A Survey of Hospital Postpartum and Postabortion Rubella Vaccination Policies in Los Angeles County, 1992

AbstractObjective:To determine the proportion of Los Angeles County (LAC) hospitals offering obstetrical services that have postpartum and postabortion rubella vaccination policies.Design:A survey was sent to the infection control practitioners (ICPs) of all operational acute care hospitals (N = 133) in LAC in 1992. A reminder and second survey was mailed to ICPs who did not respond to the first mailing.Results:Of 75 hospitals with obstetrical departments, 56 (75%) responded. Thirty-four (61%) of the 56 respondent hospitals had postpartum rubella vaccination policies. Of the 34 hospitals with policies, 30 (88%) accepted only a written record of rubella seropositivity as proof of immunity, 30 (88%) screened women with unknown immunity status before hospital discharge, and 32 (94%) vaccinated susceptible women before hospital discharge. Of the 32 hospitals that performed induced abortions, only two (6%) provided screening and vaccination services for these women.Conclusion:Only 61% of hospitals in LAC offering obstetrical services had postpartum rubella vaccination policies while only minimal screening and vaccination occurred in association with abortion services. Widespread implementation of postabortion screening and vaccination, and more stringent compliance with Advisory Committee on Immunization Practices recommendations for postpartum screening and vaccination in hospitals offering obstetrical services would reduce the number of rubella-susceptible women who have been missed by other prevention strategies.

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Infection control practices for respiratory syncytial virus (RSV) among acute care hospitals in Los Angeles County

American Journal of Infection Control ◽

10.1016/0196-6553(91)90065-k ◽

1991 ◽

Vol 19 (2) ◽

pp. 107 ◽

Cited By ~ 1

Author(s):

A. Itano ◽

F. Sorvillo

Keyword(s):

Respiratory Syncytial Virus ◽

Los Angeles ◽

Infection Control ◽

Acute Care ◽

Los Angeles County ◽

Acute Care Hospitals ◽

Syncytial Virus

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90. Impact of Infection Control Assessment and Response (ICAR) Visit on Candida auris Colonization Rates at Seven Long Term Acute Care Hospitals (LTACH) in Los Angeles County

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.090 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S57-S57

Author(s):

Kiran Bhurtyal ◽

Jennifer Nguyen ◽

Anthony Clarke ◽

Kelsey OYong ◽

Sandeep Bhaurla ◽

...

Keyword(s):

Public Health ◽

Los Angeles ◽

Infection Control ◽

Acute Care ◽

Los Angeles County ◽

Acute Care Hospitals ◽

Candida Auris ◽

Colonization Rates ◽

Environmental Disinfection

Abstract Background Public health authorities often use Infection Control Assessment and Response (ICAR) visits during Candida auris (C. auris) outbreak investigation to identify facility-level infection prevention and control (IPC) practice gaps and make recommendations to address those gaps. As an adjunct to ICAR visit, point prevalence surveys (PPS) provide an objective measure to determine if IPC recommendations are implemented. Because they require significant public health resources to perform, we evaluated the impact of ICAR visits on C. auris colonization rates. Methods PPS were conducted at seven long-term acute-care hospitals (LTACH) with C. auris outbreaks in Los Angeles County from July 2020 to May 2021. Skin swabs collected at PPS were tested for C. auris colonization by PCR technique. Pre-ICAR PPS results were compared with the average of two serial post-ICAR PPS results using repeated measures ANOVA test. Linear regression was used to estimate associations between individual ICAR domains and C. auris colonization. Results 54 PPS were conducted at seven LTACHs with at least one ICAR visit made for every two PPS. On average, PPS were conducted 14 days (range 1-15 days) before and 10 days (range 4-33 days) after an ICAR visit. PPS positive rates with ICAR visit dates for each LTACH are shown in figure 1. Overall, ICAR visits were associated with a significant decrease (p=0.035) in the average of the positive rates in two serial post-ICAR PPS. When individual domain (hand hygiene, contact precautions, and environmental disinfection) of ICAR tool was analyzed, only adherence to environmental disinfection was significantly associated (p=0.038) with decrease in C. auris colonization rates. There was a moderate negative correlation (R2 = 0.26, β= -0.33) between environmental disinfection adherence and the magnitude of decrease in the colonization rates across all LTACHs (Figure 2). Figure 1 Figure 2 Conclusion ICAR visits were found to be significantly associated with a decrease in the average PPS positive rate on serial PPS. Parts of the ICAR tool that assessed environmental disinfection at the facility seemed most correlated with decrease in C. auris colonization rate. Streamlining the ICAR process to focus on the most impactful parts of ICAR tool may be a more efficient intervention to control C. auris outbreaks. Disclosures All Authors: No reported disclosures

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542. Los Angeles County Acute Care Regional Antibiogram Suggests Changing Landscape of MDRO Threats Between 2015 and 2017

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.611 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S258-S259

Author(s):

James McKinnell ◽

Chelsea Foo ◽

Kelsey OYong ◽

Janet Hindler ◽

Sandra Ceja ◽

...

Keyword(s):

Public Health ◽

Los Angeles ◽

Acute Care ◽

Los Angeles County ◽

Multivariable Analysis ◽

Multidrug Resistant ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Level Data ◽

Facility Level

Abstract Background National surveillance for multidrug-resistant organisms (MDRO) are limited by narrow geographic sampling, few hospitals, and failure to account for local epidemiology. A Los Angeles County (LAC) regional antibiogram was created to inform public health interventions and provide a baseline for susceptibility patterns countywide. We present data to compare the 2015 and 2017 LAC regional antibiogram. Methods We conducted a cross-sectional survey of cumulative facility-level antibiograms from all hospitals in LAC; 83 hospitals (AH) and 9 Long-term Acute Care (LTAC). For 2015, submission was voluntary, 2017 data were collected by public health order. Non-respondents were contacted by phone and in person. Isolates from sterile sources were pooled. Countywide susceptibility was calculated by weighting each facility’s isolate count by its reported susceptibility rate with minimum–maximim observed (2015) and Interquartile range (IQR) for 2017. Change from 2015 mean susceptibility is reported. Results Seventy-five (75) facilities submitted antibiograms for 2015 and 86 facilities for 2017. Among non-respondents in 2017, two facilities could not provide an adequate antibiogram and 4 were specialty hospitals with too few cultures to create an antibiogram. Regional summmary tables are presented in Tables 1–4. Klebsiella pneumoniae (n = 50 hospitals/19,382 isolates) % S to meropenem was 97% (IQR 94–100%), no change from 2015. Pseudomonas aeruginosa (PA) (n = 52 hospitals/17,770 isolates)% S to meropenem was 84% (IQR 74–93%), no change from 2015. Susceptibility to Acinetobacter baumannii (AB) was reported by 48 hospitals, including 1,4361 isolates,% S to meropenem was 39% (IQR 25–75%), 14% lower than 2015. Streptococcus agalactiae (n = 13 hospitals/647 isolates)% S to clindamycin was 43% (IQR 13–59%), a 22% increase from 2015. Conclusion LAC regional antibiograms identified stable patterns of antimicrobial resistance for most pathogens, but concerning results with AB and PA. Analysis of highly drug-resistant pathogens such as AB and PA would be improved with patient-level data to generate a combination antibiogram. We favor presenting IQR %S as done for 2017. Ongoing analysis will include multivariable analysis of observed changed S controlling for hospital characteristics. Disclosures All authors: No reported disclosures.

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