A5013859625- Geriatric Care and Nursing Homes
- Antibiotic Resistance in Bacteria
- Antibiotic Use and Resistance
- COVID-19 and Mental Health
- Respiratory viral infections research
- Antimicrobial Resistance in Staphylococcus
- Infection Control in Healthcare
- Influenza Virus Research Studies
- Antifungal resistance and susceptibility
- COVID-19 and healthcare impacts
- Bacterial Identification and Susceptibility Testing
- Urinary Tract Infections Management
- Gut microbiota and health
- Infection Control and Ventilation
- Vietnamese History and Culture Studies
- Pressure Ulcer Prevention and Management
- Psoriasis: Treatment and Pathogenesis
- Clostridium difficile and Clostridium perfringens research
- Medical Device Sterilization and Disinfection
- COVID-19 Pandemic Impacts
- COVID-19 epidemiological studies
- Homelessness and Social Issues
- Fungal Infections and Studies
- Antibiotics Pharmacokinetics and Efficacy
- Nail Diseases and Treatments
University of California, Irvine
2017-2025
Community Living
2024
Office of Infectious Diseases
2023
New York Proton Center
2023
Communities In Schools of Orange County
2023
Manhattan Institute for Policy Research
2023
University of Pittsburgh
2023
Lindsay Unified School District
2023
Oregon Medical Research Center
2023
Advisory Board Company (United States)
2023
Abstract Background Environmental contamination is suspected to play an important role in Candida auris transmission. Understanding speed and risks of after room disinfection could inform environmental cleaning recommendations. Methods We conducted a prospective multicenter study associated with C. colonization at 6 ventilator-capable skilled nursing facilities 1 acute care hospital Illinois California. Known carriers were sampled 5 body sites followed by sampling nearby surfaces before 0,...
Abstract Background Multidrug-resistant organisms (MDROs) spread between hospitals, nursing homes (NHs), and long-term acute care facilities (LTACs) via patient transfers. The Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County is a regional public health collaborative involving decolonization at 38 healthcare selected based on their high degree sharing. We report baseline MDRO prevalence 21 NHs/LTACs. Methods A random sample 50 adults for...
Abstract Background The abundance and diversity of antibiotic resistance genes (ARGs) in the human respiratory microbiome remain poorly characterized. In context influenza virus infection, interactions between virus, host, resident bacteria with pathogenic potential are known to complicate worsen disease, resulting coinfection increased morbidity mortality infected individuals. When acquire resistance, they more difficult treat global health concern. Characterization ARG expression upper...
Nursing home residents are at high risk for infection, hospitalization, and colonization with multidrug-resistant organisms. Download a PDF of the Research Summary. We performed cluster-randomized trial universal decolonization as compared routine-care bathing in nursing homes. The included an 18-month baseline period intervention period. Decolonization entailed use chlorhexidine all routine showering administration nasal povidone–iodine twice daily first 5 days after admission then every...
Carbapenem-resistant Enterobacterales (CRE) are an urgent global health threat. Inferring the dynamics of local CRE dissemination is currently limited by our inability to confidently trace spread resistance determinants unrelated bacterial hosts. Whole-genome sequence comparison useful for identifying clonal transmission and outbreaks, but high-frequency horizontal gene transfer (HGT) carbapenem genes subsequent genome rearrangement complicate tracing persistence mobilization these across...
Importance Infections due to multidrug-resistant organisms (MDROs) are associated with increased morbidity, mortality, length of hospitalization, and health care costs. Regional interventions may be advantageous in mitigating MDROs infections. Objective To evaluate whether implementation a decolonization collaborative is reduced regional MDRO prevalence, incident clinical cultures, infection-related hospitalizations, costs, deaths. Design, Setting, Participants This quality improvement study...
Abstract Objective: Nursing home residents may be particularly vulnerable to coronavirus disease 2019 (COVID-19). Therefore, a question is when and how often nursing homes should test staff for COVID-19 this change as severe acute respiratory virus 2 (SARS-CoV-2) evolves. Design: We developed an agent-based model representing typical home, spread, its health economic outcomes determine the clinical value of various screening isolation strategies it under circumstances. Results: Under winter...
Abstract Background Candida auris is an emerging drug-resistant yeast that spreading rapidly in U.S. healthcare facilities, particularly nursing homes. Like MRSA, C. commonly found the nose, raising questions about whether nasal iodophor application can reduce carriage. Methods We evaluated impact of on carriage at two Nasal carriers were identified from point prevalence sampling bilateral nares residents for both and MRSA conducted each home. was given to according a 5-day twice-daily...
Abstract Background Nursing homes are high-risk settings for multidrug-resistant organism (MDRO) prevalence and spread. We investigated whether nursing home roommates were more likely to carry the same MDRO compared non-roommates. Methods conducted a secondary analysis of 44 in two studies (Protect Trial-Miller NEJM 2023; SHIELD-Gussin JAMA 2024) involving universal chlorhexidine bathing nasal iodophor. used status from baseline (2016-17) end-intervention (2018-19) visits where 50 residents...
Abstract Objective: Evaluate impact of COVID-19 prevention training with video-based feedback on nursing home (NH) staff safety behaviors. Design: Public health intervention Setting & Participants: Twelve NHs in Orange County, California, 6/2020-4/2022 Methods: received direct-to-staff and weekly reports video montages about hand hygiene, mask-wearing, mask/face-touching. One-hour periods recorded streaming from common areas (breakroom, hallway, station, entryway) were sampled randomly...
Candida auris is a human pathogen of high concern due to its extensive antifungal drug resistance and mortality rates associated with invasive infections. skin colonization persistence on environmental surfaces make this difficult control once it enters health care facility. Residents in long-term hospitals nursing homes are especially vulnerable.
<h3>Importance</h3> Multidrug-resistant organisms (MDROs) can spread across health care facilities in a region. Because of limited resources, certain interventions be implemented only some facilities; thus, decision-makers need to evaluate which may best implement. <h3>Objective</h3> To identify group target and assess MDRO intervention would implement the Shared Healthcare Intervention Eliminate Life-threatening Dissemination MDROs Orange County, large regional public collaborative...
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We evaluated whether universal chlorhexidine bathing (decolonization) with or without COVID-19 intensive training impacted rates in 63 nursing homes (NHs) during the 2020-2021 Fall/Winter surge. Decolonization was associated a 43% lesser rise staff case-rates (
Current guidance to furlough health care staff with mild COVID-19 illness may prevent the spread of but worsen nursing home staffing shortages as well outcomes that are unrelated COVID-19.
Abstract Background Clinical testing detects a fraction of carbapenem-resistant Enterobacteriaceae (CRE) carriers. Detecting greater proportion could lead to increased use infection prevention and control measures but requires resources. Therefore, it is important understand the impact detecting increasing proportions CRE Methods We used our Regional Healthcare Ecosystem Analyst–generated agent-based model adult inpatient healthcare facilities in Orange County, California, explore that...
Quantify the frequency and drivers of unreported coronavirus disease 2019 (COVID-19) symptoms among nursing home (NH) staff.Confidential telephone survey.The study was conducted in 70 NHs Orange County, California, December 2020-February 2022.The included 120 NH staff with COVID-19.We designed a 40-item survey to assess COVID-19 symptom reporting behavior types barriers [monetary, logistic, emotional (fear or stigma)] facilitators using 5-point Likert scales. Summary statistics, reliability...
Background: Candida auris is an emerging multidrug-resistant yeast that transmitted in healthcare facilities and associated with substantial morbidity mortality. Environmental contamination suspected to play important role transmission but additional information needed inform environmental cleaning recommendations prevent spread. Methods: We conducted a multiregional (Chicago, IL; Irvine, CA) prospective study of C. colonization patients residents 4 long-term care 1 acute-care hospital....
Pooling of samples can increase throughput and reduce costs for large-scale SARS-CoV-2 testing when incidence is low. In a cross-sectional study serial sampling staff residents at three nursing homes, laboratory labor constraints limited the feasibility pooling prior to maximal that favored cost savings.
Abstract In a prospective cohort study, we compared 2-swabs-per-nostril 5% iodophor regimen with 1-swab-per-nostril 10% on methicillin-resistant Staphylococcus aureus carriage in nursing-home residents. Compared baseline, both single-swab and double-swab regimens resulted an identical 40% reduction nasal 60% any carriage, skin or nasal.