scholarly journals Incidence, risk factors and outcome of nosocomial pneumonia in patients with central nervous system infections

2011 ◽  
Vol 139 (7-8) ◽  
pp. 476-480 ◽  
Author(s):  
Olgica Gajovic ◽  
Zoran Todorovic ◽  
Zeljko Mijailovic ◽  
Predrag Canovic ◽  
Ljiljana Nesic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Nervous System ◽  
Mechanical Ventilation ◽  
Nervous System ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Nosocomial Pneumonia ◽  
Central Nervous System Infections ◽  
Mechanical Ventilation Duration ◽  
Gcs Score

Introduction. Pneumonia is the most frequent nosocomial infection in intensive care units. The reported frequency varies with definition, the type of hospital or intensive care units and the population of patients. The incidence ranges from 6.8-27%. Objective. The objective of this study was to determine the frequency, risk factors and mortality of nosocomial pneumonia in intensive care patients. Methods. We analyzed retrospectively and prospectively the collected data of 180 patients with central nervous system infections who needed to stay in the intensive care unit for more than 48 hours. This study was conducted from 2003 to 2009 at the Clinical Centre of Kragujevac. Results. During the study period, 54 (30%) patients developed nosocomial pneumonia. The time to develop pneumonia was 10?6 days. We found that the following risk factors for the development of nosocomial pneumonia were statistically significant: age, Glasgow Coma Scale (GCS) score <9, mechanical ventilation, duration of mechanical ventilation, tracheostomy, presence of nasogastric tube and enteral feeding. The most commonly isolated pathogens were Klebsiella-Enterobacter spp. (33.3%), Pseudomonas aeruginosa (24.1%), Acinetobacter spp. (16.6%) and Staphylococcus aureus (25.9%). Conclusion. Nosocomial pneumonia is the major cause of morbidity and mortality of patients with central nervous system infections. Patients on mechanical ventilation are particularly at a high risk. The mortality rate of patients with nosocomial pneumonia was 54.4% and it was five times higher than in patients without pneumonia.

Spectrum of practice in the diagnosis of nosocomial pneumonia in patients requiring mechanical ventilation in European intensive care units

2009 ◽  
Vol 37 (8) ◽  
pp. 2360-2369 ◽  
Author(s):  
Despoina Koulenti ◽  
Thiago Lisboa ◽  
Christian Brun-Buisson ◽  
Wolfgang Krueger ◽  
Antonio Macor ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Nosocomial Pneumonia

scholarly journals Incidence Of Central Line-associated Bloodstream Infections In Intensive Care Units In A Private Hospital (Cairo, Egypt)

2018 ◽  
Vol 11 (1) ◽  
pp. 562-571
Author(s):  
Amira M. Malek ◽  
Hasnaa A. Abouseif ◽  
Khaled M. Abd Elaziz ◽  
Mohamed F. Allam ◽  
Hoda I. Fahim
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Private Hospital ◽  
Bloodstream Infections ◽  
Central Line ◽  
Incidence Density ◽  
Icu Stay

Objective: The study aimed to measure the incidence, risk factors and most frequent causative organisms of central line-associated bloodstream infections (CLA-BSI) in the Medical/Coronary and Surgical Intensive Care Units (ICUs) at a private hospital. Methods: This prospective study included 499 patients and was conducted between April 2014 and September 2014 in the Medical/Coronary ICU and Surgical ICU of a private hospital in Cairo, Egypt. Results: Approximately 44% of all the patients admitted to the ICUs underwent Central Venous Catheter (CVC) insertion. The overall incidence density rate of CLA-BSI was 6 cases per 1000 central line-days. The central line utilization rate was 0.94 per 1000 patient-days. The mortality rate among cases with CLA-BSI was 16.8% (95% CI: 13.6% – 20.4%) during the study period. Risk factors for CLA-BSI were detected by univariate analysis and included associated co-morbidities such as heart failure, APACHE II scores of >15, an ICU stay of 5 days or more, duration of CVC placement, subclavian insertion of CVCs, and mechanical ventilation. Additionally, logistic regression analysis identified a long ICU stay of 5 days or more, mechanical ventilation and the presence of heart failure as the only significant predictors. Gram-negative bacteria, especially Enterobacter (36.8%: 95% CI: 16.3%– 61.6%), Pseudomonas aeruginosa (21.1%: 95% CI: 16.0% - 45.5%) were the predominant organisms detected in CLA-BSI cases. Conclusion: CLA-BSI is an important cause of mortality in ICU patients. The infection rate is considerably higher than that in recent studies from developed counties, but it is still lower than the rates reported in comparable published studies in Egypt. Strict adherence to the standard infection prevention practices for critically ill patients is highly recommended.

scholarly journals Nosocomial infections in patients with acute central nervous system infections

2007 ◽  
Vol 60 (1-2) ◽  
pp. 12-18
Author(s):  
Olgica Gajovic ◽  
Predrag Canovic ◽  
Zeljko Mijailovic ◽  
Zorica Lazic
Keyword(s):  
Risk Factors ◽  
Central Nervous System ◽  
Nervous System ◽  
Nosocomial Infections ◽  
Clinical Manifestations ◽  
Central Nervous System Infections ◽  
Current Increase ◽  
Urinary Infections ◽  
Clinical Center ◽  
Clinical Presentations

Due to current increase in the rate of nosocomial infections, our objective was to examine the frequency, risk factors, clinical presentation and etiology of nosocomial infections in patients with central nervous system infections. 2246 patients with central nervous system infections, treated in the intensive care units of the Institute of Infectious and Tropical Diseases, Clinical Center of Serbia in Belgrade and at the Department of Infectious Diseases of the Clinical Hospital Center Kragujevac, were included in this retrospective and prospective study. Clinical manifestations of nosocomial infections were registered in 180 (12.7%) patients. Direct risk factors for nosocomial infections were: venous lines, urinary catheter, length of stay over 20 days, inhibitors of gastric secretion, consciousness disorders and coma, endotracheal intubation, tracheotomy and controlled ventilation for 5 days or more. The most frequent clinical presentations of nosocomial infections were: tract urinary infections, bacteriemia/sepsis and nosocomial pneumonia. Significantly higher frequency of death outcomes was registered in patients with nosocomial infections.

scholarly journals Risk factors of frailty and death or only frailty after intensive care in non-frail elderly patients: a prospective non-interventional study

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Yoann Launey ◽  
Hervé Jacquet ◽  
Matthieu Arnouat ◽  
Chloe Rousseau ◽  
Nicolas Nesseler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Risk Factor ◽  
Intensive Care ◽  
Elderly Patients ◽  
Interventional Study ◽  
Old Patients ◽  
Ventilation Duration ◽  
Frail Patients ◽  
Mechanical Ventilation Duration

Abstract Background Frailty status is recognized as an important parameter in critically ill elderly patients, but nothing is known about outcomes in non-frail patients regarding the development of frailty or frailty and death after intensive care. The aim of this study was to determine risk factors for frailty and death or only frailty 6 months after intensive care unit (ICU) admission in non-frail patients ≥ 65 years. Methods A prospective non-interventional study performed in an academic ICU from February 2015 to February 2016 included non-frail ≥ 65-year-old patients hospitalized for > 24 h in the ICU. Frailty was assessed by calculating the frailty index (FI) at admission and 6 months later. Patients who remained non-frail (FI < 0.2) were compared to patients who presented frailty (FI ≥ 0.2) and those who presented frailty and death at 6 months. Results Among 974 admissions, 136 patients were eligible for the study and 88 patients were analysed at 6 months (non-frail n = 34, frail n = 29, death n = 25). Multivariable analysis showed that mechanical ventilation duration was an independent risk factor for frailty/death at 6 months (per day of mechanical ventilation, odds ratio [OR] = 1.11; 95% confidence interval [CI] 1.04–1.19, p = 0.002). When excluding patients who died, mechanical ventilation duration remained the sole risk factor for frailty at 6 months (OR = 1.19; 95% CI 1.07–1.33, p = 0.001). Conclusion Mechanical ventilation duration was the sole predictive factor of frailty and death or only frailty 6 months after ICU hospitalization in initially non-frail patients.

scholarly journals Central nervous system infection in the intensive care unit: Development and validation of a multi-parameter diagnostic prediction tool to identify suspected patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260551
Author(s):  
Hugo Boechat Andrade ◽  
Ivan Rocha Ferreira da Silva ◽  
Justin Lee Sim ◽  
José Henrique Mello-Neto ◽  
Pedro Henrique Nascimento Theodoro ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Central Nervous System ◽  
Nervous System ◽  
Intensive Care ◽  
Validation Cohort ◽  
Diagnostic Model ◽  
High Morbidity ◽  
Operating Characteristics ◽  
Central Nervous System Infections ◽  
Receiver Operating

Background Central nervous system infections (CNSI) are diseases with high morbidity and mortality, and their diagnosis in the intensive care environment can be challenging. Objective: To develop and validate a diagnostic model to quickly screen intensive care patients with suspected CNSI using readily available clinical data. Methods Derivation cohort: 783 patients admitted to an infectious diseases intensive care unit (ICU) in Oswaldo Cruz Foundation, Rio de Janeiro RJ, Brazil, for any reason, between 01/01/2012 and 06/30/2019, with a prevalence of 97 (12.4%) CNSI cases. Validation cohort 1: 163 patients prospectively collected, between 07/01/2019 and 07/01/2020, from the same ICU, with 15 (9.2%) CNSI cases. Validation cohort 2: 7,270 patients with 88 CNSI (1.21%) admitted to a neuro ICU in Chicago, IL, USA between 01/01/2014 and 06/30/2019. Prediction model: Multivariate logistic regression analysis was performed to construct the model, and Receiver Operating Characteristic (ROC) curve analysis was used for model validation. Eight predictors—age <56 years old, cerebrospinal fluid white blood cell count >2 cells/mm3, fever (≥38°C/100.4°F), focal neurologic deficit, Glasgow Coma Scale <14 points, AIDS/HIV, and seizure—were included in the development diagnostic model (P<0.05). Results The pool data’s model had an Area Under the Receiver Operating Characteristics (AUC) curve of 0.892 (95% confidence interval 0.864–0.921, P<0.0001). Conclusions A promising and straightforward screening tool for central nervous system infections, with few and readily available clinical variables, was developed and had good accuracy, with internal and external validity.

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