Non-O157 Shiga Toxin–producing Escherichia coli Associated with Venison

News reports of “E. coli outbreaks” usually refer to Shiga toxin–producing E. coli O157. But there are other types of Shiga toxin–producing E. coli, often called STEC,about which less is known. For these other types of STEC, what is the source? What are the risk factors? An outbreak among 29 high school students in Minnesota provided some answers. The source of this outbreak was a white-tailed deer that had been butchered and eaten at the school. The risk factors for infection were handling raw or eating undercooked venison. To prevent this type of STECinfection, people should handle and cook venison with the same caution recommended for other meats

Salmonella enterica Pulsed-Field Gel Electrophoresis Clusters, Minnesota, USA, 2001–2007

This procedure can help identify outbreaks of salmonellosis

Reflecting on death: The emotionality of the research encounter

This paper considers some of the issues encountered when researching a particular space in which death is engaged: a cemetery landscape. Building on literature available on research and reflexivity, the paper addresses some of the challenges the author dealt with when both in and away from the cemetery field site. At the core of the paper is the recognition that emotional responses can both contribute and distract from the research process. It is the extent to which emotional baggage enlightens and/or diverts from the research process and the data being generated that underpins this paper

Impact of a Guideline on Management of Children Hospitalized With Community-Acquired Pneumonia

OBJECTIVES:We sought to describe the impact a clinical practice guideline (CPG) had on antibiotic management of children hospitalized with community-acquired pneumonia (CAP).PATIENTS AND METHODS:We conducted a retrospective study of discharged patients from a children’s hospital with an ICD-9-CM code for pneumonia (480–486). Eligible patients were admitted from July 8, 2007, through July 9, 2009, 12 months before and after the CAP CPG was introduced. Three-stage least squares regression analyses were performed to examine hypothesized simultaneous relationships, including the impact of our institution\x{2019}s antimicrobial stewardship program (ASP).RESULTS:The final analysis included 1033 patients: 530 (51%) before the CPG (pre-CPG) and 503 (49%) after the CPG (post-CPG). Pre-CPG, ceftriaxone (72%) was the most commonly prescribed antibiotic, followed by ampicillin (13%). Post-CPG, the most common antibiotic was ampicillin (63%). The effect of the CPG was associated with a 34% increase in ampicillin use (P &amp;lt; .001). Discharge antibiotics also changed post-CPG, showing a significant increase in amoxicillin use (P &amp;lt; .001) and a significant decrease in cefdinir and amoxicillin/clavulanate (P &amp;lt; .001), with the combined effect of the CPG and ASP leading to 12% (P &amp;lt; 0.001) and 16% (P &amp;lt; .001) reduction, respectively. Overall, treatment failure was infrequent (1.5% vs 1%).CONCLUSIONS:A CPG and ASP led to the increase in use of ampicillin for children hospitalized with CAP. In addition, less broad-spectrum discharge antibiotics were used. Patient adverse outcomes were low, indicating that ampicillin is appropriate first-line therapy for otherwise healthy children admitted with uncomplicated CAP.</jats:sec