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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 25 of 256 Research Studies DisplayedRussell A, Jenkins JL, Zhang A
A review of infectious disease epidemiology in emergency medical service clinicians.
This review synthesized existing literature on the prevalence, incidence, and severity of infections in emergency medical service (EMS) workforce personnel. The majority of studies that met the inclusion criteria were focused on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and Hepatitis C also featured in a small number of studies. In the studies that compared infection rates between EMS clinicians and firefighters, EMS clinicians had a higher chance of hospitalization or death from SAR-CoV-2, a higher prevalence of Hepatitis C, and no significant differences in MRSA colonization. The authors concluded that more research was needed to characterize the incidence and severity of occupationally acquired infections in the EMS workforce.
AHRQ-funded; 75Q80120D00003.
Citation: Russell A, Jenkins JL, Zhang A .
A review of infectious disease epidemiology in emergency medical service clinicians.
Am J Infect Control 2023 Aug; 51(8):931-37. doi: 10.1016/j.ajic.2022.12.001..
Keywords: Infectious Diseases, Emergency Medical Services (EMS)
Miller ME, Rahim MQ, Coven SL
Pediatric hematology and oncology physician and nurse practitioner views of the HPV vaccine and barriers to administration.
This study’s goal was to examine provider views regarding HPV vaccination for pediatric survivors of cancer and pediatric patients with sickle cell disease. The authors conducted qualitative interviews with 20 pediatric hematology/oncology physicians and nurse practitioners. They found that 90% of interviewees support HPV vaccination in their population. The number of providers who reported that they counsel about HPV or provide HPV vaccination was 45%, even in stem cell and sickle cell clinics, where other childhood vaccines are commonly provided. Clinicians identified provider-level, clinic-level, and system-level barriers to giving the HPV vaccination, that included but was not limited to time/flow constraints, lack of resources, and continued education regarding the HPV vaccine.
AHRQ-funded; HS026390.
Citation: Miller ME, Rahim MQ, Coven SL .
Pediatric hematology and oncology physician and nurse practitioner views of the HPV vaccine and barriers to administration.
Hum Vaccin Immunother 2023 Aug 1; 19(2):2224089. doi: 10.1080/21645515.2023.2224089..
Keywords: Vaccination, Sexual Health, Infectious Diseases, Prevention, Provider: Clinician, Provider: Physician
Jenkins JL, Hsu EB, Zhang A
Current evidence for infection prevention and control interventions in emergency medical services: a scoping review.
This study’s aim was to summarize current evidence from the United States on the effectiveness of practices and interventions for preventing, recognizing, and controlling occupationally acquired infectious diseases in Emergency Medical Service (EMS) clinicians. A database search was conducted for literature published January 2006 through March 15, 2022 to search for studies in the United States that involved EMS clinicians and firefighters, reported on one or more workplace practices or interventions that prevented or controlled infectious diseases, and included outcome measures. Eleven observational studies reported on infection prevention and control (IPC) practices providing evidence that hand hygiene, standard precautions, mandatory vaccine policies, and on-site vaccine clinics are effective. Less frequent handwashing and less frequent hand hygiene after glove use were positively correlated with nasal colonization of Methicillin-resistant Staphylococcus aureus (MRSA). Lack of personal protective equipment (PPE) or PPE breach were correlated with higher severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity and virus 2 (SARS-CoV-2) seropositivity. Workers were more likely to be vaccinated against influenza if their employer offered the vaccine. Vaccination rates for H1N1 influenza increased with the use of active, targeted education modules.
AHRQ-funded; 75Q80120D00003.
Citation: Jenkins JL, Hsu EB, Zhang A .
Current evidence for infection prevention and control interventions in emergency medical services: a scoping review.
Prehosp Disaster Med 2023 Jun; 38(3):371-77. doi: 10.1017/s1049023x23000389..
Keywords: COVID-19, Emergency Department, Evidence-Based Practice, Prevention, Public Health, Infectious Diseases
Teixeira da Silva D, Makeneni S, Wall H
Measuring quality STI care among adolescent female primary care patients in Philadelphia.
The purpose of this study was to develop and apply a cross-setting, sexually transmitted infection (STI) Care Continuum to improve STI care quality, to assess adherence to guideline-recommended care, and to standardize progress measurement toward National Strategic goals. Review of the CDC STI treatment guidelines identified seven distinct steps of care for gonorrhea, chlamydia, and syphilis; researchers used Youth Risk Behavior Surveillance Survey data to estimate step 1, and electronic health record data for steps 2, 3, 4, 6 and 7. The researchers concluded that local application of an STI Care Continuum identified STI testing, retesting, and HIV testing as areas for improvement. Similar methods may be applied to target resources, standardize data collection and reporting, and improve STI care quality.
AHRQ-funded; HS026116.
Citation: Teixeira da Silva D, Makeneni S, Wall H .
Measuring quality STI care among adolescent female primary care patients in Philadelphia.
Sex Transm Infect 2023 Jun; 99(4):272-75. doi: 10.1136/sextrans-2022-055623..
Keywords: Children/Adolescents, Sexual Health, Infectious Diseases, Primary Care, Women, Human Immunodeficiency Virus (HIV), Quality Measures, Quality of Care
Jonas DE, Riley SR, Lee LC
Screening for latent tuberculosis infection in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
This systematic review and evidence report analyzed the benefits and harms of screening for latent tuberculosis infection (LTBI) of adults, which was used to inform the U.S. Preventive Services Task Force for their final recommendation. A systematic review was conducted of English-language studies of LTBI screening, LTBI treatment, or accuracy of the tuberculin skin test (TST) or interferon-gamma release assays (IGRAs). A total of 113 publications were identified, with no studies directly evaluating the benefits and harms of screening. For treatment of LTBI, a large (n = 27,830), good-quality randomized clinical trial found a relative risk (RR) for progression to active tuberculosis at 5 years of 0.35 for 24 weeks of isoniazid compared with placebo (number needed to treat, 112) and an increase in hepatotoxicity (RR, 4.59; number needed to harm, 279). Meta-analysis found greater risk for hepatotoxicity with isoniazid than with rifampin (pooled RR, 4.22; n = 7339).
AHRQ-funded; 75Q80120D00007.
Citation: Jonas DE, Riley SR, Lee LC .
Screening for latent tuberculosis infection in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 May 2; 329(17):1495-509. doi: 10.1001/jama.2023.3954..
Keywords: U.S. Preventive Services Task Force (USPSTF), Infectious Diseases, Screening, Prevention, Evidence-Based Practice
Ahmad FA, Chan P, McGovern C
Adapting an electronic STI risk assessment program for use in pediatric primary care.
This study’s goal was to evaluate the usability of an electronic risk assessment tool to support sexually transmitted disease (STI) testing in the authors’ pediatric emergency department that they had previously designed and implemented. They conducted qualitative interviews of pediatricians, clinic staff, and adolescents from 4 pediatric practices as part of a study whose goal is to ultimately implement STI screening in pediatric primary care. The goal of the interviews was (1) to understand contextual factors related to STI screening in primary care, which they reported previously, and (2) to obtain feedback on their electronic platform, the questionnaire content, and their perspective on implementing it in primary care settings. They received quantitative feedback using the System Usability Scale (SUS). The SUS is a validated, reliable tool to measure the usability of hardware, software, websites, and applications, with a score of 68 (range 0-100) being average usability. They recruited 14 physicians, 9 clinic staff, and 12 adolescents. Participants rated the tool with a median score of 92.5, which shows a high level of usability.
AHRQ-funded; HS026704.
Citation: Ahmad FA, Chan P, McGovern C .
Adapting an electronic STI risk assessment program for use in pediatric primary care.
J Prim Care Community Health 2023 Jan-Dec; 14:21501319231172900. doi: 10.1177/21501319231172900..
Keywords: Children/Adolescents, Sexual Health, Infectious Diseases, Primary Care, Health Information Technology (HIT), Screening, Prevention
Chen Y, Lopman BA, Hall AJ
Factors driving norovirus transmission in long-term care facilities: a case-level analysis of 107 outbreaks.
Norovirus stands as the leading cause of gastroenteritis outbreaks in long-term care facilities (LTCFs) throughout the United States, resulting in significant disease impact on both residents and employees. The purpose of this study was to gain insight into the symptoms and features of individual cases that influence norovirus transmission can enhance the implementation of outbreak management strategies in LTCFs. In this study, the researchers analyzed line lists from 107 norovirus outbreaks occurring in LTCFs across five U.S. states between 2015 and 2019. The individual effective reproduction number, R(i), was calculated to determine the infectiousness of each case, while exploring the influence of vomiting, diarrhea, and being a resident (as opposed to staff) on case infectiousness. The study found that cases involving vomiting led to 1.28 times more secondary infections than those without vomiting, while LTCF residents caused 1.31 times more secondary infections than staff members. No significant difference in infectiousness was observed between cases with and without diarrhea.
AHRQ-funded; HS025987
Citation: Chen Y, Lopman BA, Hall AJ .
Factors driving norovirus transmission in long-term care facilities: a case-level analysis of 107 outbreaks.
Epidemics 2023 Mar;42:100671. doi: 10.1016/j.epidem.2023.100671.
Keywords: Long-Term Care, Infectious Diseases
Tabatneck ME, He W, Lamb GS
Interferon gamma release asssay results and testing trends among patients younger than 2 years old at two US health centers.
Researchers performed a retrospective cohort study of interferon-gamma release assay (IGRA) use for the diagnosis of tuberculosis infection in patients under 2 years old in two large Boston healthcare systems. A total of 321 IGRA results were analyzed; over 90 percent were valid. The proportion of invalid/indeterminate results was found to be significantly higher among immunocompromised patients. The researchers concluded that the high proportion of valid IGRA test results in patients less than 2 years of age in a low TB prevalence setting supported the adoption of IGRAs for this age group in certain clinical scenarios. They note that the interpretation of IGRAs, particularly in immunocompromised patients, should consider the broader clinical context.
AHRQ-funded; HS000063.
Citation: Tabatneck ME, He W, Lamb GS .
Interferon gamma release asssay results and testing trends among patients younger than 2 years old at two US health centers.
Pediatr Infect Dis J 2023 Mar; 42(3):189-94. doi: 10.1097/inf.0000000000003794..
Keywords: Newborns/Infants, Diagnostic Safety and Quality, Infectious Diseases
Majumder MS, Cusick M, Rose S
Measuring concordance of data sources used for infectious disease research in the USA: a retrospective data analysis.
This study’s objective was to investigate the strengths and limitations of sources currently being used for infectious disease research. This retrospective data analysis used four different data sources to determine differences in the yearly number of national-level and state-level disease-specific case counts and disease clusters for three diseases (measles, mumps, and varicella) during a 5-year study period (2013-2017). The four sources used were Optum (health insurance billing claims data), HealthMap (online news surveillance data), Morbidity and Mortality Weekly Reports (official government reports) and National Notifiable Disease Surveillance System (government case surveillance data). The authors found that when compared with the other three sources of interest, Optum data showed substantially higher, implausible standardized case counts for all three diseases. All four sources identified variations in state-level reporting.
AHRQ-funded; HS026128.
Citation: Majumder MS, Cusick M, Rose S .
Measuring concordance of data sources used for infectious disease research in the USA: a retrospective data analysis.
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Keywords: Infectious Diseases, Research Methodologies
Asher GN, Feltner C, Harrison WN
Serologic screening for genital herpes: updated evidence report and systematic review for the US Preventive Services Task Force.
Genital herpes, a viral sexually transmitted infection (STI) caused by herpes simplex virus (HSV) subtypes HSV-1 or HSV-2, is a prevalent STI in the US. Early identification of unrecognized HSV-2 infection could reduce transmission and morbidity. In 2016, the US Preventive Services Task Force (USPSTF) recommended against routine serologic screening for genital herpes in asymptomatic individuals. This updated evidence report aimed to identify studies published since the previous 2016 evidence review. A literature search was conducted from September 30, 2015, through January 16, 2022, with ongoing surveillance through July 22, 2022. The review identified no new eligible studies, leading to unchanged overall conclusions from the 2016 recommendation against screening. The prior recommendation was based on psychosocial harms from false-positive test results due to poor screening test accuracy and uncertain benefit of preventive viral medications for reducing viral shedding or improving health outcomes. The review focused on the general population of asymptomatic adolescents and adults and may not be applicable to populations at higher risk for infection, such as those with HIV or other immunosuppressive conditions.
AHRQ-funded; 75Q80120D00007.
Citation: Asher GN, Feltner C, Harrison WN .
Serologic screening for genital herpes: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Feb 14; 329(6):510-12. doi: 10.1001/jama.2022.20356..
Keywords: U.S. Preventive Services Task Force (USPSTF), Sexual Health, Infectious Diseases, Screening, Guidelines, Evidence-Based Practice, Prevention
Stone CA, Jr., Robinson LB, Li L
Clinical phenotypes of immediate first-dose reactions to mRNA COVID-19: a multicenter latent class analysis.
The objectives of this retrospective study were to define distinct clinical phenotypes of immediate reactions after dose 1 of mRNA COVID-19 vaccination, and to assess the relation of clinical phenotype to mRNA COVID-19 vaccine second dose tolerance. Researchers identified 265 patients who experienced dose-1 immediate reactions with 3 phenotype clusters: limited or predominantly cutaneous, sensory, or systemic. Of these, 223 patients received a second dose and 200 tolerated the second dose; sensory cluster (numbness or tingling) was associated with a higher likelihood of second dose intolerance, but this finding did not persist when accounting for objective signs.
AHRQ-funded; HS026395.
Citation: Stone CA, Jr., Robinson LB, Li L .
Clinical phenotypes of immediate first-dose reactions to mRNA COVID-19: a multicenter latent class analysis.
J Allergy Clin Immunol Pract 2023 Feb;11(2):458-65.e1. doi: 10.1016/j.jaip.2022.08.048.
Keywords: COVID-19, Medication, Adverse Drug Events (ADE), Adverse Events, Infectious Diseases, Vaccination
Patel P, Deshpande A, Yu PC
Association of fluoroquinolones or cephalosporin plus macrolide with Clostridioides difficile infection (CDI) after treatment for community-acquired pneumonia.
The purpose of this study was to explore the relationships between the antibiotic regimens of empiric therapy with a respiratory fluoroquinolone or cephalosporin plus macrolide combination and the development of hospital-onset Clostridioides difficile infection (CDI). The researchers used data from 638 United States hospitals and included adults admitted with pneumonia and discharged from July 2010 through June 2015 with a pneumonia diagnosis code who received 3 or more days of either antibiotic regimen. The study sample included 58,060 patients treated with either cephalosporin plus macrolide (36,796 patients) or a fluoroquinolone alone (21,264 patients). 0.35% of patients who received cephalosporin plus macrolide and 0.31% who received a fluoroquinolone developed CDI, making CDI risks similar for fluoroquinolones versus cephalosporin plus macrolide.
AHRQ-funded; HS024277.
Citation: Patel P, Deshpande A, Yu PC .
Association of fluoroquinolones or cephalosporin plus macrolide with Clostridioides difficile infection (CDI) after treatment for community-acquired pneumonia.
Infect Control Hosp Epidemiol 2023 Jan; 44(1):47-54. doi: 10.1017/ice.2022.60..
Keywords: Pneumonia, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication, Infectious Diseases, Community-Acquired Infections
Holmer HK, Mackey K, Fiordalisi CV
Major update 2: antibody response and risk for reinfection after SARS-CoV-2 infection-final update of a living, rapid review.
This paper is a final updated living rapid review to synthesize evidence on the SARS-CoV-2 antibody response and reinfection risk with a focus on gaps identified in the author’s prior reports. A literature review was done for English-language cohort studies evaluating IgG antibody duration at least 12 months after SARS-CoV-2 infection, the antibody response among immunocompromised adults, predictors of nonseroconversion, and reinfection risk. Study data was extracted and two investigators rated quality. Most adults had IgG antibodies after SARS-CoV-2 infection at time points greater than 12 months. Although most immunocompromised adults develop antibodies, the overall proportion with antibodies is lower compared with immunocompetent adults. Prior infection provided substantial, sustained protection against symptomatic reinfection with the Delta variant (high strength of evidence) and reduced the risk for severe disease due to Omicron variant (moderate strength of evidence). Prior infection was less protective against reinfection with Omicron overall (moderate strength of evidence), but protection from earlier variants waned rapidly (low strength of evidence).
AHRQ-funded; 290201700003C.
Citation: Holmer HK, Mackey K, Fiordalisi CV .
Major update 2: antibody response and risk for reinfection after SARS-CoV-2 infection-final update of a living, rapid review.
Ann Intern Med 2023 Jan; 176(1):85-91. doi: 10.7326/m22-1745..
Keywords: COVID-19, Evidence-Based Practice, Infectious Diseases, Risk
Campbell JI, Tabatneck M, Sun M
Increasing use of interferon gamma release assays among children ≥2 years of age in a setting with low tuberculosis prevalence.
This article describes a retrospective cohort study that examined interferon gamma release assays (IGRAs) use to diagnose tuberculosis (TB) infection in children aged 2–17. The objectives of the study were to evaluate whether testing approaches for TB has changed since 2015. Electronic health records were used to identify IGRAs and tuberculin skin tests (TSTs) completed by children in two Boston-area academic health systems. The researchers observed that the proportion of IGRA tests increased between 2015 and 2021 in this low TB-prevalence setting. Testing in public versus private insurance, inpatient/subspecialty settings, lower age, and non-English preferred language were associated with an increased chance of receiving an IGRA. Findings suggest that the TST is being “retired,” and that education and support for primary care clinicians could improve equitable access to IGRA testing for children.
AHRQ-funded; HS000063.
Citation: Campbell JI, Tabatneck M, Sun M .
Increasing use of interferon gamma release assays among children ≥2 years of age in a setting with low tuberculosis prevalence.
Pediatr Infect Dis J 2022 Dec;41(12):e534-e37. doi: 10.1097/inf.0000000000003685..
Keywords: Children/Adolescents, Treatments, Respiratory Conditions, Infectious Diseases
Crnich CJ
Reimagining infection control in U.S. nursing homes in the era of COVID-19.
This paper provides an overview of nursing home (NH) infection and control, reviews the 2016 CMS changes to federal regulations, and proposes recommendations to sustain improvements. COVID-19 put further pressure on nursing homes who were already strained by rising numbers of infections from C. difficile and multidrug-resistant organisms. The author puts out a call for reimagining infection prevention and control using the Systems Engineering Initiative for Patient Safety framework. Additional recommendations are made to enhance NH infection prevention and control programs in the areas of people, tasks, tools, organization, built environment, and external environment.
AHRQ-funded; HS022465.
Citation: Crnich CJ .
Reimagining infection control in U.S. nursing homes in the era of COVID-19.
J Am Med Dir Assoc 2022 Dec;23(12):1909-15. doi: 10.1016/j.jamda.2022.10.022..
Keywords: Elderly, COVID-19, Public Health, Infectious Diseases, Nursing Homes, Healthcare-Associated Infections (HAIs), Prevention
Whittington KJ, Ma Y, Butler AM
The impact of infectious diseases consultation for children with Staphylococcus aureus bacteremia.
The purpose of this cohort study was to explore the impact of infectious diseases (ID) consultation for Staphylococcus aureus bacteremia in children. The researchers conducted a study of 306 children at St. Louis Children's Hospital between 2011 to 2018 with S. aureus bacteremia. Adherence to six established quality-of-care indicators (QCIs) was evaluated. The study found that 63% of the study patients received ID consultation, which was associated with greater adherence to all QCIs, including proof-of-cure blood cultures, indicated laboratory studies, echocardiography, source control, targeted antibiotic therapy, and antibiotic duration. In addition, improved outcomes were related with acquiring proof-of-cure blood cultures and all indicated laboratory studies. The researchers concluded that ID consultation improved adherence to QCIs, some of which were associated with improved clinical outcomes, for children with S. aureus bacteremia.
AHRQ-funded; HS024269.
Citation: Whittington KJ, Ma Y, Butler AM .
The impact of infectious diseases consultation for children with Staphylococcus aureus bacteremia.
Pediatr Res 2022 Dec;92(6):1598-605. doi: 10.1038/s41390-022-02251-0..
Keywords: Children/Adolescents, Infectious Diseases, Patient and Family Engagement
Clements KM, Kunte PS, Clark MA
Uptake of hepatitis C virus treatment in a multi-state Medicaid population, 2013-2017.
The purpose of this study was to explore trends in the direct acting antiviral (DAA) uptake in a multi-state Medicaid population with hepatitis C virus (HCV) prior to and after ledipasvir/sofosbuvir (LDV/SOF) approval and changes in prior authorization (PA) requirements. The researchers analyzed annual enrollment, medical, and pharmacy claims for 38,302 to 45,005 people per year in four states, between December 2013 and December 2017. The study found that uptake increased from 0.34% per month in October 2014 to 0.70% per month after LDV/SOF approval and increased relative to the pre-LDV/SOV trend through June 2016. Uptake increased to 1.18% per month after PA change and remained static through 2017. In plans with few or no requirements through 2017, uptake increased to 1.19% per month after LDV/SOF approval and remained static through 2017, with 22.2% cumulatively treated. Among plans that lifted PA requirements from three to zero in mid-2016, uptake did not increase after LDV/SOF approval but did increase to 1.41% per month after PA change, with 18.1% cumulatively treated. The researchers concluded that LDV/SOF approval and lifting PA requirements led to an increase in uptake followed by static monthly utilization, and HCV treatment increased through 2017.
AHRQ-funded; HS025717.
Citation: Clements KM, Kunte PS, Clark MA .
Uptake of hepatitis C virus treatment in a multi-state Medicaid population, 2013-2017.
Health Serv Res 2022 Dec;57(6):1312-20. doi: 10.1111/1475-6773.13994..
Keywords: Hepatitis, Medicaid, Infectious Diseases, Healthcare Utilization
Teixeira da Silva D, Petsis D, Santos T
Chlamydia trachomatis/neisseria gonorrhea retesting among adolescents and young adults in a primary care network.
This study describes retesting following Chlamydia trachomatis/Neisseria gonorrhea (CT/NG) diagnosis among adolescent and young adult patients at Title X and non-Title X clinics and measures the association of patient-level factors with CT/NG retesting. Findings showed that guideline-recommended retesting following CT/NG diagnosis was low in this young primary care cohort, especially among male and non-Title X clinic patients.
AHRQ-funded; HS026116.
Citation: Teixeira da Silva D, Petsis D, Santos T .
Chlamydia trachomatis/neisseria gonorrhea retesting among adolescents and young adults in a primary care network.
J Adolesc Health 2022 Nov;71(5):545-51. doi: 10.1016/j.jadohealth.2022.06.014..
Keywords: Children/Adolescents, Young Adults, Sexual Health, Infectious Diseases, Primary Care
Krauss DM, Molefe A, Hung L
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
In this study, researchers summarized themes for maintaining infection prevention activities learned from the implementation of a quality improvement (QI) program during the COVID-19 pandemic. They concluded that future shocks such as the pandemic must be anticipated, and the healthcare system must be resilient to the resulting disruptions to healthcare-associated infection prevention activities. Their study encountered four themes for successful maintenance of infection prevention activities during the current pandemic: the value of a pre-existing infection prevention infrastructure; a flexibility in approach; broad buy-in for maintaining QI programs; and the facilitation of idea-sharing.
AHRQ-authored; AHRQ-funded; 233201500016I.
Citation: Krauss DM, Molefe A, Hung L .
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
BMJ Open Qual 2022 Nov;11(4):e001926. doi: 10.1136/bmjoq-2022-001926..
Keywords: COVID-19, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Quality Improvement, Quality of Care, Critical Care, Intensive Care Unit (ICU), Prevention, Urinary Tract Infection (UTI), Infectious Diseases
Campbell JI, Menzies D
Testing and scaling interventions to improve the tuberculosis infection care cascade.
The purpose of this study was to review and summarize current literature on barriers and solutions occurring within the tuberculosis (TB) infection care cascade, focusing on children in high- and low-burden settings, and obtaining data and information from studies on both children and adults. The researchers concluded that identifying and addressing gaps in the TB care cascade requires the utilization of tools both novel and long-standing, and will be facilitated by shared clinical practice with primary care providers, methods of quality improvement, and innovative study designs.
AHRQ-funded; HS000063.
Citation: Campbell JI, Menzies D .
Testing and scaling interventions to improve the tuberculosis infection care cascade.
J Pediatric Infect Dis Soc 2022 Oct 31;11(Suppl 3):S94-s100. doi: 10.1093/jpids/piac070..
Keywords: Respiratory Conditions, Infectious Diseases, Quality Improvement, Quality of Care
McNeil 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
Glenn BA, Nonzee NJ, Herrmann AK
Impact of a multi-level, multi-component, system intervention on HPV vaccination in a federally qualified health center.
This paper evaluates the effectiveness of a multi-component, system-level intervention to improve human papillomavirus (HPV) vaccination rates in Federally Qualified Health Center (FQHC) clinics. The eight participating clinics were randomly assigned to study condition (four intervention, four usual care) that serve a primarily low-income Latino population. The intervention included parent reminders for HPV vaccine series completion, provider training, clinic-level audit and feedback, and workflow modifications to reduce missed opportunities for vaccination. The authors compared HPV vaccination rates among patients, ages 11 to 17 during a 12-month preintervention period and a 15-month intervention period. There was a greater increase in vaccination completion rates among boys, but not girls.
AHRQ-funded; HS000046.
Citation: Glenn BA, Nonzee NJ, Herrmann AK .
Impact of a multi-level, multi-component, system intervention on HPV vaccination in a federally qualified health center.
Cancer Epidemiol Biomarkers Prev 2022 Oct 4;31(10):1952-58. doi: 10.1158/1055-9965.Epi-22-0156..
Keywords: Infectious Diseases, Sexual Health, Vaccination
Mazi PB, Olsen MA, Stwalley D
Attributable mortality of Candida bloodstream infections in the modern era: a propensity score analysis.
The purpose of this retrospective cohort study was to quantify the mortality attributed to Candida bloodstream infections (BSI). The researchers identified 626 adult patients with Candida BSI that were frequency-matched with 6269 control patients with similar candida BSI risk-factors. The study found that the 90-day crude mortality rate was 42.4% for Candida BSI cases and 17.1% for frequency matched controls. After propensity score-matching, the attributable risk difference for 90-day mortality was 28.4% with hazard ratio (HR) of 2.12. In the stratified analysis, the 90-day mortality risk was highest in patients in the lowest risk quintile to develop Candida BSI. Patients in this lowest risk quintile accounted for 61% of the untreated patients with Candida BSI. Sixty-nine percent of untreated patients died versus 35% of treated patients.
AHRQ-funded; HS019455.
Citation: Mazi PB, Olsen MA, Stwalley D .
Attributable mortality of Candida bloodstream infections in the modern era: a propensity score analysis.
Clin Infect Dis 2022 Sep 29;75(6):1031-36. doi: 10.1093/cid/ciac004..
Keywords: Infectious Diseases, Mortality, Sepsis
Henninger ML, Bean SI, Lin JS
Screening for syphilis infection in nonpregnant adults and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this systematic review was to summarize the available published evidence on the potential benefits and harms of screening for syphilis infection in non-pregnant, asymptomatic adults and adolescents at increased risk for syphilis infection, for the purpose of supporting the 2022 United States Prevention Services Task Force recommendations statement on screening for syphilis infection.
AHRQ-funded; 75Q80120D00004.
Citation: Henninger ML, Bean SI, Lin JS .
Screening for syphilis infection in nonpregnant adults and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Sep 27;328(12):1250-52. doi: 10.1001/jama.2022.8612..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Prevention, Sexual Health, Infectious Diseases, Evidence-Based Practice
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
