Outcomes and complications of hospitalised patients with HIV-TB co-infection / Alicia Inés Hidrón Botero  

Público ISBD Título : Outcomes and complications of hospitalised patients with HIV-TB co-infection Tipo de documento : documento electrónico Autores : Alicia Inés Hidrón Botero, Fecha de publicación : 2021 Títulos uniformes : Tropical Medicine & International Health Idioma : Inglés (eng) Palabras clave : co-infection HIV/TB  drug toxicity  latent tuberculosis  mortality  readmission Resumen : Background: Tuberculosis is one of the most common causes of hospitalisation in patients with HIV. Despite this, hospital outcomes of patients with this co-infection have rarely been described since antiretroviral therapy became widely available. Methods: Prospective cohort study of HIV-infected adult patients hospitalised with TB in six referral hospitals in Medellin, Colombia, from August 2014 to July 2015. Results: Among 128 HIV-infected patients hospitalised with tuberculosis, the mean age was 38.4 years; 79.7% were men. HIV was diagnosed on admission in 28.9% of patients. The median CD4 + T-cell count was 125 (±158 SD) cells/µL. Only 47.3% of patients with a known diagnosis of HIV upon admission were on antiretroviral therapy, and only 11.1% had a tuberculin skin test in the previous year. Drug toxicity due to tuberculosis medications occurred in 11.7% of patients. Mean length of stay was 23.2 days, and 10.7% of patients were readmitted. Mortality was 5.5%. Conclusions: Hospital mortality attributable to tuberculosis in patients with HIV is low in reference hospitals in Colombia. Cases of tuberculosis in HIV-infected patients occur mainly in patients with advanced HIV, or not on antiretroviral therapy, despite a known diagnosis of HIV. Only one of every 10 patients in this cohort had active screening for latent tuberculosis, possibly reflecting missed treatment opportunities. Mención de responsabilidad : Carlos Andrés Agudelo, María Fernanda Álvarez, Alicia Hidrón Juan Pablo Villa, Lina María Echeverri‐Toro, Adriana Ocampo Glenys Patricia Porras, Iván Mauricio Trompa, Laura Restrepo, Alejandro Eusse, Carlos Andrés Restrepo Referencia : Trop Med Int Health. 2021 Jan;26(1):82-88. DOI (Digital Object Identifier) : 10.1111/tmi.13509 PMID : 33155342 En línea : https://onlinelibrary.wiley.com/doi/10.1111/tmi.13509 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5754 Outcomes and complications of hospitalised patients with HIV-TB co-infection [documento electrónico] / Alicia Inés Hidrón Botero,  . - 2021. Obra : Tropical Medicine & International Health Idioma : Inglés (eng) Palabras clave : co-infection HIV/TB  drug toxicity  latent tuberculosis  mortality  readmission Resumen : Background: Tuberculosis is one of the most common causes of hospitalisation in patients with HIV. Despite this, hospital outcomes of patients with this co-infection have rarely been described since antiretroviral therapy became widely available. Methods: Prospective cohort study of HIV-infected adult patients hospitalised with TB in six referral hospitals in Medellin, Colombia, from August 2014 to July 2015. Results: Among 128 HIV-infected patients hospitalised with tuberculosis, the mean age was 38.4 years; 79.7% were men. HIV was diagnosed on admission in 28.9% of patients. The median CD4 + T-cell count was 125 (±158 SD) cells/µL. Only 47.3% of patients with a known diagnosis of HIV upon admission were on antiretroviral therapy, and only 11.1% had a tuberculin skin test in the previous year. Drug toxicity due to tuberculosis medications occurred in 11.7% of patients. Mean length of stay was 23.2 days, and 10.7% of patients were readmitted. Mortality was 5.5%. Conclusions: Hospital mortality attributable to tuberculosis in patients with HIV is low in reference hospitals in Colombia. Cases of tuberculosis in HIV-infected patients occur mainly in patients with advanced HIV, or not on antiretroviral therapy, despite a known diagnosis of HIV. Only one of every 10 patients in this cohort had active screening for latent tuberculosis, possibly reflecting missed treatment opportunities. Mención de responsabilidad : Carlos Andrés Agudelo, María Fernanda Álvarez, Alicia Hidrón Juan Pablo Villa, Lina María Echeverri‐Toro, Adriana Ocampo Glenys Patricia Porras, Iván Mauricio Trompa, Laura Restrepo, Alejandro Eusse, Carlos Andrés Restrepo Referencia : Trop Med Int Health. 2021 Jan;26(1):82-88. DOI (Digital Object Identifier) : 10.1111/tmi.13509 PMID : 33155342 En línea : https://onlinelibrary.wiley.com/doi/10.1111/tmi.13509 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5754

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Antimicrobial agent prescription: a prospective cohort study in patients with sepsis and septic shock / Fabián Alberto Jaimes Barragán  

Público ISBD Título : Antimicrobial agent prescription: a prospective cohort study in patients with sepsis and septic shock Tipo de documento : documento electrónico Autores : Fabián Alberto Jaimes Barragán, Fecha de publicación : 2019 Títulos uniformes : Tropical Medicine & International Health Idioma : Inglés (eng) Palabras clave : Antibacterial agents  hospital mortality  length of stay  shock Resumen : Objective: To assess the true association between appropriate prescription of antibiotics and prognosis in patients with sepsis, a key issue in health care and quality improvement strategies. Methods: Prospective cohort study in three university hospitals to determine whether the empirical prescription of antibiotics was adequate or inadequate, and to compare hospital death rates and length of stay according to different classifications of antibiotics prescription. Logistic regression models for risk estimation were fitted. Results: A total of 705 patients with severe sepsis were included. No differences were found in positive-culture patients (n = 545) regarding the risk of death with insufficient spectrum antibiotics, compared to patients who received adequate spectrum antibiotics (OR = 0.90; 95% CI = 0.55-1.48). Delay in initiating antibiotics was not associated with the risk of death in patients with adequate spectrum of antibiotics, either with positive (OR = 1.04; 95% CI = 0.99-1.08) or negative cultures (OR = 0.98; 95% CI = 0.92-1.04). There were no differences in the length of hospital stay, according to the antibiotic prescription (median 11 days, IQR = 7-18 days for the whole cohort). Conclusions: No associations were found between inadequate antibiotic prescription or delay to initiate therapy and mortality or length of stay Mención de responsabilidad : Pablo Castaño, Maribel Plaza, Fernando Molina, Carolina Hincapié, Wilmar Maya, Juan Cataño, Javier González, Alba León, Fabián Jaimes Referencia : Trop Med Int Health. 2019 Feb;24(2):175-184 DOI (Digital Object Identifier) : 10.1111/tmi.13186 PMID : 30489005 En línea : https://onlinelibrary.wiley.com/doi/abs/10.1111/tmi.13186 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4266 Antimicrobial agent prescription: a prospective cohort study in patients with sepsis and septic shock [documento electrónico] / Fabián Alberto Jaimes Barragán,  . - 2019. Obra : Tropical Medicine & International Health Idioma : Inglés (eng) Palabras clave : Antibacterial agents  hospital mortality  length of stay  shock Resumen : Objective: To assess the true association between appropriate prescription of antibiotics and prognosis in patients with sepsis, a key issue in health care and quality improvement strategies. Methods: Prospective cohort study in three university hospitals to determine whether the empirical prescription of antibiotics was adequate or inadequate, and to compare hospital death rates and length of stay according to different classifications of antibiotics prescription. Logistic regression models for risk estimation were fitted. Results: A total of 705 patients with severe sepsis were included. No differences were found in positive-culture patients (n = 545) regarding the risk of death with insufficient spectrum antibiotics, compared to patients who received adequate spectrum antibiotics (OR = 0.90; 95% CI = 0.55-1.48). Delay in initiating antibiotics was not associated with the risk of death in patients with adequate spectrum of antibiotics, either with positive (OR = 1.04; 95% CI = 0.99-1.08) or negative cultures (OR = 0.98; 95% CI = 0.92-1.04). There were no differences in the length of hospital stay, according to the antibiotic prescription (median 11 days, IQR = 7-18 days for the whole cohort). Conclusions: No associations were found between inadequate antibiotic prescription or delay to initiate therapy and mortality or length of stay Mención de responsabilidad : Pablo Castaño, Maribel Plaza, Fernando Molina, Carolina Hincapié, Wilmar Maya, Juan Cataño, Javier González, Alba León, Fabián Jaimes Referencia : Trop Med Int Health. 2019 Feb;24(2):175-184 DOI (Digital Object Identifier) : 10.1111/tmi.13186 PMID : 30489005 En línea : https://onlinelibrary.wiley.com/doi/abs/10.1111/tmi.13186 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4266

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