Publications by authors named "Trish Perl"

Article Synopsis
  • The study aimed to analyze the prevalence of respiratory infections in hospitalized children by comparing symptomatic and asymptomatic cases using a specific PCR testing method from August 2020 to April 2022.
  • Out of 32,812 tested children, 39.5% were symptomatic and had a significantly higher positivity rate for respiratory viruses (67.3%) compared to asymptomatic children (27.0%).
  • Despite only showing symptoms, over a quarter of asymptomatic patients still tested positive for respiratory viruses, highlighting the trend that symptomatic children are more likely to have a detectable infection.
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Article Synopsis
  • The study investigates the spread of mis- and disinformation related to COVID-19, highlighting its prevalence and the role of social media in amplifying false information.
  • A comprehensive review of 868 peer-reviewed articles from 2020 to 2022 was conducted, revealing that over a third focused on mitigation and prevention strategies.
  • Analysis showed a predominance of negative sentiments in the literature, with fear and sadness being the most common emotions linked to the misinformation surrounding the pandemic.
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Background: The interplay between SARS-CoV-2 and contemporaneous bacterial or fungal culture growth may have crucial implications for clinical outcomes of hospitalized patients. This study aimed to quantify the effect of microbiological culture positivity on mortality among hospitalized patients with SARS-CoV-2.

Methods: In this retrospective cohort study, we included adult hospitalized patients from OPTUM COVID-19 specific data set, who tested positive for SARS-CoV-2 within 14 days of hospitalization between 01/20/2020 and 01/20/2022.

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Article Synopsis
  • The rise of antimicrobial resistant (AMR) infections poses a significant global health danger, influenced by complex factors, including socioeconomic conditions.
  • A study in the Dallas-Fort Worth area analyzed patient data from 2015 to 2020, linking bacterial culture results to socioeconomic indices to understand AMR patterns.
  • Findings indicated that regions with high deprivation levels had higher AMR rates, suggesting that improving socioeconomic factors could help reduce AMR spread.
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Background: Outpatient parenteral antimicrobial therapy (OPAT) is a safe and cost-effective transitional care approach administered via different delivery models. No standards exist for appropriate OPAT program staffing. We examined outcomes of patients receiving OPAT via different care models to identify strategies to improve safety while reducing health care overuse.

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Analyzing data from a national deidentified electronic health record-based data set using a matched case-control study design, we found that antibiotic use and severity of illness were independent risk factors for healthcare-associated candidemia in adult patients hospitalized with SARS-CoV-2 infection. Interleukin-6 inhibitor and corticosteroid use were not independent risk factors.

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Since the initial publication of in 2008, the prevention of healthcare-associated infections (HAIs) has continued to be a national priority. Progress in healthcare epidemiology, infection prevention, antimicrobial stewardship, and implementation science research has led to improvements in our understanding of effective strategies for HAI prevention. Despite these advances, HAIs continue to affect ∼1 of every 31 hospitalized patients, leading to substantial morbidity, mortality, and excess healthcare expenditures, and persistent gaps remain between what is recommended and what is practiced.

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Article Synopsis
  • The study explored whether getting vaccinated against COVID-19 right before or after testing positive improves patient outcomes among those who were previously unvaccinated.
  • Researchers analyzed data from a large group of adults who tested positive for COVID-19 and looked specifically at outcomes within 30 days of their diagnosis.
  • Findings revealed no significant difference in disease progression between vaccinated and unvaccinated patients during the acute infection period, suggesting that vaccination at this time may not enhance recovery.
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Background: Studies on COVID-19 in people with HIV (PWH) have had limitations. Further investigations on risk factors and outcomes of SARS-CoV-2 infection among PWH are needed.

Methods: This retrospective cohort study leveraged the national OPTUM COVID-19 data set to investigate factors associated with SARS-CoV-2 positivity among PWH and risk factors for severe outcomes, including hospitalization, intensive care unit stays, and death.

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Article Synopsis
  • * A study involving 30 hospital staff from 6 different hospitals revealed that the complexity of these bundles and varying barriers across departments hindered successful implementation.
  • * Effective interprofessional collaboration and tailored strategies are essential for overcoming these challenges and improving the adoption and sustainability of SSI prevention practices.
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Background: With the global continuation of the COVID-19 pandemic, the large-scale administration of a SARS-CoV-2 vaccine is crucial to achieve herd immunity and curtail further spread of the virus, but success is contingent on public understanding and vaccine uptake. We aim to understand public perception about vaccines for COVID-19 through the wide-scale, organic discussion on Twitter.

Methods: This cross-sectional observational study included Twitter posts matching the search criteria (('covid*' OR 'coronavirus') AND 'vaccine') posted during vaccine development from February 1st through December 11th, 2020.

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Article Synopsis
  • The study examines the impact of COVID-19 on children, highlighting hospitalization, ICU admission, invasive support, and death as serious outcomes.
  • Factors linked to worse results include preexisting health conditions and living in the Southern U.S., while vaccination showed protective effects, especially in those aged 5 to 18 years.
  • The research stresses the need for further investigation into health inequalities and outcomes, particularly among uninsured or underinsured children.
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Background: Social media platforms like Twitter provide important insights into the public's perceptions of global outbreaks like monkeypox. By analyzing tweets, we aimed to identify public knowledge and opinions on the monkeypox virus and related public health issues.

Methods: We analyzed English-language tweets using the keyword "monkeypox" from 1 May to 23 July 2022.

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Background: Viral respiratory infections (VRIs) are common and are occupational risks for healthcare personnel (HCP). VRIs can also be acquired at home and other settings among HCPs. We sought to determine if preschool-aged household contacts are a risk factor for VRIs among HCPs working in outpatient settings.

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In the current mpox outbreak, infections are usually self-limited. We describe 3 patients with uncontrolled HIV and mpox infections lasting months, causing debilitating lesions, complications, and death, despite initiating anti-mpox and antiretroviral therapy. Delayed treatment of mpox with antiviral agents may contribute to poor outcomes in severely immunocompromised patients.

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Background: Antistaphylococcal penicillins and cefazolin are the treatments of choice for methicillin-susceptible (MSSA) infections, requiring multiple doses daily. At Parkland, eligible uninsured patients with MSSA bloodstream infections (BSI) receive self-administered outpatient parenteral antimicrobial therapy (S-OPAT). Ceftriaxone was used in a cohort of S-OPAT patients for ease of once-daily dosing.

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Texas discontinued state-sponsored business restrictions and mask mandates on March 10, 2021, and mandated that no government officials, including public school officials, may implement mask requirements even in areas where COVID-19 hospitalizations comprised more than 15% of hospitalizations. Nonetheless, some public school districts began the 2021-2022 school year with mask mandates in place. We used quasi-experimental methods to analyze the impact of school mask mandates, which appear to have resulted in approximately 40 fewer student cases per week in the first eight weeks of school.

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Objective: To determine the difference in the incidence of healthcare-associated respiratory viral infection (HARVI) in a pediatric hospital depending on the definition used.

Design: Descriptive historical cohort study.

Setting And Participants: Patients aged 0-21 years old who were admitted between July 2013 and June 2018 to a 490-bed primary to quaternary-care pediatric hospital serving northern Texas.

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Article Synopsis
  • * Conducted over four years with 5180 participant-seasons, the trial compared the effectiveness of medical masks versus N95 respirators in preventing viral infections and assessed HAI antibody levels and confirmed infections through PCR testing.
  • * Results showed that higher HAI antibody titers were significantly linked to reduced risk of influenza infections, with each increase in titer decreasing the likelihood of illness by up to 35%, highlighting the importance of vaccination to boost immunity in HCP.
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Outbreaks in Health Care Settings.

Infect Dis Clin North Am

September 2021

Outbreaks and pseudo-outbreaks in health care settings are complex and should be evaluated systematically using epidemiologic and molecular tools. Outbreaks result from failures of infection prevention practices, inadequate staffing, and undertrained or overcommitted health care personnel. Contaminated hands, equipment, supplies, water, ventilation systems, and environment may also contribute.

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Objective: The implementation of mandatory influenza vaccination policies among healthcare personnel (HCP) is controversial. Thus, we examined the affect of mandatory influenza vaccination policies among HCP working in outpatient settings.

Setting: Four Veterans' Affairs (VA) health systems and three non-VA medical centers.

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Llibre and colleagues' brief research report investigated the effect of point-of-care onsite testing, use of face masks, and improved ventilation in preventing SARS-CoV-2 transmission at a large indoor concert. The editorialists evaluate factors that contributed to the success of these multimethod prevention strategies and the cost-effectiveness of such measures. They also consider how these measures could be adapted to prevent SARS-CoV-2 transmission in other settings.

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