Asunto(s)
Betacoronavirus/aislamiento & purificación , Colitis , Infecciones por Coronavirus , Hemorragia Gastrointestinal , Hidroxicloroquina/administración & dosificación , Intestino Grueso , Pandemias , Neumonía Viral , Anciano , Antimaláricos/administración & dosificación , COVID-19 , Colitis/diagnóstico , Colitis/etiología , Colitis/fisiopatología , Colitis/terapia , Colonoscopía/métodos , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/transmisión , Diagnóstico Diferencial , Transmisión de Enfermedad Infecciosa/prevención & control , Heces/microbiología , Femenino , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiología , Humanos , Intestino Grueso/diagnóstico por imagen , Intestino Grueso/patología , Monitoreo Fisiológico/métodos , Terapia por Inhalación de Oxígeno/métodos , Neumonía Viral/diagnóstico , Neumonía Viral/etiología , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Neumonía Viral/transmisión , SARS-CoV-2 , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
BACKGROUND: Peripheral venous catheters (PVCs) are common in hospitals, but the literature surrounding PVC-associated bacteremia is lacking. We describe incidence rates, risk factors, and outcomes related to PVC-associated Staphylococcus aureus bacteremia (SAB), a common cause of hospital-onset (HO) SAB. METHODS: This is a retrospective case-control study conducted at a 537-bed teaching community hospital during 2015-2016. Cases were adult inpatients with HO SAB with infectious diseases documentation of the PVC as the only source of bacteremia. Cases were matched 1:2 with controls on approximate PVC insertion date, age, mortality prediction score, and insurance type. Odds ratios (ORs) were estimated using conditional logistic regression. PVC utilization was estimated by a point-prevalence survey from July 2017. RESULTS: Of 205 SAB episodes, 160 were community-onset and 45 were HO; 16 (36%) HO cases were PVC-associated. Cases (n = 16) were more likely than controls (n = 32) to have a PVC placed in the antecubital area (odds ratio [OR], 11.9; 95% confidence interval [CI], 1.5-95.7; P = .02) and PVC duration ≥4 days (OR, 4.0; 95% CI, 1.1-15.2; P = .04). The point prevalence of at least 1 PVC in adult inpatients was 86%, and the incidence density of HO PVC-associated SAB was 0.15 per 1000 PVC-days. The mean length of stay for cases was 13.2 days. All cases successfully completed parenteral antibiotics with a mean treatment length of 23.6 days. CONCLUSIONS: PVC-associated SAB is a common cause of HO SAB that results in significant morbidity. PVC placement in the antecubital area and line duration should be minimized to reduce HO SAB.
RESUMEN
In Minnesota, incidence of invasive group B streptococcal disease was 3 times greater in older adults in long-term care facilities than in older adults in community settings (67.7/100,000 vs. 21.4/100,000) during 2003-2007. The overall case-fatality rate was 6.8%, and concurrent conditions were common among both groups.