Journal ArticleOpen Forum Infectious Diseases · October 1, 2024
Background: The Infectious Diseases Society of America (IDSA) developed the Core Antimicrobial Stewardship (AS) Curriculum to meet the increasing demand for infectious diseases (ID) providers with AS expertise. Notable diversity in implementation approache ...
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Journal ArticleClin Infect Dis · September 26, 2024
In a multihospital cohort study of 3392 patients, positive urinalysis parameters had poor positive predictive value for diagnosing urinary tract infection (UTI). Combined urinalysis parameters (pyuria or nitrite) performed better than pyuria alone for ruli ...
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Journal ArticleInfect Control Hosp Epidemiol · June 2024
In recent years, it has become increasingly evident that surveillance metrics for invasive device-associated infections (ie, central-line-associated bloodstream infections, ventilator-associated pneumonias, and catheter-associated urinary tract infections) ...
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Journal ArticleJ Urol · May 2024
PURPOSE: Patients with suspected UTIs are categorized into 3 clinical phenotypes based on current guidelines: no UTI, asymptomatic bacteriuria (ASB), or UTI. However, all patients may not fit neatly into these groups. Our objective was to characterize clin ...
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Journal ArticleInfect Control Hosp Epidemiol · April 2024
Diagnostic stewardship seeks to improve ordering, collection, performance, and reporting of tests. Test results play an important role in reportable HAIs. The inclusion of HAIs in public reporting and pay for performance programs has highlighted the value ...
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ConferenceJAMA Netw Open · March 4, 2024
IMPORTANCE: Guidelines recommend withholding antibiotics in asymptomatic bacteriuria (ASB), including among patients with altered mental status (AMS) and no systemic signs of infection. However, ASB treatment remains common. OBJECTIVES: To determine preval ...
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Journal ArticleAntimicrob Steward Healthc Epidemiol · 2024
The escalating threat of antimicrobial resistance (AMR) necessitates impactful, reproducible, and scalable antimicrobial stewardship strategies. This review addresses the critical need to enhance the quality of antimicrobial stewardship intervention resear ...
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Journal ArticleAntimicrob Steward Healthc Epidemiol · 2024
Our interviews of inpatient clinicians (physicians, physician assistants) modeled after the Capability, Opportunity, and Motivation Model of Behavior model revealed opportunity and motivation as important drivers for overdiagnosis and overprescribing for a ...
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Journal ArticleAntimicrob Steward Healthc Epidemiol · 2024
BACKGROUND: The field of healthcare epidemiology is increasingly focused on identifying, characterizing, and addressing social determinants of health (SDOH) to address inequities in healthcare quality. To identify evidence gaps, we examined recent systemat ...
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Journal ArticleInfect Dis Clin North Am · December 2023
Diagnostic stewardship refers to the responsible and judicious use of diagnostic tests to reduce low value care and improve patient outcomes. This article provides an overview of behavioral strategies, their relevance to diagnostic stewardship and highligh ...
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Journal ArticleInfect Control Hosp Epidemiol · November 2023
This retrospective review of 4-year surveillance data revealed a higher central line-associated bloodstream infection (CLABSI) rate in non-Hispanic Black patients and higher catheter-associated urinary tract infection (CAUTI) rates in Asian and non-Hispani ...
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Journal ArticleInfect Control Hosp Epidemiol · October 2023
OBJECTIVE: Urine cultures collected from catheterized patients have a high likelihood of false-positive results due to colonization. We examined the impact of a clinical decision support (CDS) tool that includes catheter information on test utilization and ...
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Journal ArticleInfect Control Hosp Epidemiol · October 2023
Since the initial publication of A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals in 2008, the prevention of healthcare-associated infections (HAIs) has continued to be a national priority. Progress in healthca ...
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Journal ArticleInfect Control Hosp Epidemiol · August 2023
OBJECTIVES: To describe the epidemiology of complex colon surgical procedures (COLO), stratified by present at time of surgery (PATOS) surgical-site infections (SSIs) and non-PATOS SSIs and their impact on the epidemiology of colon-surgery SSIs. DESIGN: Re ...
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Journal ArticleInfect Control Hosp Epidemiol · August 2023
The intent of this document is to highlight practical recommendations in a concise format designed to assist physicians, nurses, and infection preventionists at acute-care hospitals in implementing and prioritizing their catheter-associated urinary tract i ...
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Journal ArticleClin Infect Dis · July 5, 2023
Mutations accumulated by novel Severe Acute Respiratory Syndrome Coronavirus 2 Omicron sublineages contribute to evasion of previously effective monoclonal antibodies for treatment or prevention of Coronavirus Disease 2019 (COVID-19). Other authorized or a ...
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Journal ArticleInfect Control Hosp Epidemiol · April 2023
OBJECTIVE: Sparse recent data are available on the epidemiology of surgical site infections (SSIs) in community hospitals. Our objective was to provide updated epidemiology data on complex SSIs in community hospitals and to characterize trends of SSI preva ...
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Journal ArticleClin Infect Dis · February 8, 2023
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic had a considerable impact on US healthcare systems, straining hospital resources, staff, and operations. However, a comprehensive assessment of the impact on healthcare-associated infections (HAI ...
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Journal ArticleInfect Control Hosp Epidemiol · February 2023
Initial assessments of coronavirus disease 2019 (COVID-19) preparedness revealed resource shortages and variations in infection prevention policies across US hospitals. Our follow-up survey revealed improvement in resource availability, increase in testing ...
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Journal ArticleInfect Control Hosp Epidemiol · February 2023
BACKGROUND: Clinicians and laboratories routinely use urinalysis (UA) parameters to determine whether antimicrobial treatment and/or urine cultures are needed. Yet the performance of individual UA parameters and common thresholds for action are not well de ...
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Journal ArticleAntimicrob Steward Healthc Epidemiol · 2023
Our surveys of nurses modeled after the Capability, Opportunity, and Motivation Model of Behavior (COM-B model) revealed that opportunity and motivation factors heavily influence urine-culture practices (behavior), in addition to knowledge (capability). Un ...
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Journal ArticleAntimicrob Steward Healthc Epidemiol · 2023
De-implementation is defined as the process of discontinuing, removing, reducing, or replacing a harmful, ineffective, or low-value clinical practice or intervention. The goal of de-implementation strategies is to minimize patient harm, maximize use of res ...
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Journal ArticleOpen Forum Infect Dis · December 2022
Cardiovascular implantable electronic device (CIED) infections have high mortality and morbidity. CIED infections secondary to gram-negative pathogens are rare, and there are few data regarding their treatment. We report a case of a 60-year-old male who de ...
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Journal ArticleInfect Control Hosp Epidemiol · November 2022
The paradoxical relationship between standardized infection ratio and standardized utilization ratio for catheter-associated urinary tract infections (CAUTIs) in contrast to central-line-associated bloodstream infections (CLABSIs), in addition to CAUTI def ...
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Journal ArticleTranspl Infect Dis · October 2022
BACKGROUND: Solid organ transplant (SOT) recipients are challenging populations for antimicrobial stewardship interventions due to a variety of reasons, including immunosuppression, consequent risk of opportunistic and donor-derived infections, high rates ...
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Journal ArticleJ Am Geriatr Soc · August 2022
Antibiotics are among the leading causes of adverse drug events in older adults. Short-course antibiotic therapy has been shown to work as well as the traditional longer durations for many types of infections. Antibiotic stewardship interventions including ...
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Journal ArticleInfection control and hospital epidemiology · July 2022
We reviewed the sustainability of a multifaceted intervention on catheter-associated urinary tract infection (CAUTI) in 3 intensive care units. During the 4-year postintervention period, we observed reductions in urine culture rates (from 80.9 to 47.5 per ...
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Journal ArticleClin Infect Dis · March 23, 2022
BACKGROUND: Antimicrobial stewardship (AS) programs are required by Centers for Medicare and Medicaid Services and should ideally have infectious diseases (ID) physician involvement; however, only 50% of ID fellowship programs have formal AS curricula. The ...
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Journal ArticleAntimicrob Steward Healthc Epidemiol · 2022
Mixed flora in urine cultures usually occur due to pre-analytic contamination. In our outpatient urology clinic, we found a high prevalence of mixed flora (46.2%), which was associated with female sex and older age. Patient education did not impact the rat ...
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Journal ArticleAntimicrob Steward Healthc Epidemiol · 2022
The 2021 focused update to the Infections Diseases Society of America/Society for Healthcare Epidemiology of America (IDSA/SHEA) guidelines for management of Clostridioides difficile infection (CDI) prioritizes the use of fidaxomicin over vancomycin for th ...
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Journal ArticleAntimicrob Steward Healthc Epidemiol · 2022
We surveyed trainees about their urine culture practices and assessed the impact of an educational intervention delivered electronically and in-person. Trainee scores improved across all levels of training and across all questions on the post-intervention ...
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Journal ArticleCurr Infect Dis Rep · October 2021
PURPOSE OF REVIEW: The goal of this article is to highlight how and why urinalyses and urine cultures are misused, review quality improvement interventions to optimize urine culture utilization, and highlight how to implement successful, sustainable interv ...
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Journal ArticleClin Infect Dis · September 7, 2021
Professional societies serve many functions that benefit constituents; however, few professional societies have undertaken the development and dissemination of formal, national curricula to train the future workforce while simultaneously addressing signifi ...
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Journal ArticleWorld J Urol · August 2021
PURPOSE: To assess the incidence, risk factors, and clinical outcomes associated with (Clostridioides difficile infection) CDI following urological surgery, which is the leading cause of nosocomial diarrhea and a growing public health burden. METHODS: We q ...
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Journal ArticleInfect Control Hosp Epidemiol · May 2021
We performed a cross-sectional survey of infection preventionists in 60 US community hospitals between April 22 and May 8, 2020. Several differences in hospital preparedness for SARS-CoV-2 emerged with respect to personal protective equipment conservation ...
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Journal ArticleAntimicrobial stewardship & healthcare epidemiology : ASHE · January 2021
The extensive use of the urinalysis for screening and monitoring in diverse clinical settings usually identifies abnormal urinalysis parameters in patients with no suspicion of urinary tract infection, which in turn triggers urine cultures, inappropriate a ...
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Journal ArticleAm J Infect Control · December 2020
We performed a descriptive study of reflex urine culture (RUC) practices across 51 community hospitals in southeastern United States. We found that 26 unique reflexing criteria were used in 28 hospitals. Only 14% hospitals of hospitals that offered RUC res ...
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ConferenceInfection Control & Hospital Epidemiology · October 2020
Background: The standardized infection ratio (SIR) is the nationally adopted metric used to track and compare catheter-associated urinary tract infections (CAUTIs) and central-line– associated bloodstream infections (CLABSIs) ...
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Journal ArticleInfect Control Hosp Epidemiol · September 2020
With concerns for presymptomatic transmission of COVID-19 and increasing burden of contact tracing and employee furloughs, several hospitals have supplemented pre-existing infection prevention measures with universal masking of all personnel in hospitals. ...
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Journal ArticleInfect Control Hosp Epidemiol · February 2020
OBJECTIVE: Healthcare-associated bloodstream infections (HABSIs) are a significant cause of mortality and morbidity in the neonatal intensive care unit (NICU) population. Our objectives were to review the epidemiology of HABSIs in our NICU and to examine t ...
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ConferenceInfection Control & Hospital Epidemiology · 2020
Background: Reflex urine cultures (RUCs) have the potential to reduce unnecessary urine cultures and antibiotic use. However, urinalysis parameters that best predict true infection are unknown. In this study, we surveyed different RUC practices in laborato ...
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ConferenceInfection Control & Hospital Epidemiology · 2020
Background: Antibiotic prophylaxis choice for transrectal prostate biopsy (TRPB) has been affected by the emergence of fluoroquinolone-resistant Escherichia coli (FQRE). Prebiopsy FQRE screening and targeted antibiotic prophylaxis may reduce post-TRPB bloo ...
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Journal ArticleOpen Forum Infect Dis · August 1, 2019
BACKGROUND: A positive urine culture often drives initiation of antimicrobials even in the absence of symptoms. Our objectives were to evaluate the knowledge and practice patterns related to ordering urine cultures in patients with indwelling urinary cathe ...
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Journal ArticleInfect Control Hosp Epidemiol · June 2019
Catheter-associated urinary tract infection (CAUTI) has long been considered a preventable healthcare-associated infection. Many federal agencies, the Centers for Medicare and Medicaid Services (CMS), and public and private healthcare organizations have im ...
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Journal ArticleClin Infect Dis · September 28, 2018
A needs assessment survey of infectious diseases (ID) training program directors identified gaps in educational resources for training and evaluating ID fellows in antimicrobial stewardship. An Infectious Diseases Society of America-sponsored core curricul ...
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Journal ArticleProg Transplant · September 2018
Graft-versus-host disease (GvHD) is a rare but fatal complication after solid organ transplantation arising in 1% to 2% of cases. We report 2 cases of GvHD after orthotopic liver transplantation. Both patients had a history of hepatitis C virus (HCV) infec ...
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Journal ArticleInfect Control Hosp Epidemiol · July 2018
The 2015 changes in the catheter-associated urinary tract infection definition led to an increase in central line-associated bloodstream infections (CLABSIs) and catheter-related candidemia in some health systems due to the change in CLABSI attribution. Ho ...
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Journal ArticleOpen Access J Gerontol Geriatr Med · April 2018
Suspected urinary tract infection is a common indication for antimicrobial therapy in long-term care residents. We sought to characterize antimicrobial susceptibilities among urine isolates collected from women long-term care residents enrolled in a clinic ...
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Journal ArticleJ Gerontol Geriatr Res · 2018
BACKGROUND: Empirical data regarding the frequency of infection during fever episodes among women in long-term care facilities are lacking. METHODS: We conducted a case-series analysis of women long-term care residents enrolled in a randomized trial evalua ...
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Journal ArticleOpen forum infectious diseases · January 2017
Abstract Background The National Healthcare Safety Network (NHSN) revised their catheter-associated urinary tract infection (CAUTI) definition in January 2015 to exclude funguria. This definition change led to an increase in diagnosis of catheter ...
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Journal ArticleInfect Control Hosp Epidemiol · April 2016
OBJECTIVE To identify the frequency of and risk factors associated with complications necessitating removal of the peripherally inserted central catheters (PICCs) in patients receiving outpatient parenteral antibiotic therapy (OPAT) and to determine the ap ...
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Journal ArticlePediatrics · December 2013
OBJECTIVE: To determine whether the daily risk of central line-associated bloodstream infections (CLABSIs) increases over the dwell time of peripherally inserted central catheters (PICCs) in high-risk neonates. METHODS: Multicenter retrospective cohort inc ...
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Journal ArticleAm J Infect Control · October 2013
Some hospitals screen and identify high risk patients for methicillin-resistant Staphylococcus aureus (MRSA) colonization. We performed postdischarge surveillance, including a telephone survey, and estimated a 9.5% incidence of infection in MRSA-colonized ...
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Journal ArticleJ Perinatol · October 2013
OBJECTIVE: To assess chlorhexidine absorption and skin tolerability in premature infants, following skin antisepsis with 2% aqueous chlorhexidine gluconate (CHG) prior to peripherally inserted central catheter (PICC) placement. STUDY DESIGN: Neonates less ...
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Journal ArticleJAMA Pediatr · May 2013
IMPORTANCE: Peripherally inserted central venous catheters (PICCs) are prone to infectious, thrombotic, and mechanical complications. These complications are associated with morbidity, so data are needed to inform quality improvement efforts. OBJECTIVES: T ...
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Journal ArticlePediatr Infect Dis J · December 2012
BACKGROUND: Viral respiratory infections are among the most common reasons for hospitalization of children in the United States. Our objective was to compare molecular and conventional methods in a cohort of hospitalized children with and without symptoms ...
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Journal ArticleJ Clin Virol · October 2012
BACKGROUND: Rapid detection of respiratory viruses is important for management and infection control in hospitalized patients. Multiplex nucleic acid tests (NATs) have begun to replace conventional methods as gold standards for respiratory virus detection. ...
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Journal ArticleClin Infect Dis · May 2011
BACKGROUND: Increasingly, peripherally inserted central venous catheters (PICCs) are placed for prolonged intravenous access. Few data exist regarding risk factors for central line-associated bloodstream infection (CLABSI) complicating PICCs in hospitalize ...
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