National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Antibiotics (2)
- Antimicrobial Stewardship (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (3)
- Clostridium difficile Infections (1)
- Comparative Effectiveness (1)
- Critical Care (1)
- Diagnostic Safety and Quality (1)
- Genetics (1)
- Healthcare-Associated Infections (HAIs) (10)
- Healthcare Costs (1)
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- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Long-Term Care (1)
- Medication (3)
- (-) Methicillin-Resistant Staphylococcus aureus (MRSA) (14)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (1)
- Nursing Homes (1)
- Patient Safety (4)
- Pneumonia (1)
- Prevention (3)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Sepsis (2)
- Skin Conditions (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 14 of 14 Research Studies DisplayedHogan PG, Parrish KL, Mork RL
HOME2 study: household versus personalized decolonization in households of children with methicillin-resistant staphylococcus aureus skin and soft tissue infection-a randomized clinical trial.
This study’s goal was to compare the effectiveness of colonization measures to prevent skin and soft tissue infection (SSTI) from Methicillin-resistant Staphylococcus aureus (MRSA) with targeted household members with prior years SSTI to decolonizing all household members to prevent infections in children. The hypothesis was that the former method would be noninferior. Upon completion of the 12-month observational Household Observation of Methicillin-resistant Staphylococcus aureus in the Environment (HOME) study, 102 households were enrolled with the follow-up HOME2 study, a 12-month randomized noninferiority trial. Households were randomized 1:1 to the personalized (targeted members) or household (all members) approaches. Participants followed a 5-day regimen of hygiene education, twice-daily intranasal mupirocin, and daily bleach-water baths. At 5 follow-up visits at participants’ homes, swabs were taken to detect S. aureus. Noninferiority of the personalized approach was established, with little difference in SSTI rates in the two household approaches.
AHRQ-funded; HS021736; HS024269.
Citation: Hogan PG, Parrish KL, Mork RL .
HOME2 study: household versus personalized decolonization in households of children with methicillin-resistant staphylococcus aureus skin and soft tissue infection-a randomized clinical trial.
Clin Infect Dis 2021 Dec 6;73(11):e4568-e77. doi: 10.1093/cid/ciaa752..
Keywords: Children/Adolescents, Methicillin-Resistant Staphylococcus aureus (MRSA), Skin Conditions, Prevention
Page B, Klompas M, Chan C
Surveillance for healthcare-associated infections: hospital-onset adult sepsis events versus current reportable conditions.
US hospitals are required by the Centers for Medicare and Medicaid Services to publicly report central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), Clostridioidesdiffficile, methicillin-resistant Staphylococcus aureus bacteremia, and selected surgical site infections for benchmarking and pay-for-performance programs. In this study the investigators retrospectively assessed the overlap between HO-ASEs and reportable HAIs among adults hospitalized between June 2015-June 2018 in 3 hospitals.
AHRQ-funded; HS025008.
Citation: Page B, Klompas M, Chan C .
Surveillance for healthcare-associated infections: hospital-onset adult sepsis events versus current reportable conditions.
Clin Infect Dis 2021 Sep 15;73(6):1013-19. doi: 10.1093/cid/ciab217..
Keywords: Sepsis, Healthcare-Associated Infections (HAIs), Hospitals, Clostridium difficile Infections, Catheter-Associated Urinary Tract Infection (CAUTI), Methicillin-Resistant Staphylococcus aureus (MRSA), Central Line-Associated Bloodstream Infections (CLABSI)
Pakyz AL, Wang H, Ozcan YA
Leapfrog Hospital Safety Score, magnet designation, and healthcare-associated infections in United States hospitals.
The goal of this study was to determine whether Magnet designation and hospitals with better Leapfrog Hospital Safety Scores have fewer healthcare-associated infections (HAIs). Findings showed that “A” hospitals performed better on clostridium difficile infection (CDI) but not methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections, while Magnet designation was associated with fewer than expected MRSA infections but more than expected CDIs. These mixed results show that hospital global assessments of safety and workplace quality differentially and imperfectly predict its level of HAIs.
AHRQ-funded; HS018578.
Citation: Pakyz AL, Wang H, Ozcan YA .
Leapfrog Hospital Safety Score, magnet designation, and healthcare-associated infections in United States hospitals.
J Patient Saf 2021 Sep 1;17(6):445-50. doi: 10.1097/pts.0000000000000378..
Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety
Schuetz CR, Hogan PG, Reich PJ
Factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized, critically ill neonates.
The purpose of this case-control study was to identify factors associated with development of symptomatic infection in infants colonized with methicillin-resistant Staphylococcus aureus (MRSA) in the Neonatal Intensive Care Unit (NICU). The investigators concluded that progression from MRSA colonization to symptomatic infection was associated with increased morbidity and may be mitigated through decolonization.
AHRQ-funded; HS021736; HS024269.
Citation: Schuetz CR, Hogan PG, Reich PJ .
Factors associated with progression to infection in methicillin-resistant Staphylococcus aureus-colonized, critically ill neonates.
J Perinatol 2021 Jun;41(6):1285-92. doi: 10.1038/s41372-021-00944-8..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Critical Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs)
Deshpande A, Richter SS, Haessler S
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
This study assessed antibiotic de-escalation practices across hospitals and their associations with outcomes in hospitalized patients diagnosed with pneumonia with negative cultures. The authors included 14,170 adults admitted with pneumonia in 2010-2015 to 164 US hospitals if they had negative blood and/or respiratory cultures and received both anti-MRSA and antipseudomonal agents other than quinolones. If empiric drugs were stopped on day 4 while continuing another antibiotic it was defined at de-escalation. Patients were propensity adjusted for de-escalation and compared on in-hospital 14-day mortality, late deterioration with ICU transfer, length-of-stay (LOS) and costs. Thirteen percent (1924 patients) had both initial empiric drugs stopped by hospital day 4. De-escalation rates at hospitals ranged from 2-35% and the established rate quartiles were not significantly associated with outcomes. Even at hospitals in the top quartile of de-escalation, the de-escalation rates were lower than 50%.
AHRQ-funded; HS025026; HS024277.
Citation: Deshpande A, Richter SS, Haessler S .
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
Clin Infect Dis 2021 Apr 26;72(8):1314-22. doi: 10.1093/cid/ciaa212..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Pneumonia, Respiratory Conditions, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Inpatient Care
Lydecker AD, Osei PA, Pineles L
Targeted gown and glove use to prevent Staphylococcus aureus acquisition in community-based nursing homes: a pilot study.
This study tested the feasibility of targeted gown and glove use by healthcare personnel caring for high-risk nursing home residents to present Staphylococcus aureus transmission in short-stay residents. The study included 322 residents in 2 community-based Maryland nursing homes on mixed short- and long-stay units. During a 2-month baseline period, all residents had nose and inguinal fold swabs taken to estimate S. aureus presence. MRSA acquisition rate decreased from 11.9% during the baseline period to 3.6% during the intervention period among short-stay residents. MRSA acquisition rate also decreased from 9.1% during the baseline period to 3.6% during the intervention period for longer-term care residents. Resident-to-resident transmission rate also decreased from 5.9% during the baseline period to 0.8% during the intervention period.
AHRQ-funded; HS025451.
Citation: Lydecker AD, Osei PA, Pineles L .
Targeted gown and glove use to prevent Staphylococcus aureus acquisition in community-based nursing homes: a pilot study.
Infect Control Hosp Epidemiol 2021 Apr;42(4):448-54. doi: 10.1017/ice.2020.1219..
Keywords: Nursing Homes, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Patient Safety
Neubauer HC, Hall M, Lopez MA
Antibiotic regimens and associated outcomes in children hospitalized with staphylococcal scalded skin syndrome.
Controversy exists regarding the optimal antibiotic regimen for use in hospitalized children with staphylococcal scalded skin syndrome (SSSS). Various regimens may confer toxin suppression and/or additional coverage for methicillin-susceptible Staphylococcus aureus (MSSA) or methicillin-resistant S aureus (MRSA). The purpose of this study was to describe antibiotic regimens in hospitalized children with SSSS and examine the association between antistaphylococcal antibiotic regimens and patient outcomes.
AHRQ-funded; HS026006.
Citation: Neubauer HC, Hall M, Lopez MA .
Antibiotic regimens and associated outcomes in children hospitalized with staphylococcal scalded skin syndrome.
J Hosp Med 2021 Mar;16(3):149-55. doi: 10.12788/jhm.3529..
Keywords: Children/Adolescents, Antibiotics, Medication, Methicillin-Resistant Staphylococcus aureus (MRSA), Skin Conditions, Infectious Diseases
Harris AD, Morgan DJ, Pineles L
Acquisition of antibiotic-resistant gram-negative bacteria in the Benefits of Universal Glove and Gown (BUGG) cluster randomized trial.
This study is a secondary analysis of a randomized trial in 20 hospital intensive units called Benefits of Universal Glove and Gown (BUGG) to see if intervention decreases the acquisition of antibiotic-resistant gram-negative bacteria. The primary outcome included 40,492 admission and discharge perianal swabs from 20,246 individual patient admissions. A non-statistically significant decrease in acquisition of antibiotic-resistant gram-negative bacteria was associated with universal glove and gown use.
AHRQ-funded; HS024045.
Citation: Harris AD, Morgan DJ, Pineles L .
Acquisition of antibiotic-resistant gram-negative bacteria in the Benefits of Universal Glove and Gown (BUGG) cluster randomized trial.
Clin Infect Dis 2021 Feb 1;72(3):431-37. doi: 10.1093/cid/ciaa071..
Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Patient Safety
Nelson RE, Lautenbach E, Chang N
Attributable cost of healthcare-associated methicillin-resistant Staphylococcus aureus infection in a long-term care center.
The purpose of this study was to estimate the attributable cost of methicillin-resistant Staphylococcus aureus (MRSA) healthcare-associated infections in long-term care centers (LTCCs) within the Department of Veterans Affairs. Findings showed a significant increase in the odds of being transferred to an acute care facility and in acute care costs. These findings of high cost and increased risk of transfer from LTCC to acute care are important because they highlight the substantial clinical and economic impact of MRSA infections in this population.
AHRQ-funded; HS023794.
Citation: Nelson RE, Lautenbach E, Chang N .
Attributable cost of healthcare-associated methicillin-resistant Staphylococcus aureus infection in a long-term care center.
Clin Infect Dis 2021 Jan 29;72(Suppl 1):S27-s33. doi: 10.1093/cid/ciaa1582..
Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Infectious Diseases, Healthcare Costs, Long-Term Care
Fritz SA, Hogan PG, Singh LN
Contamination of environmental surfaces with Staphylococcus aureus in households with children infected with methicillin-resistant S aureus.
This study of the households of 50 children with active or recent culture-positive community-associated methicillin-resistant staphylococcus aureus (MRSA) infection found MRSA-contaminated surfaces in 23 of the 50 households, most frequently form the bed linens (18 percent), television remote control (16 percent), and bathroom hand towel (15 percent).
AHRQ-funded; HS021736
Citation: Fritz SA, Hogan PG, Singh LN .
Contamination of environmental surfaces with Staphylococcus aureus in households with children infected with methicillin-resistant S aureus.
JAMA Pediatr. 2014 Nov;168(11):1030-8. doi: 10.1001/jamapediatrics.2014.1218..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Children/Adolescents, Racial and Ethnic Minorities
Septimus EJ, Hayden MK, Kleinman K
Does chlorhexidine bathing in adult intensive care units reduce blood culture contamination? A pragmatic cluster-randomized trial.
The investigators determined rates of blood culture contamination comparing 3 strategies to prevent intensive care unit (ICU) infections: screening and isolation, targeted decolonization, and universal decolonization. They demonstrated that universal decolonization with mupirocin and chlorhexidine bathing resulted in a significant reduction in blood culture contamination.
AHRQ-funded; 290201000008I; 290032007T.
Citation: Septimus EJ, Hayden MK, Kleinman K .
Does chlorhexidine bathing in adult intensive care units reduce blood culture contamination? A pragmatic cluster-randomized trial.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S17-22. doi: 10.1086/677822.
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Keywords: Comparative Effectiveness, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA), Sepsis
Nair R, Thapaliya D, Su Y
Resistance to zinc and cadmium in Staphylococcus aureus of human and animal origin.
The investigators determined the prevalence of zinc and cadmium resistance in S. aureus isolated in the United States. They found that resistance to zinc and cadmium was observed to be associated with MRSA, suggesting that prolonged exposure to zinc in livestock feeds and fertilizers could propagate resistance to the metal ion, hindering the use of zinc-based topical agents in treating S. aureus infections.
AHRQ-funded; HS019966.
Citation: Nair R, Thapaliya D, Su Y .
Resistance to zinc and cadmium in Staphylococcus aureus of human and animal origin.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S32-9. doi: 10.1086/677834.
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Keywords: Medication, Methicillin-Resistant Staphylococcus aureus (MRSA)
Patel PA, Schora DM, Peterson KE
Performance of the Cepheid Xpert(R) SA Nasal Complete PCR assay compared to culture for detection of methicillin-sensitive and methicillin-resistant Staphylococcus aureus colonization.
Conventional culture-based methods, including several chromogenic agars, are available for SA and MRSA surveillance but they can take several days and have reduced sensitivity compared to amplification assays. Overall, the Cepheid assay proved a rapid, sensitive, and clinically useful test for the early detection and differentiation of MRSA and MSSA colonization on patients.
AHRQ-funded; HS019968.
Citation: Patel PA, Schora DM, Peterson KE .
Performance of the Cepheid Xpert(R) SA Nasal Complete PCR assay compared to culture for detection of methicillin-sensitive and methicillin-resistant Staphylococcus aureus colonization.
Diagn Microbiol Infect Dis 2014 Sep;80(1):32-4. doi: 10.1016/j.diagmicrobio.2014.05.019..
Keywords: Diagnostic Safety and Quality, Genetics, Methicillin-Resistant Staphylococcus aureus (MRSA)
Barnes SL, Morgan DJ, Harris AD
Preventing the transmission of multidrug-resistant organisms: modeling the relative importance of hand hygiene and environmental cleaning interventions.
The authors investigated the relative impact of hand hygiene and environmental cleaning in order to assess resource allocation. They concluded that hand hygiene should remain a priority for infection control programs, but environmental cleaning can have significant benefit for hospitals or individual hospital units that have either high hand hygiene compliance levels or low terminal cleaning thoroughness.
AHRQ-funded; HS018111.
Citation: Barnes SL, Morgan DJ, Harris AD .
Preventing the transmission of multidrug-resistant organisms: modeling the relative importance of hand hygiene and environmental cleaning interventions.
Infect Control Hosp Epidemiol 2014 Sep;35(9):1156-62. doi: 10.1086/677632.
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Keywords: Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention