Background: Hospital-acquired C. difficile colitis is associated with increased length of stay (LOS) and significant morbidity and mortality. During hospitalization, patients visit many procedural, diagnostic, and treatment areas throughout the hospital, presenting opportunities for spore contamination of surfaces and nosocomial disease transmission. We developed a novel methodology using electronic health record (EHR) data to map [...]

Background: Hospital-acquired C. difficile colitis is associated with increased length of stay (LOS) and significant morbidity and mortality. During hospitalization, patients visit many procedural, diagnostic, and treatment areas throughout the hospital, presenting opportunities for spore contamination of surfaces and nosocomial disease transmission. We developed a novel methodology using electronic health record (EHR) data to map [...]

Background: Skin, soft tissue, and joint infections are common in pediatric patients and can require invasive procedures to drain purulent fluid. Atypical pathogens (fungal and acid-fast bacilli [AFB]) are important but rare causes of these infections with reported case rates as low as 0.6-1.6 cases/100,000 a year. Despite the rarity of these infections, costly atypical [...]

Background: Orbital cellulitis/abscess (OC) is an infection of eye tissues posterior to the orbital septum. OC can have significant morbidities such as vision loss, cavernous sinus thrombosis, and intracranial infection if treatment is not initiated promptly. While some patients with orbital cellulitis complicated by subperiosteal abscess require surgical drainage, many are managed with intravenous (IV) [...]

Case Presentation: A 14-year-old boy with autism presented with a five-day history of high fever (40.5 degrees C), vomiting, shortness of breath, and a rash involving the palms-and-soles. He was evaluated at urgent care and was believed to have hand-foot-mouth disease. He was brought to the emergency department for ongoing symptoms, where he was noted [...]

Background: Pediatric orbital cellulitis/abscess (OC) is a known complication of sinusitis that can have detrimental outcomes such as vision loss and intracranial extension if not diagnosed and treated promptly. In many patients with OC, the microbiologic data is not available to guide provider selection of targeted antibiotics, so variation in prescribing patterns exists. Many institutions [...]

Background: Peripherally inserted central catheters (PICCs) are frequently used to deliver intravenous (IV) antibiotic therapy. Infectious disease (ID) physicians are often consulted prior to PICC placement, but whether their engagement influences PICC appropriateness and complications is not known. Methods: Using data from the Michigan Hospital Medicine Safety Consortium on PICCs placed in hospitalized medical patients [...]

Background: Closing the gap between evidence-supported antibiotic use and prescribing patterns among clinicians is a vital component of curbing excessive antibiotic use, a practice that fosters antimicrobial resistance and exposes patients to the side effects of antimicrobial agents. Providing medication prescribing information via scorecard has been shown to improve clinician adherence to quality metrics in [...]

Background: Single-center studies have reported low yield of blood culture for skin and soft tissue infections (SSTIs) in children. Blood cultures are commonly obtained in cases of SSTI, though the degree of practice variation is uncertain. Study objectives include: 1) assess the degree of variation in rate of blood culture for SSTIs among children’s hospitals [...]

Case Presentation: A 61 year old female presented to the emergency department with 1 day of nausea, vomiting, and fever. The day prior to her symptom onset, she had undergone a colonoscopy for colon cancer screening that was normal. Her medical history was notable for splenectomy in 2000 for a hamartoma.On presentation, her temperature was [...]