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A 6-month prospective study of hospital-acquired bacteremia in Copenhagen county.

https://arctichealth.org/en/permalink/ahliterature34967
Source
Scand J Infect Dis. 1996;28(6):601-8
Publication Type
Article
Date
1996
Author
A G Jensen
A. Kirstein
I. Jensen
J. Scheibel
F. Espersen
Author Affiliation
Department of Clinical Microbiology, Herlev University Hospital, Denmark.
Source
Scand J Infect Dis. 1996;28(6):601-8
Date
1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Bacteremia - epidemiology - etiology
Child
Child, Preschool
Community-Acquired Infections - epidemiology
Comparative Study
Cross Infection - epidemiology - etiology
Denmark - epidemiology
Drug Resistance, Microbial
Female
Humans
Incidence
Infant
Male
Microbial Sensitivity Tests
Middle Aged
Prospective Studies
Abstract
During a 6-month period, 892 positive blood cultures were detected in the Copenhagen County hospitals. 302 (34%) were regarded as contaminations, and of the remaining cases 419 (71%) were community-acquired and 171 (29%) hospital-acquired, giving incidence rates of 6.8/1,000 admissions and 2.8/1,000 admissions, respectively. Both frequency and rate of hospital-acquired bacteremia were lower compared to most other studies. E. coli was more commonly found in community-acquired infections, while coagulase-negative staphylococci were the organisms most often considered as a contaminant. The main causative organisms in hospital-acquired infections were S. aureus (n = 37) and E. coli (n = 34). The proportion of polymicrobial bacteremias in this study was lower compared to most other studies (8%). E. coli from hospital-acquired infections were resistant to ampicillin in 42% of cases, but other Enterobacteriaceae showed higher percentage of resistance to beta-lactam antibiotics. S. aureus was penicillin-resistant in 92% of cases, but no methicillin-resistant strains were isolated. The frequency of antibiotic resistance was low compared to reports from other countries. A total of 136 hospital-acquired cases were followed prospectively. 61% of the patients were male and 46% were > or = 60 years of age. Most patients had predisposing diseases, 90% had foreign body and/or recent surgery performed, and 74 (54%) had an intraveneous catheter. The portal of entry was known in 132 (97%) of the cases, the most common being the urinary tract (42%), followed by an intravenous catheter (30%). The prevalence of urinary tract catheters gave an increased number of cases with E. coli bacteremia. The mortality was 16%.
PubMed ID
9060064 View in PubMed
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Bacteremic Staphylococcus aureus spondylitis.

https://arctichealth.org/en/permalink/ahliterature33987
Source
Arch Intern Med. 1998 Mar 9;158(5):509-17
Publication Type
Article
Date
Mar-9-1998
Author
A G Jensen
F. Espersen
P. Skinhøj
N. Frimodt-Møller
Author Affiliation
Sector for Microbiology, Statens Serum Institut, Copenhagen, Denmark.
Source
Arch Intern Med. 1998 Mar 9;158(5):509-17
Date
Mar-9-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Child
Denmark
Diagnosis, Differential
Female
Humans
Immobilization
Male
Middle Aged
Registries
Spondylitis - diagnosis - drug therapy - microbiology - radionuclide imaging
Staphylococcal Infections - diagnosis - drug therapy - microbiology - radionuclide imaging
Treatment Outcome
Abstract
BACKGROUND: The incidence of hematogenous Staphylococcus aureus osteomyelitis of the vertebral column is rapidly increasing and few studies dealing with the diagnosis, treatment, and outcome of this severe disease are available. METHODS: Based on a nationwide registration, the clinical and bacteriological data were reviewed from 133 cases with a positive blood culture for S aureus and symptoms of vertebral osteomyelitis in Denmark for the period 1980 to 1990. RESULTS: The 133 cases of vertebral S aureus osteomyelitis reviewed were mainly community-acquired infections (82%) in older patients (median age, 65 years) and often occurred with underlying diseases. Both symptoms and laboratory values were relatively unspecific. Bone scan methods proved to be more optimal for diagnosis of vertebral S aureus osteomyelitis in the early stages compared with conventional radiography that proved a lack of consistency in the formative stages. The infection was mostly (70%) localized in the lower part of the column. The recurrence rate and rate of therapeutic failure depended on the duration and dosage of penicillinase-stable penicillins, respectively. Patients treated with fusidic acid in addition to penicillinase-stable penicillins had a significantly lower recurrence rate. Based on these findings, we recommend treatment with penicillinase-stable penicillins and fusidic acid for a total of 8 weeks, with a daily dosage of penicillinase-stable penicillins higher than 4 g. CONCLUSIONS: The diagnosis of vertebral S aureus osteomyelitis based on clinical findings is difficult to ascertain. Bone scans are necessary because radiographic methods do not detect disease as early. Treatment with penicillinase-stable penicillins, at least 4 g/d for at least 8 weeks, is recommended.
PubMed ID
9508229 View in PubMed
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[Diabetic examination in general practice. Screening of a practice population and a study of occurrence]

https://arctichealth.org/en/permalink/ahliterature48650
Source
Ugeskr Laeger. 1991 Aug 19;153(34):2349-52
Publication Type
Article
Date
Aug-19-1991
Author
E. Busch
A G Jensen
R. Brendel
S. Fester
Author Affiliation
Laegehuset Augustenborg.
Source
Ugeskr Laeger. 1991 Aug 19;153(34):2349-52
Date
Aug-19-1991
Language
Danish
Publication Type
Article
Keywords
Adult
Aged
Blood Glucose - analysis
Denmark - epidemiology
Diabetes Mellitus - blood - diagnosis - epidemiology
English Abstract
Family Practice
Female
Humans
Male
Mass Screening - methods
Middle Aged
Prevalence
Research Support, Non-U.S. Gov't
Abstract
In a general practice, a screening examination for diabetes mellitus by measuring blood glucose in capillary blood was performed. A total of 2,843 persons aged 20-80 years were invited, 1,973 (69.4%) participated. At screening, 66 possible cases (BG greater than or equal to 8 mmol/l) were found. Among these, 16 diabetics were found, nine of whom had predisposing conditions. The prevalence of diabetes mellitus in the examined and known population of the practice was found to be 2.5% and calculated to be 2.2% in the total population of the practice. It was demonstrated that an investigation of this kind can be carried out but felt laborious and interfered with the daily work. Nevertheless, hitherto unknown diabetics were detected and instructed. A method of finding diabetics in general practice is thus described. The method is probably effective, as the prevalence of diabetes mellitus reached the expected, when the known and newly found diabetics were added.
PubMed ID
1897046 View in PubMed
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[General practice--lacking recognition. Interview by Kirsten Bjørnsson].

https://arctichealth.org/en/permalink/ahliterature221237
Source
Sygeplejersken. 1993 Apr 21;93(16):17
Publication Type
Article
Date
Apr-21-1993
Author
A G Jensen
Source
Sygeplejersken. 1993 Apr 21;93(16):17
Date
Apr-21-1993
Language
Danish
Publication Type
Article
Keywords
Consultants
Denmark
Family Practice - manpower
Health promotion
Humans
Nurse practitioners
PubMed ID
8211743 View in PubMed
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Increased risk of arterial thromboembolic events after Staphylococcus aureus bacteremia: A matched cohort study.

https://arctichealth.org/en/permalink/ahliterature271157
Source
J Infect. 2015 Aug;71(2):167-78
Publication Type
Article
Date
Aug-2015
Author
N. Mejer
N. Gotland
M L Uhre
H. Westh
H C Schønheyder
A. Petersen
A G Jensen
A R Larsen
R. Skov
T. Benfield
Source
J Infect. 2015 Aug;71(2):167-78
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Bacteremia - complications
Cohort Studies
Denmark - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - epidemiology
Risk assessment
Staphylococcal Infections - complications
Stroke - epidemiology
Thromboembolism - epidemiology
Time Factors
Young Adult
Abstract
An association between infection and arterial thromboembolic events (ATE) has been suggested. Here we examined the risk of myocardial infarction (MI), stroke and other ATE after Staphylococcus aureus bacteremia (SAB).
Danish register-based nation-wide observational cohort study between 1995 and 2008 with matched control subjects from the general population.
Within a year, 278 of 15,669 SAB patients and 2570 of 156,690 controls developed MI, stroke or another ATE. The incidence rates among SAB patients were highest within the first 30 days and decreased over a year. The adjusted relative risk of MI, stroke and other ATE during the first 30 days after SAB in patients compared to controls were 2.2 (95% CI: 1.6-3.1), 5.5 (95% CI: 3.8-8.3) and 15.5 (95% CI: 6.9-35), respectively. Compared to controls, the increased adjusted relative risk persisted for 30 days for MI, 180 days for stroke and one year for other ATE. Increasing age, hypertension, atrial flutter/fibrillation, prior ATE and endocarditis in SAB patients were associated with an increased risk of ATE.
SAB was associated with a short-term increased risk of ATE that persisted longer dependent on type of event. Studies are warranted to investigate treatment strategies to diminish ATE after SAB.
PubMed ID
25936743 View in PubMed
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Increased risk of venous thromboembolism within the first year after Staphylococcus aureus bacteraemia: a nationwide observational matched cohort study.

https://arctichealth.org/en/permalink/ahliterature106738
Source
J Intern Med. 2014 Apr;275(4):387-97
Publication Type
Article
Date
Apr-2014
Author
N. Mejer
H. Westh
H C Schønheyder
A G Jensen
A R Larsen
R. Skov
T. Benfield
Author Affiliation
Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.
Source
J Intern Med. 2014 Apr;275(4):387-97
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Bacteremia - complications - diagnosis - epidemiology - microbiology
Case-Control Studies
Cohort Studies
Denmark - epidemiology
Female
Humans
Incidence
Inpatients - statistics & numerical data
Male
Middle Aged
Registries
Risk factors
Staphylococcal Infections - complications - diagnosis - epidemiology
Staphylococcus aureus - isolation & purification - pathogenicity
Substance Abuse, Intravenous - epidemiology
Venous Thromboembolism - diagnosis - epidemiology - microbiology - prevention & control
Abstract
Recent evidence suggests that there is an association between infection and venous thromboembolism (VTE). Here, we examined the risk of VTE after Staphylococcus aureus bacteraemia (SAB) compared to the risk in control subjects.
Register-based nationwide observational cohort study of hospitalized patients and matched control subjects from the general population in Denmark between 1995 and 2008.
Amongst 15 669 SAB cases and 156 690 controls, 182 and 511, respectively, experienced VTE within 1 year. The overall incidence rate (IR) of VTE amongst cases was highest within the first 30 days [IR of deep vein thrombosis (DVT), 39.3 (95% confidence interval (CI) 28.9-53.4)/1000 person-years (PYs); IR of pulmonary embolism (PE), 16.3 (95% CI 10.1-26.2)/1000 PYs]. IRs of DVT were particularly increased amongst cases with a previous diagnosis of VTE, community-acquired infection, a history of injection drug use and in younger age groups. The overall hazard ratio of VTE for cases compared to controls declined from 15.6 (95% CI 10.3-23.5) in the first 30 days after SAB to 4.5 (95% CI 3.2-6.2) from 181 to 365 days after infection. The increased risk of VTE amongst SAB patients persisted after excluding cases with identified VTE risk factors.
There was a particularly high risk of VTE during the first month following an episode of SAB. The risk declined over time, but remained at a threefold increased level compared to control subjects, suggesting that there are shared risk factors for SAB and VTE. Patients with SAB and well-documented risk factors for VTE may benefit from thromboprophylaxis.
PubMed ID
24118528 View in PubMed
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Increasing frequency of vertebral osteomyelitis following Staphylococcus aureus bacteraemia in Denmark 1980-1990.

https://arctichealth.org/en/permalink/ahliterature34334
Source
J Infect. 1997 Mar;34(2):113-8
Publication Type
Article
Date
Mar-1997
Author
A G Jensen
F. Espersen
P. Skinhøj
V T Rosdahl
N. Frimodt-Møller
Author Affiliation
Sector for Clinical Microbiology, Statens Serum Institut, Copenhagen, Denmark.
Source
J Infect. 1997 Mar;34(2):113-8
Date
Mar-1997
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Bacteremia - complications
Child
Child, Preschool
Comparative Study
Denmark - epidemiology
Female
Humans
Infant
Male
Middle Aged
Osteomyelitis - epidemiology - etiology
Research Support, Non-U.S. Gov't
Spinal Diseases - epidemiology - etiology
Spine - microbiology
Staphylococcal Infections - complications
Time Factors
Abstract
From 1980 to 1990, 309 cases of haematogenous osteomyelitis were identified in Denmark. Haematogenous osteomyelitis of the vertebral column increased significantly (P 50 years of age with community-acquired infection. Vertebral osteomyelitis differed significantly from osteomyelitis of other bones in accordance to age distribution (median 66 vs. 16 years), male/female ratio (75/71 vs. 105/ 58) and patients with diabetes (13% vs. 6%). We found a higher risk of haematogenous osteomyelitis in patients > 50 years of age and among patients with community-acquired infection. The highest incidence (5%) of vertebral osteomyelitis in Staphylococcus aureus bacteraemia in this age group was found in cases without an identified portal of entry. The highest incidence (34%) of osteomyelitis of other bones was found in community-acquired cases in the age group 1-20 years and without an identified portal of entry. The present study discusses reasons for the continued increase of vertebral osteomyelitis among adults and describes incidence rates and major risk factors for developing haematogenous osteomyelitis among patients with S. aureus bacteraemia. We suggest that the localization of haematogenous S. aureus osteomyelitis is connected with the presence of red bone marrow.
PubMed ID
9138133 View in PubMed
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A nationwide study of comorbidity and risk of reinfection after Staphylococcus aureus bacteraemia.

https://arctichealth.org/en/permalink/ahliterature113964
Source
J Infect. 2013 Sep;67(3):199-205
Publication Type
Article
Date
Sep-2013
Author
L. Wiese
N. Mejer
H C Schønheyder
H. Westh
A G Jensen
A R Larsen
R. Skov
T. Benfield
Author Affiliation
Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark. wiese@dadlnet.dk
Source
J Infect. 2013 Sep;67(3):199-205
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Bacteremia - epidemiology
Child
Child, Preschool
Cohort Studies
Comorbidity
Denmark - epidemiology
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Risk factors
Staphylococcal Infections - epidemiology
Staphylococcus aureus - isolation & purification
Abstract
Data on risk factors and rates of reinfection associated with Staphylococcus aureus bacteraemia (SAB) are sparse.
We conducted a nationwide cohort study of cases of SAB diagnosed between 1995 and 2008. Reinfection was defined as an episode of SAB more than 90 days after the initial episode of SAB. Comorbidity was evaluated by the Charlson Comorbidity Index (CCI). Cox proportional hazards modelling was used to estimate hazard rates (HR).
Of 10,891 eligible patients, 774 (7.1%) experienced reinfection a median of 458 days (range 90-5021 days) after their primary SAB episode corresponding to a reinfection rate of 1459 (95% confidence interval (CI): 1357-1562) per 100,000 personyears. In multivariate analysis, sex, origin, a vascular or peritoneal device, endocarditis and comorbidity were associated with reinfection. The association was more than two-fold higher among patients in dialysis and for patients with severe comorbidity (CCI = 2). HIV infection (Hazard ratio (HR) 6.18, 95% CI: 4.17-9.16), renal disease (HR 3.92, 95% CI: 3.22-4.78), diabetes with complications (HR 2.11, 95% CI: 1.69-2.62), diabetes without complications (HR 1.61, 95% CI: 1.34-1.93), mild (HR: 1.94, 95% CI: 1.36-2.76) and severe liver disease (HR 2.08, 95% CI: 1.08-4.03), peptic ulcer (HR 1.33, 95% CI: 1.03-1.72), and paraplegia (HR 2.15, 95% CI: 1.02-4.54) were each associated with an increased risk of reinfection.
Patients with previous SAB have a 60-fold higher risk of SAB compared to the general population. Patients with HIV infection, renal disease, diabetes, liver disease, peptic ulcer and paraplegia had the highest rates of reinfection.
PubMed ID
23664855 View in PubMed
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Quality-of-care initiative in patients treated surgically for perforated peptic ulcer.

https://arctichealth.org/en/permalink/ahliterature117547
Source
Br J Surg. 2013 Mar;100(4):543-52
Publication Type
Article
Date
Mar-2013
Author
M H Møller
H J Larsson
S. Rosenstock
H. Jørgensen
S P Johnsen
A H Madsen
S. Adamsen
A G Jensen
E. Zimmermann-Nielsen
R W Thomsen
Author Affiliation
Department of Anaesthesiology and Intensive Care Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. mortenhylander@gmail.com
Source
Br J Surg. 2013 Mar;100(4):543-52
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Denmark
Duodenal Ulcer - surgery
Female
Humans
Male
Middle Aged
Peptic Ulcer Perforation - surgery
Prospective Studies
Quality of Health Care
Recurrence
Reoperation - statistics & numerical data
Stomach Ulcer - surgery
Abstract
Mortality and morbidity are considerable after treatment for perforated peptic ulcer (PPU). Since 2003, a Danish nationwide quality-of-care (QOC) improvement initiative has focused on reducing preoperative delay, and improving perioperative monitoring and care for patients with PPU. The present study reports the results of this initiative.
This was a nationwide cohort study based on prospectively collected data, involving all hospitals caring for patients with PPU in Denmark. Details of patients treated surgically for PPU between September 2004 and August 2011 were reported to the Danish Clinical Register of Emergency Surgery. Changes in baseline patient characteristics and in seven QOC indicators are presented, including relative risks (RRs) for achievement of the indicators.
The study included 2989 patients. An increasing number fulfilled the following four QOC indicators in 2010-2011 compared with the first 2 years of monitoring: preoperative delay no more than 6 h (59·0 versus 54·0 per cent; P = 0·030), daily monitoring of bodyweight (48·0 versus 29·0 per cent; P
PubMed ID
23288621 View in PubMed
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Risk factors for hospital-acquired Staphylococcus aureus bacteremia.

https://arctichealth.org/en/permalink/ahliterature33270
Source
Arch Intern Med. 1999 Jul 12;159(13):1437-44
Publication Type
Article
Date
Jul-12-1999
Author
A G Jensen
C H Wachmann
K B Poulsen
F. Espersen
J. Scheibel
P. Skinhøj
N. Frimodt-Møller
Author Affiliation
Sector for Microbiology, Statens Serum Institut, Copenhagen, Denmark.
Source
Arch Intern Med. 1999 Jul 12;159(13):1437-44
Date
Jul-12-1999
Language
English
Publication Type
Article
Keywords
Adolescent
Adrenal Cortex Hormones - adverse effects
Adult
Age Factors
Aged
Aged, 80 and over
Anemia - complications
Anti-Bacterial Agents - adverse effects
Bacteremia - epidemiology - etiology - microbiology
Blood Transfusion - adverse effects
Case-Control Studies
Catheterization, Central Venous - adverse effects
Child
Child, Preschool
Cross Infection - epidemiology - etiology - microbiology
Denmark - epidemiology
Female
Hospitals, Community
Humans
Hyponatremia - complications
Immunocompromised Host
Infant
Infusions, Intravenous - adverse effects
Male
Middle Aged
Nose - microbiology
Odds Ratio
Prospective Studies
Regression Analysis
Renal Dialysis - adverse effects
Research Support, Non-U.S. Gov't
Risk factors
Sex Factors
Staphylococcal Infections - epidemiology - etiology - microbiology
Staphylococcus aureus
Surgical Procedures, Operative - adverse effects
Survival Analysis
Abstract
BACKGROUND: Staphylococcus aureus bacteremia (SAB) acquired in hospitals continues to be a frequent and serious complication to hospitalization, and no previous case-control studies dealing with risk factors of this severe disease are available. METHODS: Based on a 1-year prospective analysis, the data from all patients with hospital-acquired SAB admitted to 4 hospitals in Copenhagen County, Denmark, from May 1, 1994, through April 30, 1995, were evaluated. Eighty-five patients with hospital-acquired SAB were matched to 85 control patients with a similar primary diagnosis at admission (matched controls). Of these, 62 patients with hospital-acquired SAB were compared with 118 other patients with a similar time of admission, who were randomly selected with no clinical evidence of SAB (unmatched controls). RESULTS: The incidence of hospital-acquired SAB was 0.71 per 1000 hospital admissions. The presence of a central venous catheter (odds ratio, 6.9; 95% confidence interval [CI], 2.8-17.0), anemia (odds ratio, 3.3; 95% CI, 1.4-7.6), and hyponatremia (odds ratio, 3.3; 95% CI, 1.5-7.0) was significantly associated with hospital-acquired SAB in a conditional and a usual logistic regression analysis. Nasal carriage was not an independent risk factor, but nasal carriers among patients in surgery (odds ratio, 4.0; 95% CI, 1.3-13.0) had a significantly higher risk for hospital-acquired SAB compared with matched and unmatched controls. The presence of hospital-acquired SAB increased the mortality rate 2.4-fold (95% CI, 1.1-5.2). CONCLUSIONS: The presence of a central venous catheter is an important risk factor, and hyponatremia and anemia are associated with the development of hospital-acquired SAB. Furthermore, hospital-acquired SAB in itself increases mortality.
PubMed ID
10399895 View in PubMed
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12 records – page 1 of 2.