255 results on '"Hilary M. Babcock"'
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2. Seroprevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antibodies among healthcare personnel in the Midwestern United States, September 2020–April 2021
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Rachel E. Bosserman, Christopher W. Farnsworth, Caroline A. O’Neil, Candice Cass, Daniel Park, Claire Ballman, Meghan A. Wallace, Emily Struttmann, Henry Stewart, Olivia Arter, Kate Peacock, Victoria J. Fraser, Philip J. Budge, Margaret A. Olsen, Carey-Ann D. Burnham, Hilary M. Babcock, Jennie H. Kwon, and for the CDC Prevention Epicenters more...
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Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Objective: To determine the prevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) IgG nucleocapsid (N) antibodies among healthcare personnel (HCP) with no prior history of COVID-19 and to identify factors associated with seropositivity. Design: Prospective cohort study. Setting: An academic, tertiary-care hospital in St. Louis, Missouri. Participants: The study included 400 HCP aged ≥18 years who potentially worked with coronavirus disease 2019 (COVID-19) patients and had no known history of COVID-19; 309 of these HCP also completed a follow-up visit 70–160 days after enrollment. Enrollment visits took place between September and December 2020. Follow-up visits took place between December 2020 and April 2021. Methods: At each study visit, participants underwent SARS-CoV-2 IgG N-antibody testing using the Abbott SARS-CoV-2 IgG assay and completed a survey providing information about demographics, job characteristics, comorbidities, symptoms, and potential SARS-CoV-2 exposures. Results: Participants were predominately women (64%) and white (79%), with median age of 34.5 years (interquartile range [IQR], 30–45). Among the 400 HCP, 18 (4.5%) were seropositive for IgG N-antibodies at enrollment. Also, 34 (11.0%) of 309 were seropositive at follow-up. HCP who reported having a household contact with COVID-19 had greater likelihood of seropositivity at both enrollment and at follow-up. Conclusions: In this cohort of HCP during the first wave of the COVID-19 pandemic, ∼1 in 20 had serological evidence of prior, undocumented SARS-CoV-2 infection at enrollment. Having a household contact with COVID-19 was associated with seropositivity. more...
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- 2023
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3. Isolation of SARS-CoV-2 in Viral Cell Culture in Immunocompromised Patients With Persistently Positive RT-PCR Results
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Abby Sung, Adam L. Bailey, Henry B. Stewart, David McDonald, Meghan A. Wallace, Kate Peacock, Candace Miller, Kimberly A. Reske, Caroline A. O’Neil, Victoria J. Fraser, Michael S. Diamond, Carey-Ann D. Burnham, Hilary M. Babcock, and Jennie H. Kwon more...
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COVID-19 ,SARS-CoV-2 ,immunocompromised ,rituximab ,obinutuzumab ,laboratory medicine ,Microbiology ,QR1-502 - Abstract
Immunocompromised adults can have prolonged acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive RT-PCR results, long after the initial diagnosis of coronavirus disease 2019 (COVID-19). This study aimed to determine if SARS-CoV-2 virus can be recovered in viral cell culture from immunocompromised adults with persistently positive SARS-CoV-2 RT-PCR tests. We obtained 20 remnant SARS-CoV-2 PCR positive nasopharyngeal swabs from 20 immunocompromised adults with a positive RT-PCR test ≥14 days after the initial positive test. The patients’ 2nd test samples underwent SARS-CoV-2 antigen testing, and culture with Vero-hACE2-TMPRSS2 cells. Viral RNA and cultivable virus were recovered from the cultured cells after qRT-PCR and plaque assays. Of 20 patients, 10 (50%) had a solid organ transplant and 5 (25%) had a hematologic malignancy. For most patients, RT-PCR Ct values increased over time. There were 2 patients with positive viral cell cultures; one patient had chronic lymphocytic leukemia treated with venetoclax and obinutuzumab who had a low viral titer of 27 PFU/mL. The second patient had marginal zone lymphoma treated with bendamustine and rituximab who had a high viral titer of 2 x 106 PFU/mL. Most samples collected ≥7 days after an initial positive SARS-CoV-2 RT-PCR had negative viral cell cultures. The 2 patients with positive viral cell cultures had hematologic malignancies treated with chemotherapy and B cell depleting therapy. One patient had a high concentration titer of cultivable virus. Further data are needed to determine risk factors for persistent viral shedding and methods to prevent SARS-CoV-2 transmission from immunocompromised hosts. more...
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- 2022
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4. Antibodies in healthcare personnel following severe acute respiratory syndrome coronavirus virus 2 (SARS-CoV-2) infection
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Rachel E. Bosserman, Christopher W. Farnsworth, Caroline A. O’Neil, Candice Cass, Daniel Park, Claire Ballman, Meghan A. Wallace, Emily Struttmann, Henry Stewart, Olivia Arter, Kate Peacock, Victoria J. Fraser, Philip J. Budge, Margaret A. Olsen, Carey-Ann D. Burnham, Hilary M. Babcock, Jennie H. Kwon, and for the CDC Prevention Epicenters more...
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Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
In a prospective cohort of healthcare personnel (HCP), we measured severe acute respiratory syndrome coronavirus virus 2 (SARS-CoV-2) nucleocapsid IgG antibodies after SARS-CoV-2 infection. Among 79 HCP, 68 (86%) were seropositive 14–28 days after their positive PCR test, and 54 (77%) of 70 were seropositive at the 70–180-day follow-up. Many seropositive HCP (95%) experienced an antibody decline by the second visit. more...
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- 2022
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5. Navigating the pandemic in an acute-care hospital—The overlooked relationship between hospital leadership and infection prevention
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Jonas Marschall, Hilary M. Babcock, and Urs P. Mosimann
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Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Published
- 2022
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6. At the vanguard: Leaders’ perspectives on establishing healthcare system infection prevention programs
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Michael P. Stevens, Sharon B. Wright, Keith S. Kaye, Jerry M. Zuckerman, Catherine L. Passaretti, Richard A. Martinello, Hilary M. Babcock, Michael B. Edmond, and Graham M. Snyder
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Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
Hospitals are increasingly consolidating into health systems. Some systems have appointed healthcare epidemiologists to lead system-level infection prevention programs. Ideal program infrastructure and support resources have not been described. We informally surveyed 7 healthcare epidemiologists with recent experience building and leading system-level infection prevention programs. Key facilitators and barriers for program structure and implementation are described. more...
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- 2022
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7. Coronavirus disease 2019 (COVID-19) vaccine breakthrough infections among healthcare personnel, December 2020–April 2021
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Katelin B. Nickel, Victoria J. Fraser, Hilary M. Babcock, Jennie H. Kwon, and for the CDC Prevention Epicenters Program
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Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
Coronavirus disease 2019 (COVID-19) vaccine effectiveness in the early months of vaccine availability was high among healthcare personnel (HCP) at 88.3% for 2-doses. Among those testing positive for severe acute respiratory coronavirus virus 2 (SARS-CoV-2), those with breakthrough infection after vaccination were more likely to have had a non–work-related SARS-CoV-2 exposure compared to unvaccinated HCP. more...
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- 2022
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8. Effectiveness of the Ad26.COV2.S (Johnson & Johnson) Coronavirus Disease 2019 (COVID-19) Vaccine for Preventing COVID-19 Hospitalizations and Progression to High Disease Severity in the United States
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Nathaniel M, Lewis, Wesley H, Self, Manjusha, Gaglani, Adit A, Ginde, David J, Douin, H, Keipp Talbot, Jonathan D, Casey, Nicholas M, Mohr, Anne, Zepeski, Shekhar A, Ghamande, Tresa A, McNeal, Nathan I, Shapiro, Kevin W, Gibbs, D Clark, Files, David N, Hager, Arber, Shehu, Matthew E, Prekker, Heidi L, Erickson, Michelle N, Gong, Amira, Mohamed, Nicholas J, Johnson, Vasisht, Srinivasan, Jay S, Steingrub, Ithan D, Peltan, Samuel M, Brown, Emily T, Martin, Arnold S, Monto, Akram, Khan, Laurence W, Busse, Caitlin C Ten, Lohuis, Abhijit, Duggal, Jennifer G, Wilson, Alexandra June, Gordon, Nida, Qadir, Steven Y, Chang, Christopher, Mallow, Carolina, Rivas, Hilary M, Babcock, Jennie H, Kwon, Matthew C, Exline, Adam S, Lauring, Natasha, Halasa, James D, Chappell, Carlos G, Grijalva, Todd W, Rice, Jillian P, Rhoads, Ian D, Jones, William B, Stubblefield, Adrienne, Baughman, Kelsey N, Womack, Christopher J, Lindsell, Kimberly W, Hart, Yuwei, Zhu, Katherine, Adams, Manish M, Patel, and Mark W, Tenforde more...
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Adult ,Hospitalization ,Microbiology (medical) ,COVID-19 Vaccines ,Infectious Diseases ,Ad26COVS1 ,Influenza Vaccines ,Influenza, Human ,COVID-19 ,Humans ,Severity of Illness Index ,United States - Abstract
Background . Adults in the United States (US) began receiving the adenovirus vector coronavirus disease 2019 (COVID-19) vaccine, Ad26.COV2.S (Johnson & Johnson [Janssen]), in February 2021. We evaluated Ad26.COV2.S vaccine effectiveness (VE) against COVID-19 hospitalization and high disease severity during the first 10 months of its use. Methods . In a multicenter case-control analysis of US adults (≥18 years) hospitalized 11 March to 15 December 2021, we estimated VE against susceptibility to COVID-19 hospitalization (VEs), comparing odds of prior vaccination with a single dose Ad26.COV2.S vaccine between hospitalized cases with COVID-19 and controls without COVID-19. Among hospitalized patients with COVID-19, we estimated VE against disease progression (VEp) to death or invasive mechanical ventilation (IMV), comparing odds of prior vaccination between patients with and without progression. Results . After excluding patients receiving mRNA vaccines, among 3979 COVID-19 case-patients (5% vaccinated with Ad26.COV2.S) and 2229 controls (13% vaccinated with Ad26.COV2.S), VEs of Ad26.COV2.S against COVID-19 hospitalization was 70% (95% confidence interval [CI]: 63–75%) overall, including 55% (29–72%) among immunocompromised patients, and 72% (64–77%) among immunocompetent patients, for whom VEs was similar at 14–90 days (73% [59–82%]), 91–180 days (71% [60–80%]), and 181–274 days (70% [54–81%]) postvaccination. Among hospitalized COVID-19 case-patients, VEp was 46% (18–65%) among immunocompetent patients. Conclusions . The Ad26.COV2.S COVID-19 vaccine reduced the risk of COVID-19 hospitalization by 72% among immunocompetent adults without waning through 6 months postvaccination. After hospitalization for COVID-19, vaccinated immunocompetent patients were less likely to require IMV or die compared to unvaccinated immunocompetent patients. more...
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- 2022
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9. Universal Masking in Health Care Settings: A Pandemic Strategy Whose Time Has Come and Gone, For Now
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Erica S. Shenoy, Hilary M. Babcock, Karen B. Brust, Michael S. Calderwood, Shira Doron, Anurag N. Malani, Sharon B. Wright, and Westyn Branch-Elliman
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Internal Medicine ,General Medicine - Published
- 2023
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10. Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations Among Adults Without Immunocompromising Conditions — United States, March–August 2021
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Anne Zepeski, Catherine L. Hough, Wesley H. Self, Ian Jones, Amira Mohamed, Tresa McNeal, Samuel M. Brown, Shekhar Ghamande, Jennifer G. Wilson, Alexandra June Gordon, Eric A. Naioti, Manjusha Gaglani, Jay S. Steingrub, Steven Y. Chang, Natalie J. Thornburg, Yuwei Zhu, Adrienne Baughman, Mark W Tenforde, Matthew E. Prekker, Christopher J. Lindsell, William B. Stubblefield, Arnold S. Monto, Nida Qadir, James D. Chappell, Nicholas M. Mohr, Carolina Rivas, Sandra N. Lester, Abhijit Duggal, Ithan D. Peltan, Kevin W Gibbs, Jillian P. Rhoads, Jennifer R. Verani, Miwako Kobayashi, Hilary M. Babcock, Manish M. Patel, Arber Shehu, Emily T. Martin, Natasha B. Halasa, Laurence W. Busse, Megan M. Stump, Jennie H. Kwon, David J. Douin, Daniel J. Henning, Matthew C. Exline, Kelsey N Womack, Michelle N. Gong, Todd W. Rice, Samantha M. Olson, H. Keipp Talbot, Adam S. Lauring, Jonathan D Casey, Adit A. Ginde, Kimberly W. Hart, Heidi L Erickson, D. Clark Files, David N. Hager, Carlos G. Grijalva, Lisa Mills, Christopher Mallow, Akram Khan, and Caitlin C Ten Lohuis more...
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Adult ,Male ,Emergency Use Authorization ,medicine.medical_specialty ,COVID-19 Vaccines ,Health (social science) ,Adolescent ,Coronavirus disease 2019 (COVID-19) ,Epidemiology ,Health, Toxicology and Mutagenesis ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Serum antibody ,Immunocompromised Host ,Young Adult ,Health Information Management ,Internal medicine ,Humans ,Medicine ,Full Report ,Young adult ,Aged ,Vaccines, Synthetic ,business.industry ,COVID-19 ,General Medicine ,Middle Aged ,United States ,Confidence interval ,Hospitalization ,Vaccination ,Johnson Johnson ,Female ,business - Abstract
Three COVID-19 vaccines are authorized or approved for use among adults in the United States (1,2). Two 2-dose mRNA vaccines, mRNA-1273 from Moderna and BNT162b2 from Pfizer-BioNTech, received Emergency Use Authorization (EUA) by the Food and Drug Administration (FDA) in December 2020 for persons aged ≥18 years and aged ≥16 years, respectively. A 1-dose viral vector vaccine (Ad26.COV2 from Janssen [Johnson & Johnson]) received EUA in February 2021 for persons aged ≥18 years (3). The Pfizer-BioNTech vaccine received FDA approval for persons aged ≥16 years on August 23, 2021 (4). Current guidelines from FDA and CDC recommend vaccination of eligible persons with one of these three products, without preference for any specific vaccine (4,5). To assess vaccine effectiveness (VE) of these three products in preventing COVID-19 hospitalization, CDC and collaborators conducted a case-control analysis among 3,689 adults aged ≥18 years who were hospitalized at 21 U.S. hospitals across 18 states during March 11-August 15, 2021. An additional analysis compared serum antibody levels (anti-spike immunoglobulin G [IgG] and anti-receptor binding domain [RBD] IgG) to SARS-CoV-2, the virus that causes COVID-19, among 100 healthy volunteers enrolled at three hospitals 2-6 weeks after full vaccination with the Moderna, Pfizer-BioNTech, or Janssen COVID-19 vaccine. Patients with immunocompromising conditions were excluded. VE against COVID-19 hospitalizations was higher for the Moderna vaccine (93%; 95% confidence interval [CI] = 91%-95%) than for the Pfizer-BioNTech vaccine (88%; 95% CI = 85%-91%) (p = 0.011); VE for both mRNA vaccines was higher than that for the Janssen vaccine (71%; 95% CI = 56%-81%) (all p more...
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- 2021
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11. Promoting coronavirus disease 2019 (COVID-19) vaccination among healthcare personnel: A multifaceted intervention at a tertiary-care center in Japan
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Akane Takamatsu, Tomoya Kojima, Hilary M. Babcock, Kengo Murata, and Hitoshi Honda
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0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,COVID-19 Vaccines ,Epidemiology ,Population ,Breastfeeding ,Psychological intervention ,MEDLINE ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Intervention (counseling) ,Influenza, Human ,Health care ,Pandemic ,Humans ,Medicine ,030212 general & internal medicine ,education ,education.field_of_study ,business.industry ,Vaccination ,COVID-19 ,030104 developmental biology ,Infectious Diseases ,Family medicine ,Original Article ,business ,Delivery of Health Care - Abstract
Objective:The coronavirus disease 2019 (COVID-19) vaccine may hold the key to ending the pandemic, but vaccine hesitancy is hindering the vaccination of healthcare personnel (HCP). We examined their perceptions of the COVID-19 vaccine and implemented an intervention to increase vaccination uptake.Design:Before-and-after trial.Participants and setting:Healthcare personnel at a 790-bed tertiary-care center in Tokyo, Japan.Interventions:A prevaccination questionnaire was administered to HCP to examine their perceptions of the COVID-19 vaccine. A multifaceted intervention was then implemented involving (1) distribution of informational leaflets to all HCP, (2) hospital-wide announcements encouraging vaccination, (3) a mandatory lecture, (4) an educational session about the vaccine for pregnant or breastfeeding HCP, and (5) allergy testing for HCP at risk of allergic reactions to the vaccine. A postvaccination survey was also performed.Results:Of 1,575 HCP eligible for enrollment, 1,224 (77.7%) responded to the questionnaire, 533 (43.5%) expressed willingness to be vaccinated, 593 (48.4%) were uncertain, and 98 (8.0%) expressed unwillingness to be vaccinated. The latter 2 groups were concerned about the vaccine’s safety rather than its efficacy. After the intervention, the overall vaccination rate reached 89.7% (1,413 of 1,575), and 88.9% (614 of 691) of the prevaccination survey respondents answered “unwilling” to or “unsure” about eventually receiving a vaccination. In the postvaccination questionnaire, factors contributing to increased COVID-19 vaccination included information and endorsement of vaccination at the medical center (274 of 1,037, 26.4%).Conclusions:This multifaceted intervention increased COVID-19 vaccinations among HCP at a Japanese hospital. Frequent support and provision of information were crucial for increasing the vaccination rate and may be applicable to the general population as well. more...
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- 2021
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12. Multisociety statement on coronavirus disease 2019 (COVID-19) vaccination as a condition of employment for healthcare personnel
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Robin L.P. Jump, Jaffar A. Al-Tawfiq, Zanthia Wiley, Ramy H. Elshaboury, Sharon B. Wright, Erica Pettigrew, Diane Juffras, Mohamad G. Fakih, David J. Weber, Marci L. Drees, Trini Mathew, Waleed Javaid, Hilary M. Babcock, Tara O'Shea, Anurag N. Malani, David A. Nace, Rekha Murthy, Heather Young, Joshua K. Schaffzin, David K. Henderson, Kristina A. Bryant, Katharine Essick, Julie Vaishampayan, Deborah S. Yokoe, Ann Marie Pettis, Francesca Lee, and Erica S. Shenoy more...
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Employment ,Microbiology (medical) ,medicine.medical_specialty ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,Epidemiology ,Statement (logic) ,MEDLINE ,Health care ,medicine ,Humans ,Infection control ,Child ,book ,health care economics and organizations ,SARS-CoV-2 ,business.industry ,Vaccination ,COVID-19 ,SHEA White Paper ,United States ,Infectious Diseases ,Family medicine ,Pediatric Infectious Disease ,book.journal ,business ,Delivery of Health Care - Abstract
This consensus statement by the Society for Healthcare Epidemiology of America (SHEA) and the Society for Post-Acute and Long-Term Care Medicine (AMDA), the Association for Professionals in Epidemiology and Infection Control (APIC), the HIV Medicine Association (HIVMA), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP) recommends that coronavirus disease 2019 (COVID-19) vaccination should be a condition of employment for all healthcare personnel in facilities in the United States. Exemptions from this policy apply to those with medical contraindications to all COVID-19 vaccines available in the United States and other exemptions as specified by federal or state law. The consensus statement also supports COVID-19 vaccination of nonemployees functioning at a healthcare facility (eg, students, contract workers, volunteers, etc). more...
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- 2021
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13. Vaccine Effectiveness of Primary Series and Booster Doses against Omicron Variant COVID-19-Associated Hospitalization in the United States
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Katherine Adams, Jillian P. Rhoads, Diya Surie, Manjusha Gaglani, Adit A. Ginde, Tresa McNeal, Shekhar Ghamande, David Huynh, H. Keipp Talbot, Jonathan D. Casey, Nicholas M. Mohr, Anne Zepeski, Nathan I. Shapiro, Kevin W. Gibbs, D. Clark Files, Madeline Hicks, David N. Hager, Harith Ali, Matthew E. Prekker, Anne E. Frosch, Matthew C. Exline, Michelle N. Gong, Amira Mohamed, Nicholas J. Johnson, Vasisht Srinivasan, Jay S. Steingrub, Ithan D. Peltan, Samuel M. Brown, Emily T. Martin, Arnold S. Monto, Adam S. Lauring, Akram Khan, Catherine L. Hough, Laurence W. Busse, Caitlin C. ten Lohuis, Abhijit Duggal, Jennifer G. Wilson, Alexandra June Gordon, Nida Qadir, Steven Y. Chang, Christopher Mallow, Carolina Rivas, Hilary M. Babcock, Jennie H. Kwon, James D. Chappell, Natasha Halasa, Carlos G. Grijalva, Todd W. Rice, William B. Stubblefield, Adrienne Baughman, Christopher J. Lindsell, Kimberly W. Hart, Sandra N. Lester, Natalie J. Thornburg, SoHee Park, Meredith L. McMorrow, Manish M. Patel, Mark W. Tenforde, and Wesley H. Self more...
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Adult ,COVID-19 Vaccines ,SARS-CoV-2 ,Case-Control Studies ,COVID-19 ,Humans ,Vaccine Efficacy ,Middle Aged ,Article ,BNT162 Vaccine ,Hospitals ,United States ,Aged - Abstract
To compare the effectiveness of a primary covid-19 vaccine series plus booster doses with a primary series alone for the prevention of hospital admission with omicron related covid-19 in the United States.Multicenter observational case-control study with a test negative design.Hospitals in 18 US states.4760 adults admitted to one of 21 hospitals with acute respiratory symptoms between 26 December 2021 and 30 June 2022, a period when the omicron variant was dominant. Participants included 2385 (50.1%) patients with laboratory confirmed covid-19 (cases) and 2375 (49.9%) patients who tested negative for SARS-CoV-2 (controls).The main outcome was vaccine effectiveness against hospital admission with covid-19 for a primary series plus booster doses and a primary series alone by comparing the odds of being vaccinated with each of these regimens versus being unvaccinated among cases versus controls. Vaccine effectiveness analyses were stratified by immunosuppression status (immunocompetent, immunocompromised). The primary analysis evaluated all covid-19 vaccine types combined, and secondary analyses evaluated specific vaccine products.Overall, median age of participants was 64 years (interquartile range 52-75 years), 994 (20.8%) were immunocompromised, 85 (1.8%) were vaccinated with a primary series plus two boosters, 1367 (28.7%) with a primary series plus one booster, and 1875 (39.3%) with a primary series alone, and 1433 (30.1%) were unvaccinated. Among immunocompetent participants, vaccine effectiveness for prevention of hospital admission with omicron related covid-19 for a primary series plus two boosters was 63% (95% confidence interval 37% to 78%), a primary series plus one booster was 65% (58% to 71%), and for a primary series alone was 37% (25% to 47%) (P0.001 for the pooled boosted regimens compared with a primary series alone). Vaccine effectiveness was higher for a boosted regimen than for a primary series alone for both mRNA vaccines (BNT162b2 (Pfizer-BioNTech): 73% (44% to 87%) for primary series plus two boosters, 64% (55% to 72%) for primary series plus one booster, and 36% (21% to 48%) for primary series alone (P0.001); mRNA-1273 (Moderna): 68% (17% to 88%) for primary series plus two boosters, 65% (55% to 73%) for primary series plus one booster, and 41% (25% to 54%) for primary series alone (P=0.001)). Among immunocompromised patients, vaccine effectiveness for a primary series plus one booster was 69% (31% to 86%) and for a primary series alone was 49% (30% to 63%) (P=0.04).During the first six months of 2022 in the US, booster doses of a covid-19 vaccine provided additional benefit beyond a primary vaccine series alone for preventing hospital admissions with omicron related covid-19.This article is a living test negative design study that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication. more...
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- 2022
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14. Coronavirus disease 2019 (COVID-19) research agenda for healthcare epidemiology
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Katie J. Suda, Luci P. Perri, Christopher D. Pfeiffer, Adam S. Lauring, Katherine Ellingson, Shruti K. Gohil, Clare Rock, Lona Mody, Jennie H. Kwon, Daniel J. Morgan, Thomas R. Talbot, Sarah L. Krein, Felicia Skelton, Ibukunoluwa C. Akinboyo, Valerie M Vaughn, Hilary M. Babcock, Eili Y. Klein, Heather M. Gilmartin, David J. Weber, Emily E. Sickbert-Bennett, Elizabeth Monsees, Anthony D. Harris, Timothy L. Wiemken, Daniel J Livorsi, Eric Lofgren, K C Coffey, Vincent C.C. Cheng, Curtis J. Donskey, Kimberly C. Claeys, Mohamed Yassin, Werner E. Bischoff, Katreena Collette Merrill, Matthew J Ziegler, Deverick J. Anderson, Kathleen Chiotos, Sara C. Keller, Sanjay Saint, Daniel J. Diekema, and Aaron M. Milstone more...
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Microbiology (medical) ,medicine.medical_specialty ,Isolation (health care) ,Epidemiology ,Health Personnel ,Occupational safety and health ,03 medical and health sciences ,0302 clinical medicine ,White paper ,Nursing ,Political science ,Pandemic ,Health care ,medicine ,Humans ,Antimicrobial stewardship ,030212 general & internal medicine ,Pandemics ,Personal Protective Equipment ,Personal protective equipment ,0303 health sciences ,SARS-CoV-2 ,030306 microbiology ,business.industry ,COVID-19 ,SHEA White Paper ,Infectious Diseases ,business ,Delivery of Health Care - Abstract
This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical. more...
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- 2021
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15. Preparing nursing homes for a second wave of coronavirus disease 2019 (COVID-19)
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Corey A. Forde, Trevor C. Van Schooneveld, David K. Henderson, Lona Mody, Mary K. Hayden, David J. Weber, Sarah Haessler, Latania K. Logan, Hilary M. Babcock, Judith A. Guzman-Cottrill, John P. Mills, Muhammad Salman Ashraf, Sonali D Advani, Sharon B. Wright, Jennifer Hanrahan, Clare Rock, A. Rekha Murthy, and Anurag N. Malani more...
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Microbiology (medical) ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,SARS-CoV-2 ,Epidemiology ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,COVID-19 ,Virology ,State of the Pandemic Commentary ,Nursing Homes ,Infectious Diseases ,Humans ,Medicine ,Nursing homes ,business - Published
- 2020
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16. Mandatory employee vaccination as a strategy for early and comprehensive health care personnel immunization coverage: Experience from 10 influenza seasons
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Hilary M. Babcock, Christopher Blank, Nancy Gemeinhart, and W. Claiborne Dunagan
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medicine.medical_specialty ,Vaccination Coverage ,Epidemiology ,Adverse outcomes ,Health Personnel ,Influenza season ,03 medical and health sciences ,0302 clinical medicine ,Influenza, Human ,Health care ,medicine ,Humans ,030212 general & internal medicine ,Vaccination rate ,0303 health sciences ,030306 microbiology ,business.industry ,Health Policy ,Vaccination ,Public Health, Environmental and Occupational Health ,United States ,Infectious Diseases ,Increased risk ,Vaccination policy ,Influenza Vaccines ,Family medicine ,Vaccination coverage ,Comprehensive Health Care ,Seasons ,business - Abstract
Background Influenza is responsible for thousands of deaths in the United States and presents particular challenges in health care facilities with a greater prevalence of people at increased risk for adverse outcomes. Annual influenza vaccination has long been recommended, and employer policies influence the likelihood health care personnel are immunized. Methods This is a review of vaccination data maintained by a large health care organization to assess the effects of a mandatory health care personnel vaccination policy implemented during 2008-2009. Vaccination rates, timing of immunizations, and requests for medical or religious exemptions were assessed from 2006-2007 to 2017-2018. Results The health care personnel vaccination rate was 70% during the influenza season before the mandatory policy was implemented and increased to 98.4% immediately afterward. Vaccination rates exceeded 97% during the subsequent 9 years. Religious and medical exemptions decreased at academic medical centers and remained consistent at community hospitals. Among immunized employees, the peak date for vaccination shifted to late September or early October compared to late October or early November before the mandatory policy. Conclusions Requiring vaccination led to sustained increases in staff vaccination coverage at academic medical centers and community hospitals. The mandatory policy also appeared to encourage earlier vaccination. more...
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- 2020
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17. The SARS-CoV-2 Outbreak: Diagnosis, Infection Prevention, and Public Perception
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Nathan Zelyas, David H. Persing, Ping Wang, Yang Pan, Leo L.M. Poon, Carmen L. Charlton, Hilary M. Babcock, Neil W. Anderson, and Daniel D. Rhoads
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Biochemistry, medical ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Biochemistry (medical) ,Clinical Biochemistry ,Outbreak ,Infection control ,Medicine ,business ,Q & a ,Virology - Published
- 2020
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18. Comparison of aerosol mitigation strategies and aerosol persistence in dental environments
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Shruti Choudhary, Michael J. Durkin, Daniel C. Stoeckel, Heidi M. Steinkamp, Martin H. Thornhill, Peter B. Lockhart, Hilary M. Babcock, Jennie H. Kwon, Stephen Y. Liang, and Pratim Biswas
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Microbiology (medical) ,Infectious Diseases ,Epidemiology ,respiratory system ,complex mixtures - Abstract
Objective:To determine the impact of various aerosol mitigation interventions and to establish duration of aerosol persistence in a variety of dental clinic configurations.Methods:We performed aerosol measurement studies in endodontic, orthodontic, periodontic, pediatric, and general dentistry clinics. We used an optical aerosol spectrometer and wearable particulate matter sensors to measure real-time aerosol concentration from the vantage point of the dentist during routine care in a variety of clinic configurations (eg, open bay, single room, partitioned operatories). We compared the impact of aerosol mitigation strategies (eg, ventilation and high-volume evacuation (HVE), and prevalence of particulate matter) in the dental clinic environment before, during, and after high-speed drilling, slow–speed drilling, and ultrasonic scaling procedures.Results:Conical and ISOVAC HVE were superior to standard-tip evacuation for aerosol-generating procedures. When aerosols were detected in the environment, they were rapidly dispersed within minutes of completing the aerosol-generating procedure. Few aerosols were detected in dental clinics, regardless of configuration, when conical and ISOVAC HVE were used.Conclusions:Dentists should consider using conical or ISOVAC HVE rather than standard-tip evacuators to reduce aerosols generated during routine clinical practice. Furthermore, when such effective aerosol mitigation strategies are employed, dentists need not leave dental chairs fallow between patients because aerosols are rapidly dispersed. more...
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- 2022
19. Protection of mRNA vaccines against hospitalized COVID-19 in adults over the first year following authorization in the United States
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Mark W, Tenforde, Wesley H, Self, Yuwei, Zhu, Eric A, Naioti, Manjusha, Gaglani, Adit A, Ginde, Kelly, Jensen, H Keipp, Talbot, Jonathan D, Casey, Nicholas M, Mohr, Anne, Zepeski, Tresa, McNeal, Shekhar, Ghamande, Kevin W, Gibbs, D Clark, Files, David N, Hager, Arber, Shehu, Matthew E, Prekker, Heidi L, Erickson, Michelle N, Gong, Amira, Mohamed, Nicholas J, Johnson, Vasisht, Srinivasan, Jay S, Steingrub, Ithan D, Peltan, Samuel M, Brown, Emily T, Martin, Arnold S, Monto, Akram, Khan, Catherine L, Hough, Laurence W, Busse, Caitlin, Ten Lohuis, Abhijit, Duggal, Jennifer G, Wilson, Nida, Qadir, Steven Y, Chang, Christopher, Mallow, Carolina, Rivas, Hilary M, Babcock, Jennie H, Kwon, Matthew C, Exline, Mena M, Botros, Adam S, Lauring, Nathan I, Shapiro, Natasha, Halasa, James D, Chappell, Carlos G, Grijalva, Todd W, Rice, Ian D, Jones, William B, Stubblefield, Adrienne, Baughman, Kelsey N, Womack, Jillian P, Rhoads, Christopher J, Lindsell, Kimberly W, Hart, Caitlin, Turbyfill, Samantha, Olson, Nancy, Murray, Katherine, Adams, and Manish M, Patel more...
- Abstract
COVID-19 mRNA vaccines were authorized in the United States in December 2020. Although vaccine effectiveness (VE) against mild infection declines markedly after several months, limited understanding exists on the long-term durability of protection against COVID-19-associated hospitalization.Case control analysis of adults (≥18 years) hospitalized at 21 hospitals in 18 states March 11 - December 15, 2021, including COVID-19 case patients and RT-PCR-negative controls. We included adults who were unvaccinated or vaccinated with two doses of a mRNA vaccine before the date of illness onset. VE over time was assessed using logistic regression comparing odds of vaccination in cases versus controls, adjusting for confounders. Models included dichotomous time (180 vs ≥180 days since dose two) and continuous time modeled using restricted cubic splines.10,078 patients were included, 4906 cases (23% vaccinated) and 5172 controls (62% vaccinated). Median age was 60 years (IQR 46-70), 56% were non-Hispanic White, and 81% had ≥1 medical condition. Among immunocompetent adults, VE180 days was 90% (95%CI: 88-91) vs 82% (95%CI: 79-85) at ≥180 days (p 0.001). VE declined for Pfizer-BioNTech (88% to 79%, p 0.001) and Moderna (93% to 87%, p 0.001) products, for younger adults (18-64 years) [91% to 87%, p = 0.005], and for adults ≥65 years of age (87% to 78%, p 0.001). In models using restricted cubic splines, similar changes were observed.In a period largely pre-dating Omicron variant circulation, effectiveness of two mRNA doses against COVID-19-associated hospitalization was largely sustained through 9 months. more...
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- 2022
20. mRNA Vaccine Effectiveness Against Coronavirus Disease 2019 Hospitalization Among Solid Organ Transplant Recipients
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Jennie H Kwon, Mark W Tenforde, Manjusha Gaglani, H Keipp Talbot, Adit A Ginde, Tresa McNeal, Shekhar Ghamande, David J Douin, Jonathan D Casey, Nicholas M Mohr, Anne Zepeski, Nathan I Shapiro, Kevin W Gibbs, D Clark Files, David N Hager, Arber Shehu, Matthew E Prekker, Sean D Caspers, Matthew C Exline, Mena Botros, Michelle N Gong, Alex Li, Amira Mohamed, Nicholas J Johnson, Vasisht Srinivasan, Jay S Steingrub, Ithan D Peltan, Samuel M Brown, Emily T Martin, Akram Khan, Catherine L Hough, Laurence W Busse, Abhijit Duggal, Jennifer G Wilson, Cynthia Perez, Steven Y Chang, Christopher Mallow, Randal Rovinski, Hilary M Babcock, Adam S Lauring, Laura Felley, Natasha Halasa, James D Chappell, Carlos G Grijalva, Todd W Rice, Kelsey N Womack, Christopher J Lindsell, Kimberly W Hart, Adrienne Baughman, Samantha M Olson, Stephanie Schrag, Miwako Kobayashi, Jennifer R Verani, Manish M Patel, and Wesley H Self more...
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Adult ,Hospitalization ,Vaccines, Synthetic ,Infectious Diseases ,Immunology and Allergy ,COVID-19 ,Humans ,Organ Transplantation ,RNA, Messenger ,mRNA Vaccines ,Transplant Recipients - Abstract
Background The study objective was to evaluate 2- and 3-dose coronavirus disease 2019 (COVID-19) mRNA vaccine effectiveness (VE) in preventing COVID-19 hospitalization among adult solid organ transplant (SOT) recipients. Methods We conducted a 21-site case-control analysis of 10 425 adults hospitalized in March to December 2021. Cases were hospitalized with COVID-19; controls were hospitalized for an alternative diagnosis (severe acute respiratory syndrome coronavirus 2-negative). Participants were classified as follows: SOT recipient (n = 440), other immunocompromising condition (n = 1684), or immunocompetent (n = 8301). The VE against COVID-19-associated hospitalization was calculated as 1-adjusted odds ratio of prior vaccination among cases compared with controls. Results Among SOT recipients, VE was 29% (95% confidence interval [CI], −19% to 58%) for 2 doses and 77% (95% CI, 48% to 90%) for 3 doses. Among patients with other immunocompromising conditions, VE was 72% (95% CI, 64% to 79%) for 2 doses and 92% (95% CI, 85% to 95%) for 3 doses. Among immunocompetent patients, VE was 88% (95% CI, 87% to 90%) for 2 doses and 96% (95% CI, 83% to 99%) for 3 doses. Conclusions Effectiveness of COVID-19 mRNA vaccines was lower for SOT recipients than immunocompetent adults and those with other immunocompromising conditions. Among SOT recipients, vaccination with 3 doses of an mRNA vaccine led to substantially greater protection than 2 doses. more...
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- 2022
21. Association Between mRNA Vaccination and COVID-19 Hospitalization and Disease Severity
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Amira Mohamed, Catherine L. Hough, Manjusha Gaglani, Nathan I. Shapiro, Samantha M. Olson, Abhijit Duggal, Arber Shehu, Manish M. Patel, Kimberly W. Hart, Laurence W. Busse, William B Stubblefield, Emily T. Martin, Ithan D. Peltan, Caitlin C Ten Lohuis, Kevin W Gibbs, Jillian P. Rhoads, Mark W Tenforde, Tresa McNeal, Miwako Kobayashi, Jennifer G. Wilson, Christopher J. Lindsell, Alexandra June Gordon, Kelsey N Womack, Steven Y. Chang, Jay S. Steingrub, Samuel M. Brown, Anne Zepeski, Carolina Rivas, Daniel J. Henning, Jennie H. Kwon, Christopher Mallow, Michelle N. Gong, Shekhar Ghamande, Todd W. Rice, Adrienne Baughman, Influenza, Jennifer R. Verani, Arnold S. Monto, Nida Qadir, James D. Chappell, Akram Khan, Nicholas M. Mohr, Natasha B. Halasa, H. Keipp Talbot, Hilary M. Babcock, David J. Douin, Yuwei Zhu, Carlos G. Grijalva, Matthew E. Prekker, Wesley H. Self, D. Clark Files, David N. Hager, Katherine Adams, Adam S. Lauring, Ian Jones, Matthew C. Exline, Heidi L Erickson, Jonathan D Casey, and Adit A. Ginde more...
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Adult ,Male ,medicine.medical_specialty ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,medicine.medical_treatment ,Disease ,Logistic regression ,Severity of Illness Index ,Disease severity ,Internal medicine ,Severity of illness ,medicine ,Humans ,RNA, Messenger ,BNT162 Vaccine ,Aged ,Original Investigation ,Mechanical ventilation ,business.industry ,SARS-CoV-2 ,Disease progression ,Vaccination ,COVID-19 ,General Medicine ,Middle Aged ,Respiration, Artificial ,Hospitalization ,Case-Control Studies ,Disease Progression ,Female ,business ,2019-nCoV Vaccine mRNA-1273 - Abstract
IMPORTANCE: A comprehensive understanding of the benefits of COVID-19 vaccination requires consideration of disease attenuation, determined as whether people who develop COVID-19 despite vaccination have lower disease severity than unvaccinated people. OBJECTIVE: To evaluate the association between vaccination with mRNA COVID-19 vaccines—mRNA-1273 (Moderna) and BNT162b2 (Pfizer-BioNTech)—and COVID-19 hospitalization, and, among patients hospitalized with COVID-19, the association with progression to critical disease. DESIGN, SETTING, AND PARTICIPANTS: A US 21-site case-control analysis of 4513 adults hospitalized between March 11 and August 15, 2021, with 28-day outcome data on death and mechanical ventilation available for patients enrolled through July 14, 2021. Date of final follow-up was August 8, 2021. EXPOSURES: COVID-19 vaccination. MAIN OUTCOMES AND MEASURES: Associations were evaluated between prior vaccination and (1) hospitalization for COVID-19, in which case patients were those hospitalized for COVID-19 and control patients were those hospitalized for an alternative diagnosis; and (2) disease progression among patients hospitalized for COVID-19, in which cases and controls were COVID-19 patients with and without progression to death or mechanical ventilation, respectively. Associations were measured with multivariable logistic regression. RESULTS: Among 4513 patients (median age, 59 years [IQR, 45-69]; 2202 [48.8%] women; 23.0% non-Hispanic Black individuals, 15.9% Hispanic individuals, and 20.1% with an immunocompromising condition), 1983 were case patients with COVID-19 and 2530 were controls without COVID-19. Unvaccinated patients accounted for 84.2% (1669/1983) of COVID-19 hospitalizations. Hospitalization for COVID-19 was significantly associated with decreased likelihood of vaccination (cases, 15.8%; controls, 54.8%; adjusted OR, 0.15; 95% CI, 0.13-0.18), including for sequenced SARS-CoV-2 Alpha (8.7% vs 51.7%; aOR, 0.10; 95% CI, 0.06-0.16) and Delta variants (21.9% vs 61.8%; aOR, 0.14; 95% CI, 0.10-0.21). This association was stronger for immunocompetent patients (11.2% vs 53.5%; aOR, 0.10; 95% CI, 0.09-0.13) than immunocompromised patients (40.1% vs 58.8%; aOR, 0.49; 95% CI, 0.35-0.69) (P more...
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- 2021
22. Coronavirus disease 2019 (COVID-19) vaccination preparedness policies in US hospitals
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Thomas R. Talbot, Susan E. Beekmann, Philip M. Polgreen, Mark S. Rasnake, and Hilary M. Babcock
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Microbiology (medical) ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,Epidemiology ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Vaccination ,Concise Communication ,COVID-19 ,Hospitals ,Policy ,Infectious Diseases ,Infectious disease (medical specialty) ,Family medicine ,Preparedness ,Humans ,Medicine ,business - Abstract
We surveyed infectious disease specialists about early coronavirus disease 2019 (COVID-19) vaccination preparedness. Almost all responding institutions rated their facility’s preparedness plan as either excellent or adequate. Vaccine hesitancy and concern about adverse reactions were the most commonly anticipated barriers to COVID-19 vaccination. Only 60% believed that COVID-19 vaccination should be mandatory. more...
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- 2021
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23. Multiplatform Assessment of Saliva for SARS-CoV-2 Molecular Detection in Symptomatic Healthcare Personnel and Patients Presenting to the Emergency Department
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Eric M. Ransom, Caitlin Johnson, Hilary M. Babcock, Carey-Ann D. Burnham, Neil W. Anderson, Charles S. Eby, Meghan A. Wallace, Robert F. Potter, Bijal A. Parikh, and Jennie H. Kwon
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2019-20 coronavirus outbreak ,Saliva ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Article ,Specimen Handling ,stomatognathic system ,Internal medicine ,Nasopharynx ,Medicine ,Humans ,University medical ,Cycle threshold ,business.industry ,SARS-CoV-2 ,COVID-19 ,General Medicine ,Emergency department ,AcademicSubjects/SCI01290 ,AcademicSubjects/MED00530 ,AcademicSubjects/SCI00980 ,business ,Emergency Service, Hospital ,Delivery of Health Care ,AcademicSubjects/MED00690 - Abstract
Background Saliva has garnered great interest as an alternative specimen type for molecular detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Data are limited on the relative performance of different molecular methods using saliva specimens and the relative sensitivity of saliva to nasopharyngeal (NP) swabs. Methods To address the gap in knowledge, we enrolled symptomatic healthcare personnel (n = 250) from Barnes-Jewish Hospital/Washington University Medical Center and patients presenting to the Emergency Department with clinical symptoms compatible with coronavirus disease 2019 (COVID-19; n = 292). We collected paired saliva specimens and NP swabs. The Lyra SARS-CoV-2 assay (Quidel) was evaluated on paired saliva and NP samples. Subsequently we compared the Simplexa COVID-19 Direct Kit (Diasorin) and a modified SalivaDirect (Yale) assay on a subset of positive and negative saliva specimens. Results The positive percent agreement (PPA) between saliva and NP samples using the Lyra SARS-CoV-2 assay was 63.2%. Saliva samples had higher SARS-CoV-2 cycle threshold values compared to NP swabs (P Conclusion These data demonstrate molecular assays have variability in performance for detection of SARS-CoV-2 in saliva. more...
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- 2021
24. A Comparison of Aerosol Mitigation Strategies and Aerosol Persistence in Dental Environments
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Martin H. Thornhill, Pratim Biswas, Peter B. Lockhart, Daniel C. Stoeckel, Stephen Y. Liang, Heidi M. Steinkamp, Shruti Choudhary, Hilary M. Babcock, Jennie H. Kwon, and Michael J. Durkin
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Dental clinic ,business.industry ,Vantage point ,Slow speed ,Dentistry ,Environmental science ,Evacuators ,Routine clinical practice ,Particulates ,business ,complex mixtures ,Routine care ,Aerosol - Abstract
ObjectivesTo determine the impact of various aerosol mitigation interventions and establish duration of aerosol persistence in a variety of dental clinic configurations.MethodsWe performed aerosol measurement studies in endodontic, orthodontic, periodontic, pediatric, and general dentistry clinics. We used an optical aerosol spectrometer and wearable particulate matter sensors to measure real-time aerosol concentration from the vantage point of the dentist during routine care in a variety of clinic configurations (e.g, open bay, single room, partitioned operatories). We compared the impact of aerosol mitigation strategies [ventilation and high-volume evacuation (HVE)] and prevalence of particulate matter in the dental clinic environment before, during and after high-speed drilling, slow speed drilling and ultrasonic scaling procedures.ResultsConical and ISOVAC® HVE were superior to standard tip evacuation for aerosol-generating procedures. When aerosols were detected in the environment, they were rapidly dispersed within minutes of completing the aerosol-generating procedure. Few aerosols were detected in dental clinics – regardless of configuration – when conical and ISOVAC® HVE were used.ConclusionsDentists should consider using conical or ISOVAC® HVE rather than standard tip evacuators to reduce aerosols generated during routine clinical practice. Furthermore, when such effective aerosol mitigation strategies are employed, dentists need not leave dental chairs fallow between patients as aerosols are rapidly dispersed.Clinical SignificanceISOVAC® HVE is highly effective in reducing aerosol emissions, with adequate ventilation and HVE use, dental fallow time can be reduced to 5 minutes. more...
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- 2021
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25. Whither immunity? The search for effective, durable immunity to coronavirus disease 2019 (COVID-19)
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Corey A. Forde, Trevor C. Van Schooneveld, Clare Rock, David J. Weber, Mary K. Hayden, A. Rekha Murthy, Sharon B. Wright, Latania K. Logan, David K. Henderson, Judith A. Guzman-Cottrill, Sarah Haessler, Anurag N. Malani, and Hilary M. Babcock more...
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Microbiology (medical) ,Immunity, Cellular ,2019-20 coronavirus outbreak ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,SARS-CoV-2 ,Epidemiology ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,COVID-19 ,Virology ,State of the Pandemic Commentary ,Immunity, Humoral ,Disease Models, Animal ,Infectious Diseases ,Drug Development ,Immunity ,Animals ,Humans ,Medicine ,business - Published
- 2020
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26. Reported variability in healthcare facility policies regarding healthcare personnel working while experiencing influenza-like illnesses: An emerging infections network survey
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David T. Kuhar, Angela P Campbell, Scott Santibanez, Satish K. Pillai, Leslie Lee, Susan E. Beekmann, Hilary M. Babcock, Philip M. Polgreen, and Anita Patel
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Microbiology (medical) ,medicine.medical_specialty ,Epidemiology ,Health Personnel ,MEDLINE ,Article ,03 medical and health sciences ,0302 clinical medicine ,Emerging infections ,Physicians ,Surveys and Questionnaires ,Influenza, Human ,Health care ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Enforcement ,030505 public health ,business.industry ,Health Policy ,virus diseases ,Presenteeism ,United States ,Infectious Diseases ,Work (electrical) ,Influenza Vaccines ,Family medicine ,Tracking (education) ,0305 other medical science ,business - Abstract
Background:Presenteeism, or working while ill, by healthcare personnel (HCP) experiencing influenza-like illness (ILI) puts patients and coworkers at risk. However, hospital policies and practices may not consistently facilitate HCP staying home when ill.Objective and methods:We conducted a mixed-methods survey in March 2018 of Emerging Infections Network infectious diseases physicians, describing institutional experiences with and policies for HCP working with ILI.Results:Of 715 physicians, 367 (51%) responded. Of 367, 135 (37%) were unaware of institutional policies. Of the remaining 232 respondents, 206 (89%) reported institutional policies regarding work restrictions for HCP with influenza or ILI, but only 145 (63%) said these were communicated at least annually. More than half of respondents (124, 53%) reported that adherence to work restrictions was not monitored or enforced. Work restrictions were most often not perceived to be enforced for physicians-in-training and attending physicians. Nearly all (223, 96%) reported that their facility tracked laboratory-confirmed influenza (LCI) in patients; 85 (37%) reported tracking ILI. For employees, 109 (47%) reported tracking of LCI and 53 (23%) reported tracking ILI. For independent physicians, not employed by the facility, 30 (13%) reported tracking LCI and 11 (5%) ILI.Conclusion:More than one-third of respondents were unaware of whether their institutions had policies to prevent HCP with ILI from working; among those with knowledge of institutional policies, dissemination, monitoring, and enforcement of these policies was highly variable. Improving communication about work-restriction policies, as well as monitoring and enforcement, may help prevent the spread of infections from HCP to patients. more...
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- 2019
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27. Respiratory viral surveillance of healthcare personnel and patients at an adult long-term care facility
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Nimalie D. Stone, Suxiang Tong, Shikha Garg, Mila M. Prill, Senthilkumar K. Sakthivel, Hilary M. Babcock, H. Keipp Talbot, Brett Whitaker, Caroline A O'Neil, Yange Zhang, Lindsay Kim, Susan I. Gerber, and Jing Zhang more...
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Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Epidemiology ,Health Personnel ,030106 microbiology ,03 medical and health sciences ,0302 clinical medicine ,Absenteeism ,Influenza, Human ,Health care ,Humans ,Medicine ,030212 general & internal medicine ,Respiratory system ,Respiratory Tract Infections ,Aged ,Respiratory illness ,business.industry ,Middle Aged ,Long-Term Care ,respiratory tract diseases ,Care facility ,Long-term care ,Infectious Diseases ,Influenza Vaccines ,Virus Diseases ,Epidemiological Monitoring ,Emergency medicine ,Female ,Seasons ,business - Abstract
We conducted active surveillance of acute respiratory viral infections (ARIs) among residents and healthcare personnel (HCP) at a long-term care facility during the 2015–2016 respiratory illness season. ARIs were observed among both HCP and patients, highlighting the importance of including HCP in surveillance programs. more...
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- 2019
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28. Effectiveness of SARS-CoV-2 mRNA Vaccines for Preventing Covid-19 Hospitalizations in the United States
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Wesley H. Self, Jennifer R. Verani, Caitlin C Ten Lohuis, Abhijit Duggal, Hayley B. Gershengorn, Matthew E. Prekker, Natasha B. Halasa, Laurence W. Busse, Christopher J. Lindsell, Samuel M. Brown, Ian Jones, Christopher Mallow, Emily T. Martin, Adrienne Baughman, Akram Khan, Amira Mohamed, Kevin W Gibbs, Ithan D. Peltan, Tresa McNeal, Carlos G. Grijalva, Miwako Kobayashi, Arber Shehu, Shekhar Ghamande, Adam S. Lauring, Matthew C. Exline, Jonathan D Casey, William B Stubblefield, Jennifer G. Wilson, Alexandra June Gordon, Jennie H. Kwon, Michelle N. Gong, Todd W. Rice, Kelsey N Womack, Steven Y. Chang, Adit A. Ginde, Daniel J. Henning, Heidi L Erickson, Nathan I. Shapiro, D. Clark Files, David N. Hager, Samantha M. Olson, Stephanie J. Schrag, H. Keipp Talbot, Anne Zepeski, Mark W Tenforde, David J. Douin, Influenza, Yuwei Zhu, Nicholas M. Mohr, Manish M. Patel, Kimberly W. Hart, Jay S. Steingrub, Meagan Stephenson, Manjusha Gaglani, C Terri Hough, Arnold S. Monto, Nida Qadir, James D. Chappell, and Hilary M. Babcock more...
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medicine.medical_specialty ,education.field_of_study ,2019-20 coronavirus outbreak ,vaccine effectiveness ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,medicine.medical_treatment ,Population ,COVID-19 ,Immunosuppression ,Vaccination ,mRNA vaccines ,immunocompromised ,AcademicSubjects/MED00290 ,Increased risk ,Internal medicine ,Vaccination coverage ,Major Article ,Medicine ,business ,education ,hospitalized - Abstract
BackgroundAs SARS-CoV-2 vaccination coverage increases in the United States (US), there is a need to understand the real-world effectiveness against severe Covid-19 and among people at increased risk for poor outcomes.MethodsIn a multicenter case-control analysis of US adults hospitalized March 11 - May 5, 2021, we evaluated vaccine effectiveness to prevent Covid-19 hospitalizations by comparing odds of prior vaccination with an mRNA vaccine (Pfizer-BioNTech or Moderna) between cases hospitalized with Covid-19 and hospital-based controls who tested negative for SARS-CoV-2.ResultsAmong 1210 participants, median age was 58 years, 22.8% were Black, 13.8% were Hispanic, and 20.6% had immunosuppression. SARS-CoV-2 lineage B.1.1.7 was most common variant (59.7% of sequenced viruses). Full vaccination (receipt of two vaccine doses ≥14 days before illness onset) had been received by 45/590 (7.6%) cases and 215/620 (34.7%) controls. Overall vaccine effectiveness was 86.9% (95% CI: 80.4 to 91.2%). Vaccine effectiveness was similar for Pfizer-BioNTech and Moderna vaccines, and highest in adults aged 18-49 years (97.3%; 95% CI: 78.9 to 99.7%). Among 45 patients with vaccine-breakthrough Covid hospitalizations, 44 (97.8%) were ≥50 years old and 20 (44.4%) had immunosuppression. Vaccine effectiveness was lower among patients with immunosuppression (59.2%; 95% CI: 11.9 to 81.1%) than without immunosuppression (91.3%; 95% CI: 85.5 to 94.7%).ConclusionDuring March–May 2021, SARS-CoV-2 mRNA vaccines were highly effective for preventing Covid-19 hospitalizations among US adults. SARS-CoV-2 vaccination was beneficial for patients with immunosuppression, but effectiveness was lower in the immunosuppressed population. more...
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- 2021
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29. Effectiveness of Severe Acute Respiratory Syndrome Coronavirus 2 Messenger RNA Vaccines for Preventing Coronavirus Disease 2019 Hospitalizations in the United States
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Mark W, Tenforde, Manish M, Patel, Adit A, Ginde, David J, Douin, H Keipp, Talbot, Jonathan D, Casey, Nicholas M, Mohr, Anne, Zepeski, Manjusha, Gaglani, Tresa, McNeal, Shekhar, Ghamande, Nathan I, Shapiro, Kevin W, Gibbs, D Clark, Files, David N, Hager, Arber, Shehu, Matthew E, Prekker, Heidi L, Erickson, Matthew C, Exline, Michelle N, Gong, Amira, Mohamed, Daniel J, Henning, Jay S, Steingrub, Ithan D, Peltan, Samuel M, Brown, Emily T, Martin, Arnold S, Monto, Akram, Khan, Catherine L, Hough, Laurence W, Busse, Caitlin C, Ten Lohuis, Abhijit, Duggal, Jennifer G, Wilson, Alexandra June, Gordon, Nida, Qadir, Steven Y, Chang, Christopher, Mallow, Hayley B, Gershengorn, Hilary M, Babcock, Jennie H, Kwon, Natasha, Halasa, James D, Chappell, Adam S, Lauring, Carlos G, Grijalva, Todd W, Rice, Ian D, Jones, William B, Stubblefield, Adrienne, Baughman, Kelsey N, Womack, Christopher J, Lindsell, Kimberly W, Hart, Yuwei, Zhu, Samantha M, Olson, Meagan, Stephenson, Stephanie J, Schrag, Miwako, Kobayashi, Jennifer R, Verani, and Wesley H, Self more...
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Microbiology (medical) ,Adult ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,medicine.medical_treatment ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Population ,Internal medicine ,Medicine ,Humans ,education ,education.field_of_study ,business.industry ,SARS-CoV-2 ,COVID-19 ,Immunosuppression ,Middle Aged ,United States ,Vaccination ,Hospitalization ,Infectious Diseases ,Increased risk ,Vaccination coverage ,RNA ,mRNA Vaccines ,business - Abstract
Background As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination coverage increases in the United States, there is a need to understand the real-world effectiveness against severe coronavirus disease 2019 (COVID-19) and among people at increased risk for poor outcomes. Methods In a multicenter case-control analysis of US adults hospitalized March 11–May 5, 2021, we evaluated vaccine effectiveness to prevent COVID-19 hospitalizations by comparing odds of prior vaccination with a messenger RNA (mRNA) vaccine (Pfizer-BioNTech or Moderna) between cases hospitalized with COVID-19 and hospital-based controls who tested negative for SARS-CoV-2. Results Among 1212 participants, including 593 cases and 619 controls, median age was 58 years, 22.8% were Black, 13.9% were Hispanic, and 21.0% had immunosuppression. SARS-CoV-2 lineage B0.1.1.7 (Alpha) was the most common variant (67.9% of viruses with lineage determined). Full vaccination (receipt of 2 vaccine doses ≥14 days before illness onset) had been received by 8.2% of cases and 36.4% of controls. Overall vaccine effectiveness was 87.1% (95% confidence interval [CI], 80.7–91.3). Vaccine effectiveness was similar for Pfizer-BioNTech and Moderna vaccines, and highest in adults aged 18–49 years (97.4%; 95% CI, 79.3–9.7). Among 45 patients with vaccine-breakthrough COVID hospitalizations, 44 (97.8%) were ≥50 years old and 20 (44.4%) had immunosuppression. Vaccine effectiveness was lower among patients with immunosuppression (62.9%; 95% CI,20.8–82.6) than without immunosuppression (91.3%; 95% CI, 85.6–94.8). Conclusion During March–May 2021, SARS-CoV-2 mRNA vaccines were highly effective for preventing COVID-19 hospitalizations among US adults. SARS-CoV-2 vaccination was beneficial for patients with immunosuppression, but effectiveness was lower in the immunosuppressed population. more...
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- 2021
30. Interim Estimates of Vaccine Effectiveness of Pfizer-BioNTech and Moderna COVID-19 Vaccines Among Health Care Personnel - 33 U.S. Sites, January-March 2021
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Kaytlynn Marceaux-Galli, Ryan Gierke, Katherine E. Fleming-Dutra, Nicholas M. Mohr, Rebecca Pierce, Joelle Nadle, Gregory J. Moran, Jeanmarie Mayer, Brian Chinnock, Elizabeth Krebs, Daniel J. Henning, Monica Brackney, Walter A. Schrading, Erin C Phipps, Karisa K. Harland, Jennifer L. Farrar, David G. Beiser, Tiffanie M. Markus, Shelley S. Magill, Anusha Krishnadasan, John P. Haran, Marc Fischer, Rosalyn J. Singleton, Michael Lin, Nasia Safdar, Frank LoVecchio, Stephanie J. Schrag, Devra Barter, Mark P. Steele, Stephen C. Lim, Deverick J. Anderson, Jennifer R. Verani, Amber Britton, Brett A. Faine, Lilly C. Lee, Peter C. Hou, Tamara Pilishvili, Amanda K. Debes, David A. Talan, Hilary M. Babcock, Utsav Nandi, Sarah Lim, Howard A. Smithline, Ghinwa Dumyati, and Nora Chea more...
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Health (social science) ,COVID-19 Vaccines ,Epidemiology ,Health, Toxicology and Mutagenesis ,Health Personnel ,Population ,01 natural sciences ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,COVID-19 Testing ,Health Information Management ,Interim ,Health care ,Pandemic ,medicine ,Humans ,030212 general & internal medicine ,Full Report ,0101 mathematics ,education ,Immunization Schedule ,Aged ,education.field_of_study ,business.industry ,010102 general mathematics ,Case-control study ,COVID-19 ,General Medicine ,Middle Aged ,Confidence interval ,United States ,Vaccination ,Clinical trial ,Occupational Diseases ,Case-Control Studies ,Female ,business - Abstract
Throughout the COVID-19 pandemic, health care personnel (HCP) have been at high risk for exposure to SARS-CoV-2, the virus that causes COVID-19, through patient interactions and community exposure (1). The Advisory Committee on Immunization Practices recommended prioritization of HCP for COVID-19 vaccination to maintain provision of critical services and reduce spread of infection in health care settings (2). Early distribution of two mRNA COVID-19 vaccines (Pfizer-BioNTech and Moderna) to HCP allowed assessment of the effectiveness of these vaccines in a real-world setting. A test-negative case-control study is underway to evaluate mRNA COVID-19 vaccine effectiveness (VE) against symptomatic illness among HCP at 33 U.S. sites across 25 U.S. states. Interim analyses indicated that the VE of a single dose (measured 14 days after the first dose through 6 days after the second dose) was 82% (95% confidence interval [CI] = 74%-87%), adjusted for age, race/ethnicity, and underlying medical conditions. The adjusted VE of 2 doses (measured ≥7 days after the second dose) was 94% (95% CI = 87%-97%). VE of partial (1-dose) and complete (2-dose) vaccination in this population is comparable to that reported from clinical trials and recent observational studies, supporting the effectiveness of mRNA COVID-19 vaccines against symptomatic disease in adults, with strong 2-dose protection. more...
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- 2021
31. Local, state and federal face mask mandates during the COVID-19 pandemic
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Trevor C. Van Schooneveld, Corey A. Forde, Sharon B. Wright, Sarah Haessler, Clare Rock, Hilary M. Babcock, Mary K. Hayden, Rekha Murthy, Latania K. Logan, Judith A. Guzman-Cottrill, Anurag N. Malani, David J. Weber, and David K. Henderson more...
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Microbiology (medical) ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Epidemiology ,media_common.quotation_subject ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Face (sociological concept) ,Federal Government ,Mandatory Programs ,Public administration ,State (polity) ,Pandemic ,Humans ,Medicine ,media_common ,Local Government ,business.industry ,Masks ,COVID-19 ,United States ,Infectious Diseases ,Local government ,Commentary ,business ,State Government - Published
- 2021
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32. Management of healthcare personnel living with hepatitis B, hepatitis C, or human immunodeficiency virus in US healthcare institutions
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Neil O. Fishman, Valerie M. Deloney, David J. Weber, Tammy Lundstrom, E. Patchen Dellinger, Costi D. Sifri, Carlos del Rio, Hilary M. Babcock, Louise-Marie Dembry, Tara N. Palmore, Theo Heller, David K. Henderson, Christine Grady, and Deborah S. Yokoe more...
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Microbiology (medical) ,Hepatitis B virus ,Epidemiology ,business.industry ,Health Personnel ,Human immunodeficiency virus (HIV) ,HIV ,HIV Infections ,Hepatitis C ,Hepacivirus ,Hepatitis B ,medicine.disease_cause ,medicine.disease ,Virology ,Infectious Diseases ,Health care ,medicine ,Humans ,business ,Delivery of Health Care - Published
- 2020
33. Experiences from the Missouri Antimicrobial Stewardship Collaborative: A mixed methods study
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Sena Sayood, Michael J. Durkin, Hilary M. Babcock, Erin C. Rachmiel, Kate Peacock, George Turabelidze, Tracey Habrock-Bach, Kevin Hsueh, Virginia R. McKay, Jason G. Newland, Chinmayi Venkatram, and David K. Warren more...
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Microbiology (medical) ,Medical education ,Missouri ,Scope (project management) ,Epidemiology ,media_common.quotation_subject ,health care facilities, manpower, and services ,education ,MEDLINE ,social sciences ,030501 epidemiology ,Hospitals ,Article ,Anti-Bacterial Agents ,03 medical and health sciences ,Antimicrobial Stewardship ,Infectious Diseases ,Antimicrobial stewardship ,Humans ,Business ,0305 other medical science ,Sophistication ,geographic locations ,media_common - Abstract
We performed a mixed-methods study to evaluate antimicrobial stewardship program (ASP) uptake and to assess variability of program implementation in Missouri hospitals. Despite increasing uptake of ASPs in Missouri, there is wide variability in both the scope and sophistication of these programs. more...
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- 2020
34. Shifting sands—Molecular coronavirus testing during a time of inconsistent resources
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Judith A. Guzman-Cottrill, Anurag N. Malani, Trevor C. Van Schooneveld, Hilary M. Babcock, David J. Weber, Corey A. Forde, David K. Henderson, Latania K. Logan, Mary K. Hayden, A. Rekha Murthy, Sharon B. Wright, Clare Rock, and Sarah Haessler more...
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Microbiology (medical) ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Clinical Laboratory Techniques ,SARS-CoV-2 ,Epidemiology ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,COVID-19 ,Biology ,medicine.disease_cause ,Virology ,United States ,Specimen Handling ,State of the Pandemic Commentary ,Betacoronavirus ,COVID-19 Testing ,Infectious Diseases ,medicine ,Humans ,Coronavirus Infections ,Pandemics ,Coronavirus - Published
- 2020
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35. Influenza Vaccination and Healthcare Personnel Compliance
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Hilary M. Babcock, Sarah Haessler, and Megan C Gallagher
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0301 basic medicine ,Cultural Studies ,Linguistics and Language ,History ,medicine.medical_specialty ,Influenza vaccine ,030106 microbiology ,Healthcare personnel vaccination ,Influenza season ,Language and Linguistics ,03 medical and health sciences ,0302 clinical medicine ,Health care ,Medicine ,In patient ,030212 general & internal medicine ,Intensive care medicine ,business.industry ,Mandatory vaccine policies ,Presenteeism ,New Technologies and Advances in Infections Prevention (A Marra, Section Editor) ,Influenza vaccination ,Masking requirements ,Vaccination ,Anthropology ,Absenteeism ,business - Abstract
Purpose of Review We reviewed the benefit of influenza vaccination in healthcare personnel (HCP), rates of vaccine coverage, and practices used to try to boost vaccine coverage among HCP. Recent Findings Influenza vaccination in HCP provides benefits to both HCP and patients, including reductions in patient morbidity and mortality and decreases in HCP absenteeism. Despite these benefits, influenza vaccine coverage among HCP still falls short of the Healthy People 2020 goal of 90%. As a result, healthcare institutions have used various practices to boost vaccination, including mandatory vaccine policies and requiring non-immunized HCP to wear masks during the influenza season. All of these efforts have been successful at increasing vaccination rates, and employer vaccination requirements have led to rates that meet the Healthy People 2020 goal. Rates of mandatory vaccine policies have increased over time, and several states now have influenza vaccine requirements. However, additional study into how these policies improve patient outcomes is needed. Summary Continued effort is needed to boost influenza vaccination rates among HCP, and mandatory vaccine policies may be used if other methods have not been effective in adequately raising vaccination rates. Future research should focus on how mandatory vaccine policies can improve patient outcomes. more...
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- 2020
36. Clinical severity of, and effectiveness of mRNA vaccines against, covid-19 from omicron, delta, and alpha SARS-CoV-2 variants in the United States: prospective observational study
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Adam S Lauring, Mark W Tenforde, James D Chappell, Manjusha Gaglani, Adit A Ginde, Tresa McNeal, Shekhar Ghamande, David J Douin, H Keipp Talbot, Jonathan D Casey, Nicholas M Mohr, Anne Zepeski, Nathan I Shapiro, Kevin W Gibbs, D Clark Files, David N Hager, Arber Shehu, Matthew E Prekker, Heidi L Erickson, Matthew C Exline, Michelle N Gong, Amira Mohamed, Nicholas J Johnson, Vasisht Srinivasan, Jay S Steingrub, Ithan D Peltan, Samuel M Brown, Emily T Martin, Arnold S Monto, Akram Khan, Catherine L Hough, Laurence W Busse, Caitlin C ten Lohuis, Abhijit Duggal, Jennifer G Wilson, Alexandra June Gordon, Nida Qadir, Steven Y Chang, Christopher Mallow, Carolina Rivas, Hilary M Babcock, Jennie H Kwon, Natasha Halasa, Carlos G Grijalva, Todd W Rice, William B Stubblefield, Adrienne Baughman, Kelsey N Womack, Jillian P Rhoads, Christopher J Lindsell, Kimberly W Hart, Yuwei Zhu, Katherine Adams, Stephanie J Schrag, Samantha M Olson, Miwako Kobayashi, Jennifer R Verani, Manish M Patel, and Wesley H Self more...
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General Medicine - Abstract
ObjectivesTo characterize the clinical severity of covid-19 associated with the alpha, delta, and omicron SARS-CoV-2 variants among adults admitted to hospital and to compare the effectiveness of mRNA vaccines to prevent hospital admissions related to each variant.DesignCase-control study.Setting21 hospitals across the United States.Participants11 690 adults (≥18 years) admitted to hospital: 5728 with covid-19 (cases) and 5962 without covid-19 (controls). Patients were classified into SARS-CoV-2 variant groups based on viral whole genome sequencing, and, if sequencing did not reveal a lineage, by the predominant circulating variant at the time of hospital admission: alpha (11 March to 3 July 2021), delta (4 July to 25 December 2021), and omicron (26 December 2021 to 14 January 2022).Main outcome measuresVaccine effectiveness calculated using a test negative design for mRNA vaccines to prevent covid-19 related hospital admissions by each variant (alpha, delta, omicron). Among patients admitted to hospital with covid-19, disease severity on the World Health Organization’s clinical progression scale was compared among variants using proportional odds regression.ResultsEffectiveness of the mRNA vaccines to prevent covid-19 associated hospital admissions was 85% (95% confidence interval 82% to 88%) for two vaccine doses against the alpha variant, 85% (83% to 87%) for two doses against the delta variant, 94% (92% to 95%) for three doses against the delta variant, 65% (51% to 75%) for two doses against the omicron variant; and 86% (77% to 91%) for three doses against the omicron variant. In-hospital mortality was 7.6% (81/1060) for alpha, 12.2% (461/3788) for delta, and 7.1% (40/565) for omicron. Among unvaccinated patients with covid-19 admitted to hospital, severity on the WHO clinical progression scale was higher for the delta versus alpha variant (adjusted proportional odds ratio 1.28, 95% confidence interval 1.11 to 1.46), and lower for the omicron versus delta variant (0.61, 0.49 to 0.77). Compared with unvaccinated patients, severity was lower for vaccinated patients for each variant, including alpha (adjusted proportional odds ratio 0.33, 0.23 to 0.49), delta (0.44, 0.37 to 0.51), and omicron (0.61, 0.44 to 0.85).ConclusionsmRNA vaccines were found to be highly effective in preventing covid-19 associated hospital admissions related to the alpha, delta, and omicron variants, but three vaccine doses were required to achieve protection against omicron similar to the protection that two doses provided against the delta and alpha variants. Among adults admitted to hospital with covid-19, the omicron variant was associated with less severe disease than the delta variant but still resulted in substantial morbidity and mortality. Vaccinated patients admitted to hospital with covid-19 had significantly lower disease severity than unvaccinated patients for all the variants. more...
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- 2022
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37. Readmissions With Multidrug-Resistant Infection in Patients With Prior Multidrug Resistant Infection
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Jennie H. Kwon, Marin H. Kollef, Margaret A. Olsen, Hilary M. Babcock, and Jason P. Burnham
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Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Epidemiology ,030106 microbiology ,Comorbidity ,Kaplan-Meier Estimate ,Drug resistance ,medicine.disease_cause ,Patient Readmission ,Article ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Drug Resistance, Multiple, Bacterial ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Gram-Positive Bacterial Infections ,APACHE ,Aged ,Retrospective Studies ,Aged, 80 and over ,Academic Medical Centers ,Cross Infection ,Missouri ,medicine.diagnostic_test ,biology ,Pseudomonas aeruginosa ,business.industry ,Incidence ,Incidence (epidemiology) ,Retrospective cohort study ,Middle Aged ,Acinetobacter ,biology.organism_classification ,medicine.disease ,Infectious Diseases ,Bronchoalveolar lavage ,Staphylococcus aureus ,Female ,Gram-Negative Bacterial Infections ,business - Abstract
OBJECTIVETo determine incidence of and risk factors for readmissions with multidrug-resistant organism (MDRO) infections among patients with previous MDRO infection.DESIGNRetrospective cohort of patients admitted between January 1, 2006, and October 1, 2015.SETTINGBarnes-Jewish Hospital, a 1,250-bed academic tertiary referral center in St Louis, Missouri.METHODSWe identified patients with MDROs obtained from the bloodstream, bronchoalveolar lavage (BAL)/bronchial wash, or other sterile sites. Centers for Disease Control and prevention (CDC) and European CDC definitions of MDROs were utilized. All readmissions ≤1 year from discharge from the index MDRO hospitalization were evaluated for bloodstream, BAL/bronchial wash, or other sterile site cultures positive for the same or different MDROs.RESULTSIn total, 4,429 unique patients had a positive culture for an MDRO; 3,453 of these (78.0%) survived the index hospitalization. Moreover, 2,127 patients (61.6%) were readmitted ≥1 time within a year, for a total of 5,849 readmissions. Furthermore, 512 patients (24.1%) had the same or a different MDRO isolated from blood, BAL/bronchial wash, or another sterile site during a readmission. Bone marrow transplant, end-stage renal disease, lymphoma, methicillin-resistant Staphylococcus aureus, or carbapenem-resistant Pseudomonas aeruginosa during index hospitalization were factors associated with increased risk of having an MDRO isolated during a readmission. MDROs isolated during readmissions were in the same class of MDRO as the index hospitalization 9%–78% of the time, with variation by index pathogen.CONCLUSIONSReadmissions among patients with MDRO infections are frequent. Various patient and organism factors predispose to readmission. When readmitted patients had an MDRO, it was often a pathogen in the same class as that isolated during the index admission, with the exception of Acinetobacter (~9%).Infect Control Hosp Epidemiol 2018;39:12–19 more...
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- 2017
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38. Preventing Respiratory Viral Transmission in Long-Term Care: Knowledge, Attitudes, and Practices of Healthcare Personnel
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Nimalie D. Stone, Shikha Garg, H. Keipp Talbot, Hilary M. Babcock, Caroline A O'Neil, Lindsay Kim, and Mila M. Prill
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Male ,Microbiology (medical) ,Health Knowledge, Attitudes, Practice ,Epidemiology ,Influenza vaccine ,Health Personnel ,Psychological intervention ,030501 epidemiology ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Influenza, Human ,Health care ,medicine ,Humans ,Infection control ,030212 general & internal medicine ,Response rate (survey) ,Infection Control ,Missouri ,business.industry ,Vaccination ,medicine.disease ,Long-Term Care ,Long-term care ,Infectious Diseases ,Influenza Vaccines ,Sick leave ,Female ,Medical emergency ,0305 other medical science ,business - Abstract
OBJECTIVETo examine knowledge and attitudes about influenza vaccination and infection prevention practices among healthcare personnel (HCP) in a long-term-care (LTC) setting.DESIGNKnowledge, attitudes, and practices (KAP) survey.SETTINGAn LTC facility in St Louis, Missouri.PARTICIPANTSAll HCP working at the LTC facility were eligible to participate, regardless of department or position. Of 170 full- and part-time HCP working at the facility, 73 completed the survey, a 42.9% response rate.RESULTSMost HCP agreed that respiratory viral infections were serious and that hand hygiene and face mask use were protective. However, only 46% could describe the correct transmission-based precautions for an influenza patient. Correctly answering infection prevention knowledge questions did not vary by years of experience but did vary for HCP with more direct patient contact versus less patient contact. Furthermore, 42% of respondents reported working while sick, and 56% reported that their coworkers did. In addition, 54% reported that facility policies made staying home while ill difficult. Some respondents expressed concerns about the safety (22%) and effectiveness (27%) of the influenza vaccine, and 28% of respondents stated that they would not get the influenza vaccine if it was not required.CONCLUSIONSThis survey of staff in an LTC facility identified several areas for policy improvement, particularly sick leave, as well as potential targets for interventions to improve infection prevention knowledge and to address HCP concerns about influenza vaccination to improve HCP vaccination rates in LTCs.Infect Control Hosp Epidemiol 2017;38:1449–1456 more...
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- 2017
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39. Comparing the performance of 3 bioaerosol samplers for influenza virus
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Yang Wang, Pratim Biswas, Meghan A. Wallace, Carey-Ann D. Burnham, Anna Leavey, Jiayu Li, Adrianus C. M. Boon, Hilary M. Babcock, and Caroline A O'Neil
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0301 basic medicine ,Atmospheric Science ,Environmental Engineering ,food.ingredient ,Glass fiber filter ,030106 microbiology ,Analytical chemistry ,010501 environmental sciences ,01 natural sciences ,Gelatin ,Article ,03 medical and health sciences ,Gelatin filter ,food ,Scanning mobility particle sizer ,0105 earth and related environmental sciences ,Air filter ,Fluid Flow and Transfer Processes ,Chromatography ,Mechanical Engineering ,Physical collection efficiency ,Pollution ,Aerosol ,Virus collection efficiency ,Filter (video) ,Environmental science ,Particle ,SKC BioSampler® ,Particle size ,Bioaerosol - Abstract
Respiratory viral diseases can be spread when a virus-containing particle (droplet) from one individual is aerosolized and subsequently comes into either direct or indirect contact with another individual. Increasing numbers of studies are examining the occupational risk to healthcare workers due to proximity to patients. Selecting the appropriate air sampling method is a critical factor in assuring the analytical performance characteristics of a clinical study. The objective of this study was to compare the physical collection efficiency and virus collection efficiency of a 5 mL compact SKC BioSampler®, a gelatin filter, and a glass fiber filter, in a laboratory setting. The gelatin filter and the glass fiber filter were housed in a home-made filter holder. Submersion (with vortexing and subsequent centrifugation) was used for the gelatin and glass fiber filters. Swabbing method was also tested to retrieve the viruses from the glass fiber filter. Experiments were conducted using the H1N1 influenza A virus A/Puerto Rico/8/1934 (IAV-PR8), and viral recovery was determined using culture and commercial real-time-PCR (BioFire and Xpert). An atomizer was used to aerosolize a solution of influenza virus in PBS for measurement, and two Scanning Mobility Particle Sizers were used to determine particle size distributions. The SKC BioSampler demonstrated a U-shaped physical collection efficiency, lowest for particles around 30–50 nm, and highest at 10 nm and 300–350 nm within the size range examined. The physical collection efficiency of the gelatin filter was strongly influenced by air flow and time: a stable collection across all particle sizes was only observed at 2 L/min for the 9 min sampling time, otherwise, degradation of the filter was observed. The glass fiber filter demonstrated the highest physical collection efficiency (100% for all sizes) of all tested samplers, however, its overall virus recovery efficiency fared the worst (too low to quantify). The highest viral collection efficiencies for the SKC BioSampler and gelatin filter were 5% and 1.5%, respectively. Overall, the SKC BioSampler outperformed the filters. It is important to consider the total concentration of viruses entering the sampler when interpreting the results., Highlights • A 5 mL SKC BioSampler®, gelatin filter, and glass fiber filter were compared in a laboratory. • The physical collection and influenza A viral recovery efficiencies were examined. • The glass fiber filter exhibited 100% physical collection efficiency for all sizes. • The SKC BioSampler® exhibited the highest virus collection efficiency (up to 5%). • All samplers collected only a small fraction of the total atomized viruses. more...
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- 2017
40. Characterization of Aerosols Generated During Patient Care Activities
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Yang Wang, Pratim Biswas, Meghan A. Wallace, Matthew Hink, Hilary M. Babcock, Carey-Ann D. Burnham, Jiayu Li, Anna Leavey, and Caroline A O'Neil
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0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Microbiological culture ,030106 microbiology ,Patient care ,03 medical and health sciences ,0302 clinical medicine ,Bronchoscopy ,Environmental Microbiology ,medicine ,Humans ,Infection control ,Sampling (medicine) ,030212 general & internal medicine ,Particle Size ,Intensive care medicine ,Articles and Commentaries ,Aerosols ,Infection Control ,Bacteria ,medicine.diagnostic_test ,business.industry ,Biological product ,3. Good health ,Aerosol ,Infectious Diseases ,Emergency medicine ,Noninvasive ventilation ,Patient Care ,business ,Environmental Monitoring - Abstract
Background Questions remain about the degree to which aerosols are generated during routine patient care activities and whether such aerosols could transmit viable pathogens to healthcare personnel (HCP). The objective of this study was to measure aerosol production during multiple patient care activities and to examine the samples for bacterial pathogens. Methods Five aerosol characterization instruments were used to measure aerosols during 7 patient care activities: patient bathing, changing bed linens, pouring and flushing liquid waste, bronchoscopy, noninvasive ventilation, and nebulized medication administration (NMA). Each procedure was sampled 5 times. An SKC BioSampler was used for pathogen recovery. Bacterial cultures were performed on the sampling solution. Patients on contact precautions for drug-resistant organisms were selected for most activity sampling. Any patient undergoing bronchoscopy was eligible. Results Of 35 sampling episodes, only 2 procedures showed a significant increase in particle concentrations over baseline: NMA and bronchoscopy with NMA. Bronchoscopy without NMA and noninvasive ventilation did not generate significant aerosols. Of 78 cultures from the impinger samples, 6 of 28 baseline samples (21.4%) and 14 of 50 procedure samples (28.0%) were positive. Conclusions In this study, significant aerosol generation was only observed during NMA, both alone and during bronchoscopy. Minimal viable bacteria were recovered, mostly common environmental organisms. Although more research is needed, these data suggest that some of the procedures considered to be aerosol-generating may pose little infection risk to HCP. more...
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- 2017
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41. Comparative Study on the Size Distributions, Respiratory Deposition, and Transport of Particles Generated from Commonly Used Medical Nebulizers
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Caroline A O'Neil, Hilary M. Babcock, Yang Wang, Anna Leavey, Jiayu Li, and Pratim Biswas
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Pulmonary and Respiratory Medicine ,010504 meteorology & atmospheric sciences ,Analytical chemistry ,Pharmaceutical Science ,010501 environmental sciences ,01 natural sciences ,Drug Delivery Systems ,Administration, Inhalation ,Humans ,Dosimetry ,Tissue Distribution ,Pharmacology (medical) ,Particle Size ,Lung ,0105 earth and related environmental sciences ,Aerosols ,Lung alveolus ,Chemistry ,Nebulizers and Vaporizers ,Mist ,Humidity ,Equipment Design ,Aerosol ,Nebulizer ,Deposition (aerosol physics) ,Particle ,Particle size ,Biomedical engineering - Abstract
Medical nebulizers are widely and conveniently used to deliver medication to the lungs as an inhalable mist; however, the deposition of nebulized particles in the human respiratory system and the transport of the nebulized particles in the environment have not been studied in detail.Five medical nebulizers of three different types (constant output, breath enhanced, and dosimetric) were evaluated. The size distribution functions (SDFs) and respiratory deposition of the particles generated from the nebulizers were characterized. The SDFs were obtained with an aerodynamic particle sizer (APS; TSI, Inc., St. Paul) after data correction, and the respiratory deposition was calculated according to the model developed by the International Commission on Radiological Protection. The evaporation, Brownian diffusion, and convective movement are further calculated based on aerosol properties.The SDFs measured by the APS indicated that most of the generated particles were in the size range of 1-8 μm. The operating pressure and flow rate affected the number-based SDF of the nebulized particles. Although different values of mean aerodynamic diameter (MAD) were obtained for the nebulizers, the mass median aerodynamic diameter did not differ significantly from each other (between 4 and 5 μm). According to calculation, the deposition of particles in the head airways region accounted for the most of the particle mass collected by the respiratory system. Convective movement was the dominant mechanism for the transport of particles in the size ranges investigated. Relative humidity-dependent evaporation can significantly decrease the size of the emitted particles, resulting in a different respiratory deposition pattern such that the amount of particles deposited in the alveolar region is greatly enhanced. Appropriate protection from these particles should be considered for those persons for whom the medication is not intended (e.g., healthcare workers, family members). more...
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- 2017
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42. Validation Methodology of Healthcare-Associated Infection Device Day Denominators When Switching Electronic Medical Records
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Carole Leone, Carol Sykora, Michelle Simkins, Hilary M. Babcock, Kathleen A. Gase, Lan Luong, Christine M. Hoehner, and Rachael Snyders
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Microbiology (medical) ,Healthcare associated infections ,Infectious Diseases ,Epidemiology ,business.industry ,Medical record ,medicine ,Medical emergency ,medicine.disease ,business ,behavioral disciplines and activities - Abstract
Background: From August 2017 to June 2018, 11 hospitals within a large healthcare system switched from multiple different electronic medical records (EMRs) to 1 EMR. At the time of this transition, the NHSN provided guidelines to validate healthcare-associated infection (HAI) denominators when switching from manual denominator collection to electronic denominator collection, but the NHSN did not give guidelines for validation when switching from 1 EMR to another. We aimed to build a validation process to ensure the accuracy of central-line and urinary catheter days reported to the NHSN after switching EMRs. Methods: Our validation process began with a statistical phase followed by a targeted manual validation phase. The statistical phase used 3 prediction methods (linear regression, time series analysis, and statistical process control [SPC] charts) to forecast device days after the EMR switch for units within hospitals. Models were developed using baseline data from the old EMR (January 2015 through the new EMR implementation). Using prespecified criteria for each method to determine discrepancies, we built a decision tree to identify units needing manual validation. Any unit that failed the statistical phase would need to participate in the manual validation phase, using a midnight census and direct visualization of devices. The manual validation process was composed of 14-day blocks. At the end of each block, if manual device days were within ±5% of EMR device days, they were considered validated. Manual validation would be repeated in 14-day blocks until 2 consecutive blocks passed within ±5%. Results: Overall, 157 units were evaluated for urinary catheter days and central-line days. Among them, 143 units passed the statistical validation test for urinary catheter days and 151 passed for central-line days. There was no specific pattern when comparing forecasted versus actual device days. The manual validation process for the 20 failing units (14 urinary catheter and 6 central-line units) is ongoing; preliminary results identified issues with missing nursing documentation in the EMR and with inaccurate manual counting of device days. There were no systematic discrepancies associated with the new EMR. Conclusions: We developed a novel validation process using statistical prediction methods supplemented with a targeted manual process. This process saved resources by identifying the units that need manual validation. Discrepancies were largely related to nursing documentation, which the infection prevention team addressed with additional training.Funding: NoneDisclosures: None more...
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- 2020
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43. Organizational strategies for managing COVID-19 survivors who return for care
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Hilary M. Babcock, Corey A. Forde, Clare Rock, Sarah Haessler, Judith A. Guzman-Cottrill, David K. Henderson, Rekha Murthy, Trevor C. Van Schooneveld, Mary K. Hayden, Anurag N. Malani, Sharon B. Wright, Latania K. Logan, and David J. Weber more...
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Microbiology (medical) ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Epidemiology ,SARS-CoV-2 ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,COVID-19 ,United States ,Infectious Diseases ,COVID-19 Testing ,Practice Guidelines as Topic ,Commentary ,Medicine ,Humans ,Survivors ,Centers for Disease Control and Prevention, U.S ,business ,Intensive care medicine ,Delivery of Health Care - Published
- 2020
44. Partnering with Central Sterile Processing Department Experts to Advance Infection Prevention Competency
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Carol Sykora, Hilary M. Babcock, Rachael Snyders, Carole Leone, and Cassandra A. Sherman
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medicine.medical_specialty ,Epidemiology ,business.industry ,Health Policy ,Best practice ,Public Health, Environmental and Occupational Health ,medicine.disease ,Occupational safety and health ,Subject-matter expert ,Infectious Diseases ,Ambulatory care ,Sterilization (medicine) ,Acute care ,Health care ,medicine ,Infection control ,Medical emergency ,business - Abstract
Background The Central Sterile Processing Department (CSPD) manages the cleaning, disinfection, and sterilization of reprocessed devices and instruments. Infection Preventionists (IP) work closely with CSPD to ensure devices and instruments are reprocessed and stored according to the recommendations of manufacturer, regulatory, and expert guidelines. A large healthcare system surveyed their IP and identified opportunities related to the updated Association for Professionals in Infection Control and Epidemiology (APIC) Competency Model (2019) domains. Cleaning, Disinfection and Sterilization falls under the Operations domain and was identified as an area in which IP wanted to enhance their expertise. Methods IP partnered with CSPD experts throughout the healthcare system to provide an in-depth education workshop to grow IP competency in CSPD. IP within our system are responsible for CSPD in a range of settings, including adult and pediatric acute care, critical access hospitals, ambulatory surgery centers, and over 120 physician offices or outpatient care areas. The workshop was divided into 4 sessions that consisted of oral presentations, hands-on learning, and discussion of examples and real-life scenarios. Manufacturer instructions for use (MIFU) were addressed, and a review of standard work and best practices due to sterilization failures were discussed. Results 32 attendees from 12 settings participated in the workshop, including Infectious Diseases (ID) physicians, IP, Occupational Health (OH) practitioners, and CSPD technicians. Attendees were asked to evaluate the quality of the educational sessions. 20 attendees completed their evaluations. The 4 sessions each received either an Agree (12) or a Strongly Agree (68) approval rating. The overall quality of the program received an Excellent (16) or a Good (4). Conclusions By partnering with CSPD subject matter experts (SME) from their healthcare facilities, IP, ID Physicians and OH Specialists increased their knowledge about the cleaning, disinfection, and sterilization of reusable devices and instruments and enhanced their professional relationships with their CSPD team. more...
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- 2020
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45. The perplexing problem of persistently PCR-positive personnel
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David J. Weber, A. Rekha Murthy, Sharon B. Wright, Sarah Haessler, Hilary M. Babcock, Clare Rock, David K. Henderson, Trevor C. Van Schooneveld, Judith A. Guzman-Cottrill, Corey A. Forde, Anurag N. Malani, Mary K. Hayden, and Latania K. Logan more...
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Microbiology (medical) ,2019-20 coronavirus outbreak ,Infectious Diseases ,Coronavirus disease 2019 (COVID-19) ,Epidemiology ,business.industry ,law ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Medicine ,business ,Virology ,Polymerase chain reaction ,law.invention - Published
- 2020
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46. Assessment of percent positive agreement between fluorescent marker and ATPase for environmental cleaning monitoring during sequential application in an intensive care unit
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Jennifer H. Han, David K. Warren, Emily R Shives, Cdc Prevention Epicenters Program, Hilary M. Babcock, and Jason P Burnham
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genetic structures ,Epidemiology ,ATPase ,Colony Count, Microbial ,Article ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Environmental cleaning ,law ,otorhinolaryngologic diseases ,Humans ,Medicine ,030212 general & internal medicine ,Terminal cleaning ,Fluorescent Dyes ,Adenosine Triphosphatases ,Infection Control ,0303 health sciences ,biology ,030306 microbiology ,business.industry ,Health Policy ,Public Health, Environmental and Occupational Health ,Housekeeping, Hospital ,Fluorescence ,Intensive care unit ,Disinfection ,Intensive Care Units ,Infectious Diseases ,Luminescent Measurements ,biology.protein ,business ,psychological phenomena and processes ,Percent Positive ,Environmental Monitoring ,Biomedical engineering - Abstract
Terminal room cleaning is of critical importance to prevent pathogen transmission, but the optimal cleaning effectiveness assessment modality is still being investigated. We sequentially compared cleanliness assessment agreement between a fluorescent marker and an adenosine triphosphate bioluminescence method, finding no significant differences between modalities. more...
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- 2020
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47. Mission critical partnership for infection prevention success
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Karen K. Hoffmann and Hilary M. Babcock
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Infectious Disease Medicine ,Epidemiology ,business.industry ,Health Policy ,Mission critical ,Public Health, Environmental and Occupational Health ,Medical Missions ,Congresses as Topic ,History, 21st Century ,Infectious Diseases ,Nursing ,General partnership ,Communicable Disease Control ,Infection control ,Medicine ,Humans ,Voluntary Health Agencies ,business ,Societies, Medical - Published
- 2019
48. The Impact of Social Role Identity on Communication in Hospital-Based Antimicrobial Stewardship
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Keith W Hamilton, Ebbing Lautenbach, Brandi M. Muller, Rebekah W. Moehring, Elizabeth Dodds Ashley, Hilary M. Babcock, Nikitha Shankar Shakamuri, Julia E. Szymczak, and Jason G. Newland
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Antimicrobial stewardship ,Identity (social science) ,Social role ,Gender studies ,Sociology ,Hospital based - Abstract
Background: Evidence-based hospital antimicrobial stewardship interventions, such as postprescription review with feedback, prior authorization, and handshake stewardship, involve communication between stewards and frontline prescribers. Hierarchy, asymmetric responsibility, prescribing etiquette, and autonomy can obstruct high-quality communication in stewardship. Little is known about the strategies that stewards use to overcome these barriers. The objective of this study was to identify how stewards navigate communication challenges when interacting with prescribers. Methods: We conducted semistructured interviews with antimicrobial stewards recruited from hospitals across the United States. Interviews were audio recorded, transcribed, and analyzed using a flexible coding approach and the framework method. Social identity theory and role theory were used to interpret framework matrices. Results: Interviews were conducted with 58 antimicrobial stewards (25 physicians and 33 pharmacists) from 10 hospitals (4 academic medical centers, 4 community hospitals, and 2 children’s hospitals). Respondents who felt empowered in their interactions with prescribers explicitly adopted a social identity that conceptualized stewards and prescribers as being on the “same team” with shared goals (in-group orientation). Drawing on the meaning conferred via this social role identity, respondents engaged in communication strategies to build and maintain common bonds with prescribers. These strategies included moderating language to minimize defensive recommendations when delivering stewardship recommendations, aligning the goals of stewardship with the goals of the clinical team, communicating with prescribers about things other than stewardship, compromising for the sake of future interactions, and engaging in strategic face-to-face interaction. Respondents who felt less empowered in their interactions thought of themselves as outsiders to the clinical team and experienced a heightened sense of “us versus them” mentality with the perception that stewards primarily serve a gate-keeping function (ie, outgroup orientation). These respondents expressed deference to hierarchy, a reluctance to engage in face-to-face interaction, a feeling of cynicism about the impact of stewardship, and a sense of low professional accomplishment within the role. Respondents who exhibited an in-group orientation were more likely than those who did not to describe the positive impact of stewardship mentors or colleagues on their social role identity. Conclusions: The way antimicrobial stewards perceive their role and identity within the social context of their healthcare organization influences how they approach communication with prescribers. Social role identity in stewardship is shaped by the influence of mentors and colleagues, indicating the importance of supportive relationships for the development of steward skill and confidence.Funding: NoDisclosures: None more...
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- 2021
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49. Service, science, and fortitude: Our thanks and salute to Dr. Anthony S. Fauci, October 2020
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David K. Henderson, Corey A. Forde, Judith A. Guzman-Cottrill, Mary K. Hayden, Clare Rock, Latania K. Logan, Trevor C. Van Schooneveld, A. Rekha Murthy, David J. Weber, Sharon B. Wright, Sarah Haessler, Hilary M. Babcock, and Anurag N. Malani more...
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Microbiology (medical) ,Service (business) ,2019-20 coronavirus outbreak ,Infectious Diseases ,History ,Coronavirus disease 2019 (COVID-19) ,Epidemiology ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Commentary ,Library science - Published
- 2020
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50. Infectious Diseases Consultation Reduces 30-Day and 1-Year All-Cause Mortality for Multidrug-Resistant Organism Infections
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Hilary M. Babcock, Jennie H. Kwon, Dustin Stwalley, Jason P Burnham, Marin H. Kollef, and Margaret A. Olsen
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0301 basic medicine ,medicine.medical_specialty ,030106 microbiology ,medicine.disease_cause ,infectious diseases consultation ,03 medical and health sciences ,Internal medicine ,Major Article ,Medicine ,multidrug-resistant organisms ,biology ,business.industry ,Proportional hazards model ,Hazard ratio ,Retrospective cohort study ,Acinetobacter ,biology.organism_classification ,Confidence interval ,3. Good health ,Editor's Choice ,Infectious Diseases ,Oncology ,Enterococcus ,Staphylococcus aureus ,Propensity score matching ,business - Abstract
Background Multidrug-resistant organism (MDRO) infections are associated with high mortality and readmission rates. Infectious diseases (ID) consultation improves clinical outcomes for drug-resistant Staphylococcus aureus bloodstream infections. Our goal was to determine the association between ID consultation and mortality following various MDRO infections. Methods This study was conducted with a retrospective cohort (January 1, 2006–October 1, 2015) at an academic tertiary referral center. We identified patients with MDROs in a sterile site or bronchoalveolar lavage/bronchial wash culture. Mortality and readmissions within 1 year of index culture were identified, and the association of ID consultation with these outcomes was determined using Cox proportional hazards models with inverse weighting by the propensity score for ID consultation. Results A total of 4214 patients with MDRO infections were identified. ID consultation was significantly associated with reductions in 30-day and 1-year mortality for resistant S. aureus (hazard ratio [HR], 0.48; 95% confidence interval [CI], 0.36–0.63; and HR, 0.73, 95% CI, 0.61–0.86) and Enterobacteriaceae (HR, 0.41; 95% CI, 0.27–0.64; and HR, 0.74; 95% CI, 0.59–0.94), and 30-day mortality for polymicrobial infections (HR, 0.51; 95% CI, 0.31–0.86) but not Acinetobacter or Pseudomonas. For resistant Enterococcus, ID consultation was marginally associated with decreased 30-day mortality (HR, 0.81; 95% CI, 0.62–1.06). ID consultation was associated with reduced 30-day readmission for resistant Enterobacteriaceae. Conclusions ID consultation was associated with significant reductions in 30-day and 1-year mortality for resistant S. aureus and Enterobacteriaceae, and 30-day mortality for polymicrobial infections. There was no association between ID consultation and mortality for patients with resistant Pseudomonas, Acinetobacter, or Enterococcus, possibly due to small sample sizes. Our results suggest that ID consultation may be beneficial for patients with some MDRO infections. more...
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- 2018
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