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Author Brandon J Webb

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Antibiotic Exposure and Risk for Hospital-Associated Clostridioides difficile Infection.

Brandon J Webb, Aruna Subramanian, Bert Lopansri, Bruce Goodman, Peter Bjorn Jones, Jeffrey Ferraro, Edward Stenehjem, Samuel M Brown,

Clostridioides difficile infection (CDI) is a health care-associated infection associated with significant morbidity and cost, with highly varied risk across populations. More effective, risk-based prevention strategies are needed. Here, we investigate risk factors for hospital-associated CDI in a large integrated health system. In a retrospective cohort of all adult admissions ... Read more >>

Antimicrob. Agents Chemother. (Antimicrobial agents and chemotherapy)
[2020, 64(4):]

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Strategies for prediction of drug-resistant pathogens and empiric antibiotic selection in community-acquired pneumonia.

Ryan Gil, Brandon J Webb,

PURPOSE OF REVIEW:Although most patients with community-acquired pneumonia (CAP) are appropriately treated with narrow-spectrum antibiotics, predicting which patients require coverage of drug-resistant pathogens (DRP) remains a challenge. The 2019 American Thoracic Society/Infectious Diseases Society of America CAP guidelines endorse using locally validated prediction models for DRP. Here we review risk ... Read more >>

Curr Opin Pulm Med (Current opinion in pulmonary medicine)
[2020, 26(3):249-259]

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Are Clostridioides difficile infections being overdiagnosed in hematopoietic stem cell transplant recipients?

Clyde D Ford, Bert K Lopansri, Jana Coombs, Brandon J Webb, Julie Asch, Daanish Hoda,

BACKGROUND:Because both diarrhea due to other causes and gastrointestinal colonization with toxigenic Clostridioides difficile are common in HSCT, there is a possibility of false-positive diagnoses of C difficile infections (CDI). METHODS:We estimated the probability of a patient being colonized by toxigenic C difficile by testing non-diarrheal surveillance stools from 223 HSCT recipients ... Read more >>

Transpl Infect Dis (Transplant infectious disease : an official journal of the Transplantation Society)
[2020, :e13279]

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Disseminated toxoplasmosis and haemophagocytic lymphohistiocytosis following chimeric antigen receptor T-cell therapy.

Sarah Kator, Jessica Zurko, Brandon J Webb, Michael A Balatico, Frederic Clayton, Cheryl A Palmer, Kelly Konopa, Gabriela Motyckova, Clyde D Ford, Fabiana Ostronoff,

Br. J. Haematol. (British journal of haematology)
[2020, 189(1):e4-e6]

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Clostridioides difficile colonization and infection in patients admitted for a first autologous transplantation: Incidence, risk factors, and patient outcomes.

Clyde D Ford, Bert K Lopansri, Jana Coombs, Brandon J Webb, Andy Nguyen, Julie Asch, Daanish Hoda,

BACKGROUND:More data are needed regarding the incidence, risk factors, and outcomes for Clostridioides difficile infection (CDI) and colonization in patients undergoing an autologous hematopoietic stem cell transplantation (AHSCT). METHODS:We studied 472 consecutive patients admitted for a first AHSCT and conducted a prospective C difficile stool surveillance and ribotyping analysis in a ... Read more >>

Clin Transplant (Clinical transplantation)
[2019, 33(11):e13712]

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1739. Epidemiology of Invasive Fungal Infections in Allogenic Hematopoietic Stem Cell Transplant Recipients in Utah.

Jessica Zurko, Brandon J Webb,

AbstractBackgroundInvasive fungal infections are a leading cause of death in allo-HSCT (allogenic hematopoietic stem cell transplant) recipients. We describe the epidemiology of IFIs (invasive fungal infections) in allo-HSCT recipients at a single institution in Salt Lake City, Utah between 2006 and 2015.MethodsWe searched all encounters in the Intermountain Healthcare electronic ... Read more >>

Open Forum Infect Dis (Open forum infectious diseases)
[2019, 6(Suppl 2):S636-S637]

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889. Impact of an Infectious Disease Telehealth (IDt) Service on S. aureus Bacteremia (SAB) Outcomes in 15 Small Community Hospitals.

Alithea D Gabrellas, John J Veillette, Brandon J Webb, Edward A Stenehjem, Nancy A Grisel, Todd J Vento,

AbstractBackgroundInfectious diseases (ID) consultation improves SAB readmission rates, compliance with care bundles and mortality. Small community hospitals (SCHs) (which comprise 70% of US hospitals) often lack access to on-site ID physicians. IDt is one way to overcome this barrier, but it is unknown if IDt provides similar clinical benefits to ... Read more >>

Open Forum Infect Dis (Open forum infectious diseases)
[2019, 6(Suppl 2):S22-S22]

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Antimicrobial Stewardship in a Hematological Malignancy Unit: Carbapenem Reduction and Decreased Vancomycin-Resistant Enterococcus Infection.

Brandon J Webb, Jacob Majers, Regan Healy, Peter Bjorn Jones, Allison M Butler, Greg Snow, Sandra Forsyth, Bert K Lopansri, Clyde D Ford, Daanish Hoda,

BACKGROUND:Antibiotic stewardship is challenging in hematological malignancy patients. METHODS:We performed a quasiexperimental implementation study of 2 antimicrobial stewardship interventions in a hematological malignancy unit: monthly antibiotic cycling for febrile neutropenia that included cefepime (± metronidazole) and piperacillin-tazobactam and a clinical prediction rule to guide anti-vancomycin-resistant Enterococcus faecium (VRE) therapy. We ... Read more >>

Clin. Infect. Dis. (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America)
[2019, :]

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Broad-spectrum antibiotic use and poor outcomes in community-onset pneumonia: a cohort study.

Brandon J Webb, Jeff Sorensen, Al Jephson, Ian Mecham, Nathan C Dean,

QUESTION:Is broad-spectrum antibiotic use associated with poor outcomes in community-onset pneumonia after adjusting for confounders? METHODS:We performed a retrospective, observational cohort study of 1995 adults with pneumonia admitted from four US hospital emergency departments. We used multivariable regressions to investigate the effect of broad-spectrum antibiotics on 30-day mortality, length of ... Read more >>

Eur. Respir. J. (The European respiratory journal)
[2019, 54(1):]

Cited: 1 time

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Decrease in vancomycin-resistant Enterococcus colonization associated with a reduction in carbapenem use as empiric therapy for febrile neutropenia in patients with acute leukemia.

Clyde D Ford, Jana Coombs, Michaela Gazdik Stofer, Bert K Lopansri, Brandon J Webb, Fabiana Ostronoff, Julie Asch, Daanish Hoda,

OBJECTIVE:To compare the effects of empiric carbapenems versus cycling cefepime and piperacillin/tazobactam on the rates of vancomycin-resistant Enterococcus (VRE) colonization, bloodstream infections, and outcomes of patients admitted with acute leukemia. DESIGN:Retrospective clinical study with VRE molecular strain typing and gastrointestinal microbiome comparison. SETTING:A regional referral center for acute leukemia. PATIENTS:342 ... Read more >>

Infect Control Hosp Epidemiol (Infection control and hospital epidemiology)
[2019, 40(7):774-779]

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Antibiotic Use and Outcomes After Implementation of the Drug Resistance in Pneumonia Score in ED Patients With Community-Onset Pneumonia.

Brandon J Webb, Jeffrey Sorensen, Ian Mecham, Whitney Buckel, Lilian Ooi, Al Jephson, Nathan C Dean,

BACKGROUND:To guide rational antibiotic selection in community-onset pneumonia, we previously derived and validated a novel prediction tool, the Drug-Resistance in Pneumonia (DRIP) score. In 2015, the DRIP score was integrated into an existing electronic pneumonia clinical decision support tool (ePNa). METHODS:We conducted a quasi-experimental, pre-post implementation study of ePNa with ... Read more >>

Chest (Chest)
[2019, 156(5):843-851]

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Implementation of Real-Time Electronic Clinical Decision Support for Emergency Department Patients with Pneumonia Across a Healthcare System.

Nathan C Dean, Caroline G Vines, Jenna Rubin, Dave S Collingridge, Mark Mankivsky, Raj Srivastava, Barbara E Jones, Kathryn G Kuttler, Missy Walker, Nathan Jenson, Brandon J Webb, Todd L Allen, Peter J Haug,

A real-time electronic CDS for pneumonia (ePNa) identifies possible pneumonia patients, measures severity and antimicrobial resistance risk, and then recommends disposition, antibiotics, and microbiology studies. Use is voluntary, and clinicians may modify treatment recommendations. ePNa was associated with lower mortality in emergency department (ED) patients versus usual care (Annals EM ... Read more >>

AMIA Annu Symp Proc (AMIA ... Annual Symposium proceedings. AMIA Symposium)
[2019, 2019:353-362]

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Repurposing an Old Drug for a New Epidemic: Ursodeoxycholic Acid to Prevent Recurrent Clostridioides difficile Infection.

Brandon J Webb, Ali Brunner, Julia Lewis, Clyde D Ford, Bert K Lopansri,

Recurrent Clostridioides difficile infection (rCDI) may be mediated in part by secondary bile acids. Here we report salvage therapy with ursodeoxycholic acid (UDCA) to prevent rCDI in 16 high-risk patients. Patients on UDCA had a low observed recurrence rate (12.5%). Controlled trials are needed to confirm these observations. ... Read more >>

Clin. Infect. Dis. (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America)
[2019, 68(3):498-500]

Cited: 2 times

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Clostridioides difficile colonization and infection in patients with newly diagnosed acute leukemia: Incidence, risk factors, and patient outcomes.

Clyde D Ford, Bert K Lopansri, Brandon J Webb, Jana Coombs, Launce Gouw, Julie Asch, Daanish Hoda,

BACKGROUND:The frequency, risk factors, and outcomes for Clostridioides difficile infection (CDI) in patients with newly diagnosed acute leukemia (AL) admitted for induction therapy are unclear. METHODS:We studied 509 consecutive patients with AL admitted between 2006 and 2017 and conducted a prospective C difficile surveillance and ribotyping analysis in a subset ... Read more >>

Am J Infect Control (American journal of infection control)
[2019, 47(4):394-399]

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Epidemiology and Clinical Features of Invasive Fungal Infection in a US Health Care Network.

Brandon J Webb, Jeffrey P Ferraro, Susan Rea, Stephanie Kaufusi, Bruce E Goodman, James Spalding,

A better understanding of the epidemiology and clinical features of invasive fungal infection (IFI) is integral to improving outcomes. We describe a novel case-finding methodology, reporting incidence, clinical features, and outcomes of IFI in a large US health care network.All available records in the Intermountain Healthcare Enterprise Data Warehouse from ... Read more >>

Open Forum Infect Dis (Open forum infectious diseases)
[2018, 5(8):ofy187]

Cited: 3 times

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The clinical and economic impact of cytomegalovirus infection in recipients of hematopoietic stem cell transplantation.

Brandon J Webb, Rachel Harrington, Jason Schwartz, Jennifer Kammerer, James Spalding, Edward Lee, Bart Dodds, Stephanie Kaufusi, Bruce E Goodman, Sean D Firth, Greta Martin, Jeffrey Sorensen, Daanish Hoda,

BACKGROUND:CMV infection (CMV-I) remains an important complication of hematopoietic stem cell transplantation (HSCT). METHODS:This was a retrospective, single-center cohort study in HSCT recipients. Primary outcomes were adjusted cost and all-cause mortality. Secondary analyses investigated CMV risk factors and the effect of serostatus. RESULTS:Overall, 690 transplant episodes were included (allogeneic [n = 310]; ... Read more >>

Transpl Infect Dis (Transplant infectious disease : an official journal of the Transplantation Society)
[2018, 20(5):e12961]

Cited: 2 times

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Reply to Babbel et al., "Application of the DRIP Score at a Veterans Affairs Hospital".

Brandon J Webb, Eddie Stenehjem, Kristin Dascomb, Mark Metersky, Holenarasipur R Vikram, Nathan C Dean,

Antimicrob. Agents Chemother. (Antimicrobial agents and chemotherapy)
[2018, 62(3):]

Cited: 0 times

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Decrease in Vancomycin-Resistant Enterococcus Colonization After Extensive Renovation of a Unit Dedicated to the Treatment of Hematologic Malignancies and Hematopoietic Stem-Cell Transplantation.

Clyde D Ford, Michaela A Gazdik Stofer, Jana Coombs, Bert K Lopansri, Brandon J Webb, Gabriela Motyckova, Finn Bo Petersen,

OBJECTIVE While a direct relation between hospital construction and concomitant infection rates has been clearly established, few data are available regarding the environmental decontamination effects of renovation in which surfaces are replaced and regarding subsequent infection incidence. DESIGN Retrospective clinical study with vancomycin-resistant Enterococcus (VRE) molecular strain typing and environmental ... Read more >>

Infect Control Hosp Epidemiol (Infection control and hospital epidemiology)
[2017, 38(9):1055-1061]

Cited: 0 times

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Prediction of Bloodstream Infection Due to Vancomycin-Resistant Enterococcus in Patients Undergoing Leukemia Induction or Hematopoietic Stem-Cell Transplantation.

Brandon J Webb, Regan Healy, Jacob Majers, Zachary Burr, Michaela Gazdik, Bert Lopansri, Daanish Hoda, Finn Bo Petersen, Clyde Ford,

Bloodstream infection (BSI) to due vancomycin-resistant Enterococcus (VRE) is an important complication of hematologic malignancy. Determining when to use empiric anti-VRE antibiotic therapy in this population remains a clinical challenge.A single-center cohort representing 664 admissions for induction or hematopoietic stem-cell transplant (HSCT) from 2006 to 2014 was selected. We derived ... Read more >>

Clin. Infect. Dis. (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America)
[2017, 64(12):1753-1759]

Cited: 6 times

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Derivation and Multicenter Validation of the Drug Resistance in Pneumonia Clinical Prediction Score.

Brandon J Webb, Kristin Dascomb, Edward Stenehjem, Holenarasipur R Vikram, Neera Agrwal, Kenneth Sakata, Kathryn Williams, Bruno Bockorny, Kavitha Bagavathy, Shireen Mirza, Mark Metersky, Nathan C Dean,

The health care-associated pneumonia (HCAP) criteria have a limited ability to predict pneumonia caused by drug-resistant bacteria and favor the overutilization of broad-spectrum antibiotics. We aimed to derive and validate a clinical prediction score with an improved ability to predict the risk of pneumonia due to drug-resistant pathogens compared to ... Read more >>

Antimicrob. Agents Chemother. (Antimicrobial agents and chemotherapy)
[2016, 60(5):2652-2663]

Cited: 12 times

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Use of Tracheal Aspirate Culture in Newly Intubated Patients with Community-Onset Pneumonia.

Lindsay M McCauley, Brandon J Webb, Jeffrey Sorensen, Nathan C Dean,

Successful treatment of life-threatening community-acquired pneumonia requires appropriate empiric antibiotic coverage. But using conventional diagnostic techniques, a microbiological diagnosis is often not achieved. The diagnostic usefulness of tracheal aspirate at the time of intubation in patients with severe pneumonia has not been well studied.The purpose of this study was to ... Read more >>

Ann Am Thorac Soc (Annals of the American Thoracic Society)
[2016, 13(3):376-381]

Cited: 3 times

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Empiric antibiotic selection and risk prediction of drug-resistant pathogens in community-onset pneumonia.

Brandon J Webb, Barbara Jones, Nathan C Dean,

Empiric antibiotic selection in community-onset pneumonia is complicated by uncertainty regarding risk of drug-resistant pathogens (DRPs). The healthcare-associated pneumonia (HCAP) criteria have limited predictive value and lead to unnecessary antibiotic use. Better methods of predicting risk of DRP and selecting empiric antibiotics are needed. Here we give an update on ... Read more >>

Curr. Opin. Infect. Dis. (Current opinion in infectious diseases)
[2016, 29(2):167-177]

Cited: 3 times

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Coxiella burnetii Infection With Severe Hyperferritinemia in an Asplenic Patient.

Allison Paine, Tadashi Miya, Brandon J Webb,

Q fever is an uncommon but likely underreported zoonotic infection. Severe hyperferritinemia has been associated with hemophagocytic lymphohistiocytosis and other infectious diseases. In this study, we report a case of Coxiella burnetii infection in an asplenic patient complicated by severe hyperferritinemia and bone marrow infiltration. In this case, the marked ... Read more >>

Open Forum Infect Dis (Open forum infectious diseases)
[2015, 2(4):ofv125]

Cited: 2 times

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Health care-associated pneumonia is mostly dead. Long live the acronym PES?

Nathan C Dean, Brandon J Webb,

Ann Am Thorac Soc (Annals of the American Thoracic Society)
[2015, 12(2):239-240]

Cited: 2 times

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Predicting risk of drug-resistant organisms in pneumonia: moving beyond the HCAP model.

Brandon J Webb, Kristin Dascomb, Edward Stenehjem, Nathan Dean,

Clinical management of community-acquired pneumonia (CAP) is increasingly complicated by antibiotic resistance. CAP due to pathogens resistant to guideline-recommended drugs (CAP-DRP) has increased. 2005 ATS/IDSA guidelines introduced a new category, healthcare-associated pneumonia (HCAP), and recommend extended-spectrum antibiotic treatment for patients meeting HCAP criteria. However, the predictive value of the HCAP ... Read more >>

Respir Med (Respiratory medicine)
[2015, 109(1):1-10]

Cited: 13 times

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