64 results on '"Pamela Bailey"'
Search Results
2. Implementing an Antimicrobial Stewardship Lecture Series for Family Medicine Residency Programs in South Carolina
- Author
-
Kayla Antosz, Pamela Bailey, Majdi Al-Hasan, Brandon Bookstaver, Hana Winders, and Sarah Battle
- Subjects
Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
Background: Family medicine physicians are one of the leading prescribers of antimicrobials in both the inpatient and ambulatory setting, however appropriate education on antimicrobial stewardship (AS) is lacking. The Antimicrobial Stewardship Collaborative of South Carolina (ASC-SC) created a family medicine AS lecture series to increase awareness of stewardship, improve antimicrobial prescribing throughout the state, and ultimately combat antimicrobial resistance. Methods: All family medicine residency programs in South Carolina (n=17) were contacted to determine interest in a four 1-hour long lecture series regarding various AS topics provided by infectious diseases physicians and pharmacists. The introductory AS lecture included topics such as interpreting minimal inhibitory concentrations, utilizing antibiograms, guidelines for diagnosing and treating common infections, and antibiotic essentials. Lectures were given on-site, and eight identical pre- and post-lecture questions were asked to assess baseline knowledge and efficacy of the introductory lecture. Not all the attendees answered all the pre- and post-lecture questions. A Chi-square analysis was used to determine statistical significance. Results: To date, 7 family medicine residency programs were given the introductory antimicrobial stewardship lecture and were included in the total analysis. Respondents included 1st year (25 of 99 responses, 25%) and 2nd year family medicine residents (17 of 99 responses 17%). When asked “How familiar are you with the concept of antimicrobial stewardship?”, 43 of 106 (41%) respondents were at least familiar or very familiar prior to the lecture compared to 81 of 93 (87%) after the lecture (p < 0.001). When asked “How confident are you in using antibiograms for antimicrobial decisions?”, 41 of 107 (38%) were confident or very confident pre-lecture and 83 of 101 (82%) post-lecture (p < 0.001). When given a case-based question on using an antibiogram to determine an appropriate empiric agent for inpatient pyelonephritis, 59 of 107 (55%) respondents were able to answer the question correctly pre-lecture compared to 85 of 99 (86%) post-lecture (p < 0.001). Among those who answered the question incorrectly, 60% selected the agent with the highest percentage susceptible rate in the antibiogram, despite it being an inappropriate agent for pyelonephritis. Conclusion: The ASC-SC lecture series was an effective tool to increase awareness and knowledge of antimicrobial stewardship to family medicine providers. This lecture series survey data helps determine what family medicine residents commonly misunderstood in AS concepts and helps guide future initiatives.
- Published
- 2024
- Full Text
- View/download PDF
3. Understanding the Impact of Narrow Spectrum Beta-Lactam Use on Overall and Broad-Spectrum Antimicrobial Utilization in South Carolina
- Author
-
Kayla Antosz, Sarah Battle, Pamela Bailey, Hana Winders, and Majdi Al-Hasan
- Subjects
Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
Background: The standardized antimicrobial administration ratio (SAAR) is a metric utilized to measure antimicrobial use within and between hospitals by comparing observed to predicted antimicrobial days of therapy. However, it remains unknown whether narrow-spectrum beta-lactam (NSBL) use adds to overall antimicrobial utilization or substitutes broad-spectrum agents. This muti-hospital cohort study examined the impact of NSBL use on overall antimicrobial utilization and the correlation between the use of NSBL and various broad-spectrum antimicrobial categories in South Carolina (SC) hospitals. Methods: SAARs were collected from all hospitals in SC that reported antimicrobial use (AU) data to the National Healthcare Safety Network (NHSN) between 2017 and 2021. SAARs collected included: overall SAAR, broad-spectrum agents predominantly used for hospital-onset infections (BSHO), broad-spectrum agents predominantly used for community-acquired infections (BSCA), NSBL, and antibacterial agents posing the highest risk for Clostridioides difficile infection (CDI). Category SAARs were combined to include data in both the adult intensive care unit (ICU) and adult wards using the formula: [(total observed antimicrobial days ICU + total observed antimicrobial days ward) / (total predicted antimicrobial days ICU + total predicted antimicrobial days wards)]. Pearson correlation coefficient (r) was used to examine the correlation between various SAARs categories. Results: A total of 38 hospitals in South Carolina reported AU to NHSN at least during one calendar year during the study period. The use of NSBL agents was negatively correlated with the use of BSHO (r = -0.596, p < 0.001), BSCA (r = -0.543, p < 0.001), and high-risk CDI antibiotics (r = -0.601, p < 0.001). Moreover, the use of NSBL agents did not correlate with the overall SAAR (r = 0.008, p = 0.93), whereas the use of BSHO (r = 0.587, p < 0.001), BSCA (r = 0.494, p < 0.001), and high-risk CDI agents (r = 0.464; p < 0.001) positively correlated with the overall SAAR. Conclusion: In South Carolina hospitals, the use of NSBLs does not contribute to additional antibiotic use overall as it seems to replace broad-spectrum antimicrobials in various categories. By de-escalating from broad-spectrum agents to NSBL agents, one can improve antimicrobial use without negatively impacting the overall SAAR. This observation encourages implementation of antimicrobial stewardship interventions that increase utilization of NSBLs, when appropriate, such as de-escalation of antimicrobial therapy among others without concerns for increasing the SAAR for overall antibiotic use.
- Published
- 2024
- Full Text
- View/download PDF
4. The prevalence of gram-negative bacteria with difficult-to-treat resistance and utilization of novel β-lactam antibiotics in the southeastern United States
- Author
-
Y. Vivian Tsai, P. Brandon Bookstaver, Joseph Kohn, Julie Ann Justo, Darrell Childress, Stefanie Stramel, Douglas Slain, Patrick Tu, Mary Joyce B. Wingler, Bruce M. Jones, Daniel T. Anderson, Megan M. Seddon, David A. Cretella, Joshua Eudy, Hana Winders, Kayla Antosz, Pamela Bailey, and Majdi N. Al-Hasan
- Subjects
Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Objective: To evaluate temporal trends in the prevalence of gram-negative bacteria (GNB) with difficult-to-treat resistance (DTR) in the southeastern United States. Secondary objective was to examine the use of novel β-lactams for GNB with DTR by both antimicrobial use (AU) and a novel metric of adjusted AU by microbiological burden (am-AU). Design: Retrospective, multicenter, cohort. Setting: Ten hospitals in the southeastern United States. Methods: GNB with DTR including Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter spp. from 2015 to 2020 were tracked at each institution. Cumulative AU of novel β-lactams including ceftolozane/tazobactam, ceftazidime/avibactam, meropenem/vaborbactam, imipenem/cilastatin/relebactam, and cefiderocol in days of therapy (DOT) per 1,000 patient-days was calculated. Linear regression was utilized to examine temporal trends in the prevalence of GNB with DTR and cumulative AU of novel β-lactams. Results: The overall prevalence of GNB with DTR was 0.85% (1,223/143,638) with numerical increase from 0.77% to 1.00% between 2015 and 2020 (P = .06). There was a statistically significant increase in DTR Enterobacterales (0.11% to 0.28%, P = .023) and DTR Acinetobacter spp. (4.2% to 18.8%, P = .002). Cumulative AU of novel β-lactams was 1.91 ± 1.95 DOT per 1,000 patient-days. When comparing cumulative mean AU and am-AU, there was an increase from 1.91 to 2.36 DOT/1,000 patient-days, with more than half of the hospitals shifting in ranking after adjustment for microbiological burden. Conclusions: The overall prevalence of GNB with DTR and the use of novel β-lactams remain low. However, the uptrend in the use of novel β-lactams after adjusting for microbiological burden suggests a higher utilization relative to the prevalence of GNB with DTR.
- Published
- 2024
- Full Text
- View/download PDF
5. Five steps to high quality antimicrobial stewardship research
- Author
-
Bradley J. Langford, Pamela Bailey, Daniel J. Livorsi, Kevin A. Brown, Sonali D. Advani, Elizabeth Dodds Ashley, Gonzalo Bearman, and Priya Nori
- Subjects
Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
The escalating threat of antimicrobial resistance (AMR) necessitates impactful, reproducible, and scalable antimicrobial stewardship strategies. This review addresses the critical need to enhance the quality of antimicrobial stewardship intervention research. We propose five considerations for authors planning and evaluating antimicrobial stewardship initiatives. Antimicrobial stewards should consider the following mnemonic ABCDE: (A) plan Ahead using implementation science; (B) Be clear and thoroughly describe the intervention by using the TidIER checklist; (C) Use a Checklist to comprehensively report study components; (D) Select a study Design carefully; and (E) Assess Effectiveness and implementation by selecting meaningful outcomes. Incorporating these recommendations will help strengthen the evidence base of antimicrobial stewardship literature and support optimal implementation of strategies to mitigate AMR.
- Published
- 2024
- Full Text
- View/download PDF
6. Providing value to patients and providers via a pediatric statewide antibiogram in South Carolina
- Author
-
Pamela Bailey, Kayla Antosz, Robert Daniels, Andrew B. Gainey, and Anna Kathryn Burch
- Subjects
Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Objective: Antimicrobial stewardship has special challenges in particular populations and facilities, including pediatrics. We sought to augment the information available to antimicrobial stewardship programs (ASPs) by created a cumulative statewide antibiogram for neonatal and pediatric populations. Methods: In the Antimicrobial Stewardship Collaborative of South Carolina (ASC-SC), we created statewide antibiograms, including a separate antibiogram accounting for the pediatric and neonatal intensive care unit (NICU) populations. We collated data from the 4 pediatric and 3 NICU facilities in the state to provide a cumulative statewide antibiogram. Results: Methicillin-susceptible Staphylococcus aureus was more prevalent than methicillin-resistant Staphylococcus aureus. Pseudomonas aeruginosa, Citrobacter koserii, and Acinetobacter baumannii were isolated in only 1 NICU. Conclusions: These antibiograms should improve empiric prescribing in both the inpatient and outpatient setting, providing data in some areas that historically do not have pediatric antibiogram to inform prescribing. The antibiogram alone is not sufficient independently to improve prescribing but is one important aspect of stewardship in the pediatric population of South Carolina.
- Published
- 2023
- Full Text
- View/download PDF
7. Ecologic analysis of antimicrobial use in South Carolina hospitals during 2020–2022
- Author
-
Pamela Bailey, Shujie Chen, Majdi N. Al-Hasan, Bankole Olatosi, Xiaoming Li, and Jiajia Zhang
- Subjects
Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background: Factors influencing excessive antimicrobial utilization in hospitalized patients remain poorly understood, particularly with the COVID-19 pandemic. Methods: In this retrospective cohort, we compared administrative data regarding antimicrobial prescriptions in hospitalized patients in South Carolina from March 2020 through September 2022. The study examined variables associated with antimicrobial use across demographics, COVID status, and length of stay, among other variables. Results: Significant relationships were seen with antimicrobial use in COVID-19 positive patients (OR 2.00, 95% Confidence Interval (CI): 1.9–2.1), young adults (OR 1.08, 95% CI: 0.99–1.12, COVID-19 positive Blacks and Hispanics (OR 1.06, 95% CI: 1.01–1.11, OR 1.05, 95% CI: 0.89–1.23), and COVID-19 positive patients with ≥2 comorbid conditions (OR 1.55, 95% CI: 1.43–1.68). Discussion: Further analysis in more than one healthcare system should explore these ecologic relationships further to understand if these are common trends to inform ongoing stewardship interventions.
- Published
- 2023
- Full Text
- View/download PDF
8. Restricted reproductive health and infectious diseases outcomes: A call to action
- Author
-
Pamela Bailey, Julie Ann Justo, and Priya Nori
- Subjects
Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Published
- 2022
- Full Text
- View/download PDF
9. SHEA 2022 Spring Proceedings without borders
- Author
-
Alexandre R. Marra, Anucha Apisarnthanarak, Kari A. Simonsen, Kelly L. Matson, Pamela Bailey, Pranavi V. Sreeramoju, Priya Nori, and Gonzalo M. Bearman
- Subjects
Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Published
- 2022
- Full Text
- View/download PDF
10. Show me the data: A statewide comparative report of National Healthcare Safety Network (NHSN) Antimicrobial Use Option standardized antimicrobial administration ratios (SAARs)
- Author
-
Hana R. Winders, Kayla Antosz, Majdi Al-Hasan, P. Brandon Bookstaver, Pamela Bailey, Katie Waites, and Julie Ann Justo
- Subjects
Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
The Antimicrobial Stewardship Collaborative of South Carolina created quarterly Comparative SAAR Analysis Reports based on standardized antimicrobial administration ratio (SAAR) data from the NHSN Antimicrobial Use (AU) Option. These reports provide SAAR histograms and site-specific feedback to participating facilities in South Carolina. They were created to improve antimicrobial use throughout the state, especially in rural regions.
- Published
- 2022
- Full Text
- View/download PDF
11. Experiences in outpatient parenteral antimicrobial therapy (OPAT): Barriers and challenges from the front lines
- Author
-
Nicole Ng, Pamela Bailey, Rachel Pryor, Lillian Fung, Christine Veals, Kenneth Sabouri, and Julie Reznicek
- Subjects
Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background: Outpatient parenteral antimicrobial therapy (OPAT) is now the standard of care for managing patients who no longer need inpatient care but require prolonged intravenous antimicrobial therapy. OPAT increases patient satisfaction, reduces the lengths of hospital stay, lowers emergency department readmission rates, and decreases total healthcare spending. Objective: To investigate Virginia Commonwealth University Health System’s experience with OPAT and to highlight the obstacles patients and clinicians face when navigating and utilizing this program. Design: We conducted this descriptive study at a large, academic, tertiary-care hospital in Central Virginia. Methods: We performed manual reviews of electronic medical records of 602 patient, and we evaluated the records of those receiving OPAT between 2017 and 2020. Reviews included antimicrobial agents, diagnoses requiring OPAT, adverse effects related to antimicrobials, adverse effects related to peripherally inserted central catheters (PICC), readmission rate, discharge destination, and death. We evaluated our program with descriptive statistics. Results: Among 602 patients who received OPAT, most were diagnosed with bacteremia or musculoskeletal infections. Patients were either discharged home or to another healthcare facility, with the former comprising most of the rehospitalizations. Ertapenem and vancomycin were associated with the most adverse drug events among our cohort. Elevated transaminase levels were noted in 23% of patients. The rate of PICC-line adverse events in this study population was 0.05%. Conclusions: Our findings highlight the barriers and challenges that patients and providers face when receiving OPAT, and they can inform efforts to improve patient clinical outcomes.
- Published
- 2021
- Full Text
- View/download PDF
12. Factors That Shaped Differentiation for Gifted Students in One Elementary Classroom
- Author
-
Pamela Bailey
- Abstract
This instrumental case study explores how a single teacher whose preservice teacher education program included the practice and implementation of differentiation for all students, gifted pedagogy, and a gifted clinical practicum described the factors that shaped her practice and implementation of differentiation for gifted students in her general education classroom. This study focused on one elementary classroom teacher because the teacher is at the heart of differentiated instruction and makes the decisions about the practice and implementation of differentiated instruction for each student. The combined conceptual framework encompassed the REACH Framework developed by Rock et al. (2008), specifically Quality Indicator 1: The Teacher Variable, Schon's Theory of Reflective Practice (1983, 1987), and Shulman's Pedagogical Content Knowledge (1986, 2013). The following methods were used to ensure data triangulation: semi-structured interviews, observations, short check-ins, email conversations, document/artifact analysis, and member checking. The results of the study showed an overarching theme: The Teacher's Preservice Education Program, and three themes: The Pedagogical Content Factor: Differentiation and Gifted Pedagogy, The Student-Centered Learning Environment Factor, and The Reflective Practice Factor as the factors that shaped this teacher's practice and implementation of differentiation for gifted students. Case findings suggest assertions of teacher self-efficacy and reflection as practice and are represented in a unique diagram showing this teacher's practice of differentiation for her gifted students. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]
- Published
- 2023
13. Developing New Clinical Nurse Specialist Educational Opportunities in Ambulatory Care Settings
- Author
-
Urton, Michael S., Reis, Pamela, Cowin, Pamela Bailey, and Linder, Julie Michelle
- Published
- 2022
- Full Text
- View/download PDF
14. Welcome to Our Class! Building Classroom Rapport to Support the Development of Social and Emotional Learning Skills
- Author
-
Elizabeth Michael, Pamela Bailey, Gregory J. Benner, and Sara Sanders
- Subjects
Clinical Psychology ,Developmental and Educational Psychology ,Education - Abstract
In this article, we describe practical, usable ways teachers can build rapport with students, particularly students with and at risk for emotional and behavioral disorders. By establishing rapport, teachers can increase the effectiveness of the social and emotional learning curriculum and interventions delivered. Specifically, the warm welcomes, transitions, emotion checks, two by 10, and optimistic closures strategies are described.
- Published
- 2023
- Full Text
- View/download PDF
15. Working Together: Leveraging Teacher Study Groups to Improve Social and Emotional Learning in the Classroom
- Author
-
Gregory J. Benner, Marcia L. Rock, Lisa A. Strycker, Erica O. Lee, Pamela Bailey, and Ashley S. Virgin
- Subjects
Clinical Psychology ,Developmental and Educational Psychology ,Education - Abstract
Teachers of students with or at risk for emotional and behavioral disorders (EBD) may face obstacles and feel isolated when implementing social and emotional learning (SEL) programming with students. The teacher study group (TSG) offers an effective way to overcome barriers and improve SEL. These groups provide a gathering space for teachers to investigate problems of practice, celebrate points of pride, and strengthen professional learning in a focused area. In this article, we summarize existing research on SEL and TSGs and describe available SEL programs that incorporate TSGs. We provide an example of SEL-focused TSGs in practice, offering guidance and tips for early elementary school teachers—and the administrators who support them—who work with students with or at risk for EBD.
- Published
- 2022
- Full Text
- View/download PDF
16. Assessment for Effective Screening and Progress Monitoring of Social and Emotional Learning Skills
- Author
-
Marissa J. Filderman, Clark McKown, Pamela Bailey, Gregory J. Benner, and Keith Smolkowski
- Subjects
Clinical Psychology ,Developmental and Educational Psychology ,Education - Abstract
The collection of student data through screening and progress monitoring of social and emotional learning (SEL) skills is just as important as the implementation of curriculum and practices. Monitoring skill acquisition allows teachers to identify effective practices, provide intervention, and intensify support for students who need it. In this article, we provide a practical demonstration of how to make instructional decisions based on screening and progress monitoring of student SEL skill acquisition.
- Published
- 2022
- Full Text
- View/download PDF
17. Weighing the odds of bloodstream infection. What is the perfect model to predict this risk?
- Author
-
Pamela, Bailey and Majdi N, Al-Hasan
- Subjects
Microbiology (medical) ,Infectious Diseases ,General Medicine - Published
- 2023
- Full Text
- View/download PDF
18. Healthcare Personnel Hand Hygiene Compliance: Are We There Yet?
- Author
-
JoDee Armstrong-Novak, Hui Yu Juan, Kaila Cooper, and Pamela Bailey
- Subjects
Infectious Diseases - Published
- 2023
- Full Text
- View/download PDF
19. Developing New Clinical Nurse Specialist Educational Opportunities in Ambulatory Care Settings
- Author
-
Michael S. Urton, Pamela Reis, Pamela Bailey Cowin, and Julie Michelle Linder
- Subjects
Advanced and Specialized Nursing ,Leadership and Management ,Assessment and Diagnosis ,LPN and LVN - Published
- 2022
- Full Text
- View/download PDF
20. Making 20% Matter Most: Meeting the Needs of Gifted and High Ability Students Through Type III 20Time (T4) Projects
- Author
-
Pamela Bailey and Jane L. Newman
- Subjects
Developmental and Educational Psychology ,Education - Abstract
A 9th grade Honors English class creates and publishes original poems, art, fiction, and nonfiction products through an activity called “Type Three – Twenty Time = T4.” The instructional method merges elements from Renzulli’s Type III process with elements from Brookhouser’s 20Time Project-based learning model. Each student researches an interest passion topic and creates a related original product or service for a real audience. Upon reflection on the experience, the author identifies evidence-based practices including compacting ELA course content to create time for the T4 process; enhanced student engagement; active learning versus passive learning; improved writing skills; quality presentation skills; higher level creative and critical thinking; and upgraded 21st Century skills.
- Published
- 2021
- Full Text
- View/download PDF
21. 409. Temporal Trends in Antibiotic Use of New β-lactams for Gram-Negative Bacteria with Difficult-to-Treat Resistance in the Southeastern United States
- Author
-
Y Vivian Tsai, P Brandon Bookstaver, Joseph Kohn, Julie Ann Justo, Darrell Childress, Stefanie Stramel, Douglas Slain, Patrick Tu, Mary Joyce B Wingler, Bruce M Jones, Daniel Anderson, Megan M Seddon, Geneen Gibson, David A Cretella, Joshua Eudy, Hana R Winders, Kayla Antosz, Pamela Bailey, and Majdi N Al-Hasan
- Subjects
Infectious Diseases ,Oncology - Abstract
Background Several new β-lactam antibiotics were recently developed for treatment of serious infections due to gram-negative bacteria (GNB) with difficult-to-treat resistance (DTR). This multicenter retrospective cohort study examined temporal trends in prevalence of GNB with DTR and the use of new β-lactams in the southeastern United States. Methods The prevalence of GNB with DTR, including Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter species was determined in 9 hospitals geographically spread within the Southeastern Research Group Endeavor (SERGE-45) between 2015 to 2020. Antibiotic use (AU) of new β-lactams was also obtained from the 9 hospitals during the study period. New β-lactams included ceftolozane/tazobactam, ceftazidime/avibactam, meropenem/vaborbactam, imipenem/cilastatin/relebactam, and cefiderocol. Logistic regression analysis was utilized to examine temporal trends in prevalence of GNB with DTR and cumulative AU of new β-lactams. Results The overall prevalence of GNB with DTR in the 9 hospitals was 0.78% with a numerical increase from 0.67% to 0.97% between 2015 and 2020 (p=0.067) [Figure]. DTR was more prevalent among Acinetobacter spp., followed by P. aeruginosa, and Enterobacterales (11.8%, 3.5%, and 0.2%, respectively). There was a significant increase in the prevalence of DTR isolates among Acinetobacter spp. from 2.7% to 20.7% (p< 0.001) and Enterobacterales from 0.07% to 2.6% (p=0.025), but not P. aeruginosa (p=0.46) between 2015 and 2020. The cumulative AU of new β-lactams in the 9 hospitals was 2 days of therapy per 1000 patient-days. There was numerical increase in AU of these agents from 0.03 to 2.22 days of therapy per 1000 patient days during the 6-year study period (p=0.096) [Figure]. Conclusion The overall prevalence of GNB with DTR and cumulative use of new β-lactams remain relatively low in the southeastern United States. However, the upward trend in prevalence of DTR isolates, particularly among Acinetobacter spp. and Enterobacterales, is concerning and may drive future increased use of β-lactams. Additional efforts to benchmark the use and appropriateness of new β-lactams are crucial to preserve their efficacy against bacteria with DTR. Disclosures P. Brandon Bookstaver, PharmD, Spero Therapeutics: Advisor/Consultant Julie Ann Justo, PharmD, MS, FIDSA, BCPS-AQ ID, bioMerieux: Honoraria|bioMerieux: Honoraria|Entasis Therapeutics: Advisor/Consultant|Entasis Therapeutics: Advisor/Consultant|Gilead Sciences: Advisor/Consultant|Gilead Sciences: Advisor/Consultant|Merck & Co: Advisor/Consultant|Merck & Co: Advisor/Consultant|Shionogi: Advisor/Consultant|Shionogi Inc.: Advisor/Consultant|Spero Therapeutics: Honoraria|Spero Therapeutics: Honoraria|Vaxart: Stocks/Bonds Julie Ann Justo, PharmD, MS, FIDSA, BCPS-AQ ID, bioMerieux: Honoraria|bioMerieux: Honoraria|Entasis Therapeutics: Advisor/Consultant|Entasis Therapeutics: Advisor/Consultant|Gilead Sciences: Advisor/Consultant|Gilead Sciences: Advisor/Consultant|Merck & Co: Advisor/Consultant|Merck & Co: Advisor/Consultant|Shionogi: Advisor/Consultant|Shionogi Inc.: Advisor/Consultant|Spero Therapeutics: Honoraria|Spero Therapeutics: Honoraria|Vaxart: Stocks/Bonds Bruce M. Jones, Pharm.D., FIDSA, BCPS, AbbVie: Advisor/Consultant|AbbVie: Honoraria|La Jolla: Honoraria|Melinta: Advisor/Consultant|Paratek: Honoraria|Regeneron: Honoraria.
- Published
- 2022
- Full Text
- View/download PDF
22. 338. Epidemiology and Treatment of Invasive Bartonella spp. Infections
- Author
-
Morgan Pizzuti, Pamela Bailey, Caroline Derrick, and P Brandon Bookstaver
- Subjects
Infectious Diseases ,Oncology - Abstract
Background Serology and PCR testing methods have increased ability to diagnose Bartonella spp. invasive infections. Current treatment recommendations are based primarily on case series and aging data published before newly available diagnostic techniques. These recommendations are limited in safety and effectiveness outcomes. This multicenter, retrospective cohort study describes the epidemiology and treatment outcomes of invasive bartonellosis among patients in the U.S. Methods Collaborating sites were selected from SERGE-45 (Southeastern Research Group Endeavor) research network. Data were collected through REDCap. Subjects were screened from adult patients with invasive bartonellosis diagnosis codes, positive Bartonella spp. serologies, PCR, 16/18S tests, cultures, and Karius® tests from blood or tissue between January 1, 2014, and September 1, 2021. Eligible patients had at least one positive test result, evidence of invasive bartonellosis, and received treatment for bartonellosis. Treatment failure was defined as admission or readmission while on treatment, mortality during treatment or within 30 days after end of treatment, required escalation or extended duration of therapy, premature discontinuation of therapy, or necessitated change in regimen. Those not meeting treatment failure criteria were considered treatment success. Results Of the 169 patients screened, 32 were included, with 19 having treatment success. Bartonella henselae was the most common causative pathogen (n = 31, 97%). Endocarditis was the most common invasive manifestation (n = 18, 56%). Treatment regimens are displayed in Table 1. Primary reasons for treatment failure included necessitated escalation of therapy during treatment course (n = 4, 30.8%) and discontinuation of therapy due to adverse effect (n = 4, 30.8%). Conclusion Doxycycline with rifampin was the most common treatment regimen for invasive bartonellosis, with extended durations used compared to often referenced 6-week courses for invasive infections. It is important to consider adverse drug effects, toxicities, and tolerability in patients being treated for invasive bartonellosis. Disclosures P. Brandon Bookstaver, PharmD, Spero Therapeutics: Advisor/Consultant.
- Published
- 2022
- Full Text
- View/download PDF
23. 408. Benchmarking the Use of New β-lactams Utilizing a Novel Metric of Microbiological Burden
- Author
-
Y Vivian Tsai, P Brandon Bookstaver, Joseph Kohn, Julie Ann Justo, Darrell Childress, Stefanie Stramel, Douglas Slain, Patrick Tu, Mary Joyce B Wingler, Bruce M Jones, Daniel Anderson, Megan M Seddon, Geneen Gibson, David A Cretella, Joshua Eudy, Hana R Winders, Kayla Antosz, Pamela Bailey, and Majdi N Al-Hasan
- Subjects
Infectious Diseases ,Oncology - Abstract
Background Several methods are used to account for various hospital characteristics when comparing antimicrobial use (AU) between heterogenous hospitals. Recently, a new antimicrobial stewardship metric that adjusts AU by microbiological burden (a-AU) of the bacteria was proposed (Figure 1). It accounts for the resistant phenotypes observed at a given institution, allowing for a more balanced comparison of AU across hospitals. This multicenter retrospective cohort study examined the use of new β-lactams for Gram-negative bacteria (GNB) with difficult-to-treat resistance (DTR) by both AU and adjusted (a-AU) metrics in the southeastern United States. Methods AU of new β-lactams was determined in 9 hospitals within the Southeastern Research Group Endeavor (SERGE-45) between 2015 to 2020. New β-lactams included ceftolozane/tazobactam, ceftazidime/avibactam, meropenem/vaborbactam, imipenem/cilastatin/relebactam, and cefiderocol. AU was adjusted for prevalence of GNB with DTR including Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter species. DTR was defined as nonsusceptibility to all of the following: cefepime or ceftazidime, levofloxacin or ciprofloxacin, meropenem or imipenem, and piperacillin/tazobactam if tested. Hospitals were ranked by AU and a-AU from lowest to highest. Descriptive statistics were utilized. Results The cumulative mean AU and a-AU from 2015 to 2020 were 1.96 (range 0.10 to 6.44) and 2.3 (range 0.20 to 8.05) days of therapy (DOT)/1000 patient days, respectively (Figure 2). After adjusting for the prevalence of GNB with DTR, 6 hospitals moved by at least 1 position in ranking (2 hospitals moved up; 4 hospitals moved down) and 1 hospital moved by at least 2 positions in ranking. Conclusion Overall, the AU of new β-lactams increased after adjusting for the local microbiological burden suggests a potential higher use of antibiotics in relationship to the observed prevalence of GNB with DTR. More than half of the hospitals had a shift in ranking after microbiological adjustment reflecting a more balanced comparison of antibiotic use across heterogenous hospitals. Disclosures P. Brandon Bookstaver, PharmD, Spero Therapeutics: Advisor/Consultant Julie Ann Justo, PharmD, MS, FIDSA, BCPS-AQ ID, bioMerieux: Honoraria|bioMerieux: Honoraria|Entasis Therapeutics: Advisor/Consultant|Entasis Therapeutics: Advisor/Consultant|Gilead Sciences: Advisor/Consultant|Gilead Sciences: Advisor/Consultant|Merck & Co: Advisor/Consultant|Merck & Co: Advisor/Consultant|Shionogi: Advisor/Consultant|Shionogi Inc.: Advisor/Consultant|Spero Therapeutics: Honoraria|Spero Therapeutics: Honoraria|Vaxart: Stocks/Bonds Julie Ann Justo, PharmD, MS, FIDSA, BCPS-AQ ID, bioMerieux: Honoraria|bioMerieux: Honoraria|Entasis Therapeutics: Advisor/Consultant|Entasis Therapeutics: Advisor/Consultant|Gilead Sciences: Advisor/Consultant|Gilead Sciences: Advisor/Consultant|Merck & Co: Advisor/Consultant|Merck & Co: Advisor/Consultant|Shionogi: Advisor/Consultant|Shionogi Inc.: Advisor/Consultant|Spero Therapeutics: Honoraria|Spero Therapeutics: Honoraria|Vaxart: Stocks/Bonds Bruce M. Jones, Pharm.D., FIDSA, BCPS, AbbVie: Advisor/Consultant|AbbVie: Honoraria|La Jolla: Honoraria|Melinta: Advisor/Consultant|Paratek: Honoraria|Regeneron: Honoraria.
- Published
- 2022
- Full Text
- View/download PDF
24. Reducing Central Line Associated Bloodstream Infections (CLABSIs) by Reducing Central Line Days
- Author
-
Diane Heipel, Ginger Vanhoozer, Pamela Bailey, and Amber Shaye McElveen Beville
- Subjects
medicine.medical_specialty ,Central line ,business.industry ,Best practice ,Vascular access ,Psychological intervention ,Audit ,Central line associated bloodstream infections ,equipment and supplies ,Midline catheters ,Infectious Diseases ,Documentation ,Central line days ,Bloodstream infection ,Infection prevention ,medicine ,Infection control ,Healthcare Associated Infections (G Bearman and D Morgan, Section Editors) ,Intensive care medicine ,business - Abstract
Purpose of Review While reducing unnecessary days present of central venous catheters (CVCs) is part of central line associated bloodstream infection (CLABSI) best practices, there is limited information regarding compliance with this recommendation as well as addressing barriers to compliance. Recent Findings Significant work has been directed towards daily audits of necessity and improving communication between members of the medical team. Other critical interventions include utilization of the electronic health record (EHR), leadership support of CLABSI reduction goals, and avoiding CVC placement over more appropriate vascular access. Summary Institutions have varied approaches to addressing the issue of removing idle CVCs, and more standardized approaches in checklists as well as communication, particularly on multidisciplinary rounds, will be key to CVC removal. Utilization of the EHR for reminders or appropriate documentation of necessity is a factor. Avoidance of placing a CVC or appropriateness of the CVC is also important to consider.
- Published
- 2021
25. Experiences in outpatient parenteral antimicrobial therapy (OPAT): Barriers and challenges from the front lines
- Author
-
Pamela Bailey, Rachel Pryor, Christine Veals, Lillian Fung, Kenneth Sabouri, Julie Reznicek, and Nicole Ng
- Subjects
medicine.medical_specialty ,business.industry ,medicine ,Antimicrobial ,Intensive care medicine ,business ,Front (military) - Abstract
Background: Outpatient parenteral antimicrobial therapy (OPAT) is now the standard of care for managing patients who no longer need inpatient care but require prolonged intravenous antimicrobial therapy. OPAT increases patient satisfaction, reduces the lengths of hospital stay, lowers emergency department readmission rates, and decreases total healthcare spending. Objective: To investigate Virginia Commonwealth University Health System’s experience with OPAT and to highlight the obstacles patients and clinicians face when navigating and utilizing this program. Design: We conducted this descriptive study at a large, academic, tertiary-care hospital in Central Virginia. Methods: We performed manual reviews of electronic medical records of 602 patient, and we evaluated the records of those receiving OPAT between 2017 and 2020. Reviews included antimicrobial agents, diagnoses requiring OPAT, adverse effects related to antimicrobials, adverse effects related to peripherally inserted central catheters (PICC), readmission rate, discharge destination, and death. We evaluated our program with descriptive statistics. Results: Among 602 patients who received OPAT, most were diagnosed with bacteremia or musculoskeletal infections. Patients were either discharged home or to another healthcare facility, with the former comprising most of the rehospitalizations. Ertapenem and vancomycin were associated with the most adverse drug events among our cohort. Elevated transaminase levels were noted in 23% of patients. The rate of PICC-line adverse events in this study population was 0.05%. Conclusions: Our findings highlight the barriers and challenges that patients and providers face when receiving OPAT, and they can inform efforts to improve patient clinical outcomes.
- Published
- 2021
26. The impact of coronavirus disease 2019 (COVID-19) on provider use of electronic hand hygiene monitoring technology
- Author
-
Michael P. Stevens, Jo Dee Armstrong-Novak, Gonzalo Bearman, Pamela Bailey, Olivia Hess, Emily Godbout, Kaila Cooper, and Michelle Doll
- Subjects
Microbiology (medical) ,2019-20 coronavirus outbreak ,Technology ,Coronavirus disease 2019 (COVID-19) ,Epidemiology ,media_common.quotation_subject ,Economic shortage ,030501 epidemiology ,03 medical and health sciences ,Hygiene ,Pandemic ,medicine ,Infection control ,Humans ,Hand Hygiene ,media_common ,Cross Infection ,Infection Control ,Guideline adherence ,business.industry ,SARS-CoV-2 ,Concise Communication ,COVID-19 ,Monitoring system ,medicine.disease ,Infectious Diseases ,Medical emergency ,Guideline Adherence ,Electronics ,0305 other medical science ,business - Abstract
The use of an electronic hand hygiene monitoring system (EHHMS) decreased due to the coronavirus disease 2019 (COVID-19) pandemic. We analyzed dispenser use, hand hygiene (HH) badge use, and HH compliance to determine the effect of COVID-19 on EHHMS use and HH compliance. HH product shortages and other pandemic-induced challenges influenced EHHMS use.
- Published
- 2020
27. Cutaneous Botryomycosis and Staphylococcus aureus: Diagnosis, Management, and a Systemic Literature Review
- Author
-
Pamela Bailey, Gonzalo Bearman, Jillian E. Raybould, and Sangeeta Sastry
- Subjects
Cultural Studies ,Linguistics and Language ,History ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Antimicrobial ,medicine.disease_cause ,Dermatology ,Language and Linguistics ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Botryomycosis ,0302 clinical medicine ,Systemic antibiotics ,Staphylococcus aureus ,030220 oncology & carcinogenesis ,Anthropology ,Diagnosis management ,Biopsy ,medicine ,Cutaneous botryomycosis ,business ,Immunodeficiency - Abstract
We present a case and provide a review of the literature of all confirmed cases of cutaneous botryomycosis due to Staphylococcus aureus between January 1, 1990 and January 31, 2018. Cutaneous botryomycosis occurs in diverse age groups and more frequently in men. Immunodeficiency increases risk for botryomycosis. Preceding trauma commonly occurs, and after bacterial inoculation, patients develop a variety of chronic skin lesions. Culture and biopsy of lesions aid in diagnosis. Pathology usually displays the Splendore-Hoeppli reaction. Culture confirms the identity of the bacterium and provides antimicrobial sensitivities to guide therapy. Antimicrobial therapy should be maintained until lesions resolve; surgery may be needed. Botryomycosis is a rare chronic granulomatous condition that affects the skin and the viscera and is easily misdiagnosed. Treatment is not standardized yet typically requires extended courses of systemic antibiotics. Adjunctive surgery may be required in the presence of a heavy disease burden.
- Published
- 2018
- Full Text
- View/download PDF
28. Standardization and Safety: Evaluation of Inpatient Nurse Huddle Routines and Practices at an Academic Health Care System during the COVID-19 Pandemic
- Author
-
Elizabeth, Mangin, primary, Pamela, Bailey, additional, Kaila, Cooper, additional, Rachel, Pryor, additional, Ginger, Vanhoozer, additional, Emily, Godbout, additional, Robin, Hemphill, additional, Michael P, Stevens, additional, Michelle, Doll, additional, and Gonzalo, Bearman, additional
- Published
- 2021
- Full Text
- View/download PDF
29. Change in Antimicrobial Use During COVID-19 Pandemic in South Carolina Hospitals: A Multicenter Observational Cohort Study
- Author
-
Majdi N. Al-Hasan, Joseph Kohn, Hana R Winders, Sharon Weissman, Lloyd Sarbacker, Carmen Faulkner-Fennell, Sara Utley, Evan Lantz, Pamela Bailey, Hannah Ruegner, Julie Ann Justo, and P. Brandon Bookstaver
- Subjects
Methicillin-Resistant Staphylococcus aureus ,Microbiology (medical) ,medicine.medical_specialty ,medicine.drug_class ,South Carolina ,vancomycin ,Antibiotics ,antipseudomonal agents ,MRSA, methicillin resistant Staphylococcus aureus ,Article ,antibiotics ,DOT, days of therapy ,Antimicrobial Stewardship ,Drug Utilization Review ,Antibiotic resistance ,SAAR, standardized antimicrobial administration ratio ,Internal medicine ,Pandemic ,medicine ,Humans ,Antimicrobial stewardship ,Pharmacology (medical) ,Pandemics ,Retrospective Studies ,NHSN, National Healthcare Safety Network ,Cross Infection ,Novel coronavirus ,SARS-CoV-2 ,business.industry ,COVID-19 ,Retrospective cohort study ,General Medicine ,Antimicrobial ,Hospitals ,Anti-Bacterial Agents ,Infectious Diseases ,Clostridium Infections ,Vancomycin ,business ,ASP, antimicrobial stewardship program ,medicine.drug ,Cohort study - Abstract
This retrospective cohort study examined the impact of the pandemic on antimicrobial use (AU) in South Carolina hospitals.Antimicrobial use in days of therapy (DOT) per 1000 days-present was evaluated in 17 hospitals in South Carolina. Matched-pairs mean difference was used to compare AU during the pandemic (March-June 2020) with that during the same months in 2019 in hospitals that did and did not admit patients with COVID-19.There was a 6.6% increase in overall AU in the seven hospitals that admitted patients with COVID-19 (from 530.9 to 565.8; mean difference (MD) 34.9 DOT/1000 days-present; 95% CI 4.3, 65.6; P = 0.03). There was no significant change in overall AU in the remaining 10 hospitals that did not admit patients with COVID-19 (MD 6.0 DOT/1000 days-present; 95% CI -55.5, 67.6; P = 0.83). Most of the increase in AU in the seven hospitals that admitted patients with COVID-19 was observed in broad-spectrum antimicrobial agents. A 16.4% increase was observed in agents predominantly used for hospital-onset infections (from 122.3 to 142.5; MD 20.1 DOT/1000 days-present; 95% CI 11.1, 29.1; P = 0.002). There was also a 9.9% increase in the use of anti-methicillin-resistant Staphylococcus aureus (MRSA) agents (from 66.7 to 73.3; MD 6.6 DOT/1000 days-present; 95% CI 2.3, 10.8; P = 0.01).The COVID-19 pandemic appears to drive overall and broad-spectrum antimicrobial use in South Carolina hospitals admitting patients with COVID-19. Additional antimicrobial stewardship resources are needed to curtail excessive antimicrobial use in hospitals to prevent subsequent increases in antimicrobial resistance and Clostridioides difficile infection rates, given the continuing nature of the pandemic.
- Published
- 2021
- Full Text
- View/download PDF
30. Reproductive Strategies Matter for Rare Plant Conservation: Pollination, Phenology, and Mating in an Endemic Plant of the Sky Islands of Arizona,Erigeron lemmoniiA. Gray (Lemmon's Fleabane) (Asteraceae)
- Author
-
Pamela Bailey and Peter G. Kevan
- Subjects
0106 biological sciences ,education.field_of_study ,Ecology ,Pollination ,Erigeron ,Phenology ,Population ,Plant anatomy ,Biology ,biology.organism_classification ,medicine.disease_cause ,010603 evolutionary biology ,01 natural sciences ,Erigeron lemmonii ,Pollinator ,Pollen ,Botany ,medicine ,education ,Ecology, Evolution, Behavior and Systematics ,010606 plant biology & botany - Abstract
Erigeron lemmonii A. Gray is extremely rare, but not endangered. There are fewer than 1000 individuals, but they compose an apparently stable, heterozygotic, diploid (2n = 18) population. The plants are perennial and endemic to one small location (about 0.5 km2) in Scheelite Canyon, Huachuca Mountains (Cochise County), Fort Huachuca Army Base, part of the Sky Island region, Arizona. Erigeron lemmonii grows from crevices in cliffs, ledges, and rock faces where it can form mats by spreading vegetatively from the roots as they proliferate, especially in microsites where soil accumulates. Our goals were to (1) investigate floral anatomy for reproductive structures (inflorescences, florets, and pollen), (2) record flowering phenology, and (3) determine the species' breeding and mating system. Inflorescence anatomy and development are typical for Erigeron with ray (pistillate) and disc (bisexual) florets. Stigmas of the disc florets do not fully exsert and reflex, though they do present and expose the...
- Published
- 2017
- Full Text
- View/download PDF
31. Precipitation and the robustness of a plant and flower-visiting insect network in a xeric ecosystem
- Author
-
Pamela Bailey, Denise L. Lindsay, Richard F. Lance, and Neil S. Cobb
- Subjects
0106 biological sciences ,geography ,geography.geographical_feature_category ,Ecology ,Pollination ,Biology ,Deserts and xeric shrublands ,010603 evolutionary biology ,01 natural sciences ,Grassland ,Ecological network ,Nestedness ,Ecosystem ,Species richness ,Resilience (network) ,Ecology, Evolution, Behavior and Systematics ,010606 plant biology & botany ,Earth-Surface Processes - Abstract
Complex networks of species interactions are integral to the stability of ecological communities. The responses of these networks to extreme environmental fluctuations are key to understanding the evolution of these networks and their roles in stabilizing ecological communities. From 2008 to 2009 we observed the effects of extreme differences in annual precipitation on a network of plants and flower-visiting insects in a xeric grassland. Significant decreases in plant and insect diversity in the dry year were mirrored by decreases in the number of network nodes and links. However, the relative density of network connections increased in the dry year and other important topological features, such as nestedness and modularity, were largely unchanged. The resilience of the network to node (plants or insect species) loss was high in both years. Though bees tend to dominate pollination communities in drier climes, we did not observe a shift in the relative richness of bee species in the dry year. Our results indicate that well-linked, drought-resistant plants are important to community resilience during ecologically challenging periods and that networks of plants and flowering-visiting insects may be robust to extreme climatic change, at least over short periods, as long as those critical, resilient hubs are protected.
- Published
- 2017
- Full Text
- View/download PDF
32. Buyer beware: Hidden costs in deployment of automated hand hygiene technology
- Author
-
Pamela Bailey, Rachel Pryor, J. Auricchio, O. Hess, Michael P. Stevens, Michelle Doll, Gonzalo Bearman, J. Armstrong, Emily Godbout, and Kaila Cooper
- Subjects
Microbiology (medical) ,media_common.quotation_subject ,General Medicine ,Computer security ,computer.software_genre ,lcsh:Infectious and parasitic diseases ,Infectious Diseases ,Hygiene ,Software deployment ,lcsh:RC109-216 ,Business ,computer ,Caveat emptor ,media_common - Published
- 2020
- Full Text
- View/download PDF
33. Universal screening for the SARS-CoV-2 virus on hospital admission in an area with low COVID-19 prevalence
- Author
-
Amie Patrick, Michelle Doll, Julie Reznicek, Jillian E. Raybould, Emily Godbout, Pamela Bailey, Gonzalo Bearman, Rachel Pryor, Kaila Cooper, Shelley Knowlson, Michael P. Stevens, and Sangeeta Sastry
- Subjects
Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Adolescent ,Epidemiology ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,Research Brief ,Virus ,Betacoronavirus ,Young Adult ,COVID-19 Testing ,Pregnancy ,Pandemic ,Prevalence ,Medicine ,Humans ,Mass Screening ,Child ,Asymptomatic Infections ,Pandemics ,Mass screening ,Aged ,Academic Medical Centers ,biology ,business.industry ,Clinical Laboratory Techniques ,SARS-CoV-2 ,Infant, Newborn ,Virginia ,COVID-19 ,Infant ,Middle Aged ,biology.organism_classification ,medicine.disease ,Pneumonia ,Infectious Diseases ,Child, Preschool ,Hospital admission ,Emergency medicine ,Female ,business ,Coronavirus Infections - Published
- 2020
34. Utility of retesting for diagnosis of SARS-CoV-2/COVID-19 in hospitalized patients: Impact of the interval between tests
- Author
-
Rachel Pryor, Pamela Bailey, Michael P. Stevens, Dorothy Mackey, Emily Godbout, Alexandra L. Bryson, Gonzalo Bearman, Michelle Doll, Kaila Cooper, and Christopher D. Doern
- Subjects
Microbiology (medical) ,2019-20 coronavirus outbreak ,Time Factors ,Coronavirus disease 2019 (COVID-19) ,Epidemiology ,Hospitalized patients ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,Research Brief ,Betacoronavirus ,COVID-19 Testing ,Nasopharynx ,Pandemic ,Medicine ,Humans ,False Negative Reactions ,Pandemics ,Inpatients ,biology ,business.industry ,Clinical Laboratory Techniques ,SARS-CoV-2 ,Patient Selection ,COVID-19 ,biology.organism_classification ,Virology ,Infectious Diseases ,business ,Coronavirus Infections - Published
- 2020
35. HIV-Associated Aortitis Causing Rapid Development of an Abdominal Aortic Aneurysm
- Author
-
Margaret Rigamer, Ashley Rosenberg, Mark M. Levy, and Pamela Bailey
- Subjects
medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Human immunodeficiency virus (HIV) ,Computed tomography ,HIV Infections ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Endovascular aneurysm repair ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Aortic aneurysm ,Blood Vessel Prosthesis Implantation ,0302 clinical medicine ,Aneurysm ,Medicine ,Humans ,cardiovascular diseases ,Aortitis ,Aged ,medicine.diagnostic_test ,business.industry ,Endovascular Procedures ,General Medicine ,medicine.disease ,Abdominal aortic aneurysm ,Anti-Bacterial Agents ,Treatment Outcome ,Anti-Retroviral Agents ,cardiovascular system ,Disease Progression ,Surgery ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Abdominal surgery ,Aortic Aneurysm, Abdominal - Abstract
Vasculitides are rare manifestations of human immunodeficiency virus (HIV) infection. They encompass a wide range of different pathologies, both infectious and noninfectious. We present the case of a 68-year-old female with HIV, being treated with antiretrovirals, who presented with a symptomatic abdominal aortic aneurysm. The aneurysm developed within one week. The patient underwent endovascular aneurysm repair, and her aneurysm completely resolved on follow-up computed tomography imaging 16 months later. We also present a review of HIV-associated vascular pathologies.
- Published
- 2019
36. Nocardia beijingensis lung mass in an immunocompetent adult
- Author
-
Pamela Bailey, Rasha Raslan, and Sangeeta Sastry
- Subjects
0301 basic medicine ,Doxycycline ,Lung ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Sulfamethoxazole ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,030106 microbiology ,Nocardiosis ,Case Report ,General Medicine ,medicine.disease ,Trimethoprim ,Microbiology ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030228 respiratory system ,medicine ,Nocardia beijingensis ,business ,medicine.drug - Abstract
A 47-year-old man was referred for ongoing workup of an enlarging lung mass. Extensive workup of the mass had been unrevealing for several months until cultures grew Nocardia beijingensis. He was successfully treated with trimethoprim/sulfamethoxazole and then doxycycline with near-complete resolution of the mass on follow-up. This case presents a rare species of N. beijingensis. It highlights the importance of considering nocardiosis in immunocompetent adults and the challenge in initiating targeted treatment due to delayed culture results.
- Published
- 2021
- Full Text
- View/download PDF
37. 857. Contact Precautions as a Barrier to Hand Hygiene: PDSA to Improve Compliance with Gloved Hand Hygiene
- Author
-
Jo Dee Armstrong-Novak, Kaila Cooper, Michael P. Stevens, Pamela Bailey, Gonzalo Bearman, and Michelle Doll
- Subjects
business.industry ,media_common.quotation_subject ,Hawthorne effect ,Washing hands ,medicine.disease ,Infectious Diseases ,Hand sanitizer ,Contact precautions ,AcademicSubjects/MED00290 ,Oncology ,Hygiene ,Poster Abstracts ,Medicine ,Medical emergency ,business ,PDCA ,Personal protective equipment ,media_common - Abstract
Background Full compliance with personal protective equipment (PPE) is challenging, with multiple barriers noted: adherence to appropriate PPE, lack of knowledge of appropriate PPE, added time to workflow, and appropriate donning/doffing techniques of PPE to avoid self-contamination. Recent studies note that nurses tend to batch care to achieve more while in the room. A hand hygiene technology system alerted MRICU nurses to difficulties performing WHO’s Five Moments of hand hygiene (HH) when in contact precaution PPE. Methods We implemented the ‘Plan-Do-Study-Act’ (PDSA) framework to address the MRICU team concerns. Six nurses were directly observed while providing bedside care to understand nursing workflow and barriers to HH while in contact precautions. Results All 6 nurses performed hand hygiene prior to entering the room and at the time of exiting the room. Once donning contact precautions, they had variable but low compliance with any additional HH opportunities. The average missed opportunities per encounter was 5.2 (range: 2-11). Moments that would require hand washing or sanitizer if nurse were not gloved were not met with changing gloves. An average of 9.8 tasks were achieved in each room (range: 3-18). On average, each visit was 16 (range: 4-30 minutes) minutes long. Conclusion There is significant opportunity for improved HH while in PPE. Nurses may be more aware of the “Five moments” when not wearing gloves in contact precaution rooms, but lose the trigger once the gloves are on in the contact precaution rooms. An education campaign to improve hand sanitizer usage with gloves is the next step in this PDSA. More prominent placement of glove boxes in the rooms will also serve as a trigger to remind nurses to change gloves after certain tasks. Limitations of this PDSA cycle include Hawthorne effect of the nurses knowing they were observed and potentially changing their workflow. We also only observed morning workflow; nurses on different shifts may have different workflow. Disclosures All Authors: No reported disclosures
- Published
- 2020
38. Can you see me now?: Medical device radio frequency interference with hand hygiene technology
- Author
-
Michael P. Stevens, Pamela Bailey, J. Armstrong, O. Hess, Rachel Pryor, Emily Godbout, Gonzalo Bearman, Kaila Cooper, and Michelle Doll
- Subjects
Microbiology (medical) ,Medical device ,business.industry ,Computer science ,media_common.quotation_subject ,Electrical engineering ,General Medicine ,Electromagnetic interference ,lcsh:Infectious and parasitic diseases ,Infectious Diseases ,Hygiene ,lcsh:RC109-216 ,business ,media_common - Published
- 2020
- Full Text
- View/download PDF
39. The neglected wrists under white coats: An achilles heel for hand hygiene?
- Author
-
Emily Godbout, L. Lesane, Kaila Cooper, Michelle Doll, Gonzalo Bearman, Pamela Bailey, and Michael P. Stevens
- Subjects
Microbiology (medical) ,White (horse) ,Heel ,business.industry ,media_common.quotation_subject ,Dentistry ,General Medicine ,lcsh:Infectious and parasitic diseases ,Infectious Diseases ,medicine.anatomical_structure ,Hygiene ,Medicine ,lcsh:RC109-216 ,business ,media_common - Published
- 2020
- Full Text
- View/download PDF
40. Plant community approach to establishing vegetation on DMPAs and CDFs
- Author
-
Scott G. Bourne, Sarah J. Miller, Tosin A. Sekoni, Pamela. Bailey, and Timothy J. Cary
- Subjects
Agroforestry ,medicine ,Environmental science ,Plant community ,medicine.symptom ,Vegetation (pathology) - Published
- 2019
- Full Text
- View/download PDF
41. Variation in a novel antipseudomonal antimicrobial consumption metric across hospital inpatient units at a Veterans Affairs hospital: A retrospective cohort study
- Author
-
J. Daniel Markley, Roy T. Sabo, Pamela Bailey, Daniel Tassone, Leroy Vaughan, Michael P. Stevens, and Nicole C. Vissichelli
- Subjects
medicine.medical_specialty ,Carbapenem ,Epidemiology ,Microbial Sensitivity Tests ,03 medical and health sciences ,Antimicrobial Stewardship ,0302 clinical medicine ,medicine ,Inpatient units ,Antimicrobial stewardship ,Humans ,030212 general & internal medicine ,Veterans Affairs ,Retrospective Studies ,Veterans ,Consumption (economics) ,0303 health sciences ,Inpatients ,030306 microbiology ,business.industry ,Health Policy ,Public Health, Environmental and Occupational Health ,Retrospective cohort study ,Antimicrobial ,Drug Utilization ,Hospitals ,Anti-Bacterial Agents ,Infectious Diseases ,Carbapenems ,Emergency medicine ,Pseudomonas aeruginosa ,Metric (unit) ,business ,Hospital Units ,medicine.drug - Abstract
A novel antimicrobial consumption metric designed to identify the proportion of carbapenem consumption (PoCC) among broad-spectrum antipseudomonal antimicrobials has been shown to vary significantly by US Census Bureau region. This retrospective surveillance study identified significant total PoCC variability (27%; P = .001) across 8 inpatient units from January 2017 through June 2018. This metric may be useful in identifying and comparing inpatient units that may be overusing antipseudomonal carbapenems.
- Published
- 2019
42. Growing Up Muslim: The Impact of Islamophobia on Children in a Canadian Community
- Author
-
Gina Kayssi, Yasmine Hussain, Kathryn Lambert, Siham Elkassem, Andrew Mantulak, Asad Choudhary, Pamela Bailey, and Rick Csiernik
- Subjects
Health (social science) ,Islamophobia ,media_common.quotation_subject ,05 social sciences ,Religious studies ,Ethnic group ,050109 social psychology ,Islam ,Context (language use) ,Hostility ,Criminology ,Faith ,Psychiatry and Mental health ,Politics ,medicine ,0501 psychology and cognitive sciences ,Sociology ,medicine.symptom ,Prejudice (legal term) ,050104 developmental & child psychology ,media_common - Abstract
With the increase of anti-Muslim bigotry in the current political and societal climate, ethnic minority children in western nations may experience increased negative attention fueled by Islamophobia. Islamophobia is defined as the dislike of or prejudice against Islam, and individuals who are Muslims. A literature review yielded little research that examines the experience of Muslim children and their experiences with Islamophobia, particularly in the Canadian context. However, studies on the overall issue reveal Islamophobia is a phenomenon that has impacted Muslims around the world. This community-based study explored the dichotomous experiences of Muslim school-aged children who are taught theirs is a faith of peace and yet who regularly experience microaggressions and overt hostility because of their beliefs.
- Published
- 2018
- Full Text
- View/download PDF
43. 161. Evaluating the Predictive Value of Blood Culture Bottle Reporting for Coagulase Negative Staphylococci-Positive Cultures: Assessing Contamination vs. True Bacteremia
- Author
-
Christopher D. Doern and Pamela Bailey
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.drug_class ,Antibiotics ,cons ,Contamination ,medicine.disease_cause ,medicine.disease ,Predictive value ,Abstracts ,Infectious Diseases ,Oncology ,Bacteremia ,Poster Abstracts ,Medicine ,Blood culture ,Coagulase ,business ,Intensive care medicine ,Staphylococcus - Abstract
Background Coagulase-negative staphylococci (CoNS) are common blood culture (BCx) contaminants, but can also be causes of true blood stream infection (BSI). As a result, the clinical interpretation of CoNS positive BCx poses a significant challenge for providers and drives unnecessary antibiotic use, extended lengths of stay, and increased hospital costs. Despite these challenges, little is known about whether the number of positive BCx bottles within a set can be used to predict contamination vs. true BSI. Methods This study was conducted in an 865-bed tertiary care academic medical center in Richmond, VA. A retrospective chart review of CoNS-positive BCx from October to December 2018 was performed. Data collection included patient demographics, number of positive bottles within a set (i.e., were 1 or 2 bottles positive), care setting, antibiotic use, clinical judgement of contamination, and additional workup following the positive BCx result. Polymicrobic BCx were excluded. Results 50 patients (mean age 58.2 years, 60% male) with CoNS-positive BCx were included in this study. Forty (80%) of the cultures had only 1 of 2 BCx bottles positive within a set. 10 (20%) were positive from both bottles in the set. All patients were drawn in the Emergency Department and 90% were subsequently admitted to the hospital. Upon chart review, 47 (94%) and 3 (6%) of cultures were considered to be contaminants and real BSI, respectively. Of those judged to be contaminants, 10 (20%) were positive in both bottles within a set, and thus falsely suggested true BSI. Of the 3 judged to be true BSI, 2 (66%) were positive in 1 out of 2 bottles, and thus falsely suggested contamination. 42 (84%) patients had repeat BCx drawn following the initial positive culture, and 26 (52%) were continued on IV antibiotics. Forty (80%) of the cultures were judged contaminants by the primary medical service, and 77% stopped antibiotics (20/26) when CoNS was identified. Conclusion These data show that reporting the number of bottles which are positive within a set provides misleading information and should not be used to determine whether a culture result represents contamination or true BSI. Disclosures All authors: No reported disclosures.
- Published
- 2019
44. Introduction to using native plant community on dredge material placement areas
- Author
-
Trudy J. Estes, Pamela. Bailey, Scott G. Bourne, Tosin A. Sekoni, and David L. Price
- Subjects
Dredging ,Engineering ,Geographic information system ,business.industry ,Environmental resource management ,Sustainability ,Technical report ,Technical note ,Vegetation ,Native plant ,business ,Civil engineering - Abstract
This Engineering With Nature (EWN) Technical Note (TN) is the first in a series concerning the use of vegetation in Dredge Material Placement Areas (DMPA), including Confined Disposal Facilities (CDF), to achieve specific operational, engineering, and ecological benefits. Establishment of native plant communities within DMPA and CDF offers several advantages in terms of sustainability and cost.
- Published
- 2017
- Full Text
- View/download PDF
45. Clinical Microbiology Q&A
- Author
-
Pamela Bailey, Jillian E. Raybould, and Christopher D. Doern
- Subjects
0301 basic medicine ,Microbiology (medical) ,03 medical and health sciences ,Clinical microbiology ,medicine.medical_specialty ,Infectious Diseases ,business.industry ,030106 microbiology ,medicine ,business ,Dermatology - Published
- 2018
- Full Text
- View/download PDF
46. Chromosome Number and Reproductive Attributes ForErigeron lemmonii(Asteraceae), A Cliff-Dwelling Endemic of Southeastern Arizona
- Author
-
Richard D. Noyes and Pamela Bailey
- Subjects
education.field_of_study ,Erigeron ,Population ,Endangered species ,food and beverages ,Biology ,Asteraceae ,biology.organism_classification ,medicine.disease_cause ,Erigeron lemmonii ,Pollen ,Botany ,medicine ,Ploidy ,Megaspore ,education - Abstract
Erigeron lemmonii A. Gray, restricted to Scheelite Canyon in the Huachuca Range, Arizona, has previously been proposed for federal listing as an endangered species but basic cytological and reproductive information has been wanting. The first chromosome count for the species is 2n = 18, which is the common diploid number in Erigeron. Analyses of eight plants from five disparate sites within the population show that pollen averages 85.8% staining in cotton blue in lactophenol. Microscopic observation using differential interference contrast optics shows that E. lemmonii combines about equally monosporic and bisporic megagametophyte development within a single capitulum. Despite variability in developmental route, the egg apparatus among mature megagametophytes appears to be nearly uniform in structure. In greenhouse culture, isolated plants fail to set seed indicating that plants are probably self-incompatible. Controlled crosses yield seed, but variation in seed set intimates the possible prese...
- Published
- 2014
- Full Text
- View/download PDF
47. Patterns of genetic diversity in the rare Erigeron lemmoni and comparison with its more widespread congener, Erigeron arisolius (Asteraceae)
- Author
-
Pamela Bailey, Richard F. Lance, Denise L. Lindsay, and Christine E. Edwards
- Subjects
Genetic diversity ,education.field_of_study ,Ecology ,Population size ,Population ,Outcrossing ,Biology ,Population bottleneck ,Genetic drift ,Evolutionary biology ,Erigeron lemmonii ,Genetic structure ,Genetics ,education ,Ecology, Evolution, Behavior and Systematics - Abstract
Analysis of levels and patterns of genetic variation in a rare species is important for determining whether genetic factors associated with small population size, such as genetic drift or inbreeding, may be negatively affecting a species. In this study, we compared estimates of genetic diversity and patterns of population genetic structure in a rare cliff endemic, Erigeron lemmonii, to those of a widespread congener, E. arisolius. Our goals were to assess whether rarity and small population size have negatively affected levels of genetic diversity in E. lemmonii and to identify genetic threats that may limit the ability of E. lemmonii to persist. Levels of observed and expected heterozygosity and allelic richness in E. lemmonii were approximately 60 % of those found in E. arisolius. After correcting for null alleles, inbreeding coefficients in both species of Erigeron were very small, suggesting that both species are highly outcrossing and may demonstrate self-incompatibility. Patterns of genetic structure in both species revealed almost no population substructuring, indicating that widespread gene flow is occurring within each species. Because we found no evidence for inbreeding or a genetic bottleneck in E. lemmonii, it is likely that the species’ lower genetic diversity may be the result of genetic drift. Because E. lemmoni exists in a single population, no other populations exist to bolster population size or genetic diversity in the event of declines; thus, conservation efforts should focus on seed collection from as many individuals as possible to protect against possible future losses of genetic diversity. We also recommend continued monitoring of both population size and genetic diversity in E. lemmonii to ensure the species’ long-term persistence and viability.
- Published
- 2013
- Full Text
- View/download PDF
48. Identification of Insect-Plant Pollination Networks for a Midwest Installation: Fort McCoy, WI
- Author
-
Jinelle H. Sperry, Irene E. MacAllister, and Pamela Bailey
- Subjects
Pollination ,Ecology ,Pollinator ,media_common.quotation_subject ,Plant species ,Identification (biology) ,Ecosystem ,Insect ,Biology ,Software package ,Network software ,media_common - Abstract
Pollinating insects and pollinator dependent plants are critical components of functioning ecosystems yet, for many U.S. Department of Defense (DoD) installations, the identities and relationships between pollinators and plants are unknown. This study demonstrated methods for compiling and analyzing readily available information for insect pollinators and pollination dependent plants for a single installation, Fort McCoy, WI. Although installation documents identified a total of 1470 insect species and 972 plant species were identified on the installation, this work focused on species of conservation concern (nine pollinator insect species and three pollinator-associated plant species). Published information on insect pollinators and pollination dependent plants was then used to conduct a basic plant-pollinator network analyses using free analytical network software (software package R), which revealed that all the plant species of conservation concern are pollinated by several insect pollinator species. However, many pollinator insect species of conservation concern were associated with a limited number of host plant species. The results of this work suggest that analyses that rely on publicly available information provide a useful starting point in determining basic, binary plant-pollinator relationships. Field-collected data, e.g., frequency of pollinator-plant interactions, would be required for a more detailed, robust network analysis.
- Published
- 2016
- Full Text
- View/download PDF
49. Isolation and characterization of microsatellite loci for a hyper-rare cliff endemic, Erigeron lemmonii, and a more widespread congener, Erigeron arisolius (Asteraceae)
- Author
-
Denise L. Lindsay, Joseph L. Anderson, Christine E. Edwards, Michael G. Jung, Richard F. Lance, and Pamela Bailey
- Subjects
Genetics ,Erigeron ,Biodiversity ,Biology ,Asteraceae ,biology.organism_classification ,Congener ,Evolutionary biology ,Erigeron lemmonii ,Genetic structure ,Erigeron arisolius ,Microsatellite ,Ecology, Evolution, Behavior and Systematics - Abstract
We identified eight novel polymorphic microsatellite loci in Erigeron lemmonii and nine novel polymorphic microsatellite loci in Erigeron arisolius. Of these, three loci developed for E. arisolius cross-amplified E. lemmonii DNA and four loci developed for E. lemmonii cross-amplified E. arisolius DNA. This set of 17 loci will be used to analyze patterns of genetic structure in populations of these two Erigeron species in southeastern Arizona with the ultimate goal of comparing patterns of genetic structure within a hyper-rare cliff endemic (E. lemmonii) to those of a more widespread congener (E. arisolius).
- Published
- 2012
- Full Text
- View/download PDF
50. Effects of a nonnative, invasive lovegrass on Agave palmeri distribution, abundance, and insect pollinator communities
- Author
-
Neil S. Cobb, Robert Delph, Michael J. Clifford, Denise L. Lindsay, Pamela Bailey, and Richard F. Lance
- Subjects
Agave palmeri ,Ecology ,biology ,Endangered species ,Biodiversity ,Native plant ,biology.organism_classification ,Abundance (ecology) ,Threatened species ,Species richness ,Ecology, Evolution, Behavior and Systematics ,Eragrostis lehmanniana ,Nature and Landscape Conservation - Abstract
Nonnative Lehmann lovegrass (Eragrostis lehmanniana) has invaded large areas of the Southwestern United States, and its impact on native plants is not fully understood. Palmer's agave (Agave palmeri), an important resource for many pollinators, is a key native plant potentially threatened by E. lehmanniana. Understanding potential impacts of E. lehmanniana on A. palmeri is critical for anticipating the future of the desert community where they coexist and for addressing management concerns about associated threatened and endangered species. Our study provides strong indications that E. lehman- niana negatively impacts A. palmeri in several ways. Areas of high E. lehmanniana abundance were associated with significantly lower densities and greater relative frequen- cies of small A. palmeri, suggesting that E. lehmanniana may exclude A. palmeri. There were no significant differences in species richness, abundance, or community composition when comparing flower associates associated with A. palmeri in areas of high and low E. lehmanniana abundance. However, we did find significantly lower connectedness within the pollination network associated with A. palmeri in areas with high E. lehmanniana abundance. Although E. lehmanniana forms thick stands that would presumably increase fire frequency, there was no significant association between E. lehmanniana and fire fre- quency. Interestingly, medium to high densities of A. palmeri were associated with areas of greater fire frequency. The complex ramifications of E. lehmanniana invasion for the long-lived A. palmeri and interlinked desert community warrant continued study, as these
- Published
- 2011
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.