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)
- Community-Acquired Infections (1)
- Comparative Effectiveness (1)
- Critical Care (1)
- Evidence-Based Practice (1)
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- Healthcare-Associated Infections (HAIs) (7)
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- Inpatient Care (1)
- Long-Term Care (1)
- Medication (3)
- (-) Methicillin-Resistant Staphylococcus aureus (MRSA) (11)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (1)
- Nursing Homes (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (3)
- Pneumonia (1)
- Prevention (2)
- Respiratory Conditions (1)
- Sepsis (1)
- 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 11 of 11 Research Studies DisplayedMcNeil JC, Sommer LM, Vallejo JG
Reduced ceftaroline susceptibility among invasive mrsa infections in children: a clinical and genomic investigation.
The purpose of this study was to assess the frequency of reduced susceptibility (RS) to ceftaroline among pediatric methicillin-resistant Staphylococcus aureus (MRSA) infections. The researchers evaluated MRSA isolates at a tertiary children's hospital for ceftaroline RS. Ceftaroline RS occurred only among health care associated infections in 2.9% of isolates, and were more often clindamycin-resistant.
AHRQ-funded; HS026896.
Citation: McNeil JC, Sommer LM, Vallejo JG .
Reduced ceftaroline susceptibility among invasive mrsa infections in children: a clinical and genomic investigation.
Antimicrob Agents Chemother 2022 Oct 18;66(10):e0074522. doi: 10.1128/aac.00745-22..
Keywords: Children/Adolescents, Medication, Methicillin-Resistant Staphylococcus aureus (MRSA), Infectious Diseases, Genetics
D'Orazio B, Ramachandran J, Khalida C
Stakeholder engagement in a comparative effectiveness/implementation study to prevent Staphylococcus aureus infection recurrence: CA-MRSA Project (CAMP2).
The purpose of this study was to determine whether the presence and participation of a stakeholder committee would positively impact the effectiveness of the design and execution of a home-based Methicillin-resistant Staphylococcus aureus and methicillin-sensitive Staphylococcus aureus infection prevention intervention. The trial utilized community health workers to implement infection prevention protocols in participant’s homes, including home visits, sampling household surfaces at baseline and then three months, and obtaining surveillance cultures from index patients and household members. The study assembled and convened The Clinician and Patient Stakeholder Advisory Committee (CPSAC), comprised of New York-based federally qualified health centers (FQHCs) and community health emergency departments, laboratory and clinical researchers, clinicians, and patient stakeholders. The CPSAC was tasked with trial oversight and shared decision-making and troubleshooting, and convened both in person and remotely. The researchers concluded that the inclusion and engagement of the CPSAC during the trial design and implementation was highly effective in addressing and resolving challenges in both participant recruitment and home visits.
AHRQ-funded; HS021667.
Citation: D'Orazio B, Ramachandran J, Khalida C .
Stakeholder engagement in a comparative effectiveness/implementation study to prevent Staphylococcus aureus infection recurrence: CA-MRSA Project (CAMP2).
Prog Community Health Partnersh 2022;16(1):45-60. doi: 10.1353/cpr.2022.0005..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Community-Acquired Infections, Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA), Evidence-Based Practice
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.
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