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CDA 11-215 – HSR&D Study

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CDA 11-215
Comparative Effectiveness of Strategies to Control S. aureus Infections
Marin L. Schweizer-Looby PhD BS
Iowa City VA Health Care System, Iowa City, IA
Iowa City, IA
Funding Period: May 2013 - April 2018

BACKGROUND/RATIONALE:
Staphylococcus aureus infections are associated with considerable morbidity and mortality in hospitals worldwide including the VA Healthcare System. Multiple organization-level and patient-level strategies have been proposed for S. aureus prevention and treatment. Unfortunately, all have advantages and disadvantages, and there is little evidence to support the effectiveness of these strategies. In 2007, the Veterans Health Administration (VHA) Methicillin-resistant S. aureus (MRSA) Prevention Initiative mandated that all VA Medical Centers test the noses of all admitted patients for MRSA and limit contact with MRSA positive patients in order to prevent MRSA spread. However, few studies have compared this strategy to other potential strategies to determine if this is the most effective and cost-effective strategy to reduce transmission. MRSA is an antibiotic resistant form of S. aureus and comprises approximately half of all S. aureus infections. Thus, strategies that aim to prevent both MRSA and methicillin-susceptible S. aureus (MSSA) may be more effective than strategies solely focused on MRSA. Additionally, there is little consensus on the optimal treatment for S. aureus infections. Many physicians prescribe the antibiotic vancomycin for all S. aureus infections although this may not be optimal.

OBJECTIVE(S):
The objective of this application is to compare the effectiveness of strategies to prevent and treat S. aureus infections. The three aims of this research proposal are: 1) Complete a systematic review and meta-analysis of the effectiveness and costs of different organization-level S. aureus infection prevention strategies implemented; 2) Compare the effectiveness of vancomycin to that of other anti-staphylococcal antibiotics for the treatment of invasive S. aureus (MRSA and MSSA) infections; and 3) Using organization-level and patient-level data collected in Aims 1 and 2, create a decision model to compare the effectiveness, costs, and cost-effectiveness of strategies to prevent and treat S. aureus infections.

METHODS:
Aim 1, we performed 2 systematic literature reviews and meta-analyses. The first evaluated which non-surgical patient populations would most benefit from mupirocin decolonization. The second evaluated whether universal glove use was more effective than glove use only for multidrug-resistant organism (MDRO) infected patients or standard precautions. For the meta-analyses, we conducted a systematic search to identify all publications. The pooled odds ratios (pOR) or pooled rate ratios were pooled using a random-effects model.

Aim 2, the outcomes are 30-day mortality and recurrent infection. Cox proportional hazard models were used to assess mortality hazards (stated as a hazard ratio [HR]). Optimal beta-lactam therapy was defined as cefazolin or nafcillin/oxacillin. We compared the effectiveness of different antibiotics to treat S. aureus infections.

Aim 3, we are creating a mathematical model to evaluate the effectiveness of adding mupirocin decolonization to the current VA MRSA Initiative. Data from Aim 1 is being used to parameterize the model.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
This study is consistent with the mission of the VHA in attempting to determine the most effective and cost-effective strategies that can be implemented by the VHA MRSA Prevention Initiative to prevent and treat S. aureus infections.

PUBLICATIONS:

Journal Articles

  1. Marra AR, Kobayashi T, Suzuki H, Alsuhaibani M, Tofaneto BM, Bariani LM, Auler MA, Salinas JL, Edmond MB, Doll M, Kutner JM, Pinho JRR, Rizzo LV, Miraglia JL, Schweizer ML. Short-term effectiveness of COVID-19 vaccines in immunocompromised patients: A systematic literature review and meta-analysis. The Journal of Infection. 2022 Mar 1; 84(3):297-310.
  2. Racila AM, O'Shea AMJ, Nair R, Dukes K, Herwaldt LA, Boyken L, Diekema D, Ward MA, Cobb J, Jacob J, Pegues D, Bleasdale S, Vijayan A, Mutneja A, Fraer M, O'Connell-Moore D, Tolomeo P, Mendez M, Jaworski E, Schweizer ML. Using nasal povidone-iodine to prevent bloodstream infections and transmission of among haemodialysis patients: a stepped-wedge cluster randomised control trial protocol. BMJ open. 2021 Dec 3; 11(12):e048830.
  3. Ammann EM, Chrischilles EA, Carnahan RM, Fireman B, Fuller CC, Schweizer ML, Garcia C, Pimentel M, Leonard CE, Baker MA, Cuker A, Leira EC, Robinson JG, Winiecki SK. Self-controlled assessment of thromboembolic event (TEE) risk following intravenous immune globulin (IGIV) in the U.S. (2006-2012). Journal of Thrombosis and Thrombolysis. 2022 Feb 1; 53(2):264-272.
  4. Chang NN, Reisinger HS, Schweizer ML, Jones I, Chrischilles E, Chorazy M, Huskins C, Herwaldt L. Hand Hygiene Compliance at Critical Points of Care. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2021 Mar 1; 72(5):814-820.
  5. Wilson G, Jackson V, Boyken L, Puig-Asensio M, Marra AR, Perencevich E, Schweizer ML, Diekema D, Breheny P, Petersen C. A randomized control trial evaluating efficacy of antimicrobial impregnated hospital privacy curtains in an intensive care setting. American journal of infection control. 2020 Aug 1; 48(8):862-868.
  6. Puig-Asensio M, Braun BI, Seaman AT, Chitavi S, Rasinski KA, Nair R, Perencevich EN, Lawrence JC, Hartley M, Schweizer ML. Perceived Benefits and Challenges of Ebola Preparation Among Hospitals in Developed Countries: A Systematic Literature Review. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2020 Feb 14; 70(5):976-986.
  7. Goto M, Jones MP, Schweizer ML, Livorsi DJ, Perencevich EN, Richardson K, Beck BF, Alexander B, Ohl ME. Association of Infectious Diseases Consultation With Long-term Postdischarge Outcomes Among Patients With Staphylococcus aureus Bacteremia. JAMA Network Open. 2020 Feb 5; 3(2):e1921048.
  8. Wilson GM, Jackson VB, Boyken LD, Schweizer ML, Diekema DJ, Petersen CA, Breheny PJ, Nonnenmann MW, Perencevich EN, CDC Prevention Epicenter Program. Bioaerosols generated from toilet flushing in rooms of patients with infection. Infection control and hospital epidemiology. 2020 May 1; 41(5):517-521.
  9. Mull HJ, Stolzmann K, Kalver E, Shin MH, Schweizer ML, Asundi A, Mehta P, Stanislawski M, Branch-Elliman W. Novel methodology to measure pre-procedure antimicrobial prophylaxis: integrating text searches with structured data from the Veterans Health Administration's electronic medical record. BMC medical informatics and decision making. 2020 Jan 30; 20(1):15.
  10. Nair R, Perencevich EN, Goto M, Livorsi DJ, Balkenende E, Kiscaden E, Schweizer ML. Patient care experience with utilization of isolation precautions: systematic literature review and meta-analysis. Clinical Microbiology and Infection : The Official Publication of The European Society of Clinical Microbiology and Infectious Diseases. 2020 Jun 1; 26(6):684-695.
  11. Jasper EA, Nidey NL, Schweizer ML, Ryckman KK. Gestational vitamin D and offspring risk of multiple sclerosis: a systematic review and meta-analysis. Annals of epidemiology. 2020 Mar 1; 43:11-17.
  12. Marra AR, Perencevich EN, Nelson RE, Samore M, Khader K, Chiang HY, Chorazy ML, Herwaldt LA, Diekema DJ, Kuxhausen MF, Blevins A, Ward MA, McDanel JS, Nair R, Balkenende E, Schweizer ML. Incidence and Outcomes Associated With Clostridium difficile Infections: A Systematic Review and Meta-analysis. JAMA Network Open. 2020 Jan 3; 3(1):e1917597.
  13. Singh N, Nair R, Goto M, Carvour ML, Carnahan R, Field EH, Lenert P, Vaughan-Sarrazin M, Schweizer ML, Perencevich EN. Risk of Recurrent Prosthetic Joint Infection in Rheumatoid Arthritis Patients-A Nationwide Cohort Study. Open forum infectious diseases. 2019 Nov 1; 6(11):ofz451.
  14. Chiotos K, Rock C, Schweizer ML, Deloney VM, Morgan DJ, Milstone AM, Henderson DK, Harris AD, Han JH. Current infection prevention and antibiotic stewardship program practices: A survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN). Infection control and hospital epidemiology. 2019 Sep 1; 40(9):1046-1049.
  15. Chang NN, Kates AE, Ward MA, Kiscaden EJ, Reisinger HS, Perencevich EN, Schweizer ML, CDC Prevention Epicenters Program. Association between universal gloving and healthcare-associated infections: A systematic literature review and meta-analysis. Infection control and hospital epidemiology. 2019 Jul 1; 40(7):755-760.
  16. Singh N, Varghese J, England BR, Solomon JJ, Michaud K, Mikuls TR, Healy HS, Kimpston EM, Schweizer ML. Impact of the pattern of interstitial lung disease on mortality in rheumatoid arthritis: A systematic literature review and meta-analysis. Seminars in Arthritis and Rheumatism. 2019 Dec 1; 49(3):358-365.
  17. Keller SC, Alexander M, Williams D, Rock C, Han J, Schweizer M, Chopra T, Deol S, Hirsch DK, Cosgrove SE, Gorski L. Perspectives on central-line-associated bloodstream infection surveillance in home infusion therapy. Infection control and hospital epidemiology. 2019 Jun 1; 40(6):729-731.
  18. Branch-Elliman W, Schweizer M. Real-world challenges in infection prevention: Differential implementation between stable and unstable patients may influence clinical effectiveness of interventions. Infection control and hospital epidemiology. 2019 Jun 1; 40(6):736-737.
  19. Dantes RB, Abbo LM, Anderson D, Hall L, Han JH, Harris AD, Leekha S, Milstone AM, Morgan DJ, Safdar N, Schweizer ML, Sengupta S, Seo SK, Rock C. Hospital epidemiologists' and infection preventionists' opinions regarding hospital-onset bacteremia and fungemia as a potential healthcare-associated infection metric. Infection control and hospital epidemiology. 2019 May 1; 40(5):536-540.
  20. Marra AR, Puig-Asensio M, Edmond MB, Schweizer ML, Bender D. Infectious complications of laparoscopic and robotic hysterectomy: a systematic literature review and meta-analysis. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 2019 Mar 1; 29(3):518-530.
  21. Marra AR, Puig-Asensio M, Edmond MB, Schweizer ML, Nepple KG. Infectious Complications of Conventional Laparoscopic vs Robotic Laparoscopic Prostatectomy: A Systematic Literature Review and Meta-Analysis. Journal of endourology. 2019 Mar 1; 33(3):179-188.
  22. Voruganti DC, Chennamadhavuni A, Garje R, Shantha GPS, Schweizer ML, Girotra S, Giudici M. Association between diabetes mellitus and poor patient outcomes after out-of-hospital cardiac arrest: A systematic review and meta-analysis. Scientific reports. 2018 Dec 18; 8(1):17921.
  23. Fiordellisi W, White K, Schweizer M. A Systematic Review and Meta-analysis of the Association Between Vitamin K Antagonist Use and Fracture. Journal of general internal medicine. 2019 Feb 1; 34(2):304-311.
  24. Nelson RE, Stevens VW, Jones M, Khader K, Schweizer ML, Perencevich EN, Rubin MA, Samore MH. Attributable Cost and Length of Stay Associated with Nosocomial Gram-Negative Bacterial Cultures. Antimicrobial agents and chemotherapy. 2018 Nov 1; 62(11).
  25. Khera R, CarlLee S, Blevins A, Schweizer M, Girotra S. Early coronary angiography and survival after out-of-hospital cardiac arrest: a systematic review and meta-analysis. Open heart. 2018 Oct 19; 5(2):e000809.
  26. Kenters N, Gottlieb T, Hopman J, Mehtar S, Schweizer ML, Tartari E, ISAC working group Infection Prevention and Control , Huijskens EGW, Voss A. An international survey of cleaning and disinfection practices in the healthcare environment. The Journal of hospital infection. 2018 Oct 1; 100(2):236-241.
  27. Leelakanok N, D'Cunha RR, Sutamtewagul G, Schweizer ML. A systematic review and meta-analysis of the association between vitamin A intake, serum vitamin A, and risk of liver cancer. Nutrition and health. 2018 Jun 1; 24(2):121-131.
  28. Schumacher A, Marzell M, Toepp AJ, Schweizer ML. Association Between Marijuana Use and Condom Use: A Meta-Analysis of Between-Subject Event-Based Studies. Journal of studies on alcohol and drugs. 2018 May 1; 79(3):361-369.
  29. Livorsi DJ, Chorazy ML, Schweizer ML, Balkenende EC, Blevins AE, Nair R, Samore MH, Nelson RE, Khader K, Perencevich EN. A systematic review of the epidemiology of carbapenem-resistant Enterobacteriaceae in the United States. Antimicrobial resistance and infection control. 2018 Apr 24; 7:55.
  30. Keating JA, Obasi C, McKinley L, Musuuza J, Knobloch MJ, Crnich C, Evans CT, Evans M, Livorsi D, Morgan DJ, Perencevich E, Reisinger HS, Schweizer ML, Suda KJ, Safdar N. Building Implementation Science for Veterans Affairs Healthcare Associated Infection Prevention: VA Healthcare-Associated Infection Prevention Network (VHIN). Infection control and hospital epidemiology. 2018 Jun 1; 39(6):753-757.
  31. Scherer AM, Schacht Reisinger H, Schweizer ML, Askelson NM, Fagerlin A, Lynch CF. Cross-sectional associations between psychological traits, and HPV vaccine uptake and intentions in young adults from the United States. PLoS ONE. 2018 Feb 23; 13(2):e0193363.
  32. Ayinde H, Schweizer ML, Crabb V, Ayinde A, Abugroun A, Hopson J. Age modifies the risk of atrial fibrillation among athletes: A systematic literature review and meta-analysis. International journal of cardiology. Heart & vasculature. 2018 Mar 1; 18:25-29.
  33. Ammann EM, Schweizer ML, Robinson JG, Eschol JO, Kafa R, Girotra S, Winiecki SK, Fuller CC, Carnahan RM, Leonard CE, Haskins C, Garcia C, Chrischilles EA. Chart validation of inpatient ICD-9-CM administrative diagnosis codes for acute myocardial infarction (AMI) among intravenous immune globulin (IGIV) users in the Sentinel Distributed Database. Pharmacoepidemiology and drug safety. 2018 Apr 1; 27(4):398-404.
  34. Ammann EM, Cuker A, Carnahan RM, Perepu US, Winiecki SK, Schweizer ML, Leonard CE, Fuller CC, Garcia C, Haskins C, Chrischilles EA. Chart validation of inpatient International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) administrative diagnosis codes for venous thromboembolism (VTE) among intravenous immune globulin (IGIV) users in the Sentinel Distributed Database. Medicine. 2018 Feb 1; 97(8):e9960.
  35. Kates AE, Tischendorf JS, Schweizer M, Herwaldt L, Samore M, Dukes KC, Gerding DN, Diekema DJ, Safdar N. Research Agenda for Microbiome Based Research for Multidrug-resistant Organism Prevention in the Veterans Health Administration System. Infection control and hospital epidemiology. 2018 Feb 1; 39(2):202-209.
  36. Ammann EM, Leira EC, Winiecki SK, Nagaraja N, Dandapat S, Carnahan RM, Schweizer ML, Torner JC, Fuller CC, Leonard CE, Garcia C, Pimentel M, Chrischilles EA. Chart validation of inpatient ICD-9-CM administrative diagnosis codes for ischemic stroke among IGIV users in the Sentinel Distributed Database. Medicine. 2017 Dec 1; 96(52):e9440.
  37. Nair R, Schweizer ML, Singh N. Septic Arthritis and Prosthetic Joint Infections in Older Adults. Infectious Disease Clinics of North America. 2017 Dec 1; 31(4):715-729.
  38. Marra AR, Schweizer ML, Edmond MB. No-Touch Disinfection Methods to Decrease Multidrug-Resistant Organism Infections: A Systematic Review and Meta-analysis. Infection control and hospital epidemiology. 2018 Jan 1; 39(1):20-31.
  39. Zhang Y, Chioreso C, Schweizer ML, Abràmoff MD. Effects of Aflibercept for Neovascular Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis of Observational Comparative Studies. Investigative ophthalmology & visual science. 2017 Nov 1; 58(13):5616-5627.
  40. Marra AR, Edmond MB, Schweizer ML, Ryan GW, Diekema DJ. Discontinuing contact precautions for multidrug-resistant organisms: A systematic literature review and meta-analysis. American journal of infection control. 2018 Mar 1; 46(3):333-340.
  41. Ide E, Bondar S, Hockett Sherlock S, Schweizer-Looby ML, Naylor J, Kane K, Meade R, Anderson H, Uttech C, Murphree D, McKinley L, Stampfli C, Perencevich EN, Crnich C. A Multidisciplinary Evaluation of Staphylococcus aureus Screening, Decolonization and Patient Adherence to Pre-Operative Decolonization Procedures. Open forum infectious diseases. 2017 Oct 7; 4(Suppl 1):S641-S642.
  42. Goto M, Schweizer ML, Vaughan-Sarrazin MS, Perencevich EN, Livorsi DJ, Diekema DJ, Richardson KK, Beck BF, Alexander B, Ohl ME. Association of Evidence-Based Care Processes With Mortality in Staphylococcus aureus Bacteremia at Veterans Health Administration Hospitals, 2003-2014. JAMA internal medicine. 2017 Oct 1; 177(10):1489-1497.
  43. Nelson RE, Deka R, Khader K, Stevens VW, Schweizer ML, Rubin MA. Dynamic transmission models for economic analysis applied to health care-associated infections: A review of the literature. American journal of infection control. 2017 Dec 1; 45(12):1382-1387.
  44. Schweizer ML, Nair R. A practical guide to systematic literature reviews and meta-analyses in infection prevention: Planning, challenges, and execution. American journal of infection control. 2017 Nov 1; 45(11):1292-1294.
  45. Burdsall DP, Gardner SE, Cox T, Schweizer M, Culp KR, Steelman VM, Herwaldt LA. Exploring inappropriate certified nursing assistant glove use in long-term care. American journal of infection control. 2017 Sep 1; 45(9):940-945.
  46. Ryken KO, Hogue M, Marsh JL, Schweizer M. Long-term consequences of landmine injury: A survey of civilian survivors in Bosnia-Herzegovina 20 years after the war. Injury. 2017 Dec 1; 48(12):2688-2692.
  47. Leelakanok N, Holcombe AL, Lund BC, Gu X, Schweizer ML. Association between polypharmacy and death: A systematic review and meta-analysis. Journal of the American Pharmacists Association : JAPhA. 2017 Nov 1; 57(6):729-738.e10.
  48. McDanel J, Schweizer M, Crabb V, Nelson R, Samore M, Khader K, Blevins AE, Diekema D, Chiang HY, Nair R, Perencevich E. Incidence of Extended-Spectrum -Lactamase (ESBL)-Producing Escherichia coli and Klebsiella Infections in the United States: A Systematic Literature Review. Infection control and hospital epidemiology. 2017 Oct 1; 38(10):1209-1215.
  49. Branch-Elliman W, Ripollone JE, O'Brien WJ, Itani KMF, Schweizer ML, Perencevich E, Strymish J, Gupta K. Risk of surgical site infection, acute kidney injury, and Clostridium difficile infection following antibiotic prophylaxis with vancomycin plus a beta-lactam versus either drug alone: A national propensity-score-adjusted retrospective cohort study. PLoS Medicine. 2017 Jul 1; 14(7):e1002340.
  50. McDanel JS, Roghmann MC, Perencevich EN, Ohl ME, Goto M, Livorsi DJ, Jones M, Albertson JP, Nair R, O'Shea AMJ, Schweizer ML. Comparative Effectiveness of Cefazolin Versus Nafcillin or Oxacillin for Treatment of Methicillin-Susceptible Staphylococcus aureus Infections Complicated by Bacteremia: A Nationwide Cohort Study. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2017 Jul 1; 65(1):100-106.
  51. Carrel M, Goto M, Schweizer ML, David MZ, Livorsi D, Perencevich EN. Diffusion of clindamycin-resistant and erythromycin-resistant methicillin-susceptible Staphylococcus aureus (MSSA), potential ST398, in United States Veterans Health Administration Hospitals, 2003-2014. Antimicrobial resistance and infection control. 2017 Jun 5; 6:55.
  52. Shaw CA, Steelman VM, DeBerg J, Schweizer ML. Effectiveness of active and passive warming for the prevention of inadvertent hypothermia in patients receiving neuraxial anesthesia: A systematic review and meta-analysis of randomized controlled trials. Journal of clinical anesthesia. 2017 May 1; 38:93-104.
  53. Chiang HY, Perencevich EN, Nair R, Nelson RE, Samore M, Khader K, Chorazy ML, Herwaldt LA, Blevins A, Ward MA, Schweizer ML. Incidence and Outcomes Associated With Infections Caused by Vancomycin-Resistant Enterococci in the United States: Systematic Literature Review and Meta-Analysis. Infection control and hospital epidemiology. 2017 Feb 1; 38(2):203-215.
  54. Nelson RE, Schweizer ML, Perencevich EN, Nelson SD, Khader K, Chiang HY, Chorazy ML, Blevins A, Ward MA, Samore MH. Costs and Mortality Associated With Multidrug-Resistant Healthcare-Associated Acinetobacter Infections. Infection control and hospital epidemiology. 2016 Oct 1; 37(10):1212-8.
  55. Schweizer ML, Braun BI, Milstone AM. Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship-Quasi-Experimental Designs. Infection control and hospital epidemiology. 2016 Oct 1; 37(10):1135-40.
  56. Le J, Dam Q, Schweizer M, Thienphrapa W, Nizet V, Sakoulas G. Effects of vancomycin versus nafcillin in enhancing killing of methicillin-susceptible Staphylococcus aureus causing bacteremia by human cathelicidin LL-37. European Journal of Clinical Microbiology & Infectious Diseases. 2016 Sep 1; 35(9):1441-7.
  57. McDanel JS, Perencevich EN, Storm J, Diekema DJ, Herwaldt L, Johnson JK, Winokur PL, Schweizer ML. Increased Mortality Rates Associated with Staphylococcus aureus and Influenza Co-infection, Maryland and Iowa, USA(1). Emerging Infectious Diseases. 2016 Jul 1; 22(7):1253-6.
  58. Nelson RE, Stevens VW, Khader K, Jones M, Samore MH, Evans ME, Douglas Scott R, Slayton RB, Schweizer ML, Perencevich EL, Rubin MA. Economic Analysis of Veterans Affairs Initiative to Prevent Methicillin-Resistant Staphylococcus aureus Infections. American journal of preventive medicine. 2016 May 1; 50(5 Suppl 1):S58-65.
  59. Chang NC, Reisinger HS, Jesson AR, Schweizer ML, Morgan DJ, Forrest GN, Perencevich EN. Feasibility of monitoring compliance to the My 5 Moments and Entry/Exit hand hygiene methods in US hospitals. American journal of infection control. 2016 Aug 1; 44(8):938-40.
  60. Septimus EJ, Schweizer ML. Decolonization in Prevention of Health Care-Associated Infections. Clinical microbiology reviews. 2016 Apr 1; 29(2):201-22.
  61. Nelson RE, Jones M, Leecaster M, Samore MH, Ray W, Huttner A, Huttner B, Khader K, Stevens VW, Gerding D, Schweizer ML, Rubin MA. An Economic Analysis of Strategies to Control Clostridium Difficile Transmission and Infection Using an Agent-Based Simulation Model. PLoS ONE. 2016 Mar 31; 11(3):e0152248.
  62. Donovan BM, Spracklen CN, Schweizer ML, Ryckman KK, Saftlas AF. Intimate partner violence during pregnancy and the risk for adverse infant outcomes: a systematic review and meta-analysis. BJOG : an international journal of obstetrics and gynaecology. 2016 Jul 1; 123(8):1289-99.
  63. Mohr NM, Harland KK, Crabb V, Mutnick R, Baumgartner D, Spinosi S, Haarstad M, Ahmed A, Schweizer M, Faine B. Urinary Squamous Epithelial Cells Do Not Accurately Predict Urine Culture Contamination, but May Predict Urinalysis Performance in Predicting Bacteriuria. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2016 Mar 1; 23(3):323-30.
  64. Nair R, Perencevich EN, Blevins AE, Goto M, Nelson RE, Schweizer ML. Clinical Effectiveness of Mupirocin for Preventing Staphylococcus aureus Infections in Nonsurgical Settings: A Meta-analysis. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2016 Mar 1; 62(5):618-30.
  65. Kuperman EF, Schweizer M, Joy P, Gu X, Fang MM. The effects of advanced age on primary total knee arthroplasty: a meta-analysis and systematic review. BMC geriatrics. 2016 Feb 10; 16(1):41.
  66. Leelakanok N, Holcombe A, Schweizer ML. Domperidone and Risk of Ventricular Arrhythmia and Cardiac Death: A Systematic Review and Meta-analysis. Clinical drug investigation. 2016 Feb 1; 36(2):97-107.
  67. Kelesidis T, Braykov N, Uslan DZ, Morgan DJ, Gandra S, Johannsson B, Schweizer ML, Weisenberg SA, Young H, Cantey J, Perencevich E, Septimus E, Srinivasan A, Laxminarayan R. Indications and Types of Antibiotic Agents Used in 6 Acute Care Hospitals, 2009-2010: A Pragmatic Retrospective Observational Study. Infection control and hospital epidemiology. 2016 Jan 1; 37(1):70-9.
  68. McDanel JS, Perencevich EN, Diekema DJ, Winokur PL, Johnson JK, Herwaldt LA, Smith TC, Chrischilles EA, Dawson JD, Schweizer ML. Association between microbial characteristics and poor outcomes among patients with methicillin-resistant Staphylococcus aureus pneumonia: a retrospective cohort study. Antimicrobial resistance and infection control. 2015 Dec 14; 4:51.
  69. Nelson RE, Nelson SD, Khader K, Perencevich EL, Schweizer ML, Rubin MA, Graves N, Harbarth S, Stevens VW, Samore MH. The Magnitude of Time-Dependent Bias in the Estimation of Excess Length of Stay Attributable to Healthcare-Associated Infections. Infection control and hospital epidemiology. 2015 Sep 1; 36(9):1089-94.
  70. Pugely AJ, Martin CT, Gao Y, Schweizer ML, Callaghan JJ. The Incidence of and Risk Factors for 30-Day Surgical Site Infections Following Primary and Revision Total Joint Arthroplasty. Journal of Arthroplasty. 2015 Sep 1; 30(9 Suppl):47-50.
  71. McDanel JS, Perencevich EN, Diekema DJ, Herwaldt LA, Smith TC, Chrischilles EA, Dawson JD, Jiang L, Goto M, Schweizer ML. Comparative effectiveness of beta-lactams versus vancomycin for treatment of methicillin-susceptible Staphylococcus aureus bloodstream infections among 122 hospitals. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2015 Aug 1; 61(3):361-7.
  72. Schweizer ML, Chiang HY, Septimus E, Moody J, Braun B, Hafner J, Ward MA, Hickok J, Perencevich EN, Diekema DJ, Richards CL, Cavanaugh JE, Perlin JB, Herwaldt LA. Association of a bundled intervention with surgical site infections among patients undergoing cardiac, hip, or knee surgery. JAMA. 2015 Jun 2; 313(21):2162-71.
  73. Albertson J, McDanel JS, Carnahan R, Chrischilles E, Perencevich EN, Goto M, Jiang L, Alexander B, Schweizer ML. Determination of risk factors for recurrent methicillin-resistant Staphylococcus aureus bacteremia in a Veterans Affairs healthcare system population. Infection control and hospital epidemiology. 2015 May 1; 36(5):543-9.
  74. Eko KE, Forshey BM, Carrel M, Schweizer ML, Perencevich EN, Smith TC. Molecular characterization of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization and infection isolates in a Veterans Affairs hospital. Antimicrobial resistance and infection control. 2015 Apr 2; 4:10.
  75. Braykov NP, Morgan DJ, Schweizer ML, Uslan DZ, Kelesidis T, Weisenberg SA, Johannsson B, Young H, Cantey J, Srinivasan A, Perencevich E, Septimus E, Laxminarayan R. Assessment of empirical antibiotic therapy optimisation in six hospitals: an observational cohort study. The Lancet Infectious Diseases. 2014 Dec 1; 14(12):1220-7.
  76. Ohl ME, Richardson KK, Goto M, Vaughan-Sarrazin M, Schweizer ML, Perencevich EN. HIV quality report cards: impact of case-mix adjustment and statistical methods. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2014 Oct 15; 59(8):1160-7.
  77. Yin J, Reisinger HS, Vander Weg M, Schweizer ML, Jesson A, Morgan DJ, Forrest G, Graham M, Pineles L, Perencevich EN. Establishing evidence-based criteria for directly observed hand hygiene compliance monitoring programs: a prospective, multicenter cohort study. Infection control and hospital epidemiology. 2014 Sep 1; 35(9):1163-8.
  78. Ellingson K, Haas JP, Aiello AE, Kusek L, Maragakis LL, Olmsted RN, Perencevich E, Polgreen PM, Schweizer ML, Trexler P, VanAmringe M, Yokoe DS, Society for Healthcare Epidemiology of America (SHEA). Strategies to prevent healthcare-associated infections through hand hygiene. Infection control and hospital epidemiology. 2014 Aug 1; 35(8):937-60.
  79. McDanel JS, Ward MA, Leder L, Schweizer ML, Dawson JD, Diekema DJ, Smith TC, Chrischilles EA, Perencevich EN, Herwaldt LA. Methicillin-resistant Staphylococcus aureus prevention practices in hospitals throughout a rural state. American journal of infection control. 2014 Aug 1; 42(8):868-73.
  80. Feazel LM, Malhotra A, Perencevich EN, Kaboli P, Diekema DJ, Schweizer ML. Effect of antibiotic stewardship programmes on Clostridium difficile incidence: a systematic review and meta-analysis. The Journal of antimicrobial chemotherapy. 2014 Jul 1; 69(7):1748-54.
  81. Ryken TC, Aygun N, Morris J, Schweizer M, Nair R, Spracklen C, Kalkanis SN, Olson JJ, AANS/CNS Joint Guidelines Committee. The role of imaging in the management of progressive glioblastoma : a systematic review and evidence-based clinical practice guideline. Journal of Neuro-Oncology. 2014 Jul 1; 118(3):435-60.
  82. Formanek MB, Herwaldt LA, Perencevich EN, Schweizer ML. Gentamicin/collagen sponge use may reduce the risk of surgical site infections for patients undergoing cardiac operations: a meta-analysis. Surgical Infections. 2014 Jun 1; 15(3):244-55.
  83. Schweizer ML, Cullen JJ, Perencevich EN, Vaughan Sarrazin MS. Costs Associated With Surgical Site Infections in Veterans Affairs Hospitals. JAMA surgery. 2014 Jun 1; 149(6):575-81.
  84. Reisinger HS, Perencevich EN, Morgan DJ, Forrest GN, Shardell M, Schweizer ML, Graham MM, Franciscus CL, Vander Weg MW. Improving hand hygiene compliance with point-of-use reminder signs designed using theoretically grounded messages. Infection control and hospital epidemiology. 2014 May 1; 35(5):593-4.
  85. Ward MA, Schweizer ML, Polgreen PM, Gupta K, Reisinger HS, Perencevich EN. Automated and electronically assisted hand hygiene monitoring systems: a systematic review. American journal of infection control. 2014 May 1; 42(5):472-8.
  86. Chiang HY, Herwaldt LA, Blevins AE, Cho E, Schweizer ML. Effectiveness of local vancomycin powder to decrease surgical site infections: a meta-analysis. The Spine Journal : Official Journal of The North American Spine Society. 2014 Mar 1; 14(3):397-407.
  87. Goto M, Ohl ME, Schweizer ML, Perencevich EN. Accuracy of administrative code data for the surveillance of healthcare-associated infections: a systematic review and meta-analysis. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2014 Mar 1; 58(5):688-96.
  88. Vyas A, Schweizer M, Malhotra A, Karrowni W. Meta-analysis of same versus different stent for drug-eluting stent restenosis. The American journal of cardiology. 2014 Feb 15; 113(4):601-6.
  89. Carrel M, Schweizer ML, Sarrazin MV, Smith TC, Perencevich EN. Residential proximity to large numbers of swine in feeding operations is associated with increased risk of methicillin-resistant Staphylococcus aureus colonization at time of hospital admission in rural Iowa veterans. Infection control and hospital epidemiology. 2014 Feb 1; 35(2):190-3.
  90. Schweizer ML, Reisinger HS, Ohl M, Formanek MB, Blevins A, Ward MA, Perencevich EN. Searching for an optimal hand hygiene bundle: a meta-analysis. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2014 Jan 1; 58(2):248-59.
  91. Schweizer ML, Perencevich EN, Eber MR, Cai X, Shardell MD, Braykov N, Laxminarayan R. Optimizing antimicrobial prescribing: Are clinicians following national trends in methicillin-resistant staphylococcus aureus (MRSA) infections rather than local data when treating MRSA wound infections. Antimicrobial resistance and infection control. 2013 Oct 15; 2(1):28.
  92. Karrowni W, Vyas A, Giacomino B, Schweizer M, Blevins A, Girotra S, Horwitz PA. Radial versus femoral access for primary percutaneous interventions in ST-segment elevation myocardial infarction patients: a meta-analysis of randomized controlled trials. JACC. Cardiovascular interventions. 2013 Aug 1; 6(8):814-23.
  93. Schweizer M, Perencevich E, McDanel J, Carson J, Formanek M, Hafner J, Braun B, Herwaldt L. Effectiveness of a bundled intervention of decolonization and prophylaxis to decrease Gram positive surgical site infections after cardiac or orthopedic surgery: systematic review and meta-analysis. BMJ (Clinical research ed.). 2013 Jun 13; 346:f2743.
  94. Quezada Joaquin NM, Diekema DJ, Perencevich EN, Bailey G, Winokur PL, Schweizer ML. Long-term risk for readmission, methicillin-resistant Staphylococcus aureus (MRSA) infection, and death among MRSA-colonized veterans. Antimicrobial agents and chemotherapy. 2013 Mar 1; 57(3):1169-72.
Journal Other

  1. Chiang HY, Herwaldt LA, Schweizer ML. Reply to "letter to the editor" by Baker and Chen regarding "Effectiveness of local vancomycin powder to decrease surgical site infections: a meta-analysis". [Letter to the Editor]. The Spine Journal : Official Journal of The North American Spine Society. 2014 Jul 1; 14(7):1367-8.
Reports

  1. Schweizer ML. Barrier Precautions, Patient Isolation, and Routine Surveillance for Prevention of Health Care-Associated Infections: Brief Update Review. Washington, DC: AHRQ; 2013 Mar 3. 11 p. Report No.: 211.
VA Cyberseminars

  1. Schweizer ML. Using Meta-Analyses to Inform Interventions and Quality Improvement. HSR&D Career Development Awardee Series [Cyberseminar]. HSR&D Cyberseminars. 2016 Sep 13.
  2. Schweizer ML. Hand Hygiene: VA National Clostridium difficile Infection Prevention Initiative. [Cyberseminar]. 2013 Mar 26.
  3. Schweizer ML. Effectiveness of Interventions to Improve Hand Hygiene Compliance: A Systematic Literature Review and Meta-analysis. [Cyberseminar]. 2013 Feb 12.
Conference Presentations

  1. Nair R, Perencevich EN, Chiang HY, Hockett Sherlock SM, Balkenende E, McDanel JS, Nelson RE, Samore MH, Khader K, Slayton RB, Jernigan JA, Blevins AE, Ward MA, Schweizer ML. Incidence and Outcomes Associated with Methicillin-resistant Staphylococcus aureus Infections: A Meta-Analysis. Poster session presented at: Society for Healthcare Epidemiology of America Annual Scientific Meeting; 2016 May 29; St. Louis, MO.
  2. Schweizer ML, Ward MA, Fulton D, Perencevich EN, McDanel JM, Nelson RE, Khader K, Herwaldt L, Blevins A, Diekema DJ. Mortality Associated with Candida Infections among Neonates: a Systematic Literature Review and Meta-analysis. Poster session presented at: Society for Healthcare Epidemiology of America Annual Scientific Meeting; 2016 May 18; Atlanta, GA.
  3. Chang NN, Kates AE, Ward MA, Kiscaden E, Reisinger HS, Perencevich EN, Kiscaden M, Schweizer ML. Association between Universal Glove Use, MDRO Acquisition and Healthcare-Associated Infections: a Meta-Analysis. Paper presented at: European Congress of Clinical Microbiology and Infectious Diseases; 2016 Apr 11; Amsterdam, Netherlands.
  4. Goto M, McDanel J, Livorsi D, Schweizer ML, Perencevich EN. Seasonal Peaks in Community-Acquired Gram-Negative Rods Bloodstream Infection: A Nationwide Cohort Study of US Veterans. Poster session presented at: European Congress of Clinical Microbiology and Infectious Diseases; 2016 Apr 9; Amsterdam, Netherlands.
  5. Reisinger HS, Goedken CL, Hockett Sherlock SM, Dukes K, Schweizer ML, Krein S, Perencevich EN. Changing "outbreak-response" cycles to evidence-based bundles: Implementation of a surgical site infection (SSI) prevention bundle in the Veterans Health Administration. Paper presented at: AcademyHealth Annual Research Meeting; 2015 Dec 15; Washington, DC.
  6. Branch-Elliman W, Strymish J, Schweizer ML, Itani K, Ho M, Gupta K. Effectiveness of Vancomycin versus Vancomycin plus Beta-Lactams for Prevention of Surgical Site Infections. Paper presented at: ID Week Annual Conference; 2015 Oct 9; San Diego, CA.
  7. McDanel JS, Roghmann MC, Perencevich EN, Ohl M, Goto M, Livorsi D, Jones MP, Albertson J, Nair R, O'Shea AM, Schweizer ML. Comparative Effectiveness of Third Generation Cephalosporins versus Penicillinase-Stable Penicillins for Treatment of Methicillin-Susceptible Staphylococcus aureus Infections Complicated by Bacteremia: A Nationwide Cohort Study. Poster session presented at: ID Week Annual Conference; 2015 Oct 9; San Diego, CA.
  8. McDanel J, Roghmann MC, Perencevich EN, Ohl M, Goto M, Livorsi D, Jones MP, Albertson J, Nair R, O'Shea AM, Schweizer ML. Comparative Effectiveness of Cefazolin versus Penicillinase-Stable Penicillins for Treatment of Methicillin-Susceptible Staphylococcus aureus Infections Complicated by Bacteremia: A Nationwide Cohort Study. Oral Presentation. Paper presented at: ID Week Annual Conference; 2015 Oct 8; San Diego, CA.
  9. Nair R, Perencevich EN, Diekema DJ, Torner J, Burns T, Cavanaugh J, Jiang L, Alexander B, Richardson KK, Beck B, Goto M, McDanel J, Schweizer ML. Exchange Arthroplasty is Associated with Reduced Risk for All-cause Mortality in Staphylococcus aureus Prosthetic Joint Infection. Paper presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy / Infectious Diseases Society of America Joint Meeting; 2015 Sep 21; San Diego, CA.
  10. Nair R, Perencevich EN, Diekema DJ, Torner J, Burns T, Cavanaugh J, Jiang L, Alexander B, Beck B, Goto M, McDanel J, Schweizer ML. Association of Rifampin Use with the Risk for Treatment Failure in Staphylococcus aureus Prosthetic Joint Infections. Paper presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy / Infectious Diseases Society of America Joint Meeting; 2015 Sep 19; San Diego, CA.
  11. Nair R, Perencevich EN, Blevins A, Goto M, Schweizer ML. Clinical effectiveness of mupirocin for preventing S. aureus infections in non-surgical settings: A Meta-analysis. Paper presented at: International Biennial Consortium for Prevention and Infection Control; 2015 Jun 17; Geneva, Switzerland.
  12. Schweizer ML, Nelson R, Samore M, Nelson S, Khader K, Slayton RB, Jernigan J, Chiang HY, Chorazy ML, Herwaldt L, Diekema DJ, Formanek MB, Malhotra A, Blevins A, Ward MA. US Costs and Outcomes Associated with Clostridium difficile Infections: a Systematic Literature Review, Meta-analysis, and Mathematical Model. Paper presented at: International Biennial Consortium for Prevention and Infection Control; 2015 Jun 17; Geneva, Switzerland.
  13. McDanel J, Schweizer ML, Crabb V, Nelson R, Samore M, Khader K, Blevins A, Diekema DJ, Perencevich EN. Incidence of Extended-Spectrum Beta-Lactamase E.coli and Klebsiella pneumoniae Infections in the US: a Systematic Review. Poster session presented at: Society for Healthcare Epidemiology of America Annual Scientific Meeting; 2015 May 15; Orlando, FL.
  14. Goto M, Ohl M, Schweizer ML, Perencevich EN, Vaughan-Sarrazin MS. How should we risk-adjust hospital outcomes for blood stream infections? A nationwide cohort study of Staphylococcus aureus bacteraemia. Paper presented at: European Congress of Clinical Microbiology and Infectious Diseases; 2015 Apr 25; Copenhagen, Denmark.
  15. Braykov N, Morgan D, Schweizer ML, Uslan DZ, Kelesidis T, Weisenberg S, Johannsson B, Young H, Cantey J, Srinivasan A, Perencevich EN, Septimus E, Laxminarayan R. Factors associated with optimizing empiric antibiotic therapy in six hospitals. Paper presented at: ID Week: A Joint Meeting of IDSA, SHEA, HIVMA, and PIDS; 2014 Oct 11; Philadelphia, PA.
  16. Schweizer ML, Chiang HY, Septimus E, Moody J, Braun B, Hafner J, Ward MA, Hickok J, Perencevich EN, Diekema DJ, Richards CL, Perlin JB, Herwaldt L. A Multicenter Intervention to Reduce Surgical Site Infections among Patients Undergoing Cardiac Operations and Total Joint Arthroplasty (STOP SSI Study). Paper presented at: ID Week: A Joint Meeting of IDSA, SHEA, HIVMA, and PIDS; 2014 Oct 11; Philadelphia, PA.
  17. Schweizer ML, Nelson R, Samore M, Nelson S, Khader K, Slayton RB, Jernigan J, Chiang HY, Chorazy ML, Herwaldt L, Diekema DJ, Formanek MB, Malhotra A, Blevins A, Ward MA, Perencevich EN. US Costs and Outcomes Associated with Clostridium difficile Infections: a Systematic Literature Review, Meta-analysis, and Mathematical Model. Poster session presented at: ID Week: A Joint Meeting of IDSA, SHEA, HIVMA, and PIDS; 2014 Oct 11; Philadelphia, PA.
  18. Goto M, Schweizer ML, Perencevich EN, Ohl M. Hospital-Level Variation in Mortality among Patients with Staphylococcus aureus Bacteremia: a Nationwide Cohort Study. Poster session presented at: ID Week: A Joint Meeting of IDSA, SHEA, HIVMA, and PIDS; 2014 Oct 10; Philadelphia, PA.
  19. Reisinger HS, Dukes K, Schweizer ML, Braun B, Hafner J, Moody J, Ward MM, Richards C, Perlin J, Septimus E, Herwaldt L. Facilitators and Barriers to SSI Bundle Implementation in Select Surgical Procedures. Paper presented at: ID Week: A Joint Meeting of IDSA, SHEA, HIVMA, and PIDS; 2014 Oct 10; Philadelphia, PA.
  20. Nair R, Perencevich EN, Blevins A, Goto M, Schweizer ML. Clinical effectiveness of mupirocin for preventing S. aureus infections in non-surgical settings: A Meta-analysis. Poster session presented at: ID Week: A Joint Meeting of IDSA, SHEA, HIVMA, and PIDS; 2014 Oct 9; Philadelphia, PA.
  21. Ohl M, Richardson KK, Goto M, Vaughan-Sarrazin MS, Schweizer ML, Perencevich EN. HIV Quality Report Cards: Impact of Case-Mix Adjustment and Statistical Methods. Paper presented at: ID Week: A Joint Meeting of IDSA, SHEA, HIVMA, and PIDS; 2014 Oct 9; Philadelphia, PA.
  22. McDanel JS, Perencevich EN, Diekema DJ, Herwaldt L, Smith T, Chrischilles E, Dawson J, Schweizer ML. Beta-Lactams versus Vancomycin for Treatment of Methicillin-susceptible Staphylococcus aureus Bacteremia: A Retrospective Cohort Study of Data from the U.S. Veterans Health Administration. Poster session presented at: European Society of Clinical Microbiology and Infectious Diseases Annual European Congress of Clinical Microbiology and Infectious Diseases; 2014 May 13; Barcelona, Spain.
  23. Perencevich EN, Yin J, Goto M, Ohl M, Schweizer ML, Carrel M. Higher Incidence of Community-Associated Staphylococcus aureus and MRSA Bacteremia in Southern Latitudes among 104 United States (US) Hospitals: Retrospective Cohort Study. Oral Presentation. Paper presented at: European Society of Clinical Microbiology and Infectious Diseases Annual European Congress of Clinical Microbiology and Infectious Diseases; 2014 May 13; Barcelona, Spain.
  24. Yin J, Reisinger HS, Vander Weg MW, Schweizer ML, Jesson A, Morgan DJ, Forrest G, Graham M, Pineles MA, Perencevich EN. Timing of the Emergence of the Hawthorne Effect in Hand Hygiene Surveillance: A Multicenter Prospective Cohort Study. Paper presented at: European Society of Clinical Microbiology and Infectious Diseases Annual European Congress of Clinical Microbiology and Infectious Diseases; 2014 May 12; Barcelona, Spain.
  25. Feazel LM, Malhotra A, Perencevich EN, Kaboli PJ, Diekema DJ, Schweizer ML. Effect of Antibiotic Stewardship Programs on Clostridium difficile Incidence: A Meta-Analysis. Paper presented at: European Society of Clinical Microbiology and Infectious Diseases Annual European Congress of Clinical Microbiology and Infectious Diseases; 2014 May 10; Barcelona, Spain.
  26. Goto M, Schweizer ML, Perencevich EN, Ohl M. Hospital Characteristics Associated with Higher Staphylococcus aureus Bacteremia Mortality in Veterans Affairs Healthcare System: A Retrospective Cohort Study. Poster session presented at: European Society of Clinical Microbiology and Infectious Diseases Annual European Congress of Clinical Microbiology and Infectious Diseases; 2014 May 10; Barcelona, Spain.
  27. Formanek BS, Herwaldt L, McDanel J, Blevins A, Schweizer ML. Examining the relationship between fluoroquinolone use and Clostridium difficile infections (CDI): A meta-analysis. Poster session presented at: Infectious Diseases Society of America Annual Meeting; 2013 Oct 4; San Francisco, CA.
  28. Schweizer ML, Reisinger HS, Ohl M, Formanek M, Blevins A, Ward M, Perencevich EN. Searching for an Optimal Hand Hygiene Bundle: a Meta-Analysis. Poster session presented at: Infectious Diseases Society of America Annual Meeting; 2013 Oct 4; San Francisco, CA.
  29. Carrel M, Schweizer ML, Vaughan-Sarrazin MS, Smith T, Perencevich EN. Residential proximity to large swine CAFOs is associated with increased risk of MRSA carriage at time of hospital admission in rural Iowa Veterans. Poster session presented at: Infectious Diseases Society of America Annual Meeting; 2013 Oct 3; San Francisco, CA.
  30. Braun B, Hafner J, Schweizer ML, Septimus E, Moody J, Richards C, Hickok J, Herwaldt L. Development and Implementation of a Consensus Algorithm to Optimize Pre-Operative Antimicrobial Prophylaxis and Decrease Gram Positive Surgical Site Infections for Cardiac and Orthopedic Procedures. Poster session presented at: AcademyHealth Annual Research Meeting; 2013 Jun 24; Baltimore, MD.
  31. Schweizer ML, Cullen J, Vaughan-Sarrazin MS. Costs Associated with Surgical Site Infections in VA Hospitals. Paper presented at: Infectious Diseases Society of America Annual Meeting; 2012 Oct 12; San Diego, CA.


DRA: Infectious Diseases
DRE: Prevention, Treatment - Comparative Effectiveness
Keywords: none
MeSH Terms: none

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