scholarly journals Fatal hemorrhagic pneumonia in patients with hematologic diseases and Stenotrophomonas maltophilia bacteremia: a retrospective study

2021 ◽  
Author(s):  
Lixia ZHU ◽  
Lulu Wang ◽  
Yuping Zhang ◽  
Rongrong Chen ◽  
Xueying Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Stenotrophomonas Maltophilia ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Hematologic Diseases ◽  
Hemorrhagic Pneumonia ◽  
Life Threatening ◽  
High Level ◽  
Clinical Records

Abstract Background Fatal hemorrhagic pneumonia is one of the most severe manifestations of Stenotrophomonas maltophilia (SM) infections. Here, we aimed to investigate the clinical characteristics of SM bacteremia and to identify the risk factors of hemorrhagic pneumonia caused by SM in patients with hematologic diseases. Methods The clinical records of 55 patients diagnosed with hematologic diseases and SM bacteremia were retrospectively reviewed. We compared patients’ clinical characteristics and outcomes between the hemorrhagic pneumonia group and non-hemorrhagic pneumonia group. Results Twenty-seven (49.1%) patients developed hemorrhagic pneumonia. The overall mortality rate of SM bacteremia was 67.3%. The 30-day mortality rate was significantly higher in patients with hemorrhagic pneumonia than those without hemorrhagic pneumonia (85.2% and 50.0%, respectively, P = 0.003). Compared with the non-hemorrhagic pneumonia group, patients in the hemorrhagic pneumonia group were older and showed clinical manifestations as higher proportions of isolated SM in sputum culture, neutropenia and elevated procalcitonin. Multivariate analysis showed that neutropenia, high levels of procalcitonin, prior tigecycline therapy within 1 month were independent risk factors associated with hemorrhagic pneumonia. Conclusions Hematologic patients with SM bacteremia who have neutropenia, high level of procalcitonin and prior tigecycline therapy within 1 month should be early treated with combined effective antibiotics and best supportive interventions to avoid life-threatening hemorrhagic pneumonia.

scholarly journals Fatal hemorrhagic pneumonia in patients with hematologic diseases and Stenotrophomonas maltophilia bacteremia: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lixia Zhu ◽  
Lulu Wang ◽  
Yuping Zhang ◽  
Rongrong Chen ◽  
Xueying Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stenotrophomonas Maltophilia ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Hematologic Diseases ◽  
Hemorrhagic Pneumonia ◽  
Independent Risk Factors ◽  
High Level ◽  
Clinical Records ◽  
Overall Mortality

Abstract Background Fatal hemorrhagic pneumonia is one of the most severe manifestations of Stenotrophomonas maltophilia (SM) infections. Here, we aimed to investigate the clinical characteristics of SM bacteremia and to identify the risk factors of hemorrhagic pneumonia caused by SM in patients with hematologic diseases. Methods The clinical records of 55 patients diagnosed with hematologic diseases and SM bacteremia were retrospectively reviewed. We compared patients’ clinical characteristics and outcomes between the hemorrhagic pneumonia group and non-hemorrhagic pneumonia group. Results Twenty-seven (49.1%) patients developed hemorrhagic pneumonia. The overall mortality rate of SM bacteremia was 67.3%. Hemorrhagic pneumonia (adjusted HR 2.316, 95% CI 1.140–4.705; P = 0.020) was an independent risk factor of 30-day mortality in hematological patients with SM bacteremia. Compared with the non-hemorrhagic pneumonia group, patients in the hemorrhagic pneumonia group were older and showed clinical manifestations as higher proportions of isolated SM in sputum culture, neutropenia and elevated procalcitonin (PCT). Multivariate analysis showed that neutropenia, high levels of PCT, prior tigecycline therapy within 1 month were independent risk factors associated with hemorrhagic pneumonia. Conclusions Neutropenia, high level of PCT and prior tigecycline therapy within 1 month were significant independent predictors of hemorrhagic pneumonia in hematologic patients with SM bacteremia. Due to no effective antibiotics to prevent hemorrhagic pneumonia, prophylaxis of SM infection and its progression to hemorrhagic pneumonia is particularly important.

Life-threatening hemorrhagic pneumonia caused by Stenotrophomonas maltophilia in the treatment of hematologic diseases

2014 ◽  
Vol 93 (6) ◽  
pp. 901-911 ◽  
Author(s):  
Minako Mori ◽  
Hiroko Tsunemine ◽  
Kazunori Imada ◽  
Kiminari Ito ◽  
Taiichi Kodaka ◽  
...  
Keyword(s):  
Stenotrophomonas Maltophilia ◽  
Hematologic Diseases ◽  
Hemorrhagic Pneumonia ◽  
Life Threatening

scholarly journals Epidemiology of Coronavirus disease 2019 (COVID-19)

2020 ◽  
Vol 1 (2) ◽  
pp. 14-20
Author(s):  
T. N. Bilichenko
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Statistical Data ◽  
Preventive Measures ◽  
Clinical Manifestations ◽  
Research Information ◽  
The World ◽  
Main Factors ◽  
Course Outcomes ◽  
Official Sources

An analysis of epidemiology coronavirus disease 2019 (COVID-19) in Russia and the world was carried out to identify the main factors contributing to morbidity and mortality due to COVID-19, pathogenesis and clinical manifestations of the disease. Statistical data were used from official sources (Rospotrebnadzor, WHO, US CDC, China NHC, ECDC, DXY). Research information from different countries about the course, outcomes, spread, and risk factors of the disease is presented.The study of epidemiology, risk factors, causes of increased incidence of COVID-19, mortality rate is of great importance for assessing the effectiveness of preventive measures.

scholarly journals Risk factors and clinical characteristics of Stenotrophomonas maltophilia infections in neonates

2011 ◽  
Vol 44 (6) ◽  
pp. 467-472 ◽  
Author(s):  
Mehmet Mutlu ◽  
Gürdal Yılmaz ◽  
Yakup Aslan ◽  
Gülçin Bayramoğlu
Keyword(s):  
Risk Factors ◽  
Stenotrophomonas Maltophilia ◽  
Clinical Characteristics

scholarly journals Clinical characteristics and risk factors of Fulminant Mycoplasma pneumoniae pneumonia in children

2020 ◽  
Author(s):  
yaoyao ling ◽  
Tongqiang Zhang ◽  
Zhenli Zhu ◽  
Jiao Tian ◽  
yongsheng xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Mycoplasma Pneumoniae ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Radiological Findings ◽  
Mycoplasma Pneumoniae Pneumonia ◽  
D Dimer

Abstract BACKGROUND: Analyze the clinical characteristics of Fulminant Mycoplasma pneumoniae pneumonia (FMPP), and explore the related factors predicting FMPP. METHODS: A retrospective case-control study was performed on 345 children with Mycoplasma pneumoniae pneumonia (MPP) hospitalized in our Hospital from January 2017 to June 2019. The clinical features, laboratory data and radiological findings were compared between the FMPP group, refractory Mycoplasma pneumoniae pneumonia (RMPP)group and general Mycoplasma pneumoniae pneumonia (GMPP) group. RESULTS: FMPP patients (n=69) had more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings(P<0.05). And the days of fever and the days in hospital were longer, and FMPP patients also need more complicated treatments(P<0.05). Meanwhile, the levels of white blood cell count(WBC) ,C-reactive protein(CRP), lactic dehydrogenase (LDH), interleukin (IL)-6,ferritin, D-dimer, fibrinogen(FG),alanine aminotransferase(ALT) and the percentage of neutrophils in the FMPP group were significantly higher than those in the RMPP group and the GMPP group (both P<0.05). In ROC curve analysis, the percentage of neutrophils, WBC, CRP, LDH, IL-6, ferritin, D-dimer and ALT were contributed to identify FMPP patients. Multivariate logistic regression analysis showed that ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion had significant predictive effects on the early diagnosis of FMPP (P<0.01). Conclusion: FMPP patients presented more serious clinical manifestations. Ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion were high risk factors for FMPP.

scholarly journals Bronchopleural Fistula after Pulmonary Resection: Risk Factors, Diagnoses and Management

2021 ◽  
Author(s):  
Kristina Jacobsen
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Respiratory Distress ◽  
Conservative Management ◽  
Endoscopic Treatment ◽  
Pulmonary Resection ◽  
Bronchopleural Fistula ◽  
Patient Characteristics ◽  
Pleural Space ◽  
Life Threatening

Bronchopleural fistula (BPF) after a pulmonary resection is rare with some of the most life-threatening consequences and a high mortality rate. Contamination of the pleural space resulting in empyema and spillage of the infected fluid into the remaining lung leading to respiratory distress remain the biggest concerns with BPF postoperatively. There are many patient characteristics and risk factors that can be evaluated to decrease the chance of a postoperative BPF. Presentation of BPF can be early or late with the late BPF more difficult to diagnosis and manage. Many options to treat BPF include surgical repair, conservative management, and endoscopic treatment.

scholarly journals A Study in the Clinical Characteristics of Stenotrophomonas Maltophilia Bacteremia in Hematological Patients

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4631-4631
Author(s):  
Haiyan Bao ◽  
Jia Chen ◽  
Xiaojin Wu ◽  
Xiao Ma ◽  
Chengcheng Fu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Respiratory Failure ◽  
Stenotrophomonas Maltophilia ◽  
Clinical Characteristics ◽  
Univariate Analysis ◽  
P Value ◽  
Hematological Diseases ◽  
Factors Associated

Abstract Introduction: Stenotrophomonas maltophilia is an important nosocomial pathogen, particularly in immunocompromised patients, especially in patients with hematologic diseases. Methods: We reviewed the clinical characteristics and prognosis of patients with S. maltophilia bacteremia over a five-year period from January 2010 to December 2014. Species identification was performed using the automated Vitek 2 compact system (bioMe rieux). Results: The incidence of S. maltophilia bacteremia was 25.1 per 10 000 admissions in our study. Thirty-four patients (median age: 34 years; 64.7% males) with S. maltophilia bacteremia were analyzed. The S. maltophilia bacteremia related 30-day mortality was 44.1%. Risk factors associated with mortality in patients with S. maltophilia infection in the univariate and multivariate analysis were represented in Tables I and II. In the univariate analysis, risk factors included T>39.0¡æ, septic shock, respiratory failure and non-remission after treatment for primary hematological diseases (P <0.05). In the multivariate analysis, respiratory failure and non-remission status after treatment forhematological diseases were independent prognostic factors for mortality. In vitro susceptibility was higher to ciprofloxacin(82.4%), ceftazidime(70.6%), sulbactam and cefoperazone(58.8%), which was shown in Table III. Conclusion: Combination regimens with ciprofloxacin and ceftazidime, or sulbactam and cefoperazone could be alternative treatment. Novel antibiotics are required for treatment of S. maltophilia infection, as well as infection control practices of environmental reserves, rapid detection of pathogens, risk stratification strategy and appropriate treatment for primary hematologic malignancies, which might conjointly contribute to better survival outcome of S. maltophilia bacteremia. Univariate analysis of prognostic factors associated with mortality from S. maltophilia bacteremia Table 1. Factor Mortality HR 95%CI P-value Withfactor Withoutfactor T>39.0¡æ 75% 16.7% 2.490 1.318-4.704 0.005 Septic shock 90.0% 25.0% 2.544 1.473-4.393 0.001 Respiratory failure 100% 20.8% 4.672 2.366-9.225 0.000 Treatment outcome for hematological diseases Remission 10.0% 85.7% 0.247 0.116-0.526 0.000 HR, hazard ratio; CI, confidence interval; HSCT, Hematopoietic stem cell transplantation Table 2. Multivariate analysis of prognostic factors associated with mortality from S. maltophilia bacteremia Factor HR 95%CI P-value Respiratory failure 2.688 1.297-5.569 0.008 Remission after treatment for hematological diseases 0.367 0.153-0.879 0.025 HR, hazard ratio; CI, confidence interval Table 3. Susceptibility pattern of the 34 patients with Stenotrophomonas maltophilia bacteremia Antimicrobial agents S (%) I (%) Ceftazidime 24(70.6%) 1(2.9%) Cefoperazone 19(44.1%) 6(17.6%) Sulbactam and Cefoperazone 20(58.8%) 5(14.7%) Piperacillin 7(20.6%) 6(17.6%) Piperacillin-Tazobactam 11(32.3%) 7(20.6%) Amikacin 6(17.6%) 0(0%) Ciprofloxacin 28(82.4%) 1(2.9%) S, susceptible; I, intermediately susceptible. Disclosures No relevant conflicts of interest to declare.

scholarly journals Repeat Keratoplasty for Failed Therapeutic Keratoplasty for Microbial Keratitis: An Analysis of Characteristics and Risk Factors

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jifeng Wan ◽  
Jing Lin ◽  
Yin Hu ◽  
Menghuan Wei ◽  
Yingshi Zou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Procedures ◽  
Clinical Characteristics ◽  
Southern China ◽  
Causative Organism ◽  
Corneal Perforation ◽  
Infectious Keratitis ◽  
Microbial Keratitis ◽  
Common Indication ◽  
Clinical Records

Purpose. To report the ratio of repeat-to-initial keratoplasty among patients who had underwent therapeutic keratoplasty for microbial keratitis in Southern China and to investigate the characteristics and risk factors of repeat keratoplasty. Methods. A retrospective and inclusive review of the clinical records of patients who had received therapeutic keratoplasty for microbial keratitis, at Zhongshan Ophthalmic Center during December 2012 to January 2018, was performed. Patients who suffered coexistent endophthalmitis or underwent keratoplasty combined with other surgeries were excluded. Data on clinical characteristics of all eligible patients were collected. Results. A total of 447 patients were identified. Their mean age was 48.7 ± 15.5 years, and 290 (64.9%) were male. Out of the 447 patients, 18 (4.0%) received repeat keratoplasty. Their mean age was 45.9 ± 11.3 years, and 14 (77.8%) were male. The most common indication of repeat keratoplasty (12/18) was refractory infectious keratitis. Most of the patients (15/18, 83.3%) received the second keratoplasty within 12 months after the initial keratoplasty. Factors, including age, gender, initial causative organism, presence of initial corneal perforation, ocular comorbidities, and surgical procedures were not found statistically significantly different between patients who received and not received repeat keratoplasty. Conclusion. The ratio of repeat-to-initial keratoplasty for therapeutic keratoplasty is low, compared to a failure rate of the initial grafts of over 50% reported in previous studies. The low ratio and the most common indication of repeat keratoplasty, refractory infectious keratitis, reflect caution for performing regrafts in such patients.

Allopurinol-induced hypersensitivity syndrome

2012 ◽  
Vol 153 (15) ◽  
pp. 586-591 ◽  
Author(s):  
Ágnes Kinyó ◽  
Anna Lakatos ◽  
Anita Varga ◽  
Roland Gyulai ◽  
Erika Varga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Impairment ◽  
Thiazide Diuretic ◽  
Clinical Manifestations ◽  
Hypersensitivity Syndrome ◽  
Thiazide Diuretics ◽  
Cutaneous Manifestations ◽  
Potential Risk Factors ◽  
Life Threatening ◽  
Lowering Drug

Allopurinol is an effective urate lowering drug, which is usually well-tolerated with no adverse effects in most cases, but about 2% of the treated patients develop a skin rash, and patients may experience severe allopurinol-induced hypersensitivity syndrome. Aims: The aim of the authors was to summarize and present the clinical manifestations of allopurinol-induced hypersensitivity in patients treated at the Department of Dermatology and Allergology, University of Szeged in order to identify potential associations with this syndrome. Methods: Retrospective review of all patients who were referred to the department with allopurinol-induced hypersensitivity syndrome in the last four years. Results: During four years, 11 patients were treated with allopurinol-induced hypersensitivity syndrome. The average age was 70.3 years. Before the initiation of allopurinol therapy, 36% of patients had already suffered from various degrees of renal impairment, and 72% of them had been taking thiazide diuretics. Cutaneous manifestations were mainly generalized, erythematous, maculopapular exanthemas (9 patients, 82%), and two patients showed signs of erythema multiforme (18%). Asymptomatic hyperuricemia was the indication for allopurinol therapy in all patients. Conclusions: Allopurinol-induced hypersensitivity syndrome is a severe, life-threatening disease. Administration of allopurinol should be initiated with clear indications in appropriate dose. Old age, underlying renal impairment and concomitant thiazide diuretic intake should be considered as potential risk factors for developing hypersensitivity syndrome. Orv. Hetil., 2012, 153, 586–591.

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