Antimicrobial Susceptibility Trends Observed in Urinary Pathogens Obtained From New York State

International guidelines recommend using local susceptibility data to direct empiric therapy for acute uncomplicated cystitis. We evaluated outpatient urinary isolate susceptibility trends in New York State. Nitrofurantoin had the lowest resistance prevalence whereas trimethoprim-sulfamethoxazole and fluoroquinolones had higher prevalences. This study highlights the need for local outpatient antimicrobial stewardship programs

Pilot istraživanje Clostridium difficile infekcija u bolesnika s proljevom u zdravstvenim ustanovama u Tbilisiju, Gruzija

Background: Clostridium difficile infection (CDI) is the most frequent cause of healthcare-associated diarrhoea and is increasingly recognized in the community. The epidemiology of CDI in Georgia is unknown. Methods: Pilot surveillance for CDI among patients with diarrhoea was conducted in four hospital ICUs, and three outpatient clinics in Tbilisi, Georgia. Demographic, clinical and treatment data of patients with CDI were collected from medical records. A CDI diagnosis was made if the stool sample was positive for C. difficile toxin A and/or B by nucleic acid amplification test or enzyme immunoassay, or by culture of a toxin-producing C. difficile. Results: A total of 131 patients with new onset diarrhoeal illness were recruited. Of these, laboratory confirmed CDI was found in 24% (31/131): 32% (17/53) of adult and 20% (11/55) of paediatric ICU patients, 22% (2/9) adult and 7% (1/14) of paediatric outpatients. Presenting symptoms were fever (>380C) and diarrhoea with a median duration 7 days. Most CDI cases received antibiotics before diagnosis; 94% of adults and 91% of children diagnosed in the ICU (median: 12 days); the majority receiving simultaneously two or more antibiotics. In the outpatient settings, 100% of CDI case-patients received an antibiotic for a median duration of 7 days. Conclusions: This pilot surveillance demonstrated that C. difficile is a common cause of diarrhoea in hospitalized and community patients in Georgia. It highlights the need to improve the knowledge of medical providers regarding the burden of CDI and to establish diagnostic testing at hospital laboratories.Uvod: Infekcije uzrokovane Clostridium difficile (CDI) najčešći su uzrok proljeva povezanog sa zdravstvenom skrbi i sve se više prepoznaju u zajednici. Epidemiologija C.difficile infekcija u Gruziji nije poznata. Metode: Pilot istraživanje C.difficile infekcija kod bolesnika s proljevom provedeno je u četiri bolničke jedinice za intenzivno liječenje (JIL) i tri ambulantne klinike u Tbilisiju u Gruziji. Podaci o demografskim i kliničkim karakteristikama te liječenju bolesnika s CDI prikupljeni su iz povijesti bolesti. Dijagnoza C.difficile infekcije postavljena je ukoliko je uzorak stolice bio pozitivan na C. difficile toksin A i/ili B testom amplifikacije nukleinskih kiselina ili metodom enzimskog imunoeseja ili nalazom C. difficile koji proizvode toksine u kulturi. Rezultati: U istraživanje je bio uključen 131 bolesnik s novonastalom dijarealnom bolesti. Od toga je laboratorijski dokazana CDI utvrđena kod 24% (31/131) bolesnika: u 32% (17/53) odraslih i 20% (11/55) djece liječene u JIL-u, 22% (2/9) odraslih i 7% (1/14) pedijatrijskih ambulantnih bolesnika. Simptomi su bili povišena tjelesna temperatura (> 38 ° C) i proljev s prosječnim trajanjem od 7 dana. Većina bolesnika s CDI primila je antibiotik prije postavljanja dijagnoze; 94% odraslih i 91% djece liječene u JIL-u (medijan: 12 dana); većina je istodobno primala dva ili više antibiotika. U ambulantnom okruženju, 100% bolesnika s CDI primilo je antibiotik u prosječnom trajanju od 7 dana. Zaključak: Ovo pilot istraživanje pokazalo je da je C. difficile čest uzrok proljeva u hospitaliziranih i izvanbolničkih pacijenata u Gruziji. Ono naglašava potrebu za poboljšanjem znanja pružatelja zdravstvenih usluga vezano uz probleme koje nose infekcije uzrokovane C. difficile te uspostavom dijagnostičkih testova u bolničkim laboratorijima

Community-associated Methicillin-resistant Staphylococcus aureus and Healthcare Risk Factors

To determine frequency of methicillin-resistant Staphylococcus aureus infections caused by strains typically associated with community-acquired infections (USA300) among persons with healthcare-related risk factors (HRFs), we evaluated surveillance data. Of patients with HRFs, 18%–28% had a "community-associated" strain, primarily USA300; of patients without HRFs, 26% had a "healthcare-associated" strain, typically USA100

Risk Factors for SARS-CoV-2 Infection Among US Healthcare Personnel, May-December 2020

To determine risk factors for coronavirus disease (COVID-19) among US healthcare personnel (HCP), we conducted a case-control analysis. We collected data about activities outside the workplace and COVID-19 patient care activities from HCP with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test results (cases) and from HCP with negative test results (controls) in healthcare facilities in 5 US states. We used conditional logistic regression to calculate adjusted matched odds ratios and 95% CIs for exposures. Among 345 cases and 622 controls, factors associated with risk were having close contact with persons with COVID-19 outside the workplace, having close contact with COVID-19 patients in the workplace, and assisting COVID-19 patients with activities of daily living. Protecting HCP from COVID-19 may require interventions that reduce their exposures outside the workplace and improve their ability to more safely assist COVID-19 patients with activities of daily living

Effectiveness of a Messenger RNA Vaccine Booster Dose Against Coronavirus Disease 2019 Among US Healthcare Personnel, October 2021-July 2022

BACKGROUND: Protection against symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease 2019 [COVID-19]) can limit transmission and the risk of post-COVID conditions, and is particularly important among healthcare personnel. However, lower vaccine effectiveness (VE) has been reported since predominance of the Omicron SARS-CoV-2 variant. METHODS: We evaluated the VE of a monovalent messenger RNA (mRNA) booster dose against COVID-19 from October 2021 to June 2022 among US healthcare personnel. After matching case-participants with COVID-19 to control-participants by 2-week period and site, we used conditional logistic regression to estimate the VE of a booster dose compared with completing only 2 mRNA doses \u3e150 days previously, adjusted for multiple covariates. RESULTS: Among 3279 case-participants and 3998 control-participants who had completed 2 mRNA doses, we estimated that the VE of a booster dose against COVID-19 declined from 86% (95% confidence interval, 81%-90%) during Delta predominance to 65% (58%-70%) during Omicron predominance. During Omicron predominance, VE declined from 73% (95% confidence interval, 67%-79%) 14-60 days after the booster dose, to 32% (4%-52%) ≥120 days after a booster dose. We found that VE was similar by age group, presence of underlying health conditions, and pregnancy status on the test date, as well as among immunocompromised participants. CONCLUSIONS: A booster dose conferred substantial protection against COVID-19 among healthcare personnel. However, VE was lower during Omicron predominance, and waning effectiveness was observed 4 months after booster dose receipt during this period. Our findings support recommendations to stay up to date on recommended doses of COVID-19 vaccines for all those eligible