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AHRQ Research Studies Date
Topics
- Antibiotics (3)
- Antimicrobial Stewardship (1)
- Children/Adolescents (1)
- (-) Community-Acquired Infections (14)
- Comparative Effectiveness (1)
- Diagnostic Safety and Quality (1)
- Elderly (1)
- Evidence-Based Practice (1)
- Family Health and History (1)
- Genetics (1)
- Hospitalization (3)
- Infectious Diseases (5)
- Influenza (2)
- Inpatient Care (1)
- Medication (4)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (5)
- Mortality (1)
- Outcomes (4)
- Patient-Centered Outcomes Research (1)
- Patient Safety (2)
- Pneumonia (9)
- Prevention (1)
- Respiratory Conditions (3)
- Urinary Tract Infection (UTI) (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 DisplayedDeshpande A, Klompas M, Yu PC A, Klompas M, Yu PC
Influenza testing and treatment among patients hospitalized with community-acquired pneumonia.
This study looked at testing rates for influenza in hospitalized patients admitted for community-acquired pneumonia (CAP) and whether it is associated with antiviral treatment and shorter antibiotic courses. The study included patients admitted in 179 US hospitals with pneumonia from 2010 to 2015. The authors assessed influenza testing and compared antimicrobial utilization and the outcomes of test-positive, test-negative, and untested patients. Among 166,268 patients with CAP, 23.3% were tested for influenza, of whom 11.5% tested positive. Testing increased from 15.4% to 35.5% from 2010 to 2015 and was more than triple the rate during flu season (October-May) vs June to September. Patients who tested positive for influenza received antiviral agents more often and antibiotics less often and for shorter courses than patients testing negative. Patients who received early antiviral treatment with oseltamivir experienced lower 14-day in-hospital mortality, lower costs, and shorter length of stay vs patients receiving oseltamivir later or not at all.
AHRQ-funded; HS024277.
Citation: Deshpande A, Klompas M, Yu PC A, Klompas M, Yu PC .
Influenza testing and treatment among patients hospitalized with community-acquired pneumonia.
Chest 2022 Sep;162(3):543-55. doi: 10.1016/j.chest.2022.01.053..
Keywords: Influenza, Pneumonia, Community-Acquired Infections, Outcomes, Medication, Inpatient Care
Vaughn VM, Gandhi TN, Hofer TP
A statewide collaborative quality initiative to improve antibiotic duration and outcomes in patients hospitalized with uncomplicated community-acquired pneumonia.
Researchers sought to improve antibiotic duration for community-acquired pneumonia (CAP) across 41 hospitals participating in the Michigan Hospital Medicine Safety Consortium (HMS). They found that, across diverse hospitals, HMS participation was associated with more appropriate use of short-course therapy and fewer adverse events in hospitalized patients with uncomplicated CAP.
AHRQ-funded; HS026530.
Citation: Vaughn VM, Gandhi TN, Hofer TP .
A statewide collaborative quality initiative to improve antibiotic duration and outcomes in patients hospitalized with uncomplicated community-acquired pneumonia.
Clin Infect Dis 2022 Aug 31;75(3):460-67. doi: 10.1093/cid/ciab950..
Keywords: Community-Acquired Infections, Pneumonia, Antibiotics, Antimicrobial Stewardship, Medication, Respiratory Conditions
Rothberg MB, Imrey PB, Guo N MB, Imrey PB, Guo N
A risk model to identify Legionella among patients admitted with community-acquired pneumonia: a retrospective cohort study.
This study’s goal was to derive and externally validate a model to predict a positive Legionella test among adult inpatients diagnosed with pneumonia. The study used data from 177 US hospitals in the Premier Healthcare Database and 12 Cleveland Clinic Health System (CCHS) hospitals. Of 166,689 patients hospitalized for pneumonia, out of 43,070 tested for Legionella 642 (1.5%) tested positive. The strongest predictors of a positive test were a local outbreak, June-October occurrence, hyponatremia, smoking and diarrhea. A negative test was associated with prior admission within 6 months and chronic pulmonary disease.
AHRQ-funded; HS024277.
Citation: Rothberg MB, Imrey PB, Guo N MB, Imrey PB, Guo N .
A risk model to identify Legionella among patients admitted with community-acquired pneumonia: a retrospective cohort study.
J Hosp Med 2022 Aug;17(8):624-32. doi: 10.1002/jhm.12919..
Keywords: Pneumonia, Community-Acquired Infections, Infectious Diseases, Respiratory Conditions
Haessler S, Guo N, Deshpande A
Etiology, treatments, and outcomes of patients with severe community-acquired pneumonia in a large U.S. sample.
This study compared the clinical practice and outcomes in severe community-acquired pneumonia (sCAP) patients to those in non-sCAP patients using guideline-defined criteria for sCAP. The definition for sCAP includes a principal diagnosis of pneumonia or a secondary pneumonia diagnosis paired with a principal diagnosis of sepsis or respiratory failure. One-hundred seventy-seven US hospitals within the Premier Healthcare Database were used to identify 154,799 patients with pneumonia, with 14.1% meeting criteria for sCAP. The sCAP patients had higher organ failure scores and inpatient mortality, longer lengths of stay, and higher costs than those with nonsevere disease. Patients with sCAP had twice the rate of positive blood cultures and respiratory cultures and more often had isolates resistant to first-line community-acquired pneumonia antibiotics. The most common pathogen acquired from blood cultures was Streptococcus pneumoniae and from the respiratory tract Staphylococcus aureus and Pseudomonas species. The most common antibiotics prescribed were vancomycin (65%) and piperacillin-tazobactam (42.8%), regardless of cultures positive for a resistant organism.
AHRQ-funded; HS024277.
Citation: Haessler S, Guo N, Deshpande A .
Etiology, treatments, and outcomes of patients with severe community-acquired pneumonia in a large U.S. sample.
Crit Care Med 2022 Jul;50(7):1063-71. doi: 10.1097/ccm.0000000000005498..
Keywords: Community-Acquired Infections, Pneumonia, Respiratory Conditions, Outcomes
Gupta A, Petty L, Gandhi T
Overdiagnosis of urinary tract infection linked to overdiagnosis of pneumonia: a multihospital cohort study.
This study’s goal was to determine if there is a correlation between overdiagnosis of urinary tract infection (UTI) and overdiagnosis of community-acquired pneumonia (CAP) in hospitals, resulting in unnecessary antibiotic use and diagnostic delays. The authors first determined the proportion of hospitalized patients treated for CAP or UTI at 46 hospitals in Michigan who were overdiagnosed according to national guideline definitions. Then they used Pearson's correlation coefficient to compare hospital proportions of overdiagnosis of CAP and UTI. They included 14,085 patients treated for CAP and 10,398 patients treated for UTI. There was a moderate correlation within hospitals of the proportion of patients overdiagnosed with UTI and those overdiagnosed with CAP.
AHRQ-funded; HS026530.
Citation: Gupta A, Petty L, Gandhi T .
Overdiagnosis of urinary tract infection linked to overdiagnosis of pneumonia: a multihospital cohort study.
BMJ Qual Saf 2022 May;31(5):383-86. doi: 10.1136/bmjqs-2021-013565..
Keywords: Urinary Tract Infection (UTI), Pneumonia, Community-Acquired Infections, Diagnostic Safety and Quality
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
Bartley PS, Deshpande A, Yu PC
Bacterial coinfection in influenza pneumonia: rates, pathogens, and outcomes.
Among patients hospitalized for influenza pneumonia, the researchers reported the rate of coinfection and distribution of pathogens and also compared outcomes of patients with and without bacterial coinfection. They found that, in a large US inpatient sample hospitalized with influenza and community-acquired pneumonia, Staphylococcus aureus was the most frequent cause of bacterial coinfection. Coinfection was associated with worse outcomes and higher costs.
AHRQ-funded; HS024277.
Citation: Bartley PS, Deshpande A, Yu PC .
Bacterial coinfection in influenza pneumonia: rates, pathogens, and outcomes.
Infect Control Hosp Epidemiol 2022 Feb;43(2):212-17. doi: 10.1017/ice.2021.96..
Keywords: Influenza, Pneumonia, Infectious Diseases, Community-Acquired Infections
Rastogi R, Yu PC, Deshpande A
Treatment and outcomes among patients ≥85 years hospitalized with community-acquired pneumonia.
This retrospective cohort study’s objective was to describe community-acquired pneumonia (CAP) among patients ≥85 years and compare them to patients aged 65-74. Findings showed that patients aged 85 and over have different comorbidities and etiologies of CAP, receive less intense treatment, and have greater mortality than patients between 65 and 75 years.
AHRQ-funded; HS024277.
Citation: Rastogi R, Yu PC, Deshpande A .
Treatment and outcomes among patients ≥85 years hospitalized with community-acquired pneumonia.
J Investig Med 2022 Feb;70(2):376-82. doi: 10.1136/jim-2021-002078..
Keywords: Elderly, Community-Acquired Infections, Pneumonia, Outcomes, Hospitalization
Anesi JA, Lautenbach E, Nachamkin I
Poor clinical outcomes associated with community-onset urinary tract infections due to extended-spectrum cephalosporin-resistant Enterobacteriaceae.
In this retrospective cohort study, the investigators sought to determine the clinical outcomes associated with community-onset ESC-resistant (ESC-R) EB urinary tract infections (UTIs) in a US health system. The authors found that community-onset UTI due to an ESC-R EB organism was significantly associated with clinical failure, which may be due in part to inappropriate initial antibiotic therapy. They indicate that further studies are needed to determine which patients in the community are at high risk for drug-resistant infection to help inform prompt diagnosis and appropriate antibiotic prescribing for ESC-R EB.
AHRQ-funded; HS020002.
Citation: Anesi JA, Lautenbach E, Nachamkin I .
Poor clinical outcomes associated with community-onset urinary tract infections due to extended-spectrum cephalosporin-resistant Enterobacteriaceae.
Infect Control Hosp Epidemiol 2018 Dec;39(12):1431-35. doi: 10.1017/ice.2018.254..
Keywords: Antibiotics, Community-Acquired Infections, Medication, Outcomes, Patient Safety, Urinary Tract Infection (UTI)
Frush JM, Zhu Y, Edwards KM
Prevalence of staphylococcus aureus and use of antistaphylococcal therapy in children hospitalized with pneumonia.
In a studied group of children hospitalized with community-acquired pneumonia, staphylococcal pneumonia was rare but associated with adverse in-hospital outcomes. Despite this low prevalence, use of antistaphylococcal antibiotics was common. The authors recommended efforts to minimize overuse of antistaphylococcal antibiotics while also ensuring adequate treatment for pathogen-specific diseases.
AHRQ-funded; HS022342.
Citation: Frush JM, Zhu Y, Edwards KM .
Prevalence of staphylococcus aureus and use of antistaphylococcal therapy in children hospitalized with pneumonia.
J Hosp Med 2018 Dec;13(12):848-52. doi: 10.12788/jhm.3093..
Keywords: Children/Adolescents, Infectious Diseases, Pneumonia, Methicillin-Resistant Staphylococcus aureus (MRSA), Community-Acquired Infections, Hospitalization, Antibiotics, Medication
Mork RL, Hogan PG, Muenks CE
Comprehensive modeling reveals proximity, seasonality, and hygiene practices as key determinants of MRSA colonization in exposed households.
To develop interventions to prevent recurrent infections, household attributes and individual practices influencing S. aureus colonization must be discerned. In this paper, the investigators discuss key determinants of methicillin-resistant S. aureus (MRSA) colonization in exposed households. They suggest that the practices they identified in their study, that correlate with MRSA colonization, will inform physician counseling and multifaceted interventions among MRSA-affected households to mitigate MRSA in the community.
AHRQ-funded; HS021736; HS024269.
Citation: Mork RL, Hogan PG, Muenks CE .
Comprehensive modeling reveals proximity, seasonality, and hygiene practices as key determinants of MRSA colonization in exposed households.
Pediatr Res 2018 Nov;84(5):668-76. doi: 10.1038/s41390-018-0113-x..
Keywords: Community-Acquired Infections, Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Patient Safety
Weir RE, Lyttle CS, Meltzer DO
The relative ability of comorbidity ascertainment methodologies to predict in-hospital mortality among hospitalized community-acquired pneumonia patients.
In this observational study, the investigators sought to compare the relative value of several methodologies by which comorbidities may be ascertained. The authors concluded that although comorbidities derived through administrative data did produce an area under the curve greater than chart review, their analyses suggested a coding bias in several comorbidities with a paradoxically protective effect. They assert that chart review, while labor and resource intensive, may be the ideal method for ascertainment of clinically relevant comorbidities.
AHRQ-funded; HS016948; HS010597.
Citation: Weir RE, Lyttle CS, Meltzer DO .
The relative ability of comorbidity ascertainment methodologies to predict in-hospital mortality among hospitalized community-acquired pneumonia patients.
Med Care 2018 Nov;56(11):950-55. doi: 10.1097/mlr.0000000000000989..
Keywords: Community-Acquired Infections, Hospitalization, Mortality, Pneumonia
Parrish KL, Hogan PG, Clemons AA
Spatial relationships among public places frequented by families plagued by methicillin-resistant Staphylococcus aureus.
In this study, the investigators mapped public places (including personal service establishments, fitness centers, pools, schools, and daycares) visited by members of households affected by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft tissue infection, in order to understand factors associated with CA-MRSA acquisition and infection.
AHRQ-funded; HS024269; HS021736.
Citation: Parrish KL, Hogan PG, Clemons AA .
Spatial relationships among public places frequented by families plagued by methicillin-resistant Staphylococcus aureus.
BMC Res Notes 2018 Oct 1;11(1):692. doi: 10.1186/s13104-018-3797-4..
Keywords: Community-Acquired Infections, Family Health and History, Methicillin-Resistant Staphylococcus aureus (MRSA)
Wardyn SE, Stegger M, Price LB
Whole-genome analysis of recurrent Staphylococcus aureus t571/ST398 infection in farmer, Iowa, USA.
Staphylococcus aureus strain sequence type (ST) 398 has emerged during the last decade, largely among persons who have contact with swine or other livestock. Although colonization with ST398 is common in livestock workers, infections are not frequently documented. The authors report recurrent ST398-IIa infection in an Iowa farmer in contact with swine and cattle.
AHRQ-funded; HS019966.
Citation: Wardyn SE, Stegger M, Price LB .
Whole-genome analysis of recurrent Staphylococcus aureus t571/ST398 infection in farmer, Iowa, USA.
Emerg Infect Dis 2018 Jan;24(1):153-54. doi: 10.3201/eid2401.161184.
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Keywords: Community-Acquired Infections, Genetics, Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA)