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Virulence and Clinical Outcomes in Clostridium difficile Infection: A Complex Business

0 Clinical Infectious Diseases 2013;56(6):906-7 Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2012. DOI: 10.1093/cid/cis1001 1 L. Clifford McDonald

Editorial Commentary: Climbing the Evidentiary Hierarchy for Environmental Infection Control

L. Clifford McDonald () 0 Matthew Arduino 0 0 Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention , Atlanta , Georgia - Increasing concern over multidrug-resistant

Infection Control in the Multidrug-Resistant Era: Tending the Human Microbiome

Increasing understanding of the normal commensal microorganisms in humans suggests that restoring and maintaining the microbiome may provide a key to preventing colonization and infection with multidrug-resistant organisms (MDROs). Intact communities of commensals can prevent colonization with MDROs through both competition for space and resources and the complex immunologic and...

Current Status of Clostridium difficile Infection Epidemiology

Fernanda C. Lessa 0 Carolyn V. Gould 0 L. Clifford McDonald 0 0 Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control

Confronting Clostridium difficile in Inpatient Health Care Facilities

0 L. Clifford McDonald Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention , Atlanta , Georgia - There are now a number of reports of increasing rates and outbreaks

The Roles of Clostridium difficile and Norovirus Among Gastroenteritis-Associated Deaths in the United States, 1999–2007

Background. Globally, gastroenteritis is recognized as an important contributor to mortality among children, but population-based data on gastroenteritis deaths among adults and the contributions of specific pathogens are limited. We aimed to describe trends in gastroenteritis deaths across all ages in the United States and specifically estimate the contributions of Clostridium...

Bench-to-bedside review: Clostridium difficile colitis

In recent years, the incidence and severity of Clostridium difficile-associated disease (CDAD) have increased dramatically. Beginning in 2000, widespread regional outbreaks associated with a previously uncommon hypervirulent strain of C. difficile have occurred in North America and Europe. Most likely because of increased toxin production as well as other virulence factors, this...

Trends in Antimicrobial Resistance in Health Care–Associated Pathogens and Effect on Treatment

0 L. Clifford McDonald Centers for Disease Control and Prevention , Atlanta , Georgia Antimicrobial resistance in health care-associated pathogens is a growing concern for health care and for public

The Challenges Posed by Reemerging Clostridium difficile Infection

views of the Centers for Disease Control and Prevention. GA 30333 1 David B. Blossom and L. Clifford McDonald Division of Healthcare Quality Promotion, National Center for Preparedness, Detection, and

Effect of Nucleic Acid Amplification Testing on Population-Based Incidence Rates of Clostridium difficile Infection

Nucleic acid amplification testing (NAAT) is increasingly being adopted for diagnosis of Clostridium difficile infection (CDI). Data from 3 states conducting population-based CDI surveillance showed increases ranging from 43% to 67% in CDI incidence attributable to changing from toxin enzyme immunoassays to NAAT. CDI surveillance requires adjustment for testing methods.

Short- and Long-Term Attributable Costs of Clostridium difficile-Associated Disease in Nonsurgical Inpatients

Background. The incidence of Clostridium difficile– associated disease (CDAD) is increasing. There are few data on the short-term and long-term attributable costs of CDAD. The objective of this study was to determine the acute and 180-day attributable inpatient costs of CDAD. Methods. We performed a retrospective cohort study of all patients without operating room costs who were...

Clostridium difficile—Associated Disease in a Setting of Endemicity: Identification of Novel Risk Factors

Background.Previous studies of risk factors for Clostridium difficile—associated disease (CDAD) have been limited by small sample sizes and case-control study designs. Many of these studies were performed during outbreaks of CDAD. Colonization pressure and use of fluoroquinolones, vancomycin, and gastric acid suppressors have not been fully evaluated as risk factors for CDAD. The...

Vancomycin-Resistant Staphylococcus aureus in the United States, 2002–2006

Background. This report compares the clinical characteristics, epidemiologic investigations, infection-control evaluations, and microbiologic findings of all 7 of the cases of vancomycin-resistant Staphylococcus aureus (VRSA) infection in the United States during the period 2002–2006. Methods. Epidemiologic, clinical, and infection-control information was collected. VRSA isolates...

An Association between Reduced Susceptibility to Daptomycin and Reduced Susceptibility to Vancomycin in Staphylococcus aureus

. Clifford McDonald, and Fred C. Tenover Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention , Atlanta , Georgia 1 Pathology and Laboratory Medicine, University of British Co

Changes in the Epidemiology of Methicillin-Resistant Staphylococcus aureus in Intensive Care Units in US Hospitals, 1992–2003

The proportion of Staphylococcus aureus isolates that were methicillin resistant (MRSA) increased from 35.9% in 1992 to 64.4% in 2003 for hospitals in the National Nosocomial Infections Surveillance system. During the same period, there was a decrease in resistance rates for several non—β-lactam drugs among the MRSA isolates.

Risk Factors for SARS Transmission from Patients Requiring Intubation: A Multicentre Investigation in Toronto, Canada

Background In the 2003 Toronto SARS outbreak, SARS-CoV was transmitted in hospitals despite adherence to infection control procedures. Considerable controversy resulted regarding which procedures and behaviours were associated with the greatest risk of SARS-CoV transmission. Methods A retrospective cohort study was conducted to identify risk factors for transmission of SARS-CoV...

Management of Persistent Bacteremia Caused by Methicillin-Resistant Staphylococcus aureus: A Survey of Infectious Diseases Consultants

We conducted a survey in 2005 of infectious diseases consultants and asked about persistent bacteremia due to methicillin-resistant Staphylococcus aureus. Many consultants perceived an increase in the frequency of illness, and, when presented with vancomycin minimum inhibitory concentrations approaching the limit of the susceptible range, most consultants indicated that they...

Seasonal Variation of Acinetobacter Infections: 1987–1996

To determine whether nosocomial infections due to Acinetobacter species have increased over the past 10 years and whether infections continue to have a pronounced seasonal variation, we analyzed infections reported by hospitals in the National Nosocomial Infections Surveillance System that performed adult and pediatric intensive care unit surveillance from 1987 through 1996...