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2. Socioeconomic Disparities and the Prevalence of Antimicrobial Resistance

Author

Cooper, Lauren N, primary, Beauchamp, Alaina M, additional, Ingle, Tanvi A, additional, Diaz, Marlon I, additional, Wakene, Abdi D, additional, Katterpalli, Chaitanya, additional, Keller, Tony, additional, Walker, Clark, additional, Blumberg, Seth, additional, Kanjilal, Sanjat, additional, Chen, Jonathan H, additional, Radunsky, Alexander P, additional, Most, Zachary M, additional, Hanna, John J, additional, Perl, Trish M, additional, Lehmann, Christoph U, additional, and Medford, Richard J, additional

Published
2024
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7. Gastrointestinal Manifestations Are Associated with Severe COVID-19 in Children.

Author

Akkoyun, Esra Betul, Ashraf, Bilal, Hanners, Natasha, Kahn, Jeffrey, and Most, Zachary

Subjects
COVID-19, GASTROINTESTINAL diseases, SEVERITY of illness index, CHILDREN
Abstract

Purpose: Although less severe than in adults, children can experience a range of COVID-19 symptoms, from asymptomatic to life-threatening, including respiratory and gastrointestinal symptoms. Medical conditions may also increase the severity of the disease in infected children. Methods: This study was performed at a single center, comparing cases and controls, and involving 253 pediatric patients who had been diagnosed with COVID-19. Two different outcomes were assessed. The first categorized symptomatic individuals who were hospitalized with COVID-19 (hospital) from those who were not (nonhospital). The second categorized admitted individuals who spent at least one day in the intensive care unit (ICU) from those who did not require intensive care (floor). Results: Ninety individuals (36%) had at least one underlying medical condition, the most common being pulmonary disorders, such as asthma (12%), followed by neurodevelopmental disorders (8%), gastrointestinal disorders (6%), and seizure disorders (6%). The hospital group was more likely to have a comorbidity, such as obstructive sleep apnea (OSA), diabetes mellitus, seizure disorder, hypertension, sickle cell disease, neurodevelopmental disorder, and immunocompromising conditions, including cancer, bone marrow transplant, and other immunodeficiencies, compared to the non-hospital group. Abdominal pain was more common in the hospital group. Shortness of breath (SOB) and diarrhea were significantly more common in the ICU group than in the floor group. Conclusions: Early identification of pediatric patients with severe COVID-19 is important to improve outcomes. In our single-center case–control study, we found that the presence of gastrointestinal symptoms on presentation was more commonly associated with severe COVID-19 in children. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Risk Factors for SARS-CoV-2 Infection and Severe Outcomes Among People with Human Immunodeficiency Virus: Cohort Study

Author

Hanna, John J, primary, Geresu, Liyu B, additional, Diaz, Marlon I, additional, Ho, Milan, additional, Casazza, Julia A, additional, Pickering, Madison A, additional, Lanier, Heather D, additional, Radunsky, Alexander P, additional, Cooper, Lauren N, additional, Saleh, Sameh N, additional, Bedimo, Roger J, additional, Most, Zachary M, additional, Perl, Trish M, additional, Lehmann, Christoph U, additional, Turer, Robert W, additional, Chow, Jeremy Y, additional, and Medford, Richard J, additional

Published
2023
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12. Incidence and Risk Factors for Severe Outcomes in Pediatric Patients With COVID-19

Author

Ho, Milan, primary, Most, Zachary M., additional, Perl, Trish M., additional, Diaz, Marlon I., additional, Casazza, Julia A., additional, Saleh, Sameh, additional, Pickering, Madison, additional, Radunsky, Alexander P., additional, Hanna, John J., additional, Thakur, Bhaskar, additional, Lehmann, Christoph U., additional, Medford, Richard J., additional, and Turer, Robert W., additional

Published
2023
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14. Discontinuation of Contact Precautions for Methicillin-resistant Staphylococcus aureusin a Pediatric Healthcare System

Author

Most, Zachary M, Phillips, Bethany, and Sebert, Michael E

Abstract

The requirement for contact precautions when caring for patients with methicillin-resistant Staphylococcus aureus(MRSA) was discontinued in all locations within the 3 hospitals of a pediatric healthcare system except the neonatal intensive care unit. No increase in MRSA infection or colonization was subsequently observed.

Published
2024
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16. Gastrointestinal manifestations are associated with severe COVID-19 in children

Author

Akkoyun, Esra B, Ashraf, Bilal, Kahn, Jeffrey, Hanners, Natasha, and Most, Zachary

Subjects
children, COVID-19, severe infection
Abstract

This manuscript describes the presence of gastrointestinal symptoms was more frequently associated with severe COVID-19 in children. Our study adds to growing evidence that gastrointestinal symptoms, such as diarrhea, are a manifestation of severe COVID-19 in children. Although the data used in this study does not encompass the Omicron and Delta variants, the limited information available on the pediatric population makes this knowledge crucial for clinicians. It enables them to promptly identify patients who may be susceptible to developing severe illness and to apply appropriate interventions accordingly.

Published
2023
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17. Preschool-Aged Household Contacts as a Risk Factor for Viral Respiratory Infections in Healthcare Personnel

Author

Most, Zachary M, primary, Nyquist, Ann-Christine, additional, Radonovich, Lewis J, additional, Rodriguez-Barradas, Maria C, additional, Price, Connie Savor, additional, Simberkoff, Michael S, additional, Bessesen, Mary T, additional, Cummings, Derek A T, additional, Rattigan, Susan M, additional, Warren-Gash, Charlotte, additional, Gaydos, Charlotte A, additional, Gibert, Cynthia L, additional, Gorse, Geoffrey J, additional, and Perl, Trish M, additional

Published
2023
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19. 2357. Risk Factors for COVID-19 Infection and Outcomes in People Living with HIV

Author

Hanna, John J, primary, Geresu, Liyu B, additional, Diaz, Marlon, additional, Pickering, Madison, additional, Casazza, Julia A, additional, Ho, Milan, additional, Lanier, Heather, additional, Radunsky, A L exander P, additional, Saleh, Sameh N, additional, Most, Zachary M, additional, Perl, Trish M, additional, Turer, Robert W, additional, Lehmann, Christoph U, additional, Chow, Jeremy Y, additional, and Medford, Richard J, additional

Published
2022
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20. Healthcare-associated respiratory viral infections after discontinuing universal masking

Author

Most, Zachary M., Phillips, Bethany, and Sebert, Michael E.

Abstract

AbstractIn November 2022, our pediatric hospital replaced the requirement for universal masking of all healthcare personnel and visitors in all clinical buildings with a requirement for masking only during patient encounters. Following this change, we observed an immediate, substantial, and sustained increase in healthcare-associated respiratory viral infections.

Published
2024
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26. Contrasting definitions and incidence of healthcare-associated respiratory viral infections in a pediatric hospital

Author

Most, Zachary M., Jackson, Patricia, Sebert, Michael, and Perl, Trish M.

Abstract

AbstractObjective:To determine the difference in the incidence of healthcare-associated respiratory viral infection (HARVI) in a pediatric hospital depending on the definition used.Design:Descriptive historical cohort study.Setting and participants:Patients aged 0–21 years old who were admitted between July 2013 and June 2018 to a 490-bed primary to quaternary-care pediatric hospital serving northern Texas.Methods:HARVI was defined using microbiologic confirmation, development of new symptoms while hospitalized, and exposure time greater than the minimum incubation period for each specific virus. Events that occurred following the maximum incubation period for that virus were classified as definite, otherwise they were classified as possible. This definition was compared to definitions using alternate timing of onset and symptomatology requirements. Data pertaining to demographics, diagnoses, and illness severity were collected.Results:In total, 498 HARVIs (320 definite and 178 possible) were identified, with an incidence rate of 0.98 per 1,000 patient days (0.63 and 0.35, respectively). Rhinovirus or enterovirus and respiratory syncytial virus were the most identified viruses (58% and 10%, respectively). The median time from admission until HARVI was 10.5 days (interquartile range [IQR], 5–30 days). When alternate definitions were employed, the incidence of HARVI ranged from 0.96 to 2.00 per 1,000 admitted patient days.Conclusions:HARVI remain a common nosocomial infection in pediatric hospitals and the measured incidence is dependent on the definition used. Because of the endemic and pandemic potential of respiratory viruses, standardized definitions are needed to facilitate intra- and interhospital comparisons.

Published
2023
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37. Gastrointestinal Manifestations Are Associated with Severe COVID-19 in Children.

Author

Akkoyun EB, Ashraf B, Hanners N, Kahn J, and Most Z

Abstract

Purpose: Although less severe than in adults, children can experience a range of COVID-19 symptoms, from asymptomatic to life-threatening, including respiratory and gastrointestinal symptoms. Medical conditions may also increase the severity of the disease in infected children. Methods: This study was performed at a single center, comparing cases and controls, and involving 253 pediatric patients who had been diagnosed with COVID-19. Two different outcomes were assessed. The first categorized symptomatic individuals who were hospitalized with COVID-19 (hospital) from those who were not (nonhospital). The second categorized admitted individuals who spent at least one day in the intensive care unit (ICU) from those who did not require intensive care (floor). Results: Ninety individuals (36%) had at least one underlying medical condition, the most common being pulmonary disorders, such as asthma (12%), followed by neurodevelopmental disorders (8%), gastrointestinal disorders (6%), and seizure disorders (6%). The hospital group was more likely to have a comorbidity, such as obstructive sleep apnea (OSA), diabetes mellitus, seizure disorder, hypertension, sickle cell disease, neurodevelopmental disorder, and immunocompromising conditions, including cancer, bone marrow transplant, and other immunodeficiencies, compared to the non-hospital group. Abdominal pain was more common in the hospital group. Shortness of breath (SOB) and diarrhea were significantly more common in the ICU group than in the floor group. Conclusions: Early identification of pediatric patients with severe COVID-19 is important to improve outcomes. In our single-center case-control study, we found that the presence of gastrointestinal symptoms on presentation was more commonly associated with severe COVID-19 in children.

Published
2023
Full Text
View/download PDF

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