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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Antibiotics (13)
- (-) Antimicrobial Stewardship (16)
- Case Study (1)
- Children/Adolescents (1)
- Clostridium difficile Infections (1)
- Critical Care (1)
- Decision Making (1)
- Digestive Disease and Health (1)
- Education: Continuing Medical Education (1)
- Elderly (3)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (5)
- Healthcare Costs (2)
- Imaging (1)
- Infectious Diseases (8)
- Long-Term Care (2)
- Medication (9)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Newborns/Infants (1)
- Nursing Homes (2)
- Patient Safety (5)
- Patient Self-Management (1)
- Prevention (5)
- Surgery (3)
- 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 16 of 16 Research Studies DisplayedSmith TC, Davis MF, Heaney CD
Pig movement and antimicrobial use drive transmission of livestock-associated staphylococcus aureus CC398.
Staphylococcus aureus was originally considered a hospital-associated organism, but new classes of methicillin-resistant strains have emerged outside of the hospital setting, including among livestock. This article discusses a recent study which examined the transportation of pigs on over 200 farms; the authors of this article contend that the results of the study demonstrate the importance of cooperation between occupational health services, genomics, veterinary medicine, and farmers in understanding the epidemiology of MRSAs as related to livestock.
AHRQ-funded; HS019966.
Citation: Smith TC, Davis MF, Heaney CD .
Pig movement and antimicrobial use drive transmission of livestock-associated staphylococcus aureus CC398.
MBio 2018 Dec 11;9(6). doi: 10.1128/mBio.02459-18..
Keywords: Antimicrobial Stewardship, Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA), Patient Safety, Prevention
Varda BK, Finkelstein JB, Wang HH
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
This study examined whether the routine use of continuous antibiotic prophylaxis (CAP) before initial postnatal imaging is effective to prevent urinary tract infection (UTI) in infants with a history of antenatal urinary tract dilation (AUTD). A single-institution, retrospective cohort study of infants with a history of AUTD was conducted. A random sample of 500 infants was selected with six excluded for other congenital anomalies. Of the 494 remaining, 157 (32%) received CAP. There was no difference found in UTI incidence among those treated with CAP and those who were not.
AHRQ-funded; HS000063.
Citation: Varda BK, Finkelstein JB, Wang HH .
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
J Pediatr Urol 2018 Dec;14(6):539.e1-39.e6. doi: 10.1016/j.jpurol.2018.04.022..
Keywords: Antibiotics, Antimicrobial Stewardship, Urinary Tract Infection (UTI), Newborns/Infants, Imaging, Medication, Prevention
D'Agata EMC, Lindberg CC, Lindberg CM
The positive effects of an antimicrobial stewardship program targeting outpatient hemodialysis facilities.
The purpose of this study was to quantify the effect of an antimicrobial stewardship program in reducing antimicrobial prescribing. Implementation of the antimicrobial stewardship program was associated with a 6% monthly reduction in antimicrobial doses per 100 patient months during the intervention period (P=.02). The investigators found that within 6 hemodialysis facilities, implementation of an antimicrobial stewardship was associated with a decline in antimicrobial prescribing with no negative effects.
AHRQ-funded; HS021666.
Citation: D'Agata EMC, Lindberg CC, Lindberg CM .
The positive effects of an antimicrobial stewardship program targeting outpatient hemodialysis facilities.
Infect Control Hosp Epidemiol 2018 Dec;39(12):1400-05. doi: 10.1017/ice.2018.237..
Keywords: Antibiotics, Antimicrobial Stewardship, Prevention, Medication, Medication
Kline SE, Sanstead EC, Johnson JR
Cost-effectiveness of pre-operative Staphylococcus aureus screening and decolonization.
In this study, the investigators developed a decision analytic model to evaluate the impact of a preoperative Staphylococcus aureus decolonization bundle on surgical site infections (SSIs), health-care-associated costs (HCACs), and deaths due to SSI. The investigators predict that the treat-all strategy would be the most effective and cost-saving strategy for preventing SSIs. However, they concluded that because this strategy might select more extensively for mupirocin-resistant S. aureus and cause more medication adverse effects than the test-and-treat approach or the SOC, additional studies are needed to define its comparative benefits and harms.
AHRQ-funded; HS022912.
Citation: Kline SE, Sanstead EC, Johnson JR .
Cost-effectiveness of pre-operative Staphylococcus aureus screening and decolonization.
Infect Control Hosp Epidemiol 2018 Nov;39(11):1340-46. doi: 10.1017/ice.2018.228..
Keywords: Surgery, Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention, Healthcare Costs
Kadri SS, Adjemian J, Lai YL
Difficult-to-treat resistance in gram-negative bacteremia at 173 US hospitals: retrospective cohort analysis of prevalence, predictors, and outcome of resistance to all first-line agents.
Resistance to all first-line antibiotics necessitates the use of less effective or more toxic "reserve" agents. In this study, the Premier Database was analyzed for inpatients with select Gram-negative bloodstream infections (GNBSIs). Prevalence and aminoglycoside resistance of difficult-to-treat resistance (DTR) episodes were compared with carbapenem-resistant, extended-spectrum cephalosporin-resistant, and fluoroquinolone-resistant episodes using CDC definitions. The investigators concluded that nonsusceptibility to first-line antibiotics was associated with decreased survival in GNBSIs. They suggest that DSR is a simple bedside prognostic measure of treatment-limiting coresistance.
AHRQ-funded; HS025008.
Citation: Kadri SS, Adjemian J, Lai YL .
Difficult-to-treat resistance in gram-negative bacteremia at 173 US hospitals: retrospective cohort analysis of prevalence, predictors, and outcome of resistance to all first-line agents.
Clin Infect Dis 2018 Nov 28;67(12):1803-14. doi: 10.1093/cid/ciy378..
Keywords: Antibiotics, Antimicrobial Stewardship, Infectious Diseases
D'Agata EMC, Varu A, Geffert SF
Acquisition of multidrug-resistant organisms in the absence of antimicrobials.
This nested case-control study was conducted among 137 nursing home residents who did not receive antimicrobials, with 44 acquiring a multi-drug resistant organism. Risk factors identified included receiving gastrointestinal medication that affected the gut microbiome, the number of visits from healthcare workers, pressure ulcers, and not residing in a dementia unit.
AHRQ-funded; HS021666.
Citation: D'Agata EMC, Varu A, Geffert SF .
Acquisition of multidrug-resistant organisms in the absence of antimicrobials.
Clin Infect Dis 2018 Oct 15;67(9):1437-40. doi: 10.1093/cid/ciy358..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Nursing Homes, Long-Term Care, Elderly, Digestive Disease and Health, Case Study
Doernberg SB, Aboo LM, Burdette SD
Essential resources and strategies for antibiotic stewardship programs in the acute care setting.
This study measured the success of antibiotic stewardship programs to rates of antibiotic resistant disease. A survey was conducted of US stewardship programs using a cross-section of members of 3 infectious diseases subspecialty societies. Two-hundred forty-four respondents from a variety of acute care settings filled out the survey. Eighty-five percent of surveyed programs demonstrated at least 1 improved outcome in the prior 2 years. Every 0.50 increase in pharmacist and physician full-time equivalent (FTE) support predicted a 1.48-fold increase in demonstration effectiveness.
AHRQ-funded; HS023866.
Citation: Doernberg SB, Aboo LM, Burdette SD .
Essential resources and strategies for antibiotic stewardship programs in the acute care setting.
Clin Infect Dis 2018 Sep 28;67(8):1168-74. doi: 10.1093/cid/ciy255..
Keywords: Antimicrobial Stewardship, Antibiotics, Critical Care, Medication
Michener A, Heath B, Crnich CJ
Infections in older adults: a case-based discussion series emphasizing antibiotic stewardship.
This article describes the results of a series of 1-hour case-based discussions on recognition, diagnosis, and infections common in older adults, including those living in long-term care settings, and antibiotic stewardship that were developed by the authors. This series of five discussions was held at 15 Veterans Affairs medical centers in their skilled nursing centers. There were participants from an array of disciplines who completed an evaluation as well as pre- and post-course knowledge assessment. Total participants numbered from 68 to 108 per center. There were positive assessments, with many participants saying they were likely to make changes to help combat health associated infections.
AHRQ-funded; HS023866.
Citation: Michener A, Heath B, Crnich CJ .
Infections in older adults: a case-based discussion series emphasizing antibiotic stewardship.
MedEdPORTAL 2018 Sep 21;14:10754. doi: 10.15766/mep_2374-8265.10754..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Elderly, Infectious Diseases
D'Agata EMC, Tran D, Bautista J
Clinical and economic benefits of antimicrobial stewardship programs in hemodialysis facilities: a decision analytic model.
In this study, the authors developed a decision analytic model of antimicrobial use on the clinical and economic consequences of implementing a nationwide antimicrobial stewardship program in outpatient dialysis facilities. The authors found that the model suggested that implementation of antimicrobial stewardship programs in outpatient dialysis facilities would result in substantial reductions in infections caused by multidrug-resistant organisms and C. difficile, infection-related deaths, and costs.
AHRQ-funded; R18 HS021666.
Citation: D'Agata EMC, Tran D, Bautista J .
Clinical and economic benefits of antimicrobial stewardship programs in hemodialysis facilities: a decision analytic model.
Clin J Am Soc Nephrol 2018 Sep 7;13(9):1389-97. doi: 10.2215/cjn.12521117..
Keywords: Antimicrobial Stewardship, Decision Making, Antibiotics, Medication, Healthcare Costs, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs)
Morgan JR, Barlam TF, Drainoni ML
A qualitative study of the real-world experiences of infectious diseases fellows regarding antibiotic stewardship.
A qualitative study was performed to explore infectious disease (ID) fellows' experiences and perspectives regarding their antibiotic stewardship training and their role as future antibiotic stewards. The investigators concluded that ID fellowship training was not successfully conveying the public health importance of antibiotic stewardship or the role of ID physicians as leaders of antibiotic stewardship programs. They noted that fellows were more focused on concrete tasks related to stewardship.
AHRQ-funded; HS022242.
Citation: Morgan JR, Barlam TF, Drainoni ML .
A qualitative study of the real-world experiences of infectious diseases fellows regarding antibiotic stewardship.
Open Forum Infect Dis 2018 Sep;5(9):ofy102. doi: 10.1093/ofid/ofy102..
Keywords: Antibiotics, Antimicrobial Stewardship, Education: Continuing Medical Education, Infectious Diseases
Kline SE, Neaton JD, Lynfield R
Randomized controlled trial of a self-administered five-day antiseptic bundle versus usual disinfectant soap showers for preoperative eradication of Staphylococcus aureus colonization.
The objective of this study was to determine the efficacy in eradicating Staphylococcus aureus (SA) carriage of a 5-day preoperative decolonization bundle compared to 2 disinfectant soap showers, with both regimens self-administered at home. The investigators concluded that an outpatient preoperative antiseptic decolonization bundle aimed at 4 body sites was significantly more effective in eradicating SA than the usual disinfectant showers (ie, the control).
AHRQ-funded; HS022912.
Citation: Kline SE, Neaton JD, Lynfield R .
Randomized controlled trial of a self-administered five-day antiseptic bundle versus usual disinfectant soap showers for preoperative eradication of Staphylococcus aureus colonization.
Infect Control Hosp Epidemiol 2018 Sep;39(9):1049-57. doi: 10.1017/ice.2018.151..
Keywords: Antimicrobial Stewardship, Infectious Diseases, Patient Self-Management, Prevention, Surgery, Patient Safety
Hersh AL, Olson J, Stockmann C
Impact of antimicrobial stewardship for pediatric outpatient parenteral antibiotic therapy.
In this study, the investigators developed an outpatient parenteral antibiotic therapy (OPAT) stewardship program in a freestanding children's hospital to improve the appropriateness of OPAT prescribing.
AHRQ-funded; HS023320.
Citation: Hersh AL, Olson J, Stockmann C .
Impact of antimicrobial stewardship for pediatric outpatient parenteral antibiotic therapy.
J Pediatric Infect Dis Soc 2018 May 15;7(2):e34-e36. doi: 10.1093/jpids/pix038..
Keywords: Antibiotics, Antimicrobial Stewardship, Children/Adolescents, Ambulatory Care and Surgery
Moehring RW, Dodds Ashley ES, Ren X
Denominator matters in estimating antimicrobial use: a comparison of days present and patient days.
This study discussed how the choice of different denominator metrics may affect antimicrobial use rates. There is an approximately one-third higher difference if you use days present compared to using patient days. This difference was influenced by short length of stay.
AHRQ-funded; HS023866.
Citation: Moehring RW, Dodds Ashley ES, Ren X .
Denominator matters in estimating antimicrobial use: a comparison of days present and patient days.
Infect Control Hosp Epidemiol 2018 May;39(5):612-15. doi: 10.1017/ice.2018.54..
Keywords: Antimicrobial Stewardship, Patient Safety
Johnson SP, Zhong L, Chung KC
Perioperative antibiotics for clean hand surgery: a national study.
This research is a national study on the use of prophylactic antibiotics in soft tissue hand surgery when antimicrobials are not indicated. Insurance claims from the Truven MarketScan Databases were used to identify patients who had 1 of 5 outpatient surgery procedures including: open or endoscopic carpal tunnel release; trigger finger release; de Ouervain release, and wrist ganglion excision between 2009 and 2015. An increase of 72.5% in prophylactic intravenous antibiotics was shown from 2009 to 2015. Patients with a younger age, male sex, lower income, or obesity had higher odds of receiving antibiotics. Total charge for these antibiotics equaled $1.6 million.
AHRQ-funded; HS023313.
Citation: Johnson SP, Zhong L, Chung KC .
Perioperative antibiotics for clean hand surgery: a national study.
J Hand Surg Am 2018 May;43(5):407-16.e1. doi: 10.1016/j.jhsa.2017.11.018..
Keywords: Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Infectious Diseases, Medication, Patient Safety, Surgery
D'Agata EMC
Addressing the problem of multidrug-resistant organisms in dialysis.
This review examined the problem of multi-drug resistant organisms in patients on maintenance hemodialysis. It is common problem in patients on hemodialysis, with rates of colonization of multi-drug resistant organisms ranging from 3% to over 20%. A prospective cohort study of patients was conducted in one outpatient dialysis unit. The acquisition of these organisms occurred in 40% of patients, with 13% and 15% of patients acquiring MRSA and VRE respectively. Contamination came from dialysis machines and chairs, and also believed to come from healthcare workers as well. The study recommends implementing antimicrobial stewardship programs to improve antimicrobial prescribing patterns and decreasing health care costs. AHRQ is one of the agencies involved in this promotion and research effort.
AHRQ-funded; HS021666.
Citation: D'Agata EMC .
Addressing the problem of multidrug-resistant organisms in dialysis.
Clin J Am Soc Nephrol 2018 Apr 6;13(4):666-68. doi: 10.2215/cjn.13781217..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Healthcare-Associated Infections (HAIs)
Jump RLP, Crnich CJ, Mody L
Infectious diseases in older adults of long-term care facilities: update on approach to diagnosis and management.
The diagnosis, treatment, and prevention of infectious diseases in older adults in long-term care facilities (LTCFs), particularly nursing facilities, remains a challenge for all health providers who care for this population. This review provides updated information on the currently most important challenges of infectious diseases in LTCFs. With the increasing prescribing of antibiotics in older adults, particularly in LTCFs, the topic of antibiotic stewardship is presented in this review.
AHRQ-funded; HS022465.
Citation: Jump RLP, Crnich CJ, Mody L .
Infectious diseases in older adults of long-term care facilities: update on approach to diagnosis and management.
J Am Geriatr Soc 2018 Apr;66(4):789-803. doi: 10.1111/jgs.15248.
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Keywords: Elderly, Healthcare-Associated Infections (HAIs), Infectious Diseases, Nursing Homes, Long-Term Care, Antimicrobial Stewardship, Antibiotics, Medication, Evidence-Based Practice, Guidelines