Biomedical subjects

Tracy L Ayers

Publications and source records attributed to Tracy L Ayers.

3 recordsLinked to original sources

PubMed2005

Methicillin-resistant Staphylococcus aureus, Hawaii, 2000-2002.

The emergence of methicillin-resistant Staphylococcus aureus (MRSA) has generated considerable concern among medical and public health professionals. We used a statewide, population-based antimicrobial resistance surveillance system to examine epidemiologic trends for MRSA from outpatients and inpatients in Hawaii. Pediatric and adult patient populations were compared to assess characteristics of MRSA isolates specific for each group. From 2000 to 2002, 8,206 (26%) of 31,482 total S. aureus isolates were MRSA. During this period, the proportion of MRSA isolates increased in both outpatient and inpatient clinical settings (p<0.01). When stratified by age, annual trends showed a significant increase in the proportion of MRSA in adult patients (from 24% to 30%, p<0.01) but not in pediatric patients (from 25% to 27%, p>0.05). Although MRSA isolates from adults demonstrated high resistance to most non-beta-lactams, most MRSA isolates from pediatric outpatients remained susceptible to most non-beta-lactams.

Adolescent↗

PubMed2005

Isolate removal methods and methicillin-resistant Staphylococcus aureus surveillance.

The effect of duplicate isolate removal strategies on Staphylococcal aureus susceptibility to oxacillin was compared by using antimicrobial test results for 14,595 isolates from statewide surveillance in Hawaii in 2002. No removal was compared to most resistant and most susceptible methods at 365 days and to the National Committee for Clinical Laboratory Standards (NCCLS) and Cerner algorithms at 3-, 10-, 30-, 90-, and 365-day analysis periods. Overall, no removal produced the lowest estimates of susceptibility. Estimates with either NCCLS or Cerner differed by <2% when the analysis period was the same; with either method, the difference observed between a 90- and a 365-day period was <1%. The effect of duplicate isolate removal was greater for inpatient than outpatient settings. Considering the ease of implementation and comparability of results, we recommend using the first isolate of a given species per patient to calculate susceptibility frequencies for S. aureus to oxacillin.

Anti-Bacterial Agents↗

PubMedDate not supplied

Contacting passengers after exposure to measles on an international flight: Implications for responding to new disease threats and bioterrorism.

On May 21, 2000, a passenger with measles traveled from Japan to Hawai'i on a seven-hour flight. When the flight landed, the U.S. Public Health Service (USPHS) Quarantine Station in Honolulu alerted passengers that a suspected case of measles had been identified, but they were not detained. The next day, to offer appropriate post-exposure prophylaxis, the Hawai'i Department of Health (HDOH) attempted to contact all passengers from the flight using information from the airline, U.S. Customs declaration forms, and tour agencies. Of 335 total passengers, 270 (81%) were successfully reached and provided complete information. The mean time from exposure to contact for all respondents was 61 hours (95% confidence interval 57, 66). A total of 202 (75%) of the responding passengers were contacted within 72 hours after exposure, the time period during which administration of measles vaccine would have provided protection for susceptible individuals. The time-to-contact was significantly longer for passengers who did not stay in hotels than for hotel guests. Customs forms proved to be of limited utility in contacting international travelers. This experience highlights the need for more complete and timely methods of contacting passengers potentially exposed to infectious agents aboard flights.

Adolescent↗