽  
Prospective Cohort Study ◽  
Clostridium Difficile Infection ◽  
Prospective Cohort

scholarly journals Long-Term Survival After Venous Thromboembolism: A Prospective Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Henning Nilius ◽  
Tamara Mertins ◽  
Robin Boss ◽  
Matthias Knuchel ◽  
Eva Blozik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Venous Thromboembolism ◽  
Disease Severity ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Anticoagulant Treatment ◽  
Term Survival ◽  
Cardiovascular Comorbidities

Background: Little is known about long-term survival after the initial treatment of venous thromboembolism (VTE). In a prospective cohort study, we aimed to assess the long-term mortality and key predictor variables relating to disease severity, treatment intensity, and comorbidities.Materials and Methods: Between 1988 and 2018, 6,243 consecutive patients with VTE from a University outpatient unit were prospectively included and followed until December 2019; clinical characteristics, measures of disease severity, and treatment details were recorded. Dates of death were retrieved from the Swiss Central Compensation Office.Results: Overall, 254 deaths occurred over an observation period of 57,212 patient-years. Compared to the Swiss population, the standardized mortality ratio was 1.30 (95% CI: 1.14, 1.47; overall mortality rate: 4.44 per 1,000 patient-years). The following predictors were associated with increased mortality: Unprovoked VTE (hazard ratio [HR]: 5.06; 95% CI: 3.29, 7.77), transient triggering risk factors (HR: 3.46; 95% CI: 2.18, 5.48), previous VTE (HR: 2.05; 95% CI: 1.60, 2.62), pulmonary embolism (HR: 1.45, 95% CI: 1.10, 1.89), permanent anticoagulant treatment (HR: 3.14; 95% CI: 2.40, 4.12), prolonged anticoagulant treatment (7–24 months; HR: 1.70; 95% CI: 1.16, 2.48), and cardiovascular comorbidities. Unprovoked VTE, previous VTE, permanent and prolonged anticoagulation remain independent risk factors after adjustment for age, sex, and comorbidities.Conclusion: Survival after VTE was significantly reduced compared to the Swiss general population, especially in patients with more severe disease, cardiovascular comorbidities, and longer anticoagulant treatment.

scholarly journals Clinical profile and factors associated with COVID-19 in Cameroon: a prospective cohort study

2021 ◽  
Author(s):  
Nicole Fouda Mbarga ◽  
Epee Emilienne ◽  
Marcel Mbarga ◽  
Patrick Ouamba ◽  
Herwin Nanda ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Distress ◽  
Disease Severity ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Multivariable Analysis ◽  
Age Groups ◽  
Clinical Signs ◽  
Case Fatality ◽  
Factors Associated

AbstractObjectivesThis study explores the clinical profiles and factors associated with COVID-19 in Cameroon.Research design and methodsIn this prospective cohort study, we followed patients admitted for suspicion of COVID-19 at Djoungolo Hospital between 01st April and 31st July 2020. Patients were categorised by age groups and disease severity: mild (symptomatic without clinical signs of pneumonia pneumonia), moderate (with clinical signs of pneumonia without respiratory distress) and severe cases (clinical signs of pneumonia and respiratory distress not requiring invasive ventilation). Demographic information and clinical features were summarised. Multivariable analysis was performed to predict risk.ResultsA total of 323 patients were admitted during the study period; 262 were confirmed cases of COVID-19 by Polymerase Chain Reaction (PCR). Among the confirmed cases, the male group aged 40 to 49 years (13.9%) was predominant. Disease severity ranged from mild (77%; N=204) to moderate (15%; N=40) to severe (7%; N=18); the case fatality rate was 1% (N=4). Dysgusia (46%; N=111) and hyposmia/anosmia (39%; N=89) were common features of COVID-19. Nearly one-third of patients had comorbidities (29%; N=53), of which hypertension was the most common (20%; N=48). Participation in a mass gathering (OR=5.47; P=0.03) was a risk factor for COVID-19. Age groups 60 to 69 (OR=7.41; P=0.0001), 50 to 59 (OR=4.09; P=0.03), 40 to 49 (OR=4.54; P=0.01), male gender (OR=2.53; P=0.04), diabetes (OR= 4.05; P= 0.01), HIV infection (OR=5.57; P=0.03), lung disease (OR= 6.29; P=0.01), dyspnoea (OR=3.70; P=0.008) and fatigue (OR=3.35; P=0.02) significantly predicted COVID-19 severity.ConclusionUnlike many high-income settings, most COVID-19 cases in this study were benign with low fatality. Such findings may guide public health decision-making.

scholarly journals The Persistence of Natural SARS-CoV-2 Antibodies 12 Months Post COVID-19, a Prospective Cohort Study.

2021 ◽  
Author(s):  
F. Jurgens ◽  
B. Hogema ◽  
S. Siegerink ◽  
L. Samwel ◽  
R. van Gils ◽  
...  
Keyword(s):  
Cohort Study ◽  
Disease Severity ◽  
Prospective Cohort Study ◽  
Post Infection ◽  
Prospective Cohort ◽  
Natural Course ◽  
Antibody Isotypes ◽  
Iga Antibodies

Abstract Background: It is unknown how long SARS-CoV-2 antibodies persist after COVID-19. The natural course of anti-SARS-CoV-2 antibodies was analyzed in a large post-COVID-19 cohort, until 12 months post-infection. Methods: The total antibodies SARS-CoV-2 (IgM and IgG) were tested in a cohort of patients with different COVID-19 disease severity sampled at 4 timepoints up to 12 months post COVID-19. In 23 randomly selected patients, the antibody isotypes: anti-spike IgM, IgA and IgG and anti-nucleocapsid IgG were analysed. Results: In total 152/153 patients (99%) tested positive for total anti-SARS-CoV-2 after 12 months of COVID-19; 3 patients tested positive at 8 to 10 months post infection just before vaccination. The SARS-CoV-2 antibody subclasses anti-nucleocapsid IgG, anti-spike IgG and IgA were all still detectable after 12 months. Anti-spike IgM waned after 12 months in the majority of patients.Conclusion: IgG and IgA antibodies against SARS-CoV-2 persisted 12 months post-COVID-19.

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