National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Antibiotics (3)
- Antimicrobial Stewardship (3)
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (2)
- Children/Adolescents (2)
- Clostridium difficile Infections (1)
- Community-Acquired Infections (1)
- Critical Care (1)
- Healthcare-Associated Infections (HAIs) (13)
- Healthcare Costs (1)
- Hospitals (3)
- Infectious Diseases (4)
- Injuries and Wounds (2)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (3)
- Long-Term Care (2)
- Medication (2)
- (-) Methicillin-Resistant Staphylococcus aureus (MRSA) (18)
- Neonatal Intensive Care Unit (NICU) (2)
- Newborns/Infants (3)
- Nursing Homes (1)
- Patient Safety (7)
- Pneumonia (1)
- Practice-Based Research Network (PBRN) (1)
- Prevention (7)
- Respiratory Conditions (1)
- Risk (2)
- Sepsis (1)
- Skin Conditions (2)
- Surgery (1)
- Urinary Tract Infection (UTI) (1)
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 18 of 18 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
Peterson LR, Boehm S, Beaumont JL
Reduction of methicillin-resistant Staphylococcus aureus infection in long-term care is possible while maintaining patient socialization: a prospective randomized clinical trial.
The researchers sought to demonstrate that a novel, minimally invasive program not interfering with activities of daily living or socialization could lower methicillin-resistant Staphylococcus aureus (MRSA) disease in long-term care facilities (LTCFs). They found that the MRSA infection rate decreased 65% between baseline and year 2, with a significant reduction observed at each of the three participating LTCFs. They concluded that on-site MRSA surveillance with targeted decolonization resulted in a significant decrease in clinical MRSA infection among LTCF residents.
AHRQ-funded; HS019968.
Citation: Peterson LR, Boehm S, Beaumont JL .
Reduction of methicillin-resistant Staphylococcus aureus infection in long-term care is possible while maintaining patient socialization: a prospective randomized clinical trial.
Am J Infect Control 2016 Dec;44(12):1622-27. doi: 10.1016/j.ajic.2016.04.251.
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Keywords: Healthcare-Associated Infections (HAIs), Long-Term Care, Methicillin-Resistant Staphylococcus aureus (MRSA), Patient Safety, Prevention
Piper Jenks N, Pardos de la Gandara M, D'Orazio BM
Differences in prevalence of community-associated MRSA and MSSA among U.S. and non-U.S. born populations in six New York community health centers.
As part of a research collaborative, 6 New York City-area community health centers recruited patients with Skin and Soft Tissue Infections (SSTIs). This study found that although not statistically significant, immigrants had lower rates of Methicillin-Resistant Staphylococcus aureus (MRSA) infections than did native-born participants, and immigrants showed significantly higher rates of Methicillin-Susceptible Staphylococcus aureus (MSSA) wound cultures.
AHRQ-funded; HS021667.
Citation: Piper Jenks N, Pardos de la Gandara M, D'Orazio BM .
Differences in prevalence of community-associated MRSA and MSSA among U.S. and non-U.S. born populations in six New York community health centers.
Travel Med Infect Dis 2016 Nov - Dec;14(6):551-60. doi: 10.1016/j.tmaid.2016.10.003.
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Keywords: Community-Acquired Infections, Methicillin-Resistant Staphylococcus aureus (MRSA), Injuries and Wounds, Practice-Based Research Network (PBRN), Antibiotics
Dicks KV, Lofgren E, Lewis SS
A multicenter pragmatic interrupted time series analysis of chlorhexidine gluconate bathing in community hospital intensive care units.
This study sought to determine whether daily chlorhexidine gluconate (CHG) bathing of intensive care unit (ICU) patients leads to a decrease in hospital-acquired infections (HAIs), particularly infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). It concluded that hospitals that implemented CHG bathing attained a decrease in ICU central-line-associated bloodstream infections (CLABSIs), ICU primary BSIs, and VRE central-line-associated bloodstream infections.
AHRQ-funded; HS023866.
Citation: Dicks KV, Lofgren E, Lewis SS .
A multicenter pragmatic interrupted time series analysis of chlorhexidine gluconate bathing in community hospital intensive care units.
Infect Control Hosp Epidemiol 2016 Jul;37(7):791-7. doi: 10.1017/ice.2016.23.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Patient Safety, Healthcare-Associated Infections (HAIs)
Reich PJ, Boyle MG, Hogan PG
Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit: an infection prevention and patient safety challenge.
Methicillin-resistant Staphylococcus aureus (MRSA) infections cause significant morbidity and mortality in neonatal intensive care units (NICUs). The researchers characterized the clinical and molecular epidemiology of MRSA strains colonizing NICU patients. They found that community-acquired MRSA strains are prominent in the NICU and associated with distinct risk factors.
AHRQ-funded; HS021736; HS024269.
Citation: Reich PJ, Boyle MG, Hogan PG .
Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit: an infection prevention and patient safety challenge.
Clin Microbiol Infect 2016 Jul;22(7):645.e1-8. doi: 10.1016/j.cmi.2016.04.013.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Neonatal Intensive Care Unit (NICU), Patient Safety, Prevention, Antimicrobial Stewardship, Newborns/Infants, Healthcare-Associated Infections (HAIs)
Muenks CE, Hogan PG, Wang JW
Diversity of Staphylococcus aureus strains colonizing various niches of the human body.
The objectives of this study were to determine whether S. aureus polyclonal colonization exists within one body niche and to determine the optimal sampling sites and culture methodology to capture the diversity of S. aureus strains in community-dwelling individuals. The researchers found S. aureus polyclonality within a single body niche and that culture methodology and sampling sites influenced the analytical sensitivity of S. aureus colonization detection and the robustness of phenotypic and genotypic strain recovery.
AHRQ-funded; HS021736; HS024269.
Citation: Muenks CE, Hogan PG, Wang JW .
Diversity of Staphylococcus aureus strains colonizing various niches of the human body.
J Infect 2016 Jun;72(6):698-705. doi: 10.1016/j.jinf.2016.03.015.
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Keywords: Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA), Risk
Baker AW, Dicks KV, Durkin MJ
Epidemiology of surgical site infection in a community hospital network.
The researchers described the epidemiology of complex surgical site infection (SSI) following commonly performed surgical procedures in community hospitals and to characterize trends of SSI prevalence rates over time for MRSA and other common pathogens. They found that the prevalence of MRSA SSI decreased from 2008 to 2012. This decrease in MRSA SSI prevalence led to an overall decrease in SSI prevalence.
AHRQ-funded; HS023866.
Citation: Baker AW, Dicks KV, Durkin MJ .
Epidemiology of surgical site infection in a community hospital network.
Infect Control Hosp Epidemiol 2016 May;37(5):519-26. doi: 10.1017/ice.2016.13.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Injuries and Wounds, Adverse Events, Risk, Hospitals
Popoola VO, Colantuoni E, Suwantarat N
Active surveillance cultures and decolonization to reduce staphylococcus aureus infections in the neonatal intensive care unit.
The researchers examined the impact of methicillin-susceptible S. aureus (MSSA) decolonization on the incidence of MSSA infection and to measure the prevalence of mupirocin resistance. They found that active surveillance cultures and decolonization may be effective in decreasing S. aureus infections in NICUs.
AHRQ-funded; HS022872.
Citation: Popoola VO, Colantuoni E, Suwantarat N .
Active surveillance cultures and decolonization to reduce staphylococcus aureus infections in the neonatal intensive care unit.
Infect Control Hosp Epidemiol 2016 Apr;37(4):381-7. doi: 10.1017/ice.2015.316..
Keywords: Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA), Newborns/Infants
Huang SS, Septimus E, Hayden MK
Effect of body surface decolonisation on bacteriuria and candiduria in intensive care units: an analysis of a cluster-randomised trial.
The researchers aimed to assess the effect of decolonization on bacteriuria and candiduria in patients admitted to ICUs. They concluded that universal decolonization of patients in the ICU with once a day chlorhexidine baths and short-course nasal mupirocin could be a potential preventive strategy in male patients because it significantly decreases candiduria and any bacteriuria, but not for women.
AHRQ-funded; 290201000008I; 29032007T.
Citation: Huang SS, Septimus E, Hayden MK .
Effect of body surface decolonisation on bacteriuria and candiduria in intensive care units: an analysis of a cluster-randomised trial.
Lancet Infect Dis 2016 Jan;16(1):70-9. doi: 10.1016/s1473-3099(15)00238-8.
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Keywords: Intensive Care Unit (ICU), Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention
Russell D, Beekmann SE, Polgreen PM
Routine use of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus: Which way is the pendulum swinging?
This study assessed the state of utilization of contact precautions (CP) as well as adjunctive measures to reduce the risk of transmission for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus in US hospitals. It found that the most widely used trigger for initiation of CP for both pathogens was positive clinical culture. Practices for discontinuation of isolation varied widely. Evidence-based guidelines regarding CP and horizontal interventions are needed.
AHRQ-funded; HS021188.
Citation: Russell D, Beekmann SE, Polgreen PM .
Routine use of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus: Which way is the pendulum swinging?
Infect Control Hosp Epidemiol 2016 Jan;37(1):36-40. doi: 10.1017/ice.2015.246.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Antimicrobial Stewardship, Patient Safety