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Objectives: To compare the incidence, epidemiology, testing patterns, treatment, and outcomes of Clostridioides difficile infection (CDI) among hospitalized pediatric patients from 2013 to 2019., Study Design: The Pediatric Health Information System database was queried for patient admissions (age 0-17 years) with International Classification of Diseases, 9th and 10th edition, codes for diagnoses of CDI with a billing code for a CDI-related antibiotic treatment., Results: We identified 17 142 pediatric patients, representing 23 052 admissions, with CDI. The adjusted annual CDI incidence decreased over the study period from 7.09 cases per 10 000 patient-days (95% CI, 6.15-8.18) in 2013 to 4.89 cases per 10 000 patient-days (95% CI, 4.03-5.93) in 2019 (P < .001). C difficile-specific testing also decreased during the study period (P < .001). Chronic gastrointestinal conditions (36%) and malignancy (32%) were the most common comorbidities in CDI encounters. Oral metronidazole use decreased during the study period (P < .01) and oral vancomycin use increased (P < .001)., Conclusions: Our study demonstrates a decrease in CDI incidence in hospitalized pediatric patients, a notable change from prior studies, although this may have been influenced by altered testing patterns. We found a high incidence of CDI in patients with cancer and gastrointestinal conditions: groups that warrant targeted evaluation of CDI prevention and treatment., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Objective: To detect the etiologic agents of acute gastroenteritis (AGE) in children using broad molecular-based techniques, and compare clinical presentations among etiologies., Study Design: This was a prospective population-based surveillance study of children aged <6 years with AGE conducted between 2008 and 2011 as part of the New Vaccine Surveillance Network. Stools from patients and healthy controls were tested for 21 gastrointestinal pathogens using the analyte-specific reagent Gastrointestinal Pathogen Panel and an additional reverse transcription real-time polymerase chain reaction assay for sapovirus and astrovirus., Results: Of the 216 stool samples from patients with AGE, 152 (70.4%) tested positive for a pathogen, with norovirus genogroup II (n = 78; 36.1%) and Clostridium difficile (n = 35; 16.2%) the most common pathogens detected. Forty-nine patients (22.7%) tested positive for more than 1 pathogen, including 25 (71%) with a C difficile detection. There were no significant clinical differences among the patients with no pathogen detected, those with a single pathogen detected, and those with ≥2 pathogens detected., Conclusion: Using a broad molecular testing approach, high rates of enteropathogens were detected in children with AGE, dominated by norovirus genogroup II and C difficile. Coinfections were common but had no identifiable impact on clinical manifestations. As routine diagnostics of AGE progressively evolve toward nucleic acid-based pathogen detection, ongoing systematic studies are needed to better analyze the clinical significance of results., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: Increasing the influenza vaccination rate in health care workers (HCWs) promotes patient safety as well as employee health. The average HCW influenza vaccination rate is approximately 35%. Various studies have analyzed the reasons for the low vaccination rate in HCWs and developed strategies aimed at increasing this rate., Methods: At the study hospital, the Nursing Department was contacted to recruit influenza (flu) coordinators from the various hospital departments to coordinate administration of influenza vaccinations in their respective departments, with the aim of increasing HCW vaccination rates. The flu coordinators received education about the influenza vaccine along with lists of employees, vaccination supplies, and consent/declination forms. Each flu coordinator was responsible for contacting the employees in his or her department/unit. Both consent and declination responses were documented., Results: Of the hospital's 3238 employees (including physicians), a total of 2534 were contacted (78%). Of these, 2008 consented to receive the influenza vaccine and 526 declined. This represented a 37% increase in the total number of HCWs contacted and a 20% increase in vaccine recipients over the previous influenza season., Conclusions: Partnering with the Nursing Department increased the accessibility to and acceptance of influenza vaccination among HCWs. The HCWs reported positive experiences about receiving the vaccine in the work environment.

Background: Staphylococcus aureus (S aureus) is the major cause of surgical site infections (SSI). At The Christ Hospital, Cincinnati, OH, S aureus accounted for over 80% of sternal wound infections in cardiac surgery patients. Approximately 700 cardiac surgeries are performed each year, with an associated infection rate of 1.8% per 100 procedures performed. In an attempt to reduce S aureus sternal wound infections, the use of prophylactic intranasal mupirocin was examined., Methods: Each patient undergoing cardiac surgery was nasally cultured before entering the operating room, and then intranasal mupirocin was applied and continued every 12 hours. Culture results were finalized within 48 hours. Mupirocin was discontinued when the culture returned negative and continued for 7 days when the culture returned positive for S aureus., Results: Cultures showed a S aureus carrier rate of 21%. These patients received mupirocin for 7 days. A decrease in S aureus-associated SSI rates was observed from a case rate of 1.68% to 0.37% per 100 procedures over a 17-month period., Conclusion: Identifying and treating S aureus carriers with a full course of mupirocin does impact the rate of S aureus surgical site infections.