scholarly journals Prevalence and Risk Factors Associated with Vancomycin-Resistant Staphylococcus aureus Precursor Organism Colonization among Patients with Chronic Lower-Extremity Wounds in Southeastern Michigan

2013 ◽  
Vol 34 (9) ◽  
pp. 954-960 ◽  
Author(s):  
Pritish K. Tosh ◽  
Simon Agolory ◽  
Bethany L. Strong ◽  
Kerrie VerLee ◽  
Jennie Finks ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Lower Extremity ◽  
Chronic Wounds ◽  
Cohort Analysis ◽  
Case Control ◽  
Control Analysis ◽  
Vancomycin Resistant ◽  
Clinical Records ◽  
Case Control Analysis

Background.Of the 13 US vancomycin-resistant Staphylococcus aureus (VRSA) cases, 8 were identified in southeastern Michigan, primarily in patients with chronic lower-extremity wounds. VRSA infections develop when the vanA gene from vancomycin-resistant enterococcus (VRE) transfers to S. aureus. Incl8-like plasmids in VRE and pSK41-like plasmids in S. aureus appear to be important precursors to this transfer.Objective.Identify the prevalence of VRSA precursor organisms.Design.Prospective cohort with embedded case-control study.Participants.Southeastern Michigan adults with chronic lower-extremity wounds.Methods.Adults presenting to 3 southeastern Michigan medical centers during the period February 15 through March 4, 2011, with chronic lower-extremity wounds had wound, nares, and perirectal swab specimens cultured for S. aureus and VRE, which were tested for pSK41-like and Incl8-like plasmids by polymerase chain reaction. We interviewed participants and reviewed clinical records. Risk factors for pSK41-positive S. aureus were assessed among all study participants (cohort analysis) and among only S. aureus-colonized participants (case-control analysis).Results.Of 179 participants with wound cultures, 26% were colonized with methicillin-susceptible S. aureus, 27% were colonized with methicillin-resistant S. aureus, and 4% were colonized with VRE, although only 17% consented to perirectal culture. Six participants (3%) had pSK41-positive S. aureus, and none had Incl8-positive VRE. Having chronic wounds for over 2 years was associated with pSK41-positive S. aureus colonization in both analyses.Conclusions.Colonization with VRSA precursor organisms was rare. Having long-standing chronic wounds was a risk factor for pSK41-positive S. aureus colonization. Additional investigation into the prevalence of VRSA precursors among a larger cohort of patients is warranted.

Retrospective study of clinical and radiographic risk factors associated with early onset, severe pulmonary hemorrhage in bevacizumab-treated patients with advanced non-small cell lung cancer (NSCLC)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7068-7068 ◽  
Author(s):  
A. B. Sandler ◽  
D. H. Johnson ◽  
J. Brahmer ◽  
J. H. Schiller ◽  
M. Ostland ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Early Onset ◽  
Cohort Analysis ◽  
Pulmonary Hemorrhage ◽  
Case Control ◽  
Control Analysis ◽  
Factors Associated ◽  
Complicating Factors ◽  
Case Control Analysis

7068 Background: Bevacizumab (BV) added to chemotherapy prolongs survival in non-squamous NSCLC, but was uncommonly associated with serious pulmonary hemorrhage (PH) (Sandler A, et al, ASCO 2005). A retrospective study was conducted to potentially identify clinical or radiographic (CT) risk factors associated with early onset (<150 days from initial treatment) PH. Methods: A broad search of the E4599 database for selected bleeding terms among BV-treated patients was conducted. Cases of PH were identified and adjudicated. Associations between baseline clinical factors and incidence of PH were evaluated in the full cohort of E4599 patients. In addition, a separate case-control analysis, using controls matched on age and sex, was conducted to evaluate baseline CT variables. Chest CTs were evaluated by blinded independent assessment of lesion location, cavitation, size of largest tumor or nodal mass, vascular involvement, presence of an endobronchial tumor, and total number of intra-thoracic lesions. Additional analyses were also conducted including cases of late-onset PH, post-baseline variables such as unconfirmed tumor response at 6 weeks (RECIST) and cavitation, and combined CT data from E4599 and an earlier Ph II trial. Results: Of 425 BV-treated pts, 10 cases of PH were identified. Of these, 7 were PH without additional complicating factors, and 6 were of early-onset. The cohort analysis of these 6 early-onset cases is presented ( table ). The case-control analysis on CT risk factors is ongoing. Conclusion: PH was an uncommon event, and based on this, no evidence was observed for an association between the baseline clinical variables and the incidence of early-onset events of PH without additional complicating factors. Conclusions for the CT variables evaluated will be presented. [Table: see text] [Table: see text]

A case control analysis investigating risk factors and outcomes for nephrocalcinosis and renal calculi in neonates

2017 ◽  
Vol 13 (4) ◽  
pp. 356.e1-356.e5 ◽  
Author(s):  
Melissa Huynh ◽  
Roderick Clark ◽  
Jenny Li ◽  
Guido Filler ◽  
Sumit Dave
Keyword(s):  
Risk Factors ◽  
Renal Calculi ◽  
Case Control ◽  
Control Analysis ◽  
Case Control Analysis

scholarly journals Determining the clinical significance of co-colonization of vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus in the intestinal tracts of patients in intensive care units: a case–control study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Young Kyung Yoon ◽  
Min Jung Lee ◽  
Yongguk Ju ◽  
Sung Eun Lee ◽  
Kyung Sook Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Clinical Outcomes ◽  
Intensive Care Units ◽  
Case Control Study ◽  
Case Control ◽  
Methicillin Resistant ◽  
Vancomycin Resistant ◽  
Control Study

Abstract Background The emergence of vancomycin-resistant Staphylococcus aureus (VRSA) has become a global concern for public health. The proximity of vancomycin-resistant enterococcus (VRE) and methicillin-resistant S. aureus (MRSA) is considered to be one of the foremost risk factors for the development of VRSA. This study aimed to determine the incidence, risk factors, and clinical outcomes of intestinal co-colonization with VRE and MRSA. Methods A case–control study was conducted in 52-bed intensive care units (ICUs) of a university-affiliated hospital from September 2012 to October 2017. Active surveillance using rectal cultures for VRE were conducted at ICU admission and on a weekly basis. Weekly surveillance cultures for detection of rectal MRSA were also conducted in patients with VRE carriage. Patients with intestinal co-colonization of VRE and MRSA were compared with randomly selected control patients with VRE colonization alone (1:1). Vancomycin minimum inhibitory concentrations (MICs) for MRSA isolates were determined by the Etest. Results Of the 4679 consecutive patients, 195 cases and 924 controls were detected. The median monthly incidence and duration of intestinal co-colonization with VRE and MRSA were 2.3/1000 patient-days and 7 days, respectively. The frequency of both MRSA infections and mortality attributable to MRSA were higher in the case group than in the control group: 56.9% vs. 44.1% (P = 0.011) and 8.2% vs. 1.0% (P = 0.002), respectively. Independent risk factors for intestinal co-colonization were enteral tube feeding (odds ratio [OR], 2.09; 95% confidence interval [CI] 1.32–3.32), metabolic diseases (OR, 1.75; 95% CI 1.05–2.93), male gender (OR, 1.62; 95% CI 1.06–2.50), and Charlson comorbidity index < 3 (OR, 3.61; 95% CI 1.88–6.94). All MRSA isolates from case patients were susceptible to vancomycin (MIC ≤ 2 mg/L). Conclusions Our study indicates that intestinal co-colonization of VRE and MRSA occurs commonly among patients in the ICU with MRSA endemicity, which might be associated with poor clinical outcomes.

A Case–Control Analysis of Risk Factors in HIV Transmission in South India

1997 ◽  
Vol 14 (3) ◽  
pp. 290-293 ◽  
Author(s):  
Soshamma George ◽  
Mary Jacob ◽  
T. Jacob John ◽  
Manoj K. Jain ◽  
Nawab Nathan ◽  
...  
Keyword(s):  
Risk Factors ◽  
South India ◽  
Hiv Transmission ◽  
Case Control ◽  
Control Analysis ◽  
Case Control Analysis

scholarly journals Association of bone mineral density with reoperation rate following instrumented lumbar spinal fusion: a retrospective cohort and case-control study

2019 ◽  
Author(s):  
Maximilian Thomas Löffler ◽  
Niklas Loreck ◽  
Nico Sollmann ◽  
Johannes Kaesmacher ◽  
Felix Zibold ◽  
...  
Keyword(s):  
Case Control Study ◽  
Cohort Analysis ◽  
Case Control ◽  
Control Analysis ◽  
Lumbar Spinal Fusion ◽  
Mineral Density ◽  
Lumbar Spinal ◽  
Case Control Analysis ◽  
Prevalence Of Osteoporosis ◽  
Control Study

Abstract Background Low bone mineral density (BMD) is believed to influence the outcome of instrumented spinal surgery and can lead to reoperation. Purpose of this retrospective cohort and case-control study was to investigate the association of BMD with the risk of reoperation following instrumented lumbar spinal fusion (LSF). Methods For the cohort analysis, 81 patients were included who received LSF with and without polymethyl methacrylate (PMMA)-augmentation. For the case-control analysis, 18 patients who had reoperation following LSF were matched to 26 patients who did not have reoperation (matching criteria: sex, age ± 5 years, fused levels, and augmentation). Opportunistic BMD screening was performed in perioperative CT scans using asynchronous calibration. Mean BMD was compared between patients with and without reoperation in augmented and non-augmented surgeries. Results In the cohort analysis, prevalence of osteoporosis (BMD < 80 mg/cm³) was 29% in non-augmented and 85% in augmented LSF. Seven of 48 patients with non-augmented (15%) and 4 of 33 patients with augmented LSF (12%) had reoperation. In non-augmented LSF, patients with reoperation had significantly lower BMD than patients without reoperation (p = 0.005). In the case-control analysis, patients with reoperation presented numerically lower BMD of 78.8 ± 33.1 mg/cm³ than patients without reoperation with BMD of 89.4 ± 39.7 mg/cm³ (p = 0.357).Conclusions Prevalence of osteoporosis in patients undergoing LSF is relatively high. Patients with reoperation following LSF showed slightly lower BMD compared to matched patients without reoperation, but the difference was not statistically significant. Opportunistic BMD screening in preoperative CT is feasible and can provide valuable information about osteoporotic bone status.

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