scholarly journals Use of an ingredient-based analysis to investigate a national outbreak of Escherichia coli O157, United Kingdom, July 2016

2018 ◽  
Vol 23 (26) ◽  
Author(s):  
Daniel Gardiner ◽  
Maya Gobin ◽  
Neville Q Verlander ◽  
Isabel Oliver ◽  
Jeremy Hawker
Keyword(s):  
Escherichia Coli ◽  
Case Control Study ◽  
Multivariable Analysis ◽  
Case Control ◽  
Escherichia Coli O157 ◽  
Online Questionnaire ◽  
Menu Item ◽  
Retrospective Case ◽  
The Common ◽  
Control Study

Public Health England was alerted to a national outbreak of Shiga toxin-producing Escherichia coli O157 PT34 in July 2016. Early investigations suggested that the likely source was a salad item consumed outside of the home. A number of cases reported consuming meals at a staff canteen (Venue A) and a garden café (Venue B). Both venues shared a common salad supplier. An investigation was undertaken to measure associations between salad items and illness using an 'ingredient-based analysis'. A retrospective case–control study was conducted using an online questionnaire to collect information on menu items consumed at each venue. Chefs at both venues were interviewed to identify ingredients contained within each menu item. Both venues were pooled together for multivariable analysis measuring associations at the ingredient level. Among 203 responses, 24 cases were identified (13 confirmed, two probable and nine possible). Case onsets ranged between 7 and 25 June 2016. Multivariable analysis identified strong evidence that only baby mixed-leaf salad from the common supplier was a vehicle of infection (adjusted odds ratio = 13.1; 95% confidence interval: 1.6–106.5). Identifying the specific salad ingredient associated with illness was made possible by using an ingredient-based analysis. We recommend the increased use of ingredient-based analyses.

scholarly journals Escherichia coli O157:H7 outbreak linked to salami, British Columbia, Canada, 1999

2004 ◽  
Vol 132 (2) ◽  
pp. 283-289 ◽  
Author(s):  
D. M. MacDONALD ◽  
M. FYFE ◽  
A. PACCAGNELLA ◽  
A. TRINIDAD ◽  
K. LOUIE ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Case Control Study ◽  
Meat Products ◽  
Case Control ◽  
Pfge Pattern ◽  
Escherichia Coli O157 ◽  
E Coli ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

An outbreak of E. coli O157:H7 infections was identified in November 1999 with a fivefold increase in the occurrence of laboratory-confirmed cases of E. coli O157:H7 infection. A matched case-control study was conducted. Samples of food from cases and from retailers were analysed for the presence of E. coli O157:H7. A total of 143 cases were identified over a 12-week period with the same pulsed-field gel electrophoresis (PFGE) pattern. The case-control study found that Company A salami was significantly associated with illness (Mantel–Haenszel matched odds ratio 10·0, 95% CI 1·4–434, P=0·01). Company A salami tested positive for E. coli O157:H7 and isolates had the same PFGE pattern as case isolates. An immediate voluntary national recall of Company A dry fermented meat products took place. Findings from the investigation of this outbreak suggest that the hold-and-test option may not be adequate to prevent shiga-toxigenic Escherichia coli (STEC) infection in salami consumers.

A Nationwide Case-Control Study of Escherichia coli O157:H7 Infection in the United States

1998 ◽  
Vol 177 (4) ◽  
pp. 962-966 ◽  
Author(s):  
L. Slutsker ◽  
A. A. Ries ◽  
K. Maloney ◽  
J. G. Wells ◽  
K. D. Greene ◽  
...  
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
Case Control Study ◽  
The United States ◽  
Case Control ◽  
Escherichia Coli O157 ◽  
Control Study

scholarly journals Association between intrahospital transfer and hospital-acquired infection in the elderly: a retrospective case–control study in a UK hospital network

2021 ◽  
pp. bmjqs-2020-012124 ◽  
Author(s):  
Emanuela Estera Boncea ◽  
Paul Expert ◽  
Kate Honeyford ◽  
Anne Kinderlerer ◽  
Colin Mitchell ◽  
...  
Keyword(s):  
Case Control Study ◽  
Multivariable Analysis ◽  
Case Control ◽  
Pathogen Transmission ◽  
Hospital Environment ◽  
High Risk Population ◽  
Retrospective Case ◽  
Hospital Acquired Infection ◽  
Hospital Acquired ◽  
Control Study

BackgroundIntrahospital transfers have become more common as hospital staff balance patient needs with bed availability. However, this may leave patients more vulnerable to potential pathogen transmission routes via increased exposure to contaminated surfaces and contacts with individuals.ObjectiveThis study aimed to quantify the association between the number of intrahospital transfers undergone during a hospital spell and the development of a hospital-acquired infection (HAI).MethodsA retrospective case–control study was conducted using data extracted from electronic health records and microbiology cultures of non-elective, medical admissions to a large urban hospital network which consists of three hospital sites between 2015 and 2018 (n=24 240). As elderly patients comprise a large proportion of hospital users and are a high-risk population for HAIs, the analysis focused on those aged 65 years or over. Logistic regression was conducted to obtain the OR for developing an HAI as a function of intrahospital transfers until onset of HAI for cases, or hospital discharge for controls, while controlling for age, gender, time at risk, Elixhauser comorbidities, hospital site of admission, specialty of the dominant healthcare professional providing care, intensive care admission, total number of procedures and discharge destination.ResultsOf the 24 240 spells, 2877 cases were included in the analysis. 72.2% of spells contained at least one intrahospital transfer. On multivariable analysis, each additional intrahospital transfer increased the odds of acquiring an HAI by 9% (OR=1.09; 95% CI 1.05 to 1.13).ConclusionIntrahospital transfers are associated with increased odds of developing an HAI. Strategies for minimising intrahospital transfers should be considered, and further research is needed to identify unnecessary transfers. Their reduction may diminish spread of contagious pathogens in the hospital environment.

scholarly journals Baseline blood count levels increase odds of cytopenia among CML patients in Kenya: a case control study

2021 ◽  
Author(s):  
Angela McLigeyo ◽  
Jamilla Rajab ◽  
Peter Oyiro ◽  
Mohammed Ezzi ◽  
Yatich Bett ◽  
...  
Keyword(s):  
Case Control Study ◽  
Multivariable Analysis ◽  
Molecular Data ◽  
Case Control ◽  
P Value ◽  
Retrospective Case ◽  
Chi Square ◽  
High Index Of Suspicion ◽  
Control Study

Abstract Background Imatinib is the gold standard for the treatment of all phases of Philadelphia positive Chronic Myeloid Leukemia (CML). During treatment, patients may develop cytopenia. We aimed to study the baseline characteristics and factors associated with cytopenia at a Nairobi Hospital. Methods This was a retrospective case-control study of patients aged ≥ 18 years on follow-up at the Glivec International Patient Access Program (GIPAP) clinic from 2007–2015. The cases consisted of CML patients on imatinib who developed cytopenia. The controls were CML patients on imatinib who did not develop cytopenia. Baseline socio – demographic, clinical, hematologic, and molecular data were retrieved from patients’ files. Chi square or fishers’ exact tests were used to analyze for differences between cytopenia and no cytopenia. Binary logistic regressions were employed to identify relationships. Univariate and multivariate analyses were done to identify independent predictors of cytopenia. Odds ratios (OR) were presented including the 95% confidence intervals and respective p values. Results A total of 201 patients were studied. Males were 52%, 42% were aged 36–50 years, 70% had symptoms for > 12 months before diagnosis, 78.6% had B symptoms at baseline, 80% had a moderate splenomegaly at baseline, 40% and 37.4% developed cytopenia within 3 months and 3–6 months respectively after imatinib initiation. Baseline neutrophilia, neutropenia, anaemia, thrombocytosis, thrombocytopenia was found in 68%, 11%, 11%, 23.5% and 11% respectively. Baseline hemoglobin, neutrophil and platelet level were significantly different between the cytopenia and the no cytopenia group. On univariable analysis, baseline anemia with hb < 7.9g/dL (p = 0.002), neutropenia (p = 0.001), neutrophilia > 100,000/mm3 (p = 0.002) and thrombocytopenia (p = 0.001) increased the odds of developing cytopenia. On multivariable analysis, baseline anaemia (p value < 0.002), neutropenia (p value < 0.001), thrombocytopenia (p value, < 0.001) and thrombocytosis (p value, 0.033) increased the odds of developing cytopenia. Conclusion Odds of cytopenia were higher in presence of baseline cytopenia and thrombocytosis. Clinicians should have a high index of suspicion for these patients.

scholarly journals Out-of-season increase of puerperal fever with group A Streptococcus infection: a case–control study, Netherlands, July to August 2018

2020 ◽  
Vol 25 (40) ◽  
Author(s):  
Jossy van den Boogaard ◽  
Susan JM Hahné ◽  
Margreet JM te Wierik ◽  
Mirjam J Knol ◽  
Sooria Balasegaram ◽  
...  
Keyword(s):  
Case Control Study ◽  
Puerperal Fever ◽  
Multivariable Analysis ◽  
Case Control ◽  
Simultaneous Increase ◽  
Online Questionnaire ◽  
Non Invasive ◽  
Increased Risk ◽  
Group A ◽  
Control Study

We observed an increase in notifications of puerperal group A Streptococcus (GAS) infections in July and August 2018 throughout the Netherlands without evidence for common sources. General practitioners reported a simultaneous increase in impetigo. We hypothesised that the outbreak of puerperal GAS infections resulted from increased exposure via impetigo in the community. We conducted a case–control study to assess peripartum exposure to possible, non-invasive GAS infections using an online questionnaire. Confirmed cases were recruited through public health services while probable cases and controls were recruited through social media. We calculated odds ratios (OR) and 95% confidence intervals (95% CI) with logistic regression analysis. We enrolled 22 confirmed and 23 probable cases, and 2,400 controls. Contact with persons with impetigo were reported by 8% of cases and 2% of controls (OR: 3.26, 95% CI: 0.98–10.88) and contact with possible GAS infections (impetigo, pharyngitis or scarlet fever) by 28% and 9%, respectively (OR: 4.12, 95% CI: 1.95–8.68). In multivariable analysis, contact with possible GAS infections remained an independent risk factor (aOR: 4.28, 95% CI: 2.02–9.09). We found an increased risk of puerperal fever after community contact with possible non-invasive GAS infections. Further study of this association is warranted.

scholarly journals Characteristics of individuals with tuberculosis in an urban, poor population in Osaka City, Japan — a case-control study

2020 ◽  
Vol 11 (1) ◽  
pp. 20-26
Author(s):  
Akira Shimouchi ◽  
Yuko Tsuda ◽  
Jun Komukai ◽  
Kenji Matsumoto ◽  
Hideki Yoshida ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Odds Ratio ◽  
Urban Poor ◽  
Case Control Study ◽  
Multivariable Analysis ◽  
Case Control ◽  
Individual Characteristics ◽  
Retrospective Case ◽  
Control Study ◽  
Current Alcohol

Objective: To identify individual characteristics related to the development of pulmonary tuberculosis (PTB) among residents in the Airin area (Airin), Osaka City, Japan. Methods: We conducted a retrospective case-control study of individual characteristics potentially related to the development of PTB by comparing PTB patients and residents without tuberculosis (TB) in Airin. The following binominal data of characteristics were compared: age (<65 or >65); body mass index (BMI) (<18.5 or >18.5);diabetes mellitus (diagnosed or not diagnosed); smoking (currently smoking any amount or not smoking); and alcohol use (currently drinking any amount or not drinking). Results: We compared the individual characteristics of 192 PTB patients notified from January 2015 to December 2018 and 190 residents of supportive houses who attended a health education programme from April 2016 to March 2018. Univariable analysis showed that the following characteristics were significantly related with PTB: BMI <18.5 (odds ratio [OR]: 6.54, 95% confidence interval [CI]: 3.58–11.97, P < 0.001) and current alcohol use (OR: 1.88; 95% CI:1.24–2.85, P = 0.003). Multivariable analysis showed similar results: BMI <18.5 (adjusted odds ratio [aOR]: 6.90, 95% CI: 3.72–12.79, P < 0.001) and current alcohol use (aOR: 2.15, 95% CI: 1.36–3.42, P = 0.001). Discussion: Undernutrition and alcohol use are individual characteristics associated with PTB among residents in Airin, Osaka City. To strengthen the TB control programme further, it is suggested to develop new programmes for primary prevention.

scholarly journals An outbreak of Escherichia coli O157[ratio ]H7 infections and haemolytic uraemic syndrome associated with consumption of unpasteurized apple cider

2000 ◽  
Vol 124 (1) ◽  
pp. 31-36 ◽  
Author(s):  
E. D. HILBORN ◽  
P. A. MSHAR ◽  
T. R. FIORENTINO ◽  
Z. F. DEMBEK ◽  
T. J. BARRETT ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Case Control Study ◽  
Case Control ◽  
Pulsed Field Gel Electrophoresis ◽  
Pcr Analysis ◽  
Escherichia Coli O157 ◽  
Chain Reaction ◽  
Apple Cider ◽  
Polymerase Chain ◽  
Control Study

During October 1996, an outbreak of Escherichia coli O157[ratio ]H7 infections among Connecticut residents occurred. An epidemiologic investigation included enhanced surveillance and a case-control study. Clinical isolates of Escherichia coli O157[ratio ]H7 were typed by pulsed-field gel electrophoresis (PFGE). Implicated cider samples were analysed by culture and polymerase chain reaction (PCR). Consumption of implicated cider was associated with illness; (matched odds ratio = undefined, 95% confidence interval = 3·5–infinity). Ultimately, a total of 14 outbreak-associated patients were identified. All isolates analysed by PFGE yielded the outbreak-associated subtype. Escherichia coli O157[ratio ]H7 was not cultured from three cider samples; PCR analysis detected DNA fragments consistent with Escherichia coli O157[ratio ]H7 in one. This outbreak was associated with drinking one brand of unpasteurized apple cider. PFGE subtyping supported the epidemiologic association. PCR analysis detected microbial contaminants in the absence of live organisms. Washing and brushing apples did not prevent cider contamination.

scholarly journals Swimming-associated outbreak of Escherichia coli O157[ratio ]H7

1999 ◽  
Vol 122 (1) ◽  
pp. 1-5 ◽  
Author(s):  
M. PAUNIO ◽  
R. PEBODY ◽  
M. KESKIMÄKI ◽  
M. KOKKI ◽  
P. RUUTU ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Lake Water ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
Escherichia Coli O157 ◽  
E Coli ◽  
Age Range ◽  
Population Controls ◽  
Control Study

In 1997 the first outbreak of Escherichia coli O157[ratio ]H7 infections involving 14 cases occurred in Finland. A case was defined as a resident of Alavus with an episode of diarrhoea between 5 and 17 July 1997, and from whom E. coli O157[ratio ]H7 was isolated from stool. The investigation included case searching and a population-based case control study. Five primary and eight symptomatic secondary cases of E. coli O157[ratio ]H7 illness were detected. In the 10 days before the outbreak, all 5 primary patients (aged 3–8 years), but only 6 of 32 population controls from the same age range (Fisher's test, P<0·001) and 4 of 10 sibling controls (P<0·05) had visited (but had not necessarily bathed in) a shallow beach popular among young children. Four out of 5 primary cases had remained within 5 m of the beach while swimming and had swallowed lake water compared to 1 of 5 population controls. These analytical epidemiologic findings incriminated fresh lake water as the vehicle of E. coli O157[ratio ]H7 transmission.

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