Background: Antibiotics targeted against C. difficile bacteria are necessary, but insufficient, to achieve a durable clinical response because they have no effect on C. difficile spores that germinate within a disrupted microbiome. ECOSPOR-III evaluated SER-109, an investigational, biologically-derived microbiome therapeutic of purified Firmicute spores for treatment of recurrent CDI. Methods: Adults ≥18 years with recurrent [...]

Background: Community acquired severity scores are well known and used routinely in predicting mortality and risk of inpatient and ICU admission in suspected bacterial pneumonia patients. However such scores have not been studied in patients with influenza infection and influenza pneumonia. We attempted to validate one such score, CURB65 and and identify other scores that [...]

Background: Clostridioides difficile infection (CDI) is a common, often nosocomial infection associated with substantial morbidity and mortality. Antibiotics are the most important modifiable risk factor, but empiric antibiotics remain appropriate for many patients with severe acute illness. Which antibiotics minimize the risk of CDI remains an important unanswered question. Because protective equipment and isolation were [...]

Background: Community acquired severity scores are well known and used routinely in predicting mortality and risk of inpatient and ICU admission in suspected bacterial pneumonia patients. However such scores have not been studied in patients with influenza infection and influenza pneumonia. We attempted to validate one such score, CURB65 and and identify other scores that [...]

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: Our institution’s rate of hospital acquired Clostridioides difficile (C. diff) infection (CDI) is higher than expected based on documented severity of illness of our patients. The C. diff testing algorithm at our institution utilizes a multi-step approach. It begins with two tests (antigen EIA and toxin A/B EIA). If the results of these two [...]

Background: Half of US hospitalists have contracts with pay-for-performance incentives based on quality outcomes such as length of stay (LOS) and readmission according to the 2023 State of Hospital Medicine Report. Traditionally, these measures have been linked to the discharging provider. However, as the length of a patient’s stay increases, the influence of the discharging [...]

Background: Efforts have been made to increase social determinants of health (SDoH) screening to connect patients and families to community-based organizations (CBOs) and other resources. Tracking closed loop referrals is one potential measure to assist in assessing whether the resulting referrals and interventions have affected the child’s SDoH or improved the family’s well-being. Our team [...]

Case Presentation: A 15-year-old male with HIV and inconsistent antiretroviral therapy adherence presented to an HIV clinic in Lilongwe, Malawi with weight loss, night sweats, lower extremity rash, and diarrhea. The rash on his legs had been present for 4 months and then spread to his arms. On exam, his vital signs were unremarkable. He [...]