Are lower preoperative serum sodium levels associated with postoperative surgical site infection? Results from a propensity matched case-control study

Author(s):  
N Naidoo ◽  
TE Madiba ◽  
Y Moodley

Background: We previously reported a statistical trend toward a harmful association between lower preoperative serum sodium levels and surgical site infection (SSI) in South African (SA) laparotomy patients. Serum sodium tests are widely available and could serve as a cost-effective method for preoperatively identifying patients at risk for SSI who might benefit from additional preventative strategies. We sought to investigate the possible association between lower serum sodium levels and SSI further, in a larger sample of SA patients undergoing various surgical procedures. Objective: To determine if lower preoperative serum sodium levels are associated with SSI in SA surgical patients. Method: This was a propensity matched case-control study involving data from 729 surgical patients who attended a quaternary SA hospital between 01 January 2012 and 31 July 2016. Cases were defined as patients who developed SSI. Controls were defined as patients who did not develop SSI. Multivariate logistic regression was used to investigate the association between preoperative serum sodium levels (in mmol/L) and SSI. Results: Lower preoperative serum sodium levels were associated with a higher risk of SSI (odds ratio per 1.0 mmol/L decrease in serum sodium: 1.051, 95% confidence interval: 1.007–1.097; p = 0.026). Conclusion: Although we report a statistically significant association between lower preoperative serum sodium levels and a higher risk of SSI, the magnitude of this effect size (odds ratio) is minimal and clinically insignificant. Preoperative serum sodium levels are unlikely to be useful for SSI risk stratification in our setting.

2001 ◽  
Vol 127 (3) ◽  
pp. 399-404 ◽  
Author(s):  
T. D. TENKATE ◽  
R. J. STAFFORD

Campylobacter infection has one of the highest rates of all the notifiable diseases in Australia, with a peak in children aged 0–35 months. A matched case-control study was conducted to investigate risk factors for campylobacter infection for children in this age group. Eighty-one cases and 144 controls were enrolled in the study that was conducted between 24 January 1996 and 21 January 1997. The following risk factors were found to be independently associated with illness: ownership of pet puppies (adjusted odds ratio [OR] 16·58, 95% confidence interval [CI] 3·73–73·65) and pet chickens (OR 11·80, CI 1·37–101·75), and consumption of mayonnaise (OR 4·13, CI 1·61–10·59). We propose that children aged less than 3 years are at risk of campylobacter infection if residing in a household which has puppies or chickens as pets.


2016 ◽  
Vol 144 (13) ◽  
pp. 2802-2811 ◽  
Author(s):  
L. MÜLLER ◽  
C. KJELSØ ◽  
C. FRANK ◽  
T. JENSEN ◽  
M. TORPDAHL ◽  
...  

SUMMARYIn September 2011, a patient cluster with a rareSalmonellaserotype – Strathcona – was identified in Denmark. An outbreak investigation was initiated to reveal the source in order to stop the outbreak. In addition to hypothesis-generating interviews, comparable analyses of patients’ household shopping receipts were conducted. A matched case-control study with 25 cases and 56 population register controls was conducted to test the findings of the hypothesis-generating investigation. In total, 43 cases ofSalmonellaStrathcona were reported in Denmark. Additionally, 28 cases were reported from Germany, Italy, Austria and Belgium. The results of the investigation in Denmark showed that 8/10 cases had bought datterino tomatoes prior to disease onset. Illness was associated with a specific supermarket chain [matched odds ratio (mOR) 16·9, 95% confidence interval (CI) 2·2–130], and having consumed elongated small tomatoes (OR 28·1, 95% CI 2·6–302). Traceback investigation showed that the tomatoes came from an Italian producer. This outbreak, linked to tomatoes, underpins the growing recognition of the broad source range ofSalmonellaand the ability of fresh produce to cause multi-country outbreaks. It is important to strengthen the international cooperation between public-health and food-safety authorities in the European Union to investigate future multi-country outbreaks in order to prevent illness from ready-to-eat produce.


Biomédica ◽  
2016 ◽  
Vol 36 (4) ◽  
pp. 612 ◽  
Author(s):  
Paola Mariana Arias-Ortiz ◽  
Libia Del Pilar Calderón ◽  
Juan Sebastián Castillo ◽  
José Moreno ◽  
Aura Lucía Leal ◽  
...  

Introducción. Staphylococcus aureus resistente a la meticilina es uno de los agentes patógenos más frecuentes en las unidades de cuidados intensivos. Su presencia prolonga las hospitalizaciones y aumenta el riesgo de mortalidad en los pacientes con bacteriemia. Sin embargo, la etiología de este marcador de resistencia no ha sido completamente estudiada.Objetivo. Determinar los factores asociados con la aparición de S. aureus resistente a la meticilina causante de bacteriemia en pacientes atendidos en unidades de cuidados intensivos en Bogotá.Materiales y métodos. Se hizo un estudio retrospectivo de casos y controles emparejados, anidado en una cohorte de pacientes con diagnóstico de bacteriemia por S. aureus atendidos en unidades de cuidados intensivos de Bogotá entre 2006 y 2008. Los casos fueron pacientes con hemocultivo positivo para resistencia a la meticilina, emparejados 1 a 1 con controles con hemocultivos sensibles a la meticilina de la misma institución y año de hospitalización. Se analizaron mediante regresión logística condicional los factores de riesgo asociados con la presencia de resistencia, con énfasis en el tratamiento previo con antibióticos.Resultados. Se incluyeron 372 pacientes con bacteriemia por S. aureus. Factores como el uso de dispositivos previos a la hospitalización: vasculares (Odds ratio, OR=1,986; IC95% 1,038-3,801) y urinarios (OR=2,559; IC95% 1,170-5,596), así como el número de antibióticos administrado previamente, se asociaron con la aparición de resistencia. Se registró un efecto de gradiente con el número de antibióticos usados previamente, especialmente carbapenémicos.Conclusiones. El uso racional de antibióticos y la vigilancia de la exposición a procedimientos quirúrgicos o al uso de dispositivos invasivos, son intervenciones que podrían disminuir la aparición de S. aureus resistente a meticilina causante de bacteriemia.


1996 ◽  
Vol 117 (2) ◽  
pp. 297-304 ◽  
Author(s):  
P. Osewe ◽  
D. G. Addiss ◽  
K. A. Blair ◽  
A. Hightower ◽  
M. L. Kamb ◽  
...  

SummaryDuring March–April 1993, an estimated 403000 residents of the 5-county greater Milwaukee, Wisconsin area developed cryptosporidiosis after drinking contaminated municipal water. Although the number of cases dropped precipitously after the implicated water plant closed on 9 April, cases continued to occur. To investigate risk factors for post-outbreak cryptosporidiosis, 33 Milwaukee-area residents who had laboratory-confirmed Cryptosporidium infection with onset of diarrhoea between 1 May and 27 June 1993 were interviewed by telephone. Of these, 28(85%) had onset of diarrhoea during May, 12(36%) had watery diarrhoea during the outbreak, and 5 (15%) were HIV-infected. In a neighbourhood-matched case-control study, immunosuppression (matched odds ratio (MOR) not calculable, 95 % confidence interval (CI) 3·0, infinity) and having a child less than 5 years old in the household (MOR = 17·0, CI 2·0, 395·0) were independently associated with infection. When persons who had diarrhoea during the outbreak were excluded, immunosuppression remained significantly associated with illness (MOR not calculable, CI 1·6, infinity). Cryptosporidium transmission continued after this massive waterborne outbreak but decreased rapidly within 2 months.


2013 ◽  
Vol 142 (7) ◽  
pp. 1437-1448 ◽  
Author(s):  
L. M. SØES ◽  
H. M. HOLT ◽  
B. BÖTTIGER ◽  
H. V. NIELSEN ◽  
V. ANDREASEN ◽  
...  

SUMMARYTo identify risk factors forClostridium difficileinfection (CDI) in Danish patients consulting general practice with gastrointestinal symptoms, a prospective matched case-control study was performed; cases (N = 259) had positive cultures for toxigenicC. difficileand controls (N = 455) negative cultures. Data were analysed by conditional logistic regression. In patients aged ⩾2 years (138 cases), hospitalization [odds ratio (OR) 8·4, 95% confidence interval (CI) 3·1–23], consumption of beef (OR 5·5, 95% CI 2·0–15), phenoxymethylpenicillin (OR 15, 95% CI 2·7–82), dicloxacillin (OR 27, 95% CI 3·6–211), and extended spectrum penicillins (OR 9·2, 95% CI 1·9–45) were associated with CDI. In patients aged <2 years none of these were associated with CDI, but in a subgroup analysis contact with animals was associated with CDI (OR 8·1, 95% CI 1·0–64). This study emphasizes narrow-spectrum penicillins, and suggests beef consumption, as risk factors for CDI in adults, and indicates a different epidemiology of CDI in infants.


Sexual Abuse ◽  
2016 ◽  
Vol 30 (4) ◽  
pp. 438-453
Author(s):  
C. U. Okeafor ◽  
I. N. Okeafor ◽  
C. I. Tobin-West

This study aimed to examine the relationship between exposure to childhood sexual abuse (CSA) and the occurrence of mental illness in adulthood in Nigeria. An age- and gender-matched case–control study was conducted in the University of Port Harcourt Teaching Hospital, Nigeria, from January to March 2014. Cases were defined as individuals aged 18 to 60 years diagnosed with mental illness while controls were aged 18 to 60 years who did not have mental illness. The study had 304 subjects comprised of 152 case–control pairs. This case–control study showed a statistically significant association between exposure to CSA and occurrence of mental illness in adulthood (pair-matched odds ratio = 3.25, 95% CI = [1.70, 6.21]). The association between CSA and mental illness was still significant (adjusted odds ratio = 3.11, 95% CI = [1.67, 5.82]) after controlling for family functionality. A robust CSA prevention and treatment strategy that considers the victim and the perpetrator in Nigeria is hereby advocated. This could be achieved by the collaborative efforts of the government of Nigeria and non-governmental organizations.


2013 ◽  
Vol 28 (7) ◽  
pp. 1915-1921 ◽  
Author(s):  
Alissa Lloyd ◽  
Navdeep Tangri ◽  
Leigh Anne Shafer ◽  
Claudio Rigatto ◽  
Jeffrey Perl ◽  
...  

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