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Article ; Online: Social Network Analysis of Patient Movement Across Health Care Entities in Orange County, Florida.

Rankin, Danielle A / Matthews, Sarah D

Public health reports (Washington, D.C. : 1974)

2020 Volume 135, Issue 4, Page(s) 452–460

Abstract: Objective: Multidrug-resistant organisms (MDROs) are continually emerging and threatening health care systems. Little attention has been paid to the effect of patient transfers on MDRO dissemination among health care entities in health care systems. In ... ...

Abstract	Objective: Multidrug-resistant organisms (MDROs) are continually emerging and threatening health care systems. Little attention has been paid to the effect of patient transfers on MDRO dissemination among health care entities in health care systems. In this study, the Florida Department of Health in Orange County (DOH-Orange) developed a baseline social network analysis of patient movement across health care entities in Orange County, Florida, and regionally, within 6 surrounding counties in Central Florida. Materials and methods: DOH-Orange constructed 2 directed network sociograms-graphic visualizations that show the direction of relationships (ie, county and regional)-by using 2016 health insurance data from the Centers for Medicare & Medicaid Services, which include metrics that could be useful for local public health interventions, such as MDRO outbreaks. Results: We found that both our county and regional networks were sparse and centralized. The county-level network showed that acute-care hospitals had the highest influence on controlling the flow of patients between health care entities that would otherwise not be connected. The regional-level network showed that post-acute-care hospitals and other facilities (behavioral hospitals and mental health/substance abuse facilities) served as the primary controls for flow of patients between health care entities. The most prominent health care entities in both networks were the same 2 acute-care hospitals. Practice implications: Social network analysis can help local public health officials respond to MDRO outbreak investigations by determining which health care facilities are the main contributors of dissemination of MDROs or are at high risk of receiving patients with MDROs. This information can help epidemiologists prioritize prevention efforts and develop county- or regional-specific interventions to control and halt MDRO transmission across a health care network.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Female ; Florida ; Humans ; Male ; Middle Aged ; Patient Acceptance of Health Care/psychology ; Patient Acceptance of Health Care/statistics & numerical data ; Patient Discharge/statistics & numerical data ; Patient Satisfaction/statistics & numerical data ; Patient Transfer/statistics & numerical data ; United States
Language	English
Publishing date	2020-06-08
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	120953-x
ISSN	1468-2877 ; 0033-3549
ISSN (online)	1468-2877
ISSN	0033-3549
DOI	10.1177/0033354920930213
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Article ; Online: Diagnostic models predicting paediatric viral acute respiratory infections: a systematic review.

Rankin, Danielle A / Peetluk, Lauren S / Deppen, Stephen / Slaughter, James Christopher / Katz, Sophie / Halasa, Natasha B / Khankari, Nikhil K

BMJ open

2023 Volume 13, Issue 4, Page(s) e067878

Abstract: Objectives: To systematically review and evaluate diagnostic models used to predict viral acute respiratory infections (ARIs) in children.: Design: Systematic review.: Data sources: PubMed and Embase were searched from 1 January 1975 to 3 February ...

Abstract	Objectives: To systematically review and evaluate diagnostic models used to predict viral acute respiratory infections (ARIs) in children. Design: Systematic review. Data sources: PubMed and Embase were searched from 1 January 1975 to 3 February 2022. Eligibility criteria: We included diagnostic models predicting viral ARIs in children (<18 years) who sought medical attention from a healthcare setting and were written in English. Prediction model studies specific to SARS-CoV-2, COVID-19 or multisystem inflammatory syndrome in children were excluded. Data extraction and synthesis: Study screening, data extraction and quality assessment were performed by two independent reviewers. Study characteristics, including population, methods and results, were extracted and evaluated for bias and applicability using the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies and PROBAST (Prediction model Risk Of Bias Assessment Tool). Results: Of 7049 unique studies screened, 196 underwent full text review and 18 were included. The most common outcome was viral-specific influenza (n=7; 58%). Internal validation was performed in 8 studies (44%), 10 studies (56%) reported discrimination measures, 4 studies (22%) reported calibration measures and none performed external validation. According to PROBAST, a high risk of bias was identified in the analytic aspects in all studies. However, the existing studies had minimal bias concerns related to the study populations, inclusion and modelling of predictors, and outcome ascertainment. Conclusions: Diagnostic prediction can aid clinicians in aetiological diagnoses of viral ARIs. External validation should be performed on rigorously internally validated models with populations intended for model application. Prospero registration number: CRD42022308917.
MeSH term(s)	Child ; Humans ; Bias ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19 Testing ; Prognosis ; Respiratory Tract Infections/diagnosis ; SARS-CoV-2 ; Virus Diseases/diagnosis
Language	English
Publishing date	2023-04-21
Publishing country	England
Document type	Journal Article ; Systematic Review ; Research Support, N.I.H., Extramural
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2022-067878
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Article ; Online: Provider-ordered viral testing and antibiotic administration practices among children with acute respiratory infections across healthcare settings in Nashville, Tennessee.

Rankin, Danielle A / Katz, Sophie E / Amarin, Justin Z / Hayek, Haya / Stewart, Laura S / Slaughter, James C / Deppen, Stephen / Yanis, Ahmad / Romero, Yesenia Herazo / Chappell, James D / Khankari, Nikhil K / Halasa, Natasha B

Antimicrobial stewardship & healthcare epidemiology : ASHE

2024 Volume 4, Issue 1, Page(s) e29

Abstract: Objective: Evaluate the association between provider-ordered viral testing and antibiotic treatment practices among children discharged from an ED or hospitalized with an acute respiratory infection (ARI).: Design: Active, prospective ARI ... ...

Abstract	Objective: Evaluate the association between provider-ordered viral testing and antibiotic treatment practices among children discharged from an ED or hospitalized with an acute respiratory infection (ARI). Design: Active, prospective ARI surveillance study from November 2017 to February 2020. Setting: Pediatric hospital and emergency department in Nashville, Tennessee. Participants: Children 30 days to 17 years old seeking medical care for fever and/or respiratory symptoms. Methods: Antibiotics prescribed during the child's ED visit or administered during hospitalization were categorized into (1) None administered; (2) Narrow-spectrum; and (3) Broad-spectrum. Setting-specific models were built using unconditional polytomous logistic regression with robust sandwich estimators to estimate the adjusted odds ratios and 95% confidence intervals between provider-ordered viral testing (ie, tested versus not tested) and viral test result (ie, positive test versus not tested and negative test versus not tested) and three-level antibiotic administration. Results: 4,107 children were enrolled and tested, of which 2,616 (64%) were seen in the ED and 1,491 (36%) were hospitalized. In the ED, children who received a provider-ordered viral test had 25% decreased odds (aOR: 0.75; 95% CI: 0.54, 0.98) of receiving a narrow-spectrum antibiotic during their visit than those without testing. In the inpatient setting, children with a negative provider-ordered viral test had 57% increased odds (aOR: 1.57; 95% CI: 1.01, 2.44) of being administered a broad-spectrum antibiotic compared to children without testing. Conclusions: In our study, the impact of provider-ordered viral testing on antibiotic practices differed by setting. Additional studies evaluating the influence of viral testing on antibiotic stewardship and antibiotic prescribing practices are needed.
Language	English
Publishing date	2024-03-06
Publishing country	England
Document type	Journal Article
ISSN	2732-494X
ISSN (online)	2732-494X
DOI	10.1017/ash.2024.24
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Article ; Online: Epidemiologic trends and characteristics of SARS-CoV-2 infections among children in the United States.

Rankin, Danielle A / Talj, Rana / Howard, Leigh M / Halasa, Natasha B

Current opinion in pediatrics

2020 Volume 33, Issue 1, Page(s) 114–121

Abstract: Purpose of review: To review the epidemiological characteristics and clinical features associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among children in the United States.: Recent findings: In the United States, ...

Abstract	Purpose of review: To review the epidemiological characteristics and clinical features associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among children in the United States. Recent findings: In the United States, the majority of SARS-CoV-2 infections in children have been mild illnesses, with those 5-17 years of age having the highest frequency. Specifically, the incidence of SARS-CoV-2 in children is two times higher in adolescents (12-17 years) than younger school-aged children (5-11 years). Despite the higher case counts in older children, 10% of pediatric hospitalizations have been in infants less than one year. In addition, severe respiratory and renal complications, hospitalization, and even death have been documented in children. Summary: Clinical manifestations of SARS-CoV-2 infection in children range from asymptomatic to severe respiratory distress, with mild nonspecific symptoms being the most commonly reported. The broad clinical presentation and the frequency of asymptomatic or minimally symptomatic infections in children pose challenges for controlling and detecting SARS-CoV-2. However, severe disease has been noted in children with associated medical complications and death. Thus, additional active surveillance and research is needed to understand the burden children contribute to the SARS-CoV-2 pandemic in the United States.
MeSH term(s)	Adolescent ; COVID-19 ; Child ; Child, Preschool ; Hospitalization ; Humans ; Incidence ; Pandemics ; SARS-CoV-2 ; United States/epidemiology
Language	English
Publishing date	2020-12-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1049374-8
ISSN	1531-698X ; 1040-8703
ISSN (online)	1531-698X
ISSN	1040-8703
DOI	10.1097/MOP.0000000000000971
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Article ; Online: Principal Component Patterns of Pediatric Respiratory Viral Testing Across Health Care Settings.

Rankin, Danielle A / Stewart, Laura S / Slaughter, James C / Deppen, Stephen / Katz, Sophie E / Stahl, Anna L / Stopczynski, Tess / Yanis, Ahmad / McHenry, Rendie / Guevara Pulido, Claudia / Herazo Romero, Yesenia / Chappell, James D / Halasa, Natasha B / Khankari, Nikhil K

Hospital pediatrics

2024 Volume 14, Issue 2, Page(s) 126–136

Abstract: Background and objectives: Factors prompting clinicians to request viral testing in children are unclear. We assessed patterns prompting clinicians to perform viral testing in children discharged from an emergency department (ED) or hospitalized with an ...

Abstract	Background and objectives: Factors prompting clinicians to request viral testing in children are unclear. We assessed patterns prompting clinicians to perform viral testing in children discharged from an emergency department (ED) or hospitalized with an acute respiratory infection (ARI). Methods: Using active ARI surveillance data collected from November 2017 through February 2020, children aged between 30 days and 17 years with fever or respiratory symptoms who had a research respiratory specimen tested were included. Children's presentation patterns from their initial evaluation at each health care setting were analyzed using principal components (PCs) analysis. PC-specific models using logistic regression with robust sandwich estimators were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between PCs and provider-ordered viral testing. PCs were assigned respiratory virus/viruses names a priori based on the patterns represented. Results: In total, 4107 children were enrolled and tested, with 2616 (64%) discharged from the ED and 1491 (36%) hospitalized. In the ED, children with a coviral presentation pattern had a 1.44-fold (95% CI, 1.24-1.68) increased odds of receiving a provider-ordered viral test than children showing clinical symptoms less representative of coviral-like infection. Whereas children in the ED and hospitalized with rhinovirus-like symptoms had 71% (OR, 0.29; 95% CI, 0.24-0.34) and 39% (OR, 0.61; 95% CI, 0.49-0.76) decreased odds, respectively, of receiving a provider-ordered viral test during their medical encounter. Conclusions: Viral tests are frequently ordered by clinicians, but presentation patterns vary by setting and influence the initiation of testing. Additional assessments of factors affecting provider decisions to use viral testing in pediatric ARI management are needed to maximize patient benefits of testing.
MeSH term(s)	Child ; Humans ; Infant ; Viruses ; Respiratory Tract Infections/diagnosis ; Respiratory Tract Infections/epidemiology ; Enterovirus Infections ; Emergency Service, Hospital ; Delivery of Health Care
Language	English
Publishing date	2024-01-16
Publishing country	United States
Document type	Journal Article
ISSN	2154-1671
ISSN (online)	2154-1671
DOI	10.1542/hpeds.2023-007389
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Article ; Online: Concurrent transmission of multiple carbapenemases in a long-term acute-care hospital.

Rankin, Danielle A / Walters, Maroya Spalding / Caicedo, Luz / Gable, Paige / Moulton-Meissner, Heather A / Chan, Allison / Burks, Albert / Edwards, Kendra / McAllister, Gillian / Kent, Alyssa / Laufer Halpin, Alison / Moore, Christina / McLemore, Tracy / Thomas, Linda / Dotson, Nychie Q / Chu, Alvina K

Infection control and hospital epidemiology

2024 Volume 45, Issue 3, Page(s) 292–301

Abstract: Objective: We investigated concurrent outbreaks of : Methods: We defined an incident case as the first detection of : Results: From July 2017 to December 2018, 76 incident cases were identified from 69 case patients: 51 had : Conclusions: Our ... ...

Abstract	Objective: We investigated concurrent outbreaks of Methods: We defined an incident case as the first detection of Results: From July 2017 to December 2018, 76 incident cases were identified from 69 case patients: 51 had Conclusions: Our response to a single patient colonized with VIM-CRPA and KPC-CRE identified concurrent CPO outbreaks at LTACH A. Epidemiologic and genomic investigations indicated that the observed diversity was due to a combination of multiple introductions of VIM-CRPA and KPC-CRE and to the transfer of carbapenemase genes across different bacteria species and strains. Improved infection control, including interventions that minimized potential spread from wastewater premise plumbing, stopped transmission.
MeSH term(s)	Humans ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Bacterial Proteins/genetics ; beta-Lactamases/genetics ; Hospitals ; Klebsiella pneumoniae ; Microbial Sensitivity Tests ; Plasmids
Chemical Substances	Anti-Bacterial Agents ; Bacterial Proteins ; beta-Lactamases (EC 3.5.2.6) ; carbapenemase (EC 3.5.2.6)
Language	English
Publishing date	2024-01-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2023.231
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Article ; Online: Clinical prediction model: Multisystem inflammatory syndrome in children versus Kawasaki disease.

Starnes, Lauren S / Starnes, Joseph R / Stopczynski, Tess / Amarin, Justin Z / Charnogursky, Cara / Hayek, Haya / Talj, Rana / Parra, David A / Clark, Daniel E / Patrick, Anna E / Katz, Sophie E / Howard, Leigh M / Peetluk, Lauren / Rankin, Danielle / Spieker, Andrew J / Halasa, Natasha B

Journal of hospital medicine

2024 Volume 19, Issue 3, Page(s) 175–184

Abstract: Background: Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious complication of severe acute respiratory syndrome coronavirus 2 infection. Features of MIS-C overlap with those of Kawasaki disease (KD).: Objective: The study ... ...

Abstract	Background: Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious complication of severe acute respiratory syndrome coronavirus 2 infection. Features of MIS-C overlap with those of Kawasaki disease (KD). Objective: The study objective was to develop a prediction model to assist with this diagnostic dilemma. Methods: Data from a retrospective cohort of children hospitalized with KD before the coronavirus disease 2019 pandemic were compared to a prospective cohort of children hospitalized with MIS-C. A bootstrapped backwards selection process was used to develop a logistic regression model predicting the probability of MIS-C diagnosis. A nomogram was created for application to individual patients. Results: Compared to children with incomplete and complete KD (N = 602), children with MIS-C (N = 105) were older and had longer hospitalizations; more frequent intensive care unit admissions and vasopressor use; lower white blood cell count, lymphocyte count, erythrocyte sedimentation rate, platelet count, sodium, and alanine aminotransferase; and higher hemoglobin and C-reactive protein (CRP) at admission. Left ventricular dysfunction was more frequent in patients with MIS-C, whereas coronary abnormalities were more common in those with KD. The final prediction model included age, sodium, platelet count, alanine aminotransferase, reduction in left ventricular ejection fraction, and CRP. The model exhibited good discrimination with AUC 0.96 (95% confidence interval: [0.94-0.98]) and was well calibrated (optimism-corrected intercept of -0.020 and slope of 0.99). Conclusions: A diagnostic prediction model utilizing admission information provides excellent discrimination between MIS-C and KD. This model may be useful for diagnosis of MIS-C but requires external validation.
MeSH term(s)	Child ; Humans ; Alanine Transaminase ; Mucocutaneous Lymph Node Syndrome/complications ; Mucocutaneous Lymph Node Syndrome/diagnosis ; Prospective Studies ; Retrospective Studies ; Stroke Volume ; Ventricular Function, Left ; COVID-19/complications ; Sodium ; Systemic Inflammatory Response Syndrome
Chemical Substances	Alanine Transaminase (EC 2.6.1.2) ; Sodium (9NEZ333N27)
Language	English
Publishing date	2024-01-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2233783-0
ISSN	1553-5606 ; 1553-5592
ISSN (online)	1553-5606
ISSN	1553-5592
DOI	10.1002/jhm.13290
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Article ; Online: RE: Role of rapid diagnostics for viral respiratory infections in antibiotic prescribing decision in the emergency department, by Li et al (2019).

Rankin, Danielle A / Rebeiro, Peter F / Haddadin, Zaid / Halasa, Natasha B / Greevy, Robert A

Infection control and hospital epidemiology

2020 Volume 41, Issue 8, Page(s) 991–992

MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Emergency Service, Hospital ; Humans ; Respiratory Tract Infections/diagnosis ; Respiratory Tract Infections/drug therapy ; Virus Diseases/diagnosis ; Virus Diseases/drug therapy
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2020-05-06
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2020.123
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Article ; Online: Notes from the Field: Verona Integron-Encoded Metallo-Beta-Lactamase-Producing Pseudomonas aeruginosa Outbreak in a Long-Term Acute Care Hospital - Orange County, Florida, 2017.

Rankin, Danielle / Caicedo, Luz / Dotson, Nychie / Gable, Paige / Chu, Alvina

MMWR. Morbidity and mortality weekly report

2018 Volume 67, Issue 21, Page(s) 611–612

MeSH term(s)	Adult ; Aged ; Disease Outbreaks ; Female ; Florida/epidemiology ; Hospitals ; Humans ; Integrons ; Long-Term Care ; Male ; Middle Aged ; Pseudomonas Infections/epidemiology ; Pseudomonas aeruginosa/isolation & purification ; beta-Lactamases/biosynthesis
Chemical Substances	beta-Lactamases (EC 3.5.2.6)
Language	English
Publishing date	2018-06-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	412775-4
ISSN	1545-861X ; 0149-2195
ISSN (online)	1545-861X
ISSN	0149-2195
DOI	10.15585/mmwr.mm6721a6
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Article ; Online: Extensively Drug-Resistant Pseudomonas aeruginosa Outbreak associated with Artificial Tears.

Grossman, Marissa K / Rankin, Danielle A / Maloney, Meghan / Stanton, Richard A / Gable, Paige / Stevens, Valerie A / Ewing, Thomas / Saunders, Katharine / Kogut, Sarah / Nazarian, Elizabeth / Bhaurla, Sandeep / Mephors, Jehan / Mongillo, Joshua / Stonehocker, Susan / Prignano, Jeanette / Valencia, Nickolas / Charles, Argentina / McNamara, Kiara / Fritsch, William A /

Ruelle, Shannon / Plucinski, Carrie Ann / Sosa, Lynn / Ostrowsky, Belinda / Ham, D Cal / Walters, Maroya S

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2024

Abstract: Background: Carbapenemase-producing, carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA) are extensively drug resistant bacteria. We investigated the source of a multistate CP-CRPA outbreak.: Methods: Cases were defined as a U.S. patient's first ... ...

Abstract	Background: Carbapenemase-producing, carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA) are extensively drug resistant bacteria. We investigated the source of a multistate CP-CRPA outbreak. Methods: Cases were defined as a U.S. patient's first isolation of P. aeruginosa sequence type 1203 with the carbapenemase gene blaVIM-80 and cephalosporinase gene blaGES-9 from any specimen source collected and reported to CDC between January 1, 2022-May 15, 2023. We conducted a 1:1 matched case-control study at the post-acute care facility with the most cases, assessed exposures associated with case status for all case-patients, and tested products for bacterial contamination. Results: We identified 81 case-patients from 18 states, 27 of whom were identified through surveillance cultures. Four (7%) of 54 case-patients with clinical cultures died within 30 days of culture collection, and four (22%) of 18 with eye infections underwent enucleation. In the case-control study, case-patients had increased odds of receiving artificial tears compared to controls (crude matched OR: 5.0, 95% CI: 1.1, 22.8). Overall, artificial tears use was reported by 61 (87%) of 70 case-patients with information; 43 (77%) of 56 case-patients with brand information reported use of Brand A, an imported, preservative-free, over-the-counter (OTC) product. Bacteria isolated from opened and unopened bottles of Brand A were genetically related to patient isolates. FDA inspection of the manufacturing plant identified likely sources of contamination. Conclusions: A manufactured medical product serving as the vehicle for carbapenemase-producing organisms is unprecedented in the U.S. The clinical impacts from this outbreak underscore the need for improved requirements for U.S. OTC product importers.
Language	English
Publishing date	2024-02-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciae052
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