Risk factors of acute respiratory infections in underfives of urban slum community

To ascertain the risk factors of Acute Respiratory Infections (ARI) in children, a prospective study was conducted for a period of one year among 112 underfives in urban slum community of Calcutta. Incidence of ARI was found significantly higher in undernourished children of poor socio-economic class. Parental smoking habit and solid fuel use for cooking were recognised as important risk factors of ARI.     

Risk factors for acute respiratory tract infections in young Greenlandic children

Acute respiratory infections cause considerable morbidity among Inuit children, but there is very little information on the risk factors for these infections in this population. To identify such factors, the authors performed a prospective community-based study of acute respiratory infections in an open cohort of 288 children aged 0-2 years in the town of Sisimiut, Greenland. Between July 1996 and August 1998, children were monitored weekly, and episodes of upper and lower respiratory tract infections were registered. Risk factor analyses were carried out using a multivariate Poisson regression model adjusted for age. Risk factors for upper respiratory tract infections included attending a child-care center (relative risk = 1.7 compared with home care) and sharing a bedroom with adults (relative risk = 2.5 for one adult and 3.1 for two adults). Risk factors for lower respiratory tract infections included being a boy (relative risk = 1.5), attending a child-care center (relative risk = 3.3), exposure to passive smoking (relative risk = 2.1), and sharing a bedroom with children aged 0-5 years (relative risk = 2.0 for two other children). Breastfeeding tended to be protective for lower respiratory tract infections. The population-attributable risk of lower respiratory tract infections associated with passive smoking and child-care centers was 47% and 48%, respectively. The incidence of acute respiratory infections among Inuit children may be reduced substantially through public health measures.     

Risk factors for diarrhoea and upper respiratory tract infections among children in a rural area of Uganda

This study explored risk factors associated with diarrhoea and upper respiratory tract infections (URTIs) among children in Sembabule district, Uganda. Data were collected from 300 women with children aged less than two years using the WHO 30-cluster sampling technique. The prevalence of diarrhoea among children was 40.3%. A child not immunized (odds ratio [OR] 2.8, p < 0.001), absence of latrine in a house (OR 1.4, p < 0.03), low knowledge of mixing oral rehydration salts (OR 1.7, p < 0.01), garbage thrown anywhere around the house (OR 2.6, p < 0.001), not washing hands after using latrine (OR 1.8, p < 0.03), and not washing hands before preparing food (OR 1.4, p < 0.04) were risk factors for diarrhoea. The prevalence of URTIs among children was 37.4%. A child not immunized (OR 2.4, p < 0.001), children aged 6-11 months (OR 2.1, p < 0.03), and previous episode of diarrhoea (OR 2.5, p < 0.001) were risk factors for URTIs. The results showed that low immunization status was an important risk factor for diarrhoea and URTIs among children in the study district of Uganda. For 75% of the children, care for fever was obtained from drug shops, while 9.2% were taken to health units. This is in contrast to diarrhoea cases where 49.5% of children were taken to health units for care. To reduce the burden of disease among children in this district, an integrated package of immunization services and other childcare programmes need to be implemented in addition to improved personal and environmental hygiene. There is also a need to design well-focused health-education messages to improve treatment-seeking behaviour for childhood diseases.     

急性下呼吸道感染患儿合并支气管哮喘的危险因素分析

目的探讨急性下呼吸道感染患儿发生哮喘的危险因素,为临床哮喘防治提供参考。方法回顾性分析2011年6月-2014年1月医院收治2 410例急性下呼吸道感染患儿的临床资料,采用单因素及多因素logistic回归方法对患儿可能发生哮喘的危险因素进行统计分析,采用SPSS 17.0软件进行统计处理。结果 2 410例患儿中共有112例合并支气管哮喘,发病率为4.6%;共检出112株病原体,并发哮喘患儿主要以鼻病毒(RHV)为主,共23株占37.5%;年龄小、有哮喘家族史、过敏体质及呼吸道合胞病毒(RSV)、RHV、肺炎支原体(MP)感染与急性下呼吸道感染患儿发生哮喘相关,是急性下呼吸道感染患儿发生哮喘的高危因素(P<0.05)。结论急性下呼吸道感染的患儿中具有哮喘家族史、过敏体质、RSV及RHV感染、男性以及低龄患儿发生哮喘的风险较大,临床应根据这些高危因素针对性的预防控制哮喘发生。     

腹膜透析患者呼吸道感染的因素分析

目的研究腹膜透析(PD)患者并发呼吸道感染(RTI)的诱因,以降低呼吸道感染。方法选取2011年7月-2013年7月医院收治的PD发生RTI患者84例作为研究对象,全部患者均实施标准PD治疗方案,并予以针对性的护理对策,对比PD发生RTI患者感染部位,分析PD发生RTI患者病原菌分布,并综合分析PD发生RTI诱因。结果 PD发生RTI患者的感染部位为上呼吸道与下呼吸道;共分离出病原菌21株,前5位病原菌依次为大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌、铜绿假单胞菌、变形菌属,分别占33.33%、23.81%、9.52%、9.52%、9.52%;经logistic回归法分析后发现,年龄、蛋白尿程度、血清白蛋白及合并糖尿病等指标为PD发生RTI的危险因素,而血清白蛋白的水平则是PD发生RTI的独立危险因素。结论 PD并发RTI有较多诱因,临床治疗时应加以关注,为预防RTI,可采取具有针对性的护理对策,避免发生RTI。     

Risk factors for Lyme disease in a small rural community in northern California.

A 1-year prospective study of risk factors for seropositivity to and contraction of Lyme disease among members of a small rural community (population, approximately 150) was conducted in northwestern California in 1988-1989. The initial rate of seropositivity for Borrelia burgdorferi for 119 current or former residents ranged from 15 to 20% among three laboratories, with statistically significant interlaboratory agreement. Questionnaires were completed by 93 current residents at entry and 80 residents a year later to evaluate the association of serologic status with 20 categorical and 47 continuous variables. Seropositive subjects had resided in the study area about 2 years longer, were bitten by unspecified biting flies more often, and were less likely to have engaged in hiking than seronegative subjects. One of 59 seronegative subjects seroconverted a year later (annual incidence = 1.7%). The cumulative frequency of seropositivity for Lyme disease in the study population was > or = 24%. Of 83 subjects examined physically, 13 were diagnosed as having definite and 18 as having probable Lyme disease. The seropositivity rate was significantly higher (38.7%) among individuals with definite/probable Lyme disease than in asymptomatic subjects (13.5%). Subjects who were seronegative or free of Lyme disease reported nearly as many tick bites as subjects who were seropositive or had a diagnosis of the disease. Age, time spent outdoors in the fall multiplied by a clothing index, and woodcutting were significantly associated with Lyme disease in logistic regression analyses.     

老年精神分裂症患者呼吸道感染危险因素分析

目的分析老年精神分裂症患者的呼吸道感染危险因素,为临床治疗提供参考依据。方法回顾性分析2010年1月-2013年9月医院收治的312例精神分裂症老年患者临床资料,总结老年精神分裂症患者年龄、性别、住院天数、精神分裂症分型、药物使用、吸氧时间、合并其他疾病等相关危险因素。结果 312例精神分裂症老年患者发生医院感染28例,感染率为8.97%;其中呼吸道感染20例,感染率为71.43%,表明老年精神分裂症患者以呼吸道感染为主,是医院感染的高发疾病;年龄、长期服用精神药物、食物反流等均是精神分裂症患者发生呼吸道感染的危险因素。结论老年精神分裂症易发生在呼吸道感染,年龄、药物等危险因素值得关注,加强预防和护理可以降低感染风险。     

Risk factors for croup in children with recurrent respiratory infections: a case-control study

Croup accounts for approximately 15% of all lower respiratory disease in children, but little is known about risk factors or its recurrence rate. The aim of this study was to determine the risk factors for croup and recurrent croup and to find out whether it is possible to predict the course of the disease. We considered croup patients who visited the Paediatric Department of Oulu University Hospital as primary health care patients at night during 1996–2000. For most analyses we used sex- and age-matched control patients who had had other respiratory infection but for environmental factors we used population controls. We performed conditional logistic regression analysis on data applying to 182 pairs of patients and controls.
The recurrence rate was high, as 61% of the croup patients had had at least three episodes. Family history of croup was the most significant risk factor for both croup itself and recurrent croup. In multivariable analysis the odds ratio (OR) for the parents having a history of croup was 3.2 (95% CI 1.5, 7.1, P  < 0.01) and 4.1 (95% CI 1.4, 11.7, P  < 0.01) for recurrent croup. Parental smoking appeared to be a risk factor for respiratory infections but not for croup. Patients with croup had a cat as a pet less often than the controls, with OR 0.5 (95% CI 0.2, 1.0, P  = 0.04). Family history appeared to be an exceptionally strong predictive factor for croup and its recurrence. In this patient series prone to respiratory infections recurrence of croup was common.     

Risk factors for spinal surgical-site infections in a community hospital: a case-control study.

OBJECTIVE: To characterize risk factors for surgical-site infection after spinal surgery. DESIGN: A case-control study. SETTING: A 113-bed community hospital. METHOD: From January 1998 through June 2000, the incidence of surgical-site infection in patients undergoing laminectomy, spinal fusion surgery, or both increased at community hospital A. We compared 13 patients who acquired surgical-site infections after laminectomy, spinal fusion surgery, or both with 47 patients who were operated on during the same time period but did not acquire a surgical-site infection. Information collected included demographics, risk factors, personnel involved in the operations, length of hospital stay, and hospital costs. RESULTS: Of 13 case-patients, 9 (69%) were obese, 9 (69%) had spinal compression, 5 (38.5%) had a history of tobacco use, and 4 (31%) had diabetes. Oxacillin-sensitive Staphylococcus aureus (6 of 13; 46%) was the most common organism isolated. Significant risk factors for postoperative spinal surgical-site infection were dural tear during the surgical procedure and the use of glue to cement the dural patch (3 of 13 [23%] vs 1 of 47 [2.1%]; P = .02) and American Society of Anesthesiologists risk class of 3 or more (6 of 13 [46.2%] vs 7 of 47 [15%]; P = .02). Case-patients were more likely to have prolonged length of stay (median, 16 vs 4 days; P< .001). The average excess length of stay was 11 days and the excess cost per case was $12,477. CONCLUSION: Dural tear and the use of glue should be evaluated as potential risk factors for spinal surgical-site infection. Systematic observation for potential lapses in sterile technique and surgical processes that may increase the risk of infection may help prevent spinal surgical-site infection.     

Risk factors for sporadic Campylobacter jejuni infections in rural michigan: a prospective case-control study

OBJECTIVES: This case-control study investigated risk factors for campylobacteriosis in a rural population. Exposure to live farm animals was hypothesized to increase the risk for Campylobacter jejuni enteritis. METHODS: Incident cases from rural counties reported to the Michigan Department of Community Health and matched controls completed a self-administered postal questionnaire. RESULTS: Persons engaged in poultry husbandry had increased odds of campylobacteriosis (odds ratio = 6.884; 95% confidence interval (CI) = 1.438, 32.954). There was evidence for a dose-response relationship between the number of types of poultry contact and campylobacteriosis. CONCLUSIONS: We estimate that 18% (95% CI = 6%, 30%) of Campylobacter cases occurring in rural populations are attributable to poultry husbandry. Cases occurred in individuals who were not poultry farmers by occupation.     

呼吸内科医院感染危险因素分析及护理对策

目的 探讨呼吸内科医院感染危险因素及护理对策,以降低医院感染发生率.方法 回顾性调查300例呼吸内科住院患者的临床资料,对可能影响医院感染的因素进行单因素检验,对筛选出的因素采用logistic回归分析,并提出针对性的预防护理措施.结果 该组患者医院感染率为9.0％,年龄、住院时间、气管插管、气管切开、留置导尿管、机械通气及抗菌药物的使用均是呼吸内科感染的危险因素(P＜0.05);经logistic回归分析发现侵入性操作、抗菌药物的使用是医院感染的独立危险因素(OR值分别为0.987、0.758,P＜0.05).结论 呼吸内科医院感染的发生率较高,必须做好预防性护理措施,控制和降低医院感染的发生.     

产科门诊患者呼吸道感染危险因素分析与对策

目的探讨产科门诊患者呼吸道感染的易患因素监测及对策。方法回顾性分析2009年8月-2011年10月医院妇产科进行治疗的240例孕产妇的资料,统计并比较产妇个人因素及环境因素所导致呼吸道感染的情况。结果在所有孕产妇导致呼吸道感染的个人因素中,因自身免疫力低下所引起呼吸道感染率为65.00%,明显高于其他个人因素,差异有统计学意义(P<0.05);在所有孕产妇导致呼吸道感染的环境因素中,因季节因素所引起呼吸道感染的感染率为78.75%,明显高于其他环境因素,差异有统计学意义(P<0.05)。结论引起孕产妇呼吸道感染的主要个人因素是自身免疫力低下、季节变化的因素,所以应合理安排饮食、补充机体免疫力、完善医院产科门诊的取暖设施,改善因季节变化对产妇产生的不良影响。     

Risk factors for deaths due to respiratory infections among Brazilian infants

In a population based case-control study, 127 Brazilian infants who died due to a respiratory infection were compared with 254 neighbourhood controls. The main risk factors associated with mortality were low socioeconomic status (including low levels of parental education) and--after adjustment for socioeconomic status--lack of breastfeeding, lack of supplementation with non-milk foods, crowding, the number of under-fives in the family, lack of a flush toilet, low birthweight, low weight-for-age and having a young mother. In a multivariate analysis, the variables found to be most closely associated with mortality were breastfeeding, education of the father, the number of under-fives, family income and birthweight. Having a low weight-for-age was also strongly associated with mortality but the retrospective nature of the study makes this finding difficult to interpret.     

Risk factors for insomnia in a rural population

PURPOSE: This study compared in one data set the relative importance of most previously examined risk factors for different symptoms of insomnia. METHODS: Data were obtained from personal interviews of 1,588 adults in a rural area. Statistical methods evaluated the association of 42 risk factors with any insomnia and each of four insomnia subtypes: difficulty with initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), and restless sleep (RS). RESULTS: Insomnia rates were greater in this rural population than most U.S. studies and greater in the United States than other countries. The correlations between insomnia subtype and energy level was highest for RS, -0.29, and lowest for EMA, -0.11. All sleep disturbances increased monotonically with depressive symptoms, but the increase was greatest for RS (r = 0.57) and weakest for EMA (r = 0.24). Anxiety and pain also were independently associated with each insomnia subtype. Insomnia problems of spouses were uncorrelated. Other risk factors were independently associated with some insomnia subtypes but not others. For example, the association of age with difficulty maintaining sleep was independent of health measures. CONCLUSION: The results suggest that different insomnias have different rates and risk factors and therefore possibly different etiologies and management strategies.     

呼吸重症监护病房医院感染危险因素分析

目的探讨呼吸重症监护病房(RICU)医院感染的特点、危险因素及对预后的影响。方法回顾性调查2010年1-12月入住RICU>48h患者的病例资料,对结果进行分析。结果 RICU医院感染率为30.63%(14.51/千住院日),例次感染率为45.05%(21.33/千住院日);最常见的感染部位是下呼吸道,占86.00%;最常见的病原菌是鲍氏不动杆菌,占37.50%;患者伴有肿瘤、联合使用抗菌药物>2种、有创机械通气>7d是医院感染的独立危险因素;医院感染是患者死亡的独立危险因素。结论 RICU医院感染是多因素共同作用的结果;医院感染增加RICU患者死亡风险。     

急性白血病化疗患者血流感染的医源性危险因素分析

目的分析急性白血病(AL)化疗患者血流感染的医源性危险因素,为AL感染的预防治疗提供参考。方法收集2014年1月-2015年3月274例AL患者的临床资料,分析患者发生血流感染的医源性危险因素,采用SPSS 17.0软件对数据行统计分析。结果 274例AL患者发生血流感染27例,感染率9.85%;感染患者共检出72株病原菌,其中革兰阴性菌39株占54.17%,革兰阳性菌33株占45.83%;革兰阴性菌对亚胺培南敏感率均为100.00%;革兰阳性菌对万古霉素、利奈唑胺的敏感率均为100.00%;多因素logistic回归分析显示,住院时间>30d、PICC置管时间>30d、处于化疗诱导缓解期为血流感染发生的危险因素,不应用免疫调节剂为血流感染发生的保护性因素。结论 AL患者发生血流感染的医源性危险因素较复杂,临床应严格无菌操作,在用药、置管时严格把握适应证,积极预防血流感染。     

急性心肌梗死患者医院感染危险因素分析与预防

目的分析急性心肌梗死患者发生医院感染的部位、病原菌分布和危险因素,提出预防措施,减少医院感染。方法回顾性分析医院2012年6月-2014年12月收治的816例急性心肌梗死并发医院感染的患者临床资料,调查其医院感染率、感染部位、病原菌分布,并对其危险因素进行单因素分析。结果 816例患者发生医院感染93例,医院感染率为11.4%,感染部位依次为:下呼吸道38例、泌尿道22例、消化道17例、上呼吸道9例及皮肤及黏膜7例,分别占40.9%、23.6%、18.3%、9.7%及7.5%;感染病原菌以革兰阴性菌为主,占73.5%,其次为革兰阳性菌占23.5%和真菌占3.0%;急性心肌梗死患者医院感染与患者的年龄、住院时间、合并糖尿病、心功能Ⅲ和Ⅳ分级、介入手术、气管插管和呼吸机使用等因素相关(P<0.05)。结论急性心肌梗死患者医院感染率较高,医院感染以呼吸道感染为主,大多数感染由革兰阴性菌引起,感染相关因素较多,临床应加强感染监测,并制定合理干预措施,减少医院感染发生。     

急性农药中毒患者医院感染危险因素分析

目的探讨急性农药中毒患者合并医院感染情况及相关危险因素,以提高急性农药中毒患者的抗感染疗效。方法选取2012年1月-2014年6月医院收治的90例急性农药中毒患者为研究对象,将其中31例中毒合并医院感染患者设为观察组,59例未合并感染患者为对照组,分析两组患者的感染特点及其感染相关危险因素;采用SPSS18.0软件进行统计分析。结果急性农药中毒患者多为急性有机磷中毒,占76.67%,医院感染率为34.44%,感染患者中肺部感染最多,占64.51%,其次为泌尿系统与胃肠道,各占16.13%;合并感染患者昏迷时间显著高于未感染患者(P<0.05);单因素分析显示,急性农药中毒患者年龄、气管插管、昏迷、洗胃、留置胃管、使用抗菌药物、住院时间为急性农药中毒患者医院感染相关危险因素(P<0.05)。结论急性农药中毒患者医院感染相关危险因素较多,在治疗及护理过程中应严格无菌操作,加强留置导管处理,减少侵入性操作,合理选用抗菌药物,以控制及降低医院感染的发生率。     

脑卒中急性期患者肺部感染危险因素分析

目的分析脑卒中急性期患者发生肺部感染危险因素及其对患者预后的影响,为控制及降低脑卒中急性期患者肺部感染、制定相应的预防方案提供参考。方法 2009年1月-2013年9月对收治的330例脑卒中急性期患者临床资料进行回顾性分析,分析肺部感染发生率及相关危险因素、预后,数据采用SPSS 17.0软件进行统计分析。结果 330例患者住院期间发生肺部感染者36例,肺部感染率10.91%;年龄≥65岁、有意识障碍、有吞咽困难、脑出血、合并糖尿病、低蛋白血症、有侵入性操作、卧床时间≥1周时患者肺部感染发生率分别为14.14%、23.40%、21.49%、13.86%、31.25%、32.00%、15.58%、16.39%,年龄<65岁、无意识障碍、无吞咽困难、脑梗死、未合并糖尿病、未合并低蛋白血症、无侵入性操作、卧床时间<1周时患者肺部感染发生率分别为6.06%、5.93%、4.78%、6.25%、8.73%、9.18%、6.82%、4.08%,比较差异有统计学意义(P<0.05)。结论脑卒中急性期患者肺部感染发生率较高,引起肺部感染发生的独立危险因素很多,发生肺部感染会影响到患者的预后。