Risk Factors for Central-Line–Associated Bloodstream Infections: A Focus on Comorbid Conditions

Pepin, Christopher S.; Thom, Kerri A.; Sorkin, John D.; Leekha, Surbhi; Masnick, Max; Preas, Michael Anne; Pineles, Lisa; Harris, Anthony D.

doi:10.1017/ice.2014.81

Cited by 36 publications

(39 citation statements)

References 10 publications

(14 reference statements)

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“…CRBSI are known to be associated with the duration of CVC use. 6,9 Another piece of data supporting our findings is the inverse association between obesity and risk of febrile neutropenia that has been reported recently. 10 Potential mechanisms include altered pharmacokinetics and/or reduced relative efficacy of chemotherapy due to obesity.…”

supporting

confidence: 89%

Patients with Psychiatric Disorders Can Also Have CLABSIs: A Response to “CLABSI or Munchausen’s or Both”

Brooks

Christy

Mack

et al. 2015

Infect. Control Hosp. Epidemiol.

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(range) BMI was 28.0 (15-46). Taking all 335 CVCs together, the BMI of the patients was a mean of 27.3, whereas in 95 CVCs (28.4%), the BMI of the patients was at least 30 (for the subgroup of the obese patients the mean BMI was 33.8).Complications of CVC insertion (bleeding, hematoma, >2 punctures, or malpositioning of the guidewire) were reported in 18.3% of obese patients and in 18.4% of non-obese patients. This indicates no increased risk for complications during CVC insertion among obese patients (odds ratio [OR], 0.99].Comparing the CRBSI rate in obese and in non-obese patients we found no differences in CRBSI frequency (22.1% vs 23.3%; OR, 0.93).Duration of CVC use appeared to be significantly shorter in obese compared with non-obese patients (13.5 vs 15.9 days). However, using the modified Infection Probability Score, 6

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supporting

confidence: 89%

Patients with Psychiatric Disorders Can Also Have CLABSIs: A Response to “CLABSI or Munchausen’s or Both”

Brooks

Christy

Mack

et al. 2015

Infect. Control Hosp. Epidemiol.

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“…9 Data contained within the tables of this repository have been validated for this and other research studies and were found to have positive and negative predictive values >99%. 10–12 In addition, a random sample of 2% of records had all data elements validated and the accuracy of the data was 100% for this dataset.…”

Section: Methodsmentioning

confidence: 99%

Pseudomonas aeruginosa Colonization in the Intensive Care Unit: Prevalence, Risk Factors, and Clinical Outcomes

Harris

Jackson

Robinson

et al. 2016

Infect. Control Hosp. Epidemiol.

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OBJECTIVE Determine the prevalence of Pseudomonas aeruginosa colonization on ICU admission, risk factors for P. aeruginosa colonization, and the incidence of subsequent clinical culture with P. aeruginosa among those colonized and not colonized. DESIGN A cohort study of patients admitted to the medical or surgical intensive care units between January 1, 2013, and December 31, 2013. SETTING A tertiary care hospital in Maryland. RESULTS 213 patients of 1840 patients (11.6%) were colonized with P. aeruginosa on ICU admission. Significant risk factors in the multivariable analysis for colonization were age (OR 1.02, 95% CI 1.01–1.03), anemia (1.90, 95% CI 1.05–3.42) and neurological disease (OR 1.80 95% CI 1.27–2.54). Among the 213 patients colonized with P. aeruginosa on admission, 60 (28.2%) had a subsequent clinical culture positive for P. aeruginosa on the current hospital admission (ICU period and post ICU period). 49 (82%) of the 60 patients had clinical infections. Among those not colonized on admission, only 68 (4.2%) had a subsequent clinical culture positive for P. aeruginosa on the current hospital admission. Patients colonized with P. aeruginosa were more likely to have a subsequent positive clinical culture than patients not colonized (IRR: 6.74, 95% CI: 4.91, 9.25). CONCLUSIONS These data emphasize the need to identify ICU patients colonized with P. aeruginosa on admission. Prediction rules or rapid diagnostic testing will help clinicians more appropriately choose empiric antibiotic therapy for subsequent infections.

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“…These resistance markers can be acquired either by chromosomal mutations or horizontal gene transfer [41][42]. Neonatal infection with P. aeruginosa is mostly acquired due to their underdeveloped immune system, especially when these infants are catheterized with intravascular catheters/devices and/or receiving parenteral nutrition, [43][44]. Almost all P. aeruginosa isolates in this study were resistant for one or more commonly used antibiotics in treatment of Pseudomonas infections, especially to carbapenems (meropenem and impenem) ( Table 3).…”

Section: Discussionmentioning

confidence: 89%

Intestinal colonization of infants with multidrug resistant Pseudomonas aeruginos in tertiary care center in Jordan

Shehabi¹,

Shishtawi²,

Al-lawama³

2019

int. arab. j antimicrob. agents

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Background: Pseudomonas.aeruginosa is among the most common opportunistic hospital pathogens, which exhibit an innate resistance and has developed increasing resistance to many useful antimicrobial agents over the last decades. This study investigated the occurrence of important types of ESBLs and MBLs in association with potential important virulence factors among P. aeruginosa isolates from feces of Jordanian infants. Methods: A total of 302 feces samples were obtained randamely from neonates and infants admitted to Pediatric Clinic and the Neonate Intensive Care Unit (NICU)/Jordan University Hospital (JUH), over a 9-months period(2016- 2017). Fecal samples were cultured for P.aeruginosa and their growth was identified and tested using microbiological and antibiotic susceptibility methods. Additionly, virulence factors, antimicrobial resistance genes and genotypes were detected using Polymerase Chain Reaction (PCR). Results: A total of 16/302 (5.3%) of P. aeruginosa isolates were recovered from feces samples. Antimicrobial susceptibility of the isolates ranged between the lowest 18.75% to meropenem and highest of 87.5% to azetreonam among 9 tested drugs. The percentage of specific genes of ESBLs and MBLs in 16 P.aeruginosa isolates were the following: blaOXA-50, blaTEM, blaCTX-M , blaVIM ,blaKPC , blaSHV ,blaGES, and blaVEB were detected at the rate of 13(81.2%), 13(81.2%), 12(75%), 12(75%), 11(68.7%), 10(62.5%), 2(12.5),1(6.2%), respectively. The percentage of the potential virulence genes in the same isolates were detected as follow: lasB, algD , toxA, exo S and exo U at the rate of 100%, 87.5% , 81.2%, 81.2%,31.2, respectively. All P.aeruginosa isolates observed to develop beta-hemolysis on both human and sheep blood agar, and to produce either pyoverdin ((56.3%) or pyocyanin (43.7%). Conclusions: The present study demonstrates high occurrence of multidrug resistant P.aeruginosa isolates in infant feces which carried high rates of important genes of ESBLs and MBLs and potential virulence factors.

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Risk Factors for Central-Line–Associated Bloodstream Infections: A Focus on Comorbid Conditions

Cited by 36 publications

References 10 publications

Patients with Psychiatric Disorders Can Also Have CLABSIs: A Response to “CLABSI or Munchausen’s or Both”

Patients with Psychiatric Disorders Can Also Have CLABSIs: A Response to “CLABSI or Munchausen’s or Both”

Pseudomonas aeruginosa Colonization in the Intensive Care Unit: Prevalence, Risk Factors, and Clinical Outcomes

Intestinal colonization of infants with multidrug resistant Pseudomonas aeruginos in tertiary care center in Jordan

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