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Park J, Lee W, Kang D, Min J, Jang H, Kang C, Kwon D, Kwag Y, Ha E. Summer temperature and emergency room visits due to urinary tract infection in South Korea: a national time-stratified case-crossover study. BMC Public Health 2024; 24:2274. [PMID: 39169278 PMCID: PMC11340178 DOI: 10.1186/s12889-024-19454-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 07/11/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Although urinary tract infection (UTI) is a common and severe public health concern, and there are clear biological mechanisms between UTI and hot temperatures, few studies have addressed the association between hot temperatures and UTI. METHODS We designed a time-stratified case-crossover study using a population-representative sample cohort based on the National Health Insurance System (NHIS) in South Korea. We obtained all NHIS-based hospital admissions through the emergency room (ER) due to UTI (using a primary diagnostic code) from 2006 to 2019. We assigned satellite-based reanalyzed daily summer (June to September) average temperatures as exposures, based on residential districts of beneficiaries (248 districts in South Korea). The conditional logistic regression was performed to evaluate the association between summer temperature and UTI outcome. RESULTS A total of 4,436 ER visits due to UTI were observed during the summer between 2006 and 2019 among 1,131,714 NHIS beneficiaries. For 20% increase in summer temperatures (0-2 lag days), the odd ratio (OR) was 1.06 (95% CI: 1.02-1.10) in the total population, and the association was more prominent in the elderly (people aged 65 y or older; OR:1.11, 95% CI: 1.05-1.17), females (OR: 1.12, 95% CI: 1.05-1.19), and people with diabetes history (OR: 1.14, 95% CI: 1.07-1.23). The effect modification by household income was different in the total and elderly populations. Furthermore, the association between summer temperature and UTI increased during the study period in the total population. CONCLUSIONS Our results are consistent with the hypothesis that higher summer temperatures increase the risk of severe UTIs, and the risk might be different by sub-populations.
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Affiliation(s)
- Jiwoo Park
- Deparment of Information Convergence Engineering, Pusan National University, Yangsan, South Korea
| | - Whanhee Lee
- Deparment of Information Convergence Engineering, Pusan National University, Yangsan, South Korea
- School of Biomedical Convergence Engineering, Pusan National University, Yangsan, South Korea
| | - Dukhee Kang
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Ewha Womans University, Ewha Medical Research Center, Seoul, South Korea
| | - Jieun Min
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, 260, Gonghang-daero, Gangseo-gu, Seoul, 07804, South Korea
- Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Hyemin Jang
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Cinoo Kang
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Dohoon Kwon
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Youngrin Kwag
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, 260, Gonghang-daero, Gangseo-gu, Seoul, 07804, South Korea
| | - Eunhee Ha
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, 260, Gonghang-daero, Gangseo-gu, Seoul, 07804, South Korea.
- Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University, Seoul, South Korea.
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Cao X, Tu Y, Zheng X, Xu G, Wen Q, Li P, Chen C, Yang Q, Wang J, Li X, Yu F. A retrospective analysis of the incidence and risk factors of perioperative urinary tract infections after total hysterectomy. BMC Womens Health 2024; 24:311. [PMID: 38811924 PMCID: PMC11134670 DOI: 10.1186/s12905-024-03153-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/21/2024] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Perioperative urinary tract infections (PUTIs) are common in the United States and are a significant contributor to high healthcare costs. There is a lack of large studies on the risk factors for PUTIs after total hysterectomy (TH). METHODS We conducted a retrospective study using a national inpatient sample (NIS) of 445,380 patients from 2010 to 2019 to analyze the risk factors and annual incidence of PUTIs associated with TH perioperatively. RESULTS PUTIs were found in 9087 patients overall, showing a 2.0% incidence. There were substantial differences in the incidence of PUTIs based on age group (P < 0.001). Between the two groups, there was consistently a significant difference in the type of insurance, hospital location, hospital bed size, and hospital type (P < 0.001). Patients with PUTIs exhibited a significantly higher number of comorbidities (P < 0.001). Unsurprisingly, patients with PUTIs had a longer median length of stay (5 days vs. 2 days; P < 0.001) and a higher in-hospital death rate (from 0.1 to 1.1%; P < 0.001). Thus, the overall hospitalization expenditures increased by $27,500 in the median ($60,426 vs. $32,926, P < 0.001) as PUTIs increased medical costs. Elective hospitalizations are less common in patients with PUTIs (66.8% vs. 87.6%; P < 0.001). According to multivariate logistic regression study, the following were risk variables for PUTIs following TH: over 45 years old; number of comorbidities (≥ 1); bed size of hospital (medium, large); teaching hospital; region of hospital(south, west); preoperative comorbidities (alcohol abuse, deficiency anemia, chronic blood loss anemia, congestive heart failure, diabetes, drug abuse, hypertension, hypothyroidism, lymphoma, fluid and electrolyte disorders, metastatic cancer, other neurological disorders, paralysis, peripheral vascular disorders, psychoses, pulmonary circulation disorders, renal failure, solid tumor without metastasis, valvular disease, weight loss); and complications (sepsis, acute myocardial infarction, deep vein thrombosis, gastrointestinal hemorrhage, pneumonia, stroke, wound infection, wound rupture, hemorrhage, pulmonary embolism, blood transfusion, postoperative delirium). CONCLUSIONS The findings suggest that identifying these risk factors can lead to improved preventive strategies and management of PUTIs in TH patients. Counseling should be done prior to surgery to reduce the incidence of PUTIs. THE MANUSCRIPT ADDS TO CURRENT KNOWLEDGE In medical practice, the identification of risk factors can lead to improved patient prevention and treatment strategies. We conducted a retrospective study using a national inpatient sample (NIS) of 445,380 patients from 2010 to 2019 to analyze the risk factors and annual incidence of PUTIs associated with TH perioperatively. PUTIs were found in 9087 patients overall, showing a 2.0% incidence. We found that noted increased length of hospital stay, medical cost, number of pre-existing comorbidities, size of the hospital, teaching hospitals, and region to also a play a role in the risk of UTI's. CLINICAL TOPICS Urogynecology.
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Affiliation(s)
- Xianghua Cao
- Department of Anesthesiology, Dongguan Tungwah Hospital, Dongguan, China
| | - Yunyun Tu
- Department of Anesthesia, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, 364000, China
| | - Xinyao Zheng
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Guizhen Xu
- Department of Anesthesiology, Dongguan Tungwah Hospital, Dongguan, China
| | - Qiting Wen
- Department of Anesthesiology, Dongguan Tungwah Hospital, Dongguan, China
| | - Pengfei Li
- Department of Anesthesiology, Dongguan Tungwah Hospital, Dongguan, China
| | - Chuan Chen
- Department of Obstetrics and Gynecology, Core Facility Center, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, 230001, China
| | - Qinfeng Yang
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Jian Wang
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Xueping Li
- Department of Anesthesiology, Dongguan Tungwah Hospital, Dongguan, China.
| | - Fang Yu
- Division of Orthopaedic Surgery, People's Hospital of Ganzhou, No. 17 Hongqi Avenue, Zhanggong District, Ganzhou, 341000, China.
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Barham DW, Pyrgidis N, Amini E, Hammad M, Miller J, Andrianne R, Burnett AL, Gross K, Hatzichristodoulou G, Hotaling J, Hsieh TC, Jenkins LC, Jones JM, Lentz A, Modgil V, Osmonov D, Park SH, Pearce I, Perito P, Sadeghi-Nejad H, Sempels M, Suarez-Sarmiento A, Simhan J, van Renterghem K, Warner JN, Ziegelmann M, Yafi FA, Gross MS. Does climate impact inflatable penile prosthesis infection (IPP) risk? Assessment of temperature and dew point on IPP infections. J Sex Med 2024; 21:500-504. [PMID: 38481017 DOI: 10.1093/jsxmed/qdae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Variations in climate have been associated with a greater risk of surgical site infections, urinary tract infections, and changes in the skin microbiome; however, limited data exist on the impact of climate on inflatable penile prosthesis (IPP) infections. AIM We sought to evaluate the impact of climate on the risk of IPP infections in a large international, multicenter cohort. METHODS We performed a multi-institutional, retrospective study of patients undergoing IPP surgery. We then evaluated whether the month or season, during which surgery was performed, affected device infections. Implant infections were defined as infections requiring device explantation. A univariate logistic regression analysis was undertaken. OUTCOMES Our primary outcome was implant infection. RESULTS A total of 5289 patients with a mean age of 62.2 ± 10.8 years received IPP placement. There was a fairly even distribution of implants performed in each season. A total of 103 (1.9%) infections were recorded. There were 32 (31.1%) IPP infections in patients who underwent surgery in the summer, followed by 28 (27.2%) in the winter, 26 (25.2%) in the spring, and 17 (16.5%) in the fall. No statistically significant differences were recorded in terms of season (P = .19) and month (P = .29). The mean daily temperature (P = .43), dew point (P = .43), and humidity (P = .92) at the time of IPP placement was not associated with infection. CLINICAL IMPLICATIONS These findings provide reassurance to prosthetic urologists that infection reduction strategies do not need to be tailored to local climate. STRENGTHS AND LIMITATIONS Climate data were not directly recorded for each hospital, but rather based on the monthly averages in the city where the surgery was performed. CONCLUSION The climate at time of IPP placement and time of year of surgery is not associated with IPP infection risk.
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Affiliation(s)
- David W Barham
- Urology Section, Department of Surgery, Brooke Army Medical Center, San Antonio, TX 78234, United States
| | | | - Eliad Amini
- Department of Urology, University of California, Irvine, Irvine, CA 92868, United States
| | - Muhammed Hammad
- Department of Urology, University of California, Irvine, Irvine, CA 92868, United States
| | - Jake Miller
- Department of Urology, University of California, Irvine, Irvine, CA 92868, United States
| | - Robert Andrianne
- Department of Urology, University Hospital of Liège, Liege, Belgium
| | - Arthur L Burnett
- Department of Urology, Johns Hopkins University, Baltimore, MD 21287, United States
| | - Kelli Gross
- Department of Surgery, University of Utah, Salt Lake City, Utah 84132, CA
| | | | - James Hotaling
- Department of Surgery, University of Utah, Salt Lake City, Utah 84132, CA
| | - Tung-Chin Hsieh
- Department of Urology, University of California, San Diego, San Diego, CA 92103, United States
| | - Lawrence C Jenkins
- Department of Urology, University of California, Irvine, Irvine, CA 92868, United States
| | - James M Jones
- Section of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766, United States
| | - Aaron Lentz
- Department of Urology, Duke University, Durham, NC 27710, United States
| | - Vaibhav Modgil
- Manchester Andrology Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Daniar Osmonov
- Department of Urology, University Hospital Schleswig-Holstein, Kiel, Germany
| | | | - Ian Pearce
- Manchester Andrology Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Paul Perito
- Perito Urology, Coral Gables, FL 33146, United States
| | | | - Maxime Sempels
- Department of Urology, University Hospital of Liège, Liege, Belgium
| | | | - Jay Simhan
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA 19111, United States
| | | | - J Nicholas Warner
- Department of Urology, Mayo Clinic, Rochester, MN 55905, United States
| | | | - Faysal A Yafi
- Department of Urology, University of California, Irvine, Irvine, CA 92868, United States
| | - Martin S Gross
- Section of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766, United States
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Hossain MJ, Azad AK, Shahid MSB, Shahjahan M, Ferdous J. Prevalence, antibiotic resistance pattern for bacteriuria from patients with urinary tract infections. Health Sci Rep 2024; 7:e2039. [PMID: 38617042 PMCID: PMC11009458 DOI: 10.1002/hsr2.2039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/09/2024] [Accepted: 03/26/2024] [Indexed: 04/16/2024] Open
Abstract
Background and Aims Antibiotic resistance presents a significant global public health challenge, particularly for urinary tract infections (UTIs), and is notably severe in developing countries. Surveillance of the antimicrobial susceptibility patterns of UTI-causing bacteria is crucial for effective treatment selection. This study aimed to analyze these patterns in bacteria isolated from the urine samples of patients at Mughda Medical College Hospital, Dhaka, Bangladesh. Methods A retrospective study (January 2019 to December 2020) at Mugdha Medical College and Hospital, Dhaka, examined clinical and laboratory data from patients with positive urine cultures (≥105 CFU/mL). The study classified patients into four age groups: children (1-<18 years), young adults (18-<33 years), middle-aged adults (33-50 years), and old adults (>50 years). The standard Kirby-Bauer method was used to assess antibiotic sensitivity to 28 common antibiotics. Results Among 243 positive urine cultures in both community- and hospital-acquired UTIs, Escherichia coli was the most common uropathogen (65.84%), followed by Klebsiella spp. (12.34%), Enterococcus spp. (8.23%), and other types of bacteria. Conclusion Old adults are particularly vulnerable to UTIs, with E. coli being the predominant causative agent in the study region. The observed antimicrobial resistance patterns underscore the necessity of judicious antibiotic selection to effectively treat UTIs across different age groups.
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Affiliation(s)
- Md. Jubayer Hossain
- Population Health Studies Division, Center for Health Innovation, ResearchAction, and Learning – Bangladesh (CHIRAL Bangladesh)DhakaBangladesh
| | - Abul Kalam Azad
- Department of MicrobiologyJagannath UniversityDhakaBangladesh
| | - Md. Shahadat Bin Shahid
- Population Health Studies Division, Center for Health Innovation, ResearchAction, and Learning – Bangladesh (CHIRAL Bangladesh)DhakaBangladesh
- Department of MicrobiologyJagannath UniversityDhakaBangladesh
| | - Muhibullah Shahjahan
- Population Health Studies Division, Center for Health Innovation, ResearchAction, and Learning – Bangladesh (CHIRAL Bangladesh)DhakaBangladesh
- Department of MicrobiologyJagannath UniversityDhakaBangladesh
| | - Jannatul Ferdous
- Department of Transfusion MedicineMugdha Medical College and HospitalDhakaBangladesh
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Stylemans D, Vandecruys M, Leunis S, Engelborghs S, Gargioli D, Monbaliu D, Cornelissen V, Van Craenenbroeck AH, De Smet S. Physical Exercise After Solid Organ Transplantation: A Cautionary Tale. Transpl Int 2024; 37:12448. [PMID: 38414660 PMCID: PMC10898592 DOI: 10.3389/ti.2024.12448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/02/2024] [Indexed: 02/29/2024]
Abstract
An increasing body of randomized controlled trials suggests the safety of engaging in moderate to vigorous intensity exercise training following solid organ transplantation. Fueled by emerging sport events designed for transplant recipients and the ever-growing body of research highlighting the diverse health benefits of physical activity, transplant recipients are now increasingly participating in strenuous and occasionally competitive physical endeavors that largely surpass those evaluated in controlled research settings. This viewpoint article adopts a cautionary stance to counterbalance the prevalent one-sided optimistic perspective regarding posttransplant physical activity. While discussing methodological limitations, we explore plausible adverse impacts on the cardiovascular, immunological, and musculoskeletal systems. We also examine the physiological consequences of exercising in the heat, at high altitude, and in areas with high air pollution. Risks associated with employing performance-enhancing strategies and the conceivable psychological implications regarding physical activity as a tribute to the 'gift of life' are discussed. With a deliberate focus on the potential adverse outcomes of strenuous posttransplant physical activity, this viewpoint aims to restore a balanced dialogue on our comprehension of both beneficial and potentially detrimental outcomes of physical activity that ultimately underscores the imperative of well-informed decision-making and tailored exercise regimens in the realm of posttransplant care.
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Affiliation(s)
- Dimitri Stylemans
- Department of Respiratory Diseases, Pulmonary Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Marieke Vandecruys
- Nephrology and Renal Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Sofie Leunis
- Laboratory of Abdominal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Sofie Engelborghs
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Davide Gargioli
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Diethard Monbaliu
- Laboratory of Abdominal Transplantation, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium
- Transplantoux Foundation, Leuven, Belgium
| | - Véronique Cornelissen
- Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Amaryllis H. Van Craenenbroeck
- Nephrology and Renal Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Nephrology and Kidney Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - Stefan De Smet
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
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Neyra JS, Davis RE. The association between climate and emergency department visits for renal and urinary disease in Charlottesville, Virginia. ENVIRONMENTAL RESEARCH 2024; 240:117525. [PMID: 37898224 DOI: 10.1016/j.envres.2023.117525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 10/30/2023]
Abstract
Diseases of the kidney and urinary tract impose a significant portion of the total disease burden, and linkages to high temperature exposure suggest that this burden may increase in the near future. We examined the association between climate and daily emergency department (ED) visits for kidney and urinary disease at the University of Virginia main hospital in Charlottesville, Virginia from 2005 to 2020. Generalized additive models and distributed lag nonlinear models were used to examine these associations over a 21-day lag period. After testing a variety of weather variables from observations taken at the Charlottesville, Albemarle County Airport weather station, 1 p.m. temperature was found to have the strongest association with ED visits for renal and urinary visits while controlling for seasonal and trend factors, air quality, day of the week, and wintry weather. The relative risk of ED visits exhibited a stronger association with high temperatures compared to low temperatures. The heat response was pronounced at short lags (0-1 days) with the relative risk (RR) increasing when 1 p.m. temperatures exceeded 20°C and peaking at 29°C (RR = 1.28). By comparison, low temperatures (≤0°C) exhibited a negative association (RR = 0.80 at -10°C) at short lags (0-1 day), with evidence of a weak RR increase at lags of 2-3 and 9-14 days. These results for ED visitation are consistent with other studies linking high temperatures to acute kidney injury, chronic kidney disease, the development of kidney stones, and other associated illnesses. A better understanding of the impact of temperature extremes in generating or exacerbating existing conditions could assist medical health professionals in the prevention and management of these diseases during extreme weather events.
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Affiliation(s)
- Jesus S Neyra
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA, United States.
| | - Robert E Davis
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA, United States.
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Herrmann A, van Veen FEE, Blok BFM, Watts KL. A Green Prescription: Integrating Environmental Sustainability in Urology Guidelines. Eur Urol Focus 2023; 9:897-899. [PMID: 38036340 DOI: 10.1016/j.euf.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 11/08/2023] [Indexed: 12/02/2023]
Abstract
Against the background of the climate crisis, there is an urgent need to include environmental sustainability recommendations in clinical practice guidelines. We highlight five domains for which suitable recommendations could help in mitigating the environmental impact of urology practice. PATIENT SUMMARY: Climate change is an urgent issue that requires global action. Guidelines published by urological societies should include recommendations for minimizing the impact of urology practice on the environment.
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Affiliation(s)
- Alina Herrmann
- Medical Faculty, Heidelberg University, Heidelberg, Germany
| | | | | | - Kara L Watts
- Department of Urology, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA.
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Lee R, Hass NP, Kollitz A, Wilson M. The Prevalence of Urinary Tract Infections and Antibiotic Prescription Treatments Across Three Countries: A Retrospective Study Using an Electronic Medical Record. Cureus 2023; 15:e46466. [PMID: 37927756 PMCID: PMC10623495 DOI: 10.7759/cureus.46466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction The Clinical Rotation Evaluation and Documentation Organizer (CREDO) is an electronic medical record (EMR) system created by the Edward Via College of Osteopathic Medicine (VCOM). International healthcare providers who partner with VCOM can gain access to CREDO and input their patient data. The objective of this study was to determine the frequency of urinary tract infection (UTI) diagnoses and prescription use over a one-year period in three Latin American countries. Methods Researchers analyzed the frequency of UTI diagnosis with corresponding prescription recommendations over a 12-month period in three Latin American countries (i.e., Dominican Republic, El Salvador, and Honduras) that utilize the CREDO system. For each month between May 2021 and May 2022, the total number of UTI diagnosis codes and prescription codes were summed, graphed, and analyzed. Results In El Salvador, there were 142 UTIs and 126 corresponding prescriptions written for UTIs reported from May 2021 to May 2022 but diagnoses were not consistent each month. Ciprofloxacin was prescribed most frequently at a rate of 43.7% in El Salvador. In Honduras, there were 68 UTIs and 68 corresponding prescriptions written for the UTIs reported from May 2021 until May 2022 with Ciprofloxacin being prescribed most frequently at a rate of 39.7%. Again, diagnosis frequency was not consistent each month. In the Dominican Republic, there were 42 UTIs and 14 corresponding prescriptions written for those UTIs reported, however, data only reflected two months' worth of UTI diagnoses from May 2021 to May 2022. Fosfomycin was prescribed most frequently at a rate of 61.5%. Conclusion: The findings above suggest that there are inconsistent UTI reports throughout the year with a varied use of antibiotics prescriptions for UTIs. The discovered discrepancies in disease reporting, or lack thereof of reporting, and prescription recommendation suggest inconsistent reporting in CREDO. In the future, focused education or revision on CREDO reporting and uniform coding practices could be implemented to reduce these inconsistencies.
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Affiliation(s)
- Rachael Lee
- Medicine, Edward Via College of Osteopathic Medicine, Blacksburg, USA
| | - Nathan P Hass
- Biological Sciences, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Allie Kollitz
- Biochemistry, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Meghan Wilson
- Biology, Edward Via College of Osteopathic Medicine, Blacksburg, USA
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9
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Zhuo H, Ritz B, Warren JL, Liew Z. Season of Conception and Risk of Cerebral Palsy. JAMA Netw Open 2023; 6:e2335164. [PMID: 37738049 PMCID: PMC10517373 DOI: 10.1001/jamanetworkopen.2023.35164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/16/2023] [Indexed: 09/23/2023] Open
Abstract
Importance Cerebral palsy (CP) is the most prevalent neuromotor disability in childhood, but for most cases the etiology remains unexplained. Seasonal variation in the conception of CP may provide clues for their potential etiological risk factors that vary across seasons. Objective To evaluate whether the month or season of conception is associated with CP occurrence. Design, Setting, and Participants This statewide cohort study examined more than 4 million live births that were registered in the California birth records during 2007 to 2015 and were linked to CP diagnostic records (up to year 2021). Statistical analyses were conducted between March 2022 and January 2023. Exposures The month and season of conception were estimated based on the child's date of birth and the length of gestation recorded in the California birth records. Main Outcomes and Measures CP status was ascertained from the diagnostic records obtained from the Department of Developmental Services in California. Poisson regression was used to estimate the relative risk (RR) and 95% CI for CP according to the month or the season of conception, adjusting for maternal- and neighborhood-level factors. Stratified analyses were conducted by child's sex and neighborhood social vulnerability measures, and the mediating role of preterm birth was evaluated. Results Records of 4 468 109 children (51.2% male; maternal age: 28.3% aged 19 to 25 years, 27.5% aged 26 to 30 years; maternal race and ethnicity: 5.6% African American or Black, 13.5% Asian, 49.8% Hispanic or Latinx of any race, and 28.3% non-Hispanic White) and 4697 with CP (55.1% male; maternal age: 28.3% aged 19 to 25 years, 26.0% aged 26 to 30 years; maternal race and ethnicity: 8.3% African American or Black, 8.6% Asian, 54.3% Hispanic or Latinx of any race, and 25.8% non-Hispanic White) were analyzed. Children conceived in winter (January to March) or spring (April to June) were associated with a 9% to 10% increased risk of CP (winter: RR, 1.09 [95% CI, 1.01-1.19]; spring: RR, 1.10 [95% CI, 1.02-1.20]) compared with summer (July to September) conceptions. Analyses for specific months showed similar results with children conceived in January, February, and May being at higher risk of CP. The associations were slightly stronger for mothers who lived in neighborhoods with a high social vulnerability index, but no child sex differences were observed. Only a small portion of the estimated association was mediated through preterm birth. Conclusions and Relevance In this cohort study in California, children conceived in winter and spring had a small increase in CP risk. These findings suggest that seasonally varying environmental factors should be considered in the etiological research of CP.
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Affiliation(s)
- Haoran Zhuo
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles
- Department of Neurology, School of Medicine, University of California, Los Angeles
| | - Joshua L. Warren
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Liao L, Wei X, Liu M, Gao Y, Yin Y, Zhou R. The Association Between Season and Hypertensive Disorders in Pregnancy: a Systematic Review and Meta-analysis. Reprod Sci 2023; 30:787-801. [PMID: 35764856 DOI: 10.1007/s43032-022-01010-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/10/2022] [Indexed: 10/17/2022]
Abstract
There is increasing and inconsistent evidence of a relationship between hypertensive disorders in pregnancy (HDPs) and season of delivery or conception. In this systematic review and meta-analysis, we assessed the association between season and HDPs. The review protocol was registered in PROSPERO (CRD42021285539). Four databases, the Cochrane Library, PubMed, EMBASE, and Web of Science, were searched until September 29th, 2021. Two authors extracted data independently and used the Newcastle-Ottawa quality assessment scale (NOS) to evaluate study quality. A random effects model and the Mantel-Haenszel method were used to calculate pooled Odds ratios (ORs) and 95% confidence intervals (95% CIs). Subgroup analyses and sensitivity analyses were performed to find the source of heterogeneity and Begg's funnel plot and Egger's test were used to check for the risk of publication bias. Finally, twenty articles were included in the systematic review, and 11 articles were included in the meta-analysis. The quantitative analysis of the association between delivery season and HDPs showed that the odds of HDPs was higher in women who delivered in winter than in those who delivered in summer (OR = 1.18, 95% CI 1.02-1.38, P < 0.001) and all other seasons (OR = 1.17, 95% CI 1.03-1.34, P < 0.001). In the qualitative analysis of the association between conception season and HDPs, four of seven studies suggested that women who conceived in summer had a higher risk of HDPs than those who conceived in other seasons. Based on the evidence to date, we found weakly positive relationships between HDPs and summer conception and winter delivery.
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Affiliation(s)
- Lingyun Liao
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Chengdu, Sichuan, China
| | - Xiaohong Wei
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Chengdu, Sichuan, China
| | - Min Liu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Chengdu, Sichuan, China
| | - Yijie Gao
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Chengdu, Sichuan, China
| | - Yangxue Yin
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Chengdu, Sichuan, China
| | - Rong Zhou
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Chengdu, Sichuan, China.
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11
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Rong R, Lin L, Yang Y, Zhao S, Guo R, Ye J, Zhu X, Wen Q, Liu D. Trending prevalence of healthcare-associated infections in a tertiary hospital in China during the COVID-19 pandemic. BMC Infect Dis 2023; 23:41. [PMID: 36670378 PMCID: PMC9857900 DOI: 10.1186/s12879-022-07952-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 12/19/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The purpose of this study was to demonstrate both the four-year prevalence trend of healthcare-associated infections (HAIs) in a large tertiary hospital and the trend regarding the prevalence of HAIs following the outbreak of coronavirus disease 2019 (COVID-19) in order to provide evidence of hospital infection management during the COVID-19 pandemic. METHODS Based on the hospital's electronic nosocomial infection databases related to HAIs, we retrospectively identified the HAI cases to assess the epidemiological characteristics of HAIs from January 1, 2018, to December 31, 2021, in a large tertiary hospital in China. Similarly, the trends of HAIs after the COVID-19 outbreak and the seasonal variation of HAIs were further analyzed. RESULTS The HAI cases (n = 7833) were identified from the inpatients (n = 483,258) during the 4 years. The most frequently occurring underlying cause of HAIs was respiratory tract infections (44.47%), followed by bloodstream infections (11.59%), and urinary tract infections (8.69%). The annual prevalence of HAIs decreased from 2.39% in 2018 to 1.41% in 2021 (P = 0.032), with the overall prevalence of HAIs significantly decreasing since the outbreak of COVID-19 (2.20% in 2018-2019 vs. 1.44% in 2020-2021, P < 0.001). The prevalence of respiratory tract infections decreased most significantly; whereas, overall, the prevalence of HAIs was significantly greater during the winter compared with the rest of the year. CONCLUSIONS Not only did the annual prevalence of HAIs decrease from 2018 to 2021, but it also significantly decreased since the start of the COVID-19 pandemic, particularly respiratory tract infections. These results provide evidence for the need to prevent HAIs, especially during the winter season.
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Affiliation(s)
- Rong Rong
- grid.412615.50000 0004 1803 6239Department of Nosocomial Infection, The First Affiliated Hospital, Sun Yat-sen University, Zhong Shan 2nd Road, No. 58, Guangzhou, 510080 Guangdong China
| | - Lanxi Lin
- grid.412615.50000 0004 1803 6239Department of Nosocomial Infection, The First Affiliated Hospital, Sun Yat-sen University, Zhong Shan 2nd Road, No. 58, Guangzhou, 510080 Guangdong China
| | - Yongjie Yang
- grid.412615.50000 0004 1803 6239Department of Nosocomial Infection, The First Affiliated Hospital, Sun Yat-sen University, Zhong Shan 2nd Road, No. 58, Guangzhou, 510080 Guangdong China
| | - Shumin Zhao
- grid.412615.50000 0004 1803 6239Department of Nosocomial Infection, The First Affiliated Hospital, Sun Yat-sen University, Zhong Shan 2nd Road, No. 58, Guangzhou, 510080 Guangdong China
| | - Ruiling Guo
- grid.412615.50000 0004 1803 6239Department of Nosocomial Infection, The First Affiliated Hospital, Sun Yat-sen University, Zhong Shan 2nd Road, No. 58, Guangzhou, 510080 Guangdong China
| | - Junpeng Ye
- grid.412615.50000 0004 1803 6239Department of Nosocomial Infection, The First Affiliated Hospital, Sun Yat-sen University, Zhong Shan 2nd Road, No. 58, Guangzhou, 510080 Guangdong China
| | - Xinghua Zhu
- grid.412615.50000 0004 1803 6239Department of Nosocomial Infection, The First Affiliated Hospital, Sun Yat-sen University, Zhong Shan 2nd Road, No. 58, Guangzhou, 510080 Guangdong China
| | - Qiong Wen
- grid.412615.50000 0004 1803 6239Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China ,grid.484195.5Key Laboratory of Guangdong Province, Key Laboratory of National Health Commission, Zhong Shan 2nd Road, No. 58, Guangzhou, 510080 Guangdong China
| | - Dayue Liu
- grid.412615.50000 0004 1803 6239Department of Nosocomial Infection, The First Affiliated Hospital, Sun Yat-sen University, Zhong Shan 2nd Road, No. 58, Guangzhou, 510080 Guangdong China
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12
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Alrashid S, Ashoor R, Alruhaimi S, Hamed A, Alzahrani S, Al Sayyari A. Urinary Tract Infection as the Diagnosis for Admission Through the Emergency Department: Its Prevalence, Seasonality, Diagnostic Methods, and Diagnostic Decisions. Cureus 2022; 14:e27808. [PMID: 36106240 PMCID: PMC9452062 DOI: 10.7759/cureus.27808] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2022] [Indexed: 11/18/2022] Open
Abstract
Background Urinary tract infections (UTIs) affect millions of people of all ages around the world. It constitutes one of the most common conditions encountered in emergency departments (EDs). In this study, we aimed to inquire into the prevalence of UTIs as the hospitalization primary diagnosis through the emergency department and to research the seasonal pattern, accuracy of the diagnostic methods used, and final diagnosis. Methods A retrospective cross-sectional study was undertaken that included all patients admitted with a primary diagnosis of UTIs through the ED over a four-month period (January, April, June, and September) in the emergency department of King Abdulaziz Medical City (KAMC) in Riyadh. The prevalence, diagnostics, and outcomes of UTIs were evaluated, and their association with seasonality was assessed after obtaining data from the Hospital Information System BestCare of King Abdullah National Guard Hospital. The variables that have been collected were analyzed using the Statistical Package for Social Sciences software version 26 (IBM Corp., Armonk, NY, USA). Results A total of 315 patients were admitted with a diagnosis of UTI. The prevalence of UTI among patients admitted through the ED was 10.5% with a significantly higher prevalence noted in January (13.3%) than in April (8.5%) or September (8.8%) (Fisher’s exact test: 0.009 and 0.01, respectively). As would be expected, the cohort was made up of elderly individuals with a mean age of 70.6 years, and the male/female ratio was 1:2. UTI symptoms including dysuria, frequency, urgency, rigors, and loin pain were noted in only 41% of cases or less, and urinalysis was the basis of making the diagnosis (87.9% had positive leukocyte esterase (LE) and 90.5% had positive urine WBC/HPF). Furthermore, 4.4% required urgent treatment, and 3.1% required intensive care unit (ICU) admission. Urine culture was negative in 30.8% of the cases (30.8% false positives among those admitted with UTI). The commonest organisms isolated were Escherichia coli (33%), Klebsiella pneumoniae (14.3%), and Pseudomonas aeruginosa (5.1%). The median length of hospital stay (LOS) was 3.5 days, and the Charlson Comorbidity Index (CCI) score was 5.7. The mean hemoglobin (Hb), creatinine, C-reactive protein (CRP), procalcitonin, and lactic acid were 108 gm/L, 131.3 umol/L, 38.3 mg/L, 0.28 ng/mL, and 2.07 mmol/L, respectively. Conclusion This research found that the prevalence of UTI cases as an admission diagnosis through the emergency department was high, despite some cultures being negative or contaminated, thus probably indicating an increase in the rates of false positives. The admission rate is linked to factors such as oxygen saturation and RDW, but this is not entirely understood. In addition, the study also displayed a seasonal pattern linked to the highest number of confirmed cases in January, while the lowest was in April.
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13
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Fortin SP, Swerdel J, Sarnecki M, Doua J, Colasurdo J, Geurtsen J. Performance characteristics of code‐based algorithms to identify urinary tract infections in large United States administrative claims databases. Pharmacoepidemiol Drug Saf 2022; 31:953-962. [DOI: 10.1002/pds.5492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 05/23/2022] [Accepted: 06/06/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Stephen P. Fortin
- Janssen Research & Development Observational Health Data Analytics Raritan New Jersey USA
| | - Joel Swerdel
- Janssen Research & Development Observational Health Data Analytics Raritan New Jersey USA
| | - Michal Sarnecki
- Janssen Vaccines Branch of Cilag GmbH International Bern Switzerland
| | - Joachim Doua
- Janssen Research & Development Infectious Diseases and Vaccines Beerse Belgium
| | - Jamie Colasurdo
- Janssen Research & Development, Epidemiology Raritan New Jersey USA
| | - Jeroen Geurtsen
- Janssen Vaccines & Prevention Bacterial Vaccines Research & Early Development Leiden Netherlands
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14
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Jasperse N, Hernandez-Dominguez O, Deyell JS, Prasad JP, Yuan C, Tomy M, Kuza CM, Grigorian A, Nahmias J. A single institution pre-/post-comparison after introduction of an external urinary collection device for female medical patients. J Infect Prev 2022; 23:149-154. [PMID: 37256156 PMCID: PMC10226054 DOI: 10.1177/17571774211060423] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 08/31/2021] [Indexed: 09/20/2023] Open
Abstract
Background External urinary collection devices (EUCDs) may serve as an alternative to indwelling urinary catheters (IUCs) and decrease the rate of catheter associated urinary tract infections (CAUTIs). PureWick® is a novel female EUCD; however, no study has definitively proven benefit regarding reduction of CAUTIs. Aim We sought to compare the CAUTI rate and IUC days before and after availability of the PureWick® EUCD at a single institution. We provide a descriptive analysis of female medical patients receiving an EUCD. Methods A retrospective review of adult female patients admitted to a single institution on a medical service who received an IUC and/or an EUCD was performed. Patients who received an IUC in the 3 months before EUCD availability (PRE) were compared to patients who received an IUC and/or EUCD in the 12 months after (POST). Results Out of 848 female patients, 292 received an EUCD in the POST cohort and overall, 656 received an IUC (259 (100%) PRE vs. 397 (67.4%) POST). Compared to the PRE cohort, the POST cohort had a higher number of IUC days (median, 3 vs 2 days, p = 0.001) and a higher rate of CAUTI (infections per 1000 catheter days, 9.3 vs 2.3, p = 0.001). The rate of UTI associated with EUCD use was 9.8 infections per 1000 device days. Discussion While EUCDs might appear to be a promising alternative to IUCs for female patients, this single center pre-/post-analysis found that both the number of IUC days and the CAUTI rate increased after introduction of a female EUCD.
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Affiliation(s)
- Nathan Jasperse
- Department of Emergency Medicine, Los Angeles County Harbor-UCLA Medical
Center, Torrance, CA, USA
| | | | - Jacob S Deyell
- Department of Surgery, UC Irvine Healthcare, Orange, CA, USA
| | - Janani P Prasad
- Department of Surgery, UC Irvine Healthcare, Orange, CA, USA
| | - Charlene Yuan
- Department of Surgery, UC Irvine Healthcare, Orange, CA, USA
| | - Meril Tomy
- Department of Surgery, UC Irvine Healthcare, Orange, CA, USA
| | - Catherine M Kuza
- Department of Anesthesia, University of Southern California, Los Angeles, CA, USA
| | - Areg Grigorian
- Department of Surgery, UC Irvine Healthcare, Orange, CA, USA
| | - Jeffry Nahmias
- Department of Surgery, UC Irvine Healthcare, Orange, CA, USA
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15
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Elser H, Rowland ST, Tartof SY, Parks RM, Bruxvoort K, Morello-Frosch R, Robinson SC, Pressman AR, Wei RX, Casey JA. Ambient temperature and risk of urinary tract infection in California: A time-stratified case-crossover study using electronic health records. ENVIRONMENT INTERNATIONAL 2022; 165:107303. [PMID: 35635960 PMCID: PMC9233468 DOI: 10.1016/j.envint.2022.107303] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/05/2022] [Accepted: 05/14/2022] [Indexed: 05/11/2023]
Abstract
BACKGROUND In the United States (US), urinary tract infections (UTI) lead to more than 10 million office visits each year. Temperature and season are potentially important risk factors for UTI, particularly in the context of climate change. METHODS We examined the relationship between ambient temperature and outpatient UTI diagnoses among patients followed from 2015 to 2017 in two California healthcare systems: Kaiser Permanente Southern California (KPSC) and Sutter Health in Northern California. We identified UTI diagnoses in adult patients using diagnostic codes and laboratory records from electronic health records. We abstracted patient age, sex, season of diagnosis, and linked community-level Index of Concentration at the Extremes (ICE-I, a measure of wealth and poverty concentration) based on residential address. Daily county-level average ambient temperature was assembled from the Parameter-elevation Regressions on Independent Slopes Model (PRISM). We implemented distributed lag nonlinear models (DLNM) to assess the association between UTI and lagged daily temperatures. Main analyses were confined to women. In secondary analyses, we stratified by season, healthcare system, and community-level ICE-I. RESULTS We observed 787,186 UTI cases (89% among women). We observed a threshold association between ambient temperature and UTI among women: an increase in daily temperature from the 5th percentile (6.0 ˚C) to the mean (16.2 ˚C) was associated with a 3.2% (95% CI: 2.4, 3.9%) increase in same-day UTI diagnosis rate, whereas an increase from the mean to 95th percentile was associated with no change in UTI risk (0.0%, 95% CI: -0.7, 0.6%). In secondary analyses, we observed the clearest monotonic increase in the rate of UTI diagnosis with higher temperatures in the fall. Associations did not differ meaningfully by healthcare system or community-level ICE-I. Results were robust to alternate model specifications. DISCUSSION Increasing temperature was related to higher rate of outpatient UTI, particularly in the shoulder seasons (spring, autumn).
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Affiliation(s)
- Holly Elser
- Department of Neurology, Hospital of the University of Pennsylvania, United States
| | - Sebastian T Rowland
- Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, United States
| | - Sara Y Tartof
- Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States; Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States
| | - Robbie M Parks
- Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, United States; Earth Institute, Columbia University, New York, NY, United States
| | - Katia Bruxvoort
- Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States; Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Rachel Morello-Frosch
- Department of Environment, Science, Policy, and Managmeent, UC Berkeley, Berkeley, CA, United States; School of Public Helath, UC Berkeley, Berkeley, CA, United States
| | - Sarah C Robinson
- Sutter Health Center for Health Systems Research, Walnut Creek, CA, United States
| | - Alice R Pressman
- Sutter Health Center for Health Systems Research, Walnut Creek, CA, United States; Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, United States
| | - Rong X Wei
- Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States
| | - Joan A Casey
- Environmental Health Sciences, Columbia Mailman School of Public Health, 722 West 168th Street, Room 1206, New York, NY 212-304-5502, United States.
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16
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Wen B, Xu R, Wu Y, Coêlho MDSZS, Saldiva PHN, Guo Y, Li S. Association between ambient temperature and hospitalization for renal diseases in Brazil during 2000-2015: A nationwide case-crossover study. LANCET REGIONAL HEALTH. AMERICAS 2022; 6:100101. [PMID: 36777886 PMCID: PMC9904055 DOI: 10.1016/j.lana.2021.100101] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/23/2021] [Accepted: 09/27/2021] [Indexed: 12/24/2022]
Abstract
Background Climate change is increasing the risks of injuries, diseases, and deaths globally. However, the association between ambient temperature and renal diseases has not been fully characterized. This study aimed to quantify the risk and attributable burden for hospitalizations of renal diseases related to ambient temperature. Methods Daily hospital admission data from 1816 cities in Brazil were collected during 2000 and 2015. A time-stratified case-crossover design was applied to evaluate the association between temperature and renal diseases. Relative risks (RRs), attributable fractions (AFs), and their confidence intervals (CIs) were calculated to estimate the associations and attributable burden. Findings A total of 2,726,886 hospitalizations for renal diseases were recorded during the study period. For every 1°C increase in daily mean temperature, the estimated risk of hospitalization for renal diseases over lag 0-7 days increased by 0·9% (RR = 1·009, 95% CI: 1·008-1·010) at the national level. The associations between temperature and renal diseases were largest at lag 0 days but remained for lag 1-2 days. The risk was more prominent in females, children aged 0-4 years, and the elderly ≥ 80 years. 7·4% (95% CI: 5·2-9·6%) of hospitalizations for renal diseases could be attributable to the increase of temperature, equating to 202,093 (95% CI: 141,554-260,594) cases. Interpretation This nationwide study provides robust evidence that more policies should be developed to prevent heat-related hospitalizations and mitigate climate change. Funding China Scholarship Council, and the Australian National Health and Medical Research Council.
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Affiliation(s)
- Bo Wen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yao Wu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | | | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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