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1.
Infect Control Hosp Epidemiol ; 43(1): 3-11, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34253266

RESUMO

This consensus statement by the Society for Healthcare Epidemiology of America (SHEA) and the Society for Post-Acute and Long-Term Care Medicine (AMDA), the Association for Professionals in Epidemiology and Infection Control (APIC), the HIV Medicine Association (HIVMA), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP) recommends that coronavirus disease 2019 (COVID-19) vaccination should be a condition of employment for all healthcare personnel in facilities in the United States. Exemptions from this policy apply to those with medical contraindications to all COVID-19 vaccines available in the United States and other exemptions as specified by federal or state law. The consensus statement also supports COVID-19 vaccination of nonemployees functioning at a healthcare facility (eg, students, contract workers, volunteers, etc).


Assuntos
COVID-19 , Vacinas contra COVID-19 , Criança , Atenção à Saúde , Emprego , Humanos , SARS-CoV-2 , Estados Unidos/epidemiologia , Vacinação
2.
Emerg Infect Dis ; 24(10): 1806-1815, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30226154

RESUMO

We assessed video directly observed therapy (VDOT) for monitoring tuberculosis treatment in 5 health districts in California, USA, to compare adherence between 174 patients using VDOT and 159 patients using in-person directly observed therapy (DOT). Multivariable linear regression analyses identified participant-reported sociodemographics, risk behaviors, and treatment experience associated with adherence. Median participant age was 44 (range 18-87) years; 61% of participants were male. Median fraction of expected doses observed (FEDO) among VDOT participants was higher (93.0% [interquartile range (IQR) 83.4%-97.1%]) than among patients receiving DOT (66.4% [IQR 55.1%-89.3%]). Most participants (96%) would recommend VDOT to others; 90% preferred VDOT over DOT. Lower FEDO was independently associated with US or Mexico birth, shorter VDOT duration, finding VDOT difficult, frequently taking medications while away from home, and having video-recording problems (p<0.05). VDOT cost 32% (range 6%-46%) less than DOT. VDOT was feasible, acceptable, and achieved high adherence at lower cost than DOT.


Assuntos
Antituberculosos/uso terapêutico , Terapia Diretamente Observada , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , California/epidemiologia , Custos e Análise de Custo , Terapia Diretamente Observada/economia , Terapia Diretamente Observada/métodos , Feminino , Humanos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Gravação em Vídeo , Adulto Jovem
3.
Emerg Infect Dis ; 22(4): 679-86, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26982255

RESUMO

Shiga toxins (Stx) are primarily associated with Shiga toxin-producing Escherichia coli and Shigella dysenteriae serotype 1. Stx production by other shigellae is uncommon, but in 2014, Stx1-producing S. sonnei infections were detected in California. Surveillance was enhanced to test S. sonnei isolates for the presence and expression of stx genes, perform DNA subtyping, describe clinical and epidemiologic characteristics of case-patients, and investigate for sources of infection. During June 2014-April 2015, we identified 56 cases of Stx1-producing S. sonnei, in 2 clusters. All isolates encoded stx1 and produced active Stx1. Multiple pulsed-field gel electrophoresis patterns were identified. Bloody diarrhea was reported by 71% of case-patients; none had hemolytic uremic syndrome. Some initial cases were epidemiologically linked to travel to Mexico, but subsequent infections were transmitted domestically. Continued surveillance of Stx1-producing S. sonnei in California is necessary to characterize its features and plan for reduction of its spread in the United States.


Assuntos
Diarreia/epidemiologia , Disenteria Bacilar/epidemiologia , Toxina Shiga I/biossíntese , Shigella sonnei/genética , Adolescente , Adulto , Antibacterianos/uso terapêutico , California/epidemiologia , Criança , Pré-Escolar , Diarreia/microbiologia , Diarreia/patologia , Disenteria Bacilar/microbiologia , Disenteria Bacilar/patologia , Eletroforese em Gel de Campo Pulsado , Monitoramento Epidemiológico , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Toxina Shiga I/isolamento & purificação , Shigella sonnei/classificação , Shigella sonnei/isolamento & purificação
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