The risk of drug-induced liver injury associated with flucloxacillin: a nationwide, entropy-balanced cohort study.

Objectives: In this nationwide cohort study in a Scandinavian setting, we aimed to investigate the magnitude of association between flucloxacillin use and drug-induced liver injury (DILI).

Methods: Nationwide cohort study among adults in Sweden, 2006-2018, was conducted. Register data on filled prescriptions, patient characteristics, co-medications, and DILI were linked.

Surface-Shaving of Strains and Quantitative Proteomic Analysis Reveal Differences in Protein Abundance of the Surfaceome.

is a pathogen known to cause a wide range of infections. To find new targets for identification and to understand host-pathogen interactions, many studies have focused on surface proteins. We performed bacterial-cell surface-shaving, followed by tandem mass tag for quantitative mass spectrometry proteomics, to examine the surfaceome of .

Duration from start of antibiotic exposure to onset of infection for different antibiotics in a non-outbreak setting.

Background: Antibiotic treatment is a well-known risk factor for infection (CDI). The time from start of antibiotic exposure to onset of CDI for different antibiotics is sparsely studied. CDI with onset in the community is often treatable without in-hospital care while CDI patients treated in hospital need isolation, resulting in higher costs and infection control measures.

outbreak detection: Evaluation by ribotyping and whole-genome sequencing of a surveillance algorithm based on ward-specific cutoffs.

Objective: We evaluated the performance of an early-warning algorithm, based on ward-specific incidence cutoffs for detecting transmission in hospitals. We also sought to determine the frequency of intrahospital transmission in our setting.

Design: Diagnostic performance of the algorithm was tested with confirmed transmission events as the comparison criterion.

Risk factors for recurrent healthcare-facility associated Clostridioides difficile infection in a Swedish setting.

Objective: The objectives were to determine the risk factors for recurrent healthcare facility-associated Clostridioides difficile infection (HCF-CDI) in a high CDI incidence, low antibiotic use setting and to determine if length of cefotaxime exposure is a risk factor for recurrent HCF-CDI.

Methods: The risk factors for recurrent HCF-CDI were evaluated with a retrospective nested case control study based on chart reading. The risk factors were evaluated univariately and multivariately.

[Rational use of antibiotics in Region Västra Götaland].

Optimizing antibiotic use to control the spread of antimicrobial resistance is a global health priority. The Swedish strategic programme against antibiotic resistance (Strama) has for many years supported the rational use of antibiotics. A key element has been the bottom-up approach, working closely with prescribers at the local level.

Remote investigation and assessment of vital signs (RIA-VS)-proof of concept for contactless estimation of blood pressure, pulse, respiratory rate, and oxygen saturation in patients with suspicion of COVID-19.

Background: Vital signs are critical in assessing the severity and prognosis of infections, for example, COVID-19, influenza, sepsis, and pneumonia. This study aimed to evaluate a new method for rapid camera-based non-contact measurement of heart rate, blood oxygen saturation, respiratory rate, and blood pressure.

Methods: Consecutive adult patients attending a hospital emergency department for suspected COVID-19 infection were invited to participate.

Staffing agency: A bridge to working during retirement.

Background: The ageing population has initiated a debate about a prolonged working life. There is an interest in finding the pre-retirement predictors of bridge employment and retirement decisions, but the understanding of the experiences of bridge employees is still limited.

Objectives: The aim was to describe the characteristics of the pensioners working for a staffing agency, their motivational aspects, work patterns and types of services they provided.

Mortality in Escherichia coli bloodstream infections: a multinational population-based cohort study.

Background: Escherichia coli is the most common cause of bloodstream infections (BSIs) and mortality is an important aspect of burden of disease. Using a multinational population-based cohort of E. coli BSIs, our objectives were to evaluate 30-day case fatality risk and mortality rate, and determine factors associated with each.

Impact of obesity on outcome of severe bacterial infections.

Introduction: Obesity is a rapidly growing global health concern with considerable negative impact on life-time expectancy. It has yet not been clarified if and how obesity impacts outcomes of severe bacterial infections. The aim of this study was to determine how body mass index impacts outcome of severe bacterial infections in a well-defined population-based cohort.

Interventions for prudent antibiotic use in primary healthcare: an econometric analysis.

Background: Rational antibiotic prescribing is crucial to combat antibiotic resistance. Optimal strategies to improve antibiotic use are not known. Strama, the Swedish strategic program against antibiotic resistance, has been successful in reducing antibiotic prescription rates.

An International Prospective Cohort Study To Validate 2 Prediction Rules for Infections Caused by Third-generation Cephalosporin-resistant Enterobacterales.

Background: The possibility of bloodstream infections caused by third-generation cephalosporin-resistant Enterobacterales (3GC-R-BSI) leads to a trade-off between empiric inappropriate treatment (IAT) and unnecessary carbapenem use (UCU). Accurately predicting 3GC-R-BSI could reduce IAT and UCU. We externally validate 2 previously derived prediction rules for community-onset (CO) and hospital-onset (HO) suspected bloodstream infections.

Who is willing to stay sick for the collective? - Individual characteristics, experience, and trust.

•We study attitudes towards antibiotics and antibiotic resistance.•We analyze results from a novel web-survey of Swedish citizens (n = 1906).•Acceptability of doctor's decision not to prescribe antibiotics was found to be large.

Incidences of community onset severe sepsis, Sepsis-3 sepsis, and bacteremia in Sweden - A prospective population-based study.

Background: Sepsis is a major healthcare challenge globally. However, epidemiologic data based on population studies are scarce.

Methods: During a 9-month prospective, population-based study, the Swedish Sepsis-2 criteria were used to investigate the incidence of community onset severe sepsis in adults aged ≥18 years (N = 2,196; mean age, 69; range, 18-102 years).

Biofilm formation by Staphylococcus aureus clinical isolates correlates with the infection type.

Background: Biofilms are involved in many Staphylococcus aureus infections, but relation of biofilm formation and the infection types or the clinical outcomes remain unclear.

Methods: We measured biofilm formation, with a microtiter plate assay, of a collection of methicillin-sensitive clinical isolates from 159 invasive S. aureus infections, encompassing all cases occurring within a hospital catchment area during two years, and from additional 49 non-invasive skin infections from the same region.

Clostridioides difficile incidence related to in-hospital cephalosporin use: a tale of two highly comparable hospitals.

Background: Antibiotic treatment is a well-known risk factor for healthcare facility-associated Clostridioides (Clostridium) difficile infection (HCF-CDI). Antibiotic stewardship programmes (ASPs) targeting high-risk antibiotics have been shown to decrease HCF-CDI incidence. HCF-CDI incidence is high in Nordic countries despite relatively low antibiotic use in hospital.

Diagnostic accuracy of procalcitonin, neutrophil-lymphocyte count ratio, C-reactive protein, and lactate in patients with suspected bacterial sepsis.

Background: Early recognition is a key factor to achieve improved outcomes for septic patients. Combinations of biomarkers, as opposed to single ones, may improve timely diagnosis and survival. We investigated the performance characteristics of sepsis biomarkers, alone and in combination, for diagnosis of verified bacterial sepsis using Sepsis-2 and Sepsis-3 criteria, respectively.

Respiratory viral infections are underdiagnosed in patients with suspected sepsis.

The study aim was to investigate the prevalence and clinical relevance of viral findings by multiplex PCR from the nasopharynx of clinically septic patients during a winter season. During 11 weeks of the influenza epidemic period in January-March 2012, consecutive adult patients suspected to be septic (n = 432) were analyzed with cultures from blood and nasopharynx plus multiplex PCR for respiratory viruses on the nasopharyngeal specimen. The results were compared with those from microbiology analyses ordered as part of standard care.

The changing epidemiology of group B streptococcus bloodstream infection: a multi-national population-based assessment.

Background: Population-based studies conducted in single regions or countries have identified significant changes in the epidemiology of invasive group B streptococcus (GBS) infection. However, no studies have concurrently compared the epidemiology of GBS infections among multiple different regions and countries over time. The study objectives were to define the contemporary incidence and determinants of GBS bloodstream infection (BSI) and assess temporal changes in a multi-national population.

Tissue Plasminogen Activator Coating on Implant Surfaces Reduces Staphylococcus aureus Biofilm Formation.

Staphylococcus aureus biofilm infections of indwelling medical devices are a major medical challenge because of their high prevalence and antibiotic resistance. As fibrin plays an important role in S. aureus biofilm formation, we hypothesize that coating of the implant surface with fibrinolytic agents can be used as a new method of antibiofilm prophylaxis.

Systemic symptoms predict presence or development of severe sepsis and septic shock.

Background: Severe sepsis is a major cause of mortality and morbidity globally. As the time to adequate treatment is directly linked to outcome, early recognition is of critical importance. Early, accessible markers for severe sepsis are desirable.