Rachel D Yelin
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View article: Longitudinal genomic surveillance of carriage and transmission of Clostridioides difficile in an intensive care unit
Longitudinal genomic surveillance of carriage and transmission of Clostridioides difficile in an intensive care unit Open
Despite enhanced infection prevention efforts, Clostridioides difficile remains the leading cause of healthcare-associated infections in the United States. Current prevention strategies are limited by their failure to account for patients …
View article: Impact of measurement and feedback on chlorhexidine gluconate bathing among intensive care unit patients: A multicenter study
Impact of measurement and feedback on chlorhexidine gluconate bathing among intensive care unit patients: A multicenter study Open
Objective: To assess whether measurement and feedback of chlorhexidine gluconate (CHG) skin concentrations can improve CHG bathing practice across multiple intensive care units (ICUs). Design: A before-and-after quality improvement study m…
View article: ICE volume 44 issue 9 Cover and Front matter
ICE volume 44 issue 9 Cover and Front matter Open
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View article: Threshold-free genomic cluster detection to track transmission pathways in health-care settings: a genomic epidemiology analysis
Threshold-free genomic cluster detection to track transmission pathways in health-care settings: a genomic epidemiology analysis Open
US Center for Disease Control and Prevention and University of Michigan.
View article: Admission and Discharge Sampling Underestimates Multidrug-Resistant Organism (MDRO) Acquisition in an Intensive Care Unit
Admission and Discharge Sampling Underestimates Multidrug-Resistant Organism (MDRO) Acquisition in an Intensive Care Unit Open
Background: Identification of hospitalized patients with enteric multidrug-resistant organism (MDRO) carriage, combined with implementation of targeted infection control interventions, may help reduce MDRO transmission. However, the optima…
View article: Integrated genomic, epidemiologic investigation of Candida auris skin colonization in a skilled nursing facility
Integrated genomic, epidemiologic investigation of Candida auris skin colonization in a skilled nursing facility Open
View article: 919. Understanding Intermittent Detection of Multidrug-Resistant Organisms (MDROs) in Rectally Colonized Patients
919. Understanding Intermittent Detection of Multidrug-Resistant Organisms (MDROs) in Rectally Colonized Patients Open
Background MDRO detection in colonized patients may be intermittent for reasons that are incompletely understood. We examined temporal patterns of gut MDRO colonization after initial MDRO detection by rectal swab screening, and determined …
View article: Cohorting KPC+ <i>Klebsiella pneumoniae</i> (KPC-Kp)–Positive Patients—A Genomic Exposé of Cross-Colonization Hazards
Cohorting KPC+ <i>Klebsiella pneumoniae</i> (KPC-Kp)–Positive Patients—A Genomic Exposé of Cross-Colonization Hazards Open
Background: Long-term acute-care hospitals (LTACHs) are disproportionately burdened by multidrug-resistant organisms (MDROs) like KPC-Kp. Although cohorting KPC-Kp+ patients into rooms with other carriers can be an outbreak-control strateg…
View article: Threshold-free genomic cluster detection to track transmission pathways in healthcare settings
Threshold-free genomic cluster detection to track transmission pathways in healthcare settings Open
Background Over the past decade, whole-genome sequencing (WGS) has become the gold standard for tracking the spread of infections in healthcare settings. However, a critical barrier to the routine application of WGS for infection preventio…
View article: Cohorting KPC+ <i>Klebsiella pneumoniae</i> (KPC-Kp) positive patients – a genomic exposé of cross-colonization hazards in a long-term acute care hospital (LTACH)
Cohorting KPC+ <i>Klebsiella pneumoniae</i> (KPC-Kp) positive patients – a genomic exposé of cross-colonization hazards in a long-term acute care hospital (LTACH) Open
Objective Cohorting patients who are colonized or infected with multidrug-resistant organisms (MDROs) has been demonstrated to protect uncolonized patients from acquiring MDROs in healthcare settings. A neglected aspect of cohorting is the…
View article: 897. Prevalence of Candida auris at Body Sites, Characterization of Skin Microbiota, and Relation of Chlorhexidine Gluconate (CHG) Skin Concentration to C. auris Detection Among Patients at a High-Prevalence Ventilator-Capable Skilled Nursing Facility (vSNF) with Established CHG Bathing
897. Prevalence of Candida auris at Body Sites, Characterization of Skin Microbiota, and Relation of Chlorhexidine Gluconate (CHG) Skin Concentration to C. auris Detection Among Patients at a High-Prevalence Ventilator-Capable Skilled Nursing Facility (vSNF) with Established CHG Bathing Open
Background vSNF patients are at high risk of colonization and infection with C. auris. CHG bathing has been used as an intervention to reduce nosocomial transmission of multi-drug-resistant organisms, but its effect on C. auris is unclear.…
View article: 2424. Shedding of Viable Clostridiodes difficile in Patients Admitted to a Medical Intensive Care Unit
2424. Shedding of Viable Clostridiodes difficile in Patients Admitted to a Medical Intensive Care Unit Open
Background Hospitalized patients are at risk of colonization with a range of healthcare-associated bacterial pathogens, including C. difficile. In patients admitted to intensive care units (ICUs), in whom C. difficile infection (CDI) is as…
View article: 572. Relationship Between Chlorhexidine Gluconate (CHG) Skin Concentrations and Microbial Skin Colonization among Medical Intensive Care Unit (MICU) Patients
572. Relationship Between Chlorhexidine Gluconate (CHG) Skin Concentrations and Microbial Skin Colonization among Medical Intensive Care Unit (MICU) Patients Open
Background CHG bathing is used to suppress patients’ microbial skin colonization, in order to prevent infections and transmission of multidrug-resistant organisms. Prior work has suggested that microbial growth is inhibited when CHG skin c…
View article: 2849. Gut Microbiota Differences at the Time of Medical Intensive Care Unit (MICU) Admission Are Associated with Acquisition of Multi-drug-Resistant Organisms (MDROs) Among Patients Not Already Colonized with an MDRO
2849. Gut Microbiota Differences at the Time of Medical Intensive Care Unit (MICU) Admission Are Associated with Acquisition of Multi-drug-Resistant Organisms (MDROs) Among Patients Not Already Colonized with an MDRO Open
Background Among hospitalized patients, underlying variation in gut microbiota may confer differential risk for gut MDRO acquisition. Methods Rectal swab samples were collected from patients ≤2 days of MICU admission and then daily in the …
View article: 895. Impact of Measurement and Results Feedback of Chlorhexidine Gluconate (CHG) Skin Concentrations in Medical Intensive Care Unit (MICU) Patients Receiving CHG Bathing
895. Impact of Measurement and Results Feedback of Chlorhexidine Gluconate (CHG) Skin Concentrations in Medical Intensive Care Unit (MICU) Patients Receiving CHG Bathing Open
Background Higher CHG skin levels may be needed to adequately control infection and transmission of pathogens in the ICU. We assessed whether measurement and feedback of patient CHG skin concentrations could improve CHG bathing quality and…
View article: 1764. The Gut: A Veiled Reservoir for Multidrug-resistant Organisms (MDROs) Below the Tip of the Iceberg
1764. The Gut: A Veiled Reservoir for Multidrug-resistant Organisms (MDROs) Below the Tip of the Iceberg Open
Background Clinical culture results are sometimes used to estimate the burden of multidrug-resistant organisms (MDROs) in hospitals. The association between positive clinical culture results and prevalence of MDROs in the gut is incomplete…
View article: Increased Relative Abundance of Klebsiella pneumoniae Carbapenemase-producing Klebsiella pneumoniae Within the Gut Microbiota Is Associated With Risk of Bloodstream Infection in Long-term Acute Care Hospital Patients
Increased Relative Abundance of Klebsiella pneumoniae Carbapenemase-producing Klebsiella pneumoniae Within the Gut Microbiota Is Associated With Risk of Bloodstream Infection in Long-term Acute Care Hospital Patients Open
Carbapenem receipt was associated with increased hazard for high relative abundance of KPC-Kp in the gut microbiota. Increased relative abundance of KPC-Kp was associated with KPC-Kp bacteremia. Whether bacteremia arose directly from bacte…
View article: Longitudinal Comparison of the Microbiota During Klebsiella pneumoniae Carbapenemase-Producing Klebsiella pneumoniae (KPC-Kp) Acquisition in Long-Term Acute Care Hospital (LTACH) patients
Longitudinal Comparison of the Microbiota During Klebsiella pneumoniae Carbapenemase-Producing Klebsiella pneumoniae (KPC-Kp) Acquisition in Long-Term Acute Care Hospital (LTACH) patients Open
Background Colonization with KPC-Kp precedes infection and represents a potential target for intervention. To identify microbial signatures associated with KPC-Kp acquisition, we conducted a prospective, longitudinal study of the fecal mic…