CLINICAL CHARACTERISTICS AND THE IMPACT OF VANCOMYCIN-RESISTANCE ON THE OUTCOMES IN ENTEROCOCCAL BACTEREMIA DIAGNOSED IN FEBRILE NEUTROPENIC CHILDREN

2017 ◽  
Author(s):  
Seung Beom Han
Keyword(s):  
Clinical Characteristics ◽  
Vancomycin Resistance ◽  
The Impact ◽  
Enterococcal Bacteremia

scholarly journals Vancomycin-Nonsusceptible Enterococci Mediated by vanC at a Large Children’s Hospital: Prevalence, Susceptibility, and Impact on Care of Enterococcal Bacteremia

2020 ◽  
Vol 7 (5) ◽  
Author(s):  
Daniel S Dodson ◽  
Samuel R Dominguez ◽  
Christine E MacBrayne ◽  
Manon C Williams ◽  
Sarah K Parker
Keyword(s):  
Infection Control ◽  
Patient Care ◽  
Antibiotic Stewardship ◽  
Pediatric Patients ◽  
Vancomycin Resistance ◽  
Immunocompromised Patients ◽  
Enterococcal Species ◽  
Enterococcus Gallinarum ◽  
The Impact ◽  
Enterococcal Bacteremia

Abstract Enterococcus gallinarum and casseliflavus have inherent vancomycin resistance and, though known as pathogens, have not been well characterized in pediatric patients. We identified a significant prevalence of these enterococcal species among immunocompromised patients at a large pediatric institution and describe the impact on patient care, antibiotic stewardship, and infection control.

scholarly journals Clinical Characteristics and Outcomes of Patients with High Ankle-Brachial Index from the IMPACT-ABI Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0167150 ◽  
Author(s):  
Hitoshi Nishimura ◽  
Takashi Miura ◽  
Masatoshi Minamisawa ◽  
Yasushi Ueki ◽  
Naoyuki Abe ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Ankle Brachial Index ◽  
The Impact

scholarly journals Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry

2021 ◽  
Author(s):  
Yoichi Imori ◽  
Ken Kato ◽  
Victoria L. Cammann ◽  
Konrad A. Szawan ◽  
Manfred Wischnewsky ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Clinical Characteristics ◽  
Ethnic Disparities ◽  
Japanese Patients ◽  
Learning Approach ◽  
Takotsubo Syndrome ◽  
Unique Identifier ◽  
Hospital Outcomes ◽  
Machine Learning Approach ◽  
The Impact

Abstract Background Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes. Methods TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients. Results A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 ± 11.4 years vs. 68.0 ± 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p < 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p < 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients. Conclusion Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers. Trial Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01947621.

scholarly journals Updated overview on the interplay between obesity and COVID-19

Diagnosis ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Diletta Onorato ◽  
Giovanni Carpenè ◽  
Giuseppe Lippi ◽  
Mairi Pucci
Keyword(s):  
Disease Severity ◽  
Clinical Characteristics ◽  
Literature Search ◽  
Scientific Literature ◽  
Population Sample ◽  
Obese Patients ◽  
Health Crisis ◽  
Keywords Obesity ◽  
Negative Prognostic Factor ◽  
The Impact

AbstractThe worldwide spread of coronavirus disease 2019 (COVID-19) has generated a global health crisis and more than a million deaths so far. Epidemiological and clinical characteristics of COVID-19 are increasingly reported, along with its potential relationship with overweight and/or obesity. Therefore, we aim here to review the current scientific literature on the impact of overweight and/or obesity among hospitalized patients who have developed severe or critical forms of COVID-19. Following PRISMA guidelines, our literature search identified over 300 scientific articles using the keywords “obesity” and “COVID-19”, 22 of which were finally selected for reporting useful information on the association between overweight/obesity and disease severity. In particular, in 11 out of the 14 studies (79%) which evaluated the association between obesity and disease severity providing also a risk estimate (i.e., the odd ratio; OR), the OR value was constantly >2. Although the studies were found to be heterogeneous in terms of design, population, sample size and endpoints, in most cases a significant association was found between obesity and the risk of progressing to severe COVID-19 illness, intensive care unit admission and/or death. We can hence conclude that an increased body mass index shall be considered a negative prognostic factor in patients with COVID-19, and more aggressive prevention or treatment shall hence be reserved to overweight and/or obese patients.

scholarly journals Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients with Enterococcus faecium Infections

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 105
Author(s):  
Jatapat Hemapanpairoa ◽  
Dhitiwat Changpradub ◽  
Sudaluck Thunyaharn ◽  
Wichai Santimaleeworagun
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Proportional Hazards Model ◽  
Significant Risk ◽  
Vancomycin Resistance ◽  
Cox Proportional Hazards Model ◽  
Factors Associated ◽  
Joint Infections ◽  
Bone And Joint Infections ◽  
The Impact

The prevalence of enterococcal infection, especially E. faecium, is increasing, and the issue of the impact of vancomycin resistance on clinical outcomes is controversial. This study aimed to investigate the clinical outcomes of infection caused by E. faecium and determine the risk factors associated with mortality. This retrospective study was performed at the Phramongkutklao Hospital during the period from 2014 to 2018. One hundred and forty-five patients with E. faecium infections were enrolled. The 30-day and 90-day mortality rates of patients infected with vancomycin resistant (VR)-E. faecium vs. vancomycin susceptible (VS)-E. faecium were 57.7% vs. 38.7% and 69.2% vs. 47.1%, respectively. The median length of hospitalization was significantly longer in patients with VR-E. faecium infection. In logistic regression analysis, VR-E. faecium, Sequential Organ Failure Assessment (SOFA) scores, and bone and joint infections were significant risk factors associated with both 30-day and 90-day mortality. Moreover, Cox proportional hazards model showed that VR-E. faecium infection (HR 1.91; 95%CI 1.09–3.37), SOFA scores of 6–9 points (HR 2.69; 95%CI 1.15–6.29), SOFA scores ≥ 10 points (HR 3.71; 95%CI 1.70–8.13), and bone and joint infections (HR 0.08; 95%CI 0.01–0.62) were significant risk factors for mortality. In conclusion, the present study confirmed the impact of VR-E. faecium infection on mortality and hospitalization duration. Thus, the appropriate antibiotic regimen for VR-E. faecium infection, especially for severely ill patients, is an effective strategy for improving treatment outcomes.

scholarly journals Attributable mortality of vancomycin resistance in ampicillin-resistant Enterococcus faecium bacteremia in Denmark and the Netherlands: A matched cohort study

2021 ◽  
pp. 1-9
Author(s):  
Wouter C. Rottier ◽  
Mette Pinholt ◽  
Akke K. van der Bij ◽  
Magnus Arpi ◽  
Sybrandus N. Blank ◽  
...  
Keyword(s):  
Cohort Study ◽  
The Netherlands ◽  
Antibiotic Therapy ◽  
Enterococcus Faecium ◽  
Mortality Rates ◽  
Vancomycin Resistance ◽  
Attributable Mortality ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
The Impact

Abstract Objective: To study whether replacement of nosocomial ampicillin-resistant Enterococcus faecium (ARE) clones by vancomycin-resistant E. faecium (VRE), belonging to the same genetic lineages, increases mortality in patients with E. faecium bacteremia, and to evaluate whether any such increase is mediated by a delay in appropriate antibiotic therapy. Design: Retrospective, matched-cohort study. Setting: The study included 20 Dutch and Danish hospitals from 2009 to 2014. Patients: Within the study period, 63 patients with VRE bacteremia (36 Dutch and 27 Danish) were identified and subsequently matched to 234 patients with ARE bacteremia (130 Dutch and 104 Danish) for hospital, ward, length of hospital stay prior to bacteremia, and age. For all patients, 30-day mortality after bacteremia onset was assessed. Methods: The risk ratio (RR) reflecting the impact of vancomycin resistance on 30-day mortality was estimated using Cox regression with further analytic control for confounding factors. Results: The 30-day mortality rates were 27% and 38% for ARE in the Netherlands and Denmark, respectively, and the 30-day mortality rates were 33% and 48% for VRE in these respective countries. The adjusted RR for 30-day mortality for VRE was 1.54 (95% confidence interval, 1.06–2.25). Although appropriate antibiotic therapy was initiated later for VRE than for ARE bacteremia, further analysis did not reveal mediation of the increased mortality risk. Conclusions: Compared to ARE bacteremia, VRE bacteremia was associated with higher 30-day mortality. One explanation for this association would be increased virulence of VRE, although both phenotypes belong to the same well-characterized core genomic lineage. Alternatively, it may be the result of unmeasured confounding.

scholarly journals Clinical outcomes of Japanese atrial fibrillation patients with combined valvular heart disease: the Fushimi AF Registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Doi ◽  
K Ishigami ◽  
Y Aono ◽  
S Ikeda ◽  
Y Hamatani ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Incidence Rate ◽  
Clinical Outcomes ◽  
Valvular Heart Disease ◽  
Cardiac Death ◽  
Clinical Characteristics ◽  
Valve Disease ◽  
The Impact

Abstract Background We previously reported that valvular heart disease (VHD) was not at the significant risk of stroke/systemic embolism (SE), but was associated with an increased risk of hospitalization for heart failure (HF) in Japanese atrial fibrillation patients. However, the impact of combined VHD on clinical outcomes has been little known. Purpose The aim of this study is to investigate the prevalence of combined VHD and its clinical characteristics and impact on outcomes such as stroke/SE, all-cause death, cardiac death and hospitalization for HF. Method The Fushimi AF Registry is a community-based prospective survey of AF patients in one of the wards of our city which is a typical urban district of Japan. We started to enroll patients from March 2011, and follow-up data were available for 4,466 patients by the end of November 2019. In the entire cohort, echocardiography data were available for 3,574 patients. 68 AF patients with prosthetic heart valves were excluded and we compared clinical characteristics and outcomes between 488 single VHD (103 Aortic valve disease (AVD), 315 mitral valve disease (MVD), 70 tricuspid valve disease (TVD)) and 158 combined VHD (46 AVD and MVD, 11 AVD and TVD, 66 MVD and TVD, 35 AVD and MVD and TVD). Result Compared with single VHD, patients with combined VHD were older (combined vs. single VHD: 78.5 vs. 76.0 years, respectively; p&lt;0.01), more likely to have persistent/permanent type AF (73.4% vs. 63.9%, p=0.02) and prescription of warfarin (63.1% vs. 53.8%, p=0.04). Combined VHD was less likely to have diabetes mellitus (13.9% vs. 23.6%, p=0.01) and dyslipidemia (26.6% vs. 40.4%, p&lt;0.01). Sex, body weight, hypertension, pre-existing HF were comparable between the two groups. During the median follow-up of 1,474 days, the incidence rate of stroke/SE was not significantly different between the two groups (1.58 vs. 1.89 per 100 person-years, respectively, log rank p=0.10). The incidence rate of all-cause death (7.35 vs. 5.33, p=0.65), cardiac death (1.20 vs. 0.99, p=0.91) and hospitalization for HF (5.55 vs. 4.43, p=0.53) were also not significantly different. We previously reported AVD had significant impacts on cardiac adverse outcomes in AF patients, and we further analyzed event rates between combined VHD including AVD (AVD and MVD/TVD) and without AVD (MVD and TVD). Combined VHD with AVD group had higher incidence rate of all-cause death (10.7 vs. 5.79, p=0.03) than that without AVD group. However, the incidence rate of stroke/SE (1.98 vs. 1.56, p=0.59), cardiac death (0.98 vs. 1.14, p=0.68), hospitalization for HF (8.03 vs. 5.38, p=0.17) were not significantly different between the two groups. Conclusion As compared with single VHD, the risk of stroke/SE, all-cause death, cardiac death and hospitalization for HF in combined VHD was not significantly different. Among patients with combined VHD, those having AVD had higher incidence rate of all-cause death than those without AVD. Figure 1 Funding Acknowledgement Type of funding source: None

A Report on COVID-19 Variants, COVID-19 Vaccines and the Impact of the Variants on the Efficacy of the Vaccines

2021 ◽  
Author(s):  
Michael Halim
Keyword(s):  
South Africa ◽  
Immune Response ◽  
Clinical Characteristics ◽  
Systemic Review ◽  
Review Of Literature ◽  
Negative Effects ◽  
Mortality And Morbidity ◽  
The World ◽  
Different Strains ◽  
The Impact

The Coronavirus pandemic has caused negative effects across the globe; mortality and morbidity being the main impact. After WHO, termed the disease a pandemic in March 2020, they gave in health guidelines to follow to control the spread of the disease. The health industry, academia, and different governments are united to develop and test various vaccines at an unprecedented speed to combat the pandemic fully and bring the world back to its feet. Some of the vaccines developed include Pfizer, Moderna, and AstraZeneca. However, just like other viruses, the SAR-CoV-2 virus keeps changing through mutation, as various variants, different from the first one are emerging. Evidence shows that the three new variants; UK, Brazil, and South Africa are more severe in terms of transmissibility, disease severity, evading of the immune response, and reducing the ability to neutralized antibodies, compared to the original coronavirus. With such knowledge of the existence of different strains, the arises concerns on whether the already available vaccines are effective enough in preventing the new COVID-19 strains. Studies are still underdeveloped to learn more on the virologic, epidemiologic, and clinical characteristics of the ever-emerging variants. This research, through a systemic review of literature, seeks to find out whether the variants of SAR-CoV-2 have an impact on the efficacy of various vaccines developed in fighting the disease and the entire body’s immune response.

Clinical Impact of Combined Viral and Bacterial Infection in Pediatric Mycoplasmal Community-Acquired Pneumonia in Western China

2020 ◽  
Vol 12 (11) ◽  
pp. 1315-1322
Author(s):  
Zhuoxin Liang ◽  
Wenqiang Zhang ◽  
Yongjiang Jiang ◽  
Ping Wu ◽  
Senxiong Zhang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Severe Disease ◽  
Lung Parenchyma ◽  
Community Acquired Pneumonia ◽  
Western China ◽  
Care Hospital ◽  
Hospital Data ◽  
Chest X Ray ◽  
Ventilation Rates ◽  
The Impact

Community-acquired pneumonia (CAP) refers to an infection contracted outside the hospital that leads to lung parenchyma inflammation. The clinical characteristics of Mycoplasma pneumoniae (M. pneumoniae) infection in CAP patients were rarely reported. The aim of this study was to describe the clinical characteristic and the impact of co-infections of M. pneumoniae with viral and bacterial pathogens in hospitalized children with CAP in Liuzhou, China. This study retrospects children diagnosed with CAP due to M. pneumoniae infection at a tertiary maternal and child health care hospital. Data related to co-infection pathogens, demographics, clinical characteristics, and hospitalization cost were collected from the electronic medical system in this hospital. A total of 983 children were diagnosed with mycoplasmal CAP in 2017. Among them, 18.2% had a bacterial-M. pneumoniae co-infection and 11.3% had a viral-M. pneumoniae co-infection. The highest infection rate of M. pneumoniae was 19.1% in February and March, while the highest rates of bacterial-M. pneumoniae and viral-M. pneumoniae co-infections were 3.6% in December and 2.3% in January, respectively. The prevalence of coughing and wheezing had significant differences between the bacterial- or viral-M. pneumoniae co-infections and the mono-infection groups. Furthermore, the chest X-ray progression, pleural effusions, respiratory failure, and ventilation rates were higher in the respiratory viral- and bacterial-M. pneumoniae co-infection groups than in the mono-infection group. Children with a bacterial or respiratory viral co-infection had a longer hospitalization and spent more on treatment fees than those with a M. pneumoniae mono-infection (P value <0.001). We conclude that children with mycoplasmal CAP, either with a bacterial or viral co-infection, who show signs of coughing and wheezing and have a radiographic progression, will have a severe disease progression and should be specifically treated and managed.

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