Abstract:
OBJECTIVE:Viruses are more common than bacteria in patients hospitalized with community-acquired pneumonia. Little is known, however, about the frequency of respiratory viral testing and its associations with antimicrobial utilization. DESIGN:Retrospective cohort study. SETTING:The study included 179 US hospitals. PATIENTS:Adults admitted with pneumonia between July 2010 and June 2015. METHODS:We assessed the frequency of respiratory virus testing and compared antimicrobial utilization, mortality, length of stay, and costs between tested versus untested patients, and between virus-positive versus virus-negative patients. RESULTS:Among 166,273 patients with pneumonia on admission, 40,787 patients (24.5%) were tested for respiratory viruses, 94.8% were tested for influenza, and 20.7% were tested for other viruses. Viral assays were positive in 5,133 of 40,787 tested patients (12.6%), typically for influenza and rhinovirus. Tested patients were younger and had fewer comorbidities than untested patients, but patients with positive viral assays were older and had more comorbidities than those with negative assays. Blood cultures were positive for bacterial pathogens in 2.7% of patients with positive viral assays versus 5.3% of patients with negative viral tests (P < .001). Antibacterial courses were shorter for virus-positive versus -negative patients overall (mean 5.5 vs 6.4 days; P < .001) but varied by bacterial testing: 8.1 versus 8.0 days (P = .60) if bacterial tests were positive; 5.3 versus 6.1 days (P < .001) if bacterial tests were negative; and 3.3 versus 5.2 days (P < .001) if bacterial tests were not obtained (interaction P < .001). CONCLUSIONS:A minority of patients hospitalized with pneumonia were tested for respiratory viruses; only a fraction of potential viral pathogens were assayed; and patients with positive viral tests often received long antibacterial courses.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Klompas M,Imrey PB,Yu PC,Rhee C,Deshpande A,Haessler S,Zilberberg MD,Rothberg MBdoi
10.1017/ice.2020.1312subject
Has Abstractpub_date
2020-12-01 00:00:00pages
1-9eissn
0899-823Xissn
1559-6834pii
S0899823X20013124pub_type
杂志文章abstract:OBJECTIVE:Older adults often have atypical presentation of illness and are particularly vulnerable to influenza and its sequelae, making the validity of influenza case definitions particularly relevant. We sought to assess the performance of influenza-like illness (ILI) and severe acute respiratory illness (SARI) crite...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.22
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVES:To determine glove use and handwashing practices, the factors associated with infection control practices, and the frequency of potential microbial transmission in a long-term-care facility (LTCF). DESIGN:Observational study of 230 staff-resident interactions in an LTCF. We recorded resident characteristics...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647562
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVES:To determine whether hepatitis B virus (HBV) transmission occurred among patients visiting a physician's office and to evaluate potential transmission mechanisms. DESIGN:Serologic survey, retrospective cohort study, and observation of infection control practices. SETTING:Private medical office. PATIENTS:T...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502612
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:To investigate and determine the cause of an outbreak of Mycobacterium mucogenicum bacteremias in bone marrow transplant (BMT) and oncology patients. DESIGN:Case-control study and culturing of hospital water sources. Isolates were typed using molecular methods. SETTING:University-affiliated, tertiary-care m...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502341
更新日期:2004-12-01 00:00:00
abstract::An outbreak of invasive Mycobacterium chimaera infections associated with heater-cooler devices (HCDs) has now affected patients in several countries on different continents. Clinical infections are characterized by delayed diagnosis, inadequate treatment response to antimicrobial agents, and poor prognosis. Outbreak ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1017/ice.2016.283
更新日期:2017-01-01 00:00:00
abstract::A 19-item survey instrument was designed and mailed by the Infectious Diseases Society of America to its membership to determine the media preferred by infectious diseases physicians for continuing medical education on general topics and on antimicrobial resistance. The objective of the survey was to offer the develop...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/505922
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVES:To determine risk factors for ceftazidime-resistant Klebsiella pneumoniae infection and the effect of ceftazidime-resistant K. pneumoniae infection on mortality during an isolated outbreak. DESIGN:Case-control investigation using clinical and molecular epidemiology and prospective analysis of infection cont...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502488
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:To assess the effect of multiple sources of bias on state- and hospital-specific National Healthcare Safety Network (NHSN) laboratory-identified Clostridium difficile infection (CDI) rates. DESIGN:Sensitivity analysis. SETTING:A total of 124 New York hospitals in 2010. METHODS:New York NHSN CDI events from...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/674389
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To develop an automated method for ventilator-associated condition (VAC) surveillance and to compare its accuracy and efficiency with manual VAC surveillance SETTING:The intensive care units (ICUs) of 4 hospitals METHODS:This study was conducted at Detroit Medical Center, a tertiary care center in metropoli...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.127
更新日期:2015-09-01 00:00:00
abstract::Current evidence concerning the prevalence of inappropriate care indicates that there is an opportunity for significant utilization and cost reductions. Although the efficacy of some methods of utilization control has been demonstrated, the clinical impact and safety of these techniques are unclear. Although financial...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/645912
更新日期:1989-01-01 00:00:00
abstract::The rate of purified protein derivative (PPD) conversion in workers at our hospital increased to 1.7% in 1991. After implementation of mandatory respiratory isolation of patients with community-acquired pneumonia, the rate dropped to 0.6%. This policy may protect workers in institutions where the majority of patients ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647675
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVES:Current efforts to contain anti-microbial costs in hospitals are based on restricting drugs. We explored the effects of unsolicited case-specific recommendations to physicians to discontinue parenteral antimicrobial therapy in medically stable patients with pneumonia, in order to shorten hospital length of s...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1086/646419
更新日期:1992-01-01 00:00:00
abstract::In 1980, the Public Health Service established an objective of immunizing 60% of high-risk persons with influenza vaccine annually by the year 1990. As no more than 32% of high-risk persons currently receive influenza vaccine each year, the Health Care Financing Administration (HCFA) has undertaken an influenza vaccin...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646187
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVES:To quantify specific factors believed to increase healthcare worker (HCW) risk for contaminated sharps injuries (eg, visibility, communication, and range of motion); to quantify the degree to which respirators of various designs impacted those same factors; and to assess HCW opinions about the suitability of...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647566
更新日期:1997-02-01 00:00:00
abstract::Clonal Mycobacterium mucogenicum isolates (determined by molecular typing) were recovered from 19 bronchoscopic specimens from 15 patients. None of these patients had evidence of mycobacterial infection. Laboratory culture materials and bronchoscopes were negative for Mycobacteria. This pseudo-outbreak was caused by c...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.317
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To compare the number of surgical site infections (SSIs) registered after hospital discharge with respect to various surgical procedures and to identify the procedures for which postdischarge surveillance (PDS) is most important. DESIGN:Prospective SSI surveillance with voluntary PDS. Recommended methods for...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/506403
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the prevalence, epidemiologic features, and molecular characteristics of colonization with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among hospitalized dialysis patients and their healthcare workers (HCWs). DESIGN:Prospective observational clinical and laboratory ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/592983
更新日期:2009-01-01 00:00:00
abstract::We demonstrated a 20% rate of subsequent carbapenem-resistant Enterobacteriaceae (CRE)-associated infections among hospitalized CRE carriers. Independent factors associated with the infections were number of colonization sites, central-line insertion, and receiving vancomycin before colonization. These findings unders...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.220
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:Multidrug-resistant Enterobacteriaceae pose a serious infection control challenge and have emerged as a public health threat. We examined national trends in the proportion of Klebsiella pneumoniae isolates resistant to carbapenems (CRKP) and third-generation cephalosporins (G3CRKP). DESIGN AND SETTING:Retros...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/669523
更新日期:2013-03-01 00:00:00
abstract::OBJECTIVE To analyze influential infectious diseases, antimicrobial stewardship, infection control, or medical microbiology blogs and bloggers SETTING World wide web DESIGN We conducted a systematic search for blogs in accordance with the PRISMA guidelines in September 2015. METHODS A snowball sampling approach was ap...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.69
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVES:To trace the routes of transmission and sources of Staphylococcus aureus found in the surgical wound during cardiothoracic surgery and to investigate the possibility of reducing wound contamination, with regard to total counts of bacteria and S. aureus, by wearing special scrub suits. METHODS:A total of 65 ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501910
更新日期:2001-06-01 00:00:00
abstract::During the closing years of the 20th century, there has been an unprecedented number of newly recognized infectious agents and a resurgence of infectious diseases only recently thought to be conquered. These problems have been compounded by the increasing number of pathogens that have evolved resistance to antimicrobi...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/647347
更新日期:1996-08-01 00:00:00
abstract::We aimed to determine the association between the presence of Acinetobacter baumannii in patient rooms and the carrier status of the occupants. Fifty-six (39%) of 143 rooms with A. baumannii-positive patients had results positive for A. baumannii. Only 49 (10%) of 485 rooms with A. baumannii-negative patients were pos...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/670209
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:Data on the resources and staff compensation of hospital epidemiology and infection control (HEIC) departments are limited and do not reflect current roles and responsibilities, including the public reporting of healthcare-associated infections. This study aimed to obtain information to assist HEIC profession...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/650199
更新日期:2010-02-01 00:00:00
abstract::Although Corynebacterium minutissimum is well-known as the cause of erythrasma, it is noted as the etiologic agent of nondermatologic disease only rarely. We document this organism as a cause of central venous catheter-associated bacteremia and report the use of pulsed-field gel electrophoresis to characterize its mol...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/647726
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVES:To measure the incidence of nosocomial infection (NI) among patients with septic shock according to the place of septic shock acquisition and to evaluate the increase in the risk of pulmonary infection associated with septic shock. DESIGN:Prospective cohort study. SETTING:Two intensive care units (ICUs) of...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/591859
更新日期:2008-11-01 00:00:00
abstract::Differences in reported hand hygiene compliance rates were assessed on the basis of the unit affiliation of observers. In 2 hospitals, unit-based observers more often reported higher compliance rates than did non-unit-based observers (79% vs 58.6%; difference, 20.4%; P<.001). Nonstandardized data collection methods co...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/655441
更新日期:2010-08-01 00:00:00
abstract::This retrospective case-control study examined whether there was a difference in length of time awaiting long-term-care placement for patients identified as having methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococcus compared to controls. Thirty-nine patients with methicillin-resistant Stap...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501757
更新日期:2000-04-01 00:00:00
abstract::A patient with no risk factors for malaria was hospitalized in New York City with Plasmodium falciparum infection. After investigating all potential sources of infection, we concluded the patient had been exposed to malaria while hospitalized less than 3 weeks earlier. Molecular genotyping implicated patient-to-patien...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.236
更新日期:2016-01-01 00:00:00
abstract::BACKGROUND In 2015, Denmark launched an automated surveillance system for hospital-acquired infections, the Hospital-Acquired Infections Database (HAIBA). OBJECTIVE To describe the algorithm used in HAIBA, to determine its concordance with point prevalence surveys (PPSs), and to present trends for hospital-acquired ba...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.1
更新日期:2017-05-01 00:00:00