E lautenbach | Page 4

Nimalie D Stone, Muhammad S Ashraf, Jennifer Calder, Christopher J Crnich, Kent Crossley, Paul J Drinka, Carolyn V Gould, Manisha Juthani-Mehta, Ebbing Lautenbach, Mark Loeb, Taranisia Maccannell, Preeti N Malani, Lona Mody, Joseph M Mylotte, Lindsay E Nicolle, Mary-Claire Roghmann, Steven J Schweon, Andrew E Simor, Philip W Smith, Kurt B Stevenson, Suzanne F Bradley
(See the commentary by Moro, on pages 978-980 .) Infection surveillance definitions for long-term care facilities (ie, the McGeer Criteria) have not been updated since 1991. An expert consensus panel modified these definitions on the basis of a structured review of the literature. Significant changes were made to the criteria defining urinary tract and respiratory tract infections. New definitions were added for norovirus gastroenteritis and Clostridum difficile infections.
October 2012: Infection Control and Hospital Epidemiology
Jennifer H Han, Kei Kasahara, Paul H Edelstein, Warren B Bilker, Ebbing Lautenbach
There has been a significant increase in the prevalence of Enterobacteriaceae that produce CTX-M-type extended-spectrum β-lactamases. The objective of this study was to evaluate risk factors for infection or colonization with CTX-M-positive Escherichia coli. A case-control study was conducted within a university system from 1 January 2007 to 31 December 2008. All patients with clinical cultures with E. coli demonstrating resistance to extended-spectrum cephalosporins were included. Case patients were designated as those with cultures positive for CTX-M-positive E...
November 2012: Antimicrobial Agents and Chemotherapy
J H Han, W B Bilker, P H Edelstein, K B Mascitti, E Lautenbach
Reduced vancomycin susceptibility (RVS) may lead to poor clinical outcomes in Staphylococcus aureus bacteraemia. We conducted a cohort study of 392 patients with S. aureus bacteraemia within a university health system. The association between RVS, as defined by both Etest [vancomycin minimum inhibitory concentration (MIC) >1·0 μg/ml] and broth microdilution (vancomycin MIC ≥1·0 μg/ml), and patient and clinical variables were evaluated to create separate predictive models for RVS. In total, 134 (34·2%) and 73 (18·6%) patients had S...
January 2013: Epidemiology and Infection
Oliver Gruebner, M Mobarak H Khan, Sven Lautenbach, Daniel Müller, Alexander Krämer, Tobia Lakes, Patrick Hostert
BACKGROUND: Urban health is of global concern because the majority of the world's population lives in urban areas. Although mental health problems (e.g. depression) in developing countries are highly prevalent, such issues are not yet adequately addressed in the rapidly urbanising megacities of these countries, where a growing number of residents live in slums. Little is known about the spectrum of mental well-being in urban slums and only poor knowledge exists on health promotive socio-physical environments in these areas...
2012: BMC Public Health
D O Morris, E Lautenbach, T Zaoutis, K Leckerman, P H Edelstein, S C Rankin
Colonization by methicillin-resistant Staphylococcus aureus (MRSA) may be persistent in people and is horizontally transmissible. The scientific literature suggests that domestic pets may also participate in cross-transmission of MRSA within households. The objectives of this study were to evaluate the prevalence of and risk factors for MRSA carriage by pets residing in households with an MRSA-infected person. From 66 households in which an MRSA-infected patient resided, we screened 47 dogs and 52 cats using a swab protocol...
June 2012: Zoonoses and Public Health
Kara B Mascitti, Paul H Edelstein, Neil O Fishman, Knashawn H Morales, Andrew J Baltus, Ebbing Lautenbach
OBJECTIVE: Staphylococcus aureus is a cause of community- and healthcare-acquired infections and is associated with substantial morbidity, mortality, and costs. Vancomycin minimum inhibitory concentrations (MICs) among S. aureus have increased, and reduced vancomycin susceptibility (RVS) may be associated with treatment failure. We aimed to identify clinical risk factors for RVS in S. aureus bacteremia. DESIGN: Case-control. SETTING: Academic tertiary care medical center and affiliated urban community hospital...
February 2012: Infection Control and Hospital Epidemiology
Miriam Kunz, Nicole Faltermeier, Stefan Lautenbacher
The ability to facially communicate physical distress (e.g. pain) can be essential to ensure help, support and clinical treatment for the individual experiencing physical distress. So far, it is not known to which degree this ability represents innate and biologically prepared programs or whether it requires visual learning. Here, we address this question by studying evoked and voluntary facial expressions of pain in congenitally blind (N=21) and sighted (N=42) individuals. The repertoire of evoked facial expressions was comparable in congenitally blind and sighted individuals; however, blind individuals were less capable of facially encoding different intensities of experimental pain...
February 2012: Biological Psychology
Brian L Strom, Thomas O Kelly, Sandra A Norman, John T Farrar, Stephen E Kimmel, Ebbing Lautenbach, Harold I Feldman
An innovative training program to provide clinical research training for clinicians was created in 1979 at the University of Pennsylvania School of Medicine, now the Perelman School of Medicine. The program's principal and continuing aim is to provide trainees mentored experiences and the training needed to become skilled independent investigators able to conduct clinical research and develop academic careers as independent clinical investigators.The authors identify the vision that led to the creation of the master of science in clinical epidemiology (MSCE) degree program and describe today's training program, including administration, oversight, participating faculty, and trainees...
January 2012: Academic Medicine
Lauren A Beslow, Scott E Kasner, Sabrina E Smith, Michael T Mullen, Matthew P Kirschen, Rachel A Bastian, Michael M Dowling, Warren Lo, Lori C Jordan, Timothy J Bernard, Neil Friedman, Gabrielle DeVeber, Adam Kirton, Lisa Abraham, Daniel J Licht, Abbas F Jawad, Jonas H Ellenberg, Ebbing Lautenbach, Rebecca N Ichord
BACKGROUND AND PURPOSE: The Pediatric National Institutes of Health Stroke Scale (PedNIHSS), an adaptation of the adult National Institutes of Health Stroke Scale, is a quantitative measure of stroke severity shown to be reliable when scored prospectively. The ability to calculate the PedNIHSS score retrospectively would be invaluable in the conduct of observational pediatric stroke studies. The study objective was to assess the concurrent validity and reliability of estimating the PedNIHSS score retrospectively from medical records...
February 2012: Stroke; a Journal of Cerebral Circulation
T L Lemonovich, K Haynes, E Lautenbach, V K Amorosa
PURPOSE: Although limited data exist on the efficacy and potential risk of synergistic aminoglycoside therapy for persistent Staphylococcus aureus bacteremia and endocarditis, aminoglycosides are frequently used in clinical practice. METHODS: As our study population, we included subjects fulfilling the modified Duke criteria for S. aureus endocarditis and/or having greater than 72 h of S. aureus bacteremia. Among these subjects, we compared patients who did and did not receive aminoglycoside therapy for their S...
December 2011: Infection
Oliver Gruebner, Md Mobarak H Khan, Sven Lautenbach, Daniel Müller, Alexander Kraemer, Tobia Lakes, Patrick Hostert
BACKGROUND: The deprived physical environments present in slums are well-known to have adverse health effects on their residents. However, little is known about the health effects of the social environments in slums. Moreover, neighbourhood quantitative spatial analyses of the mental health status of slum residents are still rare. The aim of this paper is to study self-rated mental health data in several slums of Dhaka, Bangladesh, by accounting for neighbourhood social and physical associations using spatial statistics...
2011: International Journal of Health Geographics
P Rattanaumpawan, P Tolomeo, W B Bilker, N O Fishman, E Lautenbach
Past studies exploring risk factors for fluoroquinolone (FQ) resistance in urinary tract infections (UTIs) focused only on UTIs caused by Gram-negative pathogens. The epidemiology of FQ resistance in enterococcal UTIs has not been studied. We conducted a case-control study at two medical centres within the University of Pennsylvania Health System in order to identify risk factors for FQ resistance in enterococcal UTIs. Subjects with positive urine cultures for enterococci and meeting CDC criteria for healthcare-acquired UTI were eligible...
June 2011: Epidemiology and Infection
P Rattanaumpawan, P Tolomeo, W B Bilker, N O Fishman, E Lautenbach
The prevalence of urinary tract infections caused by fluoroquinolone-resistant Gram-negative bacilli (FQ-resistant GNB-UTIs) has been increasing. Previous studies that explored risk factors for FQ resistance have focused only on UTIs caused by Escherichia coli and/or failed to distinguish colonisation from infection. We conducted a case-control study at two medical centres within the University of Pennsylvania Health System to identify risk factors for FQ resistance among healthcare-acquired GNB-UTIs. Subjects with positive urine cultures for GNB and who met Centers for Disease Control and Prevention criteria for healthcare-acquired UTI were eligible...
December 2010: Journal of Hospital Infection
Ebbing Lautenbach, Joshua P Metlay, Xiangqun Mao, Xiaoyan Han, Neil O Fishman, Warren B Bilker, Pam Tolomeo, Mary Wheeler, Irving Nachamkin
BACKGROUND: Fluoroquinolones are the most commonly prescribed antimicrobials. The epidemiology of fecal colonization with Escherichia coli demonstrating reduced susceptibility to fluoroquinolones remains unclear. METHODS: During a 3-year period (15 September 2004 through 19 October 2007), all patients hospitalized for >3 days were approached for fecal sampling. All E. coli isolates with reduced susceptibility to fluoroquinolones (minimum inhibitory concentration [MIC] of levofloxacin, 0...
August 1, 2010: Clinical Infectious Diseases
Ingi Lee, Knashawn H Morales, Theoklis E Zaoutis, Neil O Fishman, Irving Nachamkin, Ebbing Lautenbach
BACKGROUND: The impact of reduced fluconazole susceptibility on clinical and economic outcomes in patients with Candida glabrata bloodstream infections (BSI) is unknown. METHODS: A retrospective cohort study was conducted to evaluate 30-day inpatient mortality and postculture hospital charges in patients with C glabrata BSI with decreased fluconazole susceptibility (minimum inhibitory concentration [MIC] ≥ 16 μg/mL) versus fluconazole-susceptible C glabrata BSI (MIC ≤ 8 μg/mL)...
November 2010: American Journal of Infection Control
Kara B Mascitti, Jeffrey S Gerber, Theoklis E Zaoutis, Todd D Barton, Ebbing Lautenbach
Among pediatric and adult providers, 70% preferred trimethoprim-sulfamethoxazole for directed treatment of community-associated methicillin-resistant Staphylococcus aureus skin and soft-tissue infections, although a higher proportion of pediatric compared with adult providers favored clindamycin (36% vs 8%, respectively, P < .0001). For recurrent infections, 88% of providers employed at least 1 topical decolonization strategy.
May 2010: American Journal of Infection Control
Ingi Lee, Theoklis E Zaoutis, Neil O Fishman, Knashawn H Morales, Irving Nachamkin, Ebbing Lautenbach
BACKGROUND: Although Candida glabrata is an emerging infection, risk factors for fluconazole resistance in patients with C glabrata bloodstram infection (BSI) have not been well elucidated. METHODS: A case-control study was conducted to evaluate the primary risk factor of interest, previous fluconazole use, adjusting for demographics, comorbidities, time at risk, and antimicrobial exposure and assessing for effect modification. Secondary analyses were performed limiting the case group to C glabrata BSIs with a minimum inhibitory concentration (MIC) > or =64 microg/mL...
August 2010: American Journal of Infection Control
E Lautenbach, P Tolomeo, I Nachamkin, B Hu, T E Zaoutis
We identified eight consecutive patients who presented with a skin or soft tissue infection due to MRSA. Of seven household members of these cases, three were colonized with MRSA. The mean duration of MRSA colonization in index cases was 33 days (range 14-104), while mean duration of colonization in household cases was 54 days (range 12-95). There was a borderline significant association between having a concurrent colonized household member and a longer duration of colonization (mean 44 days vs. 26 days, P=0...
May 2010: Epidemiology and Infection
B C Caesar, R L Morgan-Jones, R E Warren, R H Wade, P J Roberts, J B Richardson
Between November 1994 and June 1999, 35 patients referred to our Problem Fracture Service with chronic diaphyseal osteomyelitis were treated using a closed double-lumen suction irrigation system after reaming and arthroscopic debridement of the intramedullary canal. This is a modified system based on that of Lautenbach. Between June and July 2007 the patients were reviewed by postal questionnaire and telephone and from the case notes. At a mean follow-up of 101 months (2 to 150), 26 had no evidence of recurrence and four had died from unrelated causes with no evidence of recurrent infection...
September 2009: Journal of Bone and Joint Surgery. British Volume
Nkuchia M M'ikanatha, R Elliott Churchill, Ebbing Lautenbach, Lindsay E Mactavish, Timothy R Pollock, Crystal L Weand, Catherine Polachek, Stanley M Reynolds, Stephen M Ostroff
This report describes Pennsylvania's 9-year experience in implementing training programs to strengthen public health response to emerging infectious diseases. During the biannual 3-5-day-long Pennsylvania Public Health Institute (PHI) events, which have been held since 2000, courses have covered topics such as emerging infectious disease outbreaks, monitoring of antimicrobial-resistant pathogens in retail food, and zoonotic diseases commonly associated with companion animals. Core competency courses include the legal basis for public health and epidemiology for nonepidemiologists...
June 2009: Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science
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