Microbiota Transplantation Among Patients Receiving Long-Term Care: The Sentinel REACT Nonrandomized Clinical Trial.

Importance: Intestinal multidrug-resistant organism (MDRO) colonization is highly prevalent in long-term acute care hospital (LTACH) patients and is associated with MDRO infection and transmission. However, there are no therapies approved by the US Food and Drug Administration to reduce intestinal MDRO colonization.

Objective: To determine the safety and acceptability of fecal microbiota transplantation (FMT) in LTACH patients.

Registered nurse workload and hospital-onset methicillin-resistant Staphylococcus aureus bloodstream infections.

The prevention of methicillin-resistant Staphylococcus aureus (MRSA) is a national priority. Data from the American Hospital Association Survey and the Centers for Medicare & Medicaid Services show that each additional registered nurse hour per patient day was associated with a 3% decrease in the rate of hospital-onset MRSA bloodstream infection.

Kinetics of SARS-CoV-2 Shedding in Nursing Home Residents and Staff.

Background: Nursing homes (NHs) were disproportionately affected by the COVID-19 pandemic. However, little is known regarding the kinetics of SARS-CoV-2 shedding in NH residents and staff, which could inform treatment and infection prevention.

Methods: We enrolled NH residents and staff in eight US states from April to November 2023 and analyzed the kinetics of SARS-CoV-2 using serial antigen and molecular (RT-PCR) tests, whole genome sequencing, and viral culture (VC).

Comparison of Medicare claims-based infection epidemiologic case classification algorithms to medical record review by the Emerging Infections Program using a linked cohort, 2016-2021.

Background: Medicare claims are frequently used to study infection (CDI) epidemiology. However, they lack specimen collection and diagnosis dates to assign location of onset. Algorithms to classify CDI onset location using claims data have been published, but the degree of misclassification is unknown.

Identifying patients at high risk for carbapenem-resistant Enterobacterales (CRE) carriage on admission to acute care hospitals: validating and expanding on a public health model.

Objective: Validate a public health model identifying patients at high risk for carbapenem-resistant Enterobacterales (CRE) on admission and evaluate performance across a healthcare network.

Design: Retrospective case-control studies.

Participants: Adults hospitalized with a clinical CRE culture within 3 days of admission (cases) and those hospitalized without a CRE culture (controls).

Evaluating racial and ethnic disparities in antibiotic treatment for pneumonia patients in a major academic health system.

Objective: Examine the relationship between patients' race and prescriber antibiotic choice while accounting for differences in underlying illness and infection severity.

Design: Retrospective cohort analysis.

Setting: Acute care facilities within an academic healthcare system.

Derivation of a risk-adjusted model to predict antibiotic prescribing among hospitalists in an academic healthcare network.

Background: Among inpatients, peer-comparison of prescribing metrics is challenging due to variation in patient-mix and prescribing by multiple providers daily. We established risk-adjusted provider-specific antibiotic prescribing metrics to allow peer-comparisons among hospitalists.

Methods: Using clinical and billing data from inpatient encounters discharged from the Hospital Medicine Service between January 2020 through June 2021 at four acute care hospitals, we calculated bimonthly (every two months) days of therapy (DOT) for antibiotics attributed to specific providers based on patient billing dates.

Assessing for race, ethnicity, and socioeconomic disparities in central line-associated bloodstream infection risk in a large academic health system.

Objective: To examine the relationship between race and ethnicity and central line-associated bloodstream infections (CLABSI) while accounting for inherent differences in CLABSI risk related to central venous catheter (CVC) type.

Design: Retrospective cohort analysis.

Setting: Acute care facilities within an academic healthcare system.

Recurrent Infection and Outcome of Fecal Microbiota Transplantation Use: A Population-Based Assessment.

Background: Fecal microbiota transplantation (FMT) is recommended for the treatment of recurrent infection (rCDI). In the current study, we evaluated rates of rCDI and subsequent FMT in a large metropolitan area. We compared demographic and clinical differences in FMT recipients and nonrecipients and quantified differences in outcomes based on treatment modality.

Social contact patterns among employees in U.S. long-term care facilities during the COVID-19 pandemic, December 2020 to June 2021.

Objective: We measured contact patterns using social contact diaries for 157 U.S. long-term care facility employees from December 2020 - June 2021.

Nurse Work Environment and Hospital-Onset Clostridioides difficile Infection.

Background: Clostridioides difficile is the leading cause of hospital-onset diarrhea and is associated with increased lengths of stay and mortality. While some hospitals have successfully reduced the burden of C. difficile infection (CDI), many still struggle to reduce hospital-onset CDI.

Risk factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seropositivity among nursing home staff.

Objectives: To estimate prior severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among skilled nursing facility (SNF) staff in the state of Georgia and to identify risk factors for seropositivity as of fall 2020.

Design: Baseline survey and seroprevalence of the ongoing longitudinal Coronavirus 2019 (COVID-19) Prevention in Nursing Homes study.

Setting: The study included 14 SNFs in the state of Georgia.

Reductions in inpatient fluoroquinolone use and postdischarge infection (CDI) from a systemwide antimicrobial stewardship intervention.

Objective: To determine the impact of an inpatient stewardship intervention targeting fluoroquinolone use on inpatient and postdischarge infection (CDI).

Design: We used an interrupted time series study design to evaluate the rate of hospital-onset CDI (HO-CDI), postdischarge CDI (PD-CDI) within 12 weeks, and inpatient fluoroquinolone use from 2 years prior to 1 year after a stewardship intervention.

Setting: An academic healthcare system with 4 hospitals.

Determinates of infection (CDI) testing practices among inpatients with diarrhea at selected acute-care hospitals in Rochester, New York, and Atlanta, Georgia, 2020-2021.

Objective: We evaluated the impact of test-order frequency per diarrheal episodes on difficile infection (CDI) incidence estimates in a sample of hospitals at 2 CDC Emerging Infections Program (EIP) sites.

Design: Observational survey.

Setting: Inpatients at 5 acute-care hospitals in Rochester, New York, and Atlanta, Georgia, during two 10-workday periods in 2020 and 2021.

Comparison of the Risk of Recurrent Infections Among Patients in 2018 Versus 2013.

Among persons with an initial infection (CDI) across 10 US sites in 2018 compared with 2013, 18.3% versus 21.1% had ≥1 recurrent CDI (rCDI) within 180 days.

Association of Registered Nurse Staffing With Mortality Risk of Medicare Beneficiaries Hospitalized With Sepsis.

Importance: Sepsis is a major physiologic response to infection that if not managed properly can lead to multiorgan failure and death. The US Centers for Medicare & Medicaid Services (CMS) requires that hospitals collect data on core sepsis measure Severe Sepsis and Septic Shock Management Bundle (SEP-1) in an effort to promote the early recognition and treatment of sepsis. Despite implementation of the SEP-1 measure, sepsis-related mortality continues to challenge acute care hospitals nationwide.

Quantifying Risk for SARS-CoV-2 Infection Among Nursing Home Workers for the 2020-2021 Winter Surge of the COVID-19 Pandemic in Georgia, USA.

Objectives: Estimate incidence of and risks for SARS-CoV-2 infection among nursing home staff in the state of Georgia during the 2020-2021 Winter COVID-19 Surge in the United States.

Design: Serial survey and serologic testing at 2 time points with 3-month interval exposure assessment.

Setting And Participants: Fourteen nursing homes in the state of Georgia; 203 contracted or employed staff members from those 14 participating nursing homes who were seronegative at the first time point and provided a serology specimen at second time point, at which time they reported no COVID-19 vaccination or only very recent vaccination (≤4 weeks).

Occupational risk factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare personnel: A 6-month prospective analysis of the COVID-19 Prevention in Emory Healthcare Personnel (COPE) Study.

Objectives: To determine the incidence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare personnel (HCP) and to assess occupational risks for SARS-CoV-2 infection.

Design: Prospective cohort of healthcare personnel (HCP) followed for 6 months from May through December 2020.

Setting: Large academic healthcare system including 4 hospitals and affiliated clinics in Atlanta, Georgia.