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1. Trends in and Risk Factors for Recurrent Clostridioides difficile Infection, New Haven County, Connecticut, USA, 2015-2020

Author

Okafor, Chinenye M., Clogher, Paula, Olson, Danyel, Niccolai, Linda, and Hadler, James

Subjects
New Haven County, Connecticut -- Health aspects, Statistics, Risk factors, Health aspects, Recurrence (Disease) -- Statistics -- Risk factors, Clostridium infections -- Statistics -- Risk factors, Diseases -- Relapse
Abstract

Clostridioides difficile infection (CDI) is one of the most common causes of healthcare-associated infection (1) and can result in serious illness and death (2). CDI is classified into 3 types [...]

Published
2023
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2. Hospitalization Rates and Characteristics of Children Aged <18 Years Hospitalized with Laboratory-Confirmed COVID-19 — COVID-NET, 14 States, March 1–July 25, 2020

Author

Kim, Lindsay, Whitaker, Michael, O’Halloran, Alissa, Kambhampati, Anita, Chai, Shua J, Reingold, Arthur, Armistead, Isaac, Kawasaki, Breanna, Meek, James, Yousey-Hindes, Kimberly, Anderson, Evan J, Openo, Kyle P, Weigel, Andy, Ryan, Patricia, Monroe, Maya L, Fox, Kimberly, Kim, Sue, Lynfield, Ruth, Bye, Erica, Shrum Davis, Sarah, Smelser, Chad, Barney, Grant, Spina, Nancy L, Bennett, Nancy M, Felsen, Christina B, Billing, Laurie M, Shiltz, Jessica, Sutton, Melissa, West, Nicole, Talbot, H Keipp, Schaffner, William, Risk, Ilene, Price, Andrea, Brammer, Lynnette, Fry, Alicia M, Hall, Aron J, Langley, Gayle E, Garg, Shikha, Coates, Ashley, Daily Kirley, Pam, Libby, Tanya, Roland, Jeremy, Alden, Nisha, Herlihy, Rachel, McLafferty, Sarah, Clogher, Paula, Kayalioglu, Hazal, Maslar, Amber, Misiorski, Adam, Niccolai, Linda, Olson, Danyel, Parisi, Christina, Fawcett, Emily, Gretzinger, Siyeh, Lengacher, Katelyn, Williams, Jeremiah, Blythe, David, Brooks, Alicia, Park, Rachel, Wilson, Michelle, Como-Sabetti, Kathryn, Danila, Richard, Cline, Cory, Angeles, Kathy, Eisenberg, Nancy, Flores, Kristina, Habrun, Caroline, Hancock, Emily, Khanlian, Sarah, Novi, Meaghan, Phipps, Erin, Salazar-Sanchez, Yadira, Dufort, Elizabeth, Muse, Alison, Bushey, Sophrena, Gaitan, Maria, Kurtz, RaeAnne, Owusu-Dommey, Ama, Snyder, Lindsey, Michaelis, Katherine, Seeley, Kylie, Markus, Tiffanie, Chatelain, Ryan, George, Andrea, Hill, Mary, McCullough, Laine, Spencer, Melanie, Swain, Ashley, McCaffrey, Keegan, Holstein, Rachel, Meador, Seth, and Wortham, Jonathan

Subjects
Pediatric, Patient Safety, Infectious Diseases, Clinical Trials and Supportive Activities, Lung, Prevention, Clinical Research, Pediatric Research Initiative, Aetiology, 2.4 Surveillance and distribution, Good Health and Well Being, Adolescent, Betacoronavirus, COVID-19, Child, Child, Preschool, Chronic Disease, Clinical Laboratory Services, Coronavirus Infections, Ethnicity, Female, Hospitalization, Humans, Infant, Infant, Newborn, Male, Pandemics, Pediatric Obesity, Pneumonia, Viral, Risk Factors, SARS-CoV-2, Severity of Illness Index, United States, COVID-NET Surveillance Team, General & Internal Medicine
Abstract

Most reported cases of coronavirus disease 2019 (COVID-19) in children aged

Published
2020

3. Epidemiology of Antibiotic Use for Urinary Tract Infection in Nursing Home Residents

Author

Thompson, Nicola D., Penna, Austin, Eure, Taniece R., Bamberg, Wendy M., Barney, Grant, Barter, Devra, Clogher, Paula, DeSilva, Malini B., Dumyati, Ghinwa, Epson, Erin, Frank, Linda, Godine, Deborah, Irizarry, Lourdes, Kainer, Marion A., Li, Linda, Lynfield, Ruth, Mahoehney, J.P., Nadle, Joelle, Ocampo, Valerie, Perry, Lewis, Ray, Susan M., Davis, Sarah Shrum, Sievers, Marla, Wilson, Lucy E., Zhang, Alexia Y., Stone, Nimalie D., and Magill, Shelley S.

Published
2020
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8. Low Sensitivity of International Classification of Diseases, Tenth Revision Coding for Culture-Confirmed Candidemia Cases in an Active Surveillance System: United States, 2019–2020

Author

Benedict, Kaitlin, primary, Gold, Jeremy A W, additional, Jenkins, Emily N, additional, Roland, Jeremy, additional, Barter, Devra, additional, Czaja, Christopher A, additional, Johnston, Helen, additional, Clogher, Paula, additional, Farley, Monica M, additional, Revis, Andrew, additional, Harrison, Lee H, additional, Tourdot, Laura, additional, Davis, Sarah Shrum, additional, Phipps, Erin C, additional, Felsen, Christina B, additional, Tesini, Brenda L, additional, Escutia, Gabriela, additional, Pierce, Rebecca, additional, Zhang, Alexia, additional, Schaffner, William, additional, and Lyman, Meghan, additional

Published
2022
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11. Symptom Profiles of a Convenience Sample of Patients with COVID-19 — United States, January–April 2020

Author

Burke, Rachel M., Killerby, Marie E., Newton, Suzanne, Ashworth, Candace E., Berns, Abby L., Brennan, Skyler, Bressler, Jonathan M., Bye, Erica, Crawford, Richard, Harduar Morano, Laurel, Lewis, Nathaniel M., Markus, Tiffanie M., Read, Jennifer S., Rissman, Tamara, Taylor, Joanne, Tate, Jacqueline E., Midgley, Claire M., Balachandran, Neha, Dahl, Rebecca M., Dott, Mary, Gilani, Zunera, Grober, Aaron, Leung, Jessica, O’Hegarty, Michelle, Person, John, Ricaldi, Jessica N., Roth, Nicole M., Sejvar, James J., Shimabukuro, Tom, Tran, Cuc H., Watson, John T., Whitham, Hilary, Chiou, Howard, Clogher, Paula, Duca, Lindsey M., Dratch, Alissa, Feldpausch, Amanda, Fill, Mary-Margaret, Ghinai, Isaac, Holshue, Michelle, Scott, Sarah, and Westergaard, Ryan

Subjects
myalgia, Male, Pediatrics, Health (social science), Epidemiology, Health, Toxicology and Mutagenesis, 01 natural sciences, Severity of Illness Index, 0302 clinical medicine, Health Information Management, Pandemic, 030212 general & internal medicine, Full Report, Young adult, Child, Aged, 80 and over, General Medicine, Middle Aged, Hospitalization, Child, Preschool, Chills, Female, medicine.symptom, Symptom Assessment, Coronavirus Infections, Adult, medicine.medical_specialty, Adolescent, Fever, Pneumonia, Viral, MEDLINE, 03 medical and health sciences, Betacoronavirus, Young Adult, Severity of illness, medicine, Humans, 0101 mathematics, Pandemics, Aged, business.industry, SARS-CoV-2, Public health, 010102 general mathematics, COVID-19, Infant, medicine.disease, United States, Pneumonia, Dyspnea, Cough, business
Abstract

Coronavirus disease 2019 (COVID-19) was first detected in the United States in January 2020 (1), and by mid-July, approximately 3.4 million cases had been reported in the United States (2). Information about symptoms among U.S. COVID-19 patients is limited, especially among nonhospitalized patients. To better understand symptom profiles of patients with laboratory-confirmed COVID-19 in the United States, CDC used an optional questionnaire to collect detailed information on a convenience sample of COVID-19 patients from participating states. Symptom data were analyzed by age group, sex, hospitalization status, and symptom onset date relative to expansion of testing guidelines on March 8, 2020 (3). Among 164 symptomatic patients with known onset during January 14-April 4, 2020, a total of 158 (96%) reported fever, cough, or shortness of breath. Among 57 hospitalized adult patients (aged ≥18 years), 39 (68%) reported all three of these symptoms, compared with 25 (31%) of the 81 nonhospitalized adult patients. Gastrointestinal (GI) symptoms and other symptoms, such as chills, myalgia, headache, and fatigue, also were commonly reported, especially after expansion of testing guidelines. To aid prompt recognition of COVID-19, clinicians and public health professionals should be aware that COVID-19 can cause a wide variety of symptoms.

Published
2020

13. Risk of Hemolytic Uremic Syndrome Related to Treatment of Escherichia coli O157 Infection with Different Antimicrobial Classes

Author

Mody, Rajal K., primary, Hoekstra, Robert M., additional, Scott, Magdalena Kendall, additional, Dunn, John, additional, Smith, Kirk, additional, Tobin-D’Angelo, Melissa, additional, Shiferaw, Beletshachew, additional, Wymore, Katie, additional, Clogher, Paula, additional, Palmer, Amanda, additional, Comstock, Nicole, additional, Burzlaff, Kari, additional, Lathrop, Sarah, additional, Hurd, Sharon, additional, and Griffin, Patricia M., additional

Published
2021
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15. The Landscape of Candidemia During the Coronavirus Disease 2019 (COVID-19) Pandemic

Author

Seagle, Emma E, primary, Jackson, Brendan R, additional, Lockhart, Shawn R, additional, Georgacopoulos, Ourania, additional, Nunnally, Natalie S, additional, Roland, Jeremy, additional, Barter, Devra M, additional, Johnston, Helen L, additional, Czaja, Christopher A, additional, Kayalioglu, Hazal, additional, Clogher, Paula, additional, Revis, Andrew, additional, Farley, Monica M, additional, Harrison, Lee H, additional, Davis, Sarah Shrum, additional, Phipps, Erin C, additional, Tesini, Brenda L, additional, Schaffner, William, additional, Markus, Tiffanie M, additional, and Lyman, Meghan M, additional

Published
2021
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16. Antimicrobial Use in a Cohort of US Nursing Homes, 2017

Author

Thompson, Nicola D., primary, Stone, Nimalie D., additional, Brown, Cedric J., additional, Penna, Austin R., additional, Eure, Taniece R., additional, Bamberg, Wendy M., additional, Barney, Grant R., additional, Barter, Devra, additional, Clogher, Paula, additional, DeSilva, Malini B., additional, Dumyati, Ghinwa, additional, Frank, Linda, additional, Felsen, Christina B., additional, Godine, Deborah, additional, Irizarry, Lourdes, additional, Kainer, Marion A., additional, Li, Linda, additional, Lynfield, Ruth, additional, Mahoehney, J. P., additional, Maloney, Meghan, additional, Nadle, Joelle, additional, Ocampo, Valerie L. S., additional, Pierce, Rebecca, additional, Ray, Susan M., additional, Davis, Sarah Shrum, additional, Sievers, Marla, additional, Srinivasan, Krithika, additional, Wilson, Lucy E., additional, Zhang, Alexia Y., additional, and Magill, Shelley S., additional

Published
2021
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19. Appropriateness of Initiating Antibiotics for Urinary Tract Infection Among Nursing Home Residents

Author

Eure, Taniece R., primary, Thompson, Nicola D., additional, Penna, Austin, additional, Bamberg, Wendy M., additional, Barney, Grant, additional, Barter, Devra, additional, Clogher, Paula, additional, DeSilva, Malini, additional, Dumyati, Ghinwa, additional, Epson, Erin, additional, Felsen, Christina B., additional, Frank, Linda, additional, Godine, Deborah, additional, Irizarry, Lourdes, additional, Johnston, Helen, additional, Kainer, Marion A., additional, Li, Linda, additional, Lynfield, Ruth, additional, Mahoehney, JP, additional, Nadle, Joelle, additional, Ocampo, Valerie L. S., additional, Ray, Susan M., additional, Samper, Monika E., additional, Davis, Sarah Shrum, additional, Sievers, Marla, additional, Srinivasan, Krithika, additional, Wilson, Lucy E., additional, Zhang, Alexia Y., additional, Magill, Shelley S., additional, and Stone, Nimalie D., additional

Published
2020
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20. Prevalence and Epidemiology of Healthcare-Associated Infections (HAI) in US Nursing Homes (NH), 2017

Author

Thompson, Nicola, primary, Stone, Nimalie, additional, Brown, Cedric, additional, Eure, Taniece, additional, Penna, Austin, additional, Barney, Grant, additional, Barter, Devra, additional, Clogher, Paula, additional, Dumyati, Ghinwa, additional, Epson, Erin, additional, Felsen, Christina B., additional, Frank, Linda, additional, Godine, Deborah, additional, Irizarry, Lourdes, additional, Johnston, Helen, additional, Kainer, Marion, additional, Li, Linda, additional, Lynfield, Ruth, additional, Mahoehney, J.P., additional, Nadle, Joelle, additional, Ocampo, Valerie, additional, Ray, Susan, additional, Samper, Monika, additional, Shrum, Sarah, additional, Sievers, Marla, additional, Krithika, Srinivasan, additional, Wilson, Lucy E., additional, Zhang, Alexia, additional, and Magill, Shelley, additional

Published
2020
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21. Antibiotic Susceptibility of Common Organisms Isolated from Urine Cultures of Nursing Home Residents

Author

Penna, Austin R., primary, Eure, Taniece R. Eure, additional, Stone, Nimalie D., additional, Barney, Grant, additional, Barter, Devra, additional, Clogher, Paula, additional, Dumyati, Ghinwa, additional, Epson, Erin, additional, Felsen, Christina B., additional, Frank, Linda, additional, Godine, Deborah, additional, Irizarry, Lourdes, additional, Johnston, Helen, additional, Kainer, Marion A., additional, Li, Linda, additional, Lynfield, Ruth, additional, Mahoehney, JP, additional, Nadle, Joelle, additional, Ray, Susan M., additional, Davis, Sarah Shrum, additional, Sievers, Marla, additional, Srinivasan, Krithika, additional, Wilson, Lucy E., additional, Zhang, Alexia Y., additional, Magill, Shelley S., additional, and Thompson, Nicola D., additional

Published
2020
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22. Documentation of acute change in mental status in nursing homes highlights opportunity to augment infection surveillance criteria

Author

Penna, Austin R., primary, Sancken, Christina L., additional, Stone, Nimalie D., additional, Eure, Taniece R., additional, Bamberg, Wendy, additional, Barney, Grant, additional, Barter, Devra, additional, Carswell, Stacy, additional, Clogher, Paula, additional, Dumyati, Ghinwa, additional, Felsen, Christina B., additional, Frank, Linda, additional, Godine, Deborah, additional, Johnston, Helen, additional, Kainer, Marion A., additional, Li, Linda, additional, Lynfield, Ruth, additional, Mahoehney, J. P., additional, Nadle, Joelle, additional, Pierce, Rebecca, additional, Ray, Susan M., additional, Davis, Sarah Shrum, additional, Sievers, Marla, additional, Wilson, Lucy E., additional, Zhang, Alexia Y., additional, Magill, Shelley S., additional, and Thompson, Nicola D., additional

Published
2020
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24. Landscape of Candidemia During the Coronavirus Disease 2019 (COVID-19) Pandemic.

Author

Seagle, Emma E, Jackson, Brendan R, Lockhart, Shawn R, Georgacopoulos, Ourania, Nunnally, Natalie S, Roland, Jeremy, Barter, Devra M, Johnston, Helen L, Czaja, Christopher A, Kayalioglu, Hazal, Clogher, Paula, Revis, Andrew, Farley, Monica M, Harrison, Lee H, Davis, Sarah Shrum, Phipps, Erin C, Tesini, Brenda L, Schaffner, William, Markus, Tiffanie M, and Lyman, Meghan M

Subjects
PUBLIC health surveillance, INTENSIVE care units, ADRENOCORTICAL hormones, CENTRAL venous catheterization, FISHER exact test, RISK assessment, LIVER diseases, ARTIFICIAL respiration, HOSPITAL mortality, DESCRIPTIVE statistics, CHI-squared test, IMMUNOSUPPRESSIVE agents, COVID-19 pandemic, CANDIDEMIA, DISEASE risk factors, DISEASE complications
Abstract

Background The COVID-19 pandemic has resulted in unprecedented healthcare challenges, and COVID-19 has been linked to secondary infections. Candidemia, a fungal healthcare-associated infection, has been described in patients hospitalized with severe COVID-19. However, studies of candidemia and COVID-19 coinfection have been limited in sample size and geographic scope. We assessed differences in patients with candidemia with and without a COVID-19 diagnosis. Methods We conducted a case-level analysis using population-based candidemia surveillance data collected through the Centers for Disease Control and Prevention's Emerging Infections Program during April–August 2020 to compare characteristics of candidemia patients with and without a positive test for COVID-19 in the 30 days before their Candida culture using chi-square or Fisher's exact tests. Results Of the 251 candidemia patients included, 64 (25.5%) were positive for SARS-CoV-2. Liver disease, solid-organ malignancies, and prior surgeries were each >3 times more common in patients without COVID-19 coinfection, whereas intensive care unit–level care, mechanical ventilation, having a central venous catheter, and receipt of corticosteroids and immunosuppressants were each >1.3 times more common in patients with COVID-19. All-cause in-hospital fatality was 2 times higher among those with COVID-19 (62.5%) than without (32.1%). Conclusions One-quarter of candidemia patients had COVID-19. These patients were less likely to have certain underlying conditions and recent surgery commonly associated with candidemia and more likely to have acute risk factors linked to COVID-19 care, including immunosuppressive medications. Given the high mortality, it is important for clinicians to remain vigilant and take proactive measures to prevent candidemia in patients with COVID-19. [ABSTRACT FROM AUTHOR]

Published
2022
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25. Changes in the microbiology, epidemiology, and outcomes of candidemia in Connecticut: A comparison between two periods using statewide surveillance

Author

Gleason-Vergados, Johanna R., Clogher, Paula, Meek, James I., and Banach, David B.

Abstract

AbstractUsing statewide surveillance, we describe candidemia in Connecticut during 1998–2000 and 2019. In 2019, candidemia was more frequently associated with community-onset and non-albicans Candidaspecies and less frequently associated with central vascular catheters, recent surgery, and in-hospital mortality. Understanding changes in candidemia can optimize clinical management and prevention strategies.

Published
2023
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27. Relationship Between Census Tract–Level Poverty and Domestically Acquired Salmonella Incidence: Analysis of Foodborne Diseases Active Surveillance Network Data, 2010–2016

Author

Hadler, James L, primary, Clogher, Paula, additional, Libby, Tanya, additional, Wilson, Elisha, additional, Oosmanally, Nadine, additional, Ryan, Patricia, additional, Magnuson, Luke, additional, Lathrop, Sarah, additional, Mcguire, Suzanne, additional, Cieslak, Paul, additional, Fankhauser, Melissa, additional, Ray, Logan, additional, Geissler, Aimee, additional, and Hurd, Sharon, additional

Published
2019
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29. Relationship Between Census Tract-Level Poverty and Domestically Acquired Salmonella Incidence: Analysis of Foodborne Diseases Active Surveillance Network Data, 2010-2016.

Author

Hadler, James L, Clogher, Paula, Libby, Tanya, Wilson, Elisha, Oosmanally, Nadine, Ryan, Patricia, Magnuson, Luke, Lathrop, Sarah, Mcguire, Suzanne, Cieslak, Paul, Fankhauser, Melissa, Ray, Logan, Geissler, Aimee, and Hurd, Sharon

Subjects
*FOODBORNE diseases, *SALMONELLA, *CENSUS, *SALMONELLA diseases, *SALMONELLA food poisoning, *AGE groups
Abstract

Background: The relationships between socioeconomic status and domestically acquired salmonellosis and leading Salmonella serotypes are poorly understood.Methods: We analyzed surveillance data from laboratory-confirmed cases of salmonellosis from 2010-2016 for all 10 Foodborne Disease Active Surveillance Network (FoodNet) sites, having a catchment population of 47.9 million. Case residential data were geocoded, linked to census tract poverty level, and then categorized into 4 groups according to census tract poverty level. After excluding those reporting international travel before illness onset, age-specific and age-adjusted salmonellosis incidence rates were calculated for each census tract poverty level, overall and for each of the 10 leading serotypes.Results: Of 52 821geocodable Salmonella infections (>96%), 48 111 (91.1%) were domestically acquired. Higher age-adjusted incidence occurred with higher census tract poverty level (P < .001; relative risk for highest [≥20%] vs lowest [<5%] census tract poverty level, 1.37). Children <5 years old had the highest relative risk (2.07). Although this relationship was consistent by race/ethnicity and by serotype, it was not present in 5 FoodNet sites or among those aged 18-49 years.Conclusion: Children and older adults living in higher-poverty census tracts have had a higher incidence of domestically acquired salmonellosis. There is a need to understand socioeconomic status differences for risk factors for domestically acquired salmonellosis by age group and FoodNet site to help focus prevention efforts. [ABSTRACT FROM AUTHOR]

Published
2020
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30. 1836. Characteristics of Nursing Homes Associated With Self-reported Implementation of Centers for Disease Control and Prevention (CDC) Core Elements of Antibiotic Stewardship

Author

Thompson, Nicola D, primary, Brown, Cedric, additional, Eure, Taniece, additional, Penna, Austin, additional, Barney, Grant, additional, Barter, Devra, additional, Buhr, Nicolai, additional, Clogher, Paula, additional, Dumyati, Ghinwa, additional, Epson, Erin, additional, Frank, Linda, additional, Godine, Deborah, additional, Irizarry, Lourdes, additional, Johnston, Helen, additional, Kainer, Marion A, additional, Lynfield, Ruth, additional, Mahoehney, J P, additional, Maloney, Meghan, additional, Morabit, Susan, additional, Nadle, Joelle, additional, Pierce, Rebecca, additional, Ray, Susan M, additional, Shrum, Sarah, additional, Sievers, Marla, additional, Wilson, Lucy E, additional, Stone, Nimalie D, additional, and Magill, Shelley S, additional

Published
2018
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31. 1831. Point Prevalence and Epidemiology of Antimicrobial Use in US Nursing Homes, 2017

Author

Thompson, Nicola D, primary, Brown, Cedric J, additional, Eure, Taniece, additional, Penna, Austin, additional, Bamberg, Wendy, additional, Barney, Grant, additional, Barter, Devra, additional, Clogher, Paula, additional, Desilva, Malini, additional, Dumyati, Ghinwa, additional, Epson, Erin, additional, Frank, Linda, additional, Godine, Deborah, additional, Irizarry, Lourdes, additional, Kainer, Marion A, additional, Lynfield, Ruth, additional, Mahoehney, J P, additional, Maloney, Meghan, additional, Morabit, Susan, additional, Nadle, Joelle, additional, Ocampo, Valerie L S, additional, Pierce, Rebecca, additional, Ray, Susan M, additional, Shrum, Sarah, additional, Sievers, Marla, additional, Wilson, Lucy E, additional, Stone, Nimalie D, additional, and Magill, Shelley S, additional

Published
2018
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32. The Relationship Between Census Tract Poverty and Shiga Toxin–Producing E. coli Risk, Analysis of FoodNet Data, 2010–2014

Author

Hadler, James L, primary, Clogher, Paula, additional, Huang, Jennifer, additional, Libby, Tanya, additional, Cronquist, Alicia, additional, Wilson, Siri, additional, Ryan, Patricia, additional, Saupe, Amy, additional, Nicholson, Cyndy, additional, McGuire, Suzanne, additional, Shiferaw, Beletshachew, additional, Dunn, John, additional, and Hurd, Sharon, additional

Published
2018
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33. Evaluation of Connecticut medical providers’ concordance with 2017 IDSA/SHEA Clostridioides difficiletreatment guidelines in New Haven County, 2018–2019

Author

Luc, Casey Morgan, Olson, Danyel, Banach, David B., Clogher, Paula, and Hadler, James

Abstract

AbstractObjectives:To assess Connecticut medical providers’ concordance (2018–2019) with the 2017 Clostridioides difficileinfection (CDI) treatment update by the Infectious Disease Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). The effect of guideline concordance on CDI recurrence risk was also assessed.Design:Prospective, population-based study.Setting:New Haven County, Connecticut, from January 1, 2017, to December 31, 2019.Patients:CDI incident case (no positive tests in the prior 8 weeks), not limited by care setting.Methods:Using data from the Emerging Infections Program’s CDI surveillance, severity and concordance were defined. Presence of megacolon and/or ileus defined fulminant disease; absence defined nonsevere/severe disease. Using 2017 treatment as baseline, 2018–2019 concordance was defined as receiving the recommended first-line antibiotic (ie, vancomycin or fidaxomicin for adult patients, vancomycin or metronidazole for pediatric patients) for exactly 10 days. For all analyses, significance was P< .05.Results:Among 990 cases, concordance increased from 24.8% in 2018 to 37.0% in 2019. First-line antibiotic concordance increased from 61.2% in 2018 to 79.9% in 2019. Recurrence risk was significantly associated with patients aged ≥65 years and was highest for those aged 75–84 years, but this factor was not significantly associated with concordance.Conclusions:From 2018 through 2019, CDI treatment in New Haven County increasingly was concordant with the 2017 treatment update but remained low in 2019. Although concordance with treatment guidelines did not affect recurrence risk, close attention should be paid by medical providers to patients aged ≥65 years, specifically those aged 75–84 years because they are at an increased risk for recurrence.

Published
2021
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34. Point Prevalence and Characteristics of In-House Antimicrobial Use in Nursing Homes, New Haven and Hartford Counties, Connecticut, 2017.

Author

Srinivasan, Krithika, Clogher, Paula, Maloney, Meghan, and Meek, James

Abstract

National trends indicate the amount and complexity of health care delivery in US nursing homes (NHs) is increasing.1 In 2017, the Centers for Disease Control and Prevention’s (CDC) Emerging Infections Program (EIP) conducted a point prevalence survey to gather data on antimicrobial use (AU) in NHs in 10 EIP sites including Connecticut (CT). NHs in two of CT’s eight counties were randomly selected to participate in a one-day AU point prevalence survey. Of 1299 residents in 11 participating NHs, 128 (10%) received ≥ 1 antimicrobial drug (AD) on the survey date or the day prior, of which 94 (73%) were ordered in-house. Most in-house AD orders (76/94, 81%) were for treatment of an active infection, and among those less than half (34/76, 45%) met the revised McGeer Criteria² for infection or had a culture performed (36, 47%). Most organisms isolated grew from urine specimens (25/36, 70%) of which (10/36, 28%) grew an organism resistant to at least one drug (range 1-7). [ABSTRACT FROM AUTHOR]

Published
2019

35. Trends in methicillin-resistant Staphylococcus aureusbloodstream infections using statewide population-based surveillance and hospital discharge data, Connecticut, 2010–2018

Author

Rose, Ashley N, Clogher, Paula, Hatfield, Kelly M, Gokhale, Runa H, See, Isaac, and Petit, Susan

Abstract

AbstractWe compared methicillin-resistant Staphylococcus aureus(MRSA) bloodstream infections (BSIs) captured by culture-based surveillance and MRSA septicemia hospitalizations captured by administrative coding using statewide hospital discharge data in Connecticut from 2010 to 2018. Observed discrepancies between identification methods suggest administrative coding is inappropriate for assessing trends in MRSA BSIs.

Published
2020
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37. Increased Recognition of Non-O157 Shiga Toxin–ProducingEscherichia coliInfections in the United States During 2000–2010: Epidemiologic Features and Comparison withE. coliO157 Infections

Author

Gould, L. Hannah, primary, Mody, Rajal K., additional, Ong, Kanyin L., additional, Clogher, Paula, additional, Cronquist, Alicia B., additional, Garman, Katie N., additional, Lathrop, Sarah, additional, Medus, Carlota, additional, Spina, Nancy L., additional, Webb, Tameka H., additional, White, Patricia L., additional, Wymore, Katie, additional, Gierke, Ruth E., additional, Mahon, Barbara E., additional, and Griffin, for the Emerging Infection, Patricia M., additional

Published
2013
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38. FoodNet Survey of Food Use and Practices in Long-Term Care Facilities

Author

Nelson, Jennifer M., primary, Bednarczyk, Robert, additional, Nadle, Joelle, additional, Clogher, Paula, additional, Gillespie, Jennifer, additional, Daniels, Allison, additional, Plantenga, Melissa, additional, Ingram, Amanda, additional, Edge, Karen, additional, Furuno, Jon P., additional, and Scallan, Elaine, additional

Published
2008
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39. Multistate Surveillance for Laboratory-Confirmed, Influenza-Associated Hospitalizations in Children

Author

Schrag, Stephanie J., primary, Shay, David K., additional, Gershman, Ken, additional, Thomas, Ann, additional, Craig, Allen S., additional, Schaffner, William, additional, Harrison, Lee H., additional, Vugia, Duc, additional, Clogher, Paula, additional, Lynfield, Ruth, additional, Farley, Monica, additional, Zansky, Shelley, additional, and Uyeki, Timothy, additional

Published
2006
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40. Increased Recognition of Non-O157 Shiga Toxin–Producing Escherichia coliInfections in the United States During 2000–2010: Epidemiologic Features and Comparison with E. coliO157 Infections

Author

Gould, L. Hannah, Mody, Rajal K., Ong, Kanyin L., Clogher, Paula, Cronquist, Alicia B., Garman, Katie N., Lathrop, Sarah, Medus, Carlota, Spina, Nancy L., Webb, Tameka H., White, Patricia L., Wymore, Katie, Gierke, Ruth E., Mahon, Barbara E., Griffin, Patricia M., and Group, for the Emerging Infections Program FoodNet Working

Abstract

AbstractBackground:Shiga toxin–producing Escherichia coli(STEC) are an important cause of diarrhea and the major cause of postdiarrheal hemolytic uremic syndrome. Non-O157 STEC infections are being recognized with greater frequency because of changing laboratory practices.Methods:Foodborne Diseases Active Surveillance Network (FoodNet) site staff conducted active, population-based surveillance for laboratory-confirmed STEC infections. We assessed frequency and incidence of STEC infections by serogroup and examined and compared demographic factors, clinical characteristics, and frequency of international travel among patients.Results:During 2000–2010, FoodNet sites reported 2006 cases of non-O157 STEC infection and 5688 cases of O157 STEC infections. The number of reported non-O157 STEC infections increased from an incidence of 0.12 per 100,000 population in 2000 to 0.95 per 100,000 in 2010; while the rate of O157 STEC infections decreased from 2.17 to 0.95 per 100,000. Among non-O157 STEC, six serogroups were most commonly reported: O26 (26%), O103 (22%), O111 (19%), O121 (6%), O45 (5%), and O145 (4%). Non-O157 STEC infections were more common among Hispanics, and infections were less severe than those caused by O157 STEC, but this varied by serogroup. Fewer non-O157 STEC infections were associated with outbreaks (7% versus 20% for O157), while more were associated with international travel (14% versus 3% for O157).Conclusions:Improved understanding of the epidemiologic features of non-O157 STEC infections can inform food safety and other prevention efforts. To detect both O157 and non-O157 STEC infections, clinical laboratories should routinely and simultaneously test all stool specimens submitted for diagnosis of acute community-acquired diarrhea for O157 STEC and for Shiga toxin and ensure that isolates are sent to a public health laboratory for serotyping and subtyping.

Published
2013
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41. Evaluation of Connecticut medical providers' concordance with 2017 IDSA/SHEA Clostridioides difficile treatment guidelines in New Haven County, 2018-2019.

Author

Luc CM, Olson D, Banach DB, Clogher P, and Hadler J

Subjects
Adult, Anti-Bacterial Agents therapeutic use, Child, Clostridioides, Connecticut epidemiology, Delivery of Health Care, Humans, Prospective Studies, Clostridioides difficile, Clostridium Infections drug therapy, Clostridium Infections epidemiology, Communicable Diseases drug therapy
Abstract

Objectives: To assess Connecticut medical providers' concordance (2018-2019) with the 2017 Clostridioides difficile infection (CDI) treatment update by the Infectious Disease Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). The effect of guideline concordance on CDI recurrence risk was also assessed., Design: Prospective, population-based study., Setting: New Haven County, Connecticut, from January 1, 2017, to December 31, 2019., Patients: CDI incident case (no positive tests in the prior 8 weeks), not limited by care setting., Methods: Using data from the Emerging Infections Program's CDI surveillance, severity and concordance were defined. Presence of megacolon and/or ileus defined fulminant disease; absence defined nonsevere/severe disease. Using 2017 treatment as baseline, 2018-2019 concordance was defined as receiving the recommended first-line antibiotic (ie, vancomycin or fidaxomicin for adult patients, vancomycin or metronidazole for pediatric patients) for exactly 10 days. For all analyses, significance was P < .05., Results: Among 990 cases, concordance increased from 24.8% in 2018 to 37.0% in 2019. First-line antibiotic concordance increased from 61.2% in 2018 to 79.9% in 2019. Recurrence risk was significantly associated with patients aged ≥65 years and was highest for those aged 75-84 years, but this factor was not significantly associated with concordance., Conclusions: From 2018 through 2019, CDI treatment in New Haven County increasingly was concordant with the 2017 treatment update but remained low in 2019. Although concordance with treatment guidelines did not affect recurrence risk, close attention should be paid by medical providers to patients aged ≥65 years, specifically those aged 75-84 years because they are at an increased risk for recurrence.

Published
2021
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42. Increased recognition of non-O157 Shiga toxin-producing Escherichia coli infections in the United States during 2000-2010: epidemiologic features and comparison with E. coli O157 infections.

Author

Gould LH, Mody RK, Ong KL, Clogher P, Cronquist AB, Garman KN, Lathrop S, Medus C, Spina NL, Webb TH, White PL, Wymore K, Gierke RE, Mahon BE, and Griffin PM

Subjects
Adolescent, Adult, Child, Demography, Diarrhea, Disease Outbreaks, Escherichia coli Infections microbiology, Female, Foodborne Diseases microbiology, Hemolytic-Uremic Syndrome microbiology, Humans, Incidence, Male, O Antigens immunology, Serotyping, Shiga Toxin metabolism, Shiga-Toxigenic Escherichia coli classification, Travel, United States epidemiology, Young Adult, Escherichia coli Infections epidemiology, Escherichia coli O157 isolation & purification, Foodborne Diseases epidemiology, Hemolytic-Uremic Syndrome epidemiology, Population Surveillance, Shiga-Toxigenic Escherichia coli isolation & purification
Abstract

Background: Shiga toxin-producing Escherichia coli (STEC) are an important cause of diarrhea and the major cause of postdiarrheal hemolytic uremic syndrome. Non-O157 STEC infections are being recognized with greater frequency because of changing laboratory practices., Methods: Foodborne Diseases Active Surveillance Network (FoodNet) site staff conducted active, population-based surveillance for laboratory-confirmed STEC infections. We assessed frequency and incidence of STEC infections by serogroup and examined and compared demographic factors, clinical characteristics, and frequency of international travel among patients., Results: During 2000-2010, FoodNet sites reported 2006 cases of non-O157 STEC infection and 5688 cases of O157 STEC infections. The number of reported non-O157 STEC infections increased from an incidence of 0.12 per 100,000 population in 2000 to 0.95 per 100,000 in 2010; while the rate of O157 STEC infections decreased from 2.17 to 0.95 per 100,000. Among non-O157 STEC, six serogroups were most commonly reported: O26 (26%), O103 (22%), O111 (19%), O121 (6%), O45 (5%), and O145 (4%). Non-O157 STEC infections were more common among Hispanics, and infections were less severe than those caused by O157 STEC, but this varied by serogroup. Fewer non-O157 STEC infections were associated with outbreaks (7% versus 20% for O157), while more were associated with international travel (14% versus 3% for O157)., Conclusions: Improved understanding of the epidemiologic features of non-O157 STEC infections can inform food safety and other prevention efforts. To detect both O157 and non-O157 STEC infections, clinical laboratories should routinely and simultaneously test all stool specimens submitted for diagnosis of acute community-acquired diarrhea for O157 STEC and for Shiga toxin and ensure that isolates are sent to a public health laboratory for serotyping and subtyping.

Published
2013
Full Text
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