A5101903831- Antibiotic Use and Resistance
- Antibiotics Pharmacokinetics and Efficacy
- Surgical site infection prevention
- Marriage and Sexual Relationships
- Antibiotic Resistance in Bacteria
- Pneumonia and Respiratory Infections
- Orthopedic Infections and Treatments
- Urinary Tract Infections Management
- Hip and Femur Fractures
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare cost, quality, practices
- Patient Satisfaction in Healthcare
- Bone fractures and treatments
- Bacterial Identification and Susceptibility Testing
- Nosocomial Infections in ICU
- Emergency and Acute Care Studies
- Meta-analysis and systematic reviews
- Trauma and Emergency Care Studies
- Statistical Methods in Clinical Trials
- Sepsis Diagnosis and Treatment
- Antimicrobial Resistance in Staphylococcus
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Respiratory Support and Mechanisms
- Infective Endocarditis Diagnosis and Management
- Urinary Bladder and Prostate Research
University of Maryland, Baltimore
2016-2025
McMaster University
2024
Population Health Research Institute
2024
Hamilton Health Sciences
2024
VA Maryland Health Care System
2002-2024
Wilson Community College
2014-2017
American Journal Experts (United States)
2017
American Society for Clinical Pathology
2017
University of Baltimore
2017
Bloomberg (United States)
2016
Studies evaluating surgical-site infection have had conflicting results with respect to the use of alcohol solutions containing iodine povacrylex or chlorhexidine gluconate as skin antisepsis before surgery repair a fractured limb (i.e., an extremity fracture).
Risk factors for the nosocomial recovery of imipenem-resistant Pseudomonas aeruginosa (IRPA) were determined. A case-control study design was used comparison 2 groups case patients with control patients. The first group had isolation IRPA, and second imipenem-susceptible P. (ISPA). Control selected from same medical or surgical services which receiving care when IRPA occurred. analyzed included antimicrobials used, comorbid conditions, demographic variables. recovered 120 patients, ISPA 662...
OBJECTIVE—The objective of this study was to assess the impact active versus usual monitoring algorithmic insulin titration and point-of-care (POC) laboratory HbA1c (A1C) measurement on glycemic control in primary care. RESEARCH DESIGN AND METHODS—The Glycemic Optimization with Algorithms Labs at Point Care (GOAL A1C) a 24-week, randomized, parallel-group, four-arm, open-label 7,893 adults type 2 diabetes uncontrolled by oral antidiabetic agents requiring insulin. Patients were randomly...
The recommended duration of antibiotic treatment for Enterobacteriaceae bloodstream infections is 7–14 days. We compared the outcomes patients receiving short-course (6–10 days) vs prolonged-course (11–16 therapy bacteremia. A retrospective cohort study was conducted at 3 medical centers and included with monomicrobial bacteremia treated in vitro active range 6–16 days between 2008 2014. 1:1 nearest neighbor propensity score matching without replacement performed prior to regression analysis...
Background. AmpC β-lactamase–producing organisms are associated with significant morbidity and mortality. Induction of resistance to third-generation cephalosporins after exposure these agents complicates treatment options carbapenems considered optimal therapy. The role cefepime, however, remains unclear. Our objective was compare clinical outcomes for patients receiving cefepime compared meropenem invasive infections caused by expressing β-lactamases. Methods. Hospitalized blood,...
Abstract Background Predicting mortality risk in patients is important research settings. The Pitt bacteremia score (PBS) commonly used as a predictor of early with bloodstream infections (BSIs). We determined whether the PBS predicts 14-day inpatient nonbacteremia carbapenem-resistant Enterobacteriaceae (CRE) infections. Methods Patients were selected from Consortium on Resistance Against Carbapenems Klebsiella and Other Enterobacteriaceae, prospective, multicenter, observational study....
Propensity score methods are increasingly being used in the infectious diseases literature to estimate causal effects from observational data. However, there remains a general gap understanding among clinicians on how critically review studies that have incorporated these analytic techniques.Using cohort of 4967 unique patients with Enterobacterales bloodstream infections, we sought answer question "Does transitioning gram-negative infections intravenous oral therapy impact 30-day...
ABSTRACT Among 477 patients with susceptible Enterobacter spp., 49 subsequently harbored third-generation cephalosporin-resistant spp. Broad-spectrum cephalosporins were independent risk factors for resistance (relative [OR] = 2.3, P 0.01); quinolone therapy was protective (OR 0.4, 0.03). There trends toward decreased among receiving broad-spectrum and either aminoglycosides or imipenem. Of the cephalosporins, 19% developed resistance.
Risk factors for developing postoperative mediastinitis (POM) due to methicillin-resistant Staphylococcus aureus (MRSA) were analyzed in a case-case control study of patients who underwent median sternotomy during the period from 1994 through 2000. Three patient groups studied. The first consisted 64 with POM MRSA; second 79 methicillin-susceptible S. (MSSA); and third 80 uninfected patients. In multivariable analysis, diabetic (adjusted OR, 2.86; 95% CI, 1.22–6.70), female (OR, 2.70;...
Hospital readmissions are a current target of initiatives to reduce healthcare costs. This study quantified the association between having clinical culture positive for 1 3 prevalent hospital-associated organisms and time hospital readmission.
OBJECTIVE To identify factors associated with the development of surgical site infection (SSI) among adult patients undergoing renal transplantation DESIGN A retrospective cohort study SETTING An urban tertiary care center in Baltimore, Maryland, a well-established program that performs ~200–250renal transplant procedures annually RESULTS At total 441 underwent between January 1, 2010, and December 31, 2011. Of these 441patients, 66 (15%) developed an SSI; 66, 31 (47%) were superficial...
Abstract Background There are limited US data assessing adherence to surgical antimicrobial prophylaxis guidelines, particularly across a large, nationwide sample. Moreover, commonly prescribed inappropriate regimens remain unknown, hindering improvement initiatives. Methods We conducted retrospective cohort study of adults who underwent elective craniotomy, hip replacement, knee spinal procedure, or hernia repair in 2019–2020 at hospitals the PINC AI (Premier) Healthcare Database. evaluated...
The aims of this study were to analyze the clinical characteristics and risk factors associated with catheter-associated candiduria due Candida glabrata albicans compare patients C. or (cases) controls. Controls a randomly chosen sample inpatients Foley catheters for whom urine cultures negative species. Univariate multivariate analyses performed. There 40 cases 289 candiduria. Factors strongly both female gender (P <. 05) being in intensive care unit 01). Fluconazole use (adjusted odds...
Abstract Background Many clinicians select broad-spectrum antibiotic therapy based on the concern that inadequate empiric coverage will be associated with a worse outcome. To explore this concern, we compared outcomes between patients started narrow-spectrum antibiotics and later escalated to v. empirically then continued antibiotics.Figure 1.Antibiotic Classification Methods We conducted retrospective observational cohort study of adult discharged in 2019 from 120 hospitals Premier...
Abstract Background Newer broad-spectrum beta-lactam antibiotics (cefiderocol, ceftazidime-avibactam, ceftolozane-tazobactam, imipenem-relebactam, meropenem-vaborbactam) have been introduced. Ceftazidime-avibactam and ceftolozane-tazobactam predominated newer antibiotic use through 2021; however, less is known about current patterns for what clinical indications, in inpatient settings. The aim of this study was to describe the these across a large national cohort. Methods We performed...
Abstract Background Every day, over 300 Americans sustain firearm injuries, but prevalence estimates for bacterial infection after these injuries vary widely. Methods We studied a retrospective cohort of adults with using administrative data from 233 US hospitals in the Premier database 1/2019 through 4/2021. Encounters injury were identified by ICD-10 diagnosis codes. The index encounter and subsequent encounters at same hospital within 90 days assessed infection, defined positive clinical...
<h3>Importance</h3> Definitive combination antibiotic therapy with a β-lactam and an aminoglycoside for the treatment of gram-negative bacteremia is commonly prescribed in pediatric patients; however, its efficacy toxicity relative to monotherapy are unknown. <h3>Objective</h3> To determine whether definitive affects mortality nephrotoxicity patients bacteremia. <h3>Design, Setting, Participants</h3> Retrospective cohort study including (aged ≤18 years) hospitalized at Johns Hopkins...
BACKGROUND: Clinical guidelines recommend a restrictive transfusion strategy in nonhemorrhaging critically ill patients. STUDY DESIGN AND METHODS: We conducted retrospective observational study of 3533 single‐admission patients, without evidence acute coronary syndromes, hemorrhage, or hemoglobinopathy admitted to the medical intensive care unit (MICU) large, academic center. RESULTS: MICU admission hemoglobin (Hb) level did not change significantly over period. The proportion transfused...