Spatiotemporal clustering of in-hospital Clostridioides difficile infection

2020 ◽  
Vol 41 (4) ◽  
pp. 418-424
Author(s):  
Shreyas Pai ◽  
Philip M. Polgreen ◽  
Alberto Maria Segre ◽  
Daniel K. Sewell ◽  
Sriram V. Pemmaraju ◽  
...  
Keyword(s):  
Environmental Factors ◽  
Aspiration Pneumonia ◽  
Mantel Test ◽  
University Of Iowa ◽  
Component Size ◽  
Clostridioides Difficile ◽  
Knox Test ◽  
Spatiotemporal Clustering ◽  
Clostridioides Difficile Infection ◽  
The University

AbstractObjective:To determine whether Clostridioides difficile infection (CDI) exhibits spatiotemporal interaction and clustering.Design:Retrospective observational study.Setting:The University of Iowa Hospitals and Clinics.Patients:This study included 1,963 CDI cases, January 2005 through December 2011.Methods:We extracted location and time information for each case and ran the Knox, Mantel, and mean and maximum component size tests for time thresholds (T = 7, 14, and 21 days) and distance thresholds (D = 2, 3, 4, and 5 units; 1 unit = 5–6 m). All tests were implemented using Monte Carlo simulations, and random CDI cases were constructed by randomly permuting times of CDI cases 20,000 times. As a counterfactual, we repeated all tests on 790 aspiration pneumonia cases because aspiration pneumonia is a complication without environmental factors.Results:Results from the Knox test and mean component size test rejected the null hypothesis of no spatiotemporal interaction (P < .0001), for all values of T and D. Results from the Mantel test also rejected the hypothesis of no spatiotemporal interaction (P < .0003). The same tests showed no such effects for aspiration pneumonia. Our results from the maximum component size tests showed similar trends, but they were not consistently significant, possibly because CDI outbreaks attributable to the environment were relatively small.Conclusion:Our results clearly show spatiotemporal interaction and clustering among CDI cases and none whatsoever for aspiration pneumonia cases. These results strongly suggest that environmental factors play a role in the onset of some CDI cases. However, our results are not inconsistent with the possibility that many genetically unrelated CDI cases occurred during the study period.

Bioaerosols generated from toilet flushing in rooms of patients with Clostridioides difficile infection

2020 ◽  
Vol 41 (5) ◽  
pp. 517-521 ◽  
Author(s):  
Geneva M. Wilson ◽  
Virgil B. Jackson ◽  
Linda D. Boyken ◽  
Marin L. Schweizer ◽  
Daniel J. Diekema ◽  
...  
Keyword(s):  
Environmental Contamination ◽  
The United States ◽  
Clinical Settings ◽  
Prevention Measures ◽  
University Of Iowa ◽  
Clostridioides Difficile ◽  
Toilet Flushing ◽  
Before And After ◽  
Clostridioides Difficile Infection ◽  
The Difference

AbstractBackground:Clostridioides difficile infection (CDI) is the most frequently reported hospital-acquired infection in the United States. Bioaerosols generated during toilet flushing are a possible mechanism for the spread of this pathogen in clinical settings.Objective:To measure the bioaerosol concentration from toilets of patients with CDI before and after flushing.Design:In this pilot study, bioaerosols were collected 0.15 m, 0.5 m, and 1.0 m from the rims of the toilets in the bathrooms of hospitalized patients with CDI. Inhibitory, selective media were used to detect C. difficile and other facultative anaerobes. Room air was collected continuously for 20 minutes with a bioaerosol sampler before and after toilet flushing. Wilcoxon rank-sum tests were used to assess the difference in bioaerosol production before and after flushing.Setting:Rooms of patients with CDI at University of Iowa Hospitals and Clinics.Results:Bacteria were positively cultured from 8 of 24 rooms (33%). In total, 72 preflush and 72 postflush samples were collected; 9 of the preflush samples (13%) and 19 of the postflush samples (26%) were culture positive for healthcare-associated bacteria. The predominant species cultured were Enterococcus faecalis, E. faecium, and C. difficile. Compared to the preflush samples, the postflush samples showed significant increases in the concentrations of the 2 large particle-size categories: 5.0 µm (P = .0095) and 10.0 µm (P = .0082).Conclusions:Bioaerosols produced by toilet flushing potentially contribute to hospital environmental contamination. Prevention measures (eg, toilet lids) should be evaluated as interventions to prevent toilet-associated environmental contamination in clinical settings.

scholarly journals Highly Local Clostridioides difficile Infection (CDI) Pressure as Risk Factors for CDI

2020 ◽  
Vol 41 (S1) ◽  
pp. s250-s250
Author(s):  
Talal Riaz ◽  
Nabeel Khan ◽  
Philip Polgreen ◽  
Alberto Segre ◽  
Daniel Sewell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
University Of Iowa ◽  
Colonization Pressure ◽  
Unit Level ◽  
Clostridioides Difficile ◽  
Out Of Sample ◽  
True Source ◽  
Clostridioides Difficile Infection ◽  
Improved Performance

Background. Colonization pressure at the unit level is known to be a risk factor for Clostridioides difficile infections in hospitals. Because C. difficile colonization is not routinely detected in clinical practice, only patients identified as having C. difficile infection (CDI) are included in these pressure calculations. We used data from the University of Iowa Hospitals and Clinics (UIHC) to determine whether highly local CDI pressure, due to patients in nearby rooms, is more strongly correlated with CDI than unit-level CDI pressure. Methods: We designed a base logistic regression model using variables known to be risk factors for CDI: age, antibiotic/gastric acid suppressor use, low albumin, prior hospitalization, comorbidities. To the base model, we add 2 measures, mean colonization pressure (MCP) and sum colonization pressure (SCP) of CDI at the unit level to obtain new models. To the base model, we also added CDI colonization pressure by considering CDI cases at different distance thresholds from the focal patient. Distances between patient rooms were extracted from hospital floor plans. Results: Adding unit-level CDI colonization pressures to the base model improved performance. However, adding CDI colonization pressures due to roommates and due to patients at different distances improved the model much more (Table 1). The top (resp. bottom) row shows in-sample (resp. out-of-sample) C-statistics for the base model, the base model with unit-level MCP, the base model with roommate MCP, and the base model with MCP from patients are different distances added as separate features. C-statistics for the base model and the base model with unit CDI pressure (SCP and MCP) are compared in Fig. 1 with C-statistics from the base model with CDI pressure from patients at distances D = 0, 1, 2, 3, 4, 5, 10, 15, 20 hops (1 hop = 5–6 meters). Conclusions: Our results support the hypothesis that unit CDI colonization pressure is a risk factor for CDI. However, by incorporating spatially granular notions of distances between patients in our analysis, we were able to demonstrate that the true source of CDI pressure at the UIHC is almost exclusively attributable to roommates and patients in adjacent rooms.Funding: NoneDisclosures: None

The consolidation of microscopy technology into a university research support facility: Reflections on the 1980's and projections for the 1990's at the university of iowa

1993 ◽  
Vol 51 ◽  
pp. 476-477
Author(s):  
Kenneth C. Moore
Keyword(s):  
Laser Scanning ◽  
Freeze Fracture ◽  
Freeze Substitution ◽  
Research Support ◽  
University Of Iowa ◽  
Staff Members ◽  
The Past ◽  
Research Grade ◽  
The University ◽  
Support Facility

The University of Iowa Central Electron Microscopy Research Facility(CEMRF) was established in 1981 to support all faculty, staff and students needing this technology. Initially the CEMRF was operated with one TEM, one SEM, three staff members and supported about 30 projects a year. During the past twelve years, the facility has replaced all instrumentation pre-dating 1981, and now includes 2 TEM's, 2 SEM's, 2 EDS systems, cryo-transfer specimen holders for both TEM and SEM, 2 parafin microtomes, 4 ultamicrotomes including cryoultramicrotomy, a Laser Scanning Confocal microscope, a research grade light microscope, an Ion Mill, film and print processing equipment, a rapid cryo-freezer, freeze substitution apparatus, a freeze-fracture/etching system, vacuum evaporators, sputter coaters, a plasma asher, and is currently evaluating scanning probe microscopes for acquisition. The facility presently consists of 10 staff members and supports over 150 projects annually from 44 departments in 5 Colleges and 10 industrial laboratories. One of the unique strengths of the CEMRF is that both Biomedical and Physical scientists use the facility.

Five Decades of Research Experience in Speech Anatomy and Physiology

2016 ◽  
Vol 1 (5) ◽  
pp. 4-12
Author(s):  
David P. Kuehn
Keyword(s):  
Ohio State University ◽  
State University ◽  
Research Experience ◽  
University Of Iowa ◽  
University Of Illinois ◽  
Anatomy And Physiology ◽  
The Ohio State University ◽  
Speech Science ◽  
The University ◽  
East Carolina University

This report highlights some of the major developments in the area of speech anatomy and physiology drawing from the author's own research experience during his years at the University of Iowa and the University of Illinois. He has benefited greatly from mentors including Professors James Curtis, Kenneth Moll, and Hughlett Morris at the University of Iowa and Professor Paul Lauterbur at the University of Illinois. Many colleagues have contributed to the author's work, especially Professors Jerald Moon at the University of Iowa, Bradley Sutton at the University of Illinois, Jamie Perry at East Carolina University, and Youkyung Bae at the Ohio State University. The strength of these researchers and their students bodes well for future advances in knowledge in this important area of speech science.

Rheometers, Bioreactors, and Vocalization Forces: Using Basic Science Investigations to Help the Voices of Teachers

2008 ◽  
Vol 18 (3) ◽  
pp. 119-125
Author(s):  
Sarah Klemuk
Keyword(s):  
Basic Science ◽  
Tissue Growth ◽  
University Of Iowa ◽  
Support Cell ◽  
Rest Periods ◽  
Collaborative Studies ◽  
Professional Voice Users ◽  
The University ◽  
Science Investigations ◽  
Professional Voice

Abstract Collaborative studies at the University of Iowa and the National Center for Voice and Speech aim to help the voices of teachers. Investigators study how cells and tissues respond to vibration doses simulating typical vocalization patterns of teachers. A commercially manufactured instrument is uniquely modified to support cell and tissue growth, to subject tissues to vocalization-like forces, and to measure viscoelastic properties of tissues. Through this basic science approach, steps toward safety limits for vocalization and habilitating rest periods for professional voice users will be achieved.

The Kontakte Multimedia Project at The University of Iowa

2013 ◽  
Vol 17 (1) ◽  
pp. 25-42 ◽  
Author(s):  
James P. Pusack
Keyword(s):  
University Of Iowa ◽  
The University
Sign in / Sign up

Export Citation Format

Share Document