A Case-Control Study to Identify Risk Factors for Totally Implantable Central Venous Port-Related Bloodstream Infection

AbstractObjective:To characterize risk factors for Stenotrophomonas maltophilia bloodstream infection in oncology patients.Design:A 3:1 case–control study.Setting:Stem Cell Transplant and Leukemic Center at Barnes–Jewish Hospital (St. Louis), a 1,442-bed, tertiary-care teaching hospital with a 26-bed transplantation ward.Method:From June 1999 to April 2001,13 patients with S. maltophilia bacteremia were compared with 39 control-patients who were on the transplantation unit on the same day as the case-patients' positive blood cultures. Information collected included patient demographics, medical history, history of transplantation, transplantation type, graft versus host disease, neutropenia, antibiotic use, chemotherapy, mucositis, diarrhea, the presence of central venous catheter(s), cultures, and concomitant infections.Results:Significant risk factors for S. maltophilia bacteremia included severe mucositis (7 [53.8%] of 13 vs 8 [20.5%] of 39; P = .034), diarrhea (7 [53.8%] of 13 vs 8 [20%] of 39; P = .034), and the use of metronidazole (9 [69.2%] of 13 vs 8 [20.5%] of 39; P = .002). In addition, the number of antibiotics used (median, 9 vs 5; P < .001), duration of mucositis (median, 29 vs 15 days; P = .032), and length of hospital stay (median, 34 vs 22 days; P = .017) were significantly different between case- and control-patients. Nine S. maltophilia isolates tested by pulsed-field gel electrophoresis were found to be distinctly different.Conclusion:Interventions to ameliorate the severity of mucositis, reduce antibiotic pressure, prevent diarrhea, and promote meticulous central venous catheter care may help prevent S. maltophilia bloodstream infection in oncology patients. The role of gastrointestinal tract colonization as a potential source of S. maltophilia bacteremia in oncology patients deserves further investigation.

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Risk factors for morbidity and mortality of bloodstream infection in patients undergoing hemodialysis: a nested case–control study

BMC Research Notes ◽

10.1186/1756-0500-7-882 ◽

2014 ◽

Vol 7 (1) ◽

pp. 882 ◽

Cited By ~ 10

Author(s):

Dayana Fram ◽

Mônica Taminato ◽

Vinicius Ponzio ◽

Silvia Manfredi ◽

Cibele Grothe ◽

...

Keyword(s):

Risk Factors ◽

Bloodstream Infection ◽

Case Control Study ◽

Case Control ◽

Morbidity And Mortality ◽

Nested Case Control ◽

Control Study

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Prehospital delay is an important risk factor for mortality in community-acquired bloodstream infection (CA-BSI): a matched case–control study

BMJ Open ◽

10.1136/bmjopen-2021-052582 ◽

2021 ◽

Vol 11 (11) ◽

pp. e052582

Author(s):

Martin Holmbom ◽

Maria Andersson ◽

Sören Berg ◽

Dan Eklund ◽

Pernilla Sobczynski ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Bloodstream Infection ◽

Case Control Study ◽

Case Control ◽

Important Risk Factor ◽

Retrospective Case ◽

Prehospital Delay ◽

All Cause Mortality ◽

Control Study

ObjectivesThe aim of this study was to identify prehospital and early hospital risk factors associated with 30-day mortality in patients with blood culture-confirmed community-acquired bloodstream infection (CA-BSI) in Sweden.MethodsA retrospective case–control study of 1624 patients with CA-BSI (2015–2016), 195 non-survivors satisfying the inclusion criteria were matched 1:1 with 195 survivors for age, gender and microorganism. All forms of contact with a healthcare provider for symptoms of infection within 7 days prior CA-BSI episode were registered. Logistic regression was used to analyse risk factors for 30-day all-cause mortality.ResultsOf the 390 patients, 61% (115 non-survivors and 121 survivors) sought prehospital contact. The median time from first prehospital contact till hospital admission was 13 hours (6–52) for non-survivors and 7 hours (3–24) for survivors (p<0.01). Several risk factors for 30-day all-cause mortality were identified: prehospital delay OR=1.26 (95% CI: 1.07 to 1.47), p<0.01; severity of illness (Sequential Organ Failure Assessment score) OR=1.60 (95% CI: 1.40 to 1.83), p<0.01; comorbidity score (updated Charlson Index) OR=1.13 (95% CI: 1.05 to 1.22), p<0.01 and inadequate empirical antimicrobial therapy OR=3.92 (95% CI: 1.64 to 9.33), p<0.01. In a multivariable model, prehospital delay >24 hours from first contact remained an important risk factor for 30-day all-cause mortality due to CA-BSI OR=6.17 (95% CI: 2.19 to 17.38), p<0.01.ConclusionPrehospital delay and inappropriate empirical antibiotic therapy were found to be important risk factors for 30-day all-cause mortality associated with CA-BSI. Increased awareness and earlier detection of BSI in prehospital and early hospital care is critical for rapid initiation of adequate management and antibiotic treatment.

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Risk factors and outcomes of Candida krusei bloodstream infection: A matched, case-control study

Journal of Infection ◽

10.1016/j.jinf.2012.11.002 ◽

2013 ◽

Vol 66 (3) ◽

pp. 278-284 ◽

Cited By ~ 20

Author(s):

Mindy G. Schuster ◽

Anne Meibohm ◽

Lisa Lloyd ◽

Brian Strom

Keyword(s):

Risk Factors ◽

Bloodstream Infection ◽

Case Control Study ◽

Case Control ◽

Candida Krusei ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

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Risk factors of Viridans Streptococci bloodstream infection in children with Acute leukemia: Case control study.

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2018.04.3648 ◽

2018 ◽

Vol 73 ◽

pp. 100

Author(s):

M. Taicz ◽

G. Perez ◽

V. Reijtman ◽

I. Sormani ◽

A. Mastroianni ◽

...

Keyword(s):

Risk Factors ◽

Acute Leukemia ◽

Bloodstream Infection ◽

Case Control Study ◽

Case Control ◽

Viridans Streptococci ◽

Control Study

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Risk Factors for Colonization or Infection Due to Methicillin-Resistant Staphylococcus Aureus in HIV-Positive Patients A Retrospective Case-Control Study

Infection Control and Hospital Epidemiology ◽

10.1086/501556 ◽

1999 ◽

Vol 20 (01) ◽

pp. 26-30 ◽

Cited By ~ 44

Author(s):

Michelle Onorato ◽

Michael J. Borucki ◽

Gwen Baillargeon ◽

David P. Paar ◽

Daniel H. Freeman ◽

...

Keyword(s):

Risk Factors ◽

Staphylococcus Aureus ◽

Central Venous Catheter ◽

Case Control Study ◽

Venous Catheter ◽

Case Control ◽

Central Venous ◽

Methicillin Resistant ◽

Hospital Days ◽

Control Study

AbstractObjective:To determine the risk factors for colonization or infection with methicillin-resistantStaphylococcus aureusin human immunodeficiency virus (HIV)-infected patients.Design:Retrospective matched-pair case-control study.Setting:Continuity clinic and inpatient HIV service of a university medical center.Population:Patients with HIV infection from the general population of eastern and coastal Texas and from the Texas Department of Criminal Justice.Data Collection:Patient charts and the AIDS Care and Clinical Research Program Database were reviewed for the following: age, race, number of admissions, total hospital days, presence of a central venous catheter, serum albumin, total white blood cell count and absolute neutrophil count, invasive or surgical procedures, any cultures positive forS aureus, and a history of opportunistic illnesses, diabetes, or dermatologie diagnoses. Data also were collected on the administration of antibiotics, antiretroviral therapy, steroids, cancer chemotherapy, and subcutaneous medications.Results:In the univariate analysis, the presence of a central venous catheter, an underlying dermatologie disease, lower serum albumin, prior steroid therapy, and prior antibiotic therapy, particularly antistaphylococcal therapy or multiple courses of antibiotics, were associated with increased risk for colonization or infection with methicillin-resistantS aureus. Multivariate analysis yielded a model that included presence of a central venous catheter, underlying dermatologie disease, broad-spectrum antibiotic exposure, and number of hospital days as independent risk factors for colonization or infection with methicillin-resistantS aureus.Conclusions:In our HIV-infected patient population, prior hospitalization, exposure to broad-spectrum antibiotics, presence of a central venous catheter, and dermatologie disease were risk factors for acquisition of methicillin-resistantS aureus

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An Outbreak of Methicillin-ResistantStaphylococcus aureusInfections Related to Central Venous Catheters for Hemodialysis

Infection Control and Hospital Epidemiology ◽

10.1086/502462 ◽

2004 ◽

Vol 25 (8) ◽

pp. 678-684 ◽

Cited By ~ 7

Author(s):

Sai-Cheong Lee ◽

Kuo-Su Chen ◽

Chi-Jen Tsai ◽

Ching-Chang Lee ◽

Hung Yu Chang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Case Control Study ◽

Case Control ◽

Apache Ii Score ◽

First Year ◽

Central Venous ◽

Historical Comparison ◽

Second Year ◽

Control Study

AbstractObjectives:To determine risk factors for hemodialysis catheter-related bloodstream infections (HCRBSIs) and investigate whether use of maximal sterile barrier precautions would prevent HCRBSIs.Setting:Tertiary-care medical center hemodialysis unit.Design:Open trial with historical comparison and case-control study of risk factors for HCRBSIs.Methods:Prospective surveillance was used to compare HCRBSI rates for 1 year before and after implementation of maximal sterile barrier precautions. A case–control study compared 50 case-patients with HCRBSI with 51 randomly selected control-patients.Results:The HCRBSI rate was 1.6% per 100 dialysis runs (CI95, 1.1%–2.3%) in the first year and 0.77% (CI95, 0.5%–1.1%) in the second year (P= .0106). The most frequent cause of HCRBSI was MRSA in the first year (15 of 32) and MSSA in the second year (13 of 18). Ten MRSA blood isolates in the first year were identical by PFGE. Diabetes mellitus was a risk factor for HCRBSI. Age, gender, site of hemodialysis central venous catheter (CVC), other underlying diseases, coma score, APACHE II score, serum albumin level, and cholesterol level were not associated with HCRBSI and did not change between the 2 years. Hospital stay was prolonged for case-patients (32.78 ± 20.96 days) versus control-patients (22.75 ± 17.33 days), but mortality did not differ.Conclusions:Use of maximal sterile barrier precautions during the insertion of CVCs reduced HCRBSIs in dialysis patients and seemed cost-effective. Diabetes mellitus was associated with HCRBSI. An outbreak of MRSA in the first year was likely caused by cross-infection via medical personnel.

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A184 INCIDENCE OF VENOUS THROMBOTIC EVENTS AND RISK FACTORS IN CHILDREN HOSPITALIZED WITH INFLAMMATORY BOWEL DISEASE: A RETROSPECTIVE, CASE-CONTROL STUDY

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.182 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 199-200

Author(s):

Z Ding ◽

M Sherlock ◽

M Zachos

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Anticoagulation Therapy ◽

Case Control ◽

Central Venous ◽

Children's Hospital ◽

Children’S Hospital ◽

Inflammatory Bowel ◽

Control Study ◽

Pediatric Ibd

Abstract Background Limited research has been published to describe the incidence of venous thromboembolism (VTE) and relevant risk factors in Canadian children with inflammatory bowel disease (IBD). Aims The present study aimed to investigate the incidence of VTE amongst hospitalized pediatric IBD patients over a 10-year period and identify risk factors for the development of VTE. Methods A retrospective, matched case-control study was performed at McMaster Children’s Hospital. Hospitalized pediatric patients with IBD (<18 years old) from September 2009 to August 2020 were selected. Inpatient data was extracted from the medical record database, including baseline demographic data, thromboembolic events and potential risk factors for VTE. Results There were 890 hospitalizations of IBD patients during the study period. 15 (1.69%) were diagnosed with a VTE, including 4 males and 11 females (mean age 13.4±2.9 years old). 12 ulcerative colitis (UC) (80%) and 3 Crohn’s disease (CD) (20%) hospitalizations were comprised in the VTE group. There was a significant difference in VTE rate between females (2.7%) and males (0.8%) (P = 0.03). The VTE rate in the UC group (4.2%) was significantly higher than in the CD group (0.6%) (P = 0.001). The incidence of VTE amongst hospitalized IBD patients did not vary over the 10-year period (P = 0.496). Length of stay in hospital, albumin level and central venous catheter were shown to be significantly different, although they were not identified as independent risk factors (P >0 .05). Of the 15 hospitalizations with VTE, 6/15 (40%) were superficial VTEs in the extremities and 9/15 (60%) had a deep vein thrombosis (DVT) including 6 in the extremities and 3 in the abdomen. VTEs were associated with a peripheral line in 7 patients and with a PICC line in 4 hospitalizations. 2 of 9 (22%) with extremity DVT developed symptomatic pulmonary embolism. An inherited thrombotic condition was identified in 2 of 15 with VTEs. 12/15 (80%) with VTEs were symptomatic and all VTE related symptoms happened in patients with extremity thrombosis and pulmonary embolism. 7 of 15 (47%) VTEs were treated with anticoagulation therapy for 1–6 months. VTE related symptoms and repeat imaging tests significantly improved, and no patient developed a bleeding complication as a result of treatment. Conclusions The VTE rate in pediatric IBD patients was relatively low at McMaster Children’s hospital. Children with VTE were disproportionately females with ulcerative colitis compared with children with no VTE. Central venous line insertion may be correlated with the risk for VTE in children with IBD. Most VTEs and related symptoms happened in patients with extremity thrombosis and secondary pulmonary embolus. Anticoagulation therapy in children with IBD with active disease appears to be safe. Funding Agencies Kids Dig Health Funding from McMaster Children’s Hospital, McMaster University

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