Background: Hospital Onset Clostridium difficile infection (HOCDI) is one of the most common causes of hospital acquired diarrhea. As per a recent study, the mean healthcare costs attributable to primary Clostridium difficile infection (CDI) is about $24,205 per patient. This would be a lot more if the patients were to be discharged to skilled nursing [...]

Background: Stony Brook University Hospital (SBUH) identified an opportunity to develop and implement prevention strategies to reduce hospital onset C. difficile infections (CDI). Hospital Onset (HO) CDI are included in National Healthcare Safety Network (NHSN) reporting and included with other hospital-acquired infections as publically reported data. CDI contribute to prolonged hospital stays, inappropriate antimicrobial use, [...]

Background: Infectious disease-related factors that may contribute to or complicate falls have received relatively little attention in the literature. Specifically, the prevalence of coexisting systemic infections (CSIs) in patients presenting with a fall and admitted to the hospital has not been previously reported. We, herein, describe the scope and characteristics of CSIs in hospitalized patients [...]

Background: Standard risk prediction tools including the quick-Sequential Organ Failure Assessment (qSOFA) have been validated using in-hospital outcomes (mortality [Died-Hosp] or intensive care unit stay >72 hours [ICU72]). Yet, risk models are often applied to predict outcomes beyond hospitalization, and it is unclear what effect outcome selection has on model performance. We derived independent robust [...]

Background: Foot amputation rates in Black patients with diabetic foot complications have been historically higher than White patients. To determine if improvements in this disparity occurred, we carried out trend analysis of lower extremity amputation rates for patients hospitalized with diabetic foot ulcers and infections (DFU/Is). Methods: Using the National Inpatient Sample database, we conducted [...]

Background: Depending on the criterion applied, the systemic inflammatory response syndrome (SIRS) criteria and the Sequential Organ Failure Assessment (SOFA) criteria initially identify distinct populations that present to the emergency department (ED) with suspected sepsis (Prasad et al., SHM 2018). Our work has shown that 52% of patients meet SIRS criteria first and 48% meet [...]

Background: Patients hospitalized with hematologic malignancy are particularly vulnerable to infection. Clostridium difficile infection (CDI) has become the most common cause of healthcare-associated infections in U. S. hospitals, and the excess healthcare costs related to CDI are estimated to be as much as 4. 8 billion dollars for acute care facilities alone. We sought to [...]

Background: Data is emerging on the efficacy of fecal microbial transplantation (FMT) for recurrent clostridium difficile infection (CDI) management with success rates of 80-90% in general population. Immunocompromised patients continue to be excluded from randomized trials involving FMT due to concerns related to its safety and efficacy. Current guidelines recommend caution with FMT in immunocompromised [...]

Background: Clostridioides difficile infection (CDI) can be prevented through infection prevention practices and antibiotic stewardship. We found in a 2013 national survey (571 hospitals, 71% response rate) that while infection prevention practices for CDI were common in U.S. hospitals, only 52% had an antibiotic stewardship program (ASP). On 1 January 2017, The Joint Commission required [...]

Background: Infants ≤ 60 days of age with a urinary tract infection (UTI) represent a challenging population without clear guidelines for diagnostic evaluation or antibiotic therapy. UTI represents a significant percentage of serious bacterial infection in this age group and is a common management dilemma for pediatricians. Our study examined patterns of UTI management in [...]