D K Warren

..Education programs may lead to a substantial decrease in medical-care costs and patient morbidity attributed to central venous catheterization when implemented as part of mandatory training...

..To determine the impact of the rotation of antimicrobial agents on the rates of infection, intestinal colonization, and acquisition with antimicrobial-resistant Gram-negative bacteria...

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..This article reviews the common infectious etiologies of central nervous system infections, especially bacterial meningitis and brain abscess, and their subsequent management in the intensive care unit...

..Education-based interventions can reduce the incidence of catheter-associated bloodstream infection. The generalizability of findings from single-center studies is limited...

..To evaluate the effectiveness of an evidence-based intervention to prevent catheter-associated bloodstream infections among intensive care unit patients at a nonteaching, community hospital...

..To determine the attributable cost of ventilator-associated pneumonia from a hospital-based cost perspective, after adjusting for potential confounders...

..Methicillin-resistant Staphylococcus aureus (MRSA) is a cause of healthcare-associated infections among surgical intensive care unit (ICU) patients, though transmission dynamics are unclear...

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..The incidence, risk factors, and serious outcomes of bloodstream infections in a nonteaching community hospital were similar to those seen in tertiary-care teaching hospitals...

..The recent emergence of vancomycin-resistant Staphylococcus aureus and the presence of a patient population co-colonized or co-infected with VRE and MRSA support the need for aggressive infection control measures in the ICU...

..After adjusting for underlying severity of illness, the attributable cost of catheter-associated bloodstream infection was approximately 11,971 dollars...

..difficile on perceived CDI burden, positive predictive value, and false-positive results...

..To determine the incidence of central venous catheter (CVC)-associated bloodstream infection (CA-BSI) among patients admitted to general medical wards outside the intensive care unit (ICU)...

..Risk factors for any S aureus and MRSA colonization on admission in oncology patients are consistent with previous studies in general populations. In addition, recent chemotherapy as a risk factor is a unique finding in this population...

..The emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has been well described; however, few studies have reviewed long-term hospital-wide data...

..These infection-control policies also require the presence of a dedicated group of infection-control practitioners to provide education, collect surveillance data, and oversee the implementation of the local infection-control plan...

..This was likely due in large part to prior VRE exposures in the rest of the hospital where these control measures were not being used...

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..Staphylococcus aureus bacteremia results in substantial mortality. Infectious diseases specialist consultation can improve adherence to evidence-based management of S. aureus bacteremia, but its effect on mortality is unclear...

..We found that MRSA infection following initial colonization or infection is caused by the same strain in most cases, suggesting that a single successful attempt at decolonization may prevent the majority of later infection...

..Three (1.2%) out of 243 isolates were bla(KPC) positive. Ertapenem nonsusceptibility had a low positive predictive value...

..aureus infection. However, MRSA-colonized patients may have more comorbidities than methicillin-susceptible S. aureus (MSSA)-colonized or noncolonized patients and therefore may be more susceptible to infection on that basis...

..Seventeen (7.1%) of 241 bacteremic patients developed recurrence (median time to recurrence = 44 days; range, 9-217 days). Recurrent and nonrecurrent bacteremic patients did not differ in clinical characteristics and mortality...

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..A considerable number of gram-negative bacteraemias occur outside intensive care units (ICUs). Inadequate antibiotic therapy in ICUs has been associated with adverse outcomes; however, there are no prospective studies in non-ICU patients...

..To determine the attributable cost of nosocomial primary bloodstream infections (BSIs) in PICU patients...

..Therapy cycling empiric antibiotics between various classes may influence bacterial resistance patterns. Understanding the impact of cycling on the appropriate treatment of suspected Gram-negative infections is important...

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..To determine the rates, risk factors, and outcomes of ventilator-associated pneumonia in pediatric intensive care unit (PICU) patients...

..Mupirocin resistance in patients with MRSA has been reported, usually in the context of widespread mupirocin use...

..The purpose of this study was to determine if chlorhexidine/silver sulfadiazine-impregnated CVCs could decrease the CR-BSI rate in an intensive care unit (ICU) with a low baseline infection rate...

..In conclusion, the successful implementation of this cycling protocol increased antibiotic heterogeneity over time in the study unit...

..Limited data exist regarding hematogenous vertebral osteomyelitis. Our objective was to describe the epidemiology and management of hematogenous vertebral osteomyelitis...

..One unit instituted enhanced environmental cleaning with a hypochlorite solution in all rooms, whereas the other unit used hypochlorite solution only in rooms of patients with CDAD. The CDAD rates decreased in both units...

..The relationship between TST conversion and birth outside of the United States and BCG vaccination suggests a booster phenomenon rather than true new TST conversions...

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..Our survey demonstrated that two-thirds of identified CVCs were not in ICU patients and suggests that more efforts should be directed to patients with CVCs who are outside the ICU...

..In addition, many assessments underestimate the incidence of acquisition by including prevalent carriers in the at-risk population...

..To evaluate the efficacy of a multifaceted hospitalwide quality improvement program that featured an intervention to remind physicians to remove unnecessary urinary catheters...

..To evaluate the epidemiology and outcomes for initiation of inappropriate urinary catheterization (IUC) among hospitalized patients...

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..We sought to determine the long-term effect of an educational program to prevent VAP in a medical ICU (MICU)...

..Multivariate analysis revealed that diabetes mellitus and surgeon A were associated risk factors. Preoperative diabetes mellitus control and the improvement of infection control practices led to the termination of the outbreak...

..I will build on the experience outlined in this proposal to establish myself an independent investigator in healthcare epidemiology, studying nosocomial infections and developing interventions to prevent them. ..