scholarly journals How the COVID-19 pandemic changed postoperative infections in urology wards: A retrospective cohort study from two urology departments

2021 ◽  
Vol 16 (5) ◽  
Author(s):  
Bernardo L. Teixeira ◽  
João Cabral ◽  
André Marques-Pinto ◽  
Fernando Vila ◽  
Joaquim Lindoro ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Postoperative Infection ◽  
Elective Surgery ◽  
Resistant Organism ◽  
Relative Reduction ◽  
Drug Resistant ◽  
Postoperative Infections ◽  
Elective Surgical Procedures

Introduction: We aimed to compare the rate of postoperative infection and drug-resistant organism (DRO) before and during the COVID-19 pandemic in urology departments. Methods: A retrospective cohort study was carried out. Data from all elective surgical procedures carried out in two urology departments between April and June 2018 and the homologous period in 2020 were collected. Main outcomes were the number of postoperative infections during the pandemic, and the number of DROs. Sample size was calculated based on a 50% relative reduction of infections during the pandemic. Variables were compared by Chi-squared test, and multivariable logistic regression was used to estimate predictors. Results: A total of 698 patients undergoing elective surgery were included. The postoperative infection rate during the pre-pandemic period was of 14.1% compared to 12.1% during the pandemic (p=0.494). DROs were lower during the pandemic (92.3% vs. 52.4%, p=0.002). The pandemic period was the main predictor for reduced multi-drug-resistant isolates, with an odds ratio of 0.10 (p=0.010, 95% confidence interval 0.016–0.57). Conclusions: Postoperative infection rates were not significantly reduced during the COVID-19 pandemic, despite the adoption of enhanced infection preventive measures. There was, however, a decrease in the rate of DROs during this period, suggesting a secondary benefit to enhanced infection prevention practices adopted during the COVID-19 era.

scholarly journals Diabetes Mellitus as a Risk Factor for Drug Resistance Tuberculosis: A Retrospective Cohort Study at King Abdul Aziz University, Jeddah

2021 ◽  
pp. 136-145
Author(s):  
Sumyia Mehrin M. D. Abulkalam ◽  
Mai Kadi ◽  
Mahmoud A. Gaddoury ◽  
Wallaa Khalid Albishi
Keyword(s):  
Diabetes Mellitus ◽  
Drug Resistance ◽  
Risk Factor ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
University Hospital ◽  
P Value ◽  
Baseline Characteristic ◽  
Drug Resistant

Background: The association between tuberculosis (TB) and diabetes mellitus (DM) is re-emerging with the epidemic of type II diabetes. Both TB and DM were of the top 10 causes of death.[1] This study explores diabetes mellitus as a risk factor for developing the different antitubercular drug-resistant (DR) patterns among TB patients.  Methods: A retrospective cohort study has been conducted on all TB cases reported to the King Abdul Aziz University Hospital, Jeddah, between January 2012 to January 2021. All culture-confirmed and PCR-positive TB cases were included in this study. Categorical baseline characteristic of TB patient has been compared with DM status by using Fisher's exact and Pearson chi-square test. The univariable and multivariable logistic regression model was used to estimate the association between DM and different drug resistance patterns.  Results: Of the total 695 diagnosed TB patients, 92 (13.24%) are resistant to 1st line anti TB drugs. Among 92 DR-TB patients, 36 (39.13%) are diabetic. The percentage of different patterns of DR-TB with DM, in the case of mono DR (12.09%), poly DR (4.19%) MDR (0.547%). As a risk factor, DM has a significant association with DR-TB, mono drug-resistant, and pyrazinamide-resistant TB (P-value <0.05). The MDR and PDR separately do not show any significant association with DM, but for further analysis, it shows a significant association with DM when we combined.  Conclusion: Our study identified diabetes mellitus as a risk factor for developing DR-TB. Better management of DM and TB infection caring programs among DM patients might improve TB control and prevent DR-TB development in KSA.

Safe Transitions and Congregate Living in the Age of COVID-19: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Christopher A Boyle ◽  
Urmila Ravichandran ◽  
Valerie Hankamp ◽  
Nadim Ilbawi ◽  
Coleen Conway-Svec ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Negative Impact ◽  
Relative Reduction ◽  
Nursing Facilities ◽  
Post Intervention ◽  
Or Efficiency ◽  
Skilled Nursing ◽  
Value Based Care

BACKGROUND: COVID-19 represents a grave risk to residents in skilled nursing facilities (SNFs). OBJECTIVE: To determine whether establishment of an appropriate-use committee was associated with a reduction in SNF utilization. DESIGNS, SETTING, AND PARTICIPANTS: Retrospective cohort study at NorthShore University HealthSystem, a multihospital integrated health system in northern Illinois. Participants were patients hospitalized from March 19, 2019, to July 16, 2020. INTERVENTION: Creation of a multidisciplinary committee to assess appropriateness of discharge to SNF following hospitalization. MAIN OUTCOME AND MEASURES: Primary outcome was total discharges to SNFs. Secondary outcomes were new discharges to SNFs, readmissions, length of stay (LOS), and COVID-19 incidence following discharge. RESULTS: Matched populations pre and post intervention were each 4424 patients. Post intervention, there was a relative reduction in total SNF discharges of 49.7% (odds ratio [OR], 0.42; 95% CI, 0.38-0.47) and in new SNF discharges of 66.9% (OR, 0.29; 95% CI, 0.25-0.34). Differences in readmissions and LOS were not statistically significant. For patients discharged to a SNF, 2.99% (95% CI, 1.59%-4.39%) developed COVID-19 within 30 days, compared with 0.26% (95% CI, 0.29%-0.93%) of patients discharged to other settings (P < .001). CONCLUSION: Implementing a review committee to assess for appropriateness of SNF use after a hospitalization during the COVID-19 pandemic is highly effective. There was no negative impact on safety or efficiency of hospital care, and reduced SNF use likely prevented several cases of COVID-19. This model could serve as a template for other hospitals to reduce the risks of COVID-19 in SNFs and as part of a value-based care strategy.

scholarly journals Epidemiology of extended spectrum β-lactamase producing Enterobacter bacteremia in a brazilian hospital

2010 ◽  
Vol 43 (4) ◽  
pp. 452-454 ◽  
Author(s):  
Felipe Francisco Tuon ◽  
Leila Carolina Bianchet ◽  
Sergio Ricardo Penteado-Filho
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Urinary Catheter ◽  
Elective Surgery ◽  
Survival Curve ◽  
Factors Associated ◽  
Extended Spectrum ◽  
Length Of Hospitalization

INTRODUCTION: Enterobacter can be included in the group of extended spectrum β-lactamases (EBSL)-producing bacteria, though few studies exist evaluating risk factors associated with this microorganism. A retrospective cohort study was conducted to determine risk factors associated with ESBL-producing-Enterobacter and mortality METHODS: A retrospective cohort study with 58 bacteremia caused by ESBL-producing-Enterobacter (28 cases) and non-ESBL (30 cases) RESULTS: Risk factors associated with ESBL-Enterobacter were trauma, length of hospitalization, admission to the intensive care unit, urinary catheter and elective surgery (p< 0.05). The survival curves were similar for ESBL and non-ESBL CONCLUSIONS: ESBL-producing-Enterobacter bacteremia is prevalent and the survival curve was similar to non-ESBL-producing strains.

Treatment of extensively drug-resistant tuberculosis in Tomsk, Russia: a retrospective cohort study

The Lancet ◽  
2008 ◽  
Vol 372 (9647) ◽  
pp. 1403-1409 ◽  
Author(s):  
Salmaan Keshavjee ◽  
Irina Y Gelmanova ◽  
Paul E Farmer ◽  
Sergey P Mishustin ◽  
Aivar K Strelis ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant

scholarly journals Successful expansion of community‐based drug‐resistant TB care in rural Eswatini – a retrospective cohort study

2019 ◽  
Vol 24 (10) ◽  
pp. 1243-1258 ◽  
Author(s):  
Bernhard Kerschberger ◽  
Alex Telnov ◽  
Nanako Yano ◽  
Helen Cox ◽  
Inoussa Zabsonre ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Drug Resistant ◽  
Community Based

Retrospective Cohort Study of Granisetron Administration for PONV Prophylaxis and Treatment

2005 ◽  
Vol 40 (7) ◽  
pp. 592-598
Author(s):  
Alicia Shillington ◽  
P. Anne Farley ◽  
Jerry A. Varkey ◽  
Cindy Dempsey ◽  
Andrew Coop ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Elective Surgery ◽  
Postoperative Nausea And Vomiting ◽  
Risk Groups ◽  
Nausea And Vomiting ◽  
Antiemetic Prophylaxis ◽  
Prevention And Treatment ◽  
Excellent Control

Postoperative nausea and vomiting (PONV) frequently complicates surgical recovery and is considered to be one of the least desirable surgical side effects. Granisetron (Kytril) 1 mg intravenously (IV) was approved by the FDA for the prevention and treatment of PONV in August 2002. Objective This cohort study evaluated outcomes and utilization associated with granisetron use for PONV prevention and treatment. Methods This was a retrospective cohort study of 400 patient records from 10 US hospitals. Patients included were those greater than or equal to 18 years of age having elective surgery under general anesthesia with granisetron administered IV for prevention or treatment of PONV. Excluded were those with concurrent radiation or chemotherapy, or those observed less than 2 hours in the post anesthesia care unit. Results Mean age was 50 y ± 17 with 272 females (68%). The majority was at moderate-high (n = 230; 58%) or mild-moderate risk of PONV (n = 155; 39%). Granisetron was administered predominantly perioperatively and at 0.1 mg dose (n = 382; 96%) from prefilled syringes extemporaneously prepared from 4 mg/4 mL vials. Total control (absence of nausea and vomiting) was experienced in 330 patients (83%), with 16 (4%) having a vomiting episode. In 167 patients at lower risk of PONV, symptoms were prevented in 148 (less than 90%). Regression analysis indicates that, in addition to absence of key risk factors, combination antiemetic prophylaxis was highly associated with optimal outcome. Granisetron dose did not impact outcome. Conclusion The majority of granisetron use for PONV was prophylactic, administered perioperatively at a 0.1 mg dose. Most patients experienced excellent control, even in the highest risk groups, particularly when granisetron was administered in combination with dexamethasone or metoclopramide.

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