Epidemiology and infection
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We evaluated the incidence of varicella-zoster virus (VZV) infections, including herpes zoster (HZ), and investigated the associated risk factors for HZ and compared lymphocyte subsets of these patients at 1, 3 and 6 months following haematopoietic stem cell transplantation (HSCT) in a case-control study in children and adolescents. The incidence of HZ infection at the first year after HSCT was 17/125 (13·6%). The cumulative incidence of HZ infection was 22/125 (17·6%). ⋯ Pre-transplant WBC count was statistically lower in the HZ group (P<0·05). The CD4/CD8 ratios were lower in the HZ group during the first 6 months after HSCT, and the decrease was statistically significant at 6 months compared to the control group. In conclusion, patients undergoing HSCT for a malignant disorder had a significantly higher risk of VZV infection than those with non-malignant disorders and pretransplant donor characteristics were not helpful in predicting risk of post-transplant VZV infection.
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Ventilator-associated pneumonias (VAPs) are a worldwide problem that significantly increases patient morbidity, mortality, and length of stay (LoS), and their effects should be estimated to account for the timing of infection. The purpose of the study was to estimate extra LoS and mortality in an intensive-care unit (ICU) due to a VAP in a cohort of 69,248 admissions followed for 283,069 days in ICUs from 10 countries. ⋯ VAP prolonged LoS by an average of 2·03 days (95% CI 1·52-2·54 days), and increased the risk of death by 14% (95% CI 2-27). The increased risk of death due to VAP was explained by confounding with patient morbidity.