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694 results on '"Herwaldt, Loreen"'

3. Prevalence and Characteristics of Diagnostic Error in Pediatric Critical Care: A Multicenter Study*

Author

Cifra, Christina L., Custer, Jason W., Smith, Craig M., Smith, Kristen A., Bagdure, Dayanand N., Bloxham, Jodi, Goldhar, Emily, Gorga, Stephen M., Hoppe, Elizabeth M., Miller, Christina D., Pizzo, Max, Ramesh, Sonali, Riffe, Joseph, Robb, Katharine, Simone, Shari L., Stoll, Haley D., Tumulty, Jamie Ann, Wall, Stephanie E., Wolfe, Katie K., Wendt, Linder, Ten Eyck, Patrick, Landrigan, Christopher P., Dawson, Jeffrey D., Reisinger, Heather Schacht, Singh, Hardeep, and Herwaldt, Loreen A.

Published
2023
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4. Implementing nasal povidone-iodine decolonization to reduce infections in hemodialysis units: a qualitative assessment

Author

Dukes, Kimberly C., primary, Hockett Sherlock, Stacey, additional, Racila, AM, additional, Herwaldt, Loreen A., additional, Jacob, Jesse, additional, Vijayan, Anitha, additional, Kellogg, Joseph, additional, Pegues, David, additional, Tolomeo, Pam C., additional, Cobb, Jason, additional, Fraer, Mony, additional, Bleasdale, Susan C., additional, Ward, Melissa A., additional, Lindsey, Brenna, additional, and Schweizer, Marin L., additional

Published
2024
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5. Interfacility Referral Communication for PICU Transfer

Author

Thirnbeck, Caitlin K., primary, Espinoza, Elizabeth T., additional, Beaman, Elizabeth A., additional, Rozen, Alexis L., additional, Dukes, Kimberly C., additional, Singh, Hardeep, additional, Herwaldt, Loreen A., additional, Landrigan, Christopher P., additional, Reisinger, Heather Schacht, additional, and Cifra, Christina L., additional

Published
2024
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7. Bacterial and viral co-infections complicating severe influenza: Incidence and impact among 507 U.S. patients, 2013–14

Author

Shah, Nirav S, Greenberg, Jared A, McNulty, Moira C, Gregg, Kevin S, Riddell, James, Mangino, Julie E, Weber, Devin M, Hebert, Courtney L, Marzec, Natalie S, Barron, Michelle A, Chaparro-Rojas, Fredy, Restrepo, Alejandro, Hemmige, Vagish, Prasidthrathsint, Kunatum, Cobb, Sandra, Herwaldt, Loreen, Raabe, Vanessa, Cannavino, Christopher R, Hines, Andrea Green, Bares, Sara H, Antiporta, Philip B, Scardina, Tonya, Patel, Ursula, Reid, Gail, Mohazabnia, Parvin, Kachhdiya, Suresh, Le, Binh-Minh, Park, Connie J, Ostrowsky, Belinda, Robicsek, Ari, Smith, Becky A, Schied, Jeanmarie, Bhatti, Micah M, Mayer, Stockton, Sikka, Monica, Murphy-Aguilu, Ivette, Patwari, Priti, Abeles, Shira R, Torriani, Francesca J, Abbas, Zainab, Toya, Sophie, Doktor, Katherine, Chakrabarti, Anindita, Doblecki-Lewis, Susanne, Looney, David J, and David, Michael Z

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Clinical Sciences, Pneumonia & Influenza, Prevention, Biodefense, Emerging Infectious Diseases, Infectious Diseases, Vaccine Related, Influenza, 2.2 Factors relating to the physical environment, Aetiology, Infection, Good Health and Well Being, Adolescent, Adult, Aged, Bacterial Infections, Child, Child, Preschool, Coinfection, Critical Care, Female, Humans, Incidence, Infant, Infant, Newborn, Influenza, Human, Male, Middle Aged, Retrospective Studies, Staphylococcal Infections, Survival Analysis, Virus Diseases, Young Adult, Severe influenza, Influenza A (H1N1) pdm09, Co-infection, Staphylococcus aureus, MRSA, ICU, Microbiology, Virology, Clinical sciences, Medical microbiology
Abstract

BackgroundInfluenza acts synergistically with bacterial co-pathogens. Few studies have described co-infection in a large cohort with severe influenza infection.ObjectivesTo describe the spectrum and clinical impact of co-infections.Study designRetrospective cohort study of patients with severe influenza infection from September 2013 through April 2014 in intensive care units at 33 U.S. hospitals comparing characteristics of cases with and without co-infection in bivariable and multivariable analysis.ResultsOf 507 adult and pediatric patients, 114 (22.5%) developed bacterial co-infection and 23 (4.5%) developed viral co-infection. Staphylococcus aureus was the most common cause of co-infection, isolated in 47 (9.3%) patients. Characteristics independently associated with the development of bacterial co-infection of adult patients in a logistic regression model included the absence of cardiovascular disease (OR 0.41 [0.23-0.73], p=0.003), leukocytosis (>11K/μl, OR 3.7 [2.2-6.2], p

Published
2016

8. Alcohol-based decontamination of gloved hands: A randomized controlled trial

Author

Thom, Kerri A., primary, Rock, Clare, additional, Robinson, Gwen L., additional, Reisinger, Heather R.S., additional, Baloh, Jure, additional, Chasco, Emily, additional, Liang, Yuanyuan, additional, Li, Shanshan, additional, Diekema, Daniel J., additional, Herwaldt, Loreen A., additional, Johnson, J. Kristie, additional, Harris, Anthony D., additional, and Perencevich, Eli N., additional

Published
2023
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10. Severe Influenza in 33 US Hospitals, 2013–2014: Complications and Risk Factors for Death in 507 Patients

Author

Shah, Nirav S, Greenberg, Jared A, McNulty, Moira C, Gregg, Kevin S, Riddell, James, Mangino, Julie E, Weber, Devin M, Hebert, Courtney L, Marzec, Natalie S, Barron, Michelle A, Chaparro-Rojas, Fredy, Restrepo, Alejandro, Hemmige, Vagish, Prasidthrathsint, Kunatum, Cobb, Sandra, Herwaldt, Loreen, Raabe, Vanessa, Cannavino, Christopher R, Hines, Andrea Green, Bares, Sara H, Antiporta, Philip B, Scardina, Tonya, Patel, Ursula, Reid, Gail, Mohazabnia, Parvin, Kachhdiya, Suresh, Le, Binh-Minh, Park, Connie J, Ostrowsky, Belinda, Robicsek, Ari, Smith, Becky A, Schied, Jeanmarie, Bhatti, Micah M, Mayer, Stockton, Sikka, Monica, Murphy-Aguilu, Ivette, Patwari, Priti, Abeles, Shira R, Torriani, Francesca J, Abbas, Zainab, Toya, Sophie, Doktor, Katherine, Chakrabarti, Anindita, Doblecki-Lewis, Susanne, Looney, David J, and David, Michael Z

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Clinical Sciences, Emerging Infectious Diseases, Pediatric, Influenza, Pneumonia & Influenza, Infectious Diseases, Clinical Research, Prevention, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Infection, Good Health and Well Being, Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Antiviral Agents, Child, Child, Preschool, Comorbidity, Female, Hospitalization, Hospitals, Humans, Infant, Infant, Newborn, Influenza A Virus, H1N1 Subtype, Influenza Vaccines, Influenza, Human, Intensive Care Units, Logistic Models, Male, Middle Aged, Retrospective Studies, Risk Factors, United States, Young Adult, Medical and Health Sciences, Epidemiology, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundInfluenza A (H1N1) pdm09 became the predominant circulating strain in the United States during the 2013-2014 influenza season. Little is known about the epidemiology of severe influenza during this season.MethodsA retrospective cohort study of severely ill patients with influenza infection in intensive care units in 33 US hospitals from September 1, 2013, through April 1, 2014, was conducted to determine risk factors for mortality present on intensive care unit admission and to describe patient characteristics, spectrum of disease, management, and outcomes.ResultsA total of 444 adults and 63 children were admitted to an intensive care unit in a study hospital; 93 adults (20.9%) and 4 children (6.3%) died. By logistic regression analysis, the following factors were significantly associated with mortality among adult patients: older age (>65 years, odds ratio, 3.1 [95% CI, 1.4-6.9], P=.006 and 50-64 years, 2.5 [1.3-4.9], P=.007; reference age 18-49 years), male sex (1.9 [1.1-3.3], P=.031), history of malignant tumor with chemotherapy administered within the prior 6 months (12.1 [3.9-37.0], P

Published
2015

15. Alcohol-based decontamination of gloved hands: A randomized controlled trial

Author

Thom, Kerri A., Rock, Clare, Robinson, Gwen L., Reisinger, Heather R.S., Baloh, Jure, Chasco, Emily, Liang, Yuanyuan, Li, Shanshan, Diekema, Daniel J., Herwaldt, Loreen A., Johnson, J. Kristie, Harris, Anthony D., and Perencevich, Eli N.

Abstract

AbstractObjective:The gold standard for hand hygiene (HH) while wearing gloves requires removing gloves, performing HH, and donning new gloves between WHO moments. The novel strategy of applying alcohol-based hand rub (ABHR) directly to gloved hands might be effective and efficient.Design:A mixed-method, multicenter, 3-arm, randomized trial.Setting:Adult and pediatric medical-surgical, intermediate, and intensive care units at 4 hospitals.Participants:Healthcare personnel (HCP).Interventions:HCP were randomized to 3 groups: ABHR applied directly to gloved hands, the current standard, or usual care.Methods:Gloved hands were sampled via direct imprint. Gold-standard and usual-care arms were compared with the ABHR intervention.Results:Bacteria were identified on gloved hands after 432 (67.4%) of 641 observations in the gold-standard arm versus 548 (82.8%) of 662 observations in the intervention arm (P< .01). HH required a mean of 14 seconds in the intervention and a mean of 28.7 seconds in the gold-standard arm (P< .01). Bacteria were identified on gloved hands after 133 (98.5%) of 135 observations in the usual-care arm versus 173 (76.6%) of 226 observations in the intervention arm (P< .01). Of 331 gloves tested 6 (1.8%) were found to have microperforations; all were identified in the intervention arm [6 (2.9%) of 205].Conclusions:Compared with usual care, contamination of gloved hands was significantly reduced by applying ABHR directly to gloved hands but statistically higher than the gold standard. Given time savings and microbiological benefit over usual care and lack of feasibility of adhering to the gold standard, the Centers for Disease Control and Prevention and the World Health Organization should consider advising HCP to decontaminate gloved hands with ABHR when HH moments arise during single-patient encounters.Trial Registration:NCT03445676.

Published
2024
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18. Examining barriers to implementing a surgical-site infection bundle

Author

Dukes, Kimberly C., Reisinger, Heather Schacht, Schweizer, Marin, Ward, Melissa A., Chapin, Laura, Ryken, Timothy C., Perl, Trish M., and Herwaldt, Loreen A.

Abstract

AbstractBackground:Surgical-site infections (SSIs) can be catastrophic. Bundles of evidence-based practices can reduce SSIs but can be difficult to implement and sustain.Objective:We sought to understand the implementation of SSI prevention bundles in 6 US hospitals.Design:Qualitative study.Methods:We conducted in-depth semistructured interviews with personnel involved in bundle implementation and conducted a thematic analysis of the transcripts.Setting:The study was conducted in 6 US hospitals: 2 academic tertiary-care hospitals, 3 academic-affiliated community hospitals, 1 unaffiliated community hospital.Participants:In total, 30 hospital personnel participated. Participants included surgeons, laboratory directors, clinical personnel, and infection preventionists.Results:Bundle complexity impeded implementation. Other barriers varied across services, even within the same hospital. Multiple strategies were needed, and successful strategies in one service did not always apply in other areas. However, early and sustained interprofessional collaboration facilitated implementation.Conclusions:The evidence-based SSI bundle is complicated and can be difficult to implement. One implementation process probably will not work for all settings. Multiple strategies were needed to overcome contextual and implementation barriers that varied by setting and implementation climate. Appropriate adaptations for specific settings and populations may improve bundle adoption, fidelity, acceptability, and sustainability.

Published
2024
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20. Improving the Assessment of Vancomycin-Resistant Enterococci by Routine Screening

Author

Huang, Susan S, Rifas-Shiman, Sheryl L, Pottinger, Jean M, Herwaldt, Loreen A, Zembower, Teresa R, Noskin, Gary A, Cosgrove, Sara E, Perl, Trish M, Curtis, Amy B, Tokars, Jerome L, Diekema, Daniel J, Jernigan, John A, Hinrichsen, Virginia L, Yokoe, Deborah S, Platt, Richard, and Program, Centers for Disease Control and Prevention Epicenters

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Prevention, Clinical Research, Academic Medical Centers, Adult, Anti-Bacterial Agents, Carrier State, Cohort Studies, Diagnostic Tests, Routine, Disease Notification, Enterococcus, Gram-Positive Bacterial Infections, Humans, Incidence, Patient-Centered Care, Retrospective Studies, United States, Vancomycin, Vancomycin Resistance, Centers for Disease Control and Prevention Epicenters Program, accuracy, article, bacterium culture, bacterium detection, cohort analysis, high risk population, incidence, nonhuman, prevalence, priority journal, retrospective study, screening, vancomycin resistant Enterococcus, Biological Sciences, Medical and Health Sciences, Microbiology, Biological sciences, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundAs infection with vancomycin-resistant enterococci (VRE) increases in hospitals, knowledge about VRE reservoirs and improved accuracy of epidemiologic measures are needed. Many assessments underestimate incidence by including prevalent carriers in at-risk populations. Routine surveillance cultures can substantially improve prevalence and incidence estimates, and assessing the range of improvement across diverse units is important.MethodsWe performed a retrospective cohort study using accurate at-risk populations to evaluate the range of benefit of admission and weekly surveillance cultures in detecting unrecognized VRE in 14 patient-care units.ResultsWe assessed 165 unit-months. The admission prevalence of VRE was 2.2%-27.2%, with admission surveillance providing 2.2-17-fold increased detection. Medical units were significantly more likely to admit VRE carriers than were surgical units. Monthly incidence was 0.8%-9.7%, with weekly surveillance providing 3.3-15.4-fold increased detection. The common practice of reporting incidence using the total number of patients, rather than patients at risk, underestimated incidence by one-third. Overall, routine surveillance prevented the misclassification of 43.0% (unit range, 0%-85.7%) of "incident" carriers on the basis of clinical cultures alone and increased VRE precaution days by 2.4-fold (unit range, 2.0-2.6-fold).ConclusionsRoutine surveillance markedly increases the detection of VRE, despite variability across patient-care units. Correct denominators prevent the substantial underestimation of incidence.

Published
2007

21. Improving Methicillin-Resistant Staphylococcus aureus Surveillance and Reporting in Intensive Care Units

Author

Huang, Susan S, Rifas-Shiman, Sheryl L, Warren, David K, Fraser, Victoria J, Climo, Michael W, Wong, Edward S, Cosgrove, Sara E, Perl, Trish M, Pottinger, Jean M, Herwaldt, Loreen A, Jernigan, John A, Tokars, Jerome L, Diekema, Daniel J, Hinrichsen, Virginia L, Yokoe, Deborah S, Platt, Richard, and Program, Centers for Disease Control and Prevention Epicenters

Subjects
Biological Sciences, Biomedical and Clinical Sciences, Microbiology, Clinical Sciences, Oncology and Carcinogenesis, Emerging Infectious Diseases, Prevention, Infectious Diseases, Clinical Research, Antimicrobial Resistance, Academic Medical Centers, Carrier State, Cohort Studies, Diagnostic Tests, Routine, Disease Notification, Disease Transmission, Infectious, Humans, Incidence, Intensive Care Units, Methicillin, Methicillin Resistance, Prevalence, Retrospective Studies, Risk Factors, Sentinel Surveillance, Staphylococcal Infections, Staphylococcus aureus, United States, Centers for Disease Control and Prevention Epicenters Program, aged, article, bacterium culture, bacterium detection, bacterium isolation, cohort analysis, female, high risk population, hospital admission, human, incidence, intensive care unit, male, methicillin resistant Staphylococcus aureus, mortality, nonhuman, prevalence, priority journal, retrospective study, Disease Transmission, Horizontal, Medical and Health Sciences, Biological sciences, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundRoutine culturing of patients in intensive care units (ICUs) for methicillin-resistant Staphylococcus aureus (MRSA) identifies unrecognized carriers and facilitates timely isolation. However, the benefit of surveillance in detecting prevalent and incident carriers likely varies among ICUs. In addition, many assessments underestimate the incidence of acquisition by including prevalent carriers in the at-risk population.MethodsWe performed a retrospective cohort study using accurate at-risk populations to evaluate the range of benefit of admission and weekly surveillance cultures in detecting otherwise unrecognized MRSA in 12 ICUs in 5 states.ResultsWe assessed 142 ICU-months. Among the 12 ICUs, the admission prevalence of imported MRSA was 5%-21%, with admission surveillance providing 30%-135% increases in rates of detection. The monthly hospital-associated incidence was 2%-6%, with weekly surveillance providing 7%-157% increases in detection. The common practice of reporting incidence using the total number of patients or total patient-days underestimated incidence by one-third. Surgical ICUs had lower MRSA importation but higher MRSA incidence. Overall, routine surveillance prevented the misclassification of 17% (unit range, 11%-29%) of "incident" carriers, compared with clinical cultures, and increased precaution days by 18% (unit range, 11%-91%).ConclusionsRoutine surveillance significantly increases the detection of MRSA, but this benefit is not uniform across ICUs, even with high compliance and the use of correct denominators.

Published
2007

23. Enhanced Identification of Postoperative Infections among Inpatients

Author

Yokoe, Deborah S, Noskin, Gary A, Cunningham, Susan M, Zuccotti, Gianna, Plaskett, Theresa, Fraser, Victoria J, Olsen, Margaret A, Tokars, Jerome I, Solomon, Steven, Perl, Trish M, Cosgrove, Sara E, Tilson, Richard S, Greenbaum, Maurice, Hooper, David C, Sands, Kenneth E, Tully, John, Herwaldt, Loreen A, Diekema, Daniel J, Wong, Edward S, Climo, Michael, and Platt, Richard

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Atherosclerosis, Cancer, Breast Cancer, Patient Safety, Infection, Good Health and Well Being, Anti-Bacterial Agents, Cesarean Section, Coronary Artery Bypass, Cross Infection, Humans, Inpatients, Mammaplasty, Patient Discharge, Population Surveillance, Surgical Wound Infection, Medical Microbiology, Public Health and Health Services, Microbiology, Clinical sciences, Epidemiology, Health services and systems
Abstract

We evaluated antimicrobial exposure, discharge diagnoses, or both to identify surgical site infections (SSI). This retrospective cohort study in 13 hospitals involved weighted, random samples of records from 8,739 coronary artery bypass graft (CABG) procedures, 7,399 cesarean deliveries, and 6,175 breast procedures. We compared routine surveillance to detection through inpatient antimicrobial exposure (> 9 days for CABG, > 2 days for cesareans, and > 6 days for breast procedures), discharge diagnoses, or both. Together, all methods identified SSI after 7.4% of CABG, 5.0% of cesareans, and 2.0% of breast procedures. Antimicrobial exposure had the highest sensitivity, 88%-91%, compared with routine surveillance, 38%-64%. Diagnosis codes improved sensitivity of detection of antimicrobial exposure after cesareans. Record review confirmed SSI after 31% to 38% of procedures that met antimicrobial surveillance criteria. Sufficient antimicrobial exposure days, together with diagnosis codes for cesareans, identified more postoperative SSI than routine surveillance methods. This screening method was efficient, readily standardized, and suitable for most hospitals.

Published
2004

33. Increased mortality rates associated with Staphylococcus aureus and influenza co-infection, Maryland and Iowa, USA

Author

McDanel, Jennifer S., Perencevich, Eli N., Storm, Jeremy, Diekema, Daniel J., Herwaldt, Loreen, Johnson, J. Kristie, Winokur, Patricia L., and Schweizer, Marin L.

Subjects
Staphylococcus aureus infections -- Statistics -- Health aspects, Staphylococcus aureus -- Statistics -- Health aspects, Resveratrol -- Statistics -- Health aspects, Influenza -- Statistics -- Health aspects, Health
Abstract

Staphylococcus aureus is a common cause of respiratory infections, including pneumonia (1), and can lead to necrotizing pneumonia and death (2-4). Influenza complicated by S. aureus co-infection can progress rapidly [...]

Published
2016
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34. Effectiveness and acceptability of intranasal povidone-iodine decolonization among fracture fixation surgery patients to reduce Staphylococcus aureus nasal colonization

Author

Schweizer, Marin L., primary, Herwaldt, Loreen A., additional, Boyken, Linda, additional, Pottinger, Jean, additional, Quinn, Rachel, additional, Diekema, Daniel J., additional, Armstrong-Pavlik, Fiona, additional, Ward, Melissa, additional, Sekar, Poorani, additional, and Willey, Michael C., additional

Published
2022
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45. Prospective Surveillance for Invasive Fungal Infections in Hematopoietic Stem Cell Transplant Recipients, 2001-2006: Overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database

Author

Kontoyiannis, Dimitrios P., Marr, Kieren A., Park, Benjamin J., Alexander, Barbara D., Anaissie, Elias J., Walsh, Thomas J., Ito, James, Andes, David R., Baddley, John W., Brown, Janice M., Brumble, Lisa M., Freifeld, Alison G., Hadley, Susan, Herwaldt, Loreen A., Kauffman, Carol A., Knapp, Katherine, Lyon, G. Marshall, Morrison, Vicki Á., Papanicolaou, Genovefa, Patterson, Thomas F., Perl, Trish M., Schuster, Mindy G., Walker, Randall, Wannemuehler, Kathleen A., Wingard, John R., Chilier, Tom M., and Pappas, Peter G.

Published
2010

46. Invasive Fungal Infections among Organ Transplant Recipients: Results of the Transplant-Associated Infection Surveillance Network (TRANSNET)

Author

Pappas, Peter G., Alexander, Barbara D., Andes, David R., Hadley, Susan, Kauffman, Carol A., Freifeld, Alison, Anaissie, Elias J., Brumble, Lisa M., Herwaldt, Loreen, Ito, James, Kontoyiannis, Dimitrios P., Lyon, G. Marshall, Marr, Kieren A., Morrison, Vicki A., Park, Benjamin J., Patterson, Thomas F., Perl, Trish M., Oster, Robert A., Schuster, Mindy G., Walker, Randall, Walsh, Thomas J., Wannemuehler, Kathleen A., and Chiller, Tom M.

Published
2010

47. A 58-Year-Old Male With a Chronic Sore Throat.

Author

Zandvakili, Arya, Kobayashi, Takaaki, Seligman, Kristen, Parsons, Meredith G, Ford, Bradley, Bayon, Rodrigo, and Herwaldt, Loreen A

Subjects
HOARSENESS, RENAL cell carcinoma, ADJUVANT chemotherapy, IMMUNE checkpoint inhibitors, BIOPSY, FUNGI, DEGLUTITION disorders, METASTASIS, VOCAL cords, LARYNGEAL diseases, BLASTOMYCOSIS, ITRACONAZOLE, LARYNGOSCOPY, IMMUNOSUPPRESSIVE agents, PHARYNGITIS
Abstract

The article presents a case study of a 58-year-old male with a history of clear cell renal cell carcinoma who developed chronic throat symptoms, including dysphagia, odynophagia, and hoarseness, which worsened after a change in cancer therapy. It mentions that the diagnosis was laryngeal blastomycosis, likely contracted during outdoor activities, and the article discusses the insidious nature of the condition and the influence of immune-checkpoint inhibitors on fungal infections.

Published
2023
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