Suspected Bacterial Infection Research Articles

Procalcitonin Levels in Identifying Bacterial Infections in Children with and without COVID-19.

Elevated procalcitonin levels have been associated with bacterial infection in children. Observational studies reported high procalcitonin values in COVID-19. Data on bacterial coinfections in pediatric COVID-19 is sparse; small studies suggest a low coinfection rate. In this study, we aimed to quantify the positive predictive value (PPV) of procalcitonin in identifying bacterial infection in children with and without COVID-19. A retrospective chart review was performed for 215 children <21 years admitted to our tertiary children's hospital between February 1, 2013, and July 15, 2020, who had procalcitonin levels measured within 48 hours of admission. Confirmed bacterial infection was defined as positive blood, urine, or cerebrospinal fluid (CSF) culture, positive endotracheal culture with evidence of leukocytosis on Gram stain, or pneumonia by chest radiograph. Suspected bacterial infection was defined as confirmed bacterial infection or administration of antibiotics for >48 hours. Of the 215 patients, 73 were admitted for COVID-19 (66% multisystem inflammatory syndrome in children [MIS-C], 34% acute COVID-19). The PPV of an elevated procalcitonin level >1.0 ng/mL in identifying suspected bacterial infections for those with MIS-C was 6.3% (95% CI=0-15), in acute COVID-19 was 29% (95% CI=0-62%), and in the non-COVID-19 cohort was 75% (95% CI=62-88%). For identification of confirmed bacterial infection, PPV of an elevated procalcitonin level was 0% in MIS-C, 14% (95% CI=0-40%) in acute COVID-19, and 55% (95% CI=40-69%) in the non-COVID-19 cohort. We found a low PPV of elevated procalcitonin level above 1 ng/mL in identifying either culture-confirmed or presumed bacterial infection in children hospitalized with COVID-19-related illness.

Bacterial co-infection raises in-hospital mortality of COVID-19 patients: a retrospective study.

We aim to explore whether the bacterial co-infection with COVID-19 will raise the in-hospital mortality. COVID-19 patients' information were collected for analysis in our retrospective study. Neutrophil count and procalcitonin (PCT) were used to estimate whether there was a suspected bacterial co-infection. The main baselines between the suspected bacterial infection (SBI) and no evidence of bacterial infection (NBI) groups were no significant differences. In SBI group, patients required more therapies than NBI group. There was significantly higher in-hospital mortality (26% vs.9%, P < 0.001) between SBI and NBI groups in overall population. And in each subgroup based on pneumonia inflammation index (PII), it also showed higher in-hospital mortality of COVID-19 patients with bacterial co-infection. With logistic regression models, it showed that bacterial co-infection was associated with significantly higher in-hospital mortality in overall population (OR 1.694, 95% CI 1.179-2.434, p = 0.004) and mild subgroup (OR 2.374, 95% CI 1.249-4.514, p = 0.008). The rate of bacterial co-infection in overall population was 51%. At the same time, it showed a significantly higher rate of bacterial co-infection in critical subgroup than severe subgroup (63% vs. 49%, p = 0.003), and than that in moderate subgroup (63% vs. 48%, p = 0.002) based on clinical classification. It showed a significantly higher rates of bacterial co-infection in severe subgroup than moderate subgroup (66% vs. 49%, p = 0.001) based on PII. The result showed that the risk factor associated with significantly higher in-hospital mortality was PII (OR 1.018, 95%CI 1.012 to 1.024, P < 0.001) with logistic regression models. Bacterial co-infection estimated by Neutrophil count and procalcitonin significantly raises in-hospital mortality of COVID-19 patients in overall population in our study. Its impact is more significant in mild and moderate PII subgroups. PII based on CT imaging combined with neutrophil count and PCT is beneficial for accurate differentiation of bacterial co-infection of COVID-19.

Comparison of QSOFA Score and SIRS Criteria for the Prediction of Sepsis Outcome in Patients with a Suspected Bacterial Infection outside the Intensive Care Unit in the North of Iran

Comparison of QSOFA Score and SIRS Criteria for the Prediction of Sepsis Outcome in Patients with a Suspected Bacterial Infection outside the Intensive Care Unit in the North of Iran

Risk Factors in Outpatients with Dermatitis and Eczema in Tertiary Hospitals of China Who Have Clinically Suspected Bacterial Infection.

Skin bacterial infections are often observed in eczema patients, but the risk factors are not fully understood. The current study evaluated the prevalence of clinically suspected bacterial infection and its associated risk factors. Moreover, we investigated the practice of skin infection diagnosis in China. A hospital-based, multicenter, cross-sectional epidemiologic survey of bacterial infection was performed in a total of 6208 outpatients diagnosed with dermatitis and eczema from 39 tertiary hospitals of 15 provinces and municipalities in China. All patients completed a specific questionnaire regarding their demographic characteristics, disease duration, distribution of lesions, severity of itching, and medical history. Univariate analysis and multivariate analysis were used to evaluate risk factors associated with bacterial infection in patients with different types of eczema. The prevalence of clinically suspected bacterial infection was 47.0% in patients with eczema. Compared to atopic dermatitis, widespread eczema (OR = 1.50, P < 0.001) and other eczema (OR = 1.42, P < 0.001) were more likely to suffer bacterial infection. The itching grade was positively associated with the infection (OR = 2.11, 7.04, and 12.3 in patients with mild, moderate, and severe itching, respectively; P < 0.001). Lesion distribution in the cubital fossa, popliteal fossa, ear, shoulder and back, axillary, foot, and pudendum was positively associated with bacterial infection (all OR > 1.0, P < 0.05). In contrast, the face and abdomen were reversely associated with bacterial infection (OR < 1.0, P < 0.005). History of asthma, allergic rhinitis, allergic conjunctivitis, atopic dermatitis, infantile eczema, and flexion dermatitis was positively associated with bacterial infection (all OR > 1.0, P < 0.005), while the history of dry skin was reversely associated with bacterial infection (OR = 0.76, 95% CI: 0.64-0.90; P = 0.002). Patients with eczema were easily infected with bacteria. Widespread eczema and other eczema were more likely to have bacterial infection than atopic dermatitis. The high rate of infection may attribute to the lack of corresponding bacterial detection, suggesting the need of guideline development in China to prevent overuse of topical antibiotics.

Clinical characteristics and antibiotics treatment in suspected bacterial infection patients with COVID-19

Coronavirus disease 2019 (COVID-19) pandemic has brought challenges to health and social care systems. However, the empirical use of antibiotics is still confusing. Presently, a total of 1123 patients with COVID-19 admitted to Renmin Hospital of Wuhan University was included in this retrospective cohort study. The clinical features, complications and outcomes were compared between the suspected bacterial infection and the no evidence of bacterial infection. The risk factors of mortality and the incidence of acute organ injury were analyzed. As a result, 473 patients were selected to suspected bacterial infection (SI) group based on higher white blood cell count and procalcitonin or bacterial pneumonia on chest radiography. 650 patients were selected to the no evidence of bacterial infection (NI) group. The SI group had more severely ill patients (70.2% vs. 39.8%), more death (20.5% vs. 2.2%), and more acute organ injury (40.2% vs. 11.2%). Antibiotics were found associated with improved mortality and an increased risk for acute organ injury in hospitalized patients with COVID-19. Intravenous moxifloxacin and meropenem increased the death rate in patients with suspected bacterial infection, while oral antibiotics reduced mortality in this group. Moreover, penicillin and meropenem treatments were associated with increased mortality of the patients with no evidence of bacterial infection. In conclusion, patients with suspected bacterial infection were more likely to have negative clinical outcomes than those without bacterial infection. Empirical use of antibiotics may not have the expected benefits.

Prevalence and clinical features of adult atopic dermatitis in tertiary hospitals of China.

The prevalence of atopic dermatitis (AD) has increased substantially. Previous studies have focused mostly on pediatric patients, while epidemiological investigation on adult AD has been very limited.The aim of this study was to determine the prevalence and clinical features of adult AD in outpatients with dermatitis and eczema in China mainland.A multicenter cross-sectional study was conducted among outpatients with eczema or dermatitis from 39 tertiary hospitals of 15 provinces in China from July 1 to September 30, 2014.Of 8758 patients, 407 were adult AD. Compared with adults with other types of dermatitis, the mean age (41.8 ± 14.3 vs 42.04 ± 15.38 years, P < 0.05) and onset age (35.2 ± 11.2 vs 39.2 ± 14.0 years, P < 0.001) of adult AD were younger, and mean disease duration was longer (5.3 ± 7.1 vs 2.8 ± 4.9 years, P < 0.001). About 53.3% adult AD involved 3 or more body locations, higher than adults with other types of dermatitis (34.4%, P < 0.001), but lower than those with pediatric and adolescent AD (73.8%, P < 0.001). History of asthma (19.2% vs 6.9%, P < 0.001) or allergic conjunctivitis (21.9% vs 14.9%, P < 0.05) was more common in adult AD than pediatric/adolescent AD. Suspected bacterial infection was more frequently in adult AD than adults with other types of dermatitis (24.3% vs 14.6%, P < 0.001) and pediatric/adolescent AD (24.3% vs 14.9%, P < 0.001). More severe itching was observed in 31.4% of adult AD, higher than that of adults with other types of dermatitis (15.4%, P < 0.001), whereas similar to that of pediatric/adolescent AD (28.7%, P > 0.05). The highest (8.7%) and lowest prevalence (3.7%) of adult AD were in 25°N to 30°N and 35°N to 40°N latitude region.A substantial part of adult outpatients with eczema or dermatitis is adult AD. Middle age, more body location involvement, more suspected bacterial infection, and severe itching are the main clinical feathers of adult AD. Geographical environment and economic situation work in synergy to adult AD.

Incidence and Predictors of Bacterial infection in Febrile Children with Sickle Cell Disease

Children with sickle cell disease are at increased risk of developing bacteremia and other serious bacterial infections. Fever is a common symptom in sickle cell disease and can also occur with sickle cell crises and viral infections. We aimed to evaluate the incidence and predictors of bacteremia and bacterial infection in children with sickle cell disease presenting with fever to a district hospital and sickle cell center in London. A retrospective analysis was performed on all attendances of children (aged under 16 years) with sickle cell disease presenting with a fever of 38.5 °C or higher over a 1-year period. Confirmed bacterial infection was defined as bacteremia, bacterial meningitis, urinary tract infection (UTI), pneumonia, osteomyelitis or other bacterial infection with positive identification of organism. Children were defined as having a suspected bacterial infection if a bacterial infection was suspected clinically, but no organism was identified. Over a 1-year period there were 88 episodes analyzed in 59 children. Bacteremia occurred in 3.4% of episodes and confirmed bacterial infection in 7.0%. Suspected bacterial infection occurred in 33.0%. One death occurred from Salmonella typhirium septicemia. C-reactive protein (CRP) level and white blood cell (WBC) count were both significantly associated with bacterial infection (p = 0.004 and 0.02, respectively.) In conclusion, bacterial infections continue to be a significant problem in children with sickle cell disease. C-reactive protein was significantly associated with bacterial infections, and could be included in clinical risk criteria for febrile children with sickle cell disease.

G185(P) Fever and Bacterial Infections in Children with Sickle Cell Disease

Background and aimsChildren with sickle cell disease (SCD) are at an increased risk of developing bacteraemia and other serious bacterial infections, which can be associated with significant morbidity and mortality....

Treating symptomatic UTIs in older people

Practice NursingVol. 22, No. 1 Clinical Older PeopleTreating symptomatic UTIs in older peopleMargaret PerryMargaret PerrySearch for more papers by this authorMargaret PerryPublished Online:29 Sep 2013https://doi.org/10.12968/pnur.2011.22.1.21AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesClinical Knowledge Summaries (2010) Urinary Tract Infection (Lower) in Men. National Institute for Health and Clinical Excellence, London. http://www.cks.nhs.uk/urinary_tract_infection_lower_men/management/detailed_answers/view_all_detailed_answers (accessed 15 December 2010) Google ScholarGray RP, Malone Lee J (1995) Urinary tract infection in elderly people—time to review management? Age Ageing 24(4): 341–5. http://ageing.oxfordjournals.org/content/24/4/341.citation (accessed 15 December 2010) Google ScholarHicks D, Li CY (2007) Management of macroscopic haematuria in the emergency department. Emerg Med J 24: 385–90 Google ScholarHowes DA, Pillow MT (2010) Male Urinary Tract Infection. emedicine, Medscape. http://emedicine.medscape.com/article/778578-overview (accessed 15 December 2010) Google ScholarJuthani-Mehta MJ (2009) Urinary tract infections in elderly persons. In: American Society of Nephrology, ed. Geriatric Nephrology Curriculum. http://www.asn-online.org/education_and_meetings/geriatrics/Chapter32.pdf (accessed 15 December 2010) Google ScholarKamel HK (2004) Managing urinary tract infections in the nursing home: myths, mysteries and realities. Internet J Geriatr Gerontol 1(2): http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijgg/vol1n2/uri.xml (accessed 15 December 2010) Google ScholarMouton CP, Bazaldua OV (2001) Common infections in older adults. Am Fam Phys 63(2): 257–69 Google ScholarMundy AR (2006) Management of urethral strictures. Postgrad Med J 82(970): 489–93 Crossref, Google ScholarNicholle L (2009) Urinary tract infections in the elderly. Clin Geriatr Med 25(3): 423–36 Crossref, Google ScholarNicholle LE (2001) Urinary tract pathogens in complicated infection and in elderly individuals. J Infect Dis 183(Suppl 1): S5–8 Crossref, Google ScholarRajagopalan S, Yoshikawa T (2010) Urinary tract infections. In: Beers MH, Berkow R, eds. Merck Manual of Geriatrics. Chapter 100. http://www.merckmanu-als.com/mm_geriatrics/sec12/ch100.htm (accessed 20 December 2010) Google ScholarRaz R, Stamm WE (1993) A controlled trial of intravaginal oestriol in postmenopausal women with recurrent urinary tract infections. N Engl J Med 329: 753–6 Crossref, Google ScholarRaz R, Gennesin Y, Wasser Jet al. (2000) Recurrent urinary tract infections in postmenopausal women. Clin Infect Dis 30: 152–6 Crossref, Google ScholarRobinson D, Cardozo L (2003) The role of oestrogens in female lower urinary tract dysfunction. Urology 62(4A Suppl): 45–51 Crossref, Google ScholarScottish Intercollegiate Guidelines Network (2006) Management of Suspected Bacterial Infection in Adults: A National Clinical Guideline. SIGN, Edinburgh. http://www.sign.ac.uk/pdf/sign88.pdf (accessed 15 December 2010) Google ScholarSmith AL, Ferlise VJ, Rovner ES (2006) Female urethral strictures: successful management with long-term, clean, intermittent catheterization after urethral dilatation. Br J Urol Int 98(1). http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2006.06206.x/full (accessed 15 December 2010) Google Scholar FiguresReferencesRelatedDetails 1 January 2011Volume 22Issue 1ISSN (print): 0964-9271ISSN (online): 2052-2940 Metrics History Accepted 30 November 2012 Published online 29 September 2013 Published in print 1 January 2011 Information© MA Healthcare LtdKeywordsUrinary tract infectionelderlyrisk factorsrecurrencealarm symptomstreatmentindications for referralPDF download