scholarly journals Relationship between age and intensive care unit-acquired bloodstream infections in infectious disease patients in Croatia

2018 ◽  
Vol 12 (05) ◽  
pp. 352-358
Author(s):  
Mirjana Balen Topic ◽  
Marija Santini ◽  
Bruno Barsic

Introduction: Intensive care unit-acquired bloodstream infections (ICU-BSI) belong to the most important nosocomial infections. Since there is scarce data available on their relationship with older age, we performed this study to estimate the age-related incidence of ICU-BSI and the odds of acquiring ICU-BSI in elderly critically ill infectious disease patients. Methodology: A retrospective observational analysis of prospectively collected demographic and clinical data of adult mechanically ventilated infectious disease patients, treated in a teaching hospital in Croatia between 1994 and 2008, using univariate, bivariate, and multivariate logistic regression analyses. Results: Of the 1,093 included patients, 509 (46.6%) were ≥ 65 years old, among 256 (23.4%) of whom a total of 353 ICU-BSI episodes were recorded. No significant difference among ICU-BSI causative microorganisms between the observed age groups was found (P = 0.4940). The rate of patients with ICU-BSI was higher among elderly ones (26.1 vs. 21.1%, P = 0.048), and elderly patients used the ICU facilities (ICU stay, duration of mechanical ventilation and central venous catheter [CVC] use) significantly longer (P < 0.05). However, older age was not positively related with the development of ICU-BSI (OR 0.99, 95% CI: 0.71-1.38); as opposed to the duration of CVC use (OR 1.09, 95% CI: 1.07-1.10). Conclusion: It seems that among adult mechanically ventilated infectious disease patients, borderline significantly higher rate of ICU-BSI among those aged ≥ 65 years was related to longer use of ICU facilities, rather than to their older age itself. The duration of CVC use was identified as the only factor positively related to the development of ICU-BSI.

2011 ◽  
Vol 15 (4) ◽  
pp. 213-223 ◽  
Author(s):  
Virendra C. Patil ◽  
Harsha V. Patil ◽  
M. N. Ramteerthkar ◽  
R. D. Kulkarni

2007 ◽  
Vol 28 (8) ◽  
pp. 905-909 ◽  
Author(s):  
Jonas Marschall ◽  
Carole Leone ◽  
Marilyn Jones ◽  
Deborah Nihill ◽  
Victoria J. Fraser ◽  
...  

Objective.To determine the incidence of central venous catheter (CVC)-associated bloodstream infection (CA-BSI) among patients admitted to general medical wards outside the intensive care unit (ICU).Design.Prospective cohort study performed over a 13-month period, from April 1, 2002, through April 30, 2003.Setting.Four selected general medical wards at Barnes-Jewish Hospital, a 1,250-bed teaching hospital in Saint Louis, Missouri.Patients.All patients admitted to 4 general medical wards.Results.A total of 7,337 catheter-days were observed during 33,174 patient-days. The device utilization ratio (defined as the number of catheter-days divided by the number of patient-days) was 0.22 overall and was similar among the 4 wards (0.21, 0.25, 0.19, and 0.24). Forty-two episodes of CA-BSI were identified (rate, 5.7 infections per 1,000 catheter-days). Twenty-four (57%) of the 42 cases of CA-BSI were caused by gram-positive bacteria: 10 isolates (24%) were coagulase-negative staphylococci, 10 (24%) were Enterococcus species, and 3 (7%) were Staphylococcus aureus. Gram-negative bacteria caused 7 infections (17%). Five CA-BSIs (12%) were caused by Candida albicans, and 5 infections (12%) had a polymicrobial etiology. Thirty-five patients (83%) with CA-BSI had nontunneled CVCs in place.Conclusions.Non-ICU medical wards in the study hospital had device utilization rates that were considerably lower than those of medical ICUs, but CA-BSI rates were similar to CA-BSI rates in medical ICUs in the United States. Studies of catheter utilization and on CVC insertion and care should be performed on medical wards. CA-BSI prevention strategies that have been used in ICUs should be studied on medical wards.


1998 ◽  
Vol 33 (9) ◽  
pp. 1383-1387 ◽  
Author(s):  
Mary E. Fallat ◽  
Robert N. Gallinaro ◽  
Beth H. Stover ◽  
Shirley Wilkerson ◽  
L. Jane Goldsmith

2017 ◽  
Vol 22 (2) ◽  
pp. 106-111
Author(s):  
Jennifer M. Schultheis ◽  
Travis S. Heath ◽  
David A. Turner

OBJECTIVE The primary objective of this study was to determine whether an association exists between deep sedation from continuous infusion sedatives and extubation failures in mechanically ventilated children. Secondary outcomes evaluated risk factors associated with deep sedation. METHODS This was a retrospective cohort study conducted between January 1, 2009, and October 31, 2012, in the pediatric intensive care unit (PICU) at Duke Children's Hospital. Patients were included in the study if they had been admitted to the PICU, had been mechanically ventilated for ≥48 hours, and had received at least one continuous infusion benzodiazepine and/or opioid infusion for ≥24 hours. Patients were separated into 2 groups: those deeply sedated and those not deeply sedated. Deep sedation was defined as having at least one documented State Behavioral Scale (SBS) of −3 or −2 within 72 hours prior to planned extubation. RESULTS A total of 108 patients were included in the analysis. Both groups were well matched with regard to baseline characteristics. For the primary outcome, there was no difference in extubation failures in those who were deeply sedated compared to those not deeply sedated (14 patients [22.6%] versus 7 patients [15.2%], respectively; p = 0.33). After adjusting for potential risk factors, patients with a higher weight percentile for age (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00–1.03), lower Glasgow Coma Score (GCS) score prior to intubation (OR 0.85; 95% CI 0.74–0.97), and larger maximum benzodiazepine dose (OR 1.93; 95% CI 1.01–3.71) were associated with greater odds of deep sedation. A higher GCS prior to intubation was significantly associated with increased odds of extubation failure (OR 1.19; 95% CI 1.02–1.39). CONCLUSIONS While there was no statistically significant difference in extubation failures between the 2 groups included in this study, considering the severe consequences of extubation failure, the numerical difference reported may be clinically important.


2012 ◽  
Vol 32 (4) ◽  
pp. 35-40 ◽  
Author(s):  
Barbara Pfaff ◽  
Teresa Heithaus ◽  
Madeline Emanuelsen

Background New transparent dressings with chlorhexidine gluconate in the dressing are available. Objectives To compare the effectiveness of a new 1-piece occlusive dressing that incorporates chlorhexidine gluconate with that of a dressing plus a chlorhexidine gluconate patch in maintaining the low rate of catheter-related bloodstream infections in the intensive care unit and to evaluate nurses’ satisfaction with and cost of the new dressing. Methods A quality improvement observational study was done in an adult medical-surgical intensive care unit. All patients with a central venous catheter had initial and/or subsequent dressing changes done with the new dressing. The central catheter bundle elements of the Institute for Healthcare Improvement were followed. Patients were monitored for catheter-related bloodstream infections, and the rate of infection was calculated. Results During the study period of 1881 device days, the infection rate was 0.051 per 1000 device days, compared with a rate of 0.052 in 2008. Nurses preferred the new dressing. Cost savings were $3807. Conclusion A low rate of catheter-related bloodstream infections can be maintained, nurses’ satisfaction achieved, and cost savings realized with the new dressing.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1929-1929
Author(s):  
Olufunmilayo A Bamigbola ◽  
Lorna E Warwick

Abstract Background Lymphomas can occur in all age groups but most commonly occur in older adults. Despite the shift towards patient- centered care, very little has been done to explore the information needs of patients with lymphoma by age. It is important for information to accessible to patients of all ages, as informed patients are consistently associated with better outcomes and healthcare experiences. In this study, Lymphoma Coalition (LC) describes the age-related differences in the information needs of patients with lymphoma using the 2020 LC Global Patient Survey (GPS). The objectives of this study were to identify: 1) how patients felt about the amount of information they received at diagnosis 2) the content of the information received at diagnosis and the level of understanding, and 3) their informational needs. Methods Globally, 11,878 respondents including 9,179 patients and 2,699 caregivers took part in the 2020 LC GPS. There were 9,078 patients included in this analysis who self-identified their age. These patients were grouped into five age groups for analysis: 18-29 (n=638), 30-39 (n=1,196), 40-59 (n=3,261), 60-69 (n=2,216), and 70+ (n=1,767). Demographics of the five age groups were examined, and descriptive analyses for all questions relating to information needs were performed in IBM SPSS v27. Results The five age groups differed significantly (p&lt; 0.001) in all the demographic categories examined. These categories included lymphoma subtype, sex, area of residence, education level, employment status, and household status. Patients were asked how they felt about the amount of information given to them at diagnosis. The oldest age group (70+) reported the highest prevalence (70%) of having received the right amount of information (Table 1). The younger age groups (18-29; 30-39; and 40-59) reported the highest prevalence of not receiving enough information (38%, 42%, and 41% respectively). Although not many patients reported being given too much information, of those who did, the younger age groups (18-29; 30-39; and 40-59) were the most prevalent (10%; 7%; and 5% respectively) (Table 1). Patients were asked about the type of information given to them at diagnosis, and how well they understood it. Compared to the younger age groups, the older age groups (60-69 and 70+) more frequently reported that they received and understood information given to them on different medical treatment options, the process and stages of their care, and how to manage side effects of treatment (Table 1). Patients were also asked what they needed more information about (Table 1). The top three areas that all patients needed more information about (regardless of age group) were treatment options, side effects from treatment, and their diagnosis and what it means. There was significant difference in the prevalence of how these information needs were reported between the age groups (Table 1). There was also significant difference in the prevalence of reporting a need for more information on support for self care, psychological support/counselling, and fertility across the age categories (Table 1). The lowest prevalence for needing more information in any of these areas was observed in the older age groups (60-69 and 70+), while the highest prevalence was observed in the youngest age groups (18-29 and 30-39) (Table 1). Although few patients reported not needing more information in any of these areas, its reporting was most prevalent in the older age groups (60-69 and 70+) (12% and 19%, respectively) (Table 1). Summary/Conclusions This analysis revealed that patients with lymphoma/CLL experience medical information differently across age groups. Compared to the mid and oldest patient groups, younger patients with lymphoma or CLL reported experiencing medical information differently than older patients do and reported less understanding of the medical information given to them. The younger patients also reported higher informational needs about their disease and treatment that may also be related to their age (e.g. information on fertility and family support). Clinicians should note these differences in age-group experiences and information needs, with the understanding that younger patients with lymphoma or CLL may require additional information, attention, and support. In the future, LC would like to explore how demographic differences may have confounded results. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.


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