A5013723626- Clostridium difficile and Clostridium perfringens research
- Antibiotic Resistance in Bacteria
- Antimicrobial Resistance in Staphylococcus
- Antibiotic Use and Resistance
- Bacterial Identification and Susceptibility Testing
- Nosocomial Infections in ICU
- Infection Control in Healthcare
- Viral gastroenteritis research and epidemiology
- Urinary Tract Infections Management
- Microscopic Colitis
- Infective Endocarditis Diagnosis and Management
- Medical Device Sterilization and Disinfection
- Central Venous Catheters and Hemodialysis
- Streptococcal Infections and Treatments
- Antifungal resistance and susceptibility
- Sepsis Diagnosis and Treatment
- Orthopedic Infections and Treatments
- COVID-19 Clinical Research Studies
- Healthcare cost, quality, practices
- SARS-CoV-2 and COVID-19 Research
- Surgical site infection prevention
- Pediatric Urology and Nephrology Studies
- Antibiotics Pharmacokinetics and Efficacy
- Pharmaceutical and Antibiotic Environmental Impacts
- Enterobacteriaceae and Cronobacter Research
University of Michigan
2015-2024
Michigan Medicine
2008-2021
Rambam Health Care Campus
2019
Engineering Associates (United States)
2015-2018
Biology of Infection
2018
University Health System
2008-2017
Office of Infectious Diseases
1996-2017
VA Ann Arbor Healthcare System
2017
Iowa City Public Library
2016
New York Proton Center
2015
Integration of rapid diagnostic testing via matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) with antimicrobial stewardship team (AST) intervention has the potential for early organism identification, customization antibiotic therapy, and improvement in patient outcomes. The objective this study was to assess impact combined approach on clinical therapy-related outcomes patients bloodstream infections.A pre-post quasi-experimental conducted analyze MALDI-TOF AST...
Abstract We describe a case of chronic coronavirus disease 2019 (COVID-19) in patient with lymphoma and associated B-cell immunodeficiency. Viral cultures sequence analysis demonstrate ongoing replication infectious severe acute respiratory syndrome 2 (SARS-CoV-2) for at least 119 days. The had 3 admissions related to COVID-19 over 4-month period was treated twice remdesivir convalescent plasma resolution symptoms. patient’s lack seroconversion prolonged course illustrate the importance...
Ideas and Opinions11 March 2020How Should U.S. Hospitals Prepare for Coronavirus Disease 2019 (COVID-19)?FREEVineet Chopra, MD, MSc, Eric Toner, Richard Waldhorn, Laraine Washer, MDVineet MScUniversity of Michigan, Ann Arbor, Michigan (V.C., L.W.), MDCenter Health Security, Bloomberg School Public Health, Johns Hopkins University, Baltimore, Maryland (E.T.), MDGeorgetown Washington, DC, Center (R.W.), MDUniversity L.W.)Author, Article, Disclosure Informationhttps://doi.org/10.7326/M20-0907...
Background. Studies of Clostridium difficile outbreaks suggested that certain ribotypes (eg, 027 and 078) cause more severe disease than other ribotypes. A growing number studies challenge the validity this hypothesis. Methods. We conducted a cross-sectional study C. infection (CDI) to test whether ribotype predicted clinical severity when adjusted for influence predictors. Toxigenic isolates were cultured from stool samples, screened genes encoding virulence factors by polymerase chain...
OBJECTIVE An estimated 293,300 healthcare-associated cases of Clostridium difficile infection (CDI) occur annually in the United States. To date, research has focused on developing risk prediction models for CDI that work well across institutions. However, this one-size-fits-all approach ignores important hospital-specific factors. We focus a generalizable method building facility-specific models. demonstrate applicability using electronic health records (EHR) from University Michigan...
Epigenetic alterations in the genome of tumor cells have attracted considerable attention since discovery widespread DNA methylation colorectal cancers over 10 years ago. However, mechanism these changes has remained obscure. el-Deiry and coworkers [el-Deiry, W. S., Nelkin, B. D., Celano, P., Yen, R. C., Falco, J. Hamilton, S. & Baylin, (1991) Proc. Natl. Acad. Sci. USA 88, 3470-3474], using a quantitative reverse transcription-PCR assay, reported 15-fold increased expression...
Rapid diagnostic testing with matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) decreases the time to organism identification by 24 36 h compared amount required conventional methods. However, there are limited data evaluating impact MALDI-TOF real-time antimicrobial stewardship team (AST) review and intervention on prescribing outcomes for patients bacteremia blood cultures contaminated coagulase-negative Staphylococcus (CoNS). A quasiexperimental study was conducted...
Study Objective To analyze the impact of a comprehensive care bundle directed by an antimicrobial stewardship team ( AST ) on management candidemia. Design Single‐center, quasi‐experimental study. Setting A 930‐bed academic hospital. Patients Seventy‐eight patients with candidemia were evaluated; 41 received group), and 37 did not (historical control group). Measurements Main Results was developed interdisciplinary , incorporating key elements from I nfectious D iseases S ociety merica's C...
BACKGROUND Peripherally inserted central catheters (PICCs) are associated with central-line–associated bloodstream infections (CLABSIs). However, no tools to predict risk of PICC-CLABSI have been developed. OBJECTIVE To operationalize or prioritize CLABSI factors when making decisions regarding the use PICCs using a model estimate an individual’s prior device placement. METHODS Using data from Michigan Hospital Medicine Safety consortium, patients that experienced between January 2013 and...
The impact of healthcare personnel hand contamination in multidrug-resistant organism (MDRO) transmission is important and well studied; however, the role patient needs to be characterized further.Patients from 2 hospitals southeast Michigan were recruited within 24 hours arrival their room followed prospectively using microbial surveillance nares, dominant hand, 6 high-touch environmental surfaces. Sampling was performed on admission, days 3 7, weekly until discharge. Paired samples...
Tigecycline is one of the few remaining therapeutic options for extensively drug-resistant (XDR) Gram-negative bacilli (GNB). MICs tigecycline to Acinetobacter baumannii have been reported be elevated when determined by Etest compared determinations broth microdilution (BMD) method. The study aim was compare susceptibility GNB four different testing methods. were collected from six health care systems (25 hospitals) in southeast Michigan January 2010 September 2011. among A. baumannii,...
The Klebsiella pneumoniae carbapenemase (KPC) was detected in carbapenem-resistant isolates of Citrobacter freundii and oxytoca recovered from different patients a Michigan hospital. Restriction analysis hybridization with KPC-specific probe showed the bla(KPC-2) genes these two genera family Enterobacteriaceae are carried on common plasmid.
Abstract Background Human adenoviruses (HAdVs) can cause outbreaks of flu-like illness in university settings. Most infections healthy young adults are mild; severe illnesses rarely occur. In Fall 2022, an adenovirus outbreak was identified students. Methods HAdV cases were defined as students 17–26 years old who presented to the University Health Service or nearby emergency department with symptoms (eg, fever, cough, headache, myalgia, nausea) and had confirmed by polymerase chain reaction...
Abstract Background In April 2020, the University of Michigan discontinued barrier contact precautions for Vancomycin-Resistant Enterococcus (VRE) colonized patients while maintaining VRE surveillance. We conducted a retrospective cohort study to assess impact this policy change on risk acquisition Inclusion and Exclusion Criteria Cohort Methods analyzed admitted between 1/2018 3/2021 who underwent weekly The primary outcome was VRE-free survival; main exposure admission before or after...
Abstract Background We previously proposed bacteremia prediction models that might save a quarter of blood cultures (BCs) while missing few patients. In this study, we aimed to validate these in the United States.Table 1:Discrimination, calibration, and clinical usefulness upon external validation for five models.Basic variables were age, systolic pressure (mmHg), heart rate (beats/min), respiratory (breaths/min), temperature (Celsius) Glasgow coma scale. The basic model was tested 46236...
Urine cultures are frequently obtained for hospitalized patients. We reviewed documented indications culture and compared these with professional society guidelines. Lack of documentation important clinical scenarios (before orthopedic procedures when the patient has altered mental status without a urinary catheter) highlighted as areas use outside current
Objective. To determine relative rates of blood culture contamination for 3 skin antisepsis interventions—10% povidone iodine aqueous solution (PI), 2% tincture (IT), and Chlorhexidine gluconate in 70% isopropyl alcohol (CHG)—when used by dedicated phlebotomy teams to obtain peripheral cultures. Design. Randomized crossover trial with hospital floor as the unit randomization. Setting. Teaching 885 beds. Patients. All adult patients undergoing collection on medical-surgical floors from May...
Carbapenem-resistant Enterobacteriaceae (CRE) are clinically challenging, threaten patient safety, and represent an emerging public health issue. CRE reporting is not mandated in Michigan.The Michigan Department of Community Health-led Surveillance Prevention Initiative enrolled 21 facilities (17 acute care 4 long-term facilities) across the state. Baseline data collection began September 1, 2012, ended February 28, 2013 (duration, 6 months). Enrolled voluntarily reported cases Klebsiella...
Treatment of asymptomatic bacteriuria contributes to antimicrobial overuse in hospitalized patients. Indications for urine culture, treatment, and targets improvement were evaluated 153 Drivers included fever with an alternative source, altered mental status, leukocytosis, which led 435 excess days therapy. Infect Control Hosp Epidemiol 2014;00(0): 1–4