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Original Articles
Factors associated with in-hospital death in patients with nosocomial infections: a registry-based study using community data in western Iran
Salman Khazaei, Erfan Ayubi, Ensiyeh Jenabi, Saeid Bashirian, Masud Shojaeian, Leili Tapak
Epidemiol Health. 2020;42:e2020037.   Published online June 1, 2020
DOI: https://doi.org/10.4178/epih.e2020037
  • 13,303 View
  • 265 Download
  • 2 Web of Science
  • 6 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
Objectives
Determining the predictors of in-hospital death related to nosocomial infections is an essential part of efforts made in the overall health system to improve the delivery of health care to patients. Therefore, this study investigated the predictors of in-hospital death related to nosocomial infections.
Methods
This registry-based, longitudinal study analyzed data on 8,895 hospital-acquired infections (HAIs) in Hamadan Province, Iran from March 2017 to December 2019. The medical records of all patients who had been admitted to the hospitals were extracted from the Iranian Nosocomial Infections Surveillance Software. The effects of the type and site of infection, as well as age group, on in-hospital death were estimated using univariate and multivariable Cox regression models.
Results
In total, 4,232 (47.8%) patients with HAIs were males, and their mean age was 48.25±26.22 years. In both sexes, most nosocomial infections involved Gram-negative bacteria and the most common site of infection was the urinary tract. Older patients had a higher risk of in-hospital death (adjusted hazard ratio [aHR], 2.26; 95% confidence interval [CI], 1.38 to 3.69 for males; aHR, 2.44; 95% CI, 1.29 to 4.62 for females). In both sexes, compared with urinary tract infections, an increased risk of in-hospital death was found for ventilator-associated events (VAEs) (by 95% for males and 93% for females) and bloodstream infections (BSIs) (by 67% for males and 82% for females).
Conclusion
We found that VAEs, BSIs, and fungal infections were independently and strongly associated with increased mortality.
Summary

Citations

Citations to this article as recorded by  
  • Predictors of In-ICU Mortality Among Older Patients with Healthcare-Associated Infection: A Cohort Study
    Fereshteh Rezaie, Farahnaz Mohammadi-Shahboulaghi, Reza Fadayevatan, Mohsen Shati, Gholamreza Ghaedamini Harouni
    Journal of Kermanshah University of Medical Sciences.2023;[Epub]     CrossRef
  • Barriers to hand hygiene compliance in intensive care units to prevent the spread of healthcare-associated infections
    Gurjeet Singh, Raksha Singh, Ranga Reddy Burri
    MGM Journal of Medical Sciences.2023; 10(4): 667.     CrossRef
  • Prevalence of Nosocomial Infections During the COVID-19 Pandemic: A Systematic Review and Meta-analysis
    Sima Rafiei, Zahra Nejatifar, Rana Soheylirad, Samira Raoofi, Fatemeh Pashazadeh Kan, Ahmad Ghashghaee
    Journal of Health Reports and Technology.2022;[Epub]     CrossRef
  • Prevalence of Nosocomial Infections During the COVID-19 Pandemic: A Systematic Review and Meta-analysis
    Sima Rafiei, Zahra Nejatifar, Rana Soheylirad, Samira Raoofi, Fatemeh Pashazadeh Kan, Ahmad Ghashghaee
    Journal of Health Reports and Technology.2022;[Epub]     CrossRef
  • The Impact of COVID-19 Outbreak on Nosocomial Infection Rate: A Case of Iran
    Maryam Jabarpour, Mahlagha Dehghan, Giti Afsharipour, Elham Hajipour Abaee, Parvin Mangolian Shahrbabaki, Mehdi Ahmadinejad, Mahboobeh Maazallahi, Aseer Manilal
    Canadian Journal of Infectious Diseases and Medical Microbiology.2021; 2021: 1.     CrossRef
  • Survival rate in patients with ICU-acquired infections and its related factors in Iran’s hospitals
    MEDSKorosh Etemad, Yousef Khani, Seyed-Saeed Hashemi-Nazari, Neda Izadi, Babak Eshrati, Yadollah Mehrabi
    BMC Public Health.2021;[Epub]     CrossRef
Asymptomatic Middle East Respiratory Syndrome coronavirus infection using a serologic survey in Korea
Yeong-jun Song, Jeong-Sun Yang, Hee Jung Yoon, Hae-Sung Nam, Soon Young Lee, Hae-Kwan Cheong, Woo-Jung Park, Sung Han Park, Bo Youl Choi, Sung Soon Kim, Moran Ki
Epidemiol Health. 2018;40:e2018014.   Published online April 15, 2018
DOI: https://doi.org/10.4178/epih.e2018014
  • 16,650 View
  • 300 Download
  • 15 Web of Science
  • 16 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The rates of asymptomatic infection with Middle East Respiratory Syndrome (MERS) coronavirus vary. A serologic study was conducted to determine the asymptomatic MERS infection rate in healthcare workers and non-healthcare workers by exposure status.
METHODS
Study participants were selected from contacts of MERS patients based on a priority system in 4 regions strongly affected by the 2015 MERS outbreak. A sero-epidemiological survey was performed in 1,610 contacts (average duration from exposure to test, 4.8 months), and the collected sera were tested using an enzyme-linked immunespecific assay (ELISA), immunofluorescence assay (IFA), and plaque reduction neutralization antibody test (PRNT). Among the 1,610 contacts, there were 7 ELISA-positive cases, of which 1 exhibited positive IFA and PRNT results.
RESULTS
The asymptomatic infection rate was 0.060% (95% confidence interval, 0.002 to 0.346). The asymptomatic MERS case was a patient who had been hospitalized with patient zero on the same floor of the hospital at the same time. The case was quarantined at home for 2 weeks after discharge, and had underlying diseases, including hypertension, angina, and degenerative arthritis.
CONCLUSIONS
The asymptomatic infection was acquired via healthcare-associated transmission. Thus, it is necessary to extend serologic studies to include inpatient contacts who have no symptoms.
Summary
Korean summary
2015년 국내 MERS 유행시에 자가격리를 시행하였던 접촉자 약 15,000명 (의료인과 비의료인 포함) 중에서 주요 유행지역, 노출 강도 등을 고려하여 선별된 3,291명을 대상으로 무증상 감염여부를 확인하기 위한 혈청 역학조사를 수행하였다. 최종 검사에 참여한 1,610명 중에서 7명이 ELISA 양성 반응을 보였고, 그 중 1명이 IFA와 PRNT에서도 양성 반응을 보여 무증상 감염률은 0.060%(95% CI: 0.002-0.346)로 기존 연구에 비하여 낮았다. 최종 양성을 보인 1명은 노출 당시 1번환자와 가까운 병실에 입원하였던 환자였다.

Citations

Citations to this article as recorded by  
  • MERS-CoV seroconversion amongst Malaysian Hajj pilgrims returning from the Middle East, 2016–2018: results from the MERCURIAL multiyear prospective cohort study
    Jefree Johari, Robert D. Hontz, Brian L. Pike, Tupur Husain, Norhayati Rusli, Rozainanee Mohd-Zain, Vunjia Tiong, Hai-Yen Lee, Boon-Teong Teoh, Sing-Sin Sam, Chee-Sieng Khor, Shih-Keng Loong, Juraina Abd-Jamil, Siti-Sarah Nor'e, Hasmawati Yahaya, Naim Che
    Emerging Microbes & Infections.2023;[Epub]     CrossRef
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    Majid Sharifi, Anwarul Hasan, Setareh Haghighat, Akbar Taghizadeh, Farnoosh Attar, Samir Haj Bloukh, Zehra Edis, Mengzhou Xue, Suliman Khan, Mojtaba Falahati
    Talanta.2021; 223: 121704.     CrossRef
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    Hanjie Jonathan Gan, Amaravadhi Harikishore, Jihye Lee, Sangeun Jeon, Sreekanth Rajan, Ming Wei Chen, Jun Long Neo, Seungtaek Kim, Ho Sup Yoon
    Antiviral Research.2021; 185: 104996.     CrossRef
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    Nash Rochman, Yuri Wolf, Eugene V. Koonin
    F1000Research.2021; 10: 447.     CrossRef
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    Nash Rochman, Yuri Wolf, Eugene V. Koonin
    F1000Research.2021; 10: 447.     CrossRef
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    Le Minh Bui, Huong Thi Thu Phung, Thuy-Tien Ho Thi, Vijai Singh, Rupesh Maurya, Khushal Khambhati, Chia-Ching Wu, Md Jamal Uddin, Do Minh Trung, Dinh Toi Chu
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    Jang-Hoon Choi, Hye-Min Woo, Tae-young Lee, So-young Lee, Sang-Mu Shim, Woo-Jung Park, Jeong-Sun Yang, Joo Ae Kim, Mi-Ran Yun, Dae-Won Kim, Sung Soon Kim, Yi Zhang, Wei Shi, Lingshu Wang, Barney S. Graham, John R. Mascola, Nanshuang Wang, Jason S. McLella
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    Dong Zhao, Mengmei Wang, Ming Wang, Yang Zhao, Zhishui Zheng, Xiaochen Li, Yunting Zhang, Tao Wang, Shaolin Zeng, Weihua Hu, Wenzhen Yu, Ke Hu
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