Publications by authors named "J P Mahoehney"

Objectives: The Centers for Disease Control and Prevention (CDC) recommends implementing Enhanced Barrier Precautions (EBP) for all nursing home (NH) residents known to be colonized with targeted multidrug-resistant organisms (MDROs), wounds, or medical devices. Differences in health care personnel (HCP) and resident interactions between units may affect risk of acquiring and transmitting MDROs, affecting EBP implementation. We studied HCP-resident interactions across a variety of NHs to characterize MDRO transmission opportunities.

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Importance: Controlling antimicrobial resistance in health care is a public health priority, although data describing antimicrobial use in US nursing homes are limited.

Objective: To measure the prevalence of antimicrobial use and describe antimicrobial classes and common indications among nursing home residents.

Design, Setting, And Participants: Cross-sectional, 1-day point-prevalence surveys of antimicrobial use performed between April 2017 and October 2017, last survey date October 31, 2017, and including 15 276 residents present on the survey date in 161 randomly selected nursing homes from selected counties of 10 Emerging Infections Program (EIP) states.

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Health care personnel (HCP) are at increased risk for infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), as a result of their exposure to patients or community contacts with COVID-19 (1,2). Since the first confirmed case of COVID-19 in Minnesota was reported on March 6, 2020, the Minnesota Department of Health (MDH) has required health care facilities* to report HCP exposures to persons with confirmed COVID-19 for exposure risk assessment and to enroll HCP with higher-risk exposures into quarantine and symptom monitoring. During March 6-July 11, MDH and 1,217 partnering health care facilities assessed 21,406 HCP exposures; among these, 5,374 (25%) were classified as higher-risk (3).

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Acute change in mental status (ACMS), defined by the Confusion Assessment Method, is used to identify infections in nursing home residents. A medical record review revealed that none of 15,276 residents had an ACMS documented. Using the revised McGeer criteria with a possible ACMS definition, we identified 296 residents and 21 additional infections.

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Article Synopsis
  • This study analyzed antibiotic use for urinary tract infections (UTIs) among nursing home residents in the U.S., based on a 2017 survey of 15,276 residents from 161 facilities across 10 states.
  • A total of 407 residents received 424 antibiotics for UTI, with a prevalence rate of 2.66 per 100 residents, varying significantly among nursing homes.
  • Notably, a quarter of these prescriptions were for UTI prophylaxis with an average duration of 111 days, despite limited supporting evidence, and fluoroquinolones were the most commonly used type of antibiotic, raising concerns about potential adverse effects in older patients.
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