A5076091226- COVID-19 and Mental Health
- Viral Infections and Vectors
- Antibiotic Use and Resistance
- Streptococcal Infections and Treatments
- Pneumonia and Respiratory Infections
- SARS-CoV-2 detection and testing
- Orthopedic Infections and Treatments
- Vector-borne infectious diseases
- SARS-CoV-2 and COVID-19 Research
- Respiratory viral infections research
- COVID-19 and healthcare impacts
- Infectious Diseases and Tuberculosis
- Mosquito-borne diseases and control
- Nosocomial Infections in ICU
- Sepsis Diagnosis and Treatment
- Antimicrobial Resistance in Staphylococcus
- Infection Control and Ventilation
- Urinary Tract Infections Management
- Emergency and Acute Care Studies
- Antibiotics Pharmacokinetics and Efficacy
- Bacterial Identification and Susceptibility Testing
- Healthcare Policy and Management
- Health and Medical Research Impacts
- Escherichia coli research studies
- Neonatal and Maternal Infections
Duke University
2019-2025
Duke Medical Center
2021-2025
Duke Institute for Health Innovation
2023-2025
Duke University Hospital
2022-2024
Durham Technical Community College
2023
Clinical Research Institute
2021-2022
Pediatric Infectious Diseases Society
2021
Chettinad Health City
2016
ABSTRACT Pediatric patients undergoing cardiothoracic surgery are at increased risk for health care–associated infections, especially surgical site infections (SSIs). Delayed sternal closures associated with prolonged lengths of stay and contribute to infection risks morbidities. At a single‐site academic pediatric center, we created an SSI‐prevention bundle targeting the preoperative, intraoperative, postoperative care periods. Using standard criteria, determined epidemiology SSIs measured...
Abstract Spotted fever group rickettsioses (SFGR) pose a global threat as emerging zoonotic infectious diseases; however, timely and cost-effective diagnostic tools are currently limited. We used data from 449 patients presenting to 2 hospitals in northern Tanzania between 2007 2008, of which 71 (15.8%) met criteria for acute SFGR based on ≥4-fold rise antibody titers convalescent serum samples. fit random forest classifiers incorporating clinical demographic hospitalized febrile...
Neonatal bloodstream infections (BSI) make a substantial contribution to morbidity and mortality in low- middle-income countries (LMICs), but data on the epidemiology antimicrobial resistance (AMR) Tanzania are limited. We describe prevalence, patterns, associated factors of neonatal BSI at Kilimanjaro Christian Medical Centre (KCMC), large referral hospital northern Tanzania. conducted prospective, observational study involving infants aged 0–60 days with perinatal risk or clinical signs...
When the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic began, experts raised concerns about in-person instruction in setting of high levels community transmission. We describe secondary transmission SARS-CoV-2 within North Carolina kindergarten through 12th-grade school districts during a winter surge to determine if mitigation strategies can hinder within-school
OBJECTIVES We evaluated the safety and efficacy of a test-to-stay program for unvaccinated students staff who experienced an unmasked, in-school exposure to someone with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Serial testing instead quarantine was offered asymptomatic contacts. measured secondary tertiary transmission rates within participating schools days preserved participants. METHODS Participating or from universally masked districts in North...
We evaluated the impact of a test-to-stay (TTS) program on within-school transmission and missed school days in optionally masked kindergarten through 12th grade schools during period high community severe acute respiratory syndrome coronavirus 2 transmission.
Observational studies in adults suggest nasal methicillin-resistant Staphylococcus aureus (MRSA) swabs have a high negative predictive value (NPV) for ruling out MRSA pneumonia, however, pediatric data are limited. This retrospective study of 505 patients found 99.8% NPV among children with suspected respiratory infections.
Abstract Background In northern Tanzania, Q fever, spotted fever group (SFG) rickettsioses, and typhus (TG) rickettsioses are common causes of febrile illness. We sought to describe the prevalence risk factors for these zoonoses in a pastoralist community. Methods Febrile patients ≥2 years old presenting Endulen Hospital Ngorongoro Conservation Area were enrolled from August 2016 through October 2017. Acute convalescent blood samples collected, questionnaire was administered. Sera tested by...
Abstract Background Children enrolled in private insurance had reduced preventive health care during the coronavirus disease 2019 (COVID-19) pandemic. However, impact of pandemic on children Medicaid has been minimally described. Methods We used an administrative claims database from North Carolina to evaluate rates well-child visits and immunization administration for ≤14 months age, a quasi-Poisson regression model estimate rate ratio (RR) each outcome period (3/15/2020 through 3/15/2021)...
Masking is an essential coronavirus 2019 mitigation tool assisting in the safe return of kindergarten through 12th grade children and staff to in-person instruction; however, masking adherence, compliance evaluation methods, potential consequences surveillance are currently unknown. We describe 2 school districts' approaches promote in-school consequent impact on severe acute respiratory syndrome secondary transmission.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related quarantines, which are required after close contact with infected individuals, have substantially disrupted in-person education for kindergarten through 12th grade (K-12) students. In recent recommendations, shortened durations of quarantine allowed if a negative SARS-CoV-2 test result is obtained at 5 to 7 days postexposure, but access testing remains limited. We hypothesized that providing in-school postexposure would...
This In Brief was accepted July, 2021. Due to the Pediatrics in Review process from authorship publication and rapidly evolving nature of COVID-19 pandemic, this may not reflect most recent events.Severe acute respiratory syndrome coronavirus 2 has infected hundreds millions individuals globally, have died as a result associated disease 2019 (COVID-19). Although severe predominantly affected older adults, children also been affected. As early May 2021, nearly 4 million total cases were...
Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) screening testing is a recommended mitigation strategy for schools, although few descriptions of program implementation are available. Methods Kindergarten through 12th grade (K–12) students and staff practicing universal masking during the delta omicron variant waves from five schools in Durham, North Carolina eight Kansas City, Missouri participated; Durham’s was structured as public health initiative...
Background: Racial inequities influence health outcomes in the United States, but their impact on sepsis among children is understudied. We aimed to evaluate for racial mortality using a nationally representative sample of pediatric hospitalizations. Methods: This population-based, retrospective cohort study used 2006, 2009, 2012 and 2016 Kids’ Inpatient Database. Eligible 1 month 17 years old were identified sepsis-related International Classification Diseases, Ninth Revision or Tenth...
Abstract Background We describe antibacterial use in light of microbiology data and treatment guidelines for common febrile syndromes Moshi, Tanzania. Methods compared from 2 hospital-based prospective cohort studies, 1 (2011–2014) (2016–2019), that enrolled children adults. A study team member administered a standardized questionnaire, performed physical examination, collected blood cultures. Participants with bloodstream infection (BSI) were categorized as receiving effective or...
Exebacase, an antistaphylococcal lysin produced from a bacteriophage-encoded gene, is promising adjunctive therapy for severe methicillin-resistant Staphylococcus aureus infections. We describe the first infant to receive exebacase, dosing, and pharmacokinetics. Exebacase may be safe efficacious in children; however, further clinical trials are needed optimize dosing.
Abstract Purpose The majority of pediatric antibiotic prescribing occurs in the outpatient setting and inappropriate use contributes to antimicrobial resistance. There are regional variations with highest rates occurring Southern states, including Appalachia. purpose this study was describe risk factors for prescription among patients enrolled North Carolina (NC) Medicaid. Methods We used Medicaid claims data from 2013 2019 patterns NC. assessed patient provider identify prescribing....
Abstract Background Knowledge gaps exist on risk factors for spotted fever group rickettsioses (SFGR) in sub-Saharan Africa. We sought to identify SFGR Kilimanjaro Region, Tanzania. Methods recruited febrile patients presenting at 2 hospitals Moshi from February 2012 through May 2014. Standardized clinical and factor questionnaires were administered. exposure was defined as a Rickettsia africae immunofluorescence antibody reciprocal titer ≥64, acute ≥4-fold rise between paired sera. Logistic...
The coronavirus disease 2019 (COVID-19) pandemic forced the suspension of in-person education in schools serving students kindergarten through 12th grade (K-12) across United States. As time passed, teachers, students, and parents struggled with remote education. With limited guidance at federal level, physicians school leaders country collaborated to develop local solutions for schools. This article describes lessons learned from development 4 academic-community partnerships collaboration...
Implementation of dedicated pediatric antimicrobial stewardship programs (ASPs) at 2 combined adult-pediatric hospitals with existing ASPs was associated sustained decreases in antibiotic use out proportion to declines seen adult inpatient units. may not detect excessive without incorporating expertise.
Abstract Spotted fever group rickettsioses (SFGR) pose a global threat as emerging zoonotic infectious diseases; however, timely and cost-effective diagnostic tools are currently limited. While traditional clinical prediction models focus on individual patient-level parameters, we hypothesize that for diseases, the inclusion of location-specific parameters such climate data may improve predictive ability. To create model, used from 449 patients presenting to two hospitals in northern...
Introduction: Approximately 75,000 children are hospitalized for sepsis yearly in the United States, with 5%–20% mortality estimates. Outcomes closely related to timeliness of recognition and antibiotic administration. Methods: A multidisciplinary task force formed Spring 2020 aimed assess improve pediatric care emergency department (ED). The electronic medical record identified patients from September 2015 July 2021. Data time delivery were analyzed using statistical process control charts...