
Susan E BeekmannUniversity of Iowa | UI · Department of Internal Medicine
Susan E Beekmann
RN, MPH
About
204
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Publications (204)
Background
Antiviral medications for COVID-19 and influenza can mitigate disease severity in high-risk outpatients if taken early in the course of illness yet are underutilized. We sought to understand barriers to providers prescribing these medications.
Table
Thematic summary from infectious disease specialists outlining barriers to outpatient ant...
Background
New antibiotics offer additional treatment options for carbapenem-resistant Enterobacterales (CRE) infections, but data are limited on healthcare provider decision making.
Figure 1. Antibiotic selections for urinary tract infection case scenarios. (A) CASE 1: A 57-year-old female with a history of recurrent urinary tract infections (othe...
There is a need to understand current practices, knowledge gaps and training needs of ID physicians regarding encephalitis. A questionnaire was sent to European ID specialists. 201 persons answered. Respondents were involved more often in infectious (64%) than autoimmune encephalitis (7.5%). Respondents reported not feeling comfortable in recognizi...
In a US survey of infectious disease specialists, 61 respondents reported seeing >1 Bartonella quintana infection during 2014-2024. Diagnostic challenges included limited healthcare provider awareness, inadequate testing, and inconsistent healthcare access among affected populations. Early recognition of B. quintana infections is needed to improve...
Antiviral therapy is underutilized for outpatients at increased risk for severe COVID-19 or influenza. Results from this survey offer insights into treatment barriers from the infectious disease specialist perspective. Further education is needed about the benefits of early antiviral therapy.
A survey of US infectious disease physicians indicated that few regularly reviewed wastewater surveillance (WWS) data but many reported examples of how WWS has affected or could affect their clinical practice. WWS data can be useful for physicians, but increased communication between public health professionals and physicians regarding WWS could im...
Antifungal-resistant dermatophyte infections have recently emerged as a global public health concern. A survey of US infectious diseases specialists found that only 65% had heard of this issue and just 39% knew how to obtain testing to determine resistance. Increased clinician awareness and access to testing for antifungal-resistant dermatophytosis...
During routine clinical practice, infectious disease physicians encounter patients with difficult-to-diagnose clinical syndromes and may order advanced molecular testing to detect pathogens. These tests may identify potential causes for illness and allow clinicians to adapt treatments or stop unnecessary antimicrobials. Cases of pathogen-agnostic d...
Background
Osteoarticular infections (OAI) are commonly treated with prolonged intravenous (IV) antimicrobials. The Oral versus Intravenous Antibiotics for Bone and Joint Infection (OVIVA) trial demonstrated that oral (PO) antibiotics are noninferior to IV antibiotics in the treatment of OAIs. We surveyed Infectious disease (ID) physicians about th...
We surveyed members of the Emerging Infections Network about Candida auris screening practices at US healthcare facilities. Only 37% of respondents reported conducting screening; among these, 75% reported detection of at least 1 C. auris case in the last year. Increased screening could improve C. auris detection and prevent spread.
Background
Several recent randomized trials have been conducted in resource-limited settings for cryptococcal meningitis which have rapidly innovated international guidelines. The 2010 IDSA cryptococcal meningitis guideline has not been updated with recent trials. The 2022 AMBITION-cm trial found that single 10mg/kg dose of liposomal amphotericin B...
Objective
To understand how healthcare facilities employ contact precautions for patients with multidrug-resistant organisms (MDROs) in the post–coronavirus disease 2019 (COVID-19) era and explore changes since 2014.
Design
Cross-sectional survey.
Participants
Emerging Infections Network (EIN) physicians involved in infection prevention or hospit...
This survey of infectious disease providers on long COVID care revealed a lack of familiarity with existing resources, a sentiment of missing guidelines, and scarcity of dedicated care centers. The low response rate suggests that infectious disease specialists do not consider themselves as the primary providers of long COVID care.
Background
Osteoarticular infections (OAI) have been commonly treated with prolonged intravenous (IV) antimicrobials. The Oral versus Intravenous Antibiotics for Bone and Joint Infection (OVIVA) trial demonstrated that oral (PO) antibiotic therapy was noninferior to IV antibiotics in the treatment of OAIs. We surveyed Infectious disease (ID) physic...
Background
Although clinical applications of SARS-CoV-2 antibody tests during the COVID-19 pandemic were limited to identifying recent/prior infection, how these tests were used for clinical management of COVID-19 patients is unknown. We consider US infectious disease (ID) physicians’ perceptions about SARS-CoV-2 antibody tests to inform preparedne...
Background: Candida auris , an emerging fungal pathogen, is frequently drug resistant and spreads rapidly in healthcare facilities. Screening to identify patients colonized with C. auris can prevent further spread by prompting aggressive infection prevention and control measures. The CDC recommends C. auris screening based on local epidemiological...
Background: The CDC recommends routine use of contact precautions for patients infected or colonized with multidrug-resistant organisms (MDROs). There is variability in implementation of and adherence to this recommendation, which we hypothesized may have been exacerbated by the COVID-19 pandemic. Methods: In September 2022, we emailed an 8-questio...
In a survey of 523 infectious disease specialists, a moderate-to-high percentage reported using any antifungal therapeutic drug monitoring (TDM) during itraconazole (72%), posaconazole (72%), and voriconazole (90%) treatment and low-to-moderate during prophylaxis (32%, 55%, and 65%, respectively). Long turnaround times for send-out TDM testing and...
Background
The rise in injection drug use (IDU) has led to an increase in drug-related infections. Harm reduction is an important strategy for preventing infections among people who inject drugs (PWID). We attempted to evaluate the harm reduction counseling that infectious diseases physicians provide to PWID presenting with infections.
Methods
An...
Background
Encephalitis is widely recognized as a challenging condition to diagnose and manage. The care of patients with encephalitis typically involves multiple disciplines, including neurologists and infectious disease (ID) physicians. Our objective was to describe the perspectives and needs of ID physicians regarding encephalitis, using a cross...
Background
SARS-CoV-2 antibody tests have had limited recommended clinical application during the COVID-19 pandemic. To inform clinical practice, an understanding is needed of current perspectives of US-based infectious disease (ID) physicians on the use, interpretation, and need for SARS-CoV-2 antibody tests.
Methods
In March 2022, members of the...
Pediatric chronic osteomyelitis is a rare, debilitating condition lacking management guidelines. In a national survey of 162 pediatric infectious disease physicians through the Emerging Infections Network, tremendous variability in diagnostic approaches and management were noted, highlighting a need for prospective study to better define the spectr...
Background
The rise in injection drug use (IDU) has led to an increase in drug-related infections and hospitalizations. Harm reduction is an important strategy for preventing infections among people who inject drugs (PWID). We set out to evaluate how infectious disease physicians counsel PWID with serious injection-related infections on harm reduct...
Background
Pediatric chronic osteomyelitis (COM) is an uncommon, poorly defined, debilitating disorder often requiring multiple surgeries and prolonged antibiotic courses. Serious long-term sequelae may occur. As accepted diagnostic criteria do not exist, assessments of disease incidence, medical/surgical approach to management and outcomes are lac...
Pediatric antimicrobial stewardship programs (ASPs) improve antibiotic use for hospitalized children. Prescriber surveys indicate acceptance of ASPs, but data on infectious diseases (ID) physician opinions of ASPs are lacking. We conducted a survey of pediatric ID physicians, ASP and non-ASP, and their perceptions of ASP practices and outcomes.
Background
The Infectious Disease Society of America (IDSA) guidelines for the management of histoplasmosis were last revised 15 years ago. Since those guidelines were compiled, new antifungal treatment options have been developed. Further, the ongoing development of immunomodulatory therapies has increased the population at increased risk to devel...
The SARS-CoV-2 pandemic has had a significant impact on the United States healthcare system. This is exacerbated by antimicrobial-resistant bacterial pathogens endemic to healthcare settings. Respiratory viral infections are known to predispose patients to bacterial infections, which were a major contributor to mortality in previous pandemics. This...
We performed a survey of adult infectious diseases (ID) physicians to explore unintended consequences of antimicrobial stewardship programs (ASP). ID physicians worried about disagreement with colleagues, provider autonomy, and remote recommendations. Non-ASP ID physicians expressed more concern regarding ASPs focus on costs, provider efficiency, a...
Objective
While a growing number of healthcare facilities are implementing healthcare personnel (HCP) COVID-19 vaccination requirements, vaccine exemption request management as a part of such programs is not well described.
Design
Cross-sectional survey
Participants
Infectious disease (ID) physician members of the Emerging Infections Network with...
Background
The perception of the transmission risks of SARS-CoV-2 in social and educational settings by US healthcare providers have not been previously quantified.
Methods
Respondents completed an online survey between September and October 2020 to estimate the risk of SARS-CoV-2 transmission on a scale of 0–10 for different social and educationa...
Objectives
Diagnostic delays are a major source of morbidity and mortality. Despite the adverse outcomes associated with diagnostic delays, few studies have examined the incidence and factors that influence diagnostic delays for different infectious diseases. The objective of this study was to understand the relative frequency of diagnostic delays...
Background
Solid organ transplant recipients (SOTR) have diminished humoral immune responses to COVID-19 vaccination and higher rates of COVID-19 vaccine breakthrough infection than the general population. Little is known about COVID-19 disease severity in SOTR with COVID-19 vaccine breakthrough infections.
Methods
Between 4/7/21 and 6/21/21 we re...
Background
Solid organ transplant recipients (SOTR) have lower humoral responses following SARS-CoV-2 vaccination. Whether this equates to reduced vaccine effectiveness in SOTR or impacts disease severity is not yet known. We used the IDSA Emerging Infections Network (EIN) to identify SARS-CoV-2 cases in vaccinated SOTR. We describe their clinical...
In an online poll, 174 infectious disease physicians reported that testing frequencies for coccidioidomycosis, histoplasmosis, blastomycosis, and cryptococcosis were similar before and during the COVID-19 pandemic, indicating that these physicians remain alert for these fungal infections and were generally not concerned about the possibility of und...
We surveyed infectious disease specialists about early COVID-19 vaccination preparedness. Almost all respondents’ institutions rated their facility’s preparedness plan as either excellent or adequate. Vaccine hesitancy and concern about adverse reactions were the most common anticipated barriers to COVID-19 vaccination. Only 60% believed currently...
Background
Childhood encephalitis causes severe morbidity and mortality. Difficulty identifying causative organisms and a lack of effective therapies leads to variability in management. The recent emergence of novel diagnostic tools and the increased recognition of auto-immune encephalitides has the potential to change the approach to this disease....
We surveyed pediatric infectious disease physicians through the Infectious Disease Society of America’s Emerging Infections Network regarding the diagnosis and management of encephalitis. We identified practice variations, particularly with the use of new diagnostic modalities and management of autoimmune encephalitides. These findings may inform t...
Background
Guidelines exist to aid clinicians in managing patients with infective endocarditis (IE), but the degree of adherence with guidelines by infectious disease (ID) physicians is largely unknown.
Methods
An electronic survey assessing adherence with selected IE guidelines was emailed to 1409 adult ID physician members of the Infectious Dise...
Background
To monitor emerging infectious diseases, the Center for Disease Control and the Infectious Disease Society of America established the Emerging Infections Network (EIN), allowing infectious disease specialists to post inquiries about clinical cases. We describe the frequency and characteristics of neuroinfectious disease-related inquiries...
The number of onsite clinical microbiology laboratories in hospitals is decreasing, likely related to the business model for laboratory consolidation and labor shortages, and this impacts a variety of clinical practices including banking isolates for clinical or epidemiologic purposes. To determine the impact of these trends, infectious disease (ID...
In an online survey, we found that nearly one fifth of physicians in the United States who responded had seen or heard about a case of invasive pulmonary aspergillosis after severe influenza at their institution. However, <10% routinely used galactomannan testing to test for this fungus in patients with severe influenza.
Background: People living with HIV (PLWH) experience age-associated health conditions earlier than their HIV-uninfected peers and have higher rates of co-occurring conditions that impact aging. Thus, HIV providers frequently confront issues related to HIV and aging. Objective: The objective of this project was to understand provider opinions about...
Background
Presenteeism, or working while ill, by healthcare personnel (HCP) experiencing influenza-like illness (ILI) puts patients and coworkers at risk. However, hospital policies and practices may not consistently facilitate HCP staying home when ill.
Objective and methods
We conducted a mixed-methods survey in March 2018 of Emerging Infection...
Background
Few studies exist to guide the management of patients with stage 4 pressure ulcers with possible underlying osteomyelitis. We hypothesized that infectious disease (ID) physicians would vary widely in their approach to such patients.
Methods
The Emerging Infections Network distributed a 10-question electronic survey in 2018 to 1332 adult...
Background
Despite the high prevalence and morbidity of stage IV pressure ulcers, there are few clinical studies to guide diagnosis and treatment of osteomyelitis in such patients.
Methods
The Emerging Infections Network conducted an electronic survey of adult ID physicians in 2018 to determine their approach to managing patients with stage IV pre...
Background
Ocular tuberculosis (OTb) is uncommon and many ID physicians (IDPs) have limited experience with OT. Ophthalmologists now include IGRAs in evaluating idiopathic uveitis, and some IDPs report increased referrals for possible OTb. Our goal was to understand how IDPs approach diagnosis, treatment, and reporting of OTb.
Methods
The Emerging...
Background
Bacteremia in adult patients has traditionally been treated with extended courses of intravenous antibiotics. Data on the use of (or rapid transition to) oral therapy are limited.
Methods
Adult infectious disease physicians participating in the Infectious Diseases Society of America (IDSA) Emerging Infections Network (EIN) were surveyed...
Background
While outpatient parenteral antimicrobial therapy (OPAT) is generally considered safe, patients are at risk for complications and thus require close monitoring. The purpose of this study is to determine how OPAT programs are structured and how United States-based infectious diseases (ID) physicians perceive barriers to safe OPAT care.
M...
Infectious disease management of Staphylococcus aureus bacteremia (SAB) was surveyed through the Emerging Infections Network. Although there were areas of consensus, we found substantial practice variation in diagnostic evaluation and management of adult patients with SAB. These findings highlight opportunities for further research and guidance to...
Background
Immunosuppressive therapy for connective tissue diseases (CTDs) increases risk for opportunistic infections including Pneumocystis pneumonia (PCP). High mortality rates are reported in CTD patients with PCP which suggests a potential need for prophylaxis but indications remain poorly defined. Wide variations in the use of PCP prophylaxis...
A nationwide survey indicated that screening for asymptomatic carriers of C. difficile is an uncommon practice in US healthcare settings. Better understanding of the role of asymptomatic carriage in C. difficile transmission, and of the measures available to reduce that risk, are needed to inform best practices regarding the management of carriers.
Objective
To characterize healthcare provider diagnostic testing practices for identifying Clostridioides (Clostridium) difficile infection (CDI) and asymptomatic carriage in children.
Design
Electronic survey.
Methods
An 11-question survey was sent by e-mail or facsimile to all pediatric infectious diseases (PID) members of the Infectious Diseas...
Background
Presenteeism, or working while ill by healthcare personnel (HCP) experiencing influenza-like illness (ILI), increases the likelihood of illness transmission to coworkers and patients. The CDC recommends that HCP with ILI not work until they are afebrile for at least 24 hours. Operationally, hospital policies and practices may not facilit...
Influenza is a significant cause of childhood morbidity and death; it contributes to up to 16% of hospitalizations for respiratory illnesses worldwide. Novel rapid viral diagnostic tests, including molecular diagnostic tests, have the potential to significantly affect both time to diagnosis and selection of optimal anti-infective therapy. However,...
Objective
To delineate the timing of, indications for, and assessment of visitor restriction policies and practices (VRPP) in pediatric facilities.
Design
An electronic survey to characterize VRPP in pediatric healthcare facilities.
Methods
The Infectious Diseases Society of America Emerging Infections Network surveyed 334 pediatric infectious di...
Background
In the context of the opioid epidemic, injection drug use (IDU) related infections are an escalating health issue for infectious diseases (ID) physicians in the United States.
Methods
We conducted a mixed methods survey of The Infectious Diseases Society of America’s (IDSA) Emerging Infections Network between February and April 2017 to...
To assess current use of vancomycin for methicillin-resistant Staphylococcus aureus bacteremia, we surveyed adult infectious disease physicians. Most respondents reported personal experience with infections failing to respond to vancomycin despite minimum inhibitory concentration data indicating susceptibility. In a hypothetical case of such an inf...
Background
In 2012, the US Food and Drug Administration (FDA) required drug manufacturers to give advance notice of impending drug shortages. A survey of infectious diseases (ID) physicians was undertaken to determine the impact of this requirement and to follow-up on prior perceptions of ID physicians on shortages of antimicrobial agents.
Methods...
Infections caused by pan-azole-resistant Aspergillus fumigatus strains have emerged in Europe and recently in the United States. Physicians specializing in infectious diseases reported observing pan-azole-resistant infections and low rates of susceptibility testing, suggesting the need for wider-scale testing.
Respiratory syncytial virus (RSV) often causes respiratory illness in adults. Over 40 RSV vaccine and monoclonal antibody products are currently in preclinical development or clinical trials. Because RSV diagnostic practices may impact disease burden estimates, we investigated infectious disease physicians' RSV diagnostic practices among their adul...
Models of care for people living with HIV (PLWH) have varied over time due to long term survival, development of HIV-associated non-AIDS conditions, and HIV specific primary care guidelines that differ from those of the general population. The objectives of this study are to assess how often infectious disease (ID) physicians provide primary care f...
Background
The opioid epidemic has swept across the U.S. at a staggering rate, with an estimated half million to one million persons injecting drugs annually. Rates of hospitalization for injection drug use (IDU)-related infection have risen precipitously, comprising an escalating proportion of infectious diseases provider volume in highly impacted...
OBJECTIVE: To evaluate the extent to which advancements in the diagnosis and treatment of latent tuberculous infection (LTBI) have been integrated into practice by pediatric infectious disease (PID) specialists.
DESIGN: We conducted an online survey of the Infectious Diseases Society of America's Emerging Infections Network (EIN) membership.
RESULT...
On September 30, 2014, the first US patient with Ebola virus disease was diagnosed. Hospitals and healthcare systems identified many complex issues that needed to be addressed to prepare for possible future outbreaks. Here we summarize themes identified in free text responses from a query of infectious disease physicians from the Infectious Disease...
Strong working relationships between infectious disease (ID) physicians and public health have resulted in the early detection of emerging infectious threats. From May 6 through June 5, 2015, we surveyed ID physicians in the Infectious Diseases Society of America’s Emerging Infections Network about communications with public health. A total of 688...
Antibiotic allergy testing (AAT) practices of Emerging Infections Network infectious disease physicians were surveyed. Although AAT was perceived to be necessary for removal of inappropriate or unnecessary allergy labels, there was limited access to any form of testing. In this study, we discuss current antibiotic allergy knowledge gaps and the dev...
Management guidelines for cardiac implantable electronic device infections exist, but practice patterns of infectious disease
(ID) specialists are not well-known. We found that while many ID specialist practices mirror existing guidelines; a combination
of complete device removal and prolonged antimicrobial therapy is favored when S. aureus is invo...
Mycobacterium abscessus is often resistant to multiple antimicrobial drugs, and data supporting effective drugs or dosing regimens are limited. To better identify treatment approaches and associated toxicities, we collected a series of case reports from the Emerging Infections Network. Side effects were common and often led to changing or discontin...
Rationale
Antibiotic allergy labels (AAL) significantly impact antibiotic prescribing and may lead to the inappropriate use of broad spectrum antibiotics which creates a public health concern. Infectious disease (ID) physicians from the Emerging Infections Network (EIN) of the Infectious Diseases Society of America (IDSA) were surveyed to determine...
Adequacy of Duodenoscope Reprocessing Methods as Reported by Infectious Disease Physicians - Volume 37 Issue 2 - Susan E. Beekmann, Tara N. Palmore, Philip M. Polgreen, John E. Bennett
BACKGROUND
Studies have suggested that contact precautions (CP) for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus may have risks that outweigh the benefits. These risks, coupled with more widespread use of horizontal interventions such as daily bathing with chlorhexidine gluconate, have brought into question the...
Background:
US Public Health Service guidelines recommend early initiation of antiretroviral treatment (ART) for human immunodeficiency virus infection (HIV)-infected patients and preexposure prophylaxis (PrEP) as a prevention option for persons at risk for HIV acquisition. Before issuance of these guidelines, few clinicians reported prescribing e...
Objectives:
The objective of this study was to attain a better understanding of infectious diseases (ID) physicians' experience with MDR organism (MDRO) urinary tract infections (UTIs) by means of a survey on disease perception, diagnostic management and treatment preferences.
Methods:
A nine-question survey was developed and distributed to memb...
Background: The first case of Ebola diagnosed in the United States and subsequent cases among two healthcare workers caring for that patient highlighted the importance of hospital preparedness in caring for Ebola patients.
Methods: Infectious disease physicians who are part of the Emerging Infections Network (EIN) were surveyed about current Ebola...
While influenza transmission is thought to occur primarily by droplet spread, the role of airborne spread remains uncertain. Understanding the beliefs and attitudes of infectious disease physicians regarding influenza transmission and respiratory and barrier protection preferences can provide insights into workplace decisions regarding respiratory...
This query of North American infectious diseases (ID) physicians reviews current and anticipated practice patterns related to HCV care. Fewer than 20% of survey respondents evaluated and/or treated >10 HCV-infected individuals in the past year. We review HCV practice patterns, barriers to management, and education among ID physicians.
© The Author...
A fully updated version of this popular, clinically oriented, user-friendly text on infectious disease, with even more helpful graphics, tables, algorithms and images. It is packed full of information on diagnosis, differential diagnosis and therapy. In addition to the traditional organization of organ-system and pathogen-related information, this...
Occupational injuries and exposure to blood and body fluids continue to be commonplace in virtually every healthcare setting. Primary prevention of these injuries and exposure is the most important component of preventing occupational infection with any blood-borne pathogen. Should primary prevention fail, secondary prevention consists of post-expo...