scholarly journals Bloodstream Infection: The Influence of Risk Factors, Etiology and Antimicrobial Therapy on Mortality Rates

2017 ◽  
Vol 06 (02) ◽  
Author(s):  
Rosana de Oliveira Santos Guimaraes ◽  
Thulio Marquez Cunha ◽  
Ana Carolina Souza Oliveira ◽  
Lucio Borges de Araujo ◽  
Reginaldo dos Santos Pedroso ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bloodstream Infection ◽  
Antimicrobial Therapy ◽  
Mortality Rates

scholarly journals Risk Factors and Mortality of Carbapenem-Resistant Klebsiella Pneumoniae Bloodstream Infection in a Tertiary-Care Hospital in China: An Eight-Year Retrospective Study

2020 ◽  
Author(s):  
Jie Chen ◽  
Hua Ma ◽  
Yongfeng Li ◽  
Michal Mastalerz ◽  
Ting Sheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Retrospective Study ◽  
Combination Therapy ◽  
Antimicrobial Therapy ◽  
Hematologic Malignancies ◽  
Mortality Rates ◽  
High Dose ◽  
Carbapenem Resistant

Abstract Background: The prevalence of carbapenem-resistant Klebsiella pneumonia bloodstream infection (CRKP-BSI) is increasing worldwide. CRKP-BSI is associated with high rates of morbidity and mortality due to limited antibiotic choices. Here, we aim to identify the prevalence and risk factors for infection and mortality of CRKP BSI. Methods: This was a retrospective study of the past data from January 1st, 2012 to December 31st, 2019 of adult patients with KP-BSI in Xiangya Hospital, China. Data from Demographic and clinical findings were retrieved from medical records. Results: Among the 706 incidences included in this study, 27.4% of them (212 / 753) being CR-KP strains. The occurrence of CRKP-BSI was increased from 20.69 to 37.40% from 2012 to 2019. Hematologic malignancies (P<0.001 , odds ratio [OR] 4.68, 95% confidence interval [CI] 2.3–9.4) and ICU acquired infection (P=0.003 , OR 2.10, 95% CI 1.3–3.4) were identified to be substantial risk factors of carbapenem resistance. The overall 28-day mortality rates of CRKP-BSI patients was significantly higher than that of CSKP-BSI (P<0.001). Logistic regression analysis identified severe sepsis or septic shock incidents (OR, 8.44; 95% CI, 1.85–38.39), inadequate empirical antimicrobial therapy (OR, 15.01; 95% CI, 3.70–60.79) and corticosteroids use preceding infection onset (OR, 6.45; 95% CI, 1.12–37.08) as the independent predictors of 28-day mortality of CRKP-BSI patients. However, high dose carbapenem combination therapy was identified as anticipated factors of low 28-day mortality (OR, 0.11; 95% CI, 0.03–0.51).Conclusion: The occurrence of CRKP-BSI was significantly increased during the study period. Hematologic malignancies and ICU acquired infection were associated with the development of CRKP BSI. Severe sepsis or septic shock incidents, inadequate empirical antimicrobial therapy and corticosteroids use preceding infection onset caused significant increase of mortality rates in CRKP-BSI patients. High dose carbapenem combination therapy was associated with better outcome.

scholarly journals Infective endocarditis due to Granulicatella adiacens: a case report and review

2014 ◽  
Vol 8 (04) ◽  
pp. 548-550 ◽  
Author(s):  
Kanne Padmaja ◽  
Vemu Lakshmi ◽  
Sreevdya Subramanian ◽  
Mamidi Neeraja ◽  
Siva Rama Krishna ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Treatment Failure ◽  
Female Patient ◽  
Antimicrobial Therapy ◽  
Mortality Rates ◽  
Elderly Female ◽  
Granulicatella Adiacens

Infective endocarditis (IE) caused by nutritionally variant Streptococci (NVS) is associated with high bacteriologic and treatment failure and mortality rates compared to endocarditis caused by other Streptococci. With automated blood culture systems, the rates of NVS-associated IE accounts for 5%-6% cases. We report a case of IE caused by NVS in an elderly female patient with no risk factors. The patient was successfully treated with combination antimicrobial therapy.

scholarly journals Emergency Department Visits During Outpatient Parenteral Antimicrobial Therapy: A Cohort Study

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S333-S334
Author(s):  
So Lim Kim ◽  
Angela Everett ◽  
Susan J Rehm ◽  
Steven Gordon ◽  
Nabin Shrestha
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Hospital Admission ◽  
Vascular Access ◽  
Antimicrobial Therapy ◽  
Cleveland Clinic ◽  
Emergency Department Visits ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Ed Visits ◽  
Access Complications

Abstract Background Outpatient parenteral antimicrobial therapy (OPAT) carries risk of vascular access complications, antimicrobial adverse effects, and worsening of infection. Both OPAT-related and unrelated events may lead to emergency department (ED) visits. The purpose of this study was to describe adverse events that result in ED visits and risk factors associated with ED visits during OPAT. Methods OPAT courses between January 1, 2013 and December 31, 2016 at Cleveland Clinic were identified from the institution’s OPAT registry. ED visits within 30 days of OPAT initiation were reviewed. Reasons and potential risk factors for ED visits were sought in the medical record. Results Among 11,440 OPAT courses during the study period, 603 (5%) were associated with 1 or more ED visits within 30 days of OPAT initiation. Mean patient age was 58 years and 57% were males. 379 ED visits (49%) were OPAT-related; the most common visit reason was vascular access complication, which occurred in 211 (56%) of OPAT-related ED visits. The most common vascular access complications were occlusion and dislodgement, which occurred in 99 and 34 patients (47% and 16% of vascular access complications, respectively). In a multivariable logistic regression model, at least one prior ED visit in the preceding year (prior ED visit) was most strongly associated with one or more ED visits during an OPAT course (OR 2.96, 95% CI 2.38 – 3.71, p-value &lt; 0.001). Other significant factors were younger age (p 0.01), female sex (p 0.01), home county residence (P &lt; 0.001), and having a PICC (p 0.05). 549 ED visits (71%) resulted in discharge from the ED within 24 hours, 18 (2%) left against medical advice, 46 (6%) were observed up to 24 hours, and 150 ED visits (20%) led to hospital admission. Prior ED visit was not associated with hospital admission among patients who visited the ED during OPAT. Conclusion OPAT-related ED visits are most often due to vascular access complications, especially line occlusions. Patients with a prior ED visit in the preceding year have a 3-fold higher odds of at least one ED visit during OPAT compared with patients without a prior ED visit. A strategy of managing occlusions at home and a focus on patients with prior ED visits could potentially prevent a substantial proportion of OPAT-related ED visits. Disclosures All authors: No reported disclosures.

scholarly journals Clinical Outcomes and Risk Factors for Tunneled Hemodialysis Catheter-Related Bloodstream Infections

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Kylie Martin ◽  
Yves S Poy Lorenzo ◽  
Po Yee Mia Leung ◽  
Sheri Chung ◽  
Emmet O’flaherty ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bloodstream Infection ◽  
Jugular Vein ◽  
Insertion Site ◽  
Bloodstream Infections ◽  
Left Internal Jugular Vein ◽  
Hemodialysis Catheter ◽  
Increased Risk ◽  
Catheter Related Bloodstream Infection ◽  
Reduced Risk

Abstract Diabetes and left internal jugular vein insertion site were significantly associated with increased risk of a catheter-related bloodstream infection from a tunneled hemodialysis catheter. Ex-smoker status was significantly associated with reduced risk.

Mortality and associated risk factors in diabetics

1985 ◽  
Vol 110 (4_Suppl) ◽  
pp. S21-S26 ◽  
Author(s):  
R. J. Jarrett ◽  
M. J. Shipley
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Mortality Risk ◽  
Mortality Rates ◽  
Potential Risk Factors ◽  
Diabetic Population ◽  
Associated Risk Factors ◽  
The Relationship

Summary. In 168 male diabetics aged 40-64 years participating in the Whitehall Study, ten-year age adjusted mortality rates were significantly higher than in non-diabetics for all causes, coronary heart disease, all cardiovascular disease and, in addition, causes other than cardiovascular. Mortality rates were not significantly related to known duration of the diabetes. The predictive effects of several major mortality risk factors were similar in diabetics and non-diabetics. Excess mortality rates in the diabetics could not be attributed to differences in levels of blood pressure or any other of the major risk factors measured. Key words: diabetics; mortality rates; risk factors; coronary heart disease. There are many studies documenting higher mortality rates - particularly from cardiovascular disease -in diabetics compared with age and sex matched diabetics from the same population (see Jarrett et al. (1982) for review). However, there is sparse information relating potential risk factors to subsequent mortality within a diabetic population, information which might help to explain the increased mortality risk and also suggest preventive therapeutic approaches. In the Whitehall Study, a number of established diabetics participated in the screening programme and data on mortality rates up to ten years after screening are available. We present here a comparison of diabetics and non-diabetics in terms of relative mortality rates and the influence of conventional risk factors as well as an analysis of the relationship between duration of diabetes and mortality risk.

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

2014 ◽  
Vol 7 (1) ◽  
pp. 882 ◽  
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

Features of Stroke in Chinese Diabetes Patients: A Hospital-based Study

2007 ◽  
Vol 35 (4) ◽  
pp. 540-546 ◽  
Author(s):  
X-D Zhang ◽  
Y-R Chen ◽  
L Ge ◽  
Z-M Ge ◽  
Y-H Zhang
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Ischaemic Stroke ◽  
Cerebral Haemorrhage ◽  
Mortality Rates ◽  
Demographic Characteristics ◽  
Major Influence ◽  
Diabetic Patients ◽  
Clinical Factors ◽  
Patients With Diabetes

In this study, demographic characteristics, risk factors, stroke subtypes and outcome were compared in 2532 patients with and without diabetes hospitalized for first-ever stroke. Diabetes was present in 471 (18.6%) of the patients. Patients with diabetes presented more frequently with ischaemic stroke (92.1% versus 71.3%), especially lacunar infarction (41.2% versus 35.2%), compared with non-diabetics. Cerebral haemorrhage was less frequent in diabetics than non-diabetics (4.2% versus 18.1%). In-hospital mortality rates from ischaemic stroke were similar in the two groups (18.2% in diabetics and 16.9% in non-diabetics). Predictors of in-hospital mortality in diabetic patients included decreased consciousness, congestive heart failure and atrial fibrillation. In conclusion, stroke in diabetic patients was different to stroke in non-diabetic patients: in diabetics the frequency of cerebral haemorrhage was lower and the rate of lacunar infarct syndrome was higher, but in-hospital mortality from ischaemic stroke was not increased. Clinical factors evident at the onset of stroke have a major influence on in-hospital mortality and may help clinicians provide a more accurate prognosis.

Age and risk factors influence the microbial aetiology of bloodstream infection in children

2012 ◽  
Vol 102 (2) ◽  
pp. 182-186 ◽  
Author(s):  
Joachim Luthander ◽  
Rutger Bennet ◽  
Christian G Giske ◽  
Anna Nilsson ◽  
Margareta Eriksson
Keyword(s):  
Risk Factors ◽  
Bloodstream Infection
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