Jane M. Gould

Isolation Precautions for Visitors

Infection Control & Hospital Epidemiology / FirstView Article / April 2015, pp 1 12 DOI: 10.1017/ice.2015.67, Published online: 10 April 2015 Link to this article: http://journals.cambridge.org/abstract_S0899823X15000677 How to cite this article: L. Silvia Munoz-Price, David B. Banach, Gonzalo Bearman, Jane M. Gould, Surbhi Leekha, Daniel J. Morgan, Tara N. Palmore, Mark E. Rupp, David J. Weber and Timothy L. Wiemken Isolation Precautions for Visitors. Infection Control & Hospital Epidemiology, Available on CJO 2015 doi:10.1017/ice.2015.67 Request Permissions : Click here

Clinical Correlates of Surveillance Events Detected by National Healthcare Safety Network Pneumonia and Lower Respiratory Infection Definitions-Pennsylvania, 2011-2012.

OBJECTIVE To determine the clinical diagnoses associated with the National Healthcare Safety Network (NHSN) pneumonia (PNEU) or lower respiratory infection (LRI) surveillance events DESIGN Retrospective chart review SETTING A convenience sample of 8 acute-care hospitals in Pennsylvania PATIENTS All patients hospitalized during 2011-2012 METHODS Medical records were reviewed from a random sample of patients reported to the NHSN to have PNEU or LRI, excluding adults with ventilator-associated PNEU. Documented clinical diagnoses corresponding temporally to the PNEU and LRI events were recorded. RESULTS We reviewed 250 (30%) of 838 eligible PNEU and LRI events reported to the NHSN; 29 reported events (12%) fulfilled neither PNEU nor LRI case criteria. Differences interpreting radiology reports accounted for most misclassifications. Of 81 PNEU events in adults not on mechanical ventilation, 84% had clinician-diagnosed pneumonia; of these, 25% were attributed to aspiration. Of 43 adult LRI, 88% were in mechanically ventilated patients and 35% had no corresponding clinical diagnosis (infectious or noninfectious) documented at the time of LRI. Of 36 pediatric PNEU events, 72% were ventilator associated, and 70% corresponded to a clinical pneumonia diagnosis. Of 61 pediatric LRI patients, 84% were mechanically ventilated and 21% had no corresponding clinical diagnosis documented. CONCLUSIONS In adults not on mechanical ventilation and in children, most NHSN-defined PNEU events corresponded with compatible clinical conditions documented in the medical record. In contrast, NHSN LRI events often did not. As a result, substantial modifications to the LRI definitions were implemented in 2015. Infect Control Hosp Epidemiol 2016;37:818-824.

Tuberculosis and Pregnancy—Maternal, Fetal, and Neonatal Considerations

The issue of tuberculosis during pregnancy is not simply a historical inquiry but rather an increasingly familiar clinical problem facing industrial nations as well as the developing countries of the world. This review focuses on the maternal aspects of tuberculous infection, as well as transmission to the fetus and newborn.

894Evaluating Clinical Credibility of Surveillance Definitions for Healthcare-Associated Pneumonia and Lower Respiratory Infections

Healthcare-Associated Pneumonia and Lower Respiratory Infections Isaac See, MD; Julia Chang, BA; Nicole Gualandi, RN, MS; Genevieve L. Buser, MDCM, MSHP; Pamela Rohrbach, RN, CIC; Debra Smeltz, RN; Mary Jo Bellush, MSN, CIC; Susan Coffin, MD, MPH; Jane M. Gould, MD; Patricia Hennessey, RN, BSN, MSN, CIC; Debra Hess, RN, CIC; Sydney Hubbard, MPH; Andrea Kiernan, MLT (ASCP), CIC; Judith O’donnell, MD; David Pegues, MD, FIDSA, FSHEA; Jeffrey R. Miller, MD, MPH; Shelley S. Magill, MD, PhD; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA; UCLA Geffen School of Medicine, Los Angeles, CA; Acute and Communicable Disease Prevention, Oregon Health Authority, Portland, OR; Pennsylvania Department of Health, Harrisburg, PA; Excela Health Westmoreland Hospital, Greensburg, PA; The Children’s Hospital of Philadelphia, Philadelphia, PA; St. Christopher’s Hospital for Children, Philadelphia, PA; Lancaster General Hospital, Lancaster, PA; Pennsylvania Presbyterian Medical Center, Philadelphia, PA; University of Pennsylvania Health System, Philadelphia, PA; Career Epidemiology Field Officer, Office of Public Health Preparedness and Response, CDC, assigned to the Pennsylvania Department of Health, Harrisburgh, PA