National partnerships address critical needs in infection prevention and control.

The COVID-19 pandemic highlighted gaps in infection control knowledge and practice across health settings nationwide. The Centers for Disease Control and Prevention, with funding through the American Rescue Plan, developed Project Firstline. Project Firstline is a national collaborative aiming to reach all aspects of the health care frontline.

A cross-sectional survey of Department of Veterans Affairs laboratory practices for identification of carbapenem-resistant and .

Control of carbapenem-resistant and spread in healthcare settings begins with timely and accurate laboratory testing practices. Survey results show most Veterans Affairs facilities are performing recommended tests to identify these organisms. Most facilities report sufficient resources to perform testing, though medium-complexity facilities report some perceived barriers.

Associations between adolescent perceived loneliness and hair cortisol concentration.

Introduction: Adolescents experience high levels of loneliness, which is linked to poor health in adulthood. Loneliness may contribute to poor health through chronic dysregulation of the hypothalamic-pituitary-adrenal axis. In this analysis, we examined the associations between survey- and ecological momentary assessment (EMA)-based measures of loneliness and hair cortisol concentrations (HCC) in a sample of 1102 adolescents and assessed sex differences in this relationship.

Relationship Between Family and Friend Support and Psychological Distress in Adolescents.

Objective: This study examines the associations between family and friend support and depressive and anxiety symptoms among adolescents, considering potential sex differences.

Methods: Secondary data from a longitudinal cohort study of 1,348 adolescents ages 11-17 were analyzed using descriptive statistics and multiple linear regression, controlling for relevant factors. Interaction terms between sex and support were created to examine moderation by sex.

Mixed-Methods Analysis of Provider-Documented and Patient-Reported Urinary Tract Infection Symptoms Among Veterans With Neurogenic Bladder.

Inappropriate urinary tract infection diagnosis in patients with neurogenic bladder may result from ambiguous symptoms experienced by these patients and contributes to antibiotic overuse. Characterization of patient-reported signs and symptoms may help providers more appropriately diagnose urinary tract infections. A previous study collected signs and symptoms recorded in electronic medical records of patients with neurogenic bladder due to spinal cord injury/disorder, multiple sclerosis, and Parkinson's disease with at least one urinary tract infection diagnosis between 2017-2018 at four medical centers.

Facility- and patient-level factors associated with implementation of contact precautions in hospitalized VA patients with positive CRE cultures.

Decreasing the time to contact precautions (CP) is critical to carbapenem-resistant Enterobacterales (CRE) prevention. Identifying factors associated with delayed CP can decrease the spread from patients with CRE. In this study, a shorter length of stay was associated with being placed in CP within 3 days.

Knowledge, perceptions, and beliefs about urinary tract infections in persons with neurogenic bladder and impacts on interventions to promote person-centered care.

Study Design: Qualitative study.

Objectives: To explore how knowledge, perceptions, and beliefs about urinary tract infections (UTIs) among persons with neurogenic bladder (NB) may impact health behaviors and provider management and enhance person-centeredness of interventions to improve UTI management.

Setting: Three Veterans Affairs (VA) medical centers.

Treatment effectiveness of antibiotic therapy in Veterans with multidrug-resistant bacteremia.

Objective: To describe antimicrobial therapy used for multidrug-resistant (MDR) bacteremia in Veterans and impacts on mortality.

Methods: This was a retrospective cohort study of hospitalized Veterans Affairs patients from 2012 to 2018 with a positive MDR blood culture who received antimicrobial treatment 2 days prior to through 5 days after the culture date. Only the first culture per patient was used.

Antimicrobial stewardship strategy implementation and impact in acute care spinal cord injury and disorder units.

Context: Antimicrobial Stewardship Programs (ASPs) are crucial to optimizing antibiotic use. ASPs are implemented in the Veterans Health Administration (VAs), but they do not target the needs of populations at high risk for resistant infections, such as spinal cord injury and disorder (SCI/D).

Objective: The goal of this study was to assess key ASP leader and SCI/D clinicians' perceived level of implementation and impact of 33 Antimicrobial Stewardship (AS) strategies.

Perceptions, experiences, and beliefs regarding urinary tract infections in patients with neurogenic bladder: A qualitative study.

Although urinary tract infections (UTIs) are common in patients with neurogenic bladder (NB), limited data exist on UTI perceptions, experiences, and beliefs in these patients. We recruited adults with NB due to spinal cord injury/disorder (SCI/D) or multiple sclerosis (MS) at three Veterans Affairs (VA) medical centers to participate in 11 virtual focus groups. Audio transcripts were coded using a mixed approach with primary deductive codes linked to the Health Belief Model, and secondary inductive codes informed by grounded theory.

Management of Asymptomatic Bacteriuria and Urinary Tract Infections in Patients With Neurogenic Bladder and Factors Associated With Inappropriate Diagnosis and Treatment.

Objective: Inappropriate diagnosis and treatment of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) are leading causes of antibiotic overuse but have not been well-studied in patients with risks for complicated UTI such as neurogenic bladder (NB). Our aim was to describe ASB and UTI management in patients with NB and assess factors associated with inappropriate management.

Design: Retrospective cohort study.

Retrospective Cohort Study of Patient-Reported Urinary Tract Infection Signs and Symptoms Among Individuals With Neurogenic Bladder.

Objective: The aim of the study is to characterize patient-reported signs and symptoms of urinary tract infections in patients with neurogenic bladder to inform development of an intervention to improve the accuracy of urinary tract infection diagnosis.

Design: This is a retrospective cohort study of adults with neurogenic bladder due to spinal cord injury/disorder, multiple sclerosis, and/or Parkinson disease and urinary tract infection encounters at four medical centers between 2017 and 2018. Data were collected through medical record review and analyzed using descriptive statistics and unadjusted logistic regression.

Clinical outcomes associated with guideline-discordant management of asymptomatic bacteriuria and urinary tract infection in hospitalized patients with neurogenic bladder.

Objective: To compare clinical outcomes associated with appropriate and inappropriate management of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) among inpatients with neurogenic bladder (NB).

Design: Multicenter, retrospective cohort.

Setting: The study was conducted across 4 Veterans' Affairs hospitals.

A qualitative approach to examining antimicrobial prescribing in the outpatient dental setting.

Objective: To understand barriers and facilitators to evidence-based prescribing of antibiotics in the outpatient dental setting.

Design: Semistructured interviews.

Setting: Outpatient dental setting.

Increased carbapenemase testing following implementation of national VA guidelines for carbapenem-resistant Enterobacterales (CRE).

Objective: To describe national trends in testing and detection of carbapenemases produced by carbapenem-resistant Enterobacterales (CRE) and associate testing with culture and facility characteristics.

Design: Retrospective cohort study.

Setting: Department of Veterans' Affairs medical centers (VAMCs).

Opportunities for penicillin allergy evaluation in dental clinics.

Objective: To evaluate opportunities for assessing penicillin allergies among patients presenting to dental clinics.

Design: Retrospective cross-sectional study.

Setting: VA dental clinics.

Comparative effectiveness of antibiotic therapy for carbapenem-resistant Enterobacterales (CRE) bloodstream infections in hospitalized US veterans.

Background: Carbapenem-resistant Enterobacterales bloodstream infections (CRE-BSI) increase mortality three-fold compared with carbapenem-susceptible bloodstream infections. Because these infections are rare, there is a paucity of information on mortality associated with different treatment regimens. This study examines treatment regimens and association with in-hospital, 30 day and 1 year mortality risk for patients with CRE-BSI.