Mary Elizabeth Sexton
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View article: Antimicrobial Stewardship Practices in Outpatient Parenteral Antimicrobial Therapy Programs in the United States
Antimicrobial Stewardship Practices in Outpatient Parenteral Antimicrobial Therapy Programs in the United States Open
Background Outpatient parenteral antimicrobial therapy (OPAT) regimens typically prioritize ease of antimicrobial administration, tolerability, safety, and accessibility over using the narrowest-spectrum antimicrobial. In light of this, OP…
View article: Management of Penicillin Allergy in the Perioperative Setting
Management of Penicillin Allergy in the Perioperative Setting Open
The selection of perioperative antibiotic prophylaxis is challenging in patients with a history of penicillin allergy; as such, we present a literature review exploring current best practices and the associated supporting evidence, as well…
View article: 509. A Comparison of Tocilizumab and Baricitinib for Hospitalized Patients with Severe COVID-19
509. A Comparison of Tocilizumab and Baricitinib for Hospitalized Patients with Severe COVID-19 Open
Background Baricitinib (BARI) and tocilizumab (TOCI) are two FDA-approved immunomodulating agents for the treatment of COVID-19 patients with worsening respiratory status, but early studies suggest no differences in outcomes between the tw…
View article: Validation of the STERIS Amsco 630LS steam sterilizer autoclave for inactivation of category a medical waste from patients with high-consequence infectious diseases
Validation of the STERIS Amsco 630LS steam sterilizer autoclave for inactivation of category a medical waste from patients with high-consequence infectious diseases Open
Hospitals caring for patients with high-consequence pathogens may need to safely manage large volumes of category A waste. Using biological indicators to assess for successful sterilization, autoclave cycle parameters that would inactivate…
View article: Factors associated with stroke after COVID-19 vaccination: a statewide analysis
Factors associated with stroke after COVID-19 vaccination: a statewide analysis Open
Background The objective of our study was to evaluate vaccine type, COVID-19 infection, and their association with stroke soon after COVID-19 vaccination. Methods In a retrospective cohort study, we estimated the 21-day post-vaccination in…
View article: Carbapenemase genes and mortality in patients with carbapenem-resistant Enterobacterales, Atlanta, Georgia, 2011–2020
Carbapenemase genes and mortality in patients with carbapenem-resistant Enterobacterales, Atlanta, Georgia, 2011–2020 Open
Background: Carbapenemase genes in carbapenem-resistant Enterobacterales (CP-CRE) may be transmitted between patients and bacteria. Reported rates of carbapenemase genes vary widely, and it is unclear whether having a carbapenemase gene po…
View article: Factors Associated with Stroke after COVID-19 Vaccination: A Statewide Analysis
Factors Associated with Stroke after COVID-19 Vaccination: A Statewide Analysis Open
Background The objective of our study was to evaluate baseline characteristics, COVID-19 infection and vaccine type and their association with stroke early after COVID-19 vaccination. Methods In a retrospective cohort study, we estimated t…
View article: Evaluating indwelling devices and other risk factors for mortality in invasive Carbapenem-resistant Enterobacterales infections in Georgia, 2012–2019
Evaluating indwelling devices and other risk factors for mortality in invasive Carbapenem-resistant Enterobacterales infections in Georgia, 2012–2019 Open
Objective: Carbapenem-resistant Enterobacterales (CRE) infections are a public health threat due to the risk of transmission between patients and high associated mortality. We sought to identify risk factors for mortality in patients with …
View article: 1930. Answering the Call: Inpatient Vaccination for SARS-CoV2 Infection in an Academic Hospital
1930. Answering the Call: Inpatient Vaccination for SARS-CoV2 Infection in an Academic Hospital Open
Background While the available SARS-CoV2 vaccines are up to 94% effective at preventing COVID-19-related death or invasive mechanical ventilation, only 76% of the United States population aged ≥18 years have received a primary series and 4…
View article: 416. Evaluating Indwelling Devices and Mortality in Invasive Carbapenem-Resistant Enterobacterales Infections, Atlanta, GA, 2012–2019.
416. Evaluating Indwelling Devices and Mortality in Invasive Carbapenem-Resistant Enterobacterales Infections, Atlanta, GA, 2012–2019. Open
Background Carbapenem-resistant Enterobacterales (CRE) infections pose a grave public health threat due to the potentially silent transmission leading to outbreaks, limited therapeutic options and high mortality. We sought to identify risk…
View article: Clinical characteristics and social determinants of health associated with 30-day hospital readmissions of patients with COVID-19
Clinical characteristics and social determinants of health associated with 30-day hospital readmissions of patients with COVID-19 Open
COVID-19 readmissions are associated with increased patient mortality and healthcare system strain. This retrospective cohort study of PCR-confirmed COVID-19 positive adults (>18 years) hospitalized and readmitted within 30 days of dischar…
View article: Efficacy of Noncarbapenem β-Lactams Compared to Carbapenems for Extended-Spectrum β-Lactamase–Producing Enterobacterales Urinary Tract Infections
Efficacy of Noncarbapenem β-Lactams Compared to Carbapenems for Extended-Spectrum β-Lactamase–Producing Enterobacterales Urinary Tract Infections Open
Background Extended-spectrum β-lactamase (ESBL)–producing Enterobacterales are frequent causes of urinary tract infections (UTIs). Severe infections caused by ESBL Enterobacterales are often treated with carbapenems, but optimal treatment …
View article: Rapid Detection and Characterization of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron Variant in a Returning Traveler
Rapid Detection and Characterization of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Omicron Variant in a Returning Traveler Open
We describe rapid detection of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant using targeted spike single-nucleotide polymorphism polymerase chain reaction and viral genome sequencing. This case occurred i…
View article: Routine Antigen Testing Is Not a Substitute for Health Care Worker Vaccination against SARS-CoV-2
Routine Antigen Testing Is Not a Substitute for Health Care Worker Vaccination against SARS-CoV-2 Open
The utility of rapid antigen testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is measured within the context for which it is applied; diagnostic accuracy must be considered in determining if rapid antigen testing is…
View article: Delayed Hypersensitivity Reactions Following First Dose of the SARS-CoV2 mRNA Vaccines
Delayed Hypersensitivity Reactions Following First Dose of the SARS-CoV2 mRNA Vaccines Open
View article: Reductions in Postdischarge <i>Clostridioides difficile</i> Infection after an Inpatient Health System Fluoroquinolone Stewardship
Reductions in Postdischarge <i>Clostridioides difficile</i> Infection after an Inpatient Health System Fluoroquinolone Stewardship Open
Background: Effective inpatient stewardship initiatives can improve antibiotic prescribing, but impact on outcomes like Clostridioides difficile infections (CDIs) is less apparent. However, the effect of inpatient stewardship efforts may e…
View article: Clinical characteristics and outcomes of toxoplasmosis among transplant recipients at two US academic medical centers
Clinical characteristics and outcomes of toxoplasmosis among transplant recipients at two US academic medical centers Open
Toxoplasma gondii can cause severe opportunistic infection in immunocompromised individuals, but diagnosis is often delayed. We conducted a retrospective review of solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) …
View article: Immediate Reactions After the First Dose of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Messenger RNA Vaccines Do Not Preclude Second-Dose Administration
Immediate Reactions After the First Dose of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Messenger RNA Vaccines Do Not Preclude Second-Dose Administration Open
Addressing coronavirus disease 2019 (COVID-19) vaccine hesitancy and minimizing potential vaccine contraindications are critical to combatting the pandemic. We describe a practical approach to immediate adverse events after the first dose …
View article: Evaluation of a risk assessment model to predict infection with healthcare facility–onset<i>Clostridioides difficile</i>
Evaluation of a risk assessment model to predict infection with healthcare facility–onset<i>Clostridioides difficile</i> Open
Purpose We evaluated a previously published risk model (Novant model) to identify patients at risk for healthcare facility–onset Clostridioides difficile infection (HCFO-CDI) at 2 hospitals within a large health system and compared its pre…
View article: Improved empiric antibiotic prescribing for common infectious disease diagnoses using order sets with built-in clinical decision support in the emergency department
Improved empiric antibiotic prescribing for common infectious disease diagnoses using order sets with built-in clinical decision support in the emergency department Open
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View article: Reductions in inpatient fluoroquinolone use and postdischarge <i>Clostridioides difficile</i> infection (CDI) from a systemwide antimicrobial stewardship intervention
Reductions in inpatient fluoroquinolone use and postdischarge <i>Clostridioides difficile</i> infection (CDI) from a systemwide antimicrobial stewardship intervention Open
Objective: To determine the impact of an inpatient stewardship intervention targeting fluoroquinolone use on inpatient and postdischarge Clostridioides difficile infection (CDI). Design: We used an interrupted time series study design to e…
View article: Carbapenem-resistant Enterobacterales bacteriuria and subsequent bacteremia: A population-based study
Carbapenem-resistant Enterobacterales bacteriuria and subsequent bacteremia: A population-based study Open
Objective: To describe the epidemiology of carbapenem-resistant Enterobacterales (CRE) bacteriuria and to determine whether urinary catheters increase the risk of subsequent CRE bacteremia. Design: Using active population- and laboratory-b…
View article: Novel approach to deployment of crisis situation supply of N95 respirator models in a healthcare system
Novel approach to deployment of crisis situation supply of N95 respirator models in a healthcare system Open
View article: Variation in Hospitalist-Specific Antibiotic Prescribing at Four Hospitals: A Novel Tool for Antibiotic Stewardship
Variation in Hospitalist-Specific Antibiotic Prescribing at Four Hospitals: A Novel Tool for Antibiotic Stewardship Open
Background: Hospitalists play a critical role in antimicrobial stewardship as the primary antibiotic prescriber for many inpatients. We sought to describe antibiotic prescribing variation among hospitalists within a healthcare system. Meth…
View article: An Interactive Sociotechnical Analysis of the Implementation of Electronic Decision Support in Antimicrobial Stewardship
An Interactive Sociotechnical Analysis of the Implementation of Electronic Decision Support in Antimicrobial Stewardship Open
Background: There is great enthusiasm for the potential of decision support tools embedded in the electronic medical record to improve antimicrobial use in hospitals. Yet they are often limited in their ability to change prescriber behavio…
View article: Approach to Cataract Surgery in an Ebola Virus Disease Survivor with Prior Ocular Viral Persistence
Approach to Cataract Surgery in an Ebola Virus Disease Survivor with Prior Ocular Viral Persistence Open
A 46-year-old patient with previously documented Ebola virus persistence in his ocular fluid, associated with severe panuveitis, developed a visually significant cataract. A multidisciplinary approach was taken to prevent and control infec…
View article: The impact of an electronic medical record nudge on reducing testing for hospital-onset <i>Clostridioides difficile</i> infection
The impact of an electronic medical record nudge on reducing testing for hospital-onset <i>Clostridioides difficile</i> infection Open
Objective: To determine the effect of an electronic medical record (EMR) nudge at reducing total and inappropriate orders testing for hospital-onset Clostridioides difficile infection (HO-CDI). Design: An interrupted time series analysis o…
View article: A streamlined approach to optimize perioperative antibiotic prophylaxis in the setting of penicillin allergy labels
A streamlined approach to optimize perioperative antibiotic prophylaxis in the setting of penicillin allergy labels Open
View article: Serosurvey on healthcare personnel caring for patients with Ebola virus disease and Lassa virus in the United States
Serosurvey on healthcare personnel caring for patients with Ebola virus disease and Lassa virus in the United States Open
Objective: Healthcare personnel (HCP) were recruited to provide serum samples, which were tested for antibodies against Ebola or Lassa virus to evaluate for asymptomatic seroconversion. Setting: From 2014 to 2016, 4 patients with Ebola vir…
View article: 506. Urinary Catheters Are Associated with Progression from Bacteriuria to Invasive Infections in Patients with Carbapenem-Resistant Enterobacteriaceae, Metropolitan Atlanta, 2011–2017
506. Urinary Catheters Are Associated with Progression from Bacteriuria to Invasive Infections in Patients with Carbapenem-Resistant Enterobacteriaceae, Metropolitan Atlanta, 2011–2017 Open
Background Patients with carbapenem-resistant Enterobacteriaceae (CRE) bacteriuria have better outcomes than patients with an invasive CRE infection, but patients with bacteriuria may subsequently develop an invasive infection (“progressio…