scholarly journals Risk factors associated with neonatal sepsis of nosocomial origin in patients at a Mexican Hospital

2012 ◽  
Vol 1 (1) ◽  
Author(s):  
Georgina Romo-Hernández ◽  
Marco A. Escamilla-Acosta ◽  
Agustín Pérez-García ◽  
Irma A. Espinosa-Oropeza
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Central Line ◽  
Retrospective Case ◽  
Histamine H2 Receptor ◽  
Factors Associated ◽  
Childhood Morbidity ◽  
Chi Squared

Nosocomial neonatal sepsis (NNS) is one of the principal causes of childhood morbidity and mortality and has a large impact on public health. Therefore, our objective was to determine the prevalence and risk factors associated with NNS in patients at Hospital del Niño DIF Hidalgo (Children’s Hospital, Hidalgo DIF). A retrospective case-control study was carried out by reviewing the medical records of 29 cases and 62 controls. The relative risk and odds ratio were calculated, and the Chi-squared test was used. The prevalence of NNS was found to be 13.6%. The statistically significant risk factors for NNS in premature infants were the male gender, the use of histamine H2 receptor blockers, a birth weight <1500 g, and an Apgar score <6. In full-term patients, the risk factors were respiratory insufficiency and anemia. The common risk factors in both groups were ventilatory assistance, presence of a central line, total parenteral nutrition, >7 days of antibiotic use, and presence of a bladder catheter. We found that the prevalence and risk factors in this study are similar to those reported in medical literature.

A Model to Predict Central-Line–Associated Bloodstream Infection Among Patients With Peripherally Inserted Central Catheters: The MPC Score

2017 ◽  
Vol 38 (10) ◽  
pp. 1155-1166 ◽  
Author(s):  
Erica Herc ◽  
Payal Patel ◽  
Laraine L. Washer ◽  
Anna Conlon ◽  
Scott A. Flanders ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Model ◽  
Significant Risk ◽  
Hospital Medicine ◽  
Central Line ◽  
Cox Proportional Hazards Model ◽  
Operating Characteristics ◽  
Peripherally Inserted Central Catheters ◽  
Factors Associated ◽  
Central Catheters

BACKGROUNDPeripherally inserted central catheters (PICCs) are associated with central-line–associated bloodstream infections (CLABSIs). However, no tools to predict risk of PICC-CLABSI have been developed.OBJECTIVETo operationalize or prioritize CLABSI risk factors when making decisions regarding the use of PICCs using a risk model to estimate an individual’s risk of PICC-CLABSI prior to device placement.METHODSUsing data from the Michigan Hospital Medicine Safety consortium, patients that experienced PICC-CLABSI between January 2013 and October 2016 were identified. A Cox proportional hazards model with robust sandwich standard error estimates was then used to identify factors associated with PICC-CLABSI. Based on regression coefficients, points were assigned to each predictor and summed for each patient to create the Michigan PICC-CLABSI (MPC) score. The predictive performance of the score was assessed using time-dependent area-under-the-curve (AUC) values.RESULTSOf 23,088 patients that received PICCs during the study period, 249 patients (1.1%) developed a CLABSI. Significant risk factors associated with PICC-CLABSI included hematological cancer (3 points), CLABSI within 3 months of PICC insertion (2 points), multilumen PICC (2 points), solid cancers with ongoing chemotherapy (2 points), receipt of total parenteral nutrition (TPN) through the PICC (1 point), and presence of another central venous catheter (CVC) at the time of PICC placement (1 point). The MPC score was significantly associated with risk of CLABSI (P<.0001). For every point increase, the hazard ratio of CLABSI increased by 1.63 (95% confidence interval, 1.56–1.71). The area under the receiver-operating-characteristics curve was 0.67 to 0.77 for PICC dwell times of 6 to 40 days, which indicates good model calibration.CONCLUSIONThe MPC score offers a novel way to inform decisions regarding PICC use, surveillance of high-risk cohorts, and utility of blood cultures when PICC-CLABSI is suspected. Future studies validating the score are necessary.Infect Control Hosp Epidemiol2017;38:1155–1166

scholarly journals Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.

2020 ◽  
Author(s):  
Yannick Lechedem Ngunyi ◽  
Gregory Halle-Ekane ◽  
Nicholas Tendongfor ◽  
Etheldreda Leinyuy Mbivnjo ◽  
Armel Evouna Mbarga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Tertiary Hospital ◽  
High Rate ◽  
E Coli ◽  
Factors Associated ◽  
Littoral Region ◽  
Perineal Tears ◽  
Chi Squared ◽  
Tract Infections

Abstract Background Postpartum febrile morbidity is relatively common, occurring in approximately 5–7% of births. Differentiating between potentially serious and benign causes of postpartum pyrexia (PP) is fundamental in curbing the mortality rate from sinister causes such as sepsis. The paucity of data on PP in Cameroon makes it difficult to access its actual burden. This study was aimed at determining the prevalence, risk factors and aetiologies of PP at a tertiary hospital in Douala, Cameroon. Methods This was a 2 – year hospital – based retrospective cohort study carried out at the Douala General Hospital (DGH), during which medical records of all postpartum admissions between January 1 st 2017 and December 31st 2018 were reviewed. The review consisted of collecting data on socio-demographic characteristics, clinical profile, investigations and final diagnoses. The collected data was analysed in SPSS 23.0. Chi-squared test was used to test the association between variables and a logistic regression analysis was fitted to identify risk factors associated to PP. Results A total of 1520 postpartum files were reviewed. The prevalence of PP was 8.82%. The most frequent causes of PP were: malaria (46.7%), urinary tract infections (18.7%), puerperal sepsis (17.9%) and pneumonia (8.7%). E. coli was the most (49.3%) cultured germ isolated in positive cultures. Onset of PP was more common (85%) within the first 3 days postpartum and malaria (60%) was the leading aetiology within this period. Five or more vaginal examinations prior to delivery (OR 59.151, 95% CI: 21.463-163.019; p<0.001), perineal tears (OR 45.157, 95% CI: 2.266-899.722; p<0.001), and duration of labour >18hours (OR 26.760, 95% CI: 7.100-100.862; p<0.001) were the most significant risk factors associated with PP. Conclusion Approximately 1 in every 12 postpartum cases in the DGH presents with PP . Malaria was the leading cause of PP at DGH especially for cases registered within 3 days postpartum. The risk factors identified were mostly associated to perinatal events, such as frequent vaginal examinations, perineal tears and prolonged labour. Efforts towards preventing identified risk factors thus becomes paramount in order to curb this high rate of PP in the DGH.

scholarly journals Clinical profile and risk factors for persistent diarrhoea in children under five years of age in an urban referral centre

2017 ◽  
Vol 4 (6) ◽  
pp. 1986
Author(s):  
Prabakar Durairaj ◽  
Sasivarathan Raju ◽  
Sivaraman Thirumalaikumarasamy
Keyword(s):  
Risk Factors ◽  
Drinking Water ◽  
Protein Energy Malnutrition ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Clinical Profile ◽  
Persistent Diarrhoea ◽  
Factors Associated ◽  
Protein Energy ◽  
Study Population

Background: Persistent diarrhoea is a known cause of childhood mortality, morbidity and malnutrition in developing countries. The present study was conducted with the aim to study the clinical profile of persistent diarrhoea in children under 5 years of age and to find the possible host and environmental risk factors associated with persistent diarrhoea.Methods: The present descriptive study was conducted on 70 children with persistent diarrhoea, between age of 1 month and 5 years who admitted to DTTU, ICH & HC, Chennai during the period from February 2005 to September 2006. Detailed history was elicited from the parents usually mother regarding illness and risk factors were noted. The children were subjected to detailed clinical examination to assess dehydration, malnutrition, parenteral infections, and nutritional status. Univariable and multivariable logistic regression analyses were used to find risk factors associated with the incidence of diarrhoea.Results: Most of the children (35.71%) were under the age of 6 months to one year. Male (55.71%) children are more affected than female (44.29%) children. Undernutrition was observed in 85.71% of cases. Parenteral infection (44.28%) was noticed as major risk factor among children. E. coli was the organism isolated from stool culture in about 73.91% of cases with gut infection. The total fatality rate in the study population was 10%. Multivariable regression revealed significant associations between persistent diarrhoeal disease in children and protein energy malnutrition (OR- 1.812; 95% CI- 1.406-2.335), irrational antibiotic use (OR- 2.414; 95% CI- 1.195-4.877), parenteral infection (OR- 2.275; 95% CI-1.165-4.443) and use of unsafe drinking water (OR- 2.738; 95% CI- 1.221-6.143) and were found to be independent risk factors. Other factors found to be insignificant.Conclusion: The results of the study conclude that protein energy malnutrition, irrational antibiotic use, use of unsafe drinking water and parenteral infections are the significant risk factors for the incidence of diarrhea in the present study population. Hence, it is important to increase the awareness in parents regarding nutrition and safe drinking water use for children. Prompt diagnosis and appropriate treatment by the doctors can decrease the fatality rates.

scholarly journals Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.

2019 ◽  
Author(s):  
Yannick Lechedem Ngunyi ◽  
Gregory Halle-Ekane ◽  
Nicholas Tendongfor ◽  
Etheldreda Leinyuy Mbivnjo ◽  
Armel Evouna Mbarga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Tertiary Hospital ◽  
High Rate ◽  
E Coli ◽  
Factors Associated ◽  
Littoral Region ◽  
Perineal Tears ◽  
Chi Squared ◽  
Tract Infections

Abstract Background Postpartum febrile morbidity is relatively common, occurring in approximately 5–7% of births. Differentiating between potentially serious and benign causes of postpartum pyrexia is fundamental in curbing the mortality rate from sinister causes such as sepsis. The paucity of data on PP in Cameroon makes it difficult to access its actual burden. This study was aimed at determining the prevalence, risk factors and aetiologies of PP at a tertiary hospital in Douala, Cameroon. Methods This was a 2 – year hospital – based retrospective cohort study carried out at the Douala General Hospital (DGH), during which medical records of all postpartum admissions between January 1st 2017 and December 31st 2018 were reviewed. The review consisted of collecting data on socio-demographic characteristics, clinical profile, investigations and final diagnoses. The collected data was analysed in SPSS 23.0. Chi-squared test was used to test the association between variables and a logistic regression analysis was fitted to identify risk factors associated to PP. Results A total of 1520 postpartum files were reviewed. The prevalence of PP was 8.82%. The most frequent causes of PP were: malaria (46.7%), urinary tract infections (18.7%), puerperal sepsis (17.9%) and pneumonia (8.7%). E. coli was the most (49.3%) cultured germ isolated in positive cultures. Onset of PP was more common (85%) within the first 3 days postpartum and malaria (60%) was the leading aetiology within this period. Five or more vaginal examinations prior to delivery (OR 59.151, 95% CI: 21.463-163.019; p<0.001), perineal tears (OR 45.157, 95% CI: 2.266-899.722; p<0.001), and duration of labour >18hours (OR 26.760, 95% CI: 7.100-100.862; p<0.001) were the most significant risk factors associated with PP.Conclusion Approximately 1 in every 12 postpartum cases in the DGH presents with PP. Malaria was the leading cause of PP at DGH especially for cases registered within 3 days postpartum. The risk factors identified were mostly associated to perinatal events, such as frequent vaginal examinations, perineal tears and prolonged labour. Efforts towards preventing identified risk factors thus becomes paramount in order to curb this high rate of PP in the DGH.

scholarly journals A retrospective analysis of risk factors associated with catheter-related thrombosis: a single-center study

Perfusion ◽  
2020 ◽  
Vol 35 (8) ◽  
pp. 806-813
Author(s):  
Xuezhen Zhou ◽  
Xi Lin ◽  
Runnan Shen ◽  
Yingying Qu ◽  
Chunling Mo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Related Factors ◽  
Exact Test ◽  
Factors Associated ◽  
Chi Squared ◽  
History Of ◽  
Systematic Risk Factors ◽  
Catheter Related Thrombosis ◽  
Catheter Care

Background: Catheter-related thrombosis may lead to catheter infections and failure, further deep venous thrombosis, and pulmonary embolism. Recognizing the risk factors for catheter-related thrombosis is extremely important to inform the development of catheter care guidelines. Methods: Data were collected from a total of 1,532 patients who had undergone venous catheterization, including indwelling catheterization from 19 March 2019 to 30 March 2019 in the Sun Yat-sen Memorial Hospital. The factors for which data were to be collected included the patients’ physical characteristics, catheter-related factors, and catheter care-related factors. Logistic regression analysis, the chi-squared test, Fisher’s exact test, and the t-test were used to analyze the data. Results: Of the 1,532 patients studied, 28 developed intraductal thrombi, and of the factors analyzed, malignancy, a catheterization history, a history of thrombophilia, surgery during the week before catheterization, the catheterization duration, and anticoagulant therapy were significant risk factors associated with catheter-related thrombosis (all p < 0.05). There were no significant associations between the catheter brand, the number of lumens, the insertion direction, or the factors associated with catheter care and catheter-related thrombosis (all p > 0.05). Conclusion: Our study incorporated clear and systematic risk factors associated with catheter-related thrombosis. Malignancy, history of thrombophilia, history of catheterization, surgery during the week before catheterization, and catheterization duration were associated with increased risks of catheter-related thrombosis. Prophylactic anticoagulation was effective for preventing and treating catheter-related thrombosis.

A retrospective case control study to investigate race level risk factors associated with horse falls in Irish point-to-point races

2018 ◽  
Vol 14 (2) ◽  
pp. 127-134 ◽  
Author(s):  
L.J. Smith ◽  
G. Tabor ◽  
J. Williams
Keyword(s):  
Risk Factors ◽  
Fall Risk ◽  
Significant Risk ◽  
Case Control ◽  
Future Research ◽  
Ratio Test ◽  
Retrospective Case ◽  
Data Set ◽  
Factors Associated ◽  
Point To Point

Horseracing as a high-risk sport can pose a significant risk to equine welfare. To date no epidemiological reviews of fall risk in horseracing have investigated the risks specific to point-to-point (PTP) racing. This study aimed to identify the main race level risk factors associated with horse falls in Irish PTP and to compare these to published findings for hurdle and steeplechase racing. The study used a retrospective case-control design. Relevant variables were identified and information was collated for all PTP races in the 2013/14 and 2014/15 seasons. Race-level variables were analysed through univariable analysis to inform multivariable model building. A final multivariable logistic regression model was refined, using fall/no fall as the dependent variable, through a backward stepwise process with variables retained if likelihood ratio test P-values were <0.05. During the study period 1,358 PTP races were recorded, 727 races (54%) included at least one horse fall. The fall frequency noted during the current study was 88/1000 starts. Race category impacted the odds of a fall occurring with all categories of maiden races having increased odds of falls compared to open races. Maiden races for 6 year olds and 6 and 7 year olds had the greatest chance of falling with 6.9 times increased odds. The chance of a race containing a fall increased 38% for each additional runner and was reduced by 25% for every horse that pulled up during the race. Using a larger data set could enable further sub-models to be developed. In the current study some of the variables had a low number of cases and/or controls which limited the analysis. Retrospective analysis of fall risk exposed some risk factors that have been previously identified in hurdle and steeplechase racing. The variables identified could inform future research and interventions aimed at improving horse and jockey safety whilst racing.

Renal Failure after Coronary Bypass Surgery and the Associated Risk Factors

2015 ◽  
Vol 18 (1) ◽  
pp. 006
Author(s):  
Hasan Reyhanoglu ◽  
Kaan Ozcan ◽  
Murat Erturk ◽  
Fatih İslamoglu ◽  
İsa Durmaz
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Renal Failure ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Significant Risk ◽  
High Morbidity ◽  
Factors Associated

<strong>Objective:</strong> We aimed to evaluate the risk factors associated with acute renal failure in patients who underwent coronary artery bypass surgery.<br /><strong>Methods:</strong> One hundred and six patients who developed renal failure after coronary artery bypass grafting (CABG) constituted the study group (RF group), while 110 patients who did not develop renal failure served as a control group <br />(C group). In addition, the RF group was divided into two subgroups: patients that were treated with conservative methods without the need for hemodialysis (NH group) and patients that required hemodialysis (HR group). Risk factors associated with renal failure were investigated.<br /><strong>Results:</strong> Among the 106 patients that developed renal failure (RF), 80 patients were treated with conservative methods without any need for hemodialysis (NH group); while <br />26 patients required hemodialysis in the postoperative period (HR group). The multivariate analysis showed that diabetes mellitus and the postoperative use of positive inotropes and adrenaline were significant risk factors associated with development of renal failure. In addition, carotid stenosis and postoperative use of adrenaline were found to be significant risk factors associated with hemodialysis-dependent renal failure (P &lt; .05). The mortality in the RF group was determined as 13.2%, while the mortality rate in patients who did not require hemodialysis and those who required hemodialysis was 6.2% and 34%, respectively.<br /><strong>Conclusion:</strong> Renal failure requiring hemodialysis after CABG often results in high morbidity and mortality. Factors affecting microcirculation and atherosclerosis, like diabetes mellitus, carotid artery stenosis, and postoperative vasopressor use remain the major risk factors for the development of renal failure.<br /><br />

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 Probability of Roadside Accidents for Curved Sections on Highways

2020 ◽  
Vol 2020 ◽  
pp. 1-18 ◽  
Author(s):  
Guozhu Cheng ◽  
Rui Cheng ◽  
Yulong Pei ◽  
Liang Xu
Keyword(s):  
Risk Factors ◽  
Decision Rules ◽  
Significant Risk ◽  
Vehicle Speed ◽  
Probabilistic Prediction ◽  
Interaction Detection ◽  
Probability Prediction ◽  
Chi Squared ◽  
Longitudinal Slope ◽  
Curve Radius

To predict the probability of roadside accidents for curved sections on highways, we chose eight risk factors that may contribute to the probability of roadside accidents to conduct simulation tests and collected a total of 12,800 data obtained from the PC-crash software. The chi-squared automatic interaction detection (CHAID) decision tree technique was employed to identify significant risk factors and explore the influence of different combinations of significant risk factors on roadside accidents according to the generated decision rules, so as to propose specific improved countermeasures as the reference for the revision of the Design Specification for Highway Alignment (JTG D20-2017) of China. Considering the effects of related interactions among different risk factors on roadside accidents, path analysis was applied to investigate the importance of the significant risk factors. The results showed that the significant risk factors were in decreasing order of importance, vehicle speed, horizontal curve radius, vehicle type, adhesion coefficient, hard shoulder width, and longitudinal slope. The first five important factors were chosen as predictors of the probability of roadside accidents in the Bayesian network analysis to establish the probability prediction model of roadside accidents. Eventually, the thresholds of the various factors for roadside accident blackspot identification were given according to probabilistic prediction results.

scholarly journals Neisseria meningitidis carriage and risk factors among teenagers in Suizhou city in China

2020 ◽  
Vol 148 ◽  
Author(s):  
Fei He ◽  
Hong mei Yang ◽  
Guo ming Li ◽  
Bing qing Zhu ◽  
Yating Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Population Density ◽  
Neisseria Meningitidis ◽  
Old Age ◽  
Age Groups ◽  
Significant Risk ◽  
Epidemiological Data ◽  
Significant Risk Factor ◽  
Antibiotic Use ◽  
Carriage Rate

Abstract Teenagers are important carriers of Neisseria meningitidis, which is a leading cause of invasive meningococcal disease. In China, the carriage rate and risk factors among teenagers are unclear. The present study presents a retrospective analysis of epidemiological data for N. meningitidis carriage from 2013 to 2017 in Suizhou city, China. The carriage rates were 3.26%, 2.22%, 3.33%, 3.53% and 9.88% for 2013, 2014, 2015, 2016 and 2017, respectively. From 2014 to 2017, the carriage rate in the 15- to 19-year-old age group (teenagers) was the highest and significantly higher than that in remain age groups. Subsequently, a larger scale survey (December 2017) for carriage rate and relative risk factors (population density, time spent in the classroom, gender and antibiotics use) were investigated on the teenagers (15- to 19-year-old age) at the same school. The carriage rate was still high at 33.48% (223/663) and varied greatly from 6.56% to 52.94% in a different class. Population density of the classroom was found to be a significant risk factor for carriage, and 1.4 persons/m2 is recommended as the maximum classroom density. Further, higher male gender ratio and more time spent in the classroom were also significantly associated with higher carriage. Finally, antibiotic use was associated with a significantly lower carriage rate. All the results imply that attention should be paid to the teenagers and various measures can be taken to reduce the N. meningitidis carriage, to prevent and control the outbreak of IMD.

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