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Article ; Online: Viral Shedding Kinetics and Transmission of Emerging SARS-CoV-2 Variants-Critical Components of Study Design.

Gowler, Camden D / Paul, Prabasaj / Reddy, Sujan C

JAMA network open

2022 Volume 5, Issue 5, Page(s) e2213614

MeSH term(s)	COVID-19 ; Humans ; Kinetics ; SARS-CoV-2/genetics ; Virus Shedding
Language	English
Publishing date	2022-05-02
Publishing country	United States
Document type	Journal Article ; Comment
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.13614
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Article ; Online: Screening for Covid-19 in Skilled Nursing Facilities. Reply.

Hatfield, Kelly M / Reddy, Sujan C / Jernigan, John A

The New England journal of medicine

2020 Volume 383, Issue 2, Page(s) 192

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Humans ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Skilled Nursing Facilities
Keywords	covid19
Language	English
Publishing date	2020-05-29
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMc2017362
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Article ; Online: Improving mathematical modeling of interventions to prevent healthcare-associated infections by interrupting transmission or pathogens: How common modeling assumptions about colonized individuals impact intervention effectiveness estimates.

Gowler, Camden D / Slayton, Rachel B / Reddy, Sujan C / O'Hagan, Justin J

PloS one

2022 Volume 17, Issue 2, Page(s) e0264344

Abstract: Mathematical models are used to gauge the impact of interventions for healthcare-associated infections. As with any analytic method, such models require many assumptions. Two common assumptions are that asymptomatically colonized individuals are more ... ...

Abstract	Mathematical models are used to gauge the impact of interventions for healthcare-associated infections. As with any analytic method, such models require many assumptions. Two common assumptions are that asymptomatically colonized individuals are more likely to be hospitalized and that they spend longer in the hospital per admission because of their colonization status. These assumptions have no biological basis and could impact the estimated effects of interventions in unintended ways. Therefore, we developed a model of methicillin-resistant Staphylococcus aureus transmission to explicitly evaluate the impact of these assumptions. We found that assuming that asymptomatically colonized individuals were more likely to be admitted to the hospital or spend longer in the hospital than uncolonized individuals biased results compared to a more realistic model that did not make either assumption. Results were heavily biased when estimating the impact of an intervention that directly reduced transmission in a hospital. In contrast, results were moderately biased when estimating the impact of an intervention that decolonized hospital patients. Our findings can inform choices modelers face when constructing models of healthcare-associated infection interventions and thereby improve their validity.
MeSH term(s)	Cross Infection/epidemiology ; Cross Infection/prevention & control ; Cross Infection/transmission ; Delivery of Health Care ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Models, Biological ; Staphylococcal Infections/epidemiology ; Staphylococcal Infections/prevention & control ; Staphylococcal Infections/transmission
Language	English
Publishing date	2022-02-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0264344
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Article ; Online: Assessment of Hospital-Onset SARS-CoV-2 Infection Rates and Testing Practices in the US, 2020-2022.

Hatfield, Kelly M / Baggs, James / Maillis, Alexander / Warner, Sarah / Jernigan, John A / Kadri, Sameer S / Klompas, Michael / Reddy, Sujan C

JAMA network open

2023 Volume 6, Issue 8, Page(s) e2329441

Abstract: Importance: Characterizing the scale and factors associated with hospital-onset SARS-CoV-2 infections could help inform hospital and public health policies regarding prevention and surveillance needs for these infections.: Objective: To evaluate ... ...

Abstract	Importance: Characterizing the scale and factors associated with hospital-onset SARS-CoV-2 infections could help inform hospital and public health policies regarding prevention and surveillance needs for these infections. Objective: To evaluate associations of hospital-onset SARS-CoV-2 infection rates with different periods of the COVID-19 pandemic, hospital characteristics, and testing practices. Design, setting, and participants: This cohort study of US hospitals reporting SARS-CoV-2 testing data in the PINC AI Healthcare Database COVID-19 special release files was conducted from July 2020 through June 2022. Data were collected from hospitals that reported at least 1 SARS-CoV-2 reverse transcription-polymerase chain reaction or antigen test during hospitalizations discharged that month. For each hospital-month where the hospital reported sufficient data, all hospitalizations discharged in that month were included in the cohort. SARS-CoV-2 viral tests and results reported in the microbiology files for all hospitalizations in the study period by discharge month were identified. Data analysis was conducted from September 2022 to March 2023. Exposure: Hospitalizations discharged in an included hospital-month. Main outcomes and measures: Multivariable generalized estimating equation negative-binomial regression models were used to assess associations of monthly rates of hospital-onset SARS-CoV-2 infections per 1000 patient-days (defined as a first positive SARS-CoV-2 test during after hospitalization day 7) with the phase of the pandemic (defined as the predominant SARS-CoV-2 variant in circulation), admission testing rates, and hospital characteristics (hospital bed size, teaching status, urban vs rural designation, Census region, and patient distribution variables). Results: A total of 5687 hospital-months from 288 distinct hospitals were included, which contributed 4 421 268 hospitalization records. Among 171 564 hospitalizations with a positive SARS-CoV-2 test, 7591 (4.4%) were found to be hospital onset and 6455 (3.8%) were indeterminate onset. The mean monthly hospital-onset infection rate per 1000 patient-days was 0.27 (95 CI, 0.26-0.29). Hospital-onset infections occurred in 2217 of 5687 hospital-months (39.0%). The monthly percentage of discharged patients tested for SARS-CoV-2 at admission varied; 1673 hospital-months (29.4%) had less than 25% of hospitalizations tested at admission; 2199 hospital-months (38.7%) had 25% to 50% of all hospitalizations tested, and 1815 hospital months (31.9%) had more than 50% of all hospitalizations tested at admission. Postadmission testing rates and community-onset infection rates increased with admission testing rates. In multivariable models restricted to hospital-months testing at least 25% of hospitalizations at admission, a 10% increase in community-onset SARS-CoV-2 infection rate was associated with a 178% increase in the hospital-onset infection rate (rate ratio, 2.78; 95% CI, 2.52-3.07). Additionally, the phase of the COVID-19 pandemic, the admission testing rate, Census region, and bed size were all significantly associated with hospital-onset SARS-CoV-2 infection rates. Conclusions and relevance: In this cohort study of hospitals reporting SARS-CoV-2 infections, there was an increase of hospital-onset SARS-CoV-2 infections when community-onset infections were higher, indicating a need for ongoing and enhanced surveillance and prevention efforts to reduce in-hospital transmission of SARS-CoV-2 infections, particularly when community-incidence of SARS-CoV-2 infections is high.
MeSH term(s)	Humans ; SARS-CoV-2 ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19 Testing ; Cohort Studies ; Pandemics ; Hospitals ; Cross Infection/diagnosis ; Cross Infection/epidemiology
Language	English
Publishing date	2023-08-01
Publishing country	United States
Document type	Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2023.29441
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Article ; Online: Improving the Use of Personal Protective Equipment: Applying Lessons Learned.

Reddy, Sujan C / Valderrama, Amy L / Kuhar, David T

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

2019 Volume 69, Issue Suppl 3, Page(s) S165–S170

Abstract: Unrecognized transmission of pathogens in healthcare settings can lead to colonization and infection of both patients and healthcare personnel. The use of personal protective equipment (PPE) is an important strategy to protect healthcare personnel from ... ...

Abstract	Unrecognized transmission of pathogens in healthcare settings can lead to colonization and infection of both patients and healthcare personnel. The use of personal protective equipment (PPE) is an important strategy to protect healthcare personnel from contamination and to prevent the spread of pathogens to subsequent patients. However, optimal PPE use is difficult, and healthcare personnel may alter delivery of care because of the PPE. Here, we summarize recent research from the Prevention Epicenters Program on healthcare personnel contamination and improvement of the routine use of PPE as well as Ebola-specific PPE. Future efforts to optimize the use of PPE should include increasing adherence to protocols for PPE use, improving PPE design, and further research into the risks, benefits, and best practices of PPE use.
MeSH term(s)	Delivery of Health Care/methods ; Health Personnel/education ; Hemorrhagic Fever, Ebola/prevention & control ; Hemorrhagic Fever, Ebola/transmission ; Humans ; Infection Control/instrumentation ; Infection Control/statistics & numerical data ; Personal Protective Equipment/statistics & numerical data ; Personal Protective Equipment/supply & distribution
Language	English
Publishing date	2019-03-26
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/ciz619
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Zs.A 1505: 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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Article: Screening for Covid-19 in Skilled Nursing Facilities. Reply

Hatfield, Kelly M / Reddy, Sujan C / Jernigan, John A

N Engl J Med

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #425654
Database	COVID19

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Article ; Online: Factors influencing environmental sampling recovery of healthcare pathogens from non-porous surfaces with cellulose sponges.

Rose, Laura J / Houston, Hollis / Martinez-Smith, Marla / Lyons, Amanda K / Whitworth, Carrie / Reddy, Sujan C / Noble-Wang, Judith

PloS one

2022 Volume 17, Issue 1, Page(s) e0261588

Abstract: Results from sampling healthcare surfaces for pathogens are difficult to interpret without understanding the factors that influence pathogen detection. We investigated the recovery of four healthcare-associated pathogens from three common surface ... ...

Abstract	Results from sampling healthcare surfaces for pathogens are difficult to interpret without understanding the factors that influence pathogen detection. We investigated the recovery of four healthcare-associated pathogens from three common surface materials, and how a body fluid simulant (artificial test soil, ATS), deposition method, and contamination levels influence the percent of organisms recovered (%R). Known quantities of carbapenemase-producing KPC+ Klebsiella pneumoniae (KPC), Acinetobacter baumannii, vancomycin-resistant Enterococcus faecalis, and Clostridioides difficile spores (CD) were suspended in Butterfield's buffer or ATS, deposited on 323cm2 steel, plastic, and laminate surfaces, allowed to dry 1h, then sampled with a cellulose sponge wipe. Bacteria were eluted, cultured, CFU counted and %R determined relative to the inoculum. The %R varied by organism, from <1% (KPC) to almost 60% (CD) and was more dependent upon the organism's characteristics and presence of ATS than on surface type. KPC persistence as determined by culture also declined by >1 log10 within the 60 min drying time. For all organisms, the %R was significantly greater if suspended in ATS than if suspended in Butterfield's buffer (p<0.05), and for most organisms the %R was not significantly different when sampled from any of the three surfaces. Organisms deposited in multiple droplets were recovered at equal or higher %R than if spread evenly on the surface. This work assists in interpreting data collected while investigating a healthcare infection outbreak or while conducting infection intervention studies.
MeSH term(s)	Acinetobacter baumannii/isolation & purification ; Bacteria/isolation & purification ; Bandages/microbiology ; Cellulose/chemistry ; Clostridioides difficile/isolation & purification ; Humans ; Klebsiella pneumoniae/isolation & purification ; Plastics/chemistry ; Specimen Handling/methods ; Steel/chemistry ; Surface Properties ; Vancomycin-Resistant Enterococci/isolation & purification
Chemical Substances	Plastics ; Steel (12597-69-2) ; Cellulose (9004-34-6)
Language	English
Publishing date	2022-01-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0261588
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Article ; Online: Modeling the Effectiveness of Healthcare Personnel Reactive Testing and Screening for the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron Variant Within Nursing Homes.

Zipfel, Casey M / Paul, Prabasaj / Gowler, Camden D / Reddy, Sujan C / Stone, Nimalie D / Jacobs Slifka, Kara / Slayton, Rachel B

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

2022 Volume 75, Issue Supplement_2, Page(s) S225–S230

Abstract: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron variant has been hypothesized to exhibit faster clearance (time from peak viral concentration to clearance of acute infection), decreased sensitivity of antigen tests, and increased ...

Abstract	The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron variant has been hypothesized to exhibit faster clearance (time from peak viral concentration to clearance of acute infection), decreased sensitivity of antigen tests, and increased immune escape (the ability of the variant to evade immunity conferred by past infection or vaccination) compared to prior variants. These factors necessitate reevaluation of prevention and control strategies, particularly in high-risk, congregate settings like nursing homes that have been heavily impacted by other coronavirus disease 2019 (COVID-19) variants. We used a simple model representing individual-level viral shedding dynamics to estimate the optimal strategy for testing nursing home healthcare personnel and quantify potential reduction in transmission of COVID-19. This provides a framework for prospectively evaluating testing strategies in emerging variant scenarios when data are limited. We find that case-initiated testing prevents 38% of transmission within a facility if implemented within a day of an index case testing positive, and screening testing strategies could prevent 30% to 78% of transmission within a facility if implemented daily, depending on test sensitivity.
MeSH term(s)	COVID-19/diagnosis ; Delivery of Health Care ; Humans ; Nursing Homes ; SARS-CoV-2
Language	English
Publishing date	2022-06-20
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/ciac505
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Article ; Online: Antibiotic-Resistant Infections Among Inpatients with Coronavirus Disease 2019 (COVID-19) in US Hospitals.

Baggs, James / Rose, Ashley N / McCarthy, Natalie L / Wolford, Hannah / Srinivasan, Arjun / Jernigan, John A / Reddy, Sujan C

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

2022 Volume 75, Issue Supplement_2, Page(s) S294–S297

Abstract: We described bacterial/fungal coinfections and antibiotic-resistant infections among inpatients with a diagnosis of coronavirus disease 2019 (COVID-19) and compared findings in those with a diagnosis of influenza like illness. Less than 10% of inpatients ...

Abstract	We described bacterial/fungal coinfections and antibiotic-resistant infections among inpatients with a diagnosis of coronavirus disease 2019 (COVID-19) and compared findings in those with a diagnosis of influenza like illness. Less than 10% of inpatients with COVID-19 had bacterial/fungal coinfection. Longer lengths of stay, critical care stay, and mechanical ventilation contribute to increased incidence of hospital-onset infections among inpatients with COVID-19.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; COVID-19 ; Coinfection/epidemiology ; Hospitals ; Humans ; Inpatients ; SARS-CoV-2 ; United States
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2022-07-02
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/ciac517
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Article ; Online: Investigation of healthcare infection risks from water-related organisms: Summary of CDC consultations, 2014-2017.

Perkins, Kiran M / Reddy, Sujan C / Fagan, Ryan / Arduino, Matthew J / Perz, Joseph F

Infection control and hospital epidemiology

2019 Volume 40, Issue 6, Page(s) 621–626

Abstract: Objective: Water exposures in healthcare settings and during healthcare delivery can place patients at risk for infection with water-related organisms and can potentially lead to outbreaks. We aimed to describe Centers for Disease Control and Prevention ...

Abstract	Objective: Water exposures in healthcare settings and during healthcare delivery can place patients at risk for infection with water-related organisms and can potentially lead to outbreaks. We aimed to describe Centers for Disease Control and Prevention (CDC) consultations involving water-related organisms leading to healthcare-associated infections (HAIs). Design: Retrospective observational study. Methods: We reviewed internal CDC records from January 1, 2014, through December 31, 2017, using water-related terms and organisms, excluding Legionella, to identify consultations that involved potential or confirmed transmission of water-related organisms in healthcare. We determined plausible exposure pathways and routes of transmission when possible. Results: Of 620 consultations during the study period, we identified 134 consultations (21.6%), with 1,380 patients, that involved the investigation of potential water-related HAIs or infection control lapses with the potential for water-related HAIs. Nontuberculous mycobacteria were involved in the greatest number of investigations (n = 40, 29.9%). Most frequently, investigations involved medical products (n = 48, 35.8%), and most of these products were medical devices (n = 40, 83.3%). We identified a variety of plausible water-exposure pathways, including medication preparation near water splash zones and water contamination at the manufacturing sites of medications and medical devices. Conclusions: Water-related investigations represent a substantial proportion of CDC HAI consultations and likely represent only a fraction of all water-related HAI investigations and outbreaks occurring in US healthcare facilities. Water-related HAI investigations should consider all potential pathways of water exposure. Finally, healthcare facilities should develop and implement water management programs to limit the growth and spread of water-related organisms.
MeSH term(s)	Centers for Disease Control and Prevention, U.S. ; Cross Infection/microbiology ; Cross Infection/prevention & control ; Disease Outbreaks/prevention & control ; Humans ; Nontuberculous Mycobacteria/pathogenicity ; Referral and Consultation/statistics & numerical data ; Retrospective Studies ; United States ; Water Microbiology ; Water Supply ; Waterborne Diseases/microbiology
Language	English
Publishing date	2019-04-03
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2019.60
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