Prolonged Mechanical Ventilation Assistance Interacts Synergistically with Carbapenem for Clostridium difficile Infection in Critically Ill Patients

Chiang, Shyh‐Ren; Lai, Chih‐Cheng; Ho, Chung‐Han; Chen, Chin‐Ming; Chao, Chien‐Ming; Wang, Jhi-Joung; Cheng, Kuo-Chen

doi:10.3390/jcm7080224

Cited by 7 publications

(5 citation statements)

References 53 publications

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“…MV is one of the most common interventions implemented in ICU. Study from Taiwan's National Intensive Care Unit Data base conducted in the large cohort of intubated patients showed that prolonged MV (> 21 days) and prolonged carbapenems therapy (> 15 days) were independent predictors of HA CDI [32]. In our study there were no differences in frequency of MV use between surgical and medical patients (14.6% vs. 15.4%, respectively, p =-0.863).…”

Section: Surgical Patientscontrasting

confidence: 58%

Healthcare associated Clostridioides difficile infection in adult surgical and medical patients hospitalized in tertiary hospital in Belgrade, Serbia: a seven years prospective cohort study

Šuljagić

Milenković

Perić

et al. 2020

Libyan Journal of Medicine

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Introduction: Clostridioides difficile (C. difficile) infection (CDI) is one of the most common healthcare-associated (HA) infections in contemporary medicine. The risk factors (RFs) for HA CDI in medical and surgical patients are poorly investigated in countries with a limited resource healthcare system. Therefore, the aim of the study was to investigate differences in patients' characteristics, factors related to healthcare and outcomes associated with HA CDI in surgical and medical patients in tertiary healthcare centre in Serbia. Materials and Methods: A prospective cohort study was conducted including adult patients diagnosed with initial episode of HA CDI, first recurrence of disease, readmission to hospital, while deaths within 30 days of CDI diagnosis and in-hospital mortality were also recorded. Patients hospitalized for any non-surgical illness, who developed initial HA CDI were assigned to medical group, whereas those who developed initial HA CDI after surgical procedures were in surgical group. The data on patients' characteristics and factors related to healthcare were collected, too. Results: During 7-year period, from 553 patients undergoing in-hospital treatment and diagnosed with CDI, 268 (48.5%) and 285 (51.5%) were surgical and medical patients, respectively. Age ≥ 65 years, use of proton pump inhibitors, chemotherapy and fluoroquinolones were positively associated with being in medical group, whereas admission to intensive care unit and use of second-and third-generation cephalosporins were positively associated with being in surgical group. Conclusions: Based on obtained results, including significant differences in 30-day mortality and in-hospital mortality, it can be concluded that medical patient were more endangered with HA CDI than surgical ones.

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Section: Surgical Patientscontrasting

confidence: 58%

Healthcare associated Clostridioides difficile infection in adult surgical and medical patients hospitalized in tertiary hospital in Belgrade, Serbia: a seven years prospective cohort study

Šuljagić

Milenković

Perić

et al. 2020

Libyan Journal of Medicine

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“…In awake mechanically ventilated patients, instead of sedation, foot reflexology may help reduce ventilation time and its associated complications, such as pneumonia, length of hospital stay, or delirium [9,10,12,31]. Similar to our study, Ebadi et Further, the researchers did not provide a clear definition of weaning time.…”

Section: Discussionmentioning

confidence: 44%

The effects of foot reflexology on agitation and extubation time in male patients following coronary artery bypass surgery: A randomized controlled clinical trial

Allahbakhhsian

Gholizadeh

Allahbakhshian

et al. 2020

Complementary Therapies in Clinical Practice

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Background and purpose: This study examined the effects of foot reflexology on agitation and extubation time of male patients following coronary artery bypass graft surgery. Materials and methods:In this randomized three-arm controlled clinical trial, participants (n=120) were randomly assigned to the intervention, placebo, or control groups. The intervention group received foot reflexology massage for 15 minutes. Agitation was assessed using the Richmond Agitation-Sedation Scale before the intervention (Time 1) and immediately (Time 2) and 10 minutes after the intervention (Time 3). Extubation time was measured as the time from gaining full consciousness to endotracheal extubation.Results: Agitation reduced in all groups from Time 1 to Time 3 (p˂0.05); however, the intervention group showed a significantly higher reduction at Time 2 (p<0.001) and Time 3 (p<0.001). Also, extubation time was significantly shorter in the intervention group (p<0.01). Conclusion:Foot reflexology may be introduced as a nursing intervention to facilitate the weaning process in the cardiac ICUs.

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“…ICU stay has been positively associated with CDI in trauma/surgery patients 34 35. A study in a large cohort of intubated patients showed that prolonged mechanical ventilation was an independent predictor of HA CDI 36…”

Section: Discussionmentioning

confidence: 99%

Outcomes ofClostridioides difficileinfection in adult cancer and non-cancer patients hospitalised in a tertiary hospital: a prospective cohort study

et al. 2021

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Background Clostridioides difficile infection (CDI) is one of the most common healthcare-associated (HA) infections. Cancer patients, particularly haemato-oncological patients, have an increased risk for CDI due to more risk factors compared with non-cancer patients. The aim of this study was to investigate differences in outcomes associated with HA CDI in patients with solid and haematological malignancies compared with patients with no underlying malignant disease in a tertiary healthcare centre in Serbia.MethodsA prospective cohort study was conducted including adult patients diagnosed with an initial episode of HA CDI. Their demographic and clinical characteristics associated with risk factors for CDI were documented. Outcomes such as all-cause 30-day mortality, cure of infection, diarrhoea relaps and recurrence of disease were followed. Patients were assigned to cancer and non-cancer groups. Within the cancer group, patients were divided into the solid tumour subgroup and haematological malignancy subgroup.ResultsDuring a 7-year period, HA CDI was observed in 28 (5.1%) patients with haematological malignancy, 101 (18.3%) patients with solid tumours and 424 (76.7%) non-cancer patients. Older age (OR 1.04, 95% CI 1.02 to 1.07, p<0.001), admission to the intensive care unit (ICU) (OR 2.61, 95% CI 1.37 to 4.95, p=0.003), mechanical ventilation (OR 5.19, 95% CI 2.78 to 9.71, p<0.001) and use of antibiotics prior to CDI (OR 1.04, 95% CI 1.02 to 1.06, p=0.02) were associated with increased mortality. Compared with patients with solid tumours, patients with haematological malignancy were younger (65 vs 57 years, p=0.015), did not require ICU admission (25.0% vs 0%) or mechanical ventilation (8.9% vs 0%) and were treated longer with antibiotics prior to CDI (14 vs 24 days, p=0.002).ConclusionsPatients with haematological malignancy were exposed to different risk factors for CDI associated with mortality compared with patients with solid tumours and non-cancer patients. Older age, ICU stay and mechanical ventilation, but not presence or type of cancer, predicted the all-cause 30-day mortality.

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Prolonged Mechanical Ventilation Assistance Interacts Synergistically with Carbapenem for Clostridium difficile Infection in Critically Ill Patients

Cited by 7 publications

References 53 publications

Healthcare associated Clostridioides difficile infection in adult surgical and medical patients hospitalized in tertiary hospital in Belgrade, Serbia: a seven years prospective cohort study

Healthcare associated Clostridioides difficile infection in adult surgical and medical patients hospitalized in tertiary hospital in Belgrade, Serbia: a seven years prospective cohort study

The effects of foot reflexology on agitation and extubation time in male patients following coronary artery bypass surgery: A randomized controlled clinical trial

Outcomes ofClostridioides difficileinfection in adult cancer and non-cancer patients hospitalised in a tertiary hospital: a prospective cohort study

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