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Full-Text Articles in Epidemiology
Multicenter Evaluation Of A Novel Surveillance Paradigm For Complications Of Mechanical Ventilation, Michael Klompas, Yosef Khan, Kenneth Kleinman, R.Scott Evans, James F. Lloyd, Kurt Stevenson, Matthew Samore, Richard Platt
Multicenter Evaluation Of A Novel Surveillance Paradigm For Complications Of Mechanical Ventilation, Michael Klompas, Yosef Khan, Kenneth Kleinman, R.Scott Evans, James F. Lloyd, Kurt Stevenson, Matthew Samore, Richard Platt
Public Health Department Faculty Publication Series
BACKGROUND:
Ventilator-associated pneumonia (VAP) surveillance is time consuming, subjective, inaccurate, and inconsistently predicts outcomes. Shifting surveillance from pneumonia in particular to complications in general might circumvent the VAP definition's subjectivity and inaccuracy, facilitate electronic assessment, make interfacility comparisons more meaningful, and encourage broader prevention strategies. We therefore evaluated a novel surveillance paradigm for ventilator-associated complications (VAC) defined by sustained increases in patients' ventilator settings after a period of stable or decreasing support.
METHODS:
We assessed 600 mechanically ventilated medical and surgical patients from three hospitals. Each hospital contributed 100 randomly selected patients ventilated 2-7 days and 100 patients ventilated >7 …
Colonization With Antibiotic-Susceptible Strains Protects Against Methicillin-Resistant Staphylococcus Aureus But Not Vancomycin-Resistant Enterococci Acquisition: A Nested Case-Control Study, Susan S. Huang, Rupak Datta, Sheryl Rifas-Shiman, Ken Kleinman, Hilary Placzek, Julie D. Lankiewicz, Richard Platt
Colonization With Antibiotic-Susceptible Strains Protects Against Methicillin-Resistant Staphylococcus Aureus But Not Vancomycin-Resistant Enterococci Acquisition: A Nested Case-Control Study, Susan S. Huang, Rupak Datta, Sheryl Rifas-Shiman, Ken Kleinman, Hilary Placzek, Julie D. Lankiewicz, Richard Platt
Public Health Department Faculty Publication Series
INTRODUCTION:
Harboring sensitive strains may prevent acquisition of resistant pathogens by competing for colonization of ecological niches. Competition may be relevant to decolonization strategies that eliminate sensitive strains and may predispose to acquiring resistant strains in high-endemic settings. We evaluated the impact of colonization with methicillin-sensitive Staphylococcus aureus (MSSA) and vancomycin-sensitive enterococci (VSE) on acquisition of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), respectively, when controlling for other risk factors.
METHODS:
We conducted a nested case-control study of patients admitted to eight ICUs performing admission and weekly bilateral nares and rectal screening for MRSA and VRE, respectively. Analyses were …