scholarly journals Bacterial Pathogens and Evaluation of a Cut-Off for Defining Early and Late Neonatal Infection

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 278
Author(s):  
Pavla Kucova ◽  
Lumir Kantor ◽  
Katerina Fiserova ◽  
Jakub Lasak ◽  
Magdalena Röderova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bacterial Infections ◽  
Late Onset ◽  
Bacterial Pathogens ◽  
Neonatal Infection ◽  
University Hospital ◽  
Neonatal Infections ◽  
Mortality And Morbidity ◽  
Amoxicillin Clavulanic Acid ◽  
The University

Bacterial infections are an important cause of mortality and morbidity in newborns. The main risk factors include low birth weight and prematurity. The study identified the most common bacterial pathogens causing neonatal infections including their resistance to antibiotics in the Neonatal Department of the University Hospital Olomouc. Additionally, the cut-off for distinguishing early- from late-onset neonatal infections was assessed. The results of this study show that a cut-off value of 72 h after birth is more suitable. Only in case of early-onset infections arising within 72 h of birth, initial antibiotic therapy based on gentamicin with ampicillin or amoxicillin/clavulanic acid may be recommended. It has been established that with the 72-h cut-off, late-onset infections caused by bacteria more resistant to antibiotics may be detected more frequently, a finding that is absolutely crucial for antibiotic treatment strategy.

scholarly journals Characterization of Neonatal Infections by Gram-Negative Bacilli and Associated Risk Factors, Havana, Cuba

2021 ◽  
Vol 13 (1) ◽  
pp. 219-229
Author(s):  
Arlenis Oliva ◽  
Yenisel Carmona ◽  
Elizabeth de La C. López ◽  
Roberto Álvarez ◽  
Meiji Soe Aung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Late Onset ◽  
Empirical Therapy ◽  
Antibiotic Use ◽  
Neonatal Infections ◽  
Cross Sectional ◽  
Prolonged Stay ◽  
Gram Negative ◽  
Associated Risk Factors ◽  
Resistance Rates

Infections represent an important problem in neonates because of the high mortality. An increase in neonatal infections has been found in Cuban hospitals in recent years. The aim of this study was to provide evidence on the clinical and microbiological behavior of Gram-negative bacilli that cause neonatal infections in hospitals of Havana, Cuba. It was carried out as a descriptive cross-sectional investigation from September 2017 to July 2018 in The Tropical Medicine Institute “Pedro Kouri” (IPK). Sixty-one Gram-negative bacilli isolated from neonates with infections in six Gyneco-Obstetric and Pediatric Hospitals of Havana were analyzed for their species and antimicrobial susceptibility. Late-onset infections were more common than early-onset ones and included urinary tract infection in the community (87%) and sepsis in hospitals (63.3%). Catheter use (47%) and prolonged stay (38%) were the most frequent risk factors. Species of major pathogens were Escherichia coli (47%) and Klebsiella spp. (26%). The isolated Gram-negative bacilli showed high resistance rates to third-generation cephalosporins, ciprofloxacin and gentamicin, while being more susceptible to carbapenems, fosfomycin, colistin and amikacin. The present study revealed the clinical impact of Gram-negative bacilli in neonatology units in hospitals of Havana. Evaluation of antimicrobial susceptibilities to the isolates from neonates is necessary for selection of appropriate empirical therapy and promotion of the rational antibiotic use.

scholarly journals Trends in the treatment of risk factors for stroke in a Czech stroke unit

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Libor Simunek ◽  
Dagmar Krajickova ◽  
Oldrich Vysata ◽  
Martin Valis
Keyword(s):  
Risk Factors ◽  
Stroke Unit ◽  
Stroke Risk ◽  
Beta Blockers ◽  
University Hospital ◽  
Stroke Recurrence ◽  
Channel Blockers ◽  
Motivation To Change ◽  
The University ◽  
Insulin Use

AbstractThe goal of this study is to evaluate therapeutic trends for several diseases that represent risk factors for stroke. The relative frequency of therapy with compounds that influence the risk factors for stroke was monitored in a group of 3,290 patients who were hospitalised in the Stroke Unit at the University Hospital in Hradec Kralove between 2005 and 2012. For most drugs monitored, the reasons for the significant decrease or increase in use were causes other than the reduction of stroke risk. Despite this finding, the majority of statistically significant changes had, according to review of comparative studies, a posi- tive effect on prevention of stroke. Motivation to change treatment of stroke risk factors, such as hypertension, diabetes mellitus and hypercholesterolemia, was mainly aimed at sufficient disease management with a minimum of adverse effects. On the other hand, optimization of stroke recurrence and economic factors were motivations to treatment changes in prevention with antiplatelets. Antidiabetics were associated with an increase in met- formin use and reduction in insulin use. For antihyperten- sives, the most significant reduction was associated with the use of diuretics, although calcium channel blockers and beta-blockers are also less used. Additionally, the use of the ACE inhibitor ramipril increased

scholarly journals Risk Factors of Pneumonia Associated with Mechanical Ventilation

2020 ◽  
Vol 17 (2) ◽  
pp. 656 ◽  
Author(s):  
Maria Kózka ◽  
Aurelia Sega ◽  
Katarzyna Wojnar-Gruszka ◽  
Agnieszka Tarnawska ◽  
Agnieszka Gniadek
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Hemorrhagic Shock ◽  
Pulmonary Disease ◽  
High Risk Group ◽  
University Hospital ◽  
Medical Documentation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The University

Background: The hospitalization of patients treated in the intensive care unit (ICU) in 5–15% of cases is associated with the occurrence of a complication in the form of ventilator-associated pneumonia (VAP). Purpose: Retrospective assessment of risk factors of VAP in patients treated at ICUs in the University Hospital in Krakow. Methods: The research involved the medical documentation of 1872 patients treated at the ICU of the University Hospital in Krakow between 2014 and 2017. The patients were mechanically ventilated for at least 48 h. The obtained data were presented by qualitative and quantitative analysis (%). The qualitative variables were compared using the Chi2 test. Statistically significant was the p < 0.05 value. Results: VAP was demonstrated in 23% of all patients treated in ICU during the analyzed period, and this infection occurred in 13% of men and 10% of women. Pneumonia associated with ventilation was found primarily in patients staying in the ward for over 15 days and subjected to intratracheal intubation (17%). A statistically significant was found between VAP and co-morbidities, e.g., chronic obstructive pulmonary disease, diabetes, alcoholism, obesity, the occurrence of VAP and multi-organ trauma, hemorrhage/hemorrhagic shock, and fractures as the reasons for admitting ICU patients. Conclusions: Patients with comorbidities such as chronic obstructive pulmonary disease, obesity, diabetes, and alcoholism are a high-risk group for VAP. Particular attention should be paid to patients admitted to the ICU with multi-organ trauma, fractures, and hemorrhage/hemorrhagic shock as patients predisposed to VAP. There is a need for further research into risk factors for non-modifiable VAP such as comorbidities and reasons for ICU admission in order to allow closer monitoring of these patients for VAP.

Colorectal Anastomotic Leakage at the University Hospital of the West Indies – An Analysis of Risk Factors

2014 ◽  
Vol 62 (8) ◽  
Author(s):  
PA Leake ◽  
JM Plummer ◽  
A Rhoden ◽  
MAC Frankson ◽  
G Gordon-Strachan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anastomotic Leakage ◽  
West Indies ◽  
University Hospital ◽  
The West ◽  
The University

scholarly journals Epidemiology of neonatal infections in hospitals of Nepal: evidence from a large- scale study

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Shyam Sundar Budhathoki ◽  
Avinash K. Sunny ◽  
Pragya Gautam Paudel ◽  
Jeevan Thapa ◽  
Lila Bahadur Basnet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Large Scale ◽  
Comparison Group ◽  
Mode Of Delivery ◽  
Clinical Signs ◽  
Birth Asphyxia ◽  
Newborn Care ◽  
Neonatal Infection ◽  
Public Hospitals ◽  
Neonatal Infections

Abstract Background Every year, neonatal infections account for approximately 750,000 neonatal deaths globally. It is the third major cause of neonatal death, globally and in Nepal. There is a paucity of data on clinical aetiology and outcomes of neonatal infection in Nepal. This paper aims to assess the incidence and risk factors of neonatal infection in babies born in public hospitals of Nepal. Methods This is a prospective cohort study conducted for a period of 14 months, nested within a large-scale cluster randomized control trial which evaluated the Helping Babies Breathe Quality Improvement package in 12 public hospitals in Nepal. All the mothers who consented to participate within the study and delivered in these hospitals were included in the analysis. All neonates admitted into the sick newborn care unit weighing > 1500 g or/and 32 weeks or more gestation with clinical signs of infection or positive septic screening were taken as cases and those that did not have an infection were the comparison group. Bivariate and multi-variate analysis of socio-demographic, maternal, obstetric and neonatal characteristics of case and comparison group were conducted to assess risk factors associated with neonatal infection. Results The overall incidence of neonatal infection was 7.3 per 1000 live births. Babies who were born to first time mothers were at 64% higher risk of having infection (aOR-1.64, 95% CI, 1.30–2.06, p-value< 0.001). Babies born to mothers who had no antenatal check-up had more than three-fold risk of infection (aOR-3.45, 95% CI, 1.82–6.56, p-value< 0.001). Babies born through caesarean section had more than two-fold risk (aOR-2.06, 95% CI, 1.48–2.87, p-value< 0.001) and babies with birth asphyxia had more than three-fold risk for infection (aOR-3.51, 95% CI, 1.71–7.20, p-value = 0.001). Conclusion Antepartum factors, such as antenatal care attendance, and intrapartum factors such as mode of delivery and birth asphyxia, were risk factors for neonatal infections. These findings highlight the importance of ANC visits and the need for proper care during resuscitation in babies with birth asphyxia.

Ventilator-Associated Pneumonia: Incidence and risk factors six intensive care units in Tunisia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Ben Cheikh ◽  
S Bhiri ◽  
N ketaka ◽  
A Gara ◽  
S Khefacha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
University Hospital ◽  
Ventilator Associated Pneumonia ◽  
Factors Associated ◽  
History Of ◽  
Independent Risk Factors ◽  
The University ◽  
Very High

Abstract Background Ventilator-Associated Pneumonia (VAP) continues to cause significant morbidity, mortality, and hospital costs, especially in the intensive care unit (ICU). This study aimed to determine incidence and factors associated with VAP in six ICUs of the University Hospital-Sahloul (Sousse, Tunisia) in 2018. Methods We conducted a prospective observational cohort study over a three months period in six ICUs of the University Hospital-Sahloul (Sousse, Tunisia) in 2018. All patients hospitalized with mechanical ventilation (MV) for more than 48 hours in the ICUs were included. Logistic regression with the stepwise method of Hosmer and Lemeshow was used to identify factors associated with VAP. Results Overall, 110 patients were enrolled. The mean age of patients was 44 ± 25 years. Of them, 66.4% were male. The median duration of MV was 5 days [2-16]. The incidence of VAP was 32% and the density incidence was 33/1000 ventilator days. The most common organism were Pseudomonas aeruginosa (n = 14). Of them, 12 were ceftazidime-resistant and thee were resistant to imipenem. Independent risk factors associated with VAP in ICU were history of antibiotic therapy during last 6 months (p = 0.007), tracheotomy (p &lt; 0.001) and reintubation (p &lt; 0.001). Conclusions VAP rates in our ICUs were very high. Antimicrobial stewardship programs involving pharmacists and physicians must be elaborated to optimize the antibiotic prescribing. Mechanical ventilation require more-effective interventions control in our hospital. Key messages Ventilator-Associated Pneumonia rates were very high. Independent risk factors associated with Ventilator-Associated Pneumonia were history of antibiotic therapy during last 6 months, tracheotomy and reintubation.

scholarly journals The contribution of teledentistry in detecting tooth erosion in patients with eating disorders

2021 ◽  
Vol 7 ◽  
pp. 205520762110192
Author(s):  
Nicolas Giraudeau ◽  
Paul Camman ◽  
Laurence Pourreyron ◽  
Camille Inquimbert ◽  
Patrick Lefebvre
Keyword(s):  
Risk Factors ◽  
Eating Disorders ◽  
Erosive Wear ◽  
Dental Erosion ◽  
University Hospital ◽  
Day Hospital ◽  
Medical File ◽  
Dental Examination ◽  
The University ◽  
Similar Risk

Objective The aim of this study was to demonstrate that including a teledentistry consultation in the standard care provided to patients in an eating disorder day hospital could be beneficial, notably for screening for particular pathologies and preventing dental erosion. Methods We included 50 patients from the eating disorders unit of the University Hospital of Montpellier, all of whom underwent a dental examination using asynchronous telemedicine. We recorded the data using teledentistry software for the medical file and an intraoral camera for the clinical videos. Remote diagnosis was performed using the Basic Erosive Wear Examination index. In addition, the participants completed a questionnaire to assess their risk factors for dental pathologies. Results We found dental erosion in 92% of the patients, and 50% had at least one tooth with BEWE 2 or 3 type erosion. Conclusions Despite the fact that there can be wide variety within a group of individuals with similar risk factors, dental telemedicine could promote awareness within this at-risk population, as well as provide personalised prevention advice to each patient. Above all, it would make it possible to treat these patients' lesions at the earliest possible moment, thereby improving their outcomes.

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