A5056568508- Infection Control in Healthcare
- Clostridium difficile and Clostridium perfringens research
- Antimicrobial Resistance in Staphylococcus
- Antibiotic Use and Resistance
- Antibiotic Resistance in Bacteria
- Food Safety and Hygiene
- Medical Device Sterilization and Disinfection
- Microscopic Colitis
- Antibiotics Pharmacokinetics and Efficacy
- Bacterial biofilms and quorum sensing
- Viral gastroenteritis research and epidemiology
- Rabies epidemiology and control
- Primary Care and Health Outcomes
- Infection Control and Ventilation
- Autopsy Techniques and Outcomes
- SARS-CoV-2 and COVID-19 Research
- Infant Health and Development
- Innovations in Medical Education
- Viral Infections and Outbreaks Research
- Health Policy Implementation Science
- Acute Ischemic Stroke Management
- Herbal Medicine Research Studies
- SARS-CoV-2 detection and testing
- Telemedicine and Telehealth Implementation
- Gastrointestinal motility and disorders
University of Pittsburgh
2021-2025
VA Pittsburgh Healthcare System
2022-2025
UPMC Presbyterian
2020-2022
University of Pittsburgh Medical Center
2020-2022
Presbyterian Hospital
2020
University of California, Los Angeles
2016-2018
Engineering Associates (United States)
2016-2018
University of Ottawa
2018
University of Florida
2017
Sinai Health System
2017
OBJECTIVE To evaluate the impact of discontinuation contact precautions (CP) for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) expansion chlorhexidine gluconate (CHG) use on health system. DESIGN Retrospective, nonrandomized, observational, quasi-experimental study. SETTING Two California hospitals. PARTICIPANTS Inpatients. METHODS We compared hospital-wide laboratory-identified clinical culture rates (as a marker healthcare-associated...
Abstract Background The risk of MRSA transmission differs by healthcare personnel (HCP) role and care activity. An alternative to an “all or none” approach contact precautions for patients with carriage is a “risk-tailored” – using gloves gowns only certain high-risk activities, locations, roles. A discrete choice experiment proven method assess HCP perspectives on varied implementation strategies. Methods We distributed survey HCPs at medical centers in three cities. Respondents were...
Abstract Background Hospital-onset bacteremia and fungemia (HOB) is under development as a surveillance measure by the CDC. This study aimed to evaluate use of HOB frontline clinicians identify infection prevention (IP) quality improvement opportunities. Figure 1: Framework for evaluation hospital-onset cases with multi-disciplinary case reviews, adapted from Joint Commission Patient Safety Event Taxonomy. Methods From 9/2022 4/2024, we conducted prospective at 6 hospitals (3 academic, 3...
OBJECTIVE To evaluate the impact of discontinuing routine contact precautions (CP) for endemic methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) on hospital adverse events. DESIGN Retrospective, nonrandomized, observational, quasi-experimental study. SETTING Academic medical center with single-occupancy rooms. PARTICIPANTS Inpatients. METHODS We compared reportable events 1 year before after discontinuation CP MRSA VRE (preintervention...
Whole genome sequencing (WGS) surveillance and electronic health record data mining have the potential to greatly enhance identification control of hospital outbreaks. The objective was develop methods for examining economic value a WGS surveillance-based infection prevention (IP) program compared standard care (SoC).The IP assessed from hospital's perspective using historical outbreaks 2011-2016. We used transmission network estimate incremental cost per averted. number transmissions...
Abstract Objective: To define conditions in which contact precautions can be safely discontinued for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). Design: Interrupted time series. Setting: 15 acute-care hospitals. Participants: Inpatients. Intervention: Contact endemic MRSA VRE were 12 intervention hospitals continued at 3 nonintervention Rates of healthcare-associated infections (HAIs) collected months before after. Trends HAI rates analyzed...
Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) control on college campuses is challenging given communal living and student social dynamics. Understanding SARS-CoV-2 transmission among students important for the development of optimal strategies. Methods nasal swab samples were collected from University Pittsburgh symptomatic testing asymptomatic surveillance August 2020 through April 2021 3 campuses. Whole-genome sequencing (WGS) was performed 308 samples,...
From 2000 to 2009, rates of multidrug-resistant Acinetobacter baumanii increased 10-fold 0.2 per 1,000 patient days. 2010 2015, however, markedly declined and have stayed below 0.05 Herein, we present a 15-year trend analysis discuss interventions that may led the decline.Infect Control Hosp Epidemiol 2018;39:608-611.
Abstract Objective: Contact precautions for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) have limited data on efficacy been associated with patient harm. Still, a 2015 Society Healthcare Epidemiology of America (SHEA) Research Network (SRN) survey showed only 7% hospitals discontinued routine MRSA/VRE contact precautions. The study objectives were to identify the current proportion that motivations change. Design: An online was conducted SRN...
Abstract “All or none” approaches to the use of contact precautions for methicillin-resistant Staphylococcus aureus (MRSA) both fail recognize that transmission risk varies. This qualitative study assessed healthcare personnel perspectives regarding feasibility a risk-tailored approach MRSA more strategically in acute care setting.
Abstract Objective: Prior studies evaluating the impact of discontinuation contact precautions (DcCP) on methicillin-resistant Staphylococcus aureus (MRSA) outcomes have characterized all healthcare-associated infections (HAIs) rather than those likely preventable by precautions. We aimed to analyze DcCP rate MRSA HAI including transmission events identified through whole genome sequencing (WGS) surveillance. Design: Quasi experimental interrupted time series. Setting: Acute care medical...
Abstract Background: Clostridioides difficile infection (CDI) may be misdiagnosed if testing is performed in the absence of signs or symptoms disease. This study sought to support appropriate by estimating impact signs, symptoms, and healthcare exposures on pre-test likelihood CDI. Methods: A panel fifteen experts infectious diseases participated a modified UCLA/RAND Delphi estimate Consensus, defined as agreement >70% panelists, was assessed via REDCap survey. Items without consensus...
Background: Contact precautions (CP) to prevent transmission of multidrug-resistant gram-negative (MDRGN) Enterobacteriaceae are recommended, although studies discontinuation CP (DcCP) have found no change in healthcare associated infections (HAI) due extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae. Limited data exists on DcCP for MDRGN a large health system. Methods: We performed retrospective observational study analyzing the relationship between use and HAI two...
Background: Inappropriate Clostridioides difficile (C. difficile) laboratory testing is common in hospitals and leads to over diagnosis, unnecessary treatment, elevated hospital onset C. infection (HO-CDI) metrics. Diagnostic stewardship essential avoid inappropriate testing, but limited data exists on optional interventions. Methods: A diagnostic intervention targeting CDI comprised of education prospective audit with feedback was performed a VA facility (inpatient, outpatient, long-term...
Abstract Training programs for infectious diseases fellows pursuing a career in infection prevention and control hospital epidemiology are grounded mentorship organizational experience. In this commentary, we propose competency-based framework creating structured learning related fields.
The Clinical and Laboratory Standards Institute (CLSI) recently lowered minimum inhibitory concentration (MIC) ciprofloxacin (CIP) levofloxacin (LEV) breakpoints for Enterobacteriaceae. These revisions are based on pharmacokinetic-pharmacodynamic attainment analyses, which may not accurately predict clinical outcomes all infections. We evaluated the of patients receiving CIP or LEV treatment bacteremia caused by Enterobacteriaceae isolates considered intermediate resistant to these agents...
To determine if treatment failure varies based on ROME III classification and adherence to guideline congruent therapy among children diagnosed in an emergency department with functional constipation.Children aged 1 month 18 years who were constipation a paediatric underwent chart review 7-day phone follow-up complete the questionnaire, confirm treatments administered, assess failure. Participants classified according criteria as having (FC) or irritable bowel syndrome - (IBS-C) subtype. The...
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