A5030566750- Antibiotic Use and Resistance
- Bacterial Identification and Susceptibility Testing
- Urinary Tract Infections Management
- Healthcare Systems and Reforms
- SARS-CoV-2 and COVID-19 Research
- Pediatric Urology and Nephrology Studies
- SARS-CoV-2 detection and testing
- Antimicrobial Resistance in Staphylococcus
- COVID-19 and healthcare impacts
- Patient Satisfaction in Healthcare
- Global Maternal and Child Health
- Nosocomial Infections in ICU
- Streptococcal Infections and Treatments
- Respiratory viral infections research
- Antibiotics Pharmacokinetics and Efficacy
- Innovations in Medical Education
- Complementary and Alternative Medicine Studies
- Respiratory and Cough-Related Research
- COVID-19 Clinical Research Studies
- Viral gastroenteritis research and epidemiology
- Clostridium difficile and Clostridium perfringens research
- Surgical site infection prevention
- Bacteriophages and microbial interactions
- Healthcare cost, quality, practices
- Interprofessional Education and Collaboration
University of Washington
2017-2025
Harborview Medical Center
2019-2025
Washington Center
2023-2025
Seattle University
2023
New York Proton Center
2023
Communities In Schools of Orange County
2023
Manhattan Institute for Policy Research
2023
Oregon Medical Research Center
2023
Lindsay Unified School District
2023
University of Washington Medical Center
2021
Identifying infectious causes of subacute or chronic meningitis can be challenging. Enhanced, unbiased diagnostic approaches are needed.To present a case series patients with diagnostically challenging using metagenomic next-generation sequencing (mNGS) cerebrospinal fluid (CSF) supported by statistical framework generated from mNGS control samples the environment and who were noninfectious.In this series, data obtained CSF 94 noninfectious neuroinflammatory disorders 24 water reagent used...
Despite modern antiseptic techniques, surgical site infection (SSI) remains a leading complication of surgery. However, the origins SSI and high rates antimicrobial resistance observed in these infections are poorly understood. Using instrumented spine surgery as model clean (class I) skin incision, we prospectively sampled preoperative microbiomes postoperative isolates cohort 204 patients. Combining multiple forms genomic analysis, correlated identity, anatomic distribution, profiles...
Abstract Using data for 20 912 patients from 2 large academic health systems, we analyzed the frequency of severe acute respiratory syndrome coronavirus reverse-transcription polymerase chain reaction test discordance among individuals initially testing negative by nasopharyngeal swab who were retested on clinical grounds within 7 days. The subsequent positivity this window was 3.5% and similar across institutions.
Two near-identical clinical Streptococcus pyogenes isolates of emm subtype emm43.4 with a pbp2x missense mutation (T553K) were detected. Minimum inhibitory concentrations (MICs) for ampicillin and amoxicillin 8-fold higher, the MIC cefotaxime was 3-fold higher than near-isogenic control isolates, consistent first step in developing β-lactam resistance.
With the availability of widespread SARS-CoV-2 vaccination, high-throughput quantitative antispike serological testing will likely become increasingly important. Here, we investigated performance characteristics recently FDA-authorized semiquantitative AdviseDx IgG II assay compared to antinucleocapsid Abbott Architect IgG, Roche Elecsys anti-SARS-CoV-2-S, EuroImmun anti-SARS-CoV-2 enzyme-linked immunosorbent (ELISA), and GenScript surrogate virus neutralization assays examined humoral...
We retrospectively evaluated off-label use of dalbavancin as secondary therapy in 32 patients with serious Staphylococcus aureus infections (endocarditis, osteomyelitis, septic thrombophlebitis, epidural infection) who were also persons drugs. The majority (56%) had a clinical response to treatment. Only 1 patient completed the intended course experienced treatment failure.
Abstract Background Healthcare workers (HCWs) who serve on the front lines of coronavirus disease 2019 (COVID-19) pandemic have been at increased risk for infection due to severe acute respiratory syndrome 2 (SARS-CoV-2) in some settings. Healthcare-acquired has reported similar epidemics, but there are limited data prevalence COVID-19 among HCWs and their associated clinical outcomes United States. Methods We established high-throughput employee testing centers Seattle, Washington, with...
Abstract Across 20 vaccine breakthrough cases detected at our institution, all (100%) infections were due to variants of concern (VOCs) and had a median Ct 20.2 (IQR, 17.1–23.3). When compared with 5174 contemporaneous samples sequenced in laboratory, VOCs significantly enriched among (P < .05).
Abstract Background SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) testing remains the cornerstone of laboratory-based identification patients with COVID-19. As availability and speed platforms improve, results are increasingly relied upon to inform critical decisions related therapy, use personal protective equipment, workforce readiness. However, early reports RT-PCR test performance have left clinicians public concerns regarding reliability this predominant modality...
On January 19, 2020, the first case of a patient with coronavirus disease 2019 (COVID-19) in United States was reported Washington State. February 29, infected severe acute respiratory syndrome 2 (SARS-CoV-2) passed away hospital Seattle-King County, COVID-19-related death States. That same day, skilled nursing and rehabilitation facility county that several its residents tested positive for SARS-CoV-2 many staff had symptoms compatible COVID-19. The University Medicine health system (UW...
Abstract Across 20 vaccine breakthrough cases detected at our institution, all (100%) infections were due to variants of concern (VOC) and had a median Ct 20.2 (IQR=17.1-23.3). When compared 5174 contemporaneous samples sequenced in laboratory, VOC significantly enriched among (p < .05).
Abstract Rotavirus is a leading cause of diarrhea among children but less known as adults. We describe clinical, epidemiologic, and genotype characteristics rotavirus outbreak adults in King County, Washington occurring January-June 2023. Adult incidence 2023 was ten times higher than the same period 2022 (5% versus 0.5% samples). Disease severity mild. G9P[4], an uncommon, non-vaccine strain USA, predominant genotype. Genotyping suggested spillover from with subsequent spread Our study...
Abstract Background In 2019, our institution implemented the MITIGATE (a Multifaceted Intervention to Improve Prescribing for Acute Respiratory Infection Adult and Children in Emergency Department Urgent Care Settings) Toolkit, a multimodal antimicrobial stewardship strategy using education, data, feedback reduce unnecessary antibiotic prescribing viral respiratory infections (RTIs) ambulatory care settings. Methods This was single center observational study. Prescribers emergency department...
Abstract Background Rural and critical access hospitals (CAHs) serve 20% of the United States population. Fewer than 10% US physicians practice in rural areas workforce shortages staff turnover are a constant threat. The University Washington Center for Stewardship Medicine (UW CSiM) supports tele-antimicrobial stewardship (AMS) program TASP ECHO) small, rural, CAHs, primarily western U.S. with education, mentoring, organizational capacity building, community peers. Methods UW CSiM...
Abstract We evaluated 249 asymptomatic patients receiving antibiotics for urinary infection: 222 had pyuria and/or nitrituria (ASPN) and 133 bacteriuria (ASB, growth ≥10 5 colony forming units/ml). ASPN identified 40% more cases of unnecessary compared to ASB may be a comprehensive measure antibiotic use.
Retrospective hospital-registry study.To characterize the microbial epidemiology of surgical site infection (SSI) in spinal fusion surgery and burden resistance to standard antibiotic prophylaxis.SSI persists as a leading complication despite growth enhanced recovery programs improvements other measures quality. Improved understandings SSI microbiology common mechanisms failure for current prevention strategies are required inform development novel approaches relevant modern practice.Spinal...
COVID-19 has a widely variable clinical syndrome that is difficult to distinguish from bacterial sepsis, leading high rates of antibiotic use. Early studies indicate low secondary infections (SBIs) but have included heterogeneous patient populations. Here, we catalogue all SBIs and prescription practices in population mechanically ventilated patients with induced acute respiratory distress (ARDS).This was retrospective cohort study ARDS requiring mechanical ventilation 3 Seattle, Washington...
Background Cause-of-death data for many developing countries are not available. Information on deaths in hospital by cause is available low- and middle-income but a representative sample of the population. We propose method to estimate population cause-specific mortality fractions (CSMFs) using already collected some low-income nations, yet rarely used: in-hospital death records. Methods Findings For given death, community's equal total community multiplied proportion occurring hospital. If...
Since 2001, Mexico has been designing, legislating, and implementing a major health-system reform.A key component was the creation of Seguro Popular, which is intended to expand insurance coverage over seven years uninsured people, nearly half total population at start 2001.The reform included five actions: legislation entitlement per family affiliated which, with full implementation, will increase public spending on health by 0.8-1.0% gross domestic product; explicit benefits packages;...