Last data update: May 20, 2024. (Total: 46824 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Kemble SK[original query] |
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Investigation of SARS-CoV-2 Transmission Associated With a Large Indoor Convention - New York City, November-December 2021.
Sami S , Horter L , Valencia D , Thomas I , Pomeroy M , Walker B , Smith-Jeffcoat SE , Tate JE , Kirking HL , Kyaw NTT , Burns R , Blaney K , Dorabawila V , Hoen R , Zirnhelt Z , Schardin C , Uehara A , Retchless AC , Brown VR , Gebru Y , Powell C , Bart SM , Vostok J , Lund H , Kaess J , Gumke M , Propper R , Thomas D , Ojo M , Green A , Wieck M , Wilson E , Hollingshead RJ , Nunez SV , Saady DM , Porse CC , Gardner K , Drociuk D , Scott J , Perez T , Collins J , Shaffner J , Pray I , Rust LT , Brady S , Kerins JL , Teran RA , Hughes V , Sepcic V , Low EW , Kemble SK , Berkley A , Cleavinger K , Safi H , Webb LM , Hutton S , Dewart C , Dickerson K , Hawkins E , Zafar J , Krueger A , Bushman D , Ethridge B , Hansen K , Tant J , Reed C , Boutwell C , Hanson J , Gillespie M , Donahue M , Lane P , Serrano R , Hernandez L , Dethloff MA , Lynfield R , Como-Sabetti K , Lutterloh E , Ackelsberg J , Ricaldi JN . MMWR Morb Mortal Wkly Rep 2022 71 (7) 243-248 During November 19-21, 2021, an indoor convention (event) in New York City (NYC), was attended by approximately 53,000 persons from 52 U.S. jurisdictions and 30 foreign countries. In-person registration for the event began on November 18, 2021. The venue was equipped with high efficiency particulate air (HEPA) filtration, and attendees were required to wear a mask indoors and have documented receipt of at least 1 dose of a COVID-19 vaccine.* On December 2, 2021, the Minnesota Department of Health reported the first case of community-acquired COVID-19 in the United States caused by the SARS-CoV-2 B.1.1.529 (Omicron) variant in a person who had attended the event (1). CDC collaborated with state and local health departments to assess event-associated COVID-19 cases and potential exposures among U.S.-based attendees using data from COVID-19 surveillance systems and an anonymous online attendee survey. Among 34,541 attendees with available contact information, surveillance data identified test results for 4,560, including 119 (2.6%) persons from 16 jurisdictions with positive SARS-CoV-2 test results. Most (4,041 [95.2%]), survey respondents reported always wearing a mask while indoors at the event. Compared with test-negative respondents, test-positive respondents were more likely to report attending bars, karaoke, or nightclubs, and eating or drinking indoors near others for at least 15 minutes. Among 4,560 attendees who received testing, evidence of widespread transmission during the event was not identified. Genomic sequencing of 20 specimens identified the SARS-CoV-2 B.1.617.2 (Delta) variant (AY.25 and AY.103 sublineages) in 15 (75%) cases, and the Omicron variant (BA.1 sublineage) in five (25%) cases. These findings reinforce the importance of implementing multiple, simultaneous prevention measures, such as ensuring up-to-date vaccination, mask use, physical distancing, and improved ventilation in limiting SARS-CoV-2 transmission, during large, indoor events.(†). |
Positive correlation between Candida auris skin-colonization burden and environmental contamination at a ventilator-capable skilled nursing facility in Chicago
Sexton DJ , Bentz ML , Welsh RM , Derado G , Furin W , Rose LJ , Noble-Wang J , Pacilli M , McPherson TD , Black S , Kemble SK , Herzegh O , Ahmad A , Forsberg K , Jackson B , Litvintseva AP . Clin Infect Dis 2021 73 (7) 1142-1148 BACKGROUND: Candida auris is an emerging multidrug-resistant yeast that contaminates healthcare environments causing healthcare-associated outbreaks. The mechanisms facilitating contamination are not established. METHODS: C. auris was quantified in residents' bilateral axillary/inguinal composite skin swabs and environmental samples during a point-prevalence survey at a ventilator-capable skilled-nursing facility (vSNF A) with documented high colonization prevalence. Environmental samples were collected from all doorknobs, windowsills and handrails of each bed in 12 rooms. C. auris concentrations were measured using culture and C. auris-specific qPCR. The relationship between C. auris concentrations in residents' swabs and associated environmental samples were evaluated using Kendall's tau-b (τb) correlation coefficient. RESULTS: C. auris was detected in 70 /100 tested environmental samples and 31/ 57 tested resident skin swabs. The mean C. auris concentration in skin swabs was 1.22 x 10 5 cells/mL by culture and 1.08 x 10 6 cells/mL by qPCR. C. auris was detected on all handrails of beds occupied by colonized residents, as well as 10/24 doorknobs and 9/12 windowsills. A positive correlation was identified between the concentrations of C. auris in skin swabs and associated handrail samples based on culture (τb = 0.54, p = 0.0004) and qPCR (τb = 0.66, p = 3.83e -6). Two uncolonized residents resided in beds contaminated with C. auris. CONCLUSIONS: Colonized residents can have high C. auris burdens on their skin, which was positively related with contamination of their surrounding healthcare environment. These findings underscore the importance of hand hygiene, transmission-based precautions, and particularly environmental disinfection in preventing spread in healthcare facilities. |
Community Transmission of SARS-CoV-2 at Three Fitness Facilities - Hawaii, June-July 2020.
Groves LM , Usagawa L , Elm J , Low E , Manuzak A , Quint J , Center KE , Buff AM , Kemble SK . MMWR Morb Mortal Wkly Rep 2021 70 (9) 316-320 On July 2, 2020, the Hawaii Department of Health was notified that a fitness instructor (instructor A) had experienced signs and symptoms compatible with coronavirus disease 2019 (COVID-19)* and received a positive reverse transcription–polymerase chain reaction (RT-PCR) test result for SARS-CoV-2, the virus that causes COVID-19. At the time, Honolulu County reported community transmission of a 7-day average of 2–3 cases per 100,000 persons per day (1). Before the onset of symptoms, instructor A taught classes at two fitness facilities in Honolulu, facilities X and Y. Twenty-one COVID-19 cases were linked to instructor A, including a case in another fitness instructor (instructor B). The aggregate attack rates in classes taught by both instructors <1 day, 1 to <2 days, and ≥2 days before symptom onset were 95% (20 of 21), 13% (one of eight), and 0% (zero of 33), respectively. Among the 21 secondary cases, 20 (95%) persons had symptomatic illness, two (10%) of whom were hospitalized. At the time of this outbreak, use of masks was not required in fitness facilities. To reduce SARS-CoV-2 transmission in fitness facilities, staff members and patrons should wear a mask (including during high-intensity exercise), and facilities should implement engineering and administrative controls including 1) improving ventilation; 2) enforcing consistent and correct mask use and physical distancing (maintaining ≥6 ft of distance between all persons, limiting physical contact and class size, and preventing crowded spaces); 3) reminding all patrons and staff members to stay home when ill; and 4) increasing opportunities for hand hygiene. Conducting exercise activities entirely outdoors or virtually could further reduce SARS-CoV-2 transmission risk. |
Regional emergence of Candida auris in Chicago and lessons learned from intensive follow-up at one ventilator-capable skilled nursing facility
Pacilli M , Kerins JL , Clegg WJ , Walblay KA , Adil H , Kemble SK , Xydis S , McPherson TD , Lin MY , Hayden MK , Froilan MC , Soda E , Tang AS , Valley A , Forsberg K , Gable P , Moulton-Meissner H , Sexton DJ , Jacobs Slifka KM , Vallabhaneni S , Walters MS , Black SR . Clin Infect Dis 2020 71 (11) e718-e725 BACKGROUND: Since the identification of the first two Candida auris cases in Chicago, Illinois, in 2016, ongoing spread has been documented in the Chicago area. We describe C. auris emergence in high-acuity long-term healthcare facilities and present a case-study of public health response to C. auris and carbapenemase-producing organisms (CPOs) at one ventilator-capable skilled nursing facility (vSNF A). METHODS: We performed point prevalence surveys (PPSs) to identify patients colonized with C. auris, infection control (IC) assessments, and provided ongoing support for IC improvements in Illinois acute and long-term care facilities during August 2016-December 2018. During 2018, we initiated a focused effort at vSNF A, and conducted seven C. auris PPSs; during four PPSs, we also performed CPO screening and environmental sampling. RESULTS: During August 2016-December 2018 in Illinois, 490 individuals were found to be colonized or infected with C. auris. PPSs identified highest prevalence of C. auris colonization in vSNF settings (prevalence 23-71%). IC assessments in multiple vSNFs identified common challenges in core IC practices. Repeat PPSs at vSNF A in 2018 identified increasing C. auris prevalence from 43% to 71%. Most residents screened during multiple PPSs remained persistently colonized with C. auris. Among 191 environmental samples collected, 39% were positive for C. auris, including samples from bedrails, windowsills, and shared patient-care items. CONCLUSIONS: High burden in vSNFs along with persistent colonization of residents and environmental contamination point to the need for prioritizing IC interventions to control spread of C. auris and CPOs. |
Notes from the Field: Large cluster of Verona integron-encoded metallo-beta-lactamase-producing carbapenem-resistant Pseudomonas aeruginosa isolates colonizing residents at a skilled nursing facility - Chicago, Illinois, November 2016-March 2018
Clegg WJ , Pacilli M , Kemble SK , Kerins JL , Hassaballa A , Kallen AJ , Walters MS , Halpin AL , Stanton RA , Boyd S , Gable P , Daniels J , Lin MY , Hayden MK , Lolans K , Burdsall DP , Lavin MA , Black SR . MMWR Morb Mortal Wkly Rep 2018 67 (40) 1130-1131 On November 1, 2016, a point prevalence survey conducted at a Chicago skilled nursing facility with ventilated residents (vSNF A) to understand the prevalence of carbapenemase-producing organisms in health care facilities in the Chicago region identified 20 patients with Verona integron-encoded metallo-beta-lactamase–producing carbapenem-resistant Pseudomonas aeruginosa (VIM-CRPA) colonization. To determine the extent of VIM-CRPA colonization at vSNF A and provide infection control recommendations, the Chicago Department of Public Health conducted an investigation. | | The first VIM-CRPA outbreak reported in the United States occurred in a Chicago acute care hospital in 2003 (1). Other outbreaks have been described; however, none was associated with a single skilled nursing facility (2–5). Carbapenemase-producing CRPA are uncommon in the United States; a surveillance pilot for CRPA at five U.S. sites identified only two carbapenemase-producing CRPA among 129 isolates tested (CDC, unpublished data, 2017). |
Notes from the field: Ongoing transmission of Candida auris in health care facilities - United States, June 2016-May 2017
Tsay S , Welsh RM , Adams EH , Chow NA , Gade L , Berkow EL , Poirot E , Lutterloh E , Quinn M , Chaturvedi S , Kerins J , Black SR , Kemble SK , Barrett PM , Barton K , Shannon DJ , Bradley K , Lockhart SR , Litvintseva AP , Moulton-Meissner H , Shugart A , Kallen A , Vallabhaneni S , Chiller TM , Jackson BR . MMWR Morb Mortal Wkly Rep 2017 66 (19) 514-515 In June 2016, CDC released a clinical alert about the emerging, and often multidrug-resistant, fungus Candida auris and later reported the first seven U.S. cases of infection through August 2016 (1). Six of these cases occurred before the clinical alert and were retrospectively identified. As of May 12, 2017, a total of 77 U.S. clinical cases of C. auris had been reported to CDC from seven states: New York (53 cases), New Jersey (16), Illinois (four), Indiana (one), Maryland (one), Massachusetts (one), and Oklahoma (one) (Figure). All of these cases were identified through cultures taken as part of routine patient care (clinical cases). Screening of close contacts of these patients, primarily of patients on the same ward in health care facilities, identified an additional 45 patients with C. auris isolated from one or more body sites (screening cases), resulting in a total of 122 patients from whom C. auris has been isolated. |
Investigation of the first seven reported cases of Candida auris, a globally emerging invasive, multidrug-resistant fungus - United States, May 2013-August 2016
Vallabhaneni S , Kallen A , Tsay S , Chow N , Welsh R , Kerins J , Kemble SK , Pacilli M , Black SR , Landon E , Ridgway J , Palmore TN , Zelzany A , Adams EH , Quinn M , Chaturvedi S , Greenko J , Fernandez R , Southwick K , Furuya EY , Calfee DP , Hamula C , Patel G , Barrett P , Lafaro P , Berkow EL , Moulton-Meissner H , Noble-Wang J , Fagan RP , Jackson BR , Lockhart SR , Litvintseva AP , Chiller TM . MMWR Morb Mortal Wkly Rep 2016 65 (44) 1234-1237 Candida auris, an emerging fungus that can cause invasive infections, is associated with high mortality and is often resistant to multiple antifungal drugs. C. auris was first described in 2009 after being isolated from external ear canal discharge of a patient in Japan. Since then, reports of C. auris infections, including bloodstream infections, have been published from several countries, including Colombia, India, Israel, Kenya, Kuwait, Pakistan, South Africa, South Korea, Venezuela, and the United Kingdom. To determine whether C. auris is present in the United States and to prepare for the possibility of transmission, CDC issued a clinical alert in June 2016 informing clinicians, laboratorians, infection control practitioners, and public health authorities about C. auris and requesting that C. auris cases be reported to state and local health departments and CDC. This report describes the first seven U.S. cases of C. auris infection reported to CDC as of August 31, 2016. Data from these cases suggest that transmission of C. auris might have occurred in U.S. health care facilities and demonstrate the need for attention to infection control measures to control the spread of this pathogen. |
Foodborne outbreak of group a streptococcus pharyngitis associated with a high school dance team banquet--Minnesota, 2012
Kemble SK , Westbrook A , Lynfield R , Bogard A , Koktavy N , Gall K , Lappi V , Devries AS , Kaplan E , Smith KE . Clin Infect Dis 2013 57 (5) 648-54 BACKGROUND: On 20 March 2012, the Minnesota Department of Health (MDH) was notified of multiple Facebook postings suggestive of a foodborne outbreak of Group A Streptococcus (GAS) pharyngitis occurring among attendees of a high school dance team banquet. An investigation was initiated. METHODS: Associations between GAS pharyngitis and specific food items were assessed among banquet attendees. Pharyngeal swabs were performed on attendees, household contacts, and food workers. Patient GAS isolates from clinical laboratories were also obtained. Pharyngeal and food specimens were cultured for GAS by the MDH Public Health Laboratory. Isolates were further characterized by pulsed-field gel electrophoresis (PFGE) and emm typing. RESULTS: Among 63 persons who consumed banquet food, 18 primary illnesses occurred, yielding an attack rate of 29%. Although no food or beverage items were significantly associated with illness, pasta consumption yielded the highest relative risk (risk ratio, 3.56; 95% confidence interval, .25-50.6). GAS colonies with indistinguishable PFGE patterns corresponding to emm subtype 1.0 were isolated from 5 patients and from leftover pasta. The pasta was prepared at home by a dance team member parent; both parent and child reported GAS pharyngitis episodes 3 weeks before the banquet. CONCLUSIONS: In this foodborne outbreak of GAS pharyngitis, pasta was implicated as the vehicle. Recognition of foodborne GAS illness is challenging because transmission is typically assumed to occur by respiratory spread; foodborne transmission should be considered when clusters of GAS pharyngitis patients are encountered. DNA-based typing can reveal potentially epidemiologically related isolates during GAS disease outbreaks and facilitate understanding and control of GAS disease. |
Fatal Naegleria fowleri infection acquired in Minnesota: possible expanded range of a deadly thermophilic organism
Kemble SK , Lynfield R , Devries AS , Drehner DM , Pomputius WF 3rd , Beach MJ , Visvesvara GS , da Silva AJ , Hill VR , Yoder JS , Xiao L , Smith KE , Danila R . Clin Infect Dis 2012 54 (6) 805-9 BACKGROUND: Primary amebic meningoencephalitis (PAM), caused by the free-living ameba Naegleria fowleri, has historically been associated with warm freshwater exposures at lower latitudes of the United States. In August 2010, a Minnesota resident, aged 7 years, died of rapidly progressive meningoencephalitis after local freshwater exposures, with no history of travel outside the state. PAM was suspected on the basis of amebae observed in cerebrospinal fluid. METHODS: Water and sediment samples were collected at locations where the patient swam during the 2 weeks preceding illness onset. Patient and environmental samples were tested for N. fowleri with use of culture and real-time polymerase chain reaction (PCR); isolates were genotyped. Historic local ambient temperature data were obtained. RESULTS: N. fowleri isolated from a specimen of the patient's brain and from water and sediment samples was confirmed using PCR as N. fowleri genotype 3. Surface water temperatures at the times of collection of the positive environmental samples ranged from 22.1 degrees C to 24.5 degrees C. August 2010 average air temperature near the exposure site was 25 degrees C, 3.6 degrees C above normal and the third warmest for August in the Minneapolis area since 1891. CONCLUSIONS: This first reported case of PAM acquired in Minnesota occurred 550 miles north of the previously reported northernmost case in the Americas. Clinicians should be aware that N. fowleri-associated PAM can occur in areas at much higher latitude than previously described. Local weather patterns and long-term climate change could impact the frequency of PAM. |
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