No Increased Risk For Invasive Bacterial Infection Found Following Diphtheria-Tetanus-Pertussis Immunization

PEDIATRICS ◽  
1992 ◽  
Vol 89 (4) ◽  
pp. 640-642
Author(s):  
Marie R. Griffin ◽  
Jo A. Taylor ◽  
James R. Daugherty ◽  
Wayne A. Ray
Keyword(s):  
Bacterial Infections ◽  
Vaccine Trial ◽  
Adjusted Relative Risk ◽  
Relative Risks ◽  
Health Clinics ◽  
Increased Risk ◽  
Serious Infections ◽  
Invasive Bacterial Infection ◽  
Serious Bacterial Infections

During the acellular pertussis vaccine trial in Sweden, 4 children who were randomly assigned to receive the vaccine died of suspected or confirmed bacterial infections compared to 1 expected. There were no deaths in the placebo arm. This raised concern about the role of pertussis immunization in the development of serious infections. Through linking computerized immunization records with an active surveillance system for serious bacterial infections in children, the authors studied a cohort of 64 591 children immunized through Tennessee county health clinics who had a total of 158 episodes of invasive bacterial infections after a diphtheria and tetanus toxoids and pertussis (DTP) immunization. There were 8 invasive bacterial infections that occurred within the first 7 days following DTP immunization,yielding an age-adjusted relative risk (95% confidence interval) of 1.0 (0.5 to 2.0), compared to the interval 29 or more days following immunization. There were 7 and 20 infections in the 8- through 14- and 15-through 28-day intervals following DTP immunization, giving relative risks of 0.8 (0.4 to 1.7) and 1.2 (0.7 to 1.9), respectively. These data provide reassurance that the use of DTP vaccine is not followed by a large increased risk of serious bacterial infections.

scholarly journals Zinc deficiency may play a crucial role in dialysis-associated bacterial infections

2020 ◽  
Vol 11 (1) ◽  
pp. e9-e9
Author(s):  
Zahra Lotfi ◽  
Abbas Ali Zeraati ◽  
Elaheh Dashti ◽  
Tina Zeraati ◽  
Maryam Arghiany ◽  
...  
Keyword(s):  
Zinc Deficiency ◽  
Bacterial Infections ◽  
Critical Role ◽  
Serum Zinc ◽  
Zinc Level ◽  
Healthy Individuals ◽  
Mortality And Morbidity ◽  
Increased Risk ◽  
The Mean

Introduction: Systemic bacterial infections are a common cause of mortality and morbidity in hemodialysis patients. Zinc has a critical role in several immune system functions. Patients who have enough amounts of zinc are able to better face infections caused by various pathogens in comparison to those with zinc insufficiency Objective We sought to assess the role of zinc deficiency in dialysis-associated bacterial infections. Patients and Methods: Eighty-Three adult patients with end-stage renal disease (ESRD) on hemodialysis including 43 patients with bacterial infectious complications and 40 non-infected patients as well as 41 healthy individuals were enrolled. Clinical data, laboratory values including serum zinc level and imaging findings were collected. SPSS was utilized to analyze the data with a significance cutoff set at P < 0.05. Results: Out of 124 participants, 80 (64.51%) were males and 44 (35.49%) were females. The mean age of infected hemodialysis group, non-infected hemodialysis group, and healthy controls were 50.8 ± 16.25, 49.1 ± 18.1, and 56.3 ± 18.2 years, respectively. Catheter site infection (37.3%) and urinary tract infection (30.2%) were the most common infections. The mean serum zinc concentration was significantly lower in the infected patients, compared to non-infected patients and healthy individuals (P < 0.001). Conclusion: The ESRD patients on hemodialysis have lower serum zinc levels which are associated with increased risk of bacterial infection. The role of screening for zinc deficiency and use of supplemental zinc in these patients need to be studied.

scholarly journals Meropenem versus Cefuroxime plus Gentamicin for Treatment of Serious Infections in Elderly Patients

1998 ◽  
Vol 42 (5) ◽  
pp. 1233-1238 ◽  
Author(s):  
C. A. J. J. Jaspers ◽  
H. Kieft ◽  
B. Speelberg ◽  
A. Buiting ◽  
M. van Marwijk Kooij ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Elderly Patients ◽  
Bacterial Infections ◽  
Clinical Success ◽  
Sepsis Syndrome ◽  
Serious Infections ◽  
Serious Bacterial Infections ◽  
Satisfactory Clinical Response ◽  
Intra Abdominal Infection ◽  
Abdominal Infections

ABSTRACT In this multicenter study, the efficacy of and tolerability for meropenem were compared with those for the combination of cefuroxime-gentamicin (±metronidazole) for the treatment of serious bacterial infections in patients ≥65 years of age. A total of 79 patients were randomized; thirty-nine received meropenem (1 g/8 h), and 40 received cefuroxime (1.5 g/8 h) plus gentamicin (4 mg/kg of body weight daily) for 5 to 10 days. Metronidazole (500 mg/6 h) could be added to the cefuroxime-gentamicin regimen for the treatment of intra-abdominal infections (n = 10). Seventy patients were evaluable for clinical efficacy; the primary diagnoses were as follows: pneumonia in 41 patients (20 treated with meropenem, 21 treated with cefuroxime-gentamicin), intra-abdominal infection in 10 patients (7 meropenem, 3 cefuroxime-gentamicin-metronidazole), urinary tract infection (UTI) in 11 patients (6 meropenem, 5 cefuroxime-gentamicin), sepsis syndrome in 7 patients (4 meropenem, 3 cefuroxime-gentamicin), and “other” in 1 patient (cefuroxime-gentamicin). The pathogens isolated from 18 patients with bacteremia were as follows:Staphylococcus spp. (n = 2),Streptococcus spp. (n = 2), members of the family Enterobacteriaceae (n = 11), and Bacteroides spp. (n = 3). A satisfactory clinical response at the end of therapy was achieved in 26 of 37 (70%) and 24 of 33 (73%) evaluable patients treated with meropenem and combination therapy, respectively. Clinical success was achieved in 23 of 31 (74%) and 21 of 28 (75%) evaluable patients with infections other than UTIs, respectively. A satisfactory microbiological response occurred in 15 of 22 (68%) patients in the meropenem group compared with 12 of 19 (63%) treated with combination therapy. Renal failure occurred during therapy in 2 of 39 (5%) meropenem recipients compared with 5 of 40 (13%) of those treated with combination therapy. The findings in this small study indicate that meropenem is as efficacious for and as well tolerated by elderly patients as the combination of cefuroxime-gentamicin (±metronidazole).

scholarly journals Hypertension and the risk of endometrial cancer: a systematic review and meta-analysis of case-control and cohort studies

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Dagfinn Aune ◽  
Abhijit Sen ◽  
Lars J. Vatten
Keyword(s):  
Systematic Review ◽  
Endometrial Cancer ◽  
Cohort Studies ◽  
Contraceptive Use ◽  
Meta Analysis ◽  
Case Control ◽  
Adjusted Relative Risk ◽  
Case Control Studies ◽  
Relative Risks ◽  
Increased Risk

Abstract A history of hypertension has been associated with increased risk of endometrial cancer in several studies, but the results have not been consistent. We conducted a systematic review and meta-analysis of case-control and cohort studies to clarify the association between hypertension and endometrial cancer risk. PubMed and Embase databases were searched up to 27th of February 2016. Prospective and case-control studies which reported adjusted relative risk estimates and 95% confidence intervals of endometrial cancer associated with a hypertension diagnosis were included. Summary relative risks were estimated using a random effects model. Nineteen case-control studies and 6 cohort studies were included. The summary RR was 1.61 (95% CI: 1.41–1.85, I2 = 86%) for all studies, 1.73 (95% CI: 1.45–2.06, I2 = 89%) for case-control studies and 1.32 (95% CI: 1.12–1.56, I2 = 47%) for cohort studies. The association between hypertension and endometrial cancer was weaker, but still significant, among studies with adjustment for smoking, BMI, oral contraceptive use, and parity, compared to studies without such adjustment. This meta-analysis suggest an increased risk of endometrial cancer among patients with hypertension, however, further studies with more comprehensive adjustments for confounders are warranted to clarify the association.

scholarly journals HPV infection and endometriosis: a systematic review and meta-analysis

2019 ◽  
Vol 31 (4) ◽  
pp. 138-142
Author(s):  
Geilson Gomes de Oliveira ◽  
José Eleutério ◽  
Renata Mírian Nunes Eleutério
Keyword(s):  
Systematic Review ◽  
Bacterial Infections ◽  
Meta Analysis ◽  
Hpv Infection ◽  
Cochrane Library ◽  
Sexually Transmitted ◽  
Unexposed Control ◽  
Relative Risks ◽  
Search Terms

Introduction: Recent research has focused on the role of persistent ascending bacterial infections and sexually transmitted infections (STI) as a factor associated to endometriosis. Indeed, some studies investigated the possible role of HPV in endometriosis, but this topic remains inconclusive. Objective:The present study aims to meta-analyze research that assessed the presence of HPV infection in patients with endometriosis. Methods: MEDLINE, Embase, Scopus, LILACS, Cochrane Library, and OpenGrey were searched until February 10th, 2020. Search terms included “endometriosis” and “HPV” without language restrictions. The combined relative risks and 95% confidence interval (95%CI) were calculated, and heterogeneity was assessed with I-square (I2 ). Results: Meta-analysis with low heterogeneity found a relative risk of twice as much in women exposed to HPV in relation to the unexposed control. Conclusion: Results indicate that HPV could be a risk factor for developing endometriosis.

The Role of Mobile Phones in Real World Motor Vehicle Crashes

2015 ◽  
pp. 1366-1375 ◽  
Author(s):  
Suzanne P. McEvoy
Keyword(s):  
Text Messaging ◽  
Motor Vehicle ◽  
Epidemiological Studies ◽  
Motor Vehicle Crashes ◽  
Vehicle Crashes ◽  
Mobile Phone Use ◽  
Relative Risks ◽  
Increased Risk ◽  
Driver Distractions

Early on, road epidemiological studies (Redelmeier & Tibshirani, 1997; McEvoy et al., 2005) indicated an increased risk of motor vehicle crashes, including injury crashes, associated with mobile phone use. However, these studies were unable to assess the relative risks pertaining to specific phone tasks (for example, conversing versus texting). Moreover, direct comparisons of risk between different types of driver distractions, while possible (McEvoy, Stevenson, Woodward, 2007), were difficult to undertake. Naturalistic driving studies using instrumented cars in every day driving have provided more details of the tasks that confer particular risk in relation to phone use and other driver distractions (Klauer et al., 2014; Olson et al., 2009; Klauer et al., 2006; Dingus et al., 2006). Interest generated in these studies has prompted current trials using similar methodologies elsewhere, for example, Australia (Regan et al., 2013). To date, phone tasks involving handling of the phone and/or multiple or prolonged eye glances away from the forward roadway (dialling, reaching for the phone and text messaging) have been shown to significantly increase the risk of crashes and near crashes.

Rule out Sepsis in Infant

2018 ◽  
pp. 257-262
Author(s):  
Temima Waltuch
Keyword(s):  
Risk Stratification ◽  
Lumbar Puncture ◽  
Antibiotic Treatment ◽  
Bacterial Infections ◽  
Individual Risk ◽  
Immune Systems ◽  
Increased Risk ◽  
Empiric Antibiotic ◽  
Empiric Antibiotic Treatment ◽  
Serious Bacterial Infections

This case reviews the workup and management of febrile infants less than 3 months of age. These infants are a unique population as their immune systems are immature, placing them at increased risk for serious bacterial infections. Most febrile infants have self-limited viral illnesses; however, it is important to identify those that have a coexisting or isolated bacterial illness. Febrile infants <28 days require a full sepsis workup and admission to the hospital for monitoring and parenteral empiric antibiotic treatment. Workup and management of febrile infants between 29 and 90 days present more of a controversy in the literature. At minimum, infants 1 to 2 months of age will have blood and urine cultures performed, while the lumbar puncture is dependent on their individual risk stratification. Workup for infants 2 to 3 months of age will be completely dependent on risk stratification.

Increased Risk of Serious Bacterial Infections Due to Maternal Immunosuppression in HIV-Exposed Uninfected Infants in a European Country

2014 ◽  
Vol 59 (9) ◽  
pp. 1332-1345 ◽  
Author(s):  
C. Taron-Brocard ◽  
J. Le Chenadec ◽  
A. Faye ◽  
C. Dollfus ◽  
T. Goetghebuer ◽  
...  
Keyword(s):  
European Country ◽  
Bacterial Infections ◽  
Increased Risk ◽  
Serious Bacterial Infections ◽  
Hiv Exposed ◽  
Exposed Uninfected

scholarly journals The effect of immunosuppressants on the prognosis of SARS-CoV-2 infection

2021 ◽  
pp. 2100769
Author(s):  
Daniel Ward ◽  
Sanne Gørtz ◽  
Martin Thomsen Ernst ◽  
Nynne Nyboe Andersen ◽  
Susanne K. Kjær ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Calcineurin Inhibitors ◽  
Adjusted Relative Risk ◽  
Icu Admission ◽  
Risk Of Death ◽  
Relative Risks ◽  
Increased Risk ◽  
Systemic Glucocorticoids ◽  
Interleukin Inhibitors ◽  
Log Linear

BackgroundImmunosuppression may worsen SARS-CoV-2 infection. We conducted a nationwide cohort study of the effect of exposure to immunosuppressants on the prognosis of SARS-CoV-2 infection in Denmark.MethodsWe identified all SARS-CoV-2 test-positive patients from February to October 2020 and linked health care data from nationwide registers, including prescriptions for the exposure, immunosuppressant drugs. We estimated relative risks of hospital admission, intensive care unit (ICU) admission, and death (each studied independently up to 30 days from testing) with a log linear binomial regression adjusted for confounders using a propensity score-based matching weights model.ResultsA composite immunosuppressant exposure was associated with a significantly increased risk of death (adjusted relative risk 1·56 [95% confidence interval 1.10–2.22]). The increased risk of death was mainly driven by exposure to systemic glucocorticoids (aRR 2.38 [95% CI 1.72–3.30]), which were also associated with an increased risk of hospital admission (aRR 1.34 [95% CI 1.10–1.62]), but not ICU admission (aRR 1.76 [95% CI [0.93–3.35]); these risks were greater for high cumulative doses of glucocorticoids than for moderate doses. Exposure to selective immunosuppressants, tumour necrosis factor inhibitors, or interleukin inhibitors, was not associated with an increased risk of hospitalisation, ICU admission, or death, nor was exposure to calcineurin inhibitors, other immunosuppressants, hydroxychloroquine, or chloroquine.ConclusionsExposure to glucocorticoids was associated with increased risks of hospital admission and death. Further investigation is needed to determine the optimal management of COVID-19 in patients with pre-morbid glucocorticoid usage, specifically whether these patients require altered doses of glucocorticoids.

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