National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Alcohol Use (1)
- Antibiotics (3)
- Antimicrobial Stewardship (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Children/Adolescents (2)
- Clinical Decision Support (CDS) (1)
- Clostridium difficile Infections (1)
- (-) Community-Acquired Infections (17)
- Comparative Effectiveness (1)
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- Infectious Diseases (8)
- Medication (3)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (3)
- Outcomes (1)
- Patient Safety (1)
- Pneumonia (4)
- Prevention (1)
- Provider (2)
- Provider: Nurse (2)
- Public Health (1)
- Quality Improvement (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Risk (5)
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- Shared Decision Making (1)
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- Stroke (1)
- Substance Abuse (1)
- Urinary Tract Infection (UTI) (3)
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 17 of 17 Research Studies DisplayedAdams V, Song J, Shang J
Infection prevention and control practices in the home environment: examining enablers and barriers to adherence among home health care nurses.
This study’s aim was to examine the impact of individual, home environment, and organization factors on Infection Prevention and Control (IPC) practices in home health care. A survey of 350 nurses across two large home care agencies was conducted to examine the relationship between IPC adherence and these factors. Multiple barriers to IPC practices in patients’ homes were reported including clutter (74.5%), and a dirty environment (70.3%). They also reported limited availability of some IPC supplies including personal protective equipment.
AHRQ-funded; HS024723.
Citation: Adams V, Song J, Shang J .
Infection prevention and control practices in the home environment: examining enablers and barriers to adherence among home health care nurses.
Am J Infect Control 2021 Jun;49(6):721-26. doi: 10.1016/j.ajic.2020.10.021..
Keywords: Home Healthcare, Community-Acquired Infections, Infectious Diseases, Prevention, Provider: Nurse, Provider
Vaughn VM, Gandhi T, Petty LA
Empiric antibacterial therapy and community-onset bacterial coinfection in patients hospitalized with COVID-19: a multi-hospital cohort study.
A randomly sampled cohort of 1705 patients hospitalized with COVID-19 was used. Data was collected on early empiric antibacterial therapy within 2 days of hospitalization, empiric antibacterial therapy and community-onset bacterial co-infections. Of the 1705 patients, 56.6% were prescribed early empiric antibacterial therapy, with 3.5% having a confirmed community-onset bacterial infection. Use varied across hospitals, ranging from 27% to 84%. Patients were more likely to receive the therapy if they were older, had more severe illness, had a lobar infiltrate, or were admitted to a for-profit hospital. Over the one-month period empiric antibacterial use decreased.
AHRQ-funded; HS026530; HS026725.
Citation: Vaughn VM, Gandhi T, Petty LA .
Empiric antibacterial therapy and community-onset bacterial coinfection in patients hospitalized with COVID-19: a multi-hospital cohort study.
Clin Infect Dis 2021 May 18;72(10):e533-e41. doi: 10.1093/cid/ciaa1239..
Keywords: COVID-19, Infectious Diseases, Community-Acquired Infections, Antimicrobial Stewardship, Antibiotics, Medication, Hospitalization
Russell D, Dowding D, Trifilio M
Individual, social, and environmental factors for infection risk among home healthcare patients: a multi-method study.
This paper is a study of nurse perceptions of individual, social, and environmental factors for infection risk among home healthcare (HHC) patients and also identifies the frequency of environmental barriers to infection prevention and control in HHC. Data were collected in 2017-2018 from qualitative interviews with 50 HHC nurses and structured observations of nurse visits to patients’ homes (n = 400). Perceived infection risk among patients was characterized as being influenced by knowledge of and attitudes towards infection prevention and engagement in hygiene practices, receipt of support from informal caregivers and nurse interventions aimed at cultivating infection control knowledge and practices, and the home environment. Frequent environmental barriers observed during visits to patients included clutter (39.5%), poor lighting (38.8%), dirtiness (28.5%), and pets (17.2%).
AHRQ-funded; HS024723.
Citation: Russell D, Dowding D, Trifilio M .
Individual, social, and environmental factors for infection risk among home healthcare patients: a multi-method study.
Health Soc Care Community 2021 May;29(3):780-88. doi: 10.1111/hsc.13321..
Keywords: Home Healthcare, Community-Acquired Infections, Risk, Provider: Nurse, Provider
O'Donoghue A, Dechen T, O'Donoghue A, Dechen T, Pavlova W W
Reopening businesses and risk of COVID-19 transmission.
In this paper, the authors used anonymized cell-phone data to quantify the potential risk of COVID-19 transmission in business establishments by building a Business Risk Index that measures transmission risk over time. They used two metrics, visits per square foot and the average duration of visits from January 2020 to June 2020. They found that an increase in a county's average Business Risk Index is associated with an increase in positive COVID-19 cases in 1 week. Their risk index provides a way for policymakers and hospital decision-makers to monitor the potential risk of COVID-19 transmission from businesses based on the frequency and density of visits to businesses.
AHRQ-funded; HS024288.
Citation: O'Donoghue A, Dechen T, O'Donoghue A, Dechen T, Pavlova W W .
Reopening businesses and risk of COVID-19 transmission.
NPJ Digit Med 2021 Mar 16;4(1):51. doi: 10.1038/s41746-021-00420-9..
Keywords: COVID-19, Community-Acquired Infections, Public Health, Risk
Turner NA, Grambow SC, Woods CW
Epidemiologic trends in Clostridioides difficile infections in a regional community hospital network.
Clostridioides difficile infection (CDI) remains a leading cause of health care facility-associated infection. A greater understanding of the regional epidemiologic profile of CDI could inform targeted prevention strategies. The objectives of this study was to assess trends in incidence of health care facility-associated and community-acquired CDI among hospitalized patients over time and to conduct a subanalysis of trends in the NAP1 strain of CDI over time.
AHRQ-funded; HS023866.
Citation: Turner NA, Grambow SC, Woods CW .
Epidemiologic trends in Clostridioides difficile infections in a regional community hospital network.
JAMA Netw Open 2019 Oct 2;2(10):e1914149. doi: 10.1001/jamanetworkopen.2019.14149..
Keywords: Clostridium difficile Infections, Community-Acquired Infections, Infectious Diseases, Hospitals
Parrish KL, Wylie KM, Reich PJ
Carriage of the toxic shock syndrome toxin gene by contemporary community-associated Staphylococcus aureus isolates.
J Pediatric Infect Dis Soc 2019 Nov 6;8(5):470-73. doi: 10.1093/jpids/piy098.
In this study, the investigators report the prevalence of the tst-1 gene among 252 methicillin-susceptible Staphylococcus aureus (MSSA) isolates and 458 methicillin-resistant S aureus (MRSA) isolates collected from 531 subjects between 2008 and 2017.
In this study, the investigators report the prevalence of the tst-1 gene among 252 methicillin-susceptible Staphylococcus aureus (MSSA) isolates and 458 methicillin-resistant S aureus (MRSA) isolates collected from 531 subjects between 2008 and 2017.
AHRQ-funded; HS024269.
Citation: Parrish KL, Wylie KM, Reich PJ .
Carriage of the toxic shock syndrome toxin gene by contemporary community-associated Staphylococcus aureus isolates.
Carriage of the toxic shock syndrome toxin gene by contemporary community-associated Staphylococcus aureus isolates.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Infectious Diseases, Community-Acquired Infections, Sepsis, Patient Safety
Obodozie-Ofoegbu OO, Teng C, Mortensen EM
Antipseudomonal monotherapy or combination therapy for older adults with community-onset pneumonia and multidrug-resistant risk factors: a retrospective cohort study.
Infectious Diseases Society of America guidelines recommend empiric antipseudomonal combination therapy when Pseudomonas is suspected. However, combination antipseudomonal therapy is controversial. This population-based retrospective cohort study compared all-cause 30-day mortality in older patients who received antipseudomonal monotherapy (PMT) or antipseudomonal combination therapy (PCT) for the treatment of community-onset pneumonia. The investigators found that older adults who received combination antipseudomonal therapy for community-onset pneumonia fared worse than those who received monotherapy.
AHRQ-funded; HS022418.
Citation: Obodozie-Ofoegbu OO, Teng C, Mortensen EM .
Antipseudomonal monotherapy or combination therapy for older adults with community-onset pneumonia and multidrug-resistant risk factors: a retrospective cohort study.
Am J Infect Control 2019 Sep;47(9):1053-58. doi: 10.1016/j.ajic.2019.02.018..
Keywords: Antibiotics, Community-Acquired Infections, Elderly, Infectious Diseases, Medication, Pneumonia, Risk
Asti L, Bartsch SM, Umscheid CA
The potential economic value of sputum culture use in patients with community-acquired pneumonia and healthcare-associated pneumonia.
Researchers developed a decision model to determine the economic and clinical value of using sputum cultures in the treatment of community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) from the hospital perspective under various conditions. They found that, overall, obtaining sputum cultures does not provide significant clinical or economic benefits for CAP or HCAP patients; however, it can reduce costs and shorten overall length of stay under some circumstances. They recommended that clinicians consider their local conditions when making decisions about sputum culture use.
AHRQ-funded; HS023317.
Citation: Asti L, Bartsch SM, Umscheid CA .
The potential economic value of sputum culture use in patients with community-acquired pneumonia and healthcare-associated pneumonia.
Clin Microbiol Infect 2019 Aug;25(8):1038.e1-38.e9. doi: 10.1016/j.cmi.2018.11.031..
Keywords: Pneumonia, Community-Acquired Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Healthcare Costs, Clinical Decision Support (CDS), Shared Decision Making
Elman MR, Williams CD, Bearden DT
Healthcare-associated urinary tract infections with onset post hospital discharge.
The objective of this study was to measure the incidence of potentially healthcare-associated (HA), community-onset (CO) urinary tract infection (UTI) in a retrospective cohort of hospitalized patients. Among 3,273 patients at risk for potentially HA-CO UTI, results found that the incidence of HA-CO UTI in the 30 days post discharge was 29.8 per 1,000 patients; independent risk factors included paraplegia, quadriplegia, indwelling catheter during index hospitalization, prior piperacillin-tazobactam prescription, prior penicillin class prescription, and private insurance. The authors conclude that HA-CO UTI may be common within 30 days following hospital discharge, and that their data suggests that surveillance efforts may need to be expanded to capture the full burden to patients and to better inform antibiotic prescribing decisions for patients with a history of hospitalization.
AHRQ-funded; HS020970.
Citation: Elman MR, Williams CD, Bearden DT .
Healthcare-associated urinary tract infections with onset post hospital discharge.
Infect Control Hosp Epidemiol 2019 Aug;40(8):863-71. doi: 10.1017/ice.2019.148..
Keywords: Adverse Events, Catheter-Associated Urinary Tract Infection (CAUTI), Community-Acquired Infections, Healthcare-Associated Infections (HAIs), Hospital Discharge, Hospitalization, Urinary Tract Infection (UTI)
Gupta NM, Lindenauer PK, Yu PC
Association between alcohol use disorders and outcomes of patients hospitalized with community-acquired pneumonia.
The purpose of this study was to compare the causes, treatment, and outcomes of pneumonia in patients with and without alcohol use disorder (AUD). Results suggest that, compared with hospitalized patients with community-acquired pneumonia but without AUD, those with AUD less often harbor resistant organisms. The authors conclude that higher age-adjusted risk of death among patients with AUD appears to be largely attributable to differences in comorbidities, whereas greater use of health care resources may be attributable to alcohol withdrawal.
AHRQ-funded; HS024277; HS025026.
Citation: Gupta NM, Lindenauer PK, Yu PC .
Association between alcohol use disorders and outcomes of patients hospitalized with community-acquired pneumonia.
JAMA Netw Open 2019 Jun 5;2(6):e195172. doi: 10.1001/jamanetworkopen.2019.5172..
Keywords: Alcohol Use, Community-Acquired Infections, Hospitalization, Outcomes, Pneumonia, Substance Abuse
Kempker JA, Panwar B, Judd SE
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
In this paper, researchers studied low baseline plasma 25-hydroxyvitamin D (25(OH)D) and its association with long-term risk of sepsis. Data from the Reasons for Geographic and Racial Differences in Stroke study was used. Findings reveals that, among community-dwelling US adults, low plasma 25(OH)D measured at a time of relative health was independently associated with increased risk of sepsis.
AHRQ-funded; HS025240.
Citation: Kempker JA, Panwar B, Judd SE .
Plasma 25-hydroxyvitamin d and the longitudinal risk of sepsis in the REGARDS cohort..
Clin Infect Dis 2019 May 17;68(11):1926-31. doi: 10.1093/cid/ciy794..
Keywords: Community-Acquired Infections, Racial and Ethnic Minorities, Risk, Sepsis, Stroke
Randad PR, Dillen CA, Ortines RV
Comparison of livestock-associated and community-associated Staphylococcus aureus pathogenicity in a mouse model of skin and soft tissue infection.
The goal of this study was to determine the degree to which livestock-associated (LA) Staphylococcus aureus strains contracted by industrial hog-operation (IHO) workers cause disease relative to a representative CA-MRSA strain in a mouse model of skin and soft tissue infection (SSTI). Mice infected with LA-S. aureus strains developed larger lesions with a higher bacterial burden than the CA-MRSA infected mice; the largest lesion size and bacterial burden were observed with a CC398 LA-S. aureus strain which had produced a recurrent SSTI in an IHO worker. The researchers conclude that more attention should be placed on the prevention of spreading LA-S. aureus into human populations.
AHRQ-funded; HS019966.
Citation: Randad PR, Dillen CA, Ortines RV .
Comparison of livestock-associated and community-associated Staphylococcus aureus pathogenicity in a mouse model of skin and soft tissue infection.
Sci Rep 2019 May 1;9(1):6774. doi: 10.1038/s41598-019-42919-y..
Keywords: Community-Acquired Infections, Comparative Effectiveness, Infectious Diseases
Weinstein EJ, Han JH, Lautenbach E
A clinical prediction tool for extended-spectrum cephalosporin resistance in community-onset Enterobacterales urinary tract infection.
Researchers sought to create a clinical prediction tool for community-onset urinary tract infections (UTIs) due to extended-spectrum cephalosporin-resistant (ESC-R) Enterobacterales (EB). Study participants included patients who presented to an emergency department or outpatient practice with an EB UTI; case patients had ESC-R EB UTIs and control patients had ESC-susceptible EB UTIs. The predictive model was develop by performing a multivariable conditional logistic regression. The researchers found after multivariable analysis that presentation with an ESC-R EB community-onset UTI could be predicted by the following factors: history of malignancy, history of diabetes, recent skilled nursing facility or hospital stay, recent trimethoprim-sulfamethoxazole exposure, pyelonephritis at the time of presentation. They conclude that community-onset ESC-R EB UTI can be predicted by using the proposed scoring system, which can be helpful to guide diagnostic and therapeutic interventions.
AHRQ-funded; HS020002.
Citation: Weinstein EJ, Han JH, Lautenbach E .
A clinical prediction tool for extended-spectrum cephalosporin resistance in community-onset Enterobacterales urinary tract infection.
Open Forum Infect Dis 2019 Apr;6(4):ofz164. doi: 10.1093/ofid/ofz164..
Keywords: Community-Acquired Infections, Risk, Urinary Tract Infection (UTI)
Leyenaar JK, Andrews CB, Tyksinski ER
Facilitators of interdepartmental quality improvement: a mixed-methods analysis of a collaborative to improve pediatric community-acquired pneumonia management.
This study examined the relationship between emergency room (ER) physicians and hospital pediatricians in the use of narrow-spectrum antibiotics to treat children hospitalized with pneumonia. There were eight inter-related domains that were identified that contribute to successful quality improvement efforts. These domains include hospital leadership and support; quality improvement champions, and interdepartmental relationships.
AHRQ-funded; HS024133; HS024554.
Citation: Leyenaar JK, Andrews CB, Tyksinski ER .
Facilitators of interdepartmental quality improvement: a mixed-methods analysis of a collaborative to improve pediatric community-acquired pneumonia management.
BMJ Qual Saf 2019 Mar;28(3):215-22. doi: 10.1136/bmjqs-2018-008065..
Keywords: Children/Adolescents, Community-Acquired Infections, Emergency Department, Pneumonia, Quality of Care, Quality Improvement
Hogan PG, Mork RL, Boyle MG
Interplay of personal, pet, and environmental colonization in households affected by community-associated methicillin-resistant Staphylococcus aureus.
In this study, the investigators sought to determine the prevalence, molecular epidemiology, and factors associated with Staphylococcus aureus environmental surface and pet colonization in households of children with community-associated methicillin-resistant S. aureus (CA-MRSA) infection. The investigators found that household environments and pet dogs and cats serve as reservoirs of MRSA. Household member MRSA colonization burden predicts environmental MRSA contamination. The authors indicated that longitudinal studies will inform the directionality of household transmission.
AHRQ-funded; HS021736; HS024269.
Citation: Hogan PG, Mork RL, Boyle MG .
Interplay of personal, pet, and environmental colonization in households affected by community-associated methicillin-resistant Staphylococcus aureus.
J Infect 2019 Mar;78(3):200-07. doi: 10.1016/j.jinf.2018.11.006..
Keywords: Community-Acquired Infections, Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA)
Immergluck LC, Leong T, Matthews K
Geographic surveillance of community associated MRSA infections in children using electronic health record data.
This study conducted a geographic surveillance of community-associated methicillin resistant Staphylococcus aureas (CA-MRSA) incidence in children from 2000 to 2010 in the Atlanta Metropolitan area. Census tract data was filtered to create maps of antibiotic resistant and non-resistant forms of CA-MRSA infection. Black children and children under the age of 4 were found to have increased risk for CA-MRSA. Poverty also made a difference in the rate of CA-MRSA with neighborhoods with larger households having a higher rate.
AHRQ-funded; HS024338.
Citation: Immergluck LC, Leong T, Matthews K .
Geographic surveillance of community associated MRSA infections in children using electronic health record data.
BMC Infect Dis 2019 Feb 18;19(1):170. doi: 10.1186/s12879-019-3682-3..
Keywords: Children/Adolescents, Community-Acquired Infections, Electronic Health Records (EHRs), Methicillin-Resistant Staphylococcus aureus (MRSA), Social Determinants of Health
Anesi JA, Lautenbach E, Nachamkin I
The role of extended-spectrum cephalosporin-resistance in recurrent community-onset
This study found an association between the use of extended-spectrum cephalosporin-resistance (ESC-R) and recurring Enterobacteriacaea urinary tract infections (EB UTIs). There was a significant increase in emergency room visits within 12 months after the first UTI visit.
AHRQ-funded; HS020002.
Citation: Anesi JA, Lautenbach E, Nachamkin I .
The role of extended-spectrum cephalosporin-resistance in recurrent community-onset
BMC Infect Dis 2019 Feb 14;19(1):163. doi: 10.1186/s12879-019-3804-y..
Keywords: Antibiotics, Community-Acquired Infections, Medication, Urinary Tract Infection (UTI)