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  1. Article ; Online: Optimized infection control practices augment the robust protective effect of vaccination for ESRD patients during a hemodialysis facility SARS-CoV-2 outbreak.

    Meller, Megan E / Pfaff, Bridget L / Borgert, Andrew J / Richmond, Craig S / Athas, Deena M / Kenny, Paraic A / Sabin, Arick P

    American journal of infection control

    2022  Volume 50, Issue 10, Page(s) 1118–1124

    Abstract: Background: While dialysis patients are at greater risk of serious SARS-CoV-2 complications, stringent infection prevention measures can help mitigate infection and transmission risks within dialysis facilities. We describe an outbreak of 14 cases ... ...

    Abstract Background: While dialysis patients are at greater risk of serious SARS-CoV-2 complications, stringent infection prevention measures can help mitigate infection and transmission risks within dialysis facilities. We describe an outbreak of 14 cases diagnosed in a hospital-based outpatient ESRD facility over 13 days in the second quarter of 2021, and our coordinated use of epidemiology, viral genome sequencing, and infection control practices to quickly end the transmission cycle.
    Methods: Symptomatic patients and staff members were diagnosed by RT-PCR. Facility-wide screening utilized SARS-CoV-2 antigen tests. SARS-CoV-2 genome sequences were obtained from residual diagnostic specimens.
    Results: Of the 106 patients receiving dialysis in the facility, 10 were diagnosed with SARS-CoV-2 infection, as was 1 patient support person. Of 3 positive staff members, 2 were unvaccinated and had provided care for 6 and 4 of the affected patients, respectively. Sequencing demonstrated that all cases in the cluster shared an identical B.1.1.7./Alpha substrain. Attack rates were greatest among unvaccinated patients and staff. Vaccine effectiveness was 88% among patients.
    Conclusions: Prompt recognition of an infection cluster and rapid intervention efforts successfully ended the outbreak. Alongside consistent adherence to core infection prevention measures, vaccination was highly effective in reducing disease incidence and morbidity in this vulnerable population.
    MeSH term(s) COVID-19/epidemiology ; COVID-19/prevention & control ; Disease Outbreaks/prevention & control ; Humans ; Infection Control ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy ; Renal Dialysis/adverse effects ; SARS-CoV-2 ; Vaccination
    Language English
    Publishing date 2022-07-19
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 392362-9
    ISSN 1527-3296 ; 0196-6553
    ISSN (online) 1527-3296
    ISSN 0196-6553
    DOI 10.1016/j.ajic.2022.06.025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1773: Show issues Location:
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  2. Article ; Online: Optimized infection control practices augment the robust protective effect of vaccination for ESRD patients during a hemodialysis facility SARS-CoV-2 outbreak

    Meller, Megan E / Pfaff, Bridget L / Borgert, Andrew J / Richmond, Craig S / Athas, Deena M / Kenny, Paraic A / Sabin, Arick P

    medRxiv

    Abstract: Background: While dialysis patients are at greater risk of serious SARS-CoV-2 complications, stringent infection prevention measures can help mitigate the risk of infection and transmission within dialysis facilities. We describe an outbreak of 14 cases ... ...

    Abstract Background: While dialysis patients are at greater risk of serious SARS-CoV-2 complications, stringent infection prevention measures can help mitigate the risk of infection and transmission within dialysis facilities. We describe an outbreak of 14 cases diagnosed in a 13-day period between May and June of 2021 in a hospital-based ESRD facility, and our coordinated use of epidemiology, viral genome sequencing, and infection control practices to quickly end the cycle of transmission. Methods: Symptomatic patients and staff members were diagnosed via RT-PCR tests. Facility-wide screening was conducted using rapid SARS-CoV-2 antigen tests. SARS-CoV-2 genome sequences were obtained from residual diagnostic PCR specimens. Results: Of the 106 patients who received dialysis in the facility, 10 were diagnosed with SARS-CoV-2 infection, as was one patient support person. Of three positive staff members, two were unvaccinated and had provided care for six and four of the affected patients, respectively. Sequencing demonstrated that all the cases in the cluster shared an identical B.1.1.7./Alpha substrain. Attack rates were greatest among unvaccinated patients and staff. Vaccine effectiveness was 88% among patients. Conclusions: Prompt recognition of an infection cluster and rapid intervention efforts successfully ended the outbreak. Alongside consistent adherence to core infection prevention measures, vaccination was highly effective in reducing disease incidence and morbidity in this vulnerable population.
    Keywords covid19
    Language English
    Publishing date 2022-03-25
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2022.03.18.22272356
    Database COVID19

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  3. Article: Blastomycosis diagnosed in a nonhyperendemic area.

    Pfaff, Bridget L / Agger, William A / Volk, Thomas J

    WMJ : official publication of the State Medical Society of Wisconsin

    2014  Volume 113, Issue 1, Page(s) 11–8; quiz 19

    Abstract: Introduction: Blastomycosis, caused by the dimorphic fungus Blastomyces dermatitidis, is hyperendemic in northern Wisconsin and is unevenly distributed in the rest of the state and contiguous Minnesota. Clinical presentation of this illness has been ... ...

    Abstract Introduction: Blastomycosis, caused by the dimorphic fungus Blastomyces dermatitidis, is hyperendemic in northern Wisconsin and is unevenly distributed in the rest of the state and contiguous Minnesota. Clinical presentation of this illness has been characterized by localized outbreaks and sporadic cases in endemic areas.
    Methods: Using ICD-9 CPT codes, we queried our electronic health record system to identify cases of blastomycosis diagnosed at Gundersen Health System over a 32-year period. Gundersen serves a region outside the hyperendemic area of Wisconsin. Records so identified were reviewed for demographic and clinical features. We attempted to interview patients with a blastomycosis diagnosis from 2002 through 2006. Blastomycosis data also were collected from the states of Wisconsin and Minnesota from 2002 through 2006 and assessed for trends.
    Results: Thirty-six patients had blastomycosis diagnoses at Gundersen Health System during the study period, as identified by ICD-9 code. Of these, 10 were excluded from further review because they were either miscoded or the code indicated a previous diagnosis. The remaining 26 patients were included in the study. Premorbid conditions included diabetes (38%) and smoking (62%). The mean time from onset of symptoms to the first laboratory specimen positive for B dermatitidis was 51 days. Notably, 73% of these patients were treated initially for bacterial pneumonia. The incidence of blastomycosis in Wisconsin in the review period was 2.0 per 100,000, and the rate in Minnesota was 0.5 per 100,000. Based on the census data in Gundersen Health System's 19-county service area, the incidence of blastomycosis is 0.17 cases per 100,000.
    Conclusion: In this review of blastomycosis cases diagnosed outside the hyperendemic area of northern Wisconsin, diagnosis was often delayed, and 4 patients whose infections might have been treatable died. Although uncommon, blastomycosis needs to be considered in the differential diagnosis in areas outside the hyperendemic area.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Blastomycosis/diagnosis ; Blastomycosis/epidemiology ; Female ; Humans ; International Classification of Diseases ; Interviews as Topic ; Male ; Middle Aged ; Minnesota/epidemiology ; Retrospective Studies ; Wisconsin/epidemiology
    Language English
    Publishing date 2014-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 441051-8
    ISSN 1098-1861 ; 0043-6542
    ISSN 1098-1861 ; 0043-6542
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.B 225: Show issues Location:
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  4. Article ; Online: Outbreak or pseudo-outbreak? Integrating SARS-CoV-2 sequencing to validate infection control practices in a dialysis facility.

    Pfaff, Bridget L / Richmond, Craig S / Sabin, Arick P / Athas, Deena M / Adams, Jessica C / Meller, Megan E / Usha, Kumari / Schmitz, Sarah A / Simmons, Brian J / Borgert, Andrew J / Kenny, Paraic A

    American journal of infection control

    2021  Volume 49, Issue 10, Page(s) 1232–1236

    Abstract: Background: The COVID-19 pandemic poses a particularly high risk for End Stage Renal Disease (ESRD) patients so rapid identification of case clusters in ESRD facilities is essential. Nevertheless, with high community prevalence, a series of ESRD ... ...

    Abstract Background: The COVID-19 pandemic poses a particularly high risk for End Stage Renal Disease (ESRD) patients so rapid identification of case clusters in ESRD facilities is essential. Nevertheless, with high community prevalence, a series of ESRD patients may test positive contemporaneously for reasons unrelated to their shared ESRD facility. Here we describe a series of 5 cases detected within 11 days in November 2020 in a hospital-based 32-station ESRD facility in Southwest Wisconsin, the subsequent facility-wide testing, and the use of genetic sequence analysis to evaluate links between cases.
    Methods: Four patient cases and one staff case were identified in symptomatic individuals by RT-PCR. Facility-wide screening was conducted using rapid SARS-CoV-2 antigen tests. SARS-CoV-2 genome sequences were obtained from residual diagnostic specimens.
    Results: Facility-wide screening of 47 staff and 107 patients identified no additional cases. Residual specimens from 4 of 5 cases were available for genetic sequencing. Clear genetic differences proved that these contemporaneous cases were not linked.
    Conclusions: With high community prevalence, epidemiological data alone is insufficient to deem a case cluster an outbreak. Cluster evaluation with genomic data, when available with a short turn-around time, can play an important role in infection prevention and control response programs.
    MeSH term(s) COVID-19 ; Disease Outbreaks ; Humans ; Infection Control ; Pandemics ; Renal Dialysis ; SARS-CoV-2 ; Sequence Analysis
    Language English
    Publishing date 2021-08-08
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 392362-9
    ISSN 1527-3296 ; 0196-6553
    ISSN (online) 1527-3296
    ISSN 0196-6553
    DOI 10.1016/j.ajic.2021.08.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1773: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Outbreak or pseudo-outbreak? Integrating SARS-CoV-2 sequencing to validate infection control practices in an end stage renal disease facility

    Pfaff, Bridget L / Richmond, Craig S / Sabin, Arick P / Athas, Deena M / Adams, Jessica C / Meller, Megan E / Usha, Kumari / Schmitz, Sarah A / Simmons, Brian J / Borgert, Andrew J / Kenny, Paraic A

    medRxiv

    Abstract: Background: The COVID-19 pandemic of 2020 poses a particularly high risk for End Stage Renal Disease (ESRD) patients and led to a need for facility-wide control plans to prevent introduction and spread of infection within ESRD facilities. Rapid ... ...

    Abstract Background: The COVID-19 pandemic of 2020 poses a particularly high risk for End Stage Renal Disease (ESRD) patients and led to a need for facility-wide control plans to prevent introduction and spread of infection within ESRD facilities. Rapid identification of clusters of contemporaneous cases is essential, as these may be indicative of within-facility spread. Nevertheless, in a setting of high community COVID-19 prevalence, a series of ESRD patients may test positive at around the same time without their shared ESRD facility being the nexus for disease spread. Here we describe a series of five cases occurring within an eleven-day period in November 2020 in a hospital-based 32-station ESRD facility in southwest Wisconsin, the subsequent facility-wide testing, and the use of genetic sequence analysis of positive specimens to evaluate whether these cases were linked. Methods: Four patient cases and one staff case were identified in symptomatic individuals by RT-PCR. Facility-wide screening was initiated at the request of local public health and conducted using Abbot BinaxNOW antigen tests. SARS-CoV-2 genome sequences were obtained from residual diagnostic test specimens using an amplicon-based approach on an Ion Torrent S5 sequencer. Results: Residual specimens from 4 of 5 cases were available for sequence analysis. Each sequence was very clearly genetically distinct from the others, indicating that these contemporaneous cases were not linked. Facility-wide screening of 47 staff and 107 patients did not identify any additional cases. Conclusions: These data indicate that despite the outward appearance of a case cluster, the facility did not experience within-facility spread nor serve as the epicenter of a new outbreak, suggesting that the enacted rigorous infection control procedures (screening, masking, distancing) practiced stringently by patients and staff were sufficient to permit dialysis to proceed safely in a very high-risk population under pressure from increasing community spread. These data also demonstrate the utility of rapid turnaround SARS-CoV-2 sequencing in outbreak investigations in settings like ESRD facilities.
    Keywords covid19
    Language English
    Publishing date 2021-01-06
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2020.12.30.20249062
    Database COVID19

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