scholarly journals Epidemiology, Microbiological Characteristics and Clinical Outcomes of Invasive Blood Stream Infections of Group B Streptococcal Isolates From Qatar

2021 ◽  
Vol 2022 (1) ◽  
Author(s):  
Maia Ali ◽  
Mohammed Alamin ◽  
Khalid Alzubaidi ◽  
Bashir Ali ◽  
Abdel-Latif Ismail ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Blood Stream ◽  
Blood Stream Infections ◽  
Microbiological Characteristics ◽  
Group B

scholarly journals 192. Epidemiology, Microbiological Characteristics and Clinical Outcomes of Invasive Blood Stream Infections of Group B Streptococcal Isolates From Qatar

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S203-S204
Author(s):  
Maisa Ali ◽  
Mohammed Alamin ◽  
Gawahir Ali ◽  
Khalid Alzubaidi ◽  
Bashir Ali ◽  
...  
Keyword(s):  
Young Adults ◽  
Clinical Outcomes ◽  
Streptococcus Agalactiae ◽  
Blood Stream Infection ◽  
The Elderly ◽  
Blood Stream ◽  
High Cure ◽  
Presenting Symptoms ◽  
Microbiological Characteristics ◽  
Group B

Abstract Background Group B Streptococci (GBS) or Streptococcus agalactiae colonize humans genitourinary and gastrointestinal tracts particularly of females. The pathogen is capable of causing invasive disease primarily in infants, pregnant and postpartum women as well as the elderly and patients with comorbidities. There is paucity of studies of the disease with regional differences in prevalence and presentation of invasive blood stream infection (BSI). In this study, we aim to assess prevalence, microbiological characteristics as well as clinical outcomes of invasive GBS disease from all ages groups at Hamad Medical Corporation (HMC), Qatar. Methods A retrospective study was conducted on all patients with microbiologically confirmed GBS bacteraemia between January 2015–March 2019. Demographic, microbiological characteristics as well as clinical data were extracted from hospital information system. Results Out of 196 confirmed cases of GBS blood stream infection, 63.7 % were females (125/196) of whom 44.8 % were pregnant (56/125), 53.6 % (30/56) were colonized while 36.3 % (71/196) were males. There were three distinct age group populations, paediatric less than 4 years of age at 35.7 %, young adults 25-34 (20.9 %) and the elderly > 65 year (17.4 %). Presenting symptoms were mild with fever recognised in only 53 % of cases (104/196) while 89% of cases had low Pitt bactermia score of 0-2. Microbiological characteristic using disc diffusion tests demonstrated all isolates were universally sensitive to penicillin (100%, 196/196) with significant resistance to clindamycin at 28.6 % (56/196) and erythromycin at 49 % (96/196) of which 34.4 % (33/96) had inducible clindamycin resistance. Clinical outcome showed high cure rate of 87.25% (171/196) with low complications at 8.76 % (17/196) and 4% (8/196) 30-day mortality. Antibiotic sensitivity profile for GBS isolates Conclusion Streptococcus agalactiae blood stream infection in Qatar is common in females, affects the very young, young adults and the elderly. Almost half of affected pregnant women are colonized. The organism remains universality sensitive to pencilling with significant resistance to clindamycin and erythromycin. Patients presents with mild symptoms with high cure rates, low complications and safe outcome for the majority of cases. Disclosures All Authors: No reported disclosures

scholarly journals 936. Risk Factors and Clinical Outcomes for Extended-Spectrum Beta-Lactamase Producing Enterobacterales Blood Stream Infections in Patients with Hematologic Malignancies

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S560-S560
Author(s):  
Amanda Lefemine ◽  
Jacqueline Meredith ◽  
Katie Hammer ◽  
Ekaterina Kachur ◽  
Jiaxian He ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Clinical Outcomes ◽  
Panel Member ◽  
Antibiotic Use ◽  
Hematologic Malignancies ◽  
Blood Stream ◽  
Review Panel ◽  
Blood Stream Infections ◽  
Optimal Therapy

Abstract Background Hematologic malignancy patients have high rates of antibiotic exposure, and increasing resistance is a major concern, particularly with extended-spectrum beta lactamases (ESBL) in Enterobacterales blood stream infections (BSIs). Identifying risk factors for ESBL-producing Enterobacterales (ESBL-E) BSIs may facilitate faster appropriate antibiotic use and decrease mortality. Methods This was a retrospective study of patients with hematologic malignancies and Escherichia coli or Klebsiella spp. bacteremia admitted to Carolinas Medical Center in Charlotte, NC from January 2010 through September 2020. The primary objective was to compare 30-day mortality rates for patients with ESBL-E BSIs to those with non-ESBL-E BSIs. Fisher’s exact or Mann-Whitney U tests were used for primary and secondary clinical outcomes as appropriate. Risk factors associated with 30-day mortality and ESBL production were assessed as secondary objectives using logistic regression models. Results A total of 28 patients with ESBL-E BSIs and 60 patients with non-ESBL-E BSIs were included. The 30-day mortality rate with ESBL-E BSIs was 25% compared to 15% with non-ESBL-E BSIs (P = .373). In-hospital mortality, 30-day infection recurrence, intensive care unit (ICU) admission, and length of stay after culture were not significantly different. However, time to optimal therapy was longer in the ESBL-E group (median 42.3 vs 1.9 hr; P < .001). Multivariate logistic regression analysis showed an association of 30-day mortality with ICU admission (OR 16.7; 95% CI, 3.56-78.4; P < .001) and longer time to optimal therapy (OR 1.03; 95% CI, 1.0-1.05; P = .026). Prior ESBL-positive culture was associated with ESBL-E BSI in the univariate logistic regression (OR 9.83; 95% CI, 1.05-92.56; P = .046). Additionally, prolonged neutropenia (OR 3.05; 95% CI, 1.01-9.23; P = .049) and prior intravenous antibiotic use (OR 2.96; 95% CI, 0.96-9.09; P = .059) were associated with ESBL-E BSI in the multivariate analysis. Conclusion Significantly longer time to optimal therapy was seen in ESBL-E BSIs and was associated with mortality in patients with hematologic malignancies. The identified ESBL risk factors create an opportunity to decrease delay in optimal therapy through risk stratification during initial antibiotic selection. Disclosures Ekaterina Kachur, PharmD, BCOP, Bristol Myers Squibb (Advisor or Review Panel member)Genentech (Employee)Glaxosmithkline (Advisor or Review Panel member)Kyowa Kirin (Advisor or Review Panel member)

scholarly journals TEMPORARY HEMODIALYSIS

2015 ◽  
Vol 22 (03) ◽  
pp. 287-292
Author(s):  
Omer Sabir ◽  
Nauman Tarif ◽  
Sheikh Rizwan ◽  
Kashif Rafique ◽  
Nabiha Rizvi ◽  
...  
Keyword(s):  
Blood Stream ◽  
Additional Benefit ◽  
Blood Stream Infections ◽  
Group A ◽  
Catheter Lock ◽  
The Mean ◽  
Group B ◽  
Lock In

Catheter related blood stream infections (CRBSI) in patients undergoinghemodialysis frequently results in significant morbidity and mortality. Attempts at prevention ofCRBSI by catheter lock antibiotics, antibiotic combinations or solutions including Taurolidinehave emerged over years. Objectives: To determine the role of taurolidine lock in presentationof Catheter related infection in hemodialysis. Design: Multicentre un-builded, randomizedcontrolled, non-inferiority trail. Period: Jul 2012 to Dec 2013. Setting: Department of Nephrology,Fatima Memorial Hospital UHS Lahore. Methods: It was a multicentre, un-blinded, randomizedcontrolled, non-inferiority trial. Results: Out of 95 patients, total of 38 patients were randomizedinto two groups. In group A catheters were locked with Taurolidine 2% and Heparin (5000IU/ml) equal to the catheter volume according to the protocol. In group B (control) catheters werelocked with Heparin alone. 36 patients completed the study protocol. For primary end pointanalysis (30 days) the mean duration of catheter days was 27.25 + 5.5 days (median 30 days).During this period of follow up only one patient from Group B had CRBSI resulting in a pointincidence of CRBSI of 2.7%. Conclusions: Catheter lock with Taurolidine 2% in combinationwith heparin compared to heparin alone had no additional benefit in prevention of CRBSI. Thishowever needs to be evaluated in a larger study using non cuffed temporary vascular access(TVA).

Use of Antimicrobial Lock Therapy for the Treatment of Central Line-Related Blood-Stream Infections: A Case Series

2018 ◽  
Author(s):  
F. Piersigilli ◽  
C. Auriti ◽  
I. Bersani ◽  
F. Campi ◽  
I. Savarese ◽  
...  
Keyword(s):  
Case Series ◽  
Blood Stream ◽  
Central Line ◽  
Blood Stream Infections ◽  
Lock Therapy

scholarly journals Effects of stent generation on clinical outcomes after acute myocardial infarction compared between prediabetes and diabetes patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yong Hoon Kim ◽  
Ae-Young Her ◽  
Myung Ho Jeong ◽  
Byeong-Keuk Kim ◽  
Sung-Jin Hong ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Clinical Outcomes ◽  
Secondary Outcome ◽  
Drug Eluting Stent ◽  
Diabetes Group ◽  
Repeat Revascularization ◽  
Group A ◽  
Group B ◽  
Diabetes Patients

AbstractWe investigated the effects of stent generation on 2-year clinical outcomes between prediabetes and diabetes patients after acute myocardial infarction (AMI). A total of 13,895 AMI patients were classified into normoglycemia (group A: 3673), prediabetes (group B: 5205), and diabetes (group C: 5017). Thereafter, all three groups were further divided into first-generation (1G)-drug-eluting stent (DES) and second-generation (2G)-DES groups. Patient-oriented composite outcomes (POCOs) defined as all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization were the primary outcome. Stent thrombosis (ST) was the secondary outcome. In both prediabetes and diabetes groups, the cumulative incidences of POCOs, any repeat revascularization, and ST were higher in the 1G-DES than that in the 2G-DES. In the diabetes group, all-cause death and cardiac death rates were higher in the 1G-DES than that in the 2G-DES. In both stent generations, the cumulative incidence of POCOs was similar between the prediabetes and diabetes groups. However, in the 2G-DES group, the cumulative incidences of Re-MI and all-cause death or MI were significantly higher in the diabetes group than that in the prediabetes group. To conclude, 2G-DES was more effective than 1G-DES in reducing the primary and secondary outcomes for both prediabetes and diabetes groups.

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