ABSTRACT
We evaluated data from gastroenteritis outbreaks in Oregon to assess sensitivity of stool testing for norovirus and determine number of specimens needed to confirm norovirus as the cause. Norovirus can be readily confirmed if 3-6 specimens are collected any time ≤7 days after onset of diarrhea and for almost that long after symptoms resolve.
Subject(s)
Disease Outbreaks , Feces/virology , Gastroenteritis/diagnosis , Norovirus/isolation & purification , Specimen Handling/methods , Caliciviridae Infections/diagnosis , Caliciviridae Infections/epidemiology , Caliciviridae Infections/virology , Gastroenteritis/epidemiology , Gastroenteritis/virology , Humans , Norovirus/genetics , Oregon/epidemiology , Reverse Transcriptase Polymerase Chain Reaction , Sensitivity and Specificity , Specimen Handling/statistics & numerical dataABSTRACT
Less than 20% of infectious diseases consultants work in hospitals that routinely employ decolonization therapy for individuals with staphylococcal carriage undergoing elective surgical procedures or for infection control efforts to limit nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA). However, infectious diseases consultants frequently encounter patients with recurrent MRSA furunculosis and attempt to decolonize them.
Subject(s)
Anti-Infective Agents, Local/administration & dosage , Carrier State/drug therapy , Cross Infection/prevention & control , Staphylococcal Infections/prevention & control , Community Networks , Female , Health Care Surveys , Humans , Infection Control/methods , Male , Methicillin Resistance , Staphylococcus aureus/drug effects , United StatesABSTRACT
BACKGROUND: Despite the increasing use of outpatient parenteral antimicrobial therapy (OPAT), little is known about the role of infectious diseases consultants in the process or their perceptions of OPAT. METHODS: In May 2004, the Infectious Diseases Society of America Emerging Infections Network (EIN) surveyed its members to characterize their involvement and experiences with OPAT. RESULTS: Of the 454 respondents (54%) who completed the questionnaire, 426 (94%) indicated that patients in their primary inpatient facility were "frequently" discharged while receiving OPAT, estimating that, on average, 19 patients are discharged from their hospitals while receiving OPAT each month. Although 86% of EIN members stated that they personally order OPAT for some patients, 18% indicated that they have no involvement, and 37% stated they only rarely or occasionally oversee OPAT. EIN members involved in OPAT estimated that approximately 90% of their patients who take OPAT received therapy at home, and the members described variable monitoring and oversight methods. Of the respondents, 68% of providers collectively estimated that they encountered 1951 infectious and serious noninfectious complications of OPAT in the past year. The most frequently used antibiotics included vancomycin, ceftriaxone, and cefazolin, most commonly used for bone and joint infections. CONCLUSIONS: These results testify to the pervasive use of OPAT in today's health care system, the variable role of infectious diseases consultants, and the heterogeneity in oversight and management practices. The widespread use of OPAT and its frequent complications indicate the need for additional studies to establish optimal methods of delivery and management to insure the quality and safety of the process.
