Browsing by Subject "Cross Infection"
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Item Association of Vitamin D Serum Concentration with Infection Outcomes for Children after Surgery(2016-01-19) Aboul-Fettouh, Nader; Williams, Timothy; Ploski, Roxana; Griffin, Allison; Szmuk, PeterVitamin D insufficiency and deficiency has been associated with various disease states and lower health outcomes. In the adult population, higher vitamin D levels correlated with decreased odds of in-hospital morbidity and mortality. However, no study examined the role of Vit D on the perioperative and post-operative outcomes in the pediatric patient population. We hypothesized that vitamin D deficient pediatric patients will have a higher incidence of composite infectious complications. As a secondary outcome we will analyze whether there is a relationship between the patient's vitamin D levels and hospital length of stay. With IRB approval we performed an EPIC search for all Children's Health patients from 2011 to 2015 where at least one 25-hydroxyvitamin D level was determined within the perioperative period (1 month pre- and post-surgery). Patients were included if they were less than 18 years of age and had underwent non-cardiac surgery. Patients were excluded if they did not receive general anesthesia, stayed less than one night in the hospital, had an American Society of Anesthesiologists Physical Status greater than 4, or underwent emergent surgery. Pertinent information including details of the surgery and relevant past medical history were collected for each patient to help analyze the data set and account for confounding factors. In order to have access to a larger number of patients, this project was performed in collaboration with Cleveland Clinic (Cleveland, OH). The EPIC search provided us with 1600 patient charts from CMC or Children's Health-Plano, and 850 were included into the study after being screened using the criteria noted previously. After analyzing the data, The incidence of infection were 5.5%, 5.8%, 4.9%, 5.8%, and 11.7% for patients with vitamin D level ≤13, 14-19, 20-25, 26-34, and ≥35 ng/ml, respectively. The odds of having infection did not differ significantly among the five vitamin D groups. Secondly, no difference was found in the length of hospital stay among the five vitamin D groups (P = 0.55). Vitamin D levels do not seem to be associated with infection or length of hospital stay in pediatric surgical patients. Other baseline and surgical factors have probably a stronger influence on in-hospital infection and length of hospital stay than vitamin D levels.Item Changes in Rate of Methicillin-Resistant Staphylococcus Infection in a Community Neonatal Intensive Care Unit Before and During the COVID-19 Pandemic(2024-01-30) Blumenfeld, Abby; Hagans, Michelle; Chan, ChristinaBACKGROUND: Methicillin-Resistant Staphylococcus aureus (MRSA) infections represent a significant healthcare challenge, particularly in neonatal intensive care units (NICUs) where patients experience increased morbidity and mortality. MRSA transmission has not been well studied in the setting of enhanced infection precautions (EIP) taken during the COVID-19 pandemic - such as universal masking and enhanced hand hygiene. OBJECTIVE: This retrospective cohort study compared rates of MRSA infection in a community NICU during two distinct time periods: January 2016 to March 2020 (Pre-EIP: before EIP was instituted) and April 2020 to December 2022 (With-EIP: after EIP was instituted). METHODS: During the study period, 74 neonates admitted to the NICU tested positive for MRSA (56 Pre-EIP and 18 With-EIP). MRSA cases were collected using laboratory and electronic medical record review. Cases were reported as infections per 1,000 patient days (IP-1000). Statistical analysis with two-sample t-tests assuming unequal variance and chi squared tests for independence were performed. RESULTS: There was a significant decrease in MRSA IP-1000 from 1.90 Pre-EIP to 0.93 With-EIP (p=0.0006). The prevalence of MRSA clusters, defined as three infections within a 30-day period, decreased from 0.27 Pre-EIP compared to 0.03 With-EIP (p=0.0004). However, The Pre-EIP cohort had a younger average gestational age (30.2 vs 33.8 weeks, p=0.001), higher rates of very low birth weight (59% vs 28%, p=0.021), and fewer inborn neonates (88% vs 100%, p=0.115) - factors known to increase risk of MRSA infection. CONCLUSION: These findings suggest that EIP may have contributed to the reduction in MRSA clusters observed in this community NICU. Findings are limited by differences in cohort risk factors, small study population, variabilities in infection precautions throughout the pandemic, and the inherent bias of retrospective cohort analysis. This underscores the importance of prevention strategies and highlights the potential benefits of continued enhanced infection precautions in reducing the transmission of MRSA in vulnerable inpatient populations.Item Hospital acquired pneumonia(1969-04-03) UnknownItem Hospital-acquired urinary tract infections(1963-10-03) Sanford, Jay P.Item Hospital-Onset Bloodstream Infection Rates after Discontinuing Active Surveillance Cultures for Methicillin-Resistant Staphylococcus aureus in a Regional Burn Center(2018-02-21) Drum, Bayless; Sreeramoju, Pranavi; Reed, W. Gary; Arnoldo, BrettInfections caused by antibiotic resistant bacteria including methicillin-resistant Staphylococcus aureus (MRSA) are associated with increased morbidity and mortality in hospitalized patients. Active surveillance culture (ASC) programs that involve identifying asymptomatically colonized patients and placing them on contact precautions have been promoted to control the spread of hospital-onset (HO) infections. Burn patients are particularly susceptible to staphylococcal infection, but a complete understanding of the effectiveness of ASC programs in preventing HO infections among burn patients is limited. The objective of this retrospective observational study is to describe the epidemiology of MRSA among patients in an academic medical center burn unit including the impact of removal of an ASC program on HO MRSA blood stream infections (BSI) in order to inform control efforts in this population. This study was done in the Burn Intensive Care Unit and Burn Acute Care Unit of Parkland Memorial Hospital. The study period was December 2011 to February 2016. The ASC program was discontinued in August 2014. The rate of MRSA HO-BSIs during the period with ASCs was 1.23 per 1,000 patient days. The rate was 1.28 in the follow-up period without the ASC program in place. The difference in incidence between the two periods was not statistically significant (P= 0.91). We conclude that ASCs and contact isolation of colonized patients may not be critical to reducing the incidence of HO-BSI caused by MRSA.Item Nosocomial pneumonia(1985-11-21) Toews, Galen B.Item Preventing hospital-acquired infections from Semmelweis to SENIC: medicine's need for the "aggregate view"(1985-02-28) Haley, Robert W.Item Reduce infections together in everyone: a concept and a hospital program(2018-09-07) Sreeramoju, PranaviItem Rethinking contact isolation for multidrug-resistant organisms(2015-03-27) Cutrell, James (Brad)Item Swine, salad, surfers and you: is the post-antibiotic era upon us?(2018-11-30) Greenberg, DavidItem [UT News](1985-10-30) Cason, Vicki