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Describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) that occurred during 2015–2017 and were reported to the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN).
Data from central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), and surgical site infections (SSIs) were reported from acute-care hospitals, long-term acute-care hospitals, and inpatient rehabilitation facilities. This analysis included device-associated HAIs reported from adult location types, and SSIs among patients ≥18 years old. Percentages of pathogens with nonsusceptibility (%NS) to selected antimicrobials were calculated for each HAI type, location type, surgical category, and surgical wound closure technique.
Overall, 5,626 facilities performed adult HAI surveillance during this period, most of which were general acute-care hospitals with <200 beds. Escherichia coli (18%), Staphylococcus aureus (12%), and Klebsiella spp (9%) were the 3 most frequently reported pathogens. Pathogens varied by HAI and location type, with oncology units having a distinct pathogen distribution compared to other settings. The %NS for most pathogens was significantly higher among device-associated HAIs than SSIs. In addition, pathogens from long-term acute-care hospitals had a significantly higher %NS than those from general hospital wards.
This report provides an updated national summary of pathogen distributions and antimicrobial resistance among select HAIs and pathogens, stratified by several factors. These data underscore the importance of tracking antimicrobial resistance, particularly in vulnerable populations such as long-term acute-care hospitals and intensive care units.
To describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) among pediatric patients that occurred in 2015–2017 and were reported to the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN).
Antimicrobial resistance data were analyzed for pathogens implicated in central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated pneumonias (VAPs), and surgical site infections (SSIs). This analysis was restricted to device-associated HAIs reported from pediatric patient care locations and SSIs among patients <18 years old. Percentages of pathogens with nonsusceptibility (%NS) to selected antimicrobials were calculated by HAI type, location type, and surgical category.
Overall, 2,545 facilities performed surveillance of pediatric HAIs in the NHSN during this period. Staphylococcus aureus (15%), Escherichia coli (12%), and coagulase-negative staphylococci (12%) were the 3 most commonly reported pathogens associated with pediatric HAIs. Pathogens and the %NS varied by HAI type, location type, and/or surgical category. Among CLABSIs, the %NS was generally lowest in neonatal intensive care units and highest in pediatric oncology units. Staphylococcus spp were particularly common among orthopedic, neurosurgical, and cardiac SSIs; however, E. coli was more common in abdominal SSIs. Overall, antimicrobial nonsusceptibility was less prevalent in pediatric HAIs than in adult HAIs.
This report provides an updated national summary of pathogen distributions and antimicrobial resistance patterns among pediatric HAIs. These data highlight the need for continued antimicrobial resistance tracking among pediatric patients and should encourage the pediatric healthcare community to use such data when establishing policies for infection prevention and antimicrobial stewardship.
Focusing on a pocket-size edition of Whitman’s poems from the early twentieth century provides an opportunity for thinking about what happens to poems we think we know well when they’re read in different published contexts. Building on the central insight from book historical studies about the inextricability of publication form and literary content, this chapter also engages aspects of the history of sexuality that likewise take shape through the practices of reading and writing. The Little Blue Book edition at this chapter’s heart juxtaposes Whitman’s poems with the writings of another figure in the long US history of sexual liberation: feminist and birth-control advocate Margaret Sanger. Reading Whitman alongside Sanger as the edition urges us to do uncovers unexpected intersections, and sometimes contradictions, at the sites of gender normativity, progressive political reform, and socialism, as well as the backlash against the progressive reforms to which Whitman and Sanger dedicated themselves.
Racial inequality in voter turnout is well-documented, but we know less about racial inequality in campaign contributions. Using new data on the racial identities of over 27 million donors, we find an unrepresentative contributor class. Black and Latino shares of contributions are smaller than their shares of the population, electorate, and elected offices. However, we argue that the presence of ethnoracial minority candidates mobilizes coethnic donors. Results from regression discontinuity and difference-in-difference designs suggest that the presence of ethnoracial minority candidates increases the share of minority contributions in US House elections. We find a reduction in white contributions to black Democrats, and to black and Latino Republicans, but little difference in overall fundraising competitiveness. Although we cannot definitively rule out alternative mechanisms that covary with candidate ethnorace, the results suggest that the nomination of minority candidates can increase the ethnoracial representativeness of campaign finance without costs to fundraising.
High-resolution Chirp sub-bottom data were obtained offshore from the Northern Channel Islands (NCI), California, to image submerged paleoshorelines and assess local uplift rates. Although modern bathymetry is often used for modeling paleoshorelines, Chirp data image paleoshorelines buried beneath sediment that obscures their seafloor expression. The NCI were a unified landmass during the last glacial maximum (LGM; ~20 ka), when eustatic sea level was ~120 m lower than present. We identified seven paleoshorelines, ranging from ~28 to 104 m in depth, across this now-submerged LGM platform. Paleoshoreline depths were compared to local sea-level curves to estimate ages, which suggest that some were reoccupied over multiple sea-level cycles. Additionally, previous studies determined conflicting uplift rates for the NCI, ranging from 0.16 to 1.5 m/ka. Our results suggest that a rate on the lower end of this range better fits the observed submerged paleoshorelines. Using the uplift rate of ~0.16 m/ka, we estimate that paleoshorelines formed during Marine Oxygen Isotope Stage 3, the LGM, and the Younger Dryas stade are preserved on the NCI platform. These results help clarify uplift rates for the NCI and illustrate the importance of sub-bottom data for mapping submerged paleoshorelines.