Papers by george turabelidze
2016 CSTE Annual Conference, Jun 21, 2016
Emerging Infectious Diseases, Aug 1, 2023
Journal of Environmental Health, Mar 1, 2019
HOOT SYSTEMS Welcomes Mike Catanzaro as Sales Director Hoot Systems is proud to announce that Mik... more HOOT SYSTEMS Welcomes Mike Catanzaro as Sales Director Hoot Systems is proud to announce that Mike Catanzaro was named as Sales Director and has joined its Residential and Commercial Wastewater Team. He is a graduate from the University of Southwestern Louisiana with a BS in Industrial Technology, and with continuing education courses in domestic and industrial wastewater treatment through Louisiana State University. Mr. Catanzaro has 25-years of experience in the commercial and residential decentralized wastewater markets. He currently holds four wastewater related patents. Mr. Catanzaro is an active member of the Water Environment Federation and NOWRA. For more information about Hoot Systems, please visit hootsystems.com.
PLOS Medicine, Aug 26, 2022
Background Equity in vaccination coverage is a cornerstone for a successful public health respons... more Background Equity in vaccination coverage is a cornerstone for a successful public health response to COVID-19. To deepen understanding of the extent to which vaccination coverage compares with initial strategies for equitable vaccination, we explore primary vaccine series and booster rollout over time and by race/ethnicity, social vulnerability, and geography. Methods and findings We analyzed data from the Missouri Department of Health and Senior Services on all COVID-19 vaccinations administered across 7 counties in the St. Louis region and 4 counties in the Kansas City region. We compared rates of receiving the primary COVID-19 vaccine series and boosters relative to time, race/ethnicity, zip-code-level Social Vulnerability Index (SVI), vaccine location type, and COVID-19 disease burden. We adapted a wellestablished tool for measuring inequity-the Lorenz curve-to quantify inequities in COVID-19 vaccination relative to these key metrics. Between 15 December 2020 and 15 February 2022, 1,763,036 individuals completed the primary series and 872,324 received a booster. During early phases of the primary series rollout, Black and Hispanic individuals from high SVI zip codes were vaccinated at less than half the rate of White individuals from low SVI zip codesAU : IchangedwerevaccinatedatlessthanhalftherateofWhiteindividualstowerevaccinatedatlessthanh , but rates increased over time until they were higher than rates in White individuals after June 2021; Asian individuals maintained high levels of vaccination throughout.
Journal of Public Health Management and Practice
Objectives: The purpose of this work was to segment the Missouri population into unique groups re... more Objectives: The purpose of this work was to segment the Missouri population into unique groups related to COVID-19 vaccine acceptance using data science and behavioral science methods to develop tailored vaccine outreach strategies. Methods: Cluster analysis techniques were applied to a large data set that aggregated vaccination data with behavioral and demographic data from the American Community Survey and Deloitte's HealthPrism™ data set. Outreach recommendations were developed for each cluster, specific to each group's practical and motivational barriers to vaccination. Results: Following selection procedures, 10 clusters—or segments—of census tracts across Missouri were identified on the basis of k-means clustering analysis of 18 different variables. Each cluster exhibited unique geographic, demographic, socioeconomic, and behavioral patterns, and outreach strategies were developed on the basis of each cluster's practical and motivational barriers. Discussion: The s...
Journal of Public Health Management and Practice, Apr 13, 2023
Objectives: The purpose of this work was to segment the Missouri population into unique groups re... more Objectives: The purpose of this work was to segment the Missouri population into unique groups related to COVID-19 vaccine acceptance using data science and behavioral science methods to develop tailored vaccine outreach strategies. Methods: Cluster analysis techniques were applied to a large data set that aggregated vaccination data with behavioral and demographic data from the American Community Survey and Deloitte's HealthPrism™ data set. Outreach recommendations were developed for each cluster, specific to each group's practical and motivational barriers to vaccination. Results: Following selection procedures, 10 clusters—or segments—of census tracts across Missouri were identified on the basis of k-means clustering analysis of 18 different variables. Each cluster exhibited unique geographic, demographic, socioeconomic, and behavioral patterns, and outreach strategies were developed on the basis of each cluster's practical and motivational barriers. Discussion: The segmentation analysis served as the foundation for “working groups” comprising the 115 local public health agencies (LPHAs) across the state. LPHAs with similar community segments in their service area were grouped together to discuss their communities' specific challenges, share lessons learned, and brainstorm new approaches. The working groups provided a novel way for public health to organize and collaborate across the state. Widening the aperture beyond Missouri, population segmentation via cluster analysis is a promising approach for public health practitioners interested in developing a richer understanding of the types of populations they serve. By pairing segmentation with behavioral science, practitioners can develop outreach programs and communications campaigns that are personalized to the specific behavioral barriers and needs of the population in focus. While our work focused on COVID-19, this approach has broad applicability to enhance the way public health practitioners understand the populations they serve to deliver more tailored services.
American Journal of Kidney Diseases, Nov 1, 2019
, at the states' request, CDC participated in an on-site investigation to determine the extent of... more , at the states' request, CDC participated in an on-site investigation to determine the extent of the outbreak and source of infections. Methods Case Definitions and Characteristics A case was defined as a blood culture from which any Gram-negative bacteria was identified during July 1, 2015 Complete author and article information provided before references.
Open Forum Infectious Diseases, Oct 1, 2019
Background. Stenotrophomonas maltophilia (SM) is a multi-drug-resistant Gram-negative organism th... more Background. Stenotrophomonas maltophilia (SM) is a multi-drug-resistant Gram-negative organism that typically impacts patients with long hospital stays or severe immunocompromise. In Q4 2017, an increase in rates of SM from adult bronchoscopic alveolar lavage (BAL) specimens was detected. Methods. The charts of all patients with SM from BAL specimens during the time frame in question were reviewed for commonalities, clinical symptoms and antibiotic treatment for Stenotrophomonas. Incidence rate ratios for the 21 months prior to, 3 months during and 15 months after the increase were compared using Fisher exact test. Results. Quarter 4 2017 rates of SM isolated from BALs performed in patients >/ = 18 years of age increased significantly from baseline of 0.46 to 2.22 per 10,000 patient-days. Upon chart review 75% (12/16) of patients with SM during the increase had BALs performed with a specific bronchoscope. Q4 2017, 22 patients had a BAL performed with the scope in question with 16 sent for culture. 75% (12/16) of the BALs done with this scope during Q4 2017 grew SM. The scope was pulled from use once the association was identified. ATP and high-level disinfection records were reviewed with no failures noted. The scope was sent to an independent lab where boroscope evaluation showed epoxy lifting. Cultures from the scope were unrevealing. After the scope was removed from service, rates of SM from adult BALs dropped significantly back to 0.58 per 10,000 patient-days (Figure 1). Upon clinical review, SM was deemed clinically insignificant in all but 1 case, however, 8 of the 12 patients received antibiotic treatment for this pathogen. To date, none of the patients in question had subsequent cultures with SM. No adverse events due to antibiotic therapy have been noted 10 of the patient isolates were retrieved and sent for pulsed-field gel electrophoresis testing. All came back with identical PFGE patterns strongly suggesting a point source. Conclusion. While the bronchoscope culture did not grow SM, the identical PFGE patterns in patients without evidence of active infection suggested a point source. Return of SM rates to baseline following removal of the scope from service strongly suggest a pseudo-outbreak resulting from a reusable bronchoscope.
American Journal of Infection Control, Sep 1, 2021
We identified a cluster of extensively drug-resistant, carbapenemase gene-positive, carbapenem-re... more We identified a cluster of extensively drug-resistant, carbapenemase gene-positive, carbapenem-resistant Acinetobacter baumannii (CP-CRAB) at a teaching hospital in Kansas City. Extensively drug-resistant CRAB was identified from eight patients and 3% of environmental cultures. We used patient cohorting and targeted environmental disinfection to stop transmission. After implementation of these measures, no additional cases were identified.
PubMed, Jan 13, 2010
This report describes the first case of human rabies in Missouri in 50 years that resulted in a p... more This report describes the first case of human rabies in Missouri in 50 years that resulted in a patient fatality. Current rabies epidemiology, treatment and management of exposures, and the signs and symptoms and treatment of human rabies is discussed.
PubMed, Jan 13, 2010
This is a case-control study of viral meningitis outbreak in Perry County, Missouri. All case-pat... more This is a case-control study of viral meningitis outbreak in Perry County, Missouri. All case-patients had viral meningitis per routine CSF analysis or PCR testing. Enterovirus VP1-specific RT-PCR and sequencing was performed on CSF. Univariate and multivariable logistic regression analysis was done to evaluate risk factors. The meningitis attack rate was 1/1,000 population. The main risk factor for meningitis was association with childcare. In patients with signs of meningitis, but normal routine CSF analysis, molecular testing of the CSF is helpful for conclusive diagnosis.
medRxiv (Cold Spring Harbor Laboratory), Jun 26, 2020
Findings: We tested 11,933 residual clinical specimens. We estimate that from 1.1% of persons in ... more Findings: We tested 11,933 residual clinical specimens. We estimate that from 1.1% of persons in the Puget Sound to 6.9% in New York City (collected March 23-April 1) had detectable antibodies. Estimates ranged from 1.9% in south Florida to 4.9% in Connecticut with specimens collected during intervals from April 6-May 3. Six to 24 times more infections were estimated per site with seroprevalence than with case report data. Meaning: For most sites, evidence suggests >10 times more SARS-CoV-2 infections occurred than reported cases. Most persons in each site likely had no detectable SARS-CoV-2 antibodies. for use under a CC0 license.
Morbidity and Mortality Weekly Report, 2009
On November 24, 2008, the Missouri State Public Health Laboratory notified CDC of suspected rabie... more On November 24, 2008, the Missouri State Public Health Laboratory notified CDC of suspected rabies in a man aged 55 years from Missouri. The man had been bitten by a bat 4--6 weeks before symptom onset and had not sought medical care at the time of the bite. After visiting two emergency departments (EDs) with symptoms consistent with rabies, he was hospitalized on November 23 and treated using the Milwaukee protocol. On November 26, infection with a rabies virus variant associated with silver-haired bats was confirmed. The patient died on November 30. This report summarizes the patient's treatment and clinical course. The report highlights the importance of raising public awareness of rabies, particularly the risk for rabies after bat and other wildlife exposures. Health-care providers should maintain a high clinical suspicion for rabies in patients with a recent animal bite history and unexplained encephalitis.
Journal of The American College of Radiology, Mar 1, 2012
Purpose: To investigate an outbreak of bacterial meningitis at an outpatient radiology clinic (cl... more Purpose: To investigate an outbreak of bacterial meningitis at an outpatient radiology clinic (clinic A) and to determine the source and implement measures to prevent additional infections. Methods: A case was defined as bacterial meningitis in a patient undergoing myelography at clinic A from October 11 to 25, 2010. Patients who underwent myelography and other procedures at clinic A during that period were interviewed, medical records were reviewed, and infection prevention practices were assessed. Case-patient cerebrospinal fluid (CSF) specimens, oral specimens from health care personnel (HCP), and opened iohexol vials were tested for bacteria. Bacterial isolates were compared using pulsed-field gel electrophoresis. A culture-negative CSF specimen was tested using a real-time polymerase chain reaction assay. Results: Three cases were identified among 35 clinic A patients who underwent procedures from October 11 to 25, 2010. All case-patients required hospitalization, 2 in an intensive care unit. Case-patients had myelography performed by the same radiology physician assistant and technician on October 25; all patients who underwent myelography on October 25 were affected. HCP did not wear facemasks and reused single-dose iohexol vials for multiple patients. Streptococcus salivarius (a bacteria commonly found in oral flora) was detected in the CSF of 2 case-patients (1 by culture, 1 using real-time polymerase chain reaction) and in HCP oral
PLOS ONE, Feb 22, 2012
We recently investigated three cases of bacterial meningitis that were reported from a midwestern... more We recently investigated three cases of bacterial meningitis that were reported from a midwestern radiology clinic where facemasks were not worn during spinal injection of contrast agent during myelography procedures. Using pulsed field gel electrophoresis we linked a case strain of S. salivarius to an oral specimen of a radiology physician assistant (RPA). We also used a real-time PCR assay to detect S. salivarius DNA within a culture-negative cerebrospinal fluid (CSF) specimen. Here we extend this investigation through using a nested PCR/sequencing strategy to link the culture-negative CSF specimen to the case strain. We also provide validation of the real-time PCR assay used, demonstrating that it is not solely specific for Streptococcus salivarius, but is also highly sensitive for detection of the closely related oral species Streptococcus vestibularis. Through using multilocus sequence typing and 16S rDNA sequencing we further strengthen the link between the CSF case isolate and the RPA carriage isolate. We also demonstrate that the newly characterized strains from this study are distinct from previously characterized S. salivarius strains associated with carriage and meningitis.
Journal of the Neurological Sciences, Jun 1, 2008
This study was conducted to estimate the current prevalence of multiple sclerosis (MS) in Jeffers... more This study was conducted to estimate the current prevalence of multiple sclerosis (MS) in Jefferson County, Missouri, USA, and to address community concerns about a perceived excess of MS around an active lead smelter. The study population consisted of the residents of Jefferson County, Missouri between 1998 and 2002. An aggressive MS case finding with capture-recapture analysis was used. The spatial clustering was examined using a spatial scan statistic. The capture-recapture analysis showed the case ascertainment to be 95%. The crude five-year period prevalence of MS in Jefferson County was 105 per 100,000 population (95% confidence interval [CI], 91-121), and 107 per 100,000 (95% CI, 95-119) when age-standardized to the 2000 U.S. population. No significant spatial clusters of MS cases were identified in the study area. The estimates of MS prevalence in Mid-western community of USA appeared to be comparable to estimates from other areas of similar latitude in the United States and Western Europe. The MS cases did not appear to cluster around the lead smelter.
Journal of Hospital Infection, Apr 1, 2023
Emerging Infectious Diseases, May 1, 2018
Heartland virus is a suspected tickborne pathogen in the United States. We describe a case of hem... more Heartland virus is a suspected tickborne pathogen in the United States. We describe a case of hemophagocytic lymphohistiocytosis, then death, in an immunosuppressed elderly man in Missouri, USA, who was infected with Heartland virus.
Morbidity and Mortality Weekly Report, Feb 21, 2020
Sexually Transmitted Diseases, Apr 1, 2012
Background: New human immunodeficiency virus (HIV) diagnoses in the St. Louis metropolitan area, ... more Background: New human immunodeficiency virus (HIV) diagnoses in the St. Louis metropolitan area, MO, occur predominantly among men who have sex with men (MSM). The Centers for Disease Control and Prevention recommends HIV testing at least annually for sexually active MSM. We examined prevalence and factors associated with recent HIV testing among MSM in the St. Louis area. Methods: The 2008 National HIV Behavioral Surveillance system recruited men in 21 US metropolitan areas through venue-based, timespace sampling. Men were interviewed for behavioral risks and testing history. The analysis included men in St. Louis who had engaged in male-male sex during the previous year and excluded men who had tested HIV-positive Ͼ12 months before the interviews. Factors associated with testing during the previous 12 months were identified using log-binomial regression. Results: Among 339 MSM, 198 (58%) had been tested during the previous 12 months. MSM were more likely to have been tested if they were black (adjusted prevalence ratio [APR]: 1.6; 95% confidence interval [CI]: 1.0-2.5); had visited a health care provider during the previous 12 months (APR: 1.6; 95% CI: 1.3-2.1); or had ever disclosed same-sex attractions or male-male sex to health care providers (APR: 1.6; 95% CI: 1.2-2.0). Of the 141 men who were untested within 12 months, 89 (63%) attributed not testing to perceived low risk. Conclusions: Nearly half of sexually active MSM in this analysis had not been tested for HIV during the previous year. Annual visits to health care providers during which sexual risk is discussed are likely to promote testing among MSM.
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Papers by george turabelidze