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7 results on '"William Dube"'

1. Estimating racial differences in risk for CLABSI in a large urban healthcare system

Author

Giancarlo Licitra, Scott Fridkin, Zanthia Wiley, Lindsey Gottlieb, William Dube, Vishnu Ravi Kumar, Rachel Patzer, and Radhika Prakash Asrani

Subjects
Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270
Abstract

Background: Socioeconomic barriers or divergent implementation of prevention measures may impact risk of healthcare-associated infections by racial groups. We utilized a previously studied cohort of patients to quantify disparities in central-line–associated bloodstream infection (CLABSI) risk by race accounting for inherent differences in risk related to device utilization. Methods: In a retrospective cohort of adult patients at 4 hospitals (range, 110–733 beds) from 2012 to 2017, we linked central-line data to patient encounter data: race, age, comorbidities, total parenteral nutrition (TPN), chemotherapy, CLABSI. Analysis was limited to patients with >2 central-line days and

Published
2023
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2. Which nursing home workers were at highest risk for SARS-CoV-2 infection during the November 2020–February 2021 winter surge of COVID-1?

Author

Joseph Kellogg, William Dube, Carly Adams, Matthew Collins, Theodore Lopman, Theodore Johnson, Avnika Amin, Joshua Weitz, and Scott Fridkin

Subjects
Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270
Abstract

Background: Nursing home (NH) residents and staff were at high risk for COVID-19 early in the pandemic; several studies estimated seroprevalence of infection in NH staff to be 3-fold higher among CNAs and nurses compared to other staff. Risk mitigation added in Fall 2020 included systematic testing of residents and staff (and furlough if positive) to reduce transmission risk. We estimated risks for SARS-CoV-2 infection among NH staff during the first winter surge before widespread vaccination. Methods: Between February and May 2021, voluntary serologic testing was performed on NH staff who were seronegative for SARS-CoV-2 in late Fall 2020 (during a previous serology study at 14 Georgia NHs). An exposure assessment at the second time point covered prior 3 months of job activities, community exposures, and self-reported COVID-19 vaccination, including very recent vaccination (≤4 weeks). Risk factors for seroconversion were estimated by job type using multivariable logistic regression, accounting for interval community-incidence and interval change in resident infections per bed. Results: Among 203 eligible staff, 72 (35.5%) had evidence of interval seroconversion (Fig. 1). Among 80 unvaccinated staff, interval infection was significantly higher among CNAs and nurses (aOR, 4.9; 95% CI, 1.4–20.7) than other staff, after adjusting for race and interval community incidence and facility infections. This risk persisted but was attenuated when utilizing the full study cohort including those with very recent vaccination (aOR, 1.8; 95% CI, 0.9–3.7). Conclusions: Midway through the first year of the pandemic, NH staff with close or common resident contact continued to be at increased risk for infection despite enhanced infection prevention efforts. Mitigation strategies, prior to vaccination, did not eliminate occupational risk for infection. Vaccine utilization is critical to eliminate occupational risk among frontline healthcare providers.

Published
2022
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3. Determinates of Clostridioides difficile infection (CDI) testing practices among inpatients with diarrhea at selected acute-care hospitals in Rochester, New York, and Atlanta, Georgia, 2020–2021

Author

Scott K. Fridkin, Udodirim N. Onwubiko, William Dube, Chad Robichaux, Jessica Traenkner, Dana Goodenough, Frederick J. Angulo, Joann M. Zamparo, Elisa Gonzalez, Sahil Khanna, Christopher Myers, and Ghinwa Dumyati

Subjects
Microbiology (medical), Infectious Diseases, Epidemiology
Abstract

Objective: We evaluated the impact of test-order frequency per diarrheal episodes on Clostridioides 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. Outcomes: We calculated diarrhea incidence, testing frequency, and CDI positivity (defined as any positive NAAT test) across strata. Predictors of CDI testing and positivity were assessed using modified Poisson regression. Population estimates of incidence using modified Emerging Infections Program methodology were compared between sites using the Mantel-Hanzel summary rate ratio. Results: Surveillance of 38,365 patient days identified 860 diarrhea cases from 107 patient-care units mapped to 26 unique NHSN defined location types. Incidence of diarrhea was 22.4 of 1,000 patient days (medians, 25.8 for Rochester and 16.2 for Atlanta; P < .01). Similar proportions of diarrhea cases were hospital onset (66%) at both sites. Overall, 35% of patients with diarrhea were tested for CDI, but this differed by site: 21% in Rochester and 49% in Atlanta (P < .01). Regression models identified location type (ie, oncology or critical care) and laxative use predictive of CDI test ordering. Adjusting for these factors, CDI testing was 49% less likely in Rochester than Atlanta (adjusted rate ratio, 0.51; 95% confidence interval [CI], 0.40–0.63). Population estimates in Rochester had a 38% lower incidence of CDI than Atlanta (summary rate ratio, 0.62; 95% CI, 0.54–0.71). Conclusion: Accounting for patient-specific factors that influence CDI test ordering, differences in testing practices between sites remain and likely contribute to regional differences in surveillance estimates.

Published
2022
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5. Determinates of

Author

Scott K, Fridkin, Udodirim N, Onwubiko, William, Dube, Chad, Robichaux, Jessica, Traenkner, Dana, Goodenough, Frederick J, Angulo, Joann M, Zamparo, Elisa, Gonzalez, Sahil, Khanna, Christopher, Myers, and Ghinwa, Dumyati

Abstract

We evaluated the impact of test-order frequency per diarrheal episodes onObservational survey.Inpatients at 5 acute-care hospitals in Rochester, New York, and Atlanta, Georgia, during two 10-workday periods in 2020 and 2021.We calculated diarrhea incidence, testing frequency, and CDI positivity (defined as any positive NAAT test) across strata. Predictors of CDI testing and positivity were assessed using modified Poisson regression. Population estimates of incidence using modified Emerging Infections Program methodology were compared between sites using the Mantel-Hanzel summary rate ratio.Surveillance of 38,365 patient days identified 860 diarrhea cases from 107 patient-care units mapped to 26 unique NHSN defined location types. Incidence of diarrhea was 22.4 of 1,000 patient days (medians, 25.8 for Rochester and 16.2 for Atlanta;Accounting for patient-specific factors that influence CDI test ordering, differences in testing practices between sites remain and likely contribute to regional differences in surveillance estimates.

Published
2022

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