Digital Commons Network^™

A Risk Score For Identifying Methicillin-Resistant Staphylococcus Aureus In Patients Presenting To The Hospital With Pneumonia., Andrew F. Shorr, Daniela E. Myers, David B. Huang, Brian H. Nathanson, Matthew F. Emons, Marin H. Kollef

Emergency Medicine Faculty Publications

Background

Methicillin-resistant Staphylococcus aureus (MRSA) represents an important pathogen in healthcare-associated pneumonia (HCAP). The concept of HCAP, though, may not perform well as a screening test for MRSA and can lead to overuse of antibiotics. We developed a risk score to identify patients presenting to the hospital with pneumonia unlikely to have MRSA.

Methods

We identified patients admitted with pneumonia (Apr 2005 – Mar 2009) at 62 hospitals in the US. We only included patients with lab evidence of bacterial infection (e.g., positive respiratory secretions, blood, or pleural cultures or urinary antigen testing). We determined variables independently associated with the …

Rapid 13(C) Urea Breath Test To Identify Helicobacter Pylori Infection In Emergency Department Patients With Upper Abdominal Pain, Andrew C. Meltzer, Rebecca Pierce, Derek A.T. Cummings, Jesse M. Pines, Larissa May, Meaghan A. Smith, Joseph Marcotte, Melissa L. Mccarthy

Emergency Medicine Faculty Publications

Introduction: In emergency department (ED) patients with upper abdominal pain, management includes ruling out serious diseases and providing symptomatic relief. One of the major causes of upper abdominal pain is an ulcer caused by Helicobacter pylori (H. pylori), which can be treated and cured with antibiotics. We sought to estimate the prevalence of H. pylori infection in symptomatic patients using a convenience sample at a single urban academic ED and demonstrate the feasibility of ED-based testing.

Methods: We prospectively enrolled patients with a chief complaint of pain or discomfort in the upper abdomen for 1 year from February …

Prevalence And Risk Factor Analysis Of Resistant Escherichia Coli Urinary Tract Infections In The Emergency Department, Abby M. Bailey, Kyle A. Weant, Stephanie N. Baker

Emergency Medicine Faculty Publications

BACKGROUND: Escherichia coli (E. coli) is a frequent uropathogen in urinary tract infections (UTI). Widespread resistance to sulfamethoxazole-trimethoprim (SMX-TMP) and increasing resistance to fluoroquinolones amongst these isolates has been recognized. There are limited data demonstrating risk factors for resistance to both SMX-TMP and fluoroquinolones.

OBJECTIVE: This study was conducted to assess for the prevalence of community resistance amongst E. coli isolates to SMX-TMP and levofloxacin in ambulatory patients discharged from the emergency department (ED).

METHODS: Adults presenting for evaluation and discharged from the ED with a diagnosis of an E. coli UTI were retrospectively reviewed. Utilizing demographic and clinical data …

Pathogen-Specific Risk Of Chronic Gastrointestinal Disorders Following Bacterial Causes Of Foodborne Illness, Chad K. Porter, Daniel Choi, Brooks Cash, Mark Pimentel, Joseph Murray, Larissa May, Mark S. Riddle

Emergency Medicine Faculty Publications

Background

The US CDC estimates over 2 million foodborne illnesses are annually caused by 4 major enteropathogens: non-typhoid Salmonella spp., Campylobacter spp., Shigella spp. and Yersinia enterocoltica. While data suggest a number of costly and morbid chronic sequelae associated with these infections, pathogen-specific risk estimates are lacking. We utilized a US Department of Defense medical encounter database to evaluate the risk of several gastrointestinal disorders following select foodborne infections.

Methods

We identified subjects with acute gastroenteritis between 1998 to 2009 attributed to Salmonella(nontyphoidal) spp., Shigella spp., Campylobacter spp. or Yersinia enterocolitica and matched each with up to 4 …

Asynchronous Web-Based Learning, A Practical Method To Enhance Teaching In Emergency Medicine, Ali Pourmand, Raymond Lucas, Mehdi Nouraie

Emergency Medicine Faculty Publications

Objective: To compare medical knowledge acquisition among emergency medicine (EM) residents who attend weekly core content lectures with those absent but asynchronously viewing the same lectures in a Web-based electronic platform.

Subjects and Methods: During the study period all EM residents attending or absent from weekly educational conferences were given a quiz on the covered material. During Phase 1, absentees were not given supplemental educational content for missed lectures. During Phase 2, absentees were sent a link to an online multimedia module containing an audiovisual recording of the actual missed lecture with presentation slides. Scores between attendees and absentees during …

A Syndromic Approach To Emergency Department Surveillance For Skin And Soft Tissue Infections, Larissa S. May, Marcus Rennick, Leah Gustafson, Julia Gunn

Emergency Medicine Faculty Publications

Objective

We sought to describe the epidemiology of emergency department (ED) visits for skin and soft tissue infections (SSTI) in an urban area with diverse neighborhood populations using syndromic surveillance system data for the time period from 2007–2011. Our aims were threefold: to demonstrate a proof of concept using syndromic surveillance for SSTI surveillance in the absence of laboratory data, to estimate the burden of ED visits associated with SSTI, and to determine potential geographic “hotspots” for these infections.

Introduction

The incidence of and hospitalizations for SSTI have steadily increased over the last decade in the United States, primarily due …