![]() ![]() Overall, the level of mite or shrimp sIgE is influenced by alterations in age, and vegetarians are at risk of shrimp sensitization via cross-reactivity between shrimp and mite. The mite-Der p 10 not only displayed high cross-reactivity to the shrimp-Pen a 1 in all age groups and vegetarians but functioned as the major allergen to sensitize un-adults. Moreover, adults were more frequently sensitized to shrimp and mite at the same time compared with the un-adult or elderly groups. In contrast, shrimp-induced sIgE was higher in the adults and elderly patients. We found that HDMs induced higher sIgE than shrimp in un-adults. The sera with sIgE levels greater than 3.5 kUA/L were cross-reactivity examined. The serum specific-IgE (sIgE) level of HDMs and shrimp in 60 children/adolescence (un-adults), 30 adults, 30 elderly, and four vegetarian adults patients were measured. Therefore, we assessed the prevalence of shrimp or mite allergy among different age groups and vegetarians. Thus, vegetarians might be sensitized to shrimp through the inadvertent inhalation of HDMs. Due to the cross-reactivity between shellfish and HDMs, HDMs were considered as the primary sensitizer for shellfish allergy. All rights reserved.The sensitization to house dust mites (HDMs) and shrimps affects the development of hypersensitivity with an increase in age. Published by Oxford University Press for the Infectious Diseases Society of America. Implementation of an antibiotic cross-reactivity chart combined with enhanced allergy assessment processes significantly improved the prescribing of β-lactam antibiotics for surgical prophylaxis.Īllergy antimicrobial stewardship beta-lactam side chain surgical prophylaxis. 323), surgical site infections, in-hospital and 30-day mortality, healthcare facility-onset Clostridiodes difficile infection, acute kidney injury, or hospital costs. No significant differences were observed in allergic reactions (0.5% vs 0.3% P =. ![]() 035) however, there was no difference in the incidence of SSIs in patients readmitted (14.8% vs 13% P =. There was a decrease in 30-day readmissions in the intervention cohort (7.9% vs 6.3% P =. There was a significant difference in patients receiving a β-lactam alternative antibiotic between cohorts (84.9% vs 15.1% P <. Interrupted time-series analysis further analyzed key outcomes.Ī total of 11 patients were included in the historical and intervention cohorts, respectively. Propensity-weighted scoring analyses compared categorical and continuous outcomes. This single-center, quasi-experimental study analyzed antibiotic prescribing in all adult patients with a documented β-lactam allergy undergoing an inpatient surgical procedure between quartile (Q) 1 (2012)-Q3 (2014) (historical group) and Q3 (2016)-Q3 (2018) (intervention group). The R-group side chain of the β-lactam ring is responsible for allergic cross-reactivity and experts recommend the use of β-lactams that are structurally dissimilar.Īn internally developed, antibiotic side-chain-based cross-reactivity chart was developed and implemented alongside enhanced allergy assessment processes. Β-Lactam antibiotics are first-line therapy for perioperative prophylaxis however, patient-reported allergies often lead to increased prescribing of alternative antibiotics that may increase the incidence of surgical site infections.
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