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Journal: Open forum infectious diseases

223

Multidrug-resistant organism (MDRO) infections are associated with high mortality and readmission rates. Infectious diseases (ID) consultation improves clinical outcomes for drug-resistantStaphylococcus aureusbloodstream infections. Our goal was to determine the association between ID consultation and mortality following various MDRO infections.

Concepts: Immune system, Medicine, Epidemiology, Disease, Infectious disease, Death, Infection, The Association

43

Directly observed therapy (DOT) remains an integral component of treatment support and adherence monitoring in tuberculosis care. In-person DOT is resource intensive and often burdensome for patients. Video DOT (vDOT) has been proposed as an alternative to increase treatment flexibility and better meet patient-specific needs.

38

Kindergarten-entry vaccination requirements have played an important role in controlling vaccine-preventable diseases in the United States. Forty-eight states and the District of Colombia offer nonmedical exemptions to vaccines, ranging in stringency.

Concepts: Vaccine, Vaccination, United States, Washington, D.C., Humid subtropical climate, Organization of American States

25

As more patients seek care in the outpatient setting, the opportunities for health care-acquired infections and associated outbreaks will increase. Without uptake of core infection prevention and control strategies through formal initiation of infection prevention programs, outbreaks and patient safety issues will surface. This review provides a step-wise approach for implementing an outpatient infection control program, highlighting some of the common pitfalls and high-priority areas.

14

We evaluated the operating characteristics of 2 comparably trained dogs as a “point-of-care” diagnostic tool to detect toxin gene-positive Clostridium difficile. Although each dog could detect toxin gene-positive C difficile in stool specimens with sensitivities of 77.6 and 92.6 and specificities of 85.1 and 84.5, respectively, interrater reliability is only modest (Cohen’s kappa 0.52), limiting widespread application.

14

Background.  Little is known about the American public’s perceptions or knowledge about antibiotic-resistant bacteria or antibiotic misuse. We hypothesized that although many people recognize antibiotic resistance as a problem, they may not understand the relationship between antibiotic consumption and selection of resistant bacteria. Methods.  We developed and tested a survey asking respondents about their perceptions and knowledge regarding appropriate antibiotic use. Respondents were recruited with the Amazon Mechanical Turk crowdsourcing platform. The survey, carefully designed to assess a crowd-sourced population, asked respondents to explain “antibiotic resistance” in their own words. Subsequent questions were multiple choice. Results.  Of 215 respondents, the vast majority agreed that inappropriate antibiotic use contributes to antibiotic resistance (92%), whereas a notable proportion (70%) responded neutrally or disagreed with the statement that antibiotic resistance is a problem. Over 40% of respondents indicated that antibiotics were the best choice to treat a fever or a runny nose and sore throat. Major themes from the free-text responses included that antibiotic resistance develops by bacteria, or by the infection, or the body (ie, an immune response). Minor themes included antibiotic overuse and antibiotic resistance caused by bacterial adaptation or an immune response. Conclusions.  Our findings indicate that the public is aware that antibiotic misuse contributes to antibiotic resistance, but many do not consider it to be an important problem. The free-text responses suggest specific educational targets, including the difference between an immune response and bacterial adaptation, to increase awareness and understanding of antibiotic resistance.

Concepts: Immune system, Bacteria, Understanding, Antibiotic resistance, Antibiotic, Microorganism, Penicillin, Antibiotics

12

With declining interest in infectious disease (ID) noted among internal medicine (IM) residents, national attention has been directed at methods to recruit more prospective ID applicants. The factors driving the recent decline in ID fellowship applications have thus far only been evaluated in survey studies. Since 2008 at our institution, all IM interns were required to complete a 4-week inpatient ID rotation. We evaluated this rotation to determine if any experiential factors could be linked to future ID interest.

8

In 2011, The Infectious Diseases Society of America released a clinical practice guideline (CPG) that recommended short-course antibiotic therapy and avoidance of fluoroquinolones for uncomplicated urinary tract infections (UTIs). Recommendations from this CPG were rapidly disseminated to clinicians via review articles, UpToDate, and the Centers for Disease Control and Prevention website; however, it is unclear if this CPG had an impact on national antibiotic prescribing practices.

7

Tuberculosis (TB) remains a major challenge to global health. Healthcare workers (HCWs) appear to be at increased risk of TB compared with the general population, despite efforts to scale up infection control and reduce nosocomial TB transmission. This review aims to provide an updated estimate of the occupational risk of latent TB infection (LTBI) and active TB among HCWs compared with the general population.

Concepts: Health care, Health care provider, Medicine, Healthcare, Epidemiology, Infectious disease, Tuberculosis, Latent tuberculosis

6

Infections caused byMycobacterium abscessusgroup strains are usually resistant to multiple antimicrobials and challenging to treat worldwide. We describe the risk factors, treatment, and clinical outcomes of patients in 2 large academic medical centers in the United States.

Concepts: Cohort study, Epidemiology, Clinical trial, United States, Avicenna, Poverty in the United States, U.S. state, At-large