Healthcare Outbreaks Associated With a Water Reservoir and Infection Prevention Strategies

Central line–associated bloodstream infections cause morbidity and mortality in children. We explore the evidence for prevention of central line–associated bloodstream infections in children, assess current practices, and propose research topics to improve prevention strategies.

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Targeted Surveillance to Identify Children Colonized with Vancomycin-Resistant Enterococcus in the Pediatric Intensive Care Unit

Infection Control and Hospital Epidemiology ◽

10.1086/649221 ◽

2010 ◽

Vol 31 (1) ◽

pp. 95-98 ◽

Cited By ~ 10

Author(s):

Aaron M. Milstone ◽

Lisa L. Maragakis ◽

Karen C. Carroll ◽

Trish M. Perl

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pediatric Intensive Care Unit ◽

Infection Prevention ◽

Pediatric Intensive Care ◽

Vancomycin Resistant Enterococcus ◽

Prevention Strategies ◽

Asymptomatic Patients ◽

Vancomycin Resistant ◽

Pediatric Infection

Performing admission surveillance cultures is a resource-intensive strategy to identify asymptomatic patients with vancomycin-resistant Enterococcus (VRE) colonization. We measured VRE prevalence among children admitted to the pediatric intensive care unit. Targeted surveillance captured 94% of VRE-colonized children and may be an effective strategy to identify VRE carriers and facilitate pediatric infection prevention strategies.

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Cost-effectiveness analysis of SARS-CoV-2 infection prevention strategies including pre-endoscopic virus testing and use of high risk personal protective equipment

Endoscopy ◽

10.1055/a-1294-0427 ◽

2020 ◽

Author(s):

Alanna Ebigbo ◽

Christoph Römmele ◽

Christina Bartenschlager ◽

Selin Temizel ◽

Elisabeth Kling ◽

...

Keyword(s):

Cost Effectiveness ◽

High Risk ◽

Personal Protective Equipment ◽

Infection Prevention ◽

High Volume ◽

Protective Equipment ◽

Prevalence Rates ◽

Prevention Strategies ◽

Universal Testing ◽

Asymptomatic Patients

Abstract Background Infection prevention strategies to protect healthcare workers in endoscopy units during the post-peak phase of the COVID-19 pandemic are currently under intense discussion. In this paper, the cost-effectiveness of routine pre-endoscopy testing and high risk personal protective equipment (PPE) is addressed. Method A model based on theoretical assumptions of 10 000 asymptomatic patients presenting to a high volume center was created. Incremental cost-effectiveness ratios (ICERs) and absolute costs per endoscopy were calculated using a Monte Carlo simulation. Results ICER values for universal testing decreased with increasing prevalence rates. For higher prevalence rates (≥ 1 %), ICER values were lowest for routine pre-endoscopy testing coupled with use of high risk PPE, while cost per endoscopy was lowest for routine use of high risk PPE without universal testing. Conclusion In general, routine pre-endoscopy testing combined with high risk PPE becomes more cost-effective with rising prevalence rates of COVID-19.

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Incidence and risk factors of non–device-associated pneumonia in an acute-care hospital

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2019.300 ◽

2019 ◽

Vol 41 (1) ◽

pp. 73-79 ◽

Cited By ~ 2

Author(s):

Paula D. Strassle ◽

Emily E. Sickbert-Bennett ◽

Michael Klompas ◽

Jennifer L. Lund ◽

Paul W. Stewart ◽

...

Keyword(s):

Risk Factors ◽

Infection Prevention ◽

Acute Care Hospital ◽

Future Research ◽

Ventilator Associated Pneumonia ◽

Care Hospital ◽

Prevention Strategies ◽

Increased Risk ◽

Academic Teaching Hospital ◽

Male Sex

AbstractObjective:To update current estimates of non–device-associated pneumonia (ND pneumonia) rates and their frequency relative to ventilator associated pneumonia (VAP), and identify risk factors for ND pneumonia.Design:Cohort study.Setting:Academic teaching hospital.Patients:All adult hospitalizations between 2013 and 2017 were included. Pneumonia (device associated and non–device associated) were captured through comprehensive, hospital-wide active surveillance using CDC definitions and methodology.Results:From 2013 to 2017, there were 163,386 hospitalizations (97,485 unique patients) and 771 pneumonia cases (520 ND pneumonia and 191 VAP). The rate of ND pneumonia remained stable, with 4.15 and 4.54 ND pneumonia cases per 10,000 hospitalization days in 2013 and 2017 respectively (P = .65). In 2017, 74% of pneumonia cases were ND pneumonia. Male sex and increasing age we both associated with increased risk of ND pneumonia. Additionally, patients with chronic bronchitis or emphysema (hazard ratio [HR], 2.07; 95% confidence interval [CI], 1.40–3.06), congestive heart failure (HR, 1.48; 95% CI, 1.07–2.05), or paralysis (HR, 1.72; 95% CI, 1.09–2.73) were also at increased risk, as were those who were immunosuppressed (HR, 1.54; 95% CI, 1.18–2.00) or in the ICU (HR, 1.49; 95% CI, 1.06–2.09). We did not detect a change in ND pneumonia risk with use of chlorhexidine mouthwash, total parenteral nutrition, all medications of interest, and prior ventilation.Conclusion:The incidence rate of ND pneumonia did not change from 2013 to 2017, and 3 of 4 nosocomial pneumonia cases were non–device associated. Hospital infection prevention programs should consider expanding the scope of surveillance to include non-ventilated patients. Future research should continue to look for modifiable risk factors and should assess potential prevention strategies.

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1154. Impact of Educational Feedback on Reducing Hospital-Onset Catheter-Associated Urinary tract Infections at an Academic Medical Center

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1017 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S412-S412

Author(s):

Bhagyashri D Navalkele ◽

Nora Truhett ◽

Miranda Ward ◽

Sheila Fletcher

Keyword(s):

Infection Prevention ◽

Medical Center ◽

Academic Medical Center ◽

Prevention Strategies ◽

Intervention Period ◽

Post Intervention ◽

Frontline Staff ◽

Post Intervention Period ◽

Tract Infections ◽

The Impact

Abstract Background High regulatory burden on hospital-onset (HO) infections has increased performance pressure on infection prevention programs. Despite the availability of comprehensive prevention guidelines, a major challenge has been communication with frontline staff to integrate appropriate prevention measures into practice. The objective of our study was to evaluate the impact of educational intervention on HO CAUTI rates and urinary catheter days. Methods At the University of Mississippi Medical Center, Infection prevention (IP) reports unit-based monthly HO infections via email to respective unit managers and ordering physician providers. Starting May 2018, IP assessed compliance to CAUTI prevention strategies per SHEA/IDSA practice recommendations (2014). HO CAUTI cases with noncompliance were labeled as “preventable” infections and educational justification was provided in the email report. No other interventions were introduced during the study period. CAUTI data were collected using ongoing surveillance per NHSN and used to calculate rates per 1,000 catheter days. One-way analysis of variance (ANOVA) was used to compare pre- and post-intervention data. Results Prior to intervention (July 2017–March 2018), HO CAUTI rate was 1.43 per 1,000 catheter days. In the post-intervention period (July 2018–March 2019), HO CAUTI rate decreased to 0.62 per 1,000 catheter days. Comparison of pre- and post-intervention rates showed a statistically significant reduction in HO CAUTIs (P = 0.04). The total number of catheter days reduced, but the difference was not statistically significant (8,604 vs. 7,583; P = 0.06). Of the 14 HO CAUTIs in post-intervention period, 64% (8/14) were reported preventable. The preventable causes included inappropriate urine culturing practice in asymptomatic patients (5) or as part of pan-culture without urinalysis (2), and lack of daily catheter assessment for necessity (1). Conclusion At our institute, regular educational feedback by IP to frontline staff resulted in a reduction of HO CAUTIs. Feedback measure improved accountability, awareness and engagement of frontline staff in practicing appropriate CAUTI prevention strategies. Disclosures All authors: No reported disclosures.

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Infection Prevention Strategies in Inpatient Psychiatric Units Using Patient Acuity and Motivation

American Journal of Infection Control ◽

10.1016/j.ajic.2013.03.101 ◽

2013 ◽

Vol 41 (6) ◽

pp. S48 ◽

Cited By ~ 1

Author(s):

Larysa M. Fedoriw ◽

Barbara Meijer

Keyword(s):

Infection Prevention ◽

Prevention Strategies ◽

Patient Acuity ◽

Psychiatric Units

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Identification of target risk groups for population-based Clostridium difficile infection prevention strategies using a population attributable risk approach

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2017.11.021 ◽

2018 ◽

Vol 66 ◽

pp. 107-112 ◽

Cited By ~ 1

Author(s):

Sung-Hee Oh ◽

Hye-Young Kang

Keyword(s):

Clostridium Difficile ◽

Clostridium Difficile Infection ◽

Infection Prevention ◽

Population Attributable Risk ◽

Risk Groups ◽

Population Based ◽

Attributable Risk ◽

Prevention Strategies ◽

Risk Approach

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Evaluation of Methicillin-Resistant Staphylococcus aureus Skin and Soft-Tissue Infection Prevention Strategies at a Military Training Center

Infection Control and Hospital Epidemiology ◽

10.1086/671278 ◽

2013 ◽

Vol 34 (8) ◽

pp. 841-843 ◽

Cited By ~ 12

Author(s):

Stephanie M. Morrison ◽

Carl R. Blaesing ◽

Eugene V. Millar ◽

Uzo Chukwuma ◽

Carey D. Schlett ◽

...

Keyword(s):

Staphylococcus Aureus ◽

High Risk ◽

Soft Tissue ◽

Infection Prevention ◽

Methicillin Resistant Staphylococcus Aureus ◽

Military Training ◽

Soft Tissue Infections ◽

Training Center ◽

Prevention Strategies ◽

Methicillin Resistant

Military trainees are at high risk for skin and soft-tissue infections (SSTIs), especially those caused by methicillin-resistant Staphylococcus aureus (MRSA). A multicomponent hygiene-based SSTI prevention strategy was implemented at a military training center. After implementation, we observed 30% and 64% reductions in overall and MRSA-associated SSTI rates, respectively.

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SARS-CoV-2 inactivation by human defensin HNP1 and retrocyclin RC-101

10.1101/2021.05.27.445985 ◽

2021 ◽

Author(s):

Elena Kudryashova ◽

Ashley Zani ◽

Geraldine Vilmen ◽

Amit Sharma ◽

Wuyuan Lu ◽

...

Keyword(s):

Cell Culture ◽

Innate Immune System ◽

Infection Prevention ◽

Bacterial Toxins ◽

Innate Immune ◽

Spike Protein ◽

Prevention Strategies ◽

Enveloped Viruses ◽

Enveloped Virus ◽

High Concentrations

Severe acute respiratory syndrome coronavirus (SARS-CoV)-2 is an enveloped virus responsible for the COVID-19 respiratory disease pandemic. While induction of adaptive antiviral immunity via vaccination holds promise for combatting the pandemic, the emergence of new potentially more transmissible and vaccine-resistant variants of SARS-CoV-2 is an ever-present threat. Thus, it remains essential to better understand innate immune mechanisms that are active against the virus. One component of the innate immune system with broad anti-pathogen, including antiviral, activity is a group of cationic immune peptides termed defensins. The defensins' ability to neutralize enveloped and non-enveloped viruses and to inactivate numerous bacterial toxins correlate with their ability to promote the unfolding of thermodynamically pliable proteins. Accordingly, we found that human neutrophil α-defensin HNP1 and retrocyclin RC-101 destabilize SARS-CoV-2 Spike protein and interfere with Spike-mediated membrane fusion and SARS-CoV-2 infection in cell culture. We show that HNP1 binds to Spike with submicromolar affinity. Although binding of HNP1 to serum albumin is more than 20-fold weaker, serum reduces the anti-SARS-CoV-2 activity of HNP1. At high concentrations of HNP1, its ability to inactivate the virus was preserved even in the presence of serum. These results suggest that specific α- and θ-defensins may be valuable tools in developing SARS-CoV-2 infection prevention strategies.

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Infection prevention strategies are highly protective in COVID-19 units while main risks to healthcare professionals come from coworkers and the community

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-021-01031-5 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Shruti K. Gohil ◽

Kathleen A. Quan ◽

Keith M. Madey ◽

Suzanne King-Adelsohn ◽

Tom Tjoa ◽

...

Keyword(s):

Infection Prevention ◽

Healthcare Professionals ◽

Cross Sectional Study ◽

Prevention Strategies ◽

Positive Serology ◽

Cross Sectional ◽

Community Factors ◽

Control Units ◽

Job Role ◽

Test Result

Abstract Background Early evaluations of healthcare professional (HCP) COVID-19 risk occurred during insufficient personal protective equipment and disproportionate testing, contributing to perceptions of high patient-care related HCP risk. We evaluated HCP COVID-19 seropositivity after accounting for community factors and coworker outbreaks. Methods Prior to universal masking, we conducted a single-center retrospective cohort plus cross-sectional study. All HCP (1) seen by Occupational Health for COVID-like symptoms (regardless of test result) or assigned to (2) dedicated COVID-19 units, (3) units with a COVID-19 HCP outbreak, or (4) control units from 01/01/2020 to 04/15/2020 were offered serologic testing by an FDA-authorized assay plus a research assay against 67 respiratory viruses, including 11 SARS-CoV-2 antigens. Multivariable models assessed the association of demographics, job role, comorbidities, care of a COVID-19 patient, and geocoded socioeconomic status with positive serology. Results Of 654 participants, 87 (13.3%) were seropositive; among these 60.8% (N = 52) had never cared for a COVID-19 patient. Being male (OR 1.79, CI 1.05–3.04, p = 0.03), working in a unit with a HCP-outbreak unit (OR 2.21, CI 1.28–3.81, p < 0.01), living in a community with low owner-occupied housing (OR = 1.63, CI = 1.00–2.64, p = 0.05), and ethnically Latino (OR 2.10, CI 1.12–3.96, p = 0.02) were positively-associated with COVID-19 seropositivity, while working in dedicated COVID-19 units was negatively-associated (OR 0.53, CI = 0.30–0.94, p = 0.03). The research assay identified 25 additional seropositive individuals (78 [12%] vs. 53 [8%], p < 0.01). Conclusions Prior to universal masking, HCP COVID-19 risk was dominated by workplace and community exposures while working in a dedicated COVID-19 unit was protective, suggesting that infection prevention protocols prevent patient-to-HCP transmission. Article summary Prior to universal masking, HCP COVID-19 risk was dominated by workplace and community exposures while working in a dedicated COVID-19 unit was protective, suggesting that infection prevention protocols prevent patient-to-HCP transmission.

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