Identification of Risk Factors for Intra-Abdominal Candidiasis.

Background: Intra-abdominal candidiasis (IAC) is associated with substantial morbidity and mortality in hospitalized patients. Identifying high-risk populations may facilitate early and selective directed therapy in appropriate patients and avoid unwarranted treatment and any associated adverse effects in those who are low risk. Patients and Methods: This retrospective, case-control study included patients >18 years of age admitted from July 1, 2010 to July 1, 2021 who had a microbiologically confirmed intra-abdominal infection (gastrointestinal culture positive for either a Candida spp. [cases] or bacterial isolate [controls] collected intra-operatively or from a drain placed within 24 hours). Patients receiving peritoneal dialysis treatment or with a peritoneal dialysis catheter in place or treated at an outside hospital were excluded. Multivariable regression was utilized to identify independent risk factors for the development of IAC. Results: Five hundred twenty-three patients were screened, and 250 met inclusion criteria (125 per cohort). Multivariable analysis identified exposure to corticosteroids (odds ratio [OR], 5.79; 95% confidence interval [CI], 2.52-13.32; p < 0.0001), upper gastrointestinal tract surgery (OR, 3.51; 95% CI, 1.25-9.87; p = 0.017), and mechanical ventilation (OR, 3.09; 95% CI 1.5-6.37; p = 0.002) were independently associated with IAC. The area under the receiver operating characteristic (AUROC) and goodness of fit were 0.7813 and p = 0.5024, respectively. Conclusions: Exposure to corticosteroids, upper gastrointestinal tract surgery, and mechanical ventilation are independent risk factors for the development of microbiologically confirmed IAC suggesting these factors may help identify high-risk individuals requiring antifungal therapy.

Exploring strategies to increase college students' motivation to receive their annual influenza vaccine.

OBJECTIVE: To evaluate college students' awareness of an educational initiative to increase campus influenza vaccination rates and strategies to improve it. PARTICIPANTS: Students attending a large public comprehensive university. METHODS: An investigator-developed, online survey evaluated awareness of the initiative, the students' perception of incentives, and other motivations to receive seasonal influenza vaccine. RESULTS: The vaccination rate was 43%, despite low awareness of the initiative (28%). Awareness was significantly higher among vaccinated students (p = 0.0013). Having knowledge that appointments to receive vaccine were not needed increased the motivation of vaccinated students more than unvaccinated students (p = 0.0001). Personal influencers increased motivation of vaccinated students only when they were aware of the initiative (p = 0.04). Tangible incentives did not motivate students. CONCLUSIONS: Campus vaccination rates increased despite low initiative awareness. Improvements to the initiative should include strategies to increase emphasis on vaccination program conveniences like accessibility and perhaps engage personal influencers more.