bluuebunny/crossref_metadata_2025_split huggingface dataset:
1404. Remotely Piloted Aircraft & Quadcopters used in Combating Malaria/Dengue in desert terrain
Authors: Srikanth V S 
Published: November 2023

Abstract

Background
Malaria is a major vector borne disease across the world. The major problem we are facing is difficulty in elimination of source. WHO World Malaria Day theme is “Harness innovation to reduce the malaria disease burden and save lives” which is the only way to eradicate malaria by using modern technologies. We used remotely piloted aircraft and quadcopters for effective malaria surveillances and also created a task force DMSEU (Drone Malaria Surveillance and eradication unit). This is first of its kind study where multimode surveillances was done using different types of UAV.

Methods
This is an observation study during malaria outbreak during Oct 2022 – Dec 2022. DMSEU was formed. Mosquito breeding locations were identified based on map marking of the areas from where clusters of malaria cases were reported. Then satellite images of locations were evaluated for gross land scape assessment. Based on this assessment RPAs were used for identification of breeding sites with the help of the the imagery systems like FLIR and Day CAM. In our unit Quad copters were used for assessment of breeding sites.

Results
Ramgarh was identified as an area of source of malarial outbreak based on cluster mapping. When the satellite images of Ramgarh was analysed, it showed a dense vegetation developed near TV tower area during rains. RPA was flown over that area to find out exact breeding sites using the coordinates. We also noticed that there were many drip irrigation fields. When RPA were flown over the area, it was identified that each field had an open water storage tank for drip irrigation. Using Quad copter, we did further assessment at each roof tops for potential breeding sites like open overhead tank, water stagnation
RPA - Surveillance of malaria breeding site
Quardcopter Malaria Breeding site surveillance

Conclusion
The malaria menace can be brought to an end only by using newer technologies and multi-sector collaboration working hand in hand. Using different types of UAV like RPA and Quadcopter was very effective in source identification and eradication. To improve the scope of area coverage and efficiency of mosquito breeding sites eradication, new drone should be built with upgraded capability of spraying and fogging capacities. Using quadcopters and drone played a major role in eliminating them and curtailing the cases drastically in a very short span of time in effective way and also saved manpower and time.

Disclosures
All Authors: No reported disclosures
1406. A Systematic Quality Improvement Initiative to Improve Chagas Disease Screening in Patients with HIV at a Large Safety Net Clinic in Denver
Authors: Barahona Lilian Vargas , Henao Martínez Andrés F , McLees Margaret P , Gardner Edward , Hawkins Kellie 
Published: November 2023

Abstract

Background
Chagas Disease (CD) is a neglected parasitic disease that affects people living in continental Latin America. Immigrants from these countries or those born to mothers from Latin America are at risk of developing disease. Detection of cases before end-organ damage has occurred is crucial for treatment to be beneficial. Patients with HIV (PWH) may be at high risk of reactivation and death. We sought to screen PWH at risk of CD that receive medical care in the safety net hospital for the Denver area.

Methods
We identified 325 PWH that receive care in the Denver Health system who self-identified as born in Latin American countries. We ordered serological Trypanosoma cruzi testing for all patients (T cruzi IgG, ELISA, ARUP Laboratories, UT). Providers were educated about the intervention and CD via email (Figure 1). Concurrently, the Denver Health refugee clinic began a process to screen for CD among people at risk who do not have HIV.Figure 1.Chagas disease screening process in patients with HIV in Denver Health, March 2022 - March 2023

Results
Between March 2021 and March 2022, a total of 265 patients completed testing (81.5%). 89.8% were male and the mean age was 45.4 years (SD +/- 11.5). Most patients had controlled HIV (mean CD4 624 +/- 303.5 cells/µL, HIV viral load &lt; 30 cps/mL in 92%). Most patients were born in Mexico (80%), followed by El Salvador (5%). Three patients had a positive test, yielding a prevalence of 1.1%. One of these patients had an already confirmed and treated infection. The other 2 patients had uncontrolled HIV with CD4 count &lt; 200 cells and have been lost to follow-up with inability to obtain confirmatory testing. Using a 2.2% prevalence of serologic positivity for CD in Hispanic patients, 90 patients at risk will need to be screened in order to detect a positive patient. Due to increased awareness of CD in our primary care clinics, a parallel 3-fold increase in testing in non-HIV patients was seen in the study period.

Conclusion
Chagas disease screening in patients at risk can be performed in clinics that provide care for patients with HIV. Obtaining a second confirmatory test is challenging and processes to facilitate blood collection should be implemented to not delay testing. Increased awareness of medical providers leads to increased screening for this disease.

Disclosures
Edward Gardner, MD, Cepheid: Grant/Research Support|Gilead Sciences: Grant/Research Support|ViiV Healthcare: Grant/Research Support
1407. Migration Timing and its Association with Disease Features in a Chagas Disease Cohort in New England
Authors: Wheelock Alyse , Reifler Katherine , Hamer Davidson H , Hochberg Natasha , Gopal Deepa , Bourque Daniel 
Published: November 2023

Abstract

Background
Chagas disease is under-recognized in the United States (US) and little is known about how time spent living in endemic versus non-endemic settings affects features of the disease.

Methods
We performed a cross-sectional, retrospective analysis of 108 individuals with Chagas disease. Presence of cardiac disease was defined according to the American Heart Association classification of Chagas cardiomyopathy. We performed a multivariate logistic regression adjusting for country of birth (COB, analyzed as El Salvador vs. other) and age at confirmatory diagnosis to evaluate whether proportion of lifetime in COB was associated with cardiac disease. We also performed an exploratory analysis of semi-quantitative Trypanosoma cruzi ELISA optical density (OD) values to assess for association with proportion of lifetime in COB, including the same covariates in a multivariate linear regression.

Results
This patient cohort was predominantly from El Salvador (92/108, 85%) and other countries in Central America (11/108, 10%), with a median age at diagnosis of 44 years (interquartile range [IQR] 18). Most individuals originated from rural areas (84/90, 93%) and immigrated to the US in adulthood (median 26 years, IQR 13) after having lived a median of 70% (IQR 25) of their life in their COB. Age at migration and age at confirmatory diagnosis were highly correlated (Pearson’s correlation coefficient [CC]= 0.69, p&lt; 0.001). Confirmatory diagnosis occurred a median of 13 years (IQR 14) after arrival in the US. Cardiac disease was present in 47/108 (44%). Adjusting for age at diagnosis and COB, the proportion of lifetime in COB was not significantly associated with cardiac disease (odds ratio 5.6, [95% CI 0.355 - 87.1], p=0.22), nor was it associated with higher OD values (CC = –0.2, 95% CI –1.2-0.9, p=0.74).
Cohort demographics and time to Chagas disease diagnosis after arrival in the U.S.
Features of migration history and Chagas cardiac disease status

Conclusion
In this cohort of individuals with Chagas disease, there was a substantial delay in diagnosis after arrival to the US, which may have been longer if not for local screening efforts. Cardiac disease was prevalent but not associated with higher proportion of time spent in COB. Exploratory analysis of serology titers was not associated with proportion of lifetime spent in COB, contrary to our expectation.

Disclosures
Davidson H. Hamer, MD, Kephera Diagnostics: Grant/Research Support|Takeda: Advisor/Consultant|Takeda: Grant/Research Support|Trinity Biotech, LLC: Advisor/Consultant|Valneva: Advisor/Consultant|Valneva: Grant/Research Support Natasha Hochberg, MD, MPH, Novartis Institute for Biomedical Research: Full-time employment|Novartis Institute for Biomedical Research: Stocks/Bonds Daniel Bourque, MD, Kephera Diagnostics: Grant/Research Support
1414. Residual Surface Disinfectant Reduces Finger Transfer of Antibiotic Resistant Bacteria and Viruses from Surfaces for 24 hours after Treatment
Authors: Gerba Charles P 
Published: November 2023

Abstract

Background
It is believed that as much as 80% of common infections are spread by the hands. Touching surfaces (fomites) contaminated with infectious microorganisms results in their transfer to the hands (fingers). Subsequent touching of the mouth, nose, or skin can result in their transmission. Disinfection of surfaces has been found to reduce such transmission. Unfortunately, highly touched surfaces (door knobs, escalator hand rails, buttons, etc.) can quickly become re-contaminated. Disinfectants which leave a residual can act as an additional barrier in between regular disinfection of surfaces, reducing the risk of transmission.
The goal of this study was to assess the reduction in the transfer of bacteria and viruses from surfaces treated with a quaternary ammonium based disinfectant (Actizone F5® spray) that leaves a residual disinfectant capability for more than 24 hours.

Methods
Stainless steel and plastic coupons were treated with Actizone F5® spray and allowed to dry for 24 hours. The test microorganisms were then added to the surfaces and after 2, 5 or 10 minutes, the surface was touched with a finger. The number of microorganisms transferred to the finger was then quantified. The experiment was repeated with untreated coupons as a control.

Results
The degree of finger transfer was reduced by more than 99.99% by the treated coupons for Salmonella Typhimurium, MRSA, Acinetobacter baumannii, and Escherichia coli. Candida auris was reduced by &gt; 99.99% on the stainless steel and ∼99.6% for the plastic coupons. Pseudomonas aeruginosa and antibiotic-resistant Klebsiella pneumoniae (CRE) were reduced by ∼98%. The transfer of human coronavirus 229E was reduced by 98.7% from the stainless steel surfaces.

Conclusion
Transfer of all the test microorganisms was reduced by the treated surfaces even after 24 hours, demonstrating residual activity. The transfer for some of the microorganisms was less from the ABS plastic than from the stainless steel surfaces. This may have been due to the attachment or spreading of the product on this type of surface, resulting in a less even coating. A longer contact time may result in significant reduction of these microorganisms. The relative humidity and short exposure time to the treated surfaces used in this study should probably be considered a worst case scenario.

Disclosures
Charles P. Gerba, PhD, □ Corning: Advisor/Consultant| □ Reckitt: Advisor/Consultant| □ Reckitt: Grant/Research Support| □ Savory: Grant/Research Support
1415. Effect of Self-Sanitizing Copper Impregnated Surfaces on Healthcare-Associated Infection Rates
Authors: Chatterjee Piyali , Williams Marjory , Choi Hosoon , Coppin John David , Bennett Morgan , Navarathna Thanuri , Corona Brandon , Bridges Angelia , Hwang Munok , Nelson Richard , Keene Robin , Jinadatha Chetan 
Published: November 2023

Abstract

Background
Healthcare-associated infections (HAI) are a major cause of morbidity and mortality in the United States. Prevention of HAIs is a multipronged approach that involves hand hygiene, antibiotic stewardship, and environmental sanitation. The efficacy of polymer-based self-sanitizing copper oxide-impregnated solid surface on Clostridioides difficile (C. diff) spores in a laboratory setting showed 1-2 log reduction. Here we assessed the efficacy of the same surface for preventing HAIs over a 7-year period in a hospital setting.

Methods
The copper surfaces installation in the hospital began in late 2016 and peaked in January 2018. HAIs that met 2017 National Healthcare Surveillance Network definitions were recorded for all infections between 2014 and 2022. A Bayesian multivariate multilevel negative binomial model was fit to assess the mean HAI rate over time for blood, urine, site specific, pneumonia, and C. diff infections, and the effect of copper on those trends while adjusting for autocorrelation, seasonality, average length of stay, and the COVID-19 pandemic. We report the median incidence rate ratio (IRR) and 95% uncertainty interval (UI), as defined by the highest density posterior interval, for the intervention.
Copper Surface Installation
The figure demonstrates the various components of the copper surfaces that were installed in the hospital and the timelines for installation.

Results
During the copper intervention there was 0.36 (0.04 – 0.94) times the incidence for blood, 0.44 (0.06 – 1.26) for pneumonias, 0.61 (0.10 – 1.61) for urine, 0.70 (0.02 – 2.89) for site specific, and 0.85 (0.31 – 1.72) for C. diff infections, indicating reduced HAIs during the intervention. Although only the effect for blood infections had a 95% UI excluding an IRR=1, the posterior probability for the model estimates indicates that conditional on this model and data, the chance that the IRR&lt; 1 (indicating reduced HAIs) was 96% for blood, 90% for pneumonia, 80% for urine, 66% for site specific, and 66% for C diff infections.
HAI Rates by time
Incident Rate Ratios for HAI and Effect of Copper

Conclusion
The overall effect of introducing copper bed rails appears to be beneficial with respect to lowering HAIs. The trends were stronger for certain infections such as blood infections and for pneumonias but weaker for C. diff infections. Due to this study being a real-world intervention that also overlapped with the COVID-19 pandemic certain beneficial factors may have been overshadowed by the unknowns that the pandemic bought.

Disclosures
All Authors: No reported disclosures
1422. Surveillance for fungi in hospital environments housing high-risk hosts using culture and culture-independent methods
Authors: Clancy Cornelius J , Cheng Shaoji , Hao Binghua , Driscoll Eileen , Fleres Giuseppe , Buser Katherine , Sundermann Alexander , Ayres Ashley , Snyder Graham M , Hong Nguyen M 
Published: November 2023

Abstract

Background
Nosocomial outbreaks of fungal infections are increasingly reported. There are scant data on fungal burdens in hospital environments. Standardized surveillance methods are lacking.

Methods
We developed culture and culture-independent (real-time PCR, reference to standard curve) methods for measuring airborne fungal burdens using SAS Super 100 and SASS 3100 Dry Air samplers. We performed serial surveillance in 7 units with high-risk, immunosuppressed patients in 2 hospitals and outside.

Results
Methods were optimized for multiple variables, including volume, duration, flow of air sampling; culturing techniques (direct impact plates, cultures at different stages of filter processing); filter DNA recovery (extraction protocols, stage of filter processing); PCR (targets, primers, PCR parameters). To date, we have surveyed each unit ≥4 times. Pathogenic moulds were cultured in &gt;50% of outdoor and indoor air, including azole-resistant Aspergillus species [Figures 1A-B]. Fungal burdens were significantly greater outside than inside hospitals, by both positive culture % and DNA burden [Figure 2]. There was no correlation between outside and inside genome equivalents (GEs; R2&lt; 0.06), nor were there significant differences in GEs within a given unit (nurses stations, patient rooms; all p &gt;0.1). GEs were greater in culture-positive than culture-negative samples (Aspergillus, 2.4 vs. 1.5 log10; pan-fungal, 2.8 vs. 1.5 log10GE; p&lt; 0.0001; best results with sonicated filters). Direct impact cultures were less sensitive than filter cultures.

Conclusion
We developed standardized methods for sampling airborne fungi in hospitals that yield reproducible results. Fungal burdens were significantly lower in hospitals than those immediately outside, but fungal DNA and viable Aspergillus and other moulds were commonly recovered from units housing high-risk patients. Outside fungal burdens could not be used to estimate relative burdens within hospitals. Direct impact cultures, commonly used in surveillance, lacked sensitivity for detecting viable fungi and did not correlate with DNA burdens. We are optimizing direct metagenomic sequencing from airborne samples. We will assess correlations between environmental surveillance data and nosocomial fungal infections.

Disclosures
Alexander Sundermann, DrPH, CIC, FAPIC, OpGen: Honoraria Graham M. Snyder, MD, SM, Infectious Diseases Connect: Advisor/Consultant
1999. Assessment of Communication Strategies 1 to 2 Years After Completion of a Vaccine Hesitancy Communication Training Program During Residency
Authors: Barton Shanna M , Calhoun Aaron W , Feygin Yana , Marshall Gary S 
Published: November 2023

Abstract

Background
We previously showed (J Pediatr 2022;241:203; Open Forum Infect Dis 2022;9(2):ofac492.626) that residents trained in a structured communication strategy called AIMS (Announce, Inquire, Mirror, Secure) demonstrated specific behaviors of interest during live and virtual encounters with standardized patients (SPs) portraying vaccine-hesitant parents. The current study was conducted to determine if those behaviors were prioritized long after completion of training.

Methods
In the original studies, blinded Pediatrics and Medicine-Pediatrics residents were randomized to AIMS training (AIMS Group) or standard of care training (Control Group; Figure 1); blinding was maintained after training and until the time of the current study. Subjects were invited to complete an online survey wherein 10 possible communication behaviors were ranked from highest priority to lowest priority (Figure 2). Respondents were considered to have prioritized AIMS behaviors if they ranked each of the 3 AIMS items in the top 5; the ability of this measure to detect prioritization of AIMS behaviors was assessed by surveying unblinded residents who underwent AIMS training in the prior 2 weeks (Validation Group). Differences between groups were assessed using Chi-square tests for proportions. We hypothesized that a higher proportion of subjects in the AIMS Group would prioritize AIMS behaviors compared to subjects in the Control Group.Figure 1:Curriculum Flow DiagramFigure 2:Rank Task

Results
Characteristics of study participants are shown in Figure 3. Seventy-seven percent of the 31 residents in the Validation Group met criteria for prioritization of AIMS behaviors, compared with only 38% of the 32 subjects in the Control Group (p-value = 0.003). However, only 19% of the 32 residents in the AIMS Group met criteria for prioritization of AIMS behaviors (p-value = 0.164, AIMS Group vs Control Group).

Conclusion
AIMS communication behaviors are ranked highly shortly after training, but this prioritization is not retained over time. Future studies of the utility of structured vaccine hesitancy communication strategies should incorporate repetition and spaced retrieval to enhance retention and ensure deployment in practice.

Disclosures
Shanna M. Barton, MD, M.Sc., Sanofi Pasteur: Grant/Research Support Gary S. Marshall, MD, GSK: Advisor/Consultant|GSK: Grant/Research Support|GSK: Honoraria|Merck: Advisor/Consultant|Merck: Grant/Research Support|Merck: Honoraria|Moderna: Advisor/Consultant|Moderna: Grant/Research Support|Moderna: Honoraria|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Pfizer: Honoraria|Sanofi: Advisor/Consultant|Sanofi: Grant/Research Support|Sanofi: Honoraria|Seqirus: Advisor/Consultant|Seqirus: Grant/Research Support|Seqirus: Honoraria
1423. A Simple Electronic Medical Record-Based Predictors of Illness Severity in Sepsis (SEPSIS) Score
Authors: Cressman Alex , Wen Bijun , Saha Sudipta , Jun Hae Young , Waters Riley , Lail Sharan , Jabeen Aneela , Koppula Radha , Lapointe-Shaw Lauren , Sheehan Kathleen , Daneman Nick , Verma Amol , Razak Fahad , MacFadden Derek 
Published: November 2023

Abstract

Background
Current scores for predicting sepsis outcomes are limited by generalizability, complexity, and electronic medical record (EMR) integration. Here, we validate a simple EMR-based score for sepsis outcomes in a large multi-centre cohort.

Methods
A simple electronic medical record-based predictor of illness severity in sepsis (SEPSIS) score was developed (4 additive lab-based predictors: Creatinine, Bilirubin, Platelet Count, Lactate) using a retrospective cohort study of patients admitted to internal medicine services from April 2010 - March 2015, across four hospitals in Toronto, Canada. We identified patients with sepsis based upon receipt of antibiotics and positive (non-screening) cultures on admission. Chart review was conducted to extract components of qSOFA and NEWS2 scores. The primary outcome was in-hospital mortality and secondary outcomes were ICU admission at 72 hours, and hospital length of stay (LOS). We calculated the area under the receiver operating curve (AUROC) for the SEPSIS score, qSOFA, and NEWS2. We then evaluated the SEPSIS score in a contemporary cohort (2015 to 2019) of patients receiving systemic antibiotics.

Results
Our initial cohort included 1,890 patients with a median age of 72 years (IQR: 56-83). 9% of the cohort died during hospitalization, 13% were admitted to ICU at 72 hours, and mean LOS was 12.7 days (SD: 21.5). In the initial and the contemporary (2015-2019, 4811 patients) cohorts, the AUROCs of the SEPSIS score for predicting in-hospital mortality were 0.63 and 0.64 respectively, which were similar to NEWS2 (0.62 and 0.67) and qSOFA (0.62 and 0.68). AUROCs for predicting ICU admission at 72 hours, and length of stay &gt;14 days, were similar between scores, in the initial and contemporary cohorts. All scores were generally well calibrated for predicting mortality (Figure 1).Figure 1.Mortality risk by predictor score (low, medium, high) and score type.

Conclusion
The EMR-based SEPSIS score shows a similar ability to predict important clinical outcomes compared with other validated scores (qSOFA and NEWS2). Because of the SEPSIS score’s simplicity, it may prove a useful tool for clinical and research applications.

Disclosures
All Authors: No reported disclosures