C-reactive protein concentration as a predictor of intensive care unit readmission: A nested case-control study

2006 ◽  
Vol 21 (3) ◽  
pp. 259-265 ◽  
Author(s):  
Kwok M. Ho ◽  
Geoffrey J. Dobb ◽  
Kok Y. Lee ◽  
Simon C. Towler ◽  
Steven A.R. Webb
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Protein Concentration ◽  
Case Control Study ◽  
Case Control ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Intensive Care Unit Readmission ◽  
Nested Case Control ◽  
Control Study

scholarly journals Prior Antibiotic Therapy and the Onset of Healthcare-Associated Infections Sustained by Multidrug-Resistant Klebsiella pneumoniae in Intensive Care Unit Patients: A Nested Case–Control Study

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 302
Author(s):  
Giuseppe Migliara ◽  
Valentina Baccolini ◽  
Claudia Isonne ◽  
Sara Cianfanelli ◽  
Carolina Di Paolo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Case Control Study ◽  
Multidrug Resistant ◽  
Case Control ◽  
Healthcare Associated Infections ◽  
Healthcare Associated ◽  
Nested Case Control ◽  
Control Study

Epidemiological research has demonstrated direct relationships between antibiotic consumption and the emergence of multidrug-resistant (MDR) bacteria. In this nested case–control study, we assessed whether prior exposure to antibiotic therapy and its duration affect the onset of healthcare-associated infections (HAIs) sustained by MDR Klebsiella pneumoniae (MDR-Kp) in intensive care unit patients. Cases were defined as patients who developed an MDR-Kp HAI. Controls matched on sex and the length of intensive care unit (ICU) stay were randomly selected from the at-risk population. Any antibiotic agent received in systemic administration before the onset of infection was considered as antibiotic exposure. Multivariable conditional logistic regression analyses were performed to estimate the effect of prior exposure to each antibiotic class (Model 1) or its duration (Model 2) on the onset of HAIs sustained by MDR-Kp. Overall, 87 cases and 261 gender-matched controls were compared. In Model 1, aminoglycosides and linezolid independently increased the likelihood of developing an MDR-Kp HAI, whereas exposure to both linezolid and penicillins reduced the effect of linezolid alone. In Model 2, cumulative exposure to aminoglycosides increased the likelihood of the outcome, as well as cumulative exposures to penicillins and colistin, while a previous exposure to both penicillins and colistin reduced the influence of the two antibiotic classes alone. Our study confirms that aminoglycosides, penicillins, linezolid, and colistin may play a role in favoring the infections sustained by MDR-Kp. However, several double exposures in the time window before HAI onset seemed to hinder the selective pressure exerted by individual agents.

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