Recurrent Infection and Outcome of Fecal Microbiota Transplantation Use: A Population-Based Assessment.

Background: Fecal microbiota transplantation (FMT) is recommended for the treatment of recurrent infection (rCDI). In the current study, we evaluated rates of rCDI and subsequent FMT in a large metropolitan area. We compared demographic and clinical differences in FMT recipients and nonrecipients and quantified differences in outcomes based on treatment modality.

Potential underreporting of treated patients using a testing algorithm that screens with a nucleic acid amplification test.

Objective: Patients tested for infection (CDI) using a 2-step algorithm with a nucleic acid amplification test (NAAT) followed by toxin assay are not reported to the National Healthcare Safety Network as a laboratory-identified CDI event if they are NAAT positive (+)/toxin negative (-). We compared NAAT+/toxin- and NAAT+/toxin+ patients and identified factors associated with CDI treatment among NAAT+/toxin- patients.

Design: Retrospective observational study.

Diversity, Equity, and Inclusion: Advancing Curricular Development and Recruitment.

Purpose Of Review: Currently, the increasing diversity of our society is poorly reflected in the urology workforce. In this review, we sought to address this disparity by highlighting key components involved in forming an academic urology department and training program that is focused on diversity, equity, and inclusion (DEI) as well as recruitment and retention of underrepresented in medicine (URiM) trainees and faculty.

Recent Findings: We identified obstacles and provided approaches to enhance the ability of a department in creating a DEI-based curriculum and recruitment strategy with a key focus on understanding and addressing unconscious biases and microaggressions in the workplace.

Reductions in inpatient fluoroquinolone use and postdischarge infection (CDI) from a systemwide antimicrobial stewardship intervention.

Objective: To determine the impact of an inpatient stewardship intervention targeting fluoroquinolone use on inpatient and postdischarge infection (CDI).

Design: We used an interrupted time series study design to evaluate the rate of hospital-onset CDI (HO-CDI), postdischarge CDI (PD-CDI) within 12 weeks, and inpatient fluoroquinolone use from 2 years prior to 1 year after a stewardship intervention.

Setting: An academic healthcare system with 4 hospitals.

Determinates of infection (CDI) testing practices among inpatients with diarrhea at selected acute-care hospitals in Rochester, New York, and Atlanta, Georgia, 2020-2021.

Objective: We evaluated the impact of test-order frequency per diarrheal episodes on difficile infection (CDI) incidence estimates in a sample of hospitals at 2 CDC Emerging Infections Program (EIP) sites.

Design: Observational survey.

Setting: Inpatients at 5 acute-care hospitals in Rochester, New York, and Atlanta, Georgia, during two 10-workday periods in 2020 and 2021.

Hospital-acquired influenza in the United States, FluSurv-NET, 2011-2012 through 2018-2019.

Objective: To estimate population-based rates and to describe clinical characteristics of hospital-acquired (HA) influenza.

Design: Cross-sectional study.

Setting: US Influenza Hospitalization Surveillance Network (FluSurv-NET) during 2011-2012 through 2018-2019 seasons.

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.

Carbapenem-resistant Enterobacterales bacteriuria and subsequent bacteremia: A population-based study.

Objective: To describe the epidemiology of carbapenem-resistant Enterobacterales (CRE) bacteriuria and to determine whether urinary catheters increase the risk of subsequent CRE bacteremia.

Design: Using active population- and laboratory-based surveillance we described a cohort of patients with incident CRE bacteriuria and identified risk factors for developing CRE bacteremia within 1 year.

Setting: The study was conducted among the 8 counties of Georgia Health District 3 (HD3) in Atlanta, Georgia.

Prescriber perceptions of fluoroquinolones, extended-spectrum cephalosporins, and infection.

Background: Fluoroquinolones (FQs) and extended-spectrum cephalosporins (ESCs) are associated with higher risk of Clostridioides difficile infection (CDI). Decreasing the unnecessary use of FQs and ESCs is a goal of antimicrobial stewardship. Understanding how prescribers perceive the risks and benefits of FQs and ESCs is needed.

Expression of lysophosphatidic acid receptor 5 is necessary for the regulation of intestinal Na/H exchanger 3 by lysophosphatidic acid in vivo.

Lysophosphatidic acid (LPA) is a bioactive lipid molecule, which regulates a broad range of pathophysiological processes. Recent studies have demonstrated that LPA modulates electrolyte flux in the intestine, and its potential as an antidiarrheal agent has been suggested. Of six LPA receptors, LPA is highly expressed in the intestine.

White matter microstructure of the uncinate fasciculus is associated with subthreshold posttraumatic stress disorder symptoms and fear potentiated startle during early extinction in recently deployed Service Members.

Early intervention following combat deployment has the potential to prevent posttraumatic stress disorder (PTSD), but there is a need for greater understanding of the factors that contribute to PTSD symptom progression. This study investigated: (1) fear-potentiated startle during a fear extinction, (2) white matter microstructure, and (3) PTSD symptom severity, in 48 recently deployed service members (SMs) who did not have sufficient PTSD symptoms to meet criteria for a clinical diagnosis. Electromyography startle during a conditional discrimination paradigm, diffusion tensor imaging, and the Clinician Administered PTSD Scale were assessed in a cohort of SMs within 2 months after their return from Iraq or Afghanistan.

Biomarkers of post-deployment resilience among military service members.

The development of PTSD after military deployment is influenced by a combination of biopsychosocial risk and resilience factors. In particular, physiological factors may mark risk for symptom progression or resiliency. Research in civilian populations suggests elevated catecholamines after trauma are associated with PTSD months following the trauma.

Association between vitamin D deficiency and methicillin-resistant Staphylococcus aureus infection.

Purpose: Given that vitamin D (25(OH)D) contributes to immune defense, we sought to determine if deficiency of 25(OH)D was significantly associated with methicillin-resistant Staphylococcus aureus (MRSA) infection.

Methods: All patients with 25(OH)D determinations at the Atlanta VAMC from 2007 to 2010 were included in the analyses. These patients were cross-referenced with a prospectively collected MRSA infection database at the AVAMC (2006-2010).

Catecholamine responses to virtual combat: implications for post-traumatic stress and dimensions of functioning.

Posttraumatic stress disorder (PTSD) symptoms can result in functional impairment among service members (SMs), even in those without a clinical diagnosis. The variability in outcomes may be related to underlying catecholamine mechanisms. Individuals with PTSD tend to have elevated basal catecholamine levels, though less is known regarding catecholamine responses to trauma-related stimuli.

Psychophysiological response to virtual reality and subthreshold posttraumatic stress disorder symptoms in recently deployed military.

Objective: Subthreshold posttraumatic stress disorder (PTSD) has garnered recent attention because of the significant distress and functional impairment associated with the symptoms as well as the increased risk of progression to full PTSD. However, the clinical presentation of subthreshold PTSD can vary widely and therefore is not clearly defined, nor is there an evidence-based treatment approach. Thus, we aim to further the understanding of subthreshold PTSD symptoms by reporting the use of a virtual combat environment in eliciting distinctive psychophysiological responses associated with PTSD symptoms in a sample of subthreshold recently deployed US service members.

Natural antisense transcripts enhance bone formation by increasing sense IFITM5 transcription.

Interferon induced transmembrane protein 5 (IFITM5) has been recognized as an osteoblast differentiation factor. Its regulation, however, is still unclear. In this report, four novel naturally occurring antisense transcripts of rat IFITM2 and IFITM5 transcribed from the opposite strand of the IFITM gene locus, were isolated and characterized.

Does hand hygiene compliance among health care workers change when patients are in contact precaution rooms in ICUs?

Background: Hand hygiene compliance rates among health care workers (HCW) rarely exceed 50%. Contact precautions are thought to increase HCWs' hand hygiene awareness. We sought to determine any differences in hand hygiene compliance rates for HCW between patients in contact precaution and those not in any isolation.

A multicenter study on optimizing piperacillin-tazobactam use: lessons on why interventions fail.

We examined interventions to optimize piperacillin-tazobactam use at 4 hospitals. Interventions for rotating house staff did not affect use. We could target empiric therapy in only 35% of cases.

Posttraumatic stress disorder may be associated with impaired fear inhibition: relation to symptom severity.

One of the central problems in posttraumatic stress disorder (PTSD) is the inability to suppress fear even under safe conditions. The neural underpinnings of fear are clinically relevant but poorly understood. This study assessed fear potentiation and fear inhibition using fear-potentiated startle in a conditional discrimination procedure (AX+/BX-).

Reducing oxidized lipids to prevent cardiovascular disease.

Despite significant success in reducing plasma cholesterol, especially low-density lipoprotein cholesterol, risks for cardiovascular disease (CVD) complications remain. Among these risks are circulating levels of oxidative modified lipoproteins, primarily oxidized low-density lipoproteins (oxLDL). The evidence supporting oxLDL as a potential target for therapeutic management to reduce metabolic complications and CVD events is reviewed in this report.

The role of hypertriglyceridemia in atherosclerosis.

Atherosclerosis is a chronic disease associated with accumulation of lipids in lesions along blood vessels, leading to the occlusion of blood flow. Much of the focus has been on the role of low-density lipoprotein (LDL), and of oxidatively modified LDL, in the initiation and progression of this disease. LDL is in fact a metabolic end-product of the triglyceride-rich lipoproteins (ie, very-low density lipoproteins).

Debate: The potential role of estrogen in the prevention of heart disease in women after menopause.

Large numbers of observational studies have described a decrease in the incidence of cardiovascular disease in women taking hormone replacement therapy (HRT). The potential mechanisms for this effect are numerous, including direct effects on lipid levels and lipid metabolism, cardiovascular dynamics, and endothelial reactivity. The beneficial effects of HRT are probably affected by various factors, including the age of onset of therapy, the presence of coronary artery disease, the type of estrogen and whether it is used in combination with progesterone, concurrent modification of other cardiac risk factors, and duration of therapy.