@article{bloch_rhea_2023, title={Assessing the impact of the early COVID-19 era on antibiotic resistant threats in inpatient settings: A mixed-Poisson regression approach}, volume={51}, ISSN={0196-6553}, url={http://dx.doi.org/10.1016/j.ajic.2023.04.159}, DOI={10.1016/j.ajic.2023.04.159}, abstractNote={During the COVID-19 pandemic, increased antibiotic prescribing and infection prevention challenges coincided with antibiotic-resistant (AR) infection increases. Clostridioides difficile (C difficile) and methicillin-resistant Staphylococcus aureus (MRSA) are serious, costly AR threats. Health inequities in pandemic-era AR infections are not well-characterized.North Carolina statewide inpatient admissions were used to determine monthly admission rates and admission rate ratios (RRs) for C difficile and MRSA infections comparing 2017-2019 (prepandemic) to 2020 (pandemic exposure) using mixed-model Poisson regression adjusted for age, sex, comorbidities, and COVID-19. We assessed effect measure modification by admissions... community-level income, county rurality, and race and ethnicity. Mean total costs by infection type were compared.With pandemic exposure, C difficile (adjusted RR.ß=.ß0.90 [95% confidence interval [CI] 0.86, 0.94]) and MRSA pneumonia (adjusted RR.ß=.ß0.97 [95% CI 0.91, 1.05]) decreased, while MRSA septicemia (adjusted RR.ß=.ß1.13 [95% CI 1.07, 1.19]) increased. Effect measure modification was not detected. C difficile or MRSA coinfection nearly doubled mean costs among COVID-19 admissions.Despite decreases in C difficile and most MRSA infections, the early COVID-19 pandemic period saw continued increases in MRSA septicemia admissions in North Carolina. Equitable interventions to curb increases and reduce health care costs should be developed.}, number={10}, journal={American Journal of Infection Control}, publisher={Elsevier BV}, author={Bloch, Rebecca and Rhea, Sarah}, year={2023}, month={Apr}, pages={1089–1094} }
 @article{bloch_faulkner_hilborn_wismer_martin_rhea_2023, title={Geographic Variability, Seasonality, and Increase in ASPCA Animal Poison Control Center Harmful Blue-Green Algae Calls-United States and Canada, 2010-2022}, volume={15}, ISSN={["2072-6651"]}, url={http://dx.doi.org/10.3390/toxins15080505}, DOI={10.3390/toxins15080505}, abstractNote={Harmful cyanobacteria (blue-green algae) exposures can cause illness or death in humans and animals. We characterized American Society for the Prevention of Cruelty to Animals (ASPCA) Animal Poison Control Center (APCC) harmful blue-green algae (HBGA) call data, compared it to a measure of harmful algal bloom public awareness, and considered its suitability as a public health information source. ASPCA APCC dog and cat “HBGA exposure” calls made 1 January 2010–31 December 2022 were included. We calculated annual HBGA call percentages and described calls (species, month, origin, exposure route). We characterized public awareness by quantifying Nexis Uni® (LexisNexis Academic; New York, NY, USA)-indexed news publications (2010–2022) pertaining to “harmful algal bloom(s)”. Call percentage increased annually, from 0.005% (2010) to 0.070% (2022). Of 999 HBGA calls, 99.4% (n = 993) were dog exposures. Over 65% (n = 655) of calls were made July–September, largely from the New England (n = 154 (15.4%)) and Pacific (n = 129 (12.9.%)) geographic divisions. Oral and dermal exposures predominated (n = 956 (95.7%)). Harmful algal bloom news publications increased overall, peaking in 2019 (n = 1834). Higher call volumes in summer and in the New England and Pacific geographic divisions drove HBGA call increases; public awareness might have contributed. Dogs and humans have similar exposure routes. ASPCA APCC HBGA call data could serve as a public health information source.}, number={8}, journal={TOXINS}, publisher={MDPI AG}, author={Bloch, Rebecca A. and Faulkner, Grace and Hilborn, Elizabeth D. and Wismer, Tina and Martin, Nicole and Rhea, Sarah}, year={2023}, month={Aug} }