Jonathan Grein
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View article: Reducing catheter-associated urinary tract infection rates in surgical critical care units via an informal catheter exchange protocol
Reducing catheter-associated urinary tract infection rates in surgical critical care units via an informal catheter exchange protocol Open
Urinary catheter replacement prior to urinary tract infection assessment, introduced as a quality improvement recommendation in two surgical intensive care units, was associated with (88% and 84%) reduction in catheter-associated urinary t…
View article: P-1829. Genomic Characterization of Clinically Significant Isolates and Its Effects on Clinical Outcomes, 2022 to 2024
P-1829. Genomic Characterization of Clinically Significant Isolates and Its Effects on Clinical Outcomes, 2022 to 2024 Open
Background Antimicrobial resistance has evolved into a complex global issue involving many clinically relevant organisms. Among these pathogens, carbapenem-resistant organisms (CROs) are of particular concern due to their limited treatment…
View article: 2414. Pulling the Cord: Removal of Urinary Catheters before Urine Culture in a Cardiothoracic-Surgery ICU
2414. Pulling the Cord: Removal of Urinary Catheters before Urine Culture in a Cardiothoracic-Surgery ICU Open
Background Detection of asymptomatic bacteriuria (ABU) can lead to significant consequences, including over-prescription of antibiotics. Numerous studies have demonstrated that urinary catheters (UCs) are quickly colonized with bacteria, e…
View article: Assessing past versus present severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection: A survey of criteria for discontinuing precautions in asymptomatic patients testing positive on admission
Assessing past versus present severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection: A survey of criteria for discontinuing precautions in asymptomatic patients testing positive on admission Open
Infection prevention program leaders report frequent use of criteria to distinguish recently recovered coronavirus disease 2019 (COVID-19) cases from actively infectious cases when incidentally positive asymptomatic patients were identifie…
View article: Coronavirus disease 2019 (COVID-19) infection prevention practices that exceed Centers for Disease Control and Prevention (CDC) guidance: Balancing extra caution against impediments to care
Coronavirus disease 2019 (COVID-19) infection prevention practices that exceed Centers for Disease Control and Prevention (CDC) guidance: Balancing extra caution against impediments to care Open
In a survey of infection prevention programs, leaders reported frequent clinical and infection prevention practice modifications to avoid coronavirus disease 2019 (COVID-19) exposure that exceeded national guidance. Future pandemic respons…
View article: Characterizing the relationship between coronavirus disease 2019 (COVID-19) and central-line–associated bloodstream infection (CLABSI) and assessing the impact of a nursing-focused CLABSI reduction intervention during the COVID-19 pandemic
Characterizing the relationship between coronavirus disease 2019 (COVID-19) and central-line–associated bloodstream infection (CLABSI) and assessing the impact of a nursing-focused CLABSI reduction intervention during the COVID-19 pandemic Open
Objective: To examine the impact of SARS-CoV-2 infection on CLABSI rate and characterize the patients who developed a CLABSI. We also examined the impact of a CLABSI-reduction quality-improvement project in patients with and without COVID-…
View article: Developing a Rapid Response Single IRB Model for Conducting Research During a Public Health Emergency
Developing a Rapid Response Single IRB Model for Conducting Research During a Public Health Emergency Open
Research is foundational for evidence-based management of patients. Clinical research, however, takes time to plan, conduct, and disseminate-a luxury that is rarely available during a public health emergency. The University of Nebraska Med…
View article: Contributions of the Regional Emerging Special Pathogen Treatment Centers to the US COVID-19 Pandemic Response
Contributions of the Regional Emerging Special Pathogen Treatment Centers to the US COVID-19 Pandemic Response Open
The National Emerging Special Pathogens Training and Education Center (NETEC) was established in 2015 to improve the capabilities of healthcare facilities to provide safe and effective care to patients with Ebola and other special pathogen…
View article: Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review
Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review Open
Background Hospitals have implemented diverse quality improvement (QI) interventions to reduce rates of catheter-associated urinary tract infections (CAUTIs). The economic value of these QI interventions is uncertain. Objective To systemat…
View article: Transmission risk of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) to healthcare personnel following unanticipated exposure to aerosol-generating procedures: Experience from epidemiologic investigations at an academic medical center
Transmission risk of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) to healthcare personnel following unanticipated exposure to aerosol-generating procedures: Experience from epidemiologic investigations at an academic medical center Open
Healthcare personnel (HCP) with unprotected exposures to aerosol-generating procedures (AGPs) on patients with coronavirus disease 2019 (COVID-19) are at risk of infection with severe acute respiratory coronavirus virus 2 (SARS-CoV-2). A r…
View article: 41. Assessing Past vs Present COVID-19 Infection: A Survey of Criteria for Discontinuing Precautions in Asymptomatic Patients
41. Assessing Past vs Present COVID-19 Infection: A Survey of Criteria for Discontinuing Precautions in Asymptomatic Patients Open
Background COVID-19 patients can remain positive by PCR-testing for several months. Pre-admission or pre-procedure testing can identify recovered asymptomatic patients who may no longer be contagious but would require precautions according…
View article: 426. COVID-19 Infection Prevention Practices That Exceed CDC Guidance: Balancing Extra Caution Against Impediments to Care
426. COVID-19 Infection Prevention Practices That Exceed CDC Guidance: Balancing Extra Caution Against Impediments to Care Open
Background At the outset of the COVID-19 pandemic, healthcare workers (HCWs) raised concerns about personal risks of acquiring infection during patient care. This led to more stringent infection prevention practices than CDC guidelines dur…
View article: 771. COVID-19 on the Line: A Significant Increase in CLABSI in Hospitalized Patients with COVID-19 at a Major Teaching Hospital
771. COVID-19 on the Line: A Significant Increase in CLABSI in Hospitalized Patients with COVID-19 at a Major Teaching Hospital Open
Background We observed an increase in central line associated bloodstream infections (CLABSI) associated with the 2020 COVID-19 pandemic and performed a retrospective analysis to better understand the impact of COVID-19 on CLABSI rates. Fi…
View article: Seroprevalence of antibodies to SARS-CoV-2 in healthcare workers: a cross-sectional study
Seroprevalence of antibodies to SARS-CoV-2 in healthcare workers: a cross-sectional study Open
Objective We sought to determine the extent of SARS-CoV-2 seroprevalence and the factors associated with seroprevalence across a diverse cohort of healthcare workers. Design Observational cohort study of healthcare workers, including SARS-…
View article: 259. A Prospective, Stewardship-Driven IV to PO Conversion in Uncomplicated Bacteremia
259. A Prospective, Stewardship-Driven IV to PO Conversion in Uncomplicated Bacteremia Open
Background Recent data has shown a transition to oral (PO) antibiotics (ABX) for definitive treatment of uncomplicated bacteremia has similar efficacy compared to continuation of intravenous (IV) ABX, and reduces hospital length of stay (L…
View article: SARS-CoV-2 Seroprevalence in Relation to Timing of Symptoms
SARS-CoV-2 Seroprevalence in Relation to Timing of Symptoms Open
Of individuals with SARS-CoV-2 IgG antibody testing performed, those who contemporaneously experienced a cluster of Covid-19 relevant symptoms in the 1-2 months preceding the antibody assay were more likely to test positive whereas those w…
View article: SARS-CoV-2 Seroprevalence Across a Diverse Cohort of Healthcare Workers
SARS-CoV-2 Seroprevalence Across a Diverse Cohort of Healthcare Workers Open
Importance Antibody testing is important for understanding patterns of exposure and potential immunity to SARS-CoV-2. Prior data on seroprevalence have been subject to variations in selection of individuals and nature as well as timing of …
View article: Pre-existing traits associated with Covid-19 illness severity
Pre-existing traits associated with Covid-19 illness severity Open
In our healthcare system, greater Covid-19 illness severity is seen in patients who are older, male, African American, obese, with diabetes, and with greater overall comorbidity burden. Certain comorbidities paradoxically augment risk to a…
View article: Pre-Existing Traits Associated with Covid-19 Illness Severity
Pre-Existing Traits Associated with Covid-19 Illness Severity Open
Background Certain individuals, when infected by SARS-CoV-2, tend to develop the more severe forms of Covid-19 illness for reasons that remain unclear. Methods We studied N=442 patients who presented with laboratory confirmed Covid-19 illn…
View article: First 12 patients with coronavirus disease 2019 (COVID-19) in the United States
First 12 patients with coronavirus disease 2019 (COVID-19) in the United States Open
Introduction More than 93,000 cases of coronavirus disease (COVID-19) have been reported worldwide. We describe the epidemiology, clinical course, and virologic characteristics of the first 12 U.S. patients with COVID-19. Methods We collec…
View article: 84. Evaluation of the NHSN Standardized Infection Ratio (SIR) Risk Adjustment for HO-CDI in Oncology and ICU Patients in General Acute Care Hospitals
84. Evaluation of the NHSN Standardized Infection Ratio (SIR) Risk Adjustment for HO-CDI in Oncology and ICU Patients in General Acute Care Hospitals Open
Background The NHSN healthcare-facility onset Clostridioides difficile infection (CDI) standardized infection ratio (SIR) is used to compare hospital quality and set hospital reimbursement but inadequate risk adjustment could penalize hosp…
View article: 1197. The Gloves Are Off: The State of Personal Protective Equipment (PPE) Use in Contact, Droplet, and Standard Precautions at a Major Teaching Hospital
1197. The Gloves Are Off: The State of Personal Protective Equipment (PPE) Use in Contact, Droplet, and Standard Precautions at a Major Teaching Hospital Open
Background PPE (gowns, gloves and masks) is used in standard precautions (SP) as well as for contact, droplet or airborne isolation. Improper PPE use can lead to self-contamination and transmission of infectious agents, and at our institut…
View article: 839. Effect of Clostridioides difficile (C. difficile) Toxin Test Reporting on Clinical Treatment and Outcomes of Toxin-Negative PCR-Positive Patients at Five California Hospitals
839. Effect of Clostridioides difficile (C. difficile) Toxin Test Reporting on Clinical Treatment and Outcomes of Toxin-Negative PCR-Positive Patients at Five California Hospitals Open
Background Guidelines support the use of toxin tests after C. difficile antigen detection or nucleic acid amplification tests (e.g., PCR) to help clinicians distinguish colonization from infection and reduce overdiagnosis but the safety of…
View article: The Special Pathogens Research Network: Enabling Research Readiness
The Special Pathogens Research Network: Enabling Research Readiness Open
The 2013-2016 epidemic of Ebola virus disease (EVD) that originated in West Africa underscored many of the challenges to conducting clinical research during an ongoing infectious disease epidemic, both in the most affected countries of Gui…
View article: A Roadmap to Implementing Antimicrobial Stewardship Principles in Long-term Care Facilities (LTCFs): Collaboration Between an Acute-Care Hospital and LTCFs
A Roadmap to Implementing Antimicrobial Stewardship Principles in Long-term Care Facilities (LTCFs): Collaboration Between an Acute-Care Hospital and LTCFs Open
Effective 28 November 2017, the Centers for Medicare & Medicaid Services (CMS) mandated long-term care facilities (LTCFs) to have antimicrobial stewardship programs (ASPs) in place. Although guidance exists for establishing ASPs in LTCFs, …
View article: Antimicrobial Stewardship Facetime: Comparison of Two Rounding Models at a Tertiary Medical Center
Antimicrobial Stewardship Facetime: Comparison of Two Rounding Models at a Tertiary Medical Center Open
As an 886-bed tertiary care hospital with both teaching and private physician groups, Cedars-Sinai Medical Center has a unique opportunity to incorporate antimicrobial stewardship pharmacist (ASP) rounds with both a general medicine teachi…
View article: Partners in Stewardship: Collaboration Between a Tertiary Hospital and Local Skilled Nursing Facilities to Improve Management of Suspected Urinary Tract Infections
Partners in Stewardship: Collaboration Between a Tertiary Hospital and Local Skilled Nursing Facilities to Improve Management of Suspected Urinary Tract Infections Open
Opportunities exist for improving antimicrobial use in skilled nursing facilities (SNF). We evaluated the impact of a tertiary medical center partnering with local SNFs to improve appropriate diagnosis and antimicrobial utilization focused…