Objective To study the risk factors of surgical wound infection among the patients in department of abodominal surgery. Methods The factors on surgical wound infection were investigated by retrospective study. The dia...Objective To study the risk factors of surgical wound infection among the patients in department of abodominal surgery. Methods The factors on surgical wound infection were investigated by retrospective study. The diagnosis standard was based on Diagnosis Standard of Hospital Infection published by Ministry of Health.展开更多
BACKGROUND: Severe acute pancreatitis(SAP) remains a clinical challenge with considerable morbidity and mortality.An early identification of infected pancreatic necrosis(IPN), a life-threatening evolution seconda...BACKGROUND: Severe acute pancreatitis(SAP) remains a clinical challenge with considerable morbidity and mortality.An early identification of infected pancreatic necrosis(IPN), a life-threatening evolution secondary to SAP, is obliged for a more preferable prognosis. Thus, the present study was conducted to identify the risk factors of IPN secondary to SAP. METHODS: The clinical data of patients with SAP were retrospectively analyzed. Univariate and multivariate logistic regression analyses were sequentially performed to assess the associations between the variables and the development of IPN secondary to SAP. A receiver operating characteristic(ROC) curve was created for each of the qualified independent risk factors. RESULTS: Of the 115 eligible patients, 39(33.9%) progressed to IPN, and the overall in-hospital mortality was 11.3%(13/115).The early enteral nutrition(EEN)(P=0.0092, OR=0.264), maximum intra-abdominal pressure(IAP)(P=0.0398, OR=1.131)and maximum D-dimer level(P=0.0001, OR=1.006) in the first three consecutive days were independent risk factors associated with IPN secondary to SAP. The area under ROC curve(AUC) was 0.774 for the maximum D-dimer level in the first three consecutive days and the sensitivity was 90% and the specificity was 58% at a cut-off value of 933.5 μg/L; the AUC was 0.831 for the maximum IAP in the first three consecutive days and the sensitivity was 95% and specificity was 58%at a cut-off value of 13.5 mm Hg. CONCLUSIONS: The present study suggested that the maximum D-dimer level and/or maximum IAP in the first three consecutive days after admission were risk factors of IPN secondary to SAP; an EEN might be helpful to prevent the progression of IPN secondary to SAP.展开更多
In order to discover the risk factors for 30-day mortality in bloodstream infections(BSI) caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and...In order to discover the risk factors for 30-day mortality in bloodstream infections(BSI) caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and the characteristics of this condition.A total of 64 patients with BSI caused by Enterococcus spp.who were treated in our hospital between 2006 and 2015 were included in the study.The clinical features of patients,microbiology,and 30-day mortality were collected from the electronic medical records database and analyzed.The results showed that there were 38 patients infected by Enterococcus faecalis(E.faecalis),24 by Enterococcus faecium(E.faecium),1 by Enterococcus casseliflavus(E.casseliflavus),and 1 by Enterococcus gallinarum(E.gallinarum).A Charlson comorbidity score ≥5,corticosteroid treatment,placement of catheters or other prosthetic devices and history of antibiotic use were found more frequently in E.faecium BSI patients than in E.faecalis patients(P=0.017,P=0.027,P=0.008 and P=0.027,respectively).Furthermore,the univariate and multivariate analysis showed that corticosteroid treatment(OR=17.385,P=0.008),hospital acquisition(OR=16.328,P=0.038),and vascular catheter infection(OR=14.788,P=0.025) were all independently associated with 30-day mortality.Our results indicate that E.faecalis and E.faecium are two different pathogens with unique microbiologic characteristics,which cause different clinical features in BSI,and the empiric antimicrobial treatments are paramount for patients with enterococcal BSI.展开更多
文摘Objective To study the risk factors of surgical wound infection among the patients in department of abodominal surgery. Methods The factors on surgical wound infection were investigated by retrospective study. The diagnosis standard was based on Diagnosis Standard of Hospital Infection published by Ministry of Health.
基金supported by grants from the National Natural Science Foundation of China(81372613 and 81170431)Doctoral Fund of Ministry of Education of China(21022307110012)Special Fund of Ministry of Public Health of China(210202007)
文摘BACKGROUND: Severe acute pancreatitis(SAP) remains a clinical challenge with considerable morbidity and mortality.An early identification of infected pancreatic necrosis(IPN), a life-threatening evolution secondary to SAP, is obliged for a more preferable prognosis. Thus, the present study was conducted to identify the risk factors of IPN secondary to SAP. METHODS: The clinical data of patients with SAP were retrospectively analyzed. Univariate and multivariate logistic regression analyses were sequentially performed to assess the associations between the variables and the development of IPN secondary to SAP. A receiver operating characteristic(ROC) curve was created for each of the qualified independent risk factors. RESULTS: Of the 115 eligible patients, 39(33.9%) progressed to IPN, and the overall in-hospital mortality was 11.3%(13/115).The early enteral nutrition(EEN)(P=0.0092, OR=0.264), maximum intra-abdominal pressure(IAP)(P=0.0398, OR=1.131)and maximum D-dimer level(P=0.0001, OR=1.006) in the first three consecutive days were independent risk factors associated with IPN secondary to SAP. The area under ROC curve(AUC) was 0.774 for the maximum D-dimer level in the first three consecutive days and the sensitivity was 90% and the specificity was 58% at a cut-off value of 933.5 μg/L; the AUC was 0.831 for the maximum IAP in the first three consecutive days and the sensitivity was 95% and specificity was 58%at a cut-off value of 13.5 mm Hg. CONCLUSIONS: The present study suggested that the maximum D-dimer level and/or maximum IAP in the first three consecutive days after admission were risk factors of IPN secondary to SAP; an EEN might be helpful to prevent the progression of IPN secondary to SAP.
基金funded by Shenzhen Scientific Research Program(No.JCYJ20150402152130173)Scientific Research Project of Shenzhen Health and Family Planning System(No.201601058)Scientific Research Program of Shenzhen Nanshan District of China(No.2015019,2015022,2016010)
文摘In order to discover the risk factors for 30-day mortality in bloodstream infections(BSI) caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and the characteristics of this condition.A total of 64 patients with BSI caused by Enterococcus spp.who were treated in our hospital between 2006 and 2015 were included in the study.The clinical features of patients,microbiology,and 30-day mortality were collected from the electronic medical records database and analyzed.The results showed that there were 38 patients infected by Enterococcus faecalis(E.faecalis),24 by Enterococcus faecium(E.faecium),1 by Enterococcus casseliflavus(E.casseliflavus),and 1 by Enterococcus gallinarum(E.gallinarum).A Charlson comorbidity score ≥5,corticosteroid treatment,placement of catheters or other prosthetic devices and history of antibiotic use were found more frequently in E.faecium BSI patients than in E.faecalis patients(P=0.017,P=0.027,P=0.008 and P=0.027,respectively).Furthermore,the univariate and multivariate analysis showed that corticosteroid treatment(OR=17.385,P=0.008),hospital acquisition(OR=16.328,P=0.038),and vascular catheter infection(OR=14.788,P=0.025) were all independently associated with 30-day mortality.Our results indicate that E.faecalis and E.faecium are two different pathogens with unique microbiologic characteristics,which cause different clinical features in BSI,and the empiric antimicrobial treatments are paramount for patients with enterococcal BSI.