Louise Dembry

Yale University School of Medicine, Internal Medicine, Faculty Member

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Monica Lypson

Columbia University

Attilio sacripanti

"Tor Vergata" University of Rome

waleed elamaim

Mansoura University

Olubunmi Ogunrin

University of Benin

aaron lerner

Technion Israel Institute of Technology

Dr. Anika Niambi Al-Shura, BSc, MSOM, PhD

Independent Academic Research Studies

Babatope Kolawole

Obafemi Awolowo University, Ile-Ife, Nigeria

Djanette Hakem

Médical University of Algiers City

Antonio Picarelli

Università degli Studi "La Sapienza" di Roma

Soma Jyothula

The University of Texas Health Science Center at Houston

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Papers by Louise Dembry

Healthcare Epidemiology: Hospital-associated Infections and Clostridium difficile

Nosocomial Candida glabrata Colonization: an Epidemiologic Study

Journal of Clinical Microbiology, 1998

Candida glabrata has emerged as an important nosocomial pathogen, yet little is known about its e... more Candida glabrata has emerged as an important nosocomial pathogen, yet little is known about its epidemiology. We prospectively followed 98 patients admitted to a medical intensive care unit and the bone marrow transplant unit of a university hospital. Samples from environmental surfaces and the hands of hospital personnel were also cultured. Patients with newly acquired C. glabrata strains were compared to controls who were culture negative for C. glabrata. C. glabrata was recovered from multiple sites from 24 patients and three environmental surfaces. Sixteen patients (17%) acquired C. glabrata after admission to the study units. Significant risk factors for the nosocomial acquisition of C. glabrata were prolonged duration of hospitalization in the unit and prior antimicrobial use. Strain delineation by restriction enzyme analysis revealed 28 different strains of C. glabrata ; three strain types were common to nine patients. The environmental isolates were of the same strain type a...

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Use of Molecular Methods in the Clinical Microbiology Laboratory

Laboratory Medicine, 1993

Molecular DNA methods are essential for evaluating the spread of hospital-acquired microorganisms... more Molecular DNA methods are essential for evaluating the spread of hospital-acquired microorganisms. These methods are increasingly used in epidemiologic investigation of bacteria, viruses, mycobacteria, and yeast. Evaluation of plasmids and chromosomal DNA is done using restriction enzyme analysis and agarose gel or pulsed-field gradient gel electrophoresis. Contour-clamped homogeneous electric field electrophoresis (CHEF) is the method of choice in most situations. A knowledge of epidemiology is essential for control of spread.

Treatment of a Laboratory-Acquired Sabi� Virus Infection

N Engl J Med, 1995

Is self-perceived personal behavior related to infection prevention safety culture?

Background: A growing body of evidence reveals the importance of evaluating and improving safety ... more Background: A growing body of evidence reveals the importance of evaluating and improving safety culture in efforts to eliminate healthcare-associated infections (HAI). However, little is known about the extent to which perceptions of personal behavior are associated with safety culture, infection prevention practices and knowledge. Under the Theory of Planned Behavior, greater social pressure to adhere to recommended infection practices should lead to changes in personal behavioral intentions and actual behavior. Objective: The primary aim was to assess whether higher scores on perceived personal behavior and knowledge were associated with HAI prevention practices and safety culture. A secondary aim was to assess the extent to which these dimensions are influenced by healthcare worker experience and roles. Methods: A cross-sectional survey was conducted of 316 staff across disciplines at five unrelated hospitals participating in an AHRQ-sponsored broad scale infection prevention in...

Iguana-Associated Extra-Intestinal Salmonellosis in an Apparently Healthy Adult

Infectious Diseases in Clinical Practice, 1996

Infection Control Basics

Foley/Hospital Acquired Infection, 2011

Changing Patterns in Neonatal Escherichia coli Sepsis and Ampicillin Resistance in the Era of Intrapartum Antibiotic Prophylaxis

Pediatrics, 2008

OBJECTIVE. The goal was to determine current trends in Escherichia coli-related early- and late-o... more OBJECTIVE. The goal was to determine current trends in Escherichia coli-related early- and late-onset sepsis and patterns of ampicillin resistance in relation to institutional changes in the use of intrapartum antibiotic prophylaxis. METHODS. A retrospective review of data for all infants with E coli sepsis at Yale-New Haven Hospital from 1979 to 2006 was performed. Study periods were based on predominant intrapartum antibiotic prophylaxis practices at Yale-New Haven Hospital, that is, (1) 1979 to 1992 (no formal intrapartum antibiotic prophylaxis), (2) 1993 to 1996 (risk factor-based), and (3) 1997 to 2006 (screening-based). Sepsis rates and patterns of ampicillin resistance were compared. RESULTS. Fifty-three cases of E coli early-onset sepsis and 129 cases of E coli late-onset sepsis were identified over 3 eras. In very low birth weight (<1500 g) infants, increases in E coli early-onset sepsis (period 1: 2.83 cases per 1000 very low birth weight admissions; period 2: 7.12 case...

Life-Threatening Sepsis Caused by Burkholderia cepacia From Contaminated Intravenous Flush Solutions Prepared by a Compounding Pharmacy in Another State

Pediatrics, 2006

We report 2 life-threatening cases of Burkholderia cepacia sepsis caused by infusate contaminatio... more We report 2 life-threatening cases of Burkholderia cepacia sepsis caused by infusate contamination during compounding. Bacterial isolates from the patients' blood cultures and the infusate were indistinguishable by pulsed-field gel electrophoresis. Proper quality controls at a local and national level are important for ensuring safe delivery of compounded medications to patients in all settings, including those outside health care facilities.

DNA Analysis in the Study of the Epidemiology of Nosocomial Candidiasis

Infection Control and Hospital Epidemiology, 1994

... 34. Sanchez V, Vazquez JA, Barth-Jones D, Dembry L, Sobel JD, Zervos MJ. Nosocomial acquisiti... more

Matched Case-Control Analysis of Polymicrobial Bloodstream Infection In A Neonatal Intensive Care Unit

Infection Control & Hospital Epidemiology, 2008

Objective.To compare and contrast the epidemiology of polymicrobial and monomicrobial bloodstream... more Objective.To compare and contrast the epidemiology of polymicrobial and monomicrobial bloodstream infections (BSIs) in newborn intensive care unit (NICU) patients.Design.Retrospective, matched case-control study.Setting.The Yale-New Haven Hospital NICU from 1989 through 2006.Subjects.NICU patients with BSIs.Methods.Each neonate with polymicrobial BSI (case patient) was matched to one neonate with monomicrobial BSI (control patient), by birth date, weight, and sex; and univariate and multivariate analyses were performed.Results.One hundred five cases of polymicrobial BSI were identified in 102 infants, representing 10% of all neonatal BSIs in our institution. Coagulase-negative staphylococci were the most common organisms recovered from culture. Infants with polymicrobial BSI had later onset of infection than infants with monomicrobial BSI (mean day of life, 37.5 vs 24.0; P< .001). Polymicrobial BSI occurred more frequently among infants with a severe underlying condition than in ...

A Decade of Prevalence Surveys in a Tertiary-Care Center: Trends in Nosocomial Infection Rates, Device Utilization, and Patient Acuity

Infection Control & Hospital Epidemiology, 1999

Objective:To evaluate the usefulness of repeated prevalence surveys to determine trends in the ra... more Objective:To evaluate the usefulness of repeated prevalence surveys to determine trends in the rates of nosocomial infections and to detect changes in risk factors (eg, use of invasive devices) associated with nosocomial infections.Patients And Methods:Ten annual prevalence surveys were conducted by trained infection control practitioners between 1985 and 1995 for acute-care patients on the medical, surgical, pediatric, and obstetric-gynecologic services at a 900-bed, tertiary-care, teaching hospital with 750 acute-care beds. The same methods of chart review and concurrent reporting from nursing, the microbiology and clinical laboratory, and the pharmacy were used each year to collect data on the prevalence of nosocomial infections, invasive-device utilization, and abnormal laboratory indicators. Although data were collected on a single day, a period-prevalence study approach was used, because charts were reviewed for any infection data occurring within the 7 days prior to the surve...

Control of Endemic Glycopeptide-Resistant Enterococci

Infection Control & Hospital Epidemiology, 1996

Objective:To evaluate the epidemiology of, and control measures for, vancomycin-resistantEnteroco... more Objective:To evaluate the epidemiology of, and control measures for, vancomycin-resistantEnterococcus(VRE) in a renal unit.Design:A 3-month, prospective, prevalence culture survey of patients on a 24-bed renal unit.Setting:A 975-bed community teaching hospital.Patients:Patients admitted to the renal unit over a 3-month period. Patients identified with VRE were each matched with four patients without VRE isolated over the study period.Interventions/Control Measures:Resistant-organism barrier precautions. To eradicate carriage of VRE, two patients with VRE stool colonization were treated with 5 days of oral doxycycline (100 mg twice per day) and rifampin (300 mg/day).Results:Seven patients with VRE (8 isolates) were identified. Five isolates wereEnterococcus faecium(vancomycin MIC=16 to 256 μg/mL), two wereEnterococcus faecalis(MICs=16 and 124 μg/mL), and one wasEnterococcus gallinarum(MIC=8.0 μg/mL). Eradication of carriage with VRE was accomplished in two patients treated with doxyc...

Educational Needs and Opportunities for the Hospital Epidemiologist

Infection Control and Hospital Epidemiology, 1996

The role of the hospital epidemiologist has changed substantially over the last 30 years as medic... more The role of the hospital epidemiologist has changed substantially over the last 30 years as medical care has become more complex. The hospital epidemiologist needs training in methods for sur veillance, prevention, and control of nosocomial infections. The hospital epidemiologist also must know how to apply these methods to other areas, including the epidemiology of noninfectious adverse out-comes of medical care. Training in hospital epidemiology should be a defined part of every infectious disease fellowship training program. Ancillary and additional training is available from several sources.

Management of a Sabiá Virus-Infected Patient in a US Hospital

Infection Control & Hospital Epidemiology, 1999

Objective:To describe the hospital precautions used to isolate a Sabiá virus (arenavirus: Arenavi... more Objective:To describe the hospital precautions used to isolate a Sabiá virus (arenavirus: Arenaviridae)-infected patient in a US hospital and to protect hospital staff and visitors.Design:Investigation of a single case of arenavirus laboratory-acquired infection and associated case-contacts.Setting:A 900-bed, tertiary-care, university-affiliated medical center.Patients or other Participants:The case-patient became ill with Sabiá virus infection. The case-contacts consisted of healthcare workers, coworkers, friends, and relatives of the case-patient.Intervention:Enhanced isolation precautions for treatment of a viral hemorrhagic fever (VHF) patient were implemented in the clinical laboratory and patient-care setting to prevent nosocomial transmission. The enhanced precautions included preventing aerosol spread of the virus from the patient or his clinical specimens. All case-contacts were tested for Sabiá virus antibodies and monitored for signs and symptoms of early disease.Results:...

Comparison of In Vitro Activity of Trovafloxacin Against Gram-positive and Gram-negative Organisms with Quinolones and β-Lactam Antimicrobial Agents

Diagnostic Microbiology and Infectious Disease, 1998

Its enhanced activity against anaerobes and Grampositive microorganisms , including Streptococcus... more Its enhanced activity against anaerobes and Grampositive microorganisms , including Streptococcus pneumoniae, gives trovafloxacin a special position among the numerous quinolones. [4] Shortly before the marketing of trovafloxacin in Turkey, its activity on some bacterial strains was compared with that of 2 antibacterials that have been used in this country for a long time.

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Comparative antimicrobial activity of gatifloxacin with ciprofloxacin and beta-lactams against gram-positive bacteria

Diagnostic Microbiology and Infectious Disease, 2001

Gatifloxacin is a new 8-methoxy fluoroquinolone. The in-vitro antibacterial activity of gatifloxa... more Gatifloxacin is a new 8-methoxy fluoroquinolone. The in-vitro antibacterial activity of gatifloxacin was compared to that of ciprofloxacin, ceftriaxone, imipenem, piperacillin/tazobactam and amoxicillin/clavulanic acid against 165 streptococcal isolates, 369 staphylococcal isolates, and 50 enterococcal isolates recently recovered from clinical isolates. Gatifloxacin was the most active agent tested against streptococci including penicillin-nonsusceptible Streptococcus pneumoniae (MIC 90 0.5 g/mL). Imipenem and gatifloxacin (MIC 90 0.5 g/mL) were the most active agents tested against viridans group streptococci. All the agents demonstrated excellent activity against methicillin-susceptible S. aureus. Imipenem, piperacillin/tazobactam, amoxicillin/clavulanic acid, and gatifloxacin had good activity against methicillin-sensitive S. epidermidis. Among the methicillin-sensitive and methicillin-resistant coagulase-negative staphylococci tested, gatifloxacin was the most active agent. Amoxicillin/clavulanic acid and gatifloxacin were the most active agents against E. faecalis. Thus, gatifloxacin possesses equal or superior activity when compared to ciprofloxacin and beta-lactams making it a promising new fluoroquinolone for clinical use in treating Gram-positive infections.

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Approaches to vancomycin-resistant enterococci

Current Opinion in Infectious Diseases, 2004

This article reviews recent publications regarding new antimicrobial drugs for the treatment of v... more This article reviews recent publications regarding new antimicrobial drugs for the treatment of vancomycin-resistant enterococci. Newer drugs against vancomycin-resistant enterococci are now available or will soon be available. Quinupristin-dalfopristin, a streptogramin, and linezolid, an oxazolidinone, are effective and safe but only bacteriostatic against enterococi. Bacterial isolates resistant to either antibiotic have been described. Daptomycin, a lipopeptide antimicrobial, has good in-vitro bactericidal activity against enterococci, but very limited clinical data exist regarding the treatment of serious enterococcal infection with this compound. Ramoplanin, the first glycolipodepsipeptide antimicrobial in clinical trials, is not systemically absorbed after oral administration, and is being evaluated for the prevention of bloodstream infection in patients colonized with vancomycin-resistant enterococci. Oritavancin and dalbavancin (both glycopeptides) and tigecycline (a monocycline derivative) are being evaluated in phase II and III trials and are not yet commercially available. Treatment of vancomycin-resistant enterococci continues to be problematical although these new drugs offer some hope. The rational use of antibiotics, strict guidelines for the use of new compounds, and adherence to infection control practices continue to be essential components of the management of vancomycin-resistant enterococci colonization and infection.

1162. An Evaluation of Metrics for Catheter-Associated Urinary Tract Infections (CAUTIs): A Statewide Comparison

Open Forum Infectious Diseases, 2019

Background The Standardized Infection Ratio (SIR) is a metric used to gauge catheter-associated u... more Background The Standardized Infection Ratio (SIR) is a metric used to gauge catheter-associated urinary tract infection (CAUTI) prevention, both locally and nationally. The device utilization ratio (DUR) is a process metric that captures catheter harm. More recently, the cumulative attributable difference (CAD) was introduced, which identifies the number of excess infections that need to be prevented to reach the desired goal. Our objective was to evaluate these metrics across all acute care hospitals in Connecticut (CT) by facility size. Methods A CAUTI Targeted Assessment for Prevention (TAP) Report for acute care hospitals across CT was generated from 1/1/2018 to December 31/2018, using the National Healthcare Safety Network (NHSN) database. CAUTI events, SIR, DUR, and CAD were compared across all hospitals. The SIR goal of 0.75 was used to calculate the CAD. Hospitals were stratified into large ( >425 beds), medium (250 to 424 beds), and small ( <249 beds) based on the Hea...

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Epidemiology of Clostridium difficile infection in hospitalized oncology patients

American journal of infection control, 2016

The epidemiology of Clostridium difficile infection (CDI) among oncology inpatients is poorly und... more The epidemiology of Clostridium difficile infection (CDI) among oncology inpatients is poorly understood. In multivariate analysis we identified age, history of CDI, and prior receipt of cephalosporins, β-lactam/β-lactamase inhibitors, metronidazole, and blood transfusion as risk factors associated with CDI. Reducing broad-spectrum antibiotic use, particularly among older patients and those with a CDI history and recent blood transfusions, may decrease CDI risk in this population.

Healthcare Epidemiology: Hospital-associated Infections and Clostridium difficile

Nosocomial Candida glabrata Colonization: an Epidemiologic Study

Journal of Clinical Microbiology, 1998

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Use of Molecular Methods in the Clinical Microbiology Laboratory

Laboratory Medicine, 1993

Treatment of a Laboratory-Acquired Sabi� Virus Infection

N Engl J Med, 1995

Is self-perceived personal behavior related to infection prevention safety culture?

Iguana-Associated Extra-Intestinal Salmonellosis in an Apparently Healthy Adult

Infectious Diseases in Clinical Practice, 1996

Infection Control Basics

Foley/Hospital Acquired Infection, 2011

Changing Patterns in Neonatal Escherichia coli Sepsis and Ampicillin Resistance in the Era of Intrapartum Antibiotic Prophylaxis

Pediatrics, 2008

Life-Threatening Sepsis Caused by Burkholderia cepacia From Contaminated Intravenous Flush Solutions Prepared by a Compounding Pharmacy in Another State

Pediatrics, 2006