Author Contributions: Dr Maragakis had full
access to all of the data in the study and takes responsibility for the integrity
of the data and the accuracy of the data analysis.
Study concept and design: Maragakis, Cosgrove,
Song, Kim, Rosenbaum, Srinivasan, Perl.
Acquisition of data: Maragakis, Kim, Rosenbaum,
Ciesla, Ross, Carroll.
Analysis and interpretation of data: Maragakis,
Cosgrove, Song, Kim, Srinivasan, Ross, Carroll, Perl.
Drafting of the manuscript: Maragakis.
Critical revision of the manuscript for important
intellectual content: Maragakis, Cosgrove, Song, Kim, Rosenbaum, Ciesla,
Srinivasan, Ross, Carroll, Perl.
Statistical analysis: Maragakis, Cosgrove,
Obtained funding: Maragakis, Perl.
Administrative, technical, or material support:
Song, Kim, Rosenbaum, Ciesla, Ross, Carroll.
Study supervision: Maragakis, Cosgrove, Perl.
Funding/Support: This study was supported in
part by a Prevention Epicenters cooperative agreement (grant UR8/CCU315092)
from the CDC, by grant 5-T32/AI07291 from the National Institutes of Health,
and by grant 1 K01 CI000300-01 from the CDC.
Role of the Sponsors: The sponsors had no role
in the design and conduct of the study, in the collection, analysis, and interpretation
of the data, or in the preparation, review, or approval of the manuscript.
Dr Srinivasan works in an investigative capacity at the Division of Healthcare
Quality and Promotion and has no involvement with the funding aspect of the
Acknowledgment: We are indebted to Beryl Rosenstein,
MD, for support and for facilitating the implementation of appropriate patient
safety measures; John G. Bartlett, MD, for advice and for reviewing an early
version of the manuscript; David Blythe, MD, MPH, Maryland Department of Health
and Mental Hygiene, for advice and assistance; Melissa Johnson, PT, BS, and
the members of the Department of Physical Medicine and Rehabilitation, Johns
Hopkins Hospital, for reviewing treatment logbooks and contacting and evaluating
patients; Henry Garbelman, for design and construction of new pulsatile lavage
treatment rooms; the members of epidemiology and infection control departments
of other institutions affected by MDR-Ab, for their advice on prevention and
control of the organism; and Harriett Loehne, PT, CWS, for assistance with
development of new infection control guidelines.