SARS-CoV-2 coinfections among pertussis cases identified through the Enhanced Pertussis Surveillance system in the United States, January 2020-February 2023.

Background: Bacterial and viral respiratory coinfections are common, but the prevalence of SARS-CoV-2 infections among pertussis cases has not been estimated. We examine the prevalence and temporality of SARS-CoV-2 infections among pertussis patients and describe pertussis clinical severity among patients with and without SARS-CoV-2 coinfections.

Methods: Confirmed and probable pertussis cases among individuals with cough onset between January 1, 2020 and February 15, 2023 were identified through surveillance in seven Enhanced Pertussis Surveillance (EPS) sites.

Reductions in positive events reportable to National Healthcare Safety Network (NHSN) with adoption of reflex enzyme immunoassay (EIA) testing in 13 Atlanta hospitals.

In total, 13 facilities changed testing to reflexive testing by enzyme immunoassay (EIA) only after a positive nucleic acid-amplification test (NAAT); the standardized infection ratio (SIR) decreased by 46% (range, -12% to -71% per hospital). Changing testing practice greatly influenced a performance metric without changing infection prevention practice.

Changes in treatment of community-onset Clostridioides difficile infection after release of updated guidelines, Atlanta, Georgia, 2018.

Updated Clostridioides difficile infection (CDI) guidelines published in 2018 recommend vancomycin as first-line treatment. Of 833 community-onset CDI cases in metropolitan Atlanta, Georgia in 2018, over half did not receive first-line treatment, although guideline adherence increased over the year. Second-line treatment was more common in patients treated in ambulatory settings.

Outcomes measurement in the operating room suite.

The objectives of quality improvement in the OR include improved perioperative care of the patient and OR efficiency, decreased hospital length of stay, and decreased costs. We submit that multidisciplinary outcome measurement is a prerequisite for coordinated outcomes management to achieve quality patient care in an effective, efficient, and financially responsible way, and we provide a guide to do so. The data obtained by such cross-discipline study can identify the need for patient, family, and/or staff education, improved interaction and collaboration across disciplines, revision of clinical paths, and improved hospital systems as well as benchmarking the performance of the OR against local or national standards.

A comparison of felodipine and propranolol as additions to hydrochlorothiazide in the treatment of hypertension.

Eighty one patients with uncomplicated hypertension who required additional antihypertensive medication (diastolic Phase V [dBP] greater than or equal to 95 mm Hg) after 4 weeks treatment with hydrochlorothiazide (HCTZ) 25 mg o.m. were randomized to receive felodipine 5 mg b.