The Epidemiology of Mupirocin Resistance Among Methicillin-ResistantStaphylococcus aureusat a Veterans' Affairs Hospital

2000 ◽  
Vol 21 (7) ◽  
pp. 459-464 ◽  
Author(s):  
Jose E. Vasquez ◽  
Elaine S. Walker ◽  
Bettylene W. Franzus ◽  
Barbara K. Overbay ◽  
David R. Reagan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Medical Center ◽  
Case Control ◽  
Veterans Affairs ◽  
Care Hospital ◽  
Mupirocin Resistance ◽  
Mupirocin Ointment ◽  
High Level ◽  
Control Study

Objective:To describe the clinical and molecular epidemiology of mupirocin-resistant (MR) and mupirocin-susceptible (MS) methicillin-resistantStaphylococcus aureus(MRSA) at a Veterans' Affairs hospital and to assess risk factors associated with the acquisition of MR MRSA.Design:All clinical MRSA isolates for the period October 1990 through March 1995 underwent susceptibility testing to mupirocin. Mupirocin resistance trends were measured, and MS MRSA and MR MRSA isolates underwent typing by pulsed-field gel electrophoresis (PFGE). A retrospective case-control study was conducted to evaluate risk factors for having MR versus MS MRSA.Setting:The James H. Quillen Veterans' Affairs Medical Center in Mountain Home, Tennessee, included a 324-bed acute-care hospital, a 120-bed nursing home, and a 525-bed domiciliary. Colonizations and infections with MRSA were endemic, and mupirocin ointment was commonly used.Patients:Inpatients and outpatients at the facility.Results:MS MRSA was recovered from 506 patients and MR MRSA from 126. Among MR MRSA isolates, 58% showed low-level mupirocin resistance (minimum inhibitory concentration [MIC] ≥4 to 256 μg/mL), and 42% showed high-level mupirocin resistance (MIC ≥512 μg/mL). A significant increase (P=.002) in the number of high-level MR isolates occurred during the 1993 to 1995 period. A case-control study showed that presence of a decubitus ulcer correlated with high-level resistant isolates (P<.05). The distribution of PFGE patterns did not differ for MR and MS MRSA.Conclusions:Use of mupirocin ointment in a program aimed at managing endemic MRSA infection or colonization resulted in a significant increase in the recovery of high-level MR MRSA isolates. These isolates appeared to emerge from our existing MRSA pool. A case-control study provided few clues concerning patients likely to harbor MR MRSA We confirmed the position that the extended use of mupirocin ointment should be avoided in settings where MRSA is endemic.

Clostridium difficile- Associated Diarrhea in a VA Medical Center Clustering of Cases, Association With Antibiotic Usage, and Impact on HIV-infected Patients

2001 ◽  
Vol 22 (1) ◽  
pp. 42-45 ◽  
Author(s):  
Lona R. Mody ◽  
Sharon M. Smith ◽  
Lisa L. Dever
Keyword(s):  
Clostridium Difficile ◽  
Case Control Study ◽  
Medical Center ◽  
Case Control ◽  
Veterans Affairs ◽  
Antibiotic Usage ◽  
Immunodeficiency Virus ◽  
Clostridium Difficile Associated Diarrhea ◽  
Third Generation Cephalosporins ◽  
Control Study

AbstractA case-control study of patients with stools assayed forClostridium difficiletoxin over a 24-month period at a Veterans Affairs hospital found that the majority of cases (70.6%) occurred in temporal clusters. Clustering was particularly evident on a designated human immunodeficiency virus (RW) unit. Thirty-four (75.5%) of 45 HIV-infected patients withC difficile-associated diarrhea (CDAD) died during their hospitalization. Third-generation cephalosporins were the antibiotics most strongly associated with CDAD.

scholarly journals Risk factors associated with carcinoma breast: a case control study

2017 ◽  
Vol 4 (9) ◽  
pp. 3136 ◽  
Author(s):  
Palachandra A. ◽  
Ishwaraprasad G. D. ◽  
Sreelatha C. Y. ◽  
Sumana M.
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Case Control Study ◽  
Tertiary Care ◽  
Reproductive Factors ◽  
Developed Countries ◽  
Case Control ◽  
Age At Menarche ◽  
Care Hospital ◽  
Control Study

Background: The burden of breast cancer is increasing in both developed and developing countries; the peak occurrence of breast cancer in developed countries is above the age of 50 whereas in India it is above the age of 40. Reproductive factors contribute most to the development of breast cancer. Nulliparity, more age at first live birth and no breastfeeding are major reproductive risk factors for breast cancer in the developed countries. The role of reproductive factors in the development of breast cancer in Indian population is different as compared with that seen in the western population. Objective of this study was to find out some of the various risk factors of breast cancer among patients attending the tertiary care hospital in Hassan.Methods: The case control study was conducted at surgery wards of Sri Chamarajendra district hospital which is a teaching hospital. The calculated number of cases was 110, including 110 controls total 220 individuals were included in the study. A case was defined as any female patient histopathologically confirmed to have breast cancer.Results: The maximum cases (38%) were between 51 to 60 years of age group. Age at menarche, age at first child birth, age at marriage and age at menopause reported significant risk for breast cancer.Conclusions: Information, education and communication activities regarding these risk factors, early signs and symptoms of breast carcinoma, and breast self‑examination should be imparted to the women to create awareness about this fatal disease.

scholarly journals A case control study on behavioural risk factors of anaemia among pregnant women delivered at a tertiary care hospital in Haryana

2021 ◽  
Vol 10 (8) ◽  
pp. 3062
Author(s):  
Sunny Ohlan ◽  
S. K. Jha ◽  
Parul Singhal
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Case Control Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Case Control ◽  
Behavioral Risk Factors ◽  
Behavioral Risk ◽  
Care Hospital ◽  
Control Study

Background: Anaemia in pregnancy (AIP) is one of the most common preventable causes of maternal morbidity and poor prenatal outcome. World Health Organization (WHO) has accepted up to 11 gm/dl as the normal hemoglobin (Hb) level in pregnancy. In Haryana state, the prevalence of anaemia among pregnant women is 50.2% in urban areas and 58.1% in rural areas. Pregnant women are predominantly susceptible to nutritional deficiencies because of the increased metabolic demands imposed by pregnancy and its related factors. The aim and objective of the study was to determine the behavioural factors associated with anaemia among pregnant women delivering at a tertiary care hospital in Haryana.Methods: This hospital-based case control study was carried out in BPS Government Medical College for Women, Khanpur Kalan, Sonipat (Haryana). Study was conducted for one year. One hundred sixty-eight pregnant women were enrolled for study. Inclusion criteria for cases and controls was age of 18 years and above and residents of Sonepat district. Analysis was performed by using R statistical software.Results: The majority 57 (67.9%) of cases and 49 (58.3%) of controls were in age group of 18-24 years. Among different behavioral risk factors studied, not using bed nets, not wearing shoes consistently, eating pica and no use of the other drugs during pregnancy were significantly associated with anemia during pregnancy. However, on Multivariable Logistic regression analysis, the major behavioral risk factors for anemia were not using bed net during pregnancy (AOR: 1.83, 95% CI: 0.68-5.01), and not wearing shoes consistently during pregnancy (AOR: 2.77, 95% CI: 0.83-10.01). The odds of getting anaemia in pregnant mothers who reported pica during their pregnancy was AOR = 2.85 (CI: 0.90 – 10.01) than odds of mothers who did not report pica during their pregnancy.Conclusions: Consistent use of bed net, wearing shoes and not consuming pica prevent anaemia during pregnancy. 

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