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1دورية أكاديمية
المؤلفون: Meghan A Baker, Bethany Baer, Martin Kulldorff, Lauren Zichittella, Rebecca Reindel, Sandra DeLuccia, Hana Lipowicz, Katherine Freitas, Robert Jin, W Katherine Yih
المصدر: PLoS Medicine, Vol 16, Iss 7, p e1002844 (2019)
مصطلحات موضوعية: Medicine
الوصف: BackgroundKawasaki disease is an acute vasculitis that primarily affects children younger than 5 years of age. Its etiology is unknown. The United States Vaccine Safety Datalink conducted postlicensure safety surveillance for 13-valent pneumococcal conjugate vaccine (PCV13), comparing the risk of Kawasaki disease within 28 days of PCV13 vaccination with the historical risk after 7-valent PCV (PCV7) vaccination and using chart-validation. A relative risk (RR) of 2.38 (95% CI 0.92-6.38) was found. Concurrently, the Food and Drug Administration (FDA) conducted a postlicensure safety review that identified cases of Kawasaki disease through adverse event reporting. The FDA decided to initiate a larger study of Kawasaki disease risk following PCV13 vaccination in the claims-based Sentinel/Postlicensure Rapid Immunization Safety Monitoring (PRISM) surveillance system. The objective of this study was to determine the existence and magnitude of any increased risk of Kawasaki disease in the 28 days following PCV13 vaccination.Methods and findingsThe study population included mostly commercially insured children from birth to ConclusionsWith more than 6 million doses of PCV13 administered, no evidence was found of an association between PCV13 vaccination and Kawasaki disease onset in the 4 weeks after vaccination nor of an elevated risk extending or concentrated somewhat beyond 4 weeks. These null results were consistent across alternative designs, age-adjustment methods, control intervals, and categories of Kawasaki disease case included.
وصف الملف: electronic resource
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المؤلفون: Michael Klompas, Chidiebere Akusobi, Jon Boyer, Ann Woolley, Ian D. Wolf, Robert Tucker, Chanu Rhee, Karen Fiumara, Madelyn Pearson, Charles A. Morris, Eric Rubin, Meghan A. Baker
المصدر: Annals of Internal Medicine. 176:333-339
مصطلحات موضوعية: Internal Medicine, General Medicine
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::1761af97723e2afb00b41a2dc2ee423f
https://doi.org/10.7326/m22-3306 -
3دورية أكاديمية
المؤلفون: Chanu Rhee, Meghan A. Baker, Robert Tucker, Diane Griesbach, Dinah McDonald, Sarah A. Williams, Karen Fiumara, Andrew Resnick, Michael Klompas, for the CDC Prevention Epicenters Program
المصدر: Antimicrobial Stewardship & Healthcare Epidemiology, Vol 1 (2021)
مصطلحات موضوعية: Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270
الوصف: We interviewed 1,208 healthcare workers with positive SARS-CoV-2 tests between October 2020 and June 2021 to determine likely exposure sources. Overall, 689 (57.0%) had community exposures (479 from household members), 76 (6.3%) had hospital exposures (64 from other employees including 49 despite masking), 11 (0.9%) had community and hospital exposures, and 432 (35.8%) had no identifiable source of exposure.
وصف الملف: electronic resource
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المؤلفون: Chanu Rhee, Meghan A. Baker, Michael Klompas
المصدر: Infection Control & Hospital Epidemiology. 44:597-603
مصطلحات موضوعية: Microbiology (medical), Infectious Diseases, Epidemiology
الوصف: Objective:To assess coronavirus disease 2019 (COVID-19) infection policies at leading US medical centers in the context of the initial wave of the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) omicron variant.Design:Electronic survey study eliciting hospital policies on masking, personal protective equipment, cohorting, airborne-infection isolation rooms (AIIRs), portable HEPA filters, and patient and employee testing.Setting and participants:“Hospital epidemiologists from U.S. News top 20 hospitals and 10 hospitals in the CDC Prevention Epicenters program.” As it is currently written, it implies all 30 hospitals are from the CDC Prevention Epicenters program, but that only applies to 10 hospitals. Alternatively, we could just say “Hospital epidemiologists from 30 leading US hospitals.”Methods:Survey results were reported using descriptive statistics.Results:Of 30 hospital epidemiologists surveyed, 23 (77%) completed the survey between February 15 and March 3, 2022. Among the responding hospitals, 18 (78%) used medical masks for universal masking and 5 (22%) used N95 respirators. 16 hospitals (70%) required universal eye protection. 22 hospitals (96%) used N95s for routine COVID-19 care and 1 (4%) reserved N95s for aerosol-generating procedures. 2 responding hospitals (9%) utilized dedicated COVID-19 wards; 8 (35%) used mixed COVID-19 and non–COVID-19 units; and 13 (57%) used both dedicated and mixed units. 4 hospitals (17%) used AIIRs for all COVID-19 patients, 10 (43%) prioritized AIIRs for aerosol-generating procedures, 3 (13%) used alternate risk-stratification criteria (not based on aerosol-generating procedures), and 6 (26%) did not routinely use AIIRs. 9 hospitals (39%) did not use portable HEPA filters, but 14 (61%) used them for various indications, most commonly as substitutes for AIIRs when unavailable or for specific high-risk areas or situations. 21 hospitals (91%) tested asymptomatic patients on admission, but postadmission testing strategies and preferred specimen sites varied substantially. 5 hospitals (22%) required regular testing of unvaccinated employees and 1 hospital (4%) reported mandatory weekly testing even for vaccinated employees during the SARS-CoV-2 omicron surge.Conclusions:COVID-19 infection control practices in leading hospitals vary substantially. Clearer public health guidance and transparency around hospital policies may facilitate more consistent national standards.
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المؤلفون: Zoe Freeman Weiss, Maria Hoffmann, Saranya Seetharaman, Samantha Taffner, Marc Allerd, Yan Luo, Zachary Pearson, Meghan A. Baker, Michael Klompas, Lynn Bry, Nicole Pecora
المصدر: Antimicrob Agents Chemother
مصطلحات موضوعية: Pharmacology, Cross Infection, Infectious Diseases, Bacterial Proteins, Enterobacter, Humans, Pharmacology (medical), Microbial Sensitivity Tests, Letter to the Editor, beta-Lactamases, Anti-Bacterial Agents, Plasmids
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::50c63a2c43cee43ce300403da5c79957
https://pubmed.ncbi.nlm.nih.gov/36121219 -
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المؤلفون: Meghan A Baker, Edward J Septimus, Ken Kleinman, Julia Moody, Kenneth E Sands, Neha Varma, Amanda Isaacs, Laura E McLean, Micaela H Coady, Jackie Blanchard, Russell Poland, Deborah S Yokoe, John Stelling, Katherine Haffenreffer, Adam Clark, Taliser Avery, Selsebil Sljivo, Robert A Weinstein, Kimberly Smith, Brandon Carver, Brittany Meador, Caren Spencer-Smith, Chamaine Washington, Megha Bhattarai, Lauren Shimelman, Jonathan B Perlin, Richard Platt, Susan S Huang
المصدر: Open Forum Infectious Diseases. 9
مصطلحات موضوعية: Infectious Diseases, Oncology
الوصف: Background The CLUSTER trial assessed the impact of prospective identification of clusters coupled with a response protocol on the containment of hospital clusters. Methods This 82-hospital CRT in 16 states compared clusters of bacterial and fungal healthcare pathogens using a statistical outbreak detection tool (WHONET-SaTScan) coupled with a standardized response protocol (automated cluster detection arm) compared to routine surveillance with the response protocol (control arm). Trial periods: 24 mo Baseline (2/17–1/19); 5 mo Phase-in (2/19–6/19); 30 mo Intervention (7/19–1/22). The primary outcome was the number of additional cases occurring after initial cluster detection. Analyses used generalized linear mixed models to assess differences in additional cases between the intervention vs baseline periods across arms, clustering by hospital. Results were assessed overall and, to account for the effect of COVID-19 on hospital operations, stratified into pre-COVID-19 (7/19–6/20) and during COVID-19 (7/20–1/22) intervention periods. We also assessed the probability that a patient was in a cluster. Results In the baseline period, the automated cluster detection and control arms had 0.09 and 0.07 additional cluster cases/1000 admissions, respectively. The automated cluster detection arm had a 22% greater relative reduction in additional cluster cases in the intervention vs baseline period compared to control (P=0.5). Within the intervention period, the automated cluster detection arm had a significant 64% relative reduction pre-COVID-19 (P< 0.05) and a non-significant 6% relative reduction during COVID-19 (P=0.9) compared to control (Figure). When evaluating patient risk of being part of a cluster across the entire intervention period, the automated cluster detection arm had a significant 35% relative reduction vs control (P< 0.01). Conclusion A statistical automated tool coupled with a response protocol improved cluster containment by 64% pre-COVID-19 but not during COVID-19; there were no significant differences between the arms when using the entire intervention period. Automated cluster detection may substantially improve outbreak containment in non-pandemic periods when infection prevention programs are able to optimize containment protocols. Disclosures Susan S. Huang, MD, MPH, Medline: Conducted studies in which hospitals and nursing homes received contributed antiseptic and/or environmental cleaning products|Molnlyke: Conducted clinical studies in which hospitals received contributed antiseptic product|Stryker: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products|Xttrium Laboratories: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic product.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::417b45336149875d4e05f059f8deee2b
https://doi.org/10.1093/ofid/ofac492.145 -
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المؤلفون: Meghan A, Baker, Chanu, Rhee, Robert, Tucker, Vineeta, Vaidya, Meghan, Holtzman, Raghu R, Seethala, Maria, Bentain-Melanson, Jesslyn, Lenox, Adam R, Smith, Allison, Gassett, Miriam, Huntley, Mohamad, Sater, Karen, Reilly, Michael, Klompas
المصدر: Clinical Infectious Diseases. 75:1838-1840
مصطلحات موضوعية: Microbiology (medical), Ralstonia pickettii, Extracorporeal Membrane Oxygenation, Infectious Diseases, Pseudomonas aeruginosa, Humans, Water, Bacteremia, Pseudomonas Infections
الوصف: We report on probable factory-based contamination of portable water heaters with waterborne pathogens and 2 bloodstream infections potentially attributable to off-label use of these water heaters to warm extracorporeal membrane oxygenation circuits. Great caution is warranted when using water-based devices to care for critically ill patients.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::74d2d6c9f9acc16a405778248dc73aa8
https://doi.org/10.1093/cid/ciac379 -
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المؤلفون: Donald K. Milton, Meghan A Baker, Michael Klompas, Chanu Rhee, Surbhi Leekha
المصدر: Annals of Internal Medicine. 174:1710-1718
مصطلحات موضوعية: medicine.medical_specialty, Infectious Disease Transmission, Patient-to-Professional, business.product_category, Measles, Influenza, Human, Health care, Internal Medicine, Humans, Medicine, Infection control, Respirator, Intensive care medicine, Respiratory Tract Infections, Aerosols, Cross Infection, Infection Control, Labored breathing, SARS-CoV-2, business.industry, Transmission (medicine), Health Policy, Masks, COVID-19, General Medicine, medicine.disease, United States, Ventilation, Personnel, Hospital, Breathing, Respiratory virus, medicine.symptom, business
الوصف: Policies to prevent respiratory virus transmission in health care settings have traditionally divided organisms into Droplet versus Airborne categories. Droplet organisms (for example, influenza) are said to be transmitted via large respiratory secretions that rapidly fall to the ground within 1 to 2 meters and are adequately blocked by surgical masks. Airborne pathogens (for example, measles), by contrast, are transmitted by aerosols that are small enough and light enough to carry beyond 2 meters and to penetrate the gaps between masks and faces; health care workers are advised to wear N95 respirators and to place these patients in negative-pressure rooms. Respirators and negative-pressure rooms are also recommended when caring for patients with influenza or SARS-CoV-2 who are undergoing "aerosol-generating procedures," such as intubation. An increasing body of evidence, however, questions this framework. People routinely emit respiratory particles in a range of sizes, but most are aerosols, and most procedures do not generate meaningfully more aerosols than ordinary breathing, and far fewer than coughing, exercise, or labored breathing. Most transmission nonetheless occurs at close range because virus-laden aerosols are most concentrated at the source; they then diffuse and dilute with distance, making long-distance transmission rare in well-ventilated spaces. The primary risk factors for nosocomial transmission are community incidence rates, viral load, symptoms, proximity, duration of exposure, and poor ventilation. Failure to appreciate these factors may lead to underappreciation of some risks (for example, overestimation of the protection provided by medical masks, insufficient attention to ventilation) or misallocation of limited resources (for example, reserving N95 respirators and negative-pressure rooms only for aerosol-generating procedures or requiring negative-pressure rooms for all patients with SARS-CoV-2 infection regardless of stage of illness). Enhanced understanding of the factors governing respiratory pathogen transmission may inform the development of more effective policies to prevent nosocomial transmission of respiratory pathogens.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::aec9e6ab2f0380ea83a0a23b34f20a4b
https://doi.org/10.7326/m21-2780 -
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المؤلفون: Jennifer G. Robinson, Adam Cuker, Crystal Garcia, Madelyn Pimentel, Scott K. Winiecki, Ryan M. Carnahan, Bruce Fireman, Candace C. Fuller, Eric M. Ammann, Enrique C. Leira, Meghan A Baker, Marin L. Schweizer, Charles E. Leonard, Elizabeth A. Chrischilles
المصدر: Journal of Thrombosis and Thrombolysis. 53:264-272
مصطلحات موضوعية: medicine.medical_specialty, business.industry, Incidence (epidemiology), Confounding, Absolute risk reduction, Boxed warning, Hematology, medicine.disease, Thrombosis, Internal medicine, Cohort, Epidemiology, Pharmacovigilance, medicine, Cardiology and Cardiovascular Medicine, business, human activities
الوصف: Since 2013, the U.S. Food and Drug administration (FDA) has required that intravenous immune globulin (IGIV) products carry a boxed warning concerning the risk of thromboembolic events (TEEs). This study assessed the incidence of TEEs attributable to IGIV in a large population-based cohort. A self-controlled risk interval design was used to quantify the transient increase in TEE risk during the risk interval (days 0-2 and 0-13 following IGIV for arterial and venous TEEs, respectively) relative to a later control interval (days 14-27 following IGIV). Potential IGIV-exposed TEE cases from 2006 to 2012 were identified from the FDA-sponsored Sentinel Distributed Database and confirmed through medical record review. Inpatient IGIV exposures were not included in the venous TEE analysis due to concerns about time-varying confounding. 19,069 new users of IGIV who received 93,555 treatment episodes were included. Charts were retrieved for 62% and 70% of potential venous and arterial cases, respectively. There was a transient increase in the risk of arterial TEEs during days 0-2 following IGIV treatment (RR = 4.69; 95% CI 1.87, 11.90; absolute increase in risk = 8.86 events per 10,000 patients, 95% CI 3.25, 14.6), but no significant increase in venous TEE risk during days 0-13 following outpatient IGIV treatments (RR = 1.07, 95% CI 0.34, 3.48). Our results suggest there is a small increase in the absolute risk of arterial TEEs following IGIV. However, lower-than-expected chart retrieval rates and the possibility of time-varying confounding mean that our results should be interpreted cautiously. Continued pharmacovigilance efforts are warranted.
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المؤلفون: Shangyuan Ye, Vineeta Vaidya, Dean Hashimoto, Michael Klompas, Rui Wang, Chanu Rhee, Karen Hopcia, Meghan A Baker, Aileen Ochoa
المصدر: Clinical Infectious Diseases. 74:2230-2233
مصطلحات موضوعية: Microbiology (medical), medicine.medical_specialty, 2019-20 coronavirus outbreak, Isolation (health care), Coronavirus disease 2019 (COVID-19), Transmission (medicine), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Healthcare worker, Infectious Diseases, Emergency medicine, medicine, Infection control, business
الوصف: We compared healthcare worker severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates between March and August 2020 in 2 similar hospitals with high vs low airborne infection isolation room utilization rates but otherwise identical infection control policies. We found no difference in healthcare worker infection rates between the 2 hospitals, nor between patient-facing vs non-patient-facing providers.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::a742538548f46deb177ad245d030de61
https://doi.org/10.1093/cid/ciab849
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