Eleanor Adams
New York State Department of Health
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Morbidity and Mortality Weekly Report | 2017
Sharon Tsay; Rory M. Welsh; Eleanor Adams; Nancy A. Chow; Lalitha Gade; Elizabeth L. Berkow; Eugenie Poirot; Emily Lutterloh; Monica Quinn; Sudha Chaturvedi; Janna L Kerins; Stephanie Black; Sarah Kemble; Patricia M Barrett; Kerri Barton; Dj Shannon; Kristy K Bradley; Shawn R. Lockhart; Anastasia P. Litvintseva; Heather Moulton-Meissner; Alicia Shugart; Alex Kallen; Snigdha Vallabhaneni; Tom Chiller; Brendan R. Jackson
Ongoing Transmission of Candida auris in Health Care Facilities — United States, June 2016–May 2017 Sharon Tsay, MD1,2; Rory M. Welsh, PhD1; Eleanor H. Adams, MD3; Nancy A. Chow, PhD1; Lalitha Gade, MPharm1; Elizabeth L. Berkow, PhD1; Eugenie Poirot, PhD2,4; Emily Lutterloh, MD3,5; Monica Quinn, MS3; Sudha Chaturvedi, PhD3,5; Janna Kerins, VMD2,6; Stephanie R. Black, MD6; Sarah K. Kemble, MD6; Patricia M. Barrett, MSD7; Kerri Barton, MPH8; D.J. Shannon, MPH9; Kristy Bradley, DVM10; Shawn R. Lockhart, PhD1; Anastasia P. Litvintseva, PhD1; Heather MoultonMeissner, PhD11; Alicia Shugart, MA11; Alex Kallen, MD11; Snigdha Vallabhaneni, MD1; Tom M. Chiller, MD1; Brendan R. Jackson, MD1
Emerging Infectious Diseases | 2018
Eleanor Adams; Monica Quinn; Sharon Tsay; Eugenie Poirot; Sudha Chaturvedi; Karen Southwick; Jane Greenko; Rafael Fernandez; Alex Kallen; Snigdha Vallabhaneni; Valerie B. Haley; Brad Hutton; Debra Blog; Emily Lutterloh; Howard Zucker; Candida auris Investigation Workgroup
Candida auris is an emerging yeast that causes healthcare-associated infections. It can be misidentified by laboratories and often is resistant to antifungal medications. We describe an outbreak of C. auris infections in healthcare facilities in New York City, New York, USA. The investigation included laboratory surveillance, record reviews, site visits, contact tracing with cultures, and environmental sampling. We identified 51 clinical case-patients and 61 screening case-patients. Epidemiologic links indicated a large, interconnected web of affected healthcare facilities throughout New York City. Of the 51 clinical case-patients, 23 (45%) died within 90 days and isolates were resistant to fluconazole for 50 (98%). Of screening cultures performed for 572 persons (1,136 total cultures), results were C. auris positive for 61 (11%) persons. Environmental cultures were positive for samples from 15 of 20 facilities. Colonization was frequently identified during contact investigations; environmental contamination was also common.
Lancet Infectious Diseases | 2018
Nancy A. Chow; Lalitha Gade; Sharon Tsay; Kaitlin Forsberg; Jane Greenko; Karen Southwick; Patricia M Barrett; Janna L Kerins; Shawn R. Lockhart; Tom Chiller; Anastasia P. Litvintseva; Eleanor Adams; Kerri Barton; Karlyn D. Beer; Meghan L. Bentz; Elizabeth L. Berkow; Stephanie Black; Kristy K Bradley; Richard Brooks; Sudha Chaturvedi; Whitney Clegg; Melissa Cumming; Alfred DeMaria; Nychie Dotson; Erin E. Epson; Rafael Fernandez; Tara Fulton; Rebecca Greeley; Brendan R. Jackson; Sarah Kemble
BACKGROUND Transmission of multidrug-resistant Candida auris infection has been reported in the USA. To better understand its emergence and transmission dynamics and to guide clinical and public health responses, we did a molecular epidemiological investigation of C auris cases in the USA. METHODS In this molecular epidemiological survey, we used whole-genome sequencing to assess the genetic similarity between isolates collected from patients in ten US states (California, Connecticut, Florida, Illinois, Indiana, Maryland, Massachusetts, New Jersey, New York, and Oklahoma) and those identified in several other countries (Colombia, India, Japan, Pakistan, South Africa, South Korea, and Venezuela). We worked with state health departments, who provided us with isolates for sequencing. These isolates of C auris were collected during the normal course of clinical care (clinical cases) or as part of contact investigations or point prevalence surveys (screening cases). We integrated data from standardised case report forms and contact investigations, including travel history and epidemiological links (ie, patients that had shared a room or ward with a patient with C auris). Genetic diversity of C auris within a patient, a facility, and a state were evaluated by pairwise differences in single-nucleotide polymorphisms (SNPs). FINDINGS From May 11, 2013, to Aug 31, 2017, isolates that corresponded to 133 cases (73 clinical cases and 60 screening cases) were collected. Of 73 clinical cases, 66 (90%) cases involved isolates related to south Asian isolates, five (7%) cases were related to South American isolates, one (1%) case to African isolates, and one (1%) case to east Asian isolates. Most (60 [82%]) clinical cases were identified in New York and New Jersey; these isolates, although related to south Asian isolates, were genetically distinct. Genomic data corroborated five (7%) clinical cases in which patients probably acquired C auris through health-care exposures abroad. Among clinical and screening cases, the genetic diversity of C auris isolates within a person was similar to that within a facility during an outbreak (median SNP difference three SNPs, range 0-12). INTERPRETATION Isolates of C auris in the USA were genetically related to those from four global regions, suggesting that C auris was introduced into the USA several times. The five travel-related cases are examples of how introductions can occur. Genetic diversity among isolates from the same patients, health-care facilities, and states indicates that there is local and ongoing transmission. FUNDING US Centers for Disease Control and Prevention.
Clinical Infectious Diseases | 2018
Lalitha Parameswaran; Agam K Rao; Katherine Chastain; Joel Ackelsburg; Eleanor Adams; Brendan R. Jackson; Louis P Voigt; Xi Chen; Farid Boulad; Ying Taur
We report a laboratory-confirmed case of adult intestinal toxemia botulism in an allogeneic hematopoietic stem cell transplantation (allo-HCT) recipient. Onset of symptoms occurred within the hospitalized setting, making this case particularly unique. Botulism may have arisen because of significant intestinal disruption and compromise, and not directly from immune compromise.
Infection Control and Hospital Epidemiology | 2016
Ellen H. Lee; Eleanor Adams; Susan Madison-Antenucci; Lillian V. Lee; John W. Barnwell; Joan Whitehouse; Ernest J. Clement; Waheed I. Bajwa; Lucretia Jones; Emily Lutterloh; Don Weiss; Joel Ackelsberg
A patient with no risk factors for malaria was hospitalized in New York City with Plasmodium falciparum infection. After investigating all potential sources of infection, we concluded the patient had been exposed to malaria while hospitalized less than 3 weeks earlier. Molecular genotyping implicated patient-to-patient transmission in a hospital setting. Infect. Control Hosp. Epidemiol. 2015;37(1):113-115.
Journal of the Pediatric Infectious Diseases Society | 2018
Misha Robyn; Elizabeth Dufort; Jennifer B. Rosen; Karen Southwick; Patrick W. Bryant; Jane Greenko; Eleanor Adams; Philip Kurpiel; Kimberly J Alvarez; Gale R. Burstein; Kathryn Sen; Deborah Vasquez; Elizabeth Rausch-Phung; Cynthia Schulte; Emily Lutterloh; Debra Blog
Rubella was declared eliminated in the United States in 2004. During 2013-2015, 2 infants with congenital rubella syndrome (CRS) were born in New York State. Both mothers were foreign born and traveled to Yemen during their pregnancy. Delayed consideration of CRS led to preventable exposures and a substantial public health response.
Journal of Medical Virology | 2018
Daryl M. Lamson Bs; Adriana E. Kajon; Matthew Shudt; Monica Quinn; Alexandra P. Newman; Joan Whitehouse; Jane Greenko; Eleanor Adams; Kirsten St. George
Ocular infections caused by human adenovirus (HAdV) are highly contagious. The most severe are usually caused by members of species HAdV‐D (types HAdV8, 19, 37, 53, 54, and 56) and can manifest as epidemic keratoconjunctivitis (EKC), often resulting in prolonged impairment of vision. During the early months of 2012, EKC outbreaks occurred in neonatal intensive care units (NICUs) in 3 hospitals in New York State (New York and Suffolk Counties). A total of 32 neonates were affected. For 14 of them, HAdV8 was laboratory‐confirmed as the causative agent. Nine healthcare workers were also affected with 3 laboratory‐confirmed, HAdV‐positive EKC. A fourth EKC outbreak was documented among patients attending a private ophthalmology practice in Ulster County involving a total of 35 cases. Epidemiological linkage between the neonatal intensive care unit outbreaks was demonstrated by molecular typing of virus isolates with restriction enzyme analysis and next generation whole genome sequencing. The strain isolated from the ophthalmology clinic was easily distinguishable from the others by restriction enzyme analysis.
Clinical Infectious Diseases | 2018
Richard Brooks; Patrick K Mitchell; Jeffrey R. Miller; Amber Vasquez; Jessica Havlicek; Hannah Lee; Monica Quinn; Eleanor Adams; Deborah Baker; Rebecca Greeley; Kathleen Ross; Irini Daskalaki; Judy Walrath; Heather Moulton-Meissner; Matthew B. Crist; Burkholderia cepacia Workgroup
Background Burkholderia cepacia complex (Bcc) has caused healthcare-associated outbreaks, often in association with contaminated products. The identification of four Bcc bloodstream infections (BSIs) in patients residing at a single skilled nursing facility (SNF) within one week led to an epidemiological investigation to identify additional cases and the outbreak source. Methods A case was initially defined as a blood culture yielding Bcc in a SNF resident receiving intravenous therapy after August 1, 2016. Multistate notifications were issued to identify additional cases. Public health authorities performed site visits at facilities with cases to conduct chart reviews and identify possible sources. Pulsed-field gel electrophoresis (PFGE) was performed on isolates from cases and suspect products. Facilities involved in manufacturing suspect products were inspected to assess possible root causes. Results An outbreak of 162 Bcc BSIs across 59 nursing facilities in 5 states occurred during September 2016-January 2017. Isolates from patients and pre-filled saline flush syringes were closely related by PFGE, identifying contaminated flushes as the outbreak source and prompting a nationwide recall. Inspection of facilities at the saline flush manufacturer identified deficiencies which might have led to the failure to sterilize a specific case containing a partial lot of product. Conclusions Communication and coordination among key stakeholders, including healthcare facilities, public health authorities, and state and federal agencies, led to the rapid identification of an outbreak source and likely prevented many additional infections. Effective processes to ensure the sterilization of injectable products are essential to prevent similar outbreaks in the future.
American Journal of Transplantation | 2017
S. Vallabhaneni; S. Tsay; N. Chow; R. Welsh; Janna L Kerins; S. K. Kemble; Massimo Pacilli; Stephanie Black; Emily Landon; Jessica P. Ridgway; T. N. Palmore; A. Zelzany; Eleanor Adams; Monica Quinn; Sudha Chaturvedi; Jane Greenko; R. Fernandez; Karen Southwick; E. Y. Furuya; David P. Calfee; C. Hamula; Gopi Patel; Patricia M Barrett; P. Lafaro; E. L. Berkow; H. Moulton-Meissner; J. Noble-Wang; R. P. Fagan; B. R. Jackson; S. R. Lockhart
Open Forum Infectious Diseases | 2017
Eleanor Adams; Monica Quinn; Emily Lutterloh; Karen Southwick; Jane Greenko; Rafael Fernandez; Rosalie Giardina; Rutvik Patel; Richard Erazo; Ronald Jean Denis; Elizabeth Dufort; Debra Blog