Ari A. Robicsek, M.D.

Ari A. Robicsek, M.D.

Ari A. Robicsek, M.D.

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Conditions & Procedures


Bone and Joint Infection, Fever of Unknown Origin, Illness in Returning Travelers, Infection Associated with Healthcare Contact, Infection in Patients over 18 Years of Age, Infections Associated with Implanted Devices, New Diagnosis HIV or Ongoing Care, Skin and Soft Tissue Infection


Appropriate Utilization of Antimicrobials, Diagnosis and Treatment of Infections during Immunosuppression, Medical Informatics, Prevention of Infection, Surveillance and Prevention of Infection in Healthcare

General Information




NorthShore Medical Group


Infectious Diseases

Academic Rank

Clinical Associate Professor



Board Certified

Infectious Disease, Internal Medicine

Clinical Service

Infectious Diseases

Education, Training & Fellowships

Medical School

University of Toronto Medical School, 1998


Mount Sinai Hospital - Canada, 1999


Toronto General Hospital, 2001


Toronto General Hospital, 2002
Harvard Medical School - Massachusetts General Hospital, 2005



NorthShore Medical Group

2650 Ridge Ave.
Evanston, IL 60201
847.657.5959 847.657.5764 fax This location is wheelchair accessible.


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  • Clinical decision support systems and infection prevention: To know is not enough.

    American journal of infection control 2015 Mar 19

    Authors: Wright MO,
    Clinical decision support (CDS) systems are an increasingly used form of technology designed to guide health care providers toward established protocols and best practices with the intent of improving patient care. Utilization of CDS for infection prevention is not widespread and is particularly focused on antimicrobial stewardship. This article provides an overview of CDS systems and summarizes key attributes of successfully executed tools. A selection of published reports of CDS for infection prevention and antimicrobial stewardship are described. Finally, an individual organization describes its CDS infrastructure, process of prioritization, design, and development, with selected highlights of CDS tools specifically targeting common infection prevention quality improvement initiatives.
    PMID: 25798779 [PubMed - as supplied by publisher]
  • Active Surveillance and Decolonization Without Isolation Is Effective in Preventing Methicillin-Resistant Staphylococcus aureus Transmission in the Psychiatry Units.

    Open forum infectious diseases 2014 Sep

    Authors: Das S,
    Control of methicillin-resistant Staphylococcus aureus (MRSA) is difficult in select populations. We used molecular typing to study the effect of universal surveillance and decolonization of carriers, without isolation, on MRSA transmission in a specialized unit.
    Patients admitted to the unit were screened for nasal MRSA at admission and discharge. Those who acquired MRSA during their stay were identified and linked to carriers with shared time in unit. Molecular typing of isolates was performed to identify transmission.
    Of 3285 admissions, 82% were tested for MRSA nasal carriage; the discharge screening compliance was 64.7%. Admission prevalence was 2.3% among patients screened, and 7 (0.42%) acquired nasal MRSA during their stay. All patients who acquired MRSA shared time in the unit with a colonized patient. There were 3.9 MRSA acquisitions per 1000 at-risk days. Isolates from 5 patients that acquired MRSA during their stay as well as their potential donors (11 donor: recipient patient pairs) were available for typing. Pulsed-field gel electrophoresis matched 1 acquisition isolate to a colonized patient isolate. There were no MRSA infections during the study period.
    Despite less than perfect nasal screening compliance and exemption from traditional isolation precautions, acquisition of MRSA was 0.42% in this patient population over a course of 4.75 years, including a single case of acquisition, genetically similar to a known potential donor source. Screening for MRSA colonization and decolonizing of carriers was sufficient in reducing transmission in this vulnerable population.
    PMID: 25734137 [PubMed - as supplied by publisher]
  • Outpatient advance care planning for patients with metastatic cancer: a pilot quality improvement initiative.

    Journal of palliative medicine 2014 Nov

    Authors: Obel J,
    Despite American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) guidelines recommending that oncologists discuss advance care planning (ACP) with patients with stage IV cancer early in treatment, in standard practice ACP remains a late step of a terminal illness. ACP preserves comfort and dignity at the end of life, ensuring patients receive the care that they desire.
    A feasibility study in patients with stage IV cancer was developed to test whether incorporating ACP immediately after a stage IV cancer diagnosis is feasible. Inclusion criteria were consecutive new gastrointestinal and thoracic oncology patients treated by one of two oncologists. The project included creation of new workflow; development of an ACP patient education guidebook; training seminars for oncology staff; and enhancements to the electronic health record (EHR) to improve ACP documentation.
    The oncologists recorded 33 of 48 (69%) advance directive notes (ADNs) and 22 of 48 (46%) code status orders (CSOs) in the EHR of patients newly diagnosed with stage IV cancer by following ACP protocol during the 6-month trial period. Twenty-one of 33 ADNs were entered within 7 days of first consultation. The median time to ADN placement was 1 day after consultation. Twenty-two of 33 patients with ADNs had CSOs placed, of which 16 were do-not-resuscitate (DNR) and 6 were full code. One year prior to the feasibility study, only 1 of 75 deceased patients of the two oncologists had outpatient ADNs and CSOs.
    Outpatient ACP is feasible early in the care of patients with stage IV cancer through systematic improvement in workflow and motivated providers. Education and infrastructure were pivotal to routine development of advance care plans.
    PMID: 25343403 [PubMed - as supplied by publisher]
  • Multidrug-resistant organisms contaminating supply carts of contact isolation patients.

    American journal of infection control 2014 Oct

    Authors: Zelencik S,
    Contamination of supply carts stored within rooms of patients on contact isolation for multidrug-resistant organisms was assessed. Despite the presence of environmentally persistent organisms, very little contamination occurred to these carts or the supplies stored within them. A single isolate containing a multidrug-resistant Acinetobacter baumannii was isolated, representing 1.3% of the 80 swabs collected.
    PMID: 25278409 [PubMed - as supplied by publisher]
  • Sensitivity of surveillance testing for multidrug-resistant Gram-negative bacteria in the intensive care unit.

    Journal of clinical microbiology 2014 Nov

    Authors: Ridgway JP,
    We tested intensive care unit patients for colonization with multidrug-resistant Gram-negative bacilli (MDR GNB) and compared the results with those of concurrent clinical cultures. The sensitivity of the surveillance test for detecting MDR GNB was 58.8% (95% confidence interval, 48.6 to 68.5%). Among 133 patients with positive surveillance tests, 61% had no prior clinical culture with MDR GNB.
    PMID: 25143577 [PubMed - as supplied by publisher]
  • Multicenter development and validation of a risk stratification tool for ward patients.

    American journal of respiratory and critical care medicine 2014 Sep 15

    Authors: Churpek MM,
    Most ward risk scores were created using subjective opinion in individual hospitals and only use vital signs.
    To develop and validate a risk score using commonly collected electronic health record data.
    All patients hospitalized on the wards in five hospitals were included in this observational cohort study. Discrete-time survival analysis was used to predict the combined outcome of cardiac arrest (CA), intensive care unit (ICU) transfer, or death on the wards. Laboratory results, vital signs, and demographics were used as predictor variables. The model was developed in the first 60% of the data at each hospital and then validated in the remaining 40%. The final model was compared with the Modified Early Warning Score (MEWS) using the area under the receiver operating characteristic curve and the net reclassification index (NRI).
    A total of 269,999 patient admissions were included, with 424 CAs, 13,188 ICU transfers, and 2,840 deaths occurring during the study period. The derived model was more accurate than the MEWS in the validation dataset for all outcomes (area under the receiver operating characteristic curve, 0.83 vs. 0.71 for CA; 0.75 vs. 0.68 for ICU transfer; 0.93 vs. 0.88 for death; and 0.77 vs. 0.70 for the combined outcome; P value < 0.01 for all comparisons). This accuracy improvement was seen across all hospitals. The NRI for the electronic Cardiac Arrest Risk Triage compared with the MEWS was 0.28 (0.18-0.38), with a positive NRI of 0.19 (0.09-0.29) and a negative NRI of 0.09 (0.09-0.09).
    We developed an accurate ward risk stratification tool using commonly collected electronic health record variables in a large multicenter dataset. Further study is needed to determine whether implementation in real-time would improve patient outcomes.
    PMID: 25089847 [PubMed - as supplied by publisher]
  • Predictive utility of prior positive urine cultures.

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2014 Nov

    Authors: MacFadden DR,
    A patient's prior urine cultures are often considered when choosing empiric antibiotic therapy for a suspected urinary tract infection. We sought to evaluate how well previous urine cultures predict the identity and susceptibility of organisms in a patient's subsequent urine cultures.
    We conducted a multinational, multicenter, retrospective cohort study, including 22 019 pairs of positive urine cultures from 4351 patients across 2 healthcare systems in Toronto, Ontario, and Chicago, Illinois. We examined the probability of the same organism being identified from the same patient's positive urine culture as a function of time elapsed from the previous positive urine specimen; in cases where the same organism was identified we also examined the likelihood of the organism exhibiting the same or better antimicrobial susceptibility profile.
    At 4-8 weeks between cultures, the correspondence in isolate identity was 57% (95% confidence interval [CI], 55%-59%), and at >32 weeks it was 49% (95% CI, 48%-50%), still greater than expected by chance (P < .001). The susceptibility profile was the same or better in 83% (95% CI, 81%-85%) of isolate pairs at 4-8 weeks, and 75% (95% CI, 73%-77%) at >32 weeks, still greater than expected by chance (P < .001). Despite high local rates of ciprofloxacin resistance in urine isolates across all patients (40%; 95% CI, 39.5%-40.5%), ciprofloxacin resistance was <20% among patients with a prior ciprofloxacin sensitive organism and no subsequent fluoroquinolone exposure.
    A patient's prior urine culture results are useful in predicting the identity and susceptibility of a current positive urine culture. In areas of high fluoroquinolone resistance, ciprofloxacin can be used empirically when prior urine culture results indicate a ciprofloxacin-susceptible organism and there has been no history of intervening fluoroquinolone use.
    PMID: 25048850 [PubMed - as supplied by publisher]
  • A technology-based quality innovation to identify undiagnosed hypertension among active primary care patients.

    Annals of family medicine 2014 Jul

    Authors: Rakotz MK,
    The goal of this study was to develop a technology-based strategy to identify patients with undiagnosed hypertension in 23 primary care practices and integrate this innovation into a continuous quality improvement initiative in a large, integrated health system.
    In phase 1, we reviewed electronic health records (EHRs) using algorithms designed to identify patients at risk for undiagnosed hypertension. We then invited each at-risk patient to complete an automated office blood pressure (AOBP) protocol. In phase 2, we instituted a quality improvement process that included regular physician feedback and office-based computer alerts to evaluate at-risk patients not screened in phase 1. Study patients were observed for 24 additional months to determine rates of diagnostic resolution.
    Of the 1,432 patients targeted for inclusion in the study, 475 completed the AOBP protocol during the 6 months of phase 1. Of the 1,033 at-risk patients who remained active during phase 2, 740 (72%) were classified by the end of the follow-up period: 361 had hypertension diagnosed, 290 had either white-coat hypertension, prehypertension, or elevated blood pressure diagnosed, and 89 had normal blood pressure. By the end of the follow-up period, 293 patients (28%) had not been classified and remained at risk for undiagnosed hypertension.
    Our technology-based innovation identified a large number of patients at risk for undiagnosed hypertension and successfully classified the majority, including many with hypertension. This innovation has been implemented as an ongoing quality improvement initiative in our medical group and continues to improve the accuracy of diagnosis of hypertension among primary care patients.
    PMID: 25024244 [PubMed - as supplied by publisher]
  • Reply to Daniell.

    Infection control and hospital epidemiology 2014 Jan

    Authors: Ridgway JP,
    Methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization among inpatients is a well-established risk factor for MRSA infection during the same hospitalization, but the long-term risk of MRSA infection is uncertain. We performed a retrospective cohort study to determine the one-year risk of MRSA infection among inpatients with MRSA-positive nasal polymerase chain reaction (PCR) tests confirmed by positive nasal culture (Group 1), patients with positive nasal PCR but negative nasal culture (Group 2), and patients with negative nasal PCR (Group 3).
    Subjects were adults admitted to a four-hospital system between November 1, 2006 and March 31, 2011, comprising 195,255 admissions. Patients underwent nasal swab for MRSA PCR upon admission; if positive, nasal culture for MRSA was performed; if recovered, MRSA was tested for Panton-Valentine Leukocidin (PVL). Outcomes included MRSA-positive clinical culture and skin and soft tissue infection (SSTI). Group 1 patients had a one-year risk of MRSA-positive clinical culture of 8.0% compared with 3.0% for Group 2 patients, and 0.6% for Group 3 patients (p<0.001). In a multivariable model, the hazard ratios for future MRSA-positive clinical culture were 6.52 (95% CI, 5.57 to 7.64) for Group 1 and 3.40 (95% CI, 2.70 to 4.27) for Group 2, compared with Group 3 (p<0.0001). History of MRSA and concurrent MRSA-positive clinical culture were significant risk factors for future MRSA-positive clinical culture. Group 1 patients colonized with PVL-positive MRSA had a one-year risk of MRSA-positive clinical culture of 10.1%, and a one-year risk of MRSA-positive clinical culture or SSTI diagnosis of 21.7%, compared with risks of 7.1% and 12.5%, respectively, for patients colonized with PVL-negative MRSA (p = 0.04, p = 0.005, respectively).
    MRSA nasal colonization is a significant risk factor for future MRSA infection; more so if detected by culture than PCR. Colonization with PVL-positive MRSA is associated with greater risk than PVL-negative MRSA.
    PMID: 24334807 [PubMed - as supplied by publisher]

In the News

Jan 2015

Jan 2014

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Novel H1N1: Dr. Ari Robicsek (Infectious Diseases)

Novel H1N1: Dr. Ari Robicsek (Infectious Diseases)

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