Laboratory information of the fatal and control groups^*.

<p>*WBC = white cell count; APTT = activated partial thromboplastin time; PT = prothrombin time; ALT = serum alanine aminotransferase; AST = serum aspartate aminotransferase; n/N = no. of patients/no. of patients with data available.</p>†<p>Data detected from specimen(s) sampled at patient's arrival at the hospital.</p>‡<p>Pre-fatal laboratory data were data detected from the blood specimens of fatal patients sampled within the immediate 48 h before fatality.</p>§<p>Bandemia referred to presence of band cell (immature white blood cell) in peripheral blood.</p>¶<p>Prolongation of PT was defined as a PT>3 seconds than that of control.</p><p>**Prolongation of APTT was defined an APTT>20% than that of control.</p

Demographic and clinical information of the fatal and control groups^*.

<p>*Data are number of patients (%), unless stated otherwise. DSS = Dengue shock syndrome; COPD = chronic obstructive pulmonary disease; GI = gastrointestinal; n/N = no. of patients/no. of patients with data available.</p>†<p>An individual patient might have more than one underlying disease/condition.</p>‡<p>One patient with lung cancer found in the fatal group; 2 patients with breast cancer and 1 with esophagus cancer found in the control group,.</p>§<p>One patient with hypovolemia had a concurrent <i>Enterococcus faecalis</i> bacteremia.</p>¶<p>Blood culture was available in 8 patients; one of them experienced <i>Klebsiella pneumoniae</i> meningitis and the other primary <i>E. faecalis</i> bacteremia, and shock was found in both.</p><p>**The patient had primary <i>Rosemonas</i> bacteremia.</p>††<p>Primary <i>K. pneumoniae</i> bacteremia was found in 1 patient the fatal group, and in 2 patients in the control group.</p>‡‡<p>Three patients concurrently had pulmonary edema.</p>§§<p>One lung cancer patient developed pulmonary edema in day 16 of his hospitalization.</p>¶¶<p>An individual patient might have more than one symptom and/or sign.</p><p>***One originally febrile patient developed hypothermia during hospital stay.</p>†††<p>Three (75%) patients experienced massive GI bleeding.</p

Symptoms/signs and laboratory characteristics of patients with and without GI bleeding.

<p>Symptoms/signs and laboratory characteristics of patients with and without GI bleeding.</p

Characteristics and predictors for gastrointestinal hemorrhage among adult patients with dengue virus infection: Emphasizing the impact of existing comorbid disease(s)

<div><p>Background</p><p>Gastrointestinal (GI) bleeding is a leading cause of death in dengue. This study aims to identify predictors for GI bleeding in adult dengue patients, emphasizing the impact of existing comorbid disease(s).</p><p>Methods</p><p>Of 1300 adults with dengue virus infection, 175 (mean age, 56.5±13.7 years) patients with GI bleeding and 1,125 (mean age, 49.2±15.6 years) without GI bleeding (controls) were retrospectively analyzed.</p><p>Results</p><p>Among 175 patients with GI bleeding, dengue hemorrhagic fever was found in 119 (68%) patients; the median duration from onset dengue illness to GI bleeding was 5 days. Gastric ulcer, erythematous gastritis, duodenal ulcer, erosive gastritis, and hemorrhagic gastritis were found in 52.3%, 33.3%, 28.6%, 28.6%, and 14.3% of 42 patients with GI bleeding who had undergone endoscopic examination, respectively. Overall, nine of the 175 patients with GI bleeding died, giving an in-hospital mortality rate of 5.1%. Multivariate analysis showed age ≥60 years (cases vs. controls: 48% vs. 28.3%) (odds ratio [OR]: 1.663, 95% confidence interval [CI]: 1.128–2.453), end stage renal disease with additional comorbidities (cases vs. controls: 1.7% vs. 0.2%) (OR: 9.405, 95% CI: 1.4–63.198), previous stroke with additional comorbidities (cases vs. controls: 7.4% vs. 0.6%) (OR: 9.772, 95% CI: 3.302–28.918), gum bleeding (cases vs. controls: 27.4% vs. 11.5%) (OR: 1.732, 95% CI: 1.1–2.727), petechiae (cases vs. controls: 56.6% vs. 29.1%) (OR: 2.109, 95% CI: 1.411–3.153), and platelet count <50×10⁹ cells/L (cases vs. controls: 53.1% vs. 25.8%) (OR: 3.419, 95% CI: 2.103–5.558) were independent predictors of GI bleeding in patients with dengue virus infection.</p><p>Conclusions</p><p>Our study is the first to disclose that end stage renal disease and previous stroke, with additional comorbidities, were strongly significant associated with the risk of GI bleeding in patients with dengue virus infection. Identification of these risk factors can be incorporated into the patient assessment and management protocol of dengue virus infection to reduce its mortality.</p></div

Multivariate analysis of independent risk factors associated with GI bleeding in patients with dengue.

<p>Multivariate analysis of independent risk factors associated with GI bleeding in patients with dengue.</p

Number of dengue cases with and without gastrointestinal bleeding, 2002–2013.

<p>Number of dengue cases with and without gastrointestinal bleeding, 2002–2013.</p

Characteristics and outcomes of dengue patients with and without GI bleeding.

<p>Characteristics and outcomes of dengue patients with and without GI bleeding.</p

The resistance proportion of healthcare-associated infections caused by multidrug-resistant Gram-negative bacilli from 2002 to 2009.

<p>Abbreviations: CR =  carbapenems resistant; GNB =  Gram-negative bacilli; MDR =  multidrug-resistant; Q =  quarter.</p

Numbers of healthcare-associated infection (HAI) and the pathogenic Gram-negative bacilli from 2002 to 2009 at KSCGMH.

<p><b>Abbreviations:</b> BSI: bloodstream infection; CLABSI: central-line associated bloodstream infection; GI: gastrointestinal system infection; SSI: surgical site infection; SST: skin and soft tissue infection; UTI: urinary tract infection.</p>*<p>Derived from n/N X 100.</p>†<p>Including K. oxytoca, Enterobacter cloacae, Serratia marcescens, Proteus spp., Stenotrophomonas maltophilia, and other glucose-nonfermenting GNB (such as P. fluorescens, P. putida, Burkholderia cepacia, Chryseobacterium meningosepticum, C. indologenes, and Alcaligenes spp.).</p><p>! Including bone and joint infection, cardiovascular system infection, central nervous system infection, eye, ear, nose, throat or mouth infection, and reproductive tract infection.</p

Trends in antibiotic consumption (DDD/1,000 inpatient-days/quarter) and incidences of healthcare-associated infections (events/1,000 inpatient-days/ quarter) from 2002 to 2009 at KSCGMH.

<p>Abbreviation: DDD =  defined daily dose; HAI: healthcare associated infection; GNB: Gram-negative bacilli; MDR: multidrug-resistant.</p>a<p>AR, autoregressive, representing the past values of the quarterly incidence; MA, moving average, representing the past variance of the quarterly observations.</p>b<p>Delay in quarters before the effect is observed.</p>c<p>A significant trend referred to that with a <i>R²</i>>0.3 and <i>P</i><0.05.</p