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Anita K. Kambhampati Mary E. Wikswo Leslie Barclay Jan Vinj Sara A. Mirza NoroSTAT Network NoroSTAT Network Esther Rei Brandon Sabina Jennifer Beggs Diana K. Riner Elizabeth Cebelinski Amy Saupe Amanda Bartling Brianna K.D. Loeck Nicole Chase Jessica Houston Eric Brandt Ellen Salehi Emilio DeBess Laura Tsaknaridis Gregory Goodwin Hani Mohamed Mugdha Golwalkar Linda Thomas Mary Kathryne Donnelly Haley Greene Timothy Davis Lynn Roberts Rob Christensen Matthew Peterson 《MMWR. Morbidity and mortality weekly report》2022,71(38):1222
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Brian Rha Isaac See Lindsay Dunham Preeta K. Kutty Lauren Moccia Ibironke W. Apata Jennifer Ahern Shelley Jung Rongxia Li Joelle Nadle Susan Petit Susan M. Ray Lee H. Harrison Carmen Bernu Ruth Lynfield Ghinwa Dumyati Marissa Tracy William Schaffner D. Cal Ham Shelley S. Magill Erin N. OLeary Jeneita Bell Arjun Srinivasan L. Clifford McDonald Jonathan R. Edwards Shannon Novosad 《MMWR. Morbidity and mortality weekly report》2023,72(6):153
IntroductionRacial and ethnic minorities are disproportionately affected by end-stage kidney disease (ESKD). ESKD patients on dialysis are at increased risk for Staphylococcus aureus bloodstream infections, but racial, ethnic, and socioeconomic disparities associated with this outcome are not well described.MethodsSurveillance data from the 2020 National Healthcare Safety Network (NHSN) and the 2017–2020 Emerging Infections Program (EIP) were used to describe bloodstream infections among patients on hemodialysis (hemodialysis patients) and were linked to population-based data sources (CDC/Agency for Toxic Substances and Disease Registry [ATSDR] Social Vulnerability Index [SVI], United States Renal Data System [USRDS], and U.S. Census Bureau) to examine associations with race, ethnicity, and social determinants of health.ResultsIn 2020, 4,840 dialysis facilities reported 14,822 bloodstream infections to NHSN; 34.2% were attributable to S. aureus. Among seven EIP sites, the S. aureus bloodstream infection rate during 2017–2020 was 100 times higher among hemodialysis patients (4,248 of 100,000 person-years) than among adults not on hemodialysis (42 of 100,000 person-years). Unadjusted S. aureus bloodstream infection rates were highest among non-Hispanic Black or African American (Black) and Hispanic or Latino (Hispanic) hemodialysis patients. Vascular access via central venous catheter was strongly associated with S. aureus bloodstream infections (NHSN: adjusted rate ratio [aRR] = 6.2; 95% CI = 5.7–6.7 versus fistula; EIP: aRR = 4.3; 95% CI = 3.9–4.8 versus fistula or graft). Adjusting for EIP site of residence, sex, and vascular access type, S. aureus bloodstream infection risk in EIP was highest in Hispanic patients (aRR = 1.4; 95% CI = 1.2–1.7 versus non-Hispanic White [White] patients), and patients aged 18–49 years (aRR = 1.7; 95% CI = 1.5–1.9 versus patients aged ≥65 years). Areas with higher poverty levels, crowding, and lower education levels accounted for disproportionately higher proportions of hemodialysis-associated S. aureus bloodstream infections.Conclusions and implications for public health practiceDisparities exist in hemodialysis-associated S. aureus infections. Health care providers and public health professionals should prioritize prevention and optimized treatment of ESKD, identify and address barriers to lower-risk vascular access placement, and implement established best practices to prevent bloodstream infections. 相似文献
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Alice E. White Alexandra R. Tillman Craig Hedberg Beau B. Bruce Michael Batz Scott A. Seys Daniel Dewey-Mattia Michael C. Bazaco Elaine Scallan Walter 《Emerging infectious diseases》2022,28(6):1117
Foodborne outbreaks reported to national surveillance systems represent a subset of all outbreaks in the United States; not all outbreaks are detected, investigated, and reported. We described the structural factors and outbreak characteristics of outbreaks reported during 2009–2018. We categorized states (plus DC) as high (highest quintile), middle (middle 3 quintiles), or low (lowest quintile) reporters on the basis of the number of reported outbreaks per 10 million population. Analysis revealed considerable variation across states in the number and types of foodborne outbreaks reported. High-reporting states reported 4 times more outbreaks than low reporters. Low reporters were more likely than high reporters to report larger outbreaks and less likely to implicate a setting or food vehicle; however, we did not observe a significant difference in the types of food vehicles identified. Per capita funding was strongly associated with increased reporting. Investments in public health programming have a measurable effect on outbreak reporting. 相似文献
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