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16 results on '"Junkins, Alan D"'

8. Effect of Intranasal Mupirocin Prophylaxis on Methicillin-Resistant Staphylococcus aureusTransmission and Invasive Staphylococcal Infections in a Neonatal Intensive Care Unit

Author

Ristagno, Elizabeth H., Bryant, Kristina A., Boland, Lynette F., Stout, Gordon G., Junkins, Alan D., Woods, Charles R., Myers, John A., and Espinosa, Claudia M.

Abstract

The use of monthly intranasal mupirocin was associated with a significant reduction in the rate of methicillin-resistant Staphylococcus aureustransmission and Staphylococcus aureusinvasive infection in a large neonatal intensive care unit. Resistance to mupirocin emerged over time, but it was rare and was not associated with adverse clinical outcomes.Infect Control Hosp Epidemiol2018;39:741–745

Published
2018
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14. BD Phoenix and Vitek 2 Detection of mecA-Mediated Resistance in Staphylococcus aureuswith Cefoxitin

Author

Junkins, Alan D., Lockhart, Shawn R., Heilmann, Kristopher P., Dohrn, Cassie L., Von Stein, Diana L., Winokur, Patricia L., Doern, Gary V., and Richter, Sandra S.

Abstract

ABSTRACTThe BD Phoenix (BD Diagnostics, Sparks, MD) and Vitek 2 (bioMe´rieux, Durham, NC) automated susceptibility testing systems have implemented the use of cefoxitin to enhance the detection of methicillin (meticillin)-resistant Staphylococcus aureus(MRSA). To assess the impact of this change, 620 clinically significant S. aureusisolates were tested in parallel on Phoenix PMIC/ID-102 panels and Vitek 2 AST-GP66 cards. The results for oxacillin and cefoxitin generated by the automated systems were compared to those generated by two reference methods: mecAgene detection and MICs of oxacillin previously determined by broth microdilution according to CLSI guidelines. Testing of isolates with discordant results was repeated to attain a majority or consensus final result. There was 100% final agreement between the results of the two reference methods. For the 448 MRSA and 172 methicillin-susceptible S. aureusisolates tested, the rates of categorical agreement of the results obtained with the automated systems with those obtained by the reference methods were 99.8% for the Phoenix panels and 99.7% for the Vitek 2 cards. A single very major error occurred on each instrument (0.2%) with different MRSA isolates. The only major error was attributed to the Vitek 2 system overcalling oxacillin resistance. In 16 instances (9 on the Phoenix system, 7 on the Vitek 2 system), an oxacillin MIC in the susceptible range was correctly changed to resistant by the expert system on the basis of the cefoxitin result. The inclusion of cefoxitin in the Phoenix and Vitek 2 panels has optimized the detection of MRSA by both systems.

Published
2009
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15. Implementation of a pharmacy-driven rapid bacteremia response program.

Author

Wilde, Ashley M, Song, Matthew, Allen, W Paul, Junkins, Alan D, Frazier, James M, Moore, Sarah E, and Schulz, Paul S

Subjects
*BACTEREMIA diagnosis, *ANTIBIOTICS, *BACTEREMIA, *BLOOD, *ANTIMICROBIAL stewardship, *CELL culture, *HEALTH services accessibility, *DRUGSTORES, *COMMUNITY health services, *MOLECULAR pathology, *RAPID diagnostic tests, *HUMAN services programs, *ISOLATION (Hospital care), *MICROBIAL sensitivity tests
Abstract

Purpose This report describes a comprehensive pharmacy-driven rapid bacteremia response program. Summary This novel program positioned the pharmacy department at a large, community health system to receive and respond to critical microbiologic diagnostic testing results, 24/7/365. The program empowered pharmacists to provide centralized, comprehensive care including assessing blood culture Gram stain results, adjusting antibiotic therapy per protocol, ordering repeat blood cultures, analyzing and interpreting rapid molecular diagnostic test results, placing orders for contact isolation, and communicating antibiotic recommendations to the treatment team. In the first year after program implementation, 2,282 blood culture Gram stains and 2,046 rapid diagnostic test results were called in to the pharmacy department. The program reduced the median time to effective therapy in patients who did not already have active antimicrobial orders from over 10 hours to less than 1 hour. Based on the Gram stain results, antibiotics were started per protocol in 34.2% of patients. Based on the rapid molecular diagnostic test results, adjustments were made to antibiotic regimens in 55.7% of cases after discussion with a provider. Of these adjustments, 39.9% were for escalation of antibiotics and 37.7% were for de-escalation of antibiotics. Conclusion By expanding the scope of pharmacy practice, barriers to optimizing clinical care were overcome. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Effect of Intranasal Mupirocin Prophylaxis on Methicillin-Resistant Staphylococcus aureus Transmission and Invasive Staphylococcal Infections in a Neonatal Intensive Care Unit.

Author

Ristagno EH, Bryant KA, Boland LF, Stout GG, Junkins AD, Woods CR, Myers JA, and Espinosa CM

Subjects
Administration, Intranasal, Antibiotic Prophylaxis methods, Cross Infection epidemiology, Female, Humans, Infant, Newborn, Intensive Care Units, Neonatal, Interrupted Time Series Analysis, Male, Methicillin-Resistant Staphylococcus aureus isolation & purification, Mupirocin, Regression Analysis, Anti-Bacterial Agents therapeutic use, Cross Infection microbiology, Cross Infection prevention & control, Methicillin-Resistant Staphylococcus aureus drug effects, Staphylococcal Infections epidemiology, Staphylococcal Infections prevention & control
Abstract

The use of monthly intranasal mupirocin was associated with a significant reduction in the rate of methicillin-resistant Staphylococcus aureus transmission and Staphylococcus aureus invasive infection in a large neonatal intensive care unit. Resistance to mupirocin emerged over time, but it was rare and was not associated with adverse clinical outcomes.Infect Control Hosp Epidemiol 2018;39:741-745.

Published
2018
Full Text
View/download PDF

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