A5114833524- Antibiotic Resistance in Bacteria
- Antibiotic Use and Resistance
- Bacterial Identification and Susceptibility Testing
- Clostridium difficile and Clostridium perfringens research
- Infection Control in Healthcare
- Urinary Tract Infections Management
- Nosocomial Infections in ICU
- Antimicrobial Resistance in Staphylococcus
- Patient Satisfaction in Healthcare
- Antifungal resistance and susceptibility
- Gut microbiota and health
- Data-Driven Disease Surveillance
- Mycobacterium research and diagnosis
- COVID-19 and healthcare impacts
- Medical Device Sterilization and Disinfection
- Tuberculosis Research and Epidemiology
- Fungal Infections and Studies
- Surgical site infection prevention
- Pressure Ulcer Prevention and Management
- Enterobacteriaceae and Cronobacter Research
- Healthcare cost, quality, practices
- Infection Control and Ventilation
- COVID-19 Clinical Research Studies
- SARS-CoV-2 and COVID-19 Research
- COVID-19 and Mental Health
Rush University Medical Center
2016-2025
University of South Alabama
2024
Advisory Board Company (United States)
2023
New York Proton Center
2015-2023
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
Museum of Heilongjiang Province
2021
Background. In the United States, Klebsiella pneumoniae carbapenemase (KPC)–producing Enterobacteriaceae are increasingly detected in clinical infections; however, colonization burden of these organisms among short-stay and long-term acute care hospitals is unknown.
Risks for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care personnel (HCP) are unclear.
Background. Klebsiella pneumoniae carbapenemase–producing Enterobacteriaceae (hereafter "KPC") are an increasing threat to healthcare institutions. Long-term acute-care hospitals (LTACHs) have especially high prevalence of KPC. Methods. Using a stepped-wedge design, we tested whether bundled intervention (screening patients for KPC rectal colonization upon admission and every other week; contact isolation geographic separation KPC-positive in ward cohorts or single rooms; bathing all daily...
To determine the effect of a bundle infection control interventions on horizontal transmission Klebsiella pneumoniae carbapenemase (KPC)-producing K. during an outbreak.Quasi-experimental study. Setting. Long-term acute care hospital. Intervention. On July 23, 2008, bundled intervention was implemented: daily 2% chlorhexidine gluconate baths for patients, enhanced environmental cleaning, surveillance cultures at admission, serial point prevalence (PPS), isolation precautions, and training...
Central line-associated bloodstream infection (BSI) rates, determined by preventionists using the Centers for Disease Control and Prevention (CDC) surveillance definitions, are increasingly published to compare quality of patient care delivered hospitals. However, such comparisons valid only if is performed consistently across institutions.To assess institutional variation in performance traditional central BSI surveillance.We a retrospective cohort study 20 intensive units among 4 medical...
An association between increased relative abundance of specific bacterial taxa in the intestinal microbiota and bacteremia has been reported some high-risk patient populations. We collected weekly rectal swab samples from patients at 1 long-term acute care hospital (LTACH) Chicago May 2015 to 2016. Samples positive for Klebsiella pneumoniae carbapenemase-producing (KPC-Kp) by polymerase chain reaction culture underwent 16S rRNA gene sequence analysis; operational taxonomic unit containing...
Since the identification of first 2 Candida auris cases in Chicago, Illinois, 2016, ongoing spread has been documented Chicago area. We describe C. emergence high-acuity, long-term healthcare facilities and present a case study public health response to carbapenemase-producing organisms (CPOs) at one ventilator-capable skilled nursing facility (vSNF-A).We performed point prevalence surveys (PPSs) identify patients colonized with infection-control (IC) assessments provided support for IC...
Abstract Despite enhanced infection prevention efforts, Clostridioides difficile remains the leading cause of healthcare-associated infections in United States. Current strategies are limited by their failure to account for patients who carry C. asymptomatically, may act as hidden reservoirs transmitting other patients. To improve understanding asymptomatic carriers’ contribution spread, we conducted admission and daily longitudinal culture-based screening a US-based intensive care unit over...
Increasing bacterial antimicrobial resistance has prompted physicians to choose broad-spectrum antimicrobials in order reduce the likelihood of inactive empirical therapy. However, for bacteremic patients already receiving supportive care, it is unclear whether delay active therapy significantly impacts patient outcomes. We performed a retrospective cohort study with monomicrobial bloodstream infections at large urban hospital United States from 2001 2006. assessed impact on mortality by...
To determine whether transfer from a long-term care facility (LTCF) is risk factor for colonization with Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae upon acute hospital admission.Microbiologic survey and nested case-control study.Four hospitals in metropolitan area (Chicago) an early KPC epidemic.Hospitalized adults.Patients transferred LTCFs were matched 1∶1 to patients admitted the community by age (± 10 years), admitting clinical service, admission date 2...
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...
Background. Carbapenem-resistant Enterobacteriaceae (CRE) spread regionally throughout healthcare facilities through patient transfer and cause difficult-to-treat infections. We developed a state-wide patient-sharing matrix applied social network analyses to determine whether greater connectedness (centrality) other sharing with long-term acute care hospitals (LTACHs) predicted higher facility CRE rates. Methods. combined case information from the Illinois extensively drug-resistant organism...
Abstract Background Carbapenem-resistant Enterobacterales (CRE) harboring blaKPC have been endemic in Chicago-area healthcare networks for more than a decade. During 2016–2019, series of regional point-prevalence surveys identified increasing prevalence blaNDM-containing CRE multiple long-term acute care hospitals (LTACHs) and ventilator-capable skilled nursing facilities (vSNFs). We performed genomic epidemiology investigation blaNDM-producing to understand their emergence spread. Methods...
Surveillance of wastewater from healthcare facilities has the potential to identify emergence multidrug-resistant organisms (MDROs) public health importance. Specifically, surveillance can provide sentinel novel MDROs (e.g., Candida auris) in and could help direct targeted prevention efforts monitor longitudinal effects. Several knowledge gaps need be addressed before used routinely for MDRO surveillance, including determining optimal approaches sampling, processing, testing MDROs. To this...
After conjugation in hypotrichous ciliates, a new macronucleus is produced from copy of the micronucleus. This transformation involves large-scale reorganization DNA, with conversion chromosomal micronuclear genome into short, gene-sized DNA molecules macronucleus. To study directly changes that occur during this process, we have developed techniques for synchronous mating large populations ciliate Euplotes crassus. Electron microscope studies show chromosomes are polytenized first 20 h...
ABSTRACT We report four adult patients who presented with septic pulmonary emboli and community-acquired methicillin-resistant Staphylococcus aureus bacteremia associated deep tissue infections, such as pyomyositis, osteomyelitis, prostatic abscess. The lacked evidence of right-sided endocarditis or thrombophlebitis. This association, previously described in children, may also be important adults.
Objective. To determine anatomic sites of colonization in patients and to assess environmental contamination with Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae. Design, Setting, Patients. We conducted a cross-sectional microbiologic survey 33 their environments at 6 long-term acute care hospitals (LTACHs) metropolitan Chicago. Swab samples inanimate surfaces patients' rooms common areas were cultured. bla KPC was verified by polymerase chain reaction. Patient charts...
We evaluated the effectiveness of daily chlorhexidine gluconate (CHG) bathing in decreasing skin carriage Klebsiella pneumoniae carbapenemase–producing Enterobacteriaceae (KPC) among long-term acute care hospital patients. CHG reduced KPC colonization, particularly when concentrations greater than or equal to 128 μ g/mL were achieved.
Objective To formulate a model for translating manual infection control surveillance methods to automated, algorithmic approaches.
OBJECTIVE Prevalence of bla KPC -encoding Enterobacteriaceae (KPC) in Chicago long-term acute care hospitals (LTACHs) rose rapidly after the first recognition 2007. We studied epidemiology and transmission capacity LTACHs effect patient cohorting. METHODS Data were available from 4 June 2012 to 2013 during a period bundled interventions. These consisted screening for rectal carriage, daily chlorhexidine bathing, medical staff education, 3 cohort strategies: pure (all KPC-positive patients on...
In response to clusters of carbapenem-resistant Enterobacteriaceae (CRE) in Illinois, USA, the Illinois Department Public Health and Centers for Disease Control Prevention Chicago Epicenter launched a statewide Web-based registry designed bidirectional data exchange among health care facilities. CRE occurrences are entered searchable system, enabling interfacility communication patient information. For rapid notification facilities, admission feeds automated. During first 12 months...