Dataset Information

Livestock-associated risk factors for pneumonia in an area of intensive animal farming in the Netherlands.

ABSTRACT: Previous research conducted in 2009 found a significant positive association between pneumonia in humans and living close to goat and poultry farms. However, as this result might have been affected by a large goat-related Q fever epidemic, the aim of the current study was to re-evaluate this association, now that the Q-fever epidemic had ended. In 2014/15, 2,494 adults (aged 20-72 years) living in a livestock-dense area in the Netherlands participated in a medical examination and completed a questionnaire on respiratory health, lifestyle and other items. We retrieved additional information for 2,426/2,494 (97%) participants from electronic medical records (EMR) from general practitioners. The outcome was self-reported, physician-diagnosed pneumonia or pneumonia recorded in the EMR in the previous three years. Livestock license data was used to determine exposure to livestock. We quantified associations between livestock exposures and pneumonia using odds ratios adjusted for participant characteristics and comorbidities (aOR). The three-year cumulative frequency of pneumonia was 186/2,426 (7.7%). Residents within 2,000m of a farm with at least 50 goats had an increased risk of pneumonia, which increased the closer they lived to the farm (2,000m aOR 1.9, 95% CI 1.4-2.6; 500m aOR 4.4, 95% CI 2.0-9.8). We found no significant associations between exposure to other farm animals and pneumonia. However, when conducting sensitivity analyses using pneumonia outcome based on EMR only, we found a weak but statistically significant association with presence of a poultry farm within 1,000m (aOR: 1.7, 95% CI 1.1-2.7). Living close to goat and poultry farms still constitute risk factors for pneumonia. Individuals with pneumonia were not more often seropositive for Coxiella burnetii, indicating that results are not explained by Q fever. We strongly recommend identification of pneumonia causes by the use of molecular diagnostics and investigating the role of non-infectious agents such as particulate matter or endotoxins.

SUBMITTER: Freidl GS

PROVIDER: S-EPMC5376295 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Livestock-associated risk factors for pneumonia in an area of intensive animal farming in the Netherlands.

Freidl Gudrun S GS Spruijt Ineke T IT Borlée Floor F Smit Lidwien A M LA van Gageldonk-Lafeber Arianne B AB Heederik Dick J J DJ Yzermans Joris J van Dijk Christel E CE Maassen Catharina B M CB van der Hoek Wim W

PloS one 20170331 3

Previous research conducted in 2009 found a significant positive association between pneumonia in humans and living close to goat and poultry farms. However, as this result might have been affected by a large goat-related Q fever epidemic, the aim of the current study was to re-evaluate this association, now that the Q-fever epidemic had ended. In 2014/15, 2,494 adults (aged 20-72 years) living in a livestock-dense area in the Netherlands participated in a medical examination and completed a que ...[more]

PMID: 28362816

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Project description:OBJECTIVES:To study the incidence, etiology and risk factors associated with ventilator associated pneumonia (VAP) in children. METHODS:This prospective cohort study was conducted on patients admitted to the Pediatric Intensive Care Unit (PICU) of a tertiary care institute of North India, from June 2012 through March 2014, who received mechanical ventilation for more than 24 h. All enrolled children were assessed daily for development of ventilator associated pneumonia (VAP) using the case definition given by Centers for Disease Control and Prevention (CDC). Chest radiograph and microbiologic samplings were performed in children suspected to have VAP. Risk factors associated with VAP were calculated by doing bivariate and multivariate analysis. RESULTS:A total of 128 patients were screened and 86 were enrolled (median age 30 mo 95% CI 4.0-84.0; 72% boys). The most common admitting diagnosis was sepsis (16%) followed by acyanotic congenital heart disease with pneumonia (14%) and the most common indication for ventilation was respiratory failure (45.3%). The incidence of VAP according to CDC criteria was 38.4%, while the incidence of microbiologically confirmed VAP was 24.4%. The incidence of ventilator associated tracheobronchitis (VAT) was found to be 11.6%. Acinetobacter was the most frequently isolated organism (47%) followed by Pseudomonas (28%), Klebsiella (15%), E. coli (5%) and Enterobacter (5%). Risk factors for VAP on bivariate analysis were use of proton pump inhibitor (PPI) (p?=?0.027, OR 5.2, 95% CI 1.1-24.3), enteral feeding (p?<?0.001, OR 6.5, 95% CI 2.1-19.4) and re-intubation (p?=?0.024, OR 3.3 and 95% CI 1.1-9.6). On multivariate analysis, use of PPI (p?=?0.03, OR 8.47, 95% CI 1.19-60.33) and enteral feeding (p?<?0.001, OR 12.2, 95% CI 2.58-57.78) were identified as independent risk factors for VAP. CONCLUSIONS:Ventilator associated pneumonia is an important complication in children receiving mechanical ventilation in PICU and Gram negative bacilli (Acinetobacter and Pseudomonas) being the important causative agents. Ventilator associated tracheobronchitis is an emerging entity; recognition and treatment of same might prevent the development of VAP.

Project description:BackgroundDespite the high mortality in patients with pneumonia admitted to an ICU, data on risk factors for death remain limited.MethodsIn this secondary analysis of PROTECT (Prophylaxis for Thromboembolism in Critical Care Trial), we focused on the patients admitted to ICU with a primary diagnosis of pneumonia. The primary outcome for this study was 90-day hospital mortality and the secondary outcome was 90-day ICU mortality. Cox regression model was conducted to examine the relationship between baseline and time-dependent variables and hospital and ICU mortality.ResultsSix hundred sixty seven patients admitted with pneumonia (43.8 % females) were included in our analysis, with a mean age of 60.7 years and mean APACHE II score of 21.3. During follow-up, 111 patients (16.6 %) died in ICU and in total, 149 (22.3 %) died in hospital. Multivariable analysis demonstrated significant independent risk factors for hospital mortality including male sex (hazard ratio (HR) = 1.5, 95 % confidence interval (CI): 1.1 - 2.2, p-value = 0.021), higher APACHE II score (HR = 1.2, 95 % CI: 1.1 - 1.4, p-value < 0.001 for per-5 point increase), chronic heart failure (HR = 2.9, 95 % CI: 1.6 - 5.4, p-value = 0.001), and dialysis (time-dependent effect: HR = 2.7, 95 % CI: 1.3 - 5.7, p-value = 0.008). Higher APACHE II score (HR = 1.2, 95 % CI: 1.1 - 1.4, p-value = 0.002 for per-5 point increase) and chronic heart failure (HR = 2.6, 95 % CI: 1.3 - 5.0, p-value = 0.004) were significantly related to risk of death in the ICU.ConclusionIn this study using data from a multicenter thromboprophylaxis trial, we found that male sex, higher APACHE II score on admission, chronic heart failure, and dialysis were independently associated with risk of hospital mortality in patients admitted to ICU with pneumonia. While high illness severity score, presence of a serious comorbidity (heart failure) and need for an advanced life support (dialysis) are not unexpected risk factors of mortality, male sex might necessitate further exploration. More studies are warranted to clarify the effect of these risk factors on survival in critically ill patients admitted to ICU with pneumonia.Trial registrationClinicalTrials.gov Identifier: NCT00182143 .

Project description:Several precision livestock farming (PLF) technologies, conceived for optimizing farming processes, are developed to detect the physical and behavioral changes of animals continuously and in real-time. The aim of this review was to explore the capacity of existing PLF technologies to contribute to the assessment of pig welfare. In a web search for commercially available PLF for pigs, 83 technologies were identified. A literature search was conducted, following systematic review guidelines (PRISMA), to identify studies on the validation of sensor technologies for assessing animal-based welfare indicators. Two validation levels were defined: internal (evaluation during system building within the same population that were used for system building) and external (evaluation on a different population than during system building). From 2,463 articles found, 111 were selected, which validated some PLF that could be applied to the assessment of animal-based welfare indicators of pigs (7% classified as external, and 93% as internal validation). From our list of commercially available PLF technologies, only 5% had been externally validated. The more often validated technologies were vision-based solutions (n = 45), followed by load-cells (n = 28; feeders and drinkers, force plates and scales), accelerometers (n = 14) and microphones (n = 14), thermal cameras (n = 10), photoelectric sensors (n = 5), radio-frequency identification (RFID) for tracking (n = 2), infrared thermometers (n = 1), and pyrometer (n = 1). Externally validated technologies were photoelectric sensors (n = 2), thermal cameras (n = 2), microphone (n = 1), load-cells (n = 1), RFID (n = 1), and pyrometer (n = 1). Measured traits included activity and posture-related behavior, feeding and drinking, other behavior, physical condition, and health. In conclusion, existing PLF technologies are potential tools for on-farm animal welfare assessment in pig production. However, validation studies are lacking for an important percentage of market available tools, and in particular research and development need to focus on identifying the feature candidates of the measures (e.g., deviations from diurnal pattern, threshold levels) that are valid signals of either negative or positive animal welfare. An important gap identified are the lack of technologies to assess affective states (both positive and negative states).

Dataset Information

Livestock-associated risk factors for pneumonia in an area of intensive animal farming in the Netherlands.

Publications

Livestock-associated risk factors for pneumonia in an area of intensive animal farming in the Netherlands.

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