American Journal of Infection Control via MedWorm.com

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American Journal of Infection Control — Wed, 01 Feb 2012 05:00:00 +0100

(Source: American Journal of Infection Control)

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American Journal of Infection Control — Wed, 01 Feb 2012 05:00:00 +0100

(Source: American Journal of Infection Control)

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American Journal of Infection Control — Wed, 01 Feb 2012 05:00:00 +0100

(Source: American Journal of Infection Control)

Editorial Board

American Journal of Infection Control — Wed, 01 Feb 2012 05:00:00 +0100

(Source: American Journal of Infection Control)

American Journal of Infection Control — Wed, 01 Feb 2012 05:00:00 +0100

(Source: American Journal of Infection Control)

Frequency of outbreak investigations in US hospitals: Results of a national survey of infection preventionists

American Journal of Infection Control — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: Norovirus is emerging as an increasingly common hospital-associated organism causing outbreaks in nonacute settings and may lead to unit/department closures. (Source: American Journal of Infection Control)

Save the Date for APIC 2012

American Journal of Infection Control — Wed, 01 Feb 2012 05:00:00 +0100

The CDC recently reported improvement in health care provider adherence to proven prevention measures and released evidence that showed a commensurate decrease in 4 common health care-associated infections—CLABSI, CAUTI, SSI, and MRSA—in 2010. (Source: American Journal of Infection Control)

Response to “A call for consideration of needlestick injury data in evaluating staffing effectiveness”

American Journal of Infection Control — Mon, 12 Dec 2011 05:00:00 +0100

Mr Jett, my coauthors and I thank you for your thoughtful letter concerning our June 2011 paper on the association of needlestick injuries among inpatient staff nurses and nurse staffing. We particularly applaud your regard for the multifactorial nature of needlestick injuries. Despite advances in needleless devices, needlestick injuries continue to occur, and, as our data show, contaminated needles are still a serious threat to the occupational safety of nursing personnel, not to mention others who work in hospitals (eg, housekeeping staff) whom we did not study. Just as with the patient safety movement, we need to seriously consider not only the actions of the individual nurses but the systems in which they provide nursing care, or the context of their respective work environments, if w...

Compliance with standard precautions among gastrointestinal endoscopists and endoscopy nurses in Japan

American Journal of Infection Control — Fri, 09 Dec 2011 05:00:00 +0100

Gastrointestinal endoscopists (GEs) and gastrointestinal endoscopy nurses (GENs) are exposed to many potential hazards during endoscopy procedures. Standard precautions (SPs) are important, given that knowledge of a patient’s infection status is only presumptive. It is also impossible to predict when accidents might occur. Therefore, we examined the level of compliance with SPs in Japanese GEs and GENs. (Source: American Journal of Infection Control)

A call for consideration of needlestick injury data in evaluating staffing effectiveness

American Journal of Infection Control — Thu, 08 Dec 2011 05:00:00 +0100

Dr Larson, I applaud the effort to promote improved understanding of contributing factors to occupational injuries and bloodborne pathogen exposures that Patrician, Prior, Fridman, and Loan discussed in their June 2011 article. As the authors posit, the impact of staffing on the prevalence of needlesticks and other injuries among nurses has received limited attention to date. In my experience in occupational health nursing and infection prevention, the primary targets of needlestick injury follow-up investigations are typically individual behavioral factors and the use of engineered safety devices. This approach is an appropriate initial step but fails to determine potential root causes for the injury event. Other research has demonstrated scheduling and work factors such as extended-hour ...

Over-the-counter delivery of antibiotics: Are we sending the right message?

American Journal of Infection Control — Mon, 05 Dec 2011 05:00:00 +0100

In the preantibiotic era, infection syndromes had been treated with antibody-based therapy. Although effective, these forms of therapy were pathogen specific and were limited by adverse effects such as serum sickness and viral contamination and supplanted by the development of antibiotics in the 1940s. Antibiotics have probably saved more lives than any other group of drugs. However, the efficacy of antimicrobial chemotherapy is diminishing because of the rapidly escalating resistance. In the 70 years of the antibiotic era in the treatment of human infectious diseases, pathogenic bacteria have developed relentlessly with clinically significant resistances to one class of antibiotic after another. (Source: American Journal of Infection Control)

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American Journal of Infection Control — Thu, 01 Dec 2011 05:00:00 +0100

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APIC Masthead

American Journal of Infection Control — Thu, 01 Dec 2011 05:00:00 +0100

(Source: American Journal of Infection Control)

Editorial Board

American Journal of Infection Control — Thu, 01 Dec 2011 05:00:00 +0100

(Source: American Journal of Infection Control)

American Journal of Infection Control — Thu, 01 Dec 2011 05:00:00 +0100

(Source: American Journal of Infection Control)

Beliefs about hand hygiene: A survey in medical students in their first clinical year

American Journal of Infection Control — Thu, 01 Dec 2011 05:00:00 +0100

Medical students were asked regarding knowledge and beliefs on hand hygiene before entering the clinical phase of education. By this, we noticed a lack of knowledge concerning the correct indications for hand disinfection. Regardless of previous experience in hospitals, the medical students expected that the compliance towards hand hygiene would be worse in more experienced physicians and senior consultants—who are often considered to be role models for medical students. (Source: American Journal of Infection Control)

National Healthcare Safety Network (NHSN) Report, data summary for 2010, device-associated module

American Journal of Infection Control — Thu, 01 Dec 2011 05:00:00 +0100

This report is a summary of Device-associated (DA) Module data collected by hospitals participating in the National Healthcare Safety Network (NHSN) for events occurring from January through December 2010 and reported to the Centers for Disease Control and Prevention (CDC) by July 7, 2011. This report updates previously published DA Module data from the NHSN and provides contemporary comparative rates. This report complements other NHSN reports, including national and state-specific reports of standardized infection ratios for select health care-associated infections (HAIs). (Source: American Journal of Infection Control)

Year-end message from APIC 2011 President

American Journal of Infection Control — Thu, 01 Dec 2011 05:00:00 +0100

As my year of service as president of APIC comes to a close, I reflect on the tremendous accomplishments of our organization and the terrific infection prevention work taking place each and every day in care settings around the world. This work is reflected in the critical work of infection preventionists, health care epidemiologists, and other scientists who improve our understanding through the pages of AJIC. While there is a long list of accomplishments this year, I’d like to call out three in particular. First, we’ve hired a CEO for the Association, Ms Katrina Crist, and are benefiting significantly from her leadership of the superb team at APIC Headquarters. Second, the APIC Board and a broad array of other key stakeholders convened a Strategic Planning Summit earlier this fall ai...

Rapid screening method for multiple gastroenteric pathogens also detects novel enterohemorrhagic Escherichia coli O104:H4

American Journal of Infection Control — Mon, 21 Nov 2011 05:00:00 +0100

We have read a current article by Frank et al reporting the preliminary data on the current outbreak of a new aggressive enterohemorrhagic Escherichia coli (EHEC) strain in Germany with great interest. During the last phase of the outbreak, our hospital also treated several patients suspected of being infected with said novel EHEC strain E coli O104:H4. The patients were suffering from hemorrhagic diarrhea and at the risk of developing the serious and life-threatening hemolytic-uremic syndrome and thus needed a rapid differential diagnosis. To avoid misdiagnosis potentially leading to incorrect initial therapy or infection control measures, rapid screening diagnostic methods were required because it was difficult to contact specialized laboratories for rapid confirmation of suspected stra...

Risk factors for coronary artery bypass graft chest surgical site infections in New York State, 2008

American Journal of Infection Control — Mon, 21 Nov 2011 05:00:00 +0100

Conclusions: Additional risk factors collected using a secondary database improved the prediction of SSIs, however, there remained unexplained variation in rates between hospitals. (Source: American Journal of Infection Control)

Vancomycin-resistant enterococci rectal colonization in an intensive care unit: A report from Turkey

American Journal of Infection Control — Mon, 07 Nov 2011 05:00:00 +0100

The prevalance of vancomycin-resistant enterococcus (VRE) nosocomial infections has dramatically increased in recent years throughout the world. Current recommendations for hospital infection control include VRE fecal surveillance cultures obtaining from high-risk patients, such as those in intensive care units, hematology-oncology wards, and transplant units. (Source: American Journal of Infection Control)

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American Journal of Infection Control — Tue, 01 Nov 2011 04:00:00 +0100

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American Journal of Infection Control — Tue, 01 Nov 2011 04:00:00 +0100

(Source: American Journal of Infection Control)

Editorial Board

American Journal of Infection Control — Tue, 01 Nov 2011 04:00:00 +0100

(Source: American Journal of Infection Control)

American Journal of Infection Control — Tue, 01 Nov 2011 04:00:00 +0100

(Source: American Journal of Infection Control)

Environmental contamination because of multidrug-resistant Acinetobacter baumannii surrounding colonized or infected patients

American Journal of Infection Control — Tue, 01 Nov 2011 04:00:00 +0100

Conclusion: For patients with MDR-AB, the surrounding environment is frequently contaminated, even among patients with a remote history of MDR-AB. Surfaces often touched by health care workers during routine patient care are commonly contaminated and may be a source of nosocomial spread. (Source: American Journal of Infection Control)

Make sure your infection prevention library is complete with these popular resources from APIC

American Journal of Infection Control — Tue, 01 Nov 2011 04:00:00 +0100

APIC’s Top Resources (Source: American Journal of Infection Control)

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American Journal of Infection Control — Sat, 01 Oct 2011 04:00:00 +0100

(Source: American Journal of Infection Control)

APIC Masthead

American Journal of Infection Control — Sat, 01 Oct 2011 04:00:00 +0100

(Source: American Journal of Infection Control)

Editorial Board

American Journal of Infection Control — Sat, 01 Oct 2011 04:00:00 +0100

(Source: American Journal of Infection Control)

American Journal of Infection Control — Sat, 01 Oct 2011 04:00:00 +0100

(Source: American Journal of Infection Control)

Methicillin-resistant Staphylococcus aureus from dental school clinic surfaces and students

American Journal of Infection Control — Sat, 01 Oct 2011 04:00:00 +0100

Conclusion: The MRSA-positive samples were from 4 of 7 dental clinics. In addition, 21% of the dental students carried MRSA, which is > 10 times higher than the general public and twice as frequent as in other university students. This is the first study to characterize MRSA from dental clinic surfaces and dental students and suggests that both may be reservoirs for MRSA. Further studies are needed to verify this premise. (Source: American Journal of Infection Control)

Infection control: Accomplishments and priorities from an individual, state, national, and international perspective

American Journal of Infection Control — Sat, 01 Oct 2011 04:00:00 +0100

In celebration of International Infection Control Week (October 16-22), we have asked 4 of AJIC's colleagues to address the following: Major accomplishments in infection prevention over the past decade or so; (Source: American Journal of Infection Control)

APIC welcomes new Chief Executive Officer

American Journal of Infection Control — Sat, 01 Oct 2011 04:00:00 +0100

APIC is pleased to welcome Katrina Crist, MBA, as Chief Executive Officer (CEO) of APIC. Crist comes to APIC with more than 15 years of experience in health care association management, having most recently served as CEO and Executive Director for the American Society of Transplant Surgeons (ASTS). While at ASTS, she led the organization to increased visibility and credibility and doubled the size of its membership. (Source: American Journal of Infection Control)

Treatment of tuberculosis: Timely or accurately?

American Journal of Infection Control — Mon, 26 Sep 2011 04:00:00 +0100

In this study, the authors found that the implementation of an expedited acid-fast bacilli (AFB) smear laboratory procedure and an automatic, real-time laboratory notification system by short message with mobile phones can significantly decrease delay in the diagnosis and isolation of patients with active tuberculosis (TB). Despite recent progress in infection control efforts, TB remains one of the greatest challenges to global public health, and Taiwan is not exempt from this threat. The estimated prevalence of TB infection in Taiwan was 111 per 100,000 population in 2007, and there were 14,265 new cases (62.0 per 100,000 population) in 2008. Therefore, patients with AFB-positive specimen, especially respiratory samples, were generally presumed to be Mycobacterium tuberculosis (MTB) unles...

Factors affecting nursing students' knowledge of HIV/AIDS in Singapore

American Journal of Infection Control — Mon, 26 Sep 2011 04:00:00 +0100

Nursing students in Singapore are taught about HIV/AIDS during their course of training and also have the opportunity to interact with and care for patients living with HIV/AIDS during their clinical posting. As the next generation of health care professionals, these student nurses need to increase their knowledge as well as their self-awareness of fears and concerns related to caring for patients living with HIV/AIDS. The prevalence of HIV/AIDS in Singapore is increasing, and every nurse will care for these patients at some point in her career. Nursing students need sufficient knowledge and self-awareness to provide quality care for thse patients. Limited information is available on the knowledge level regarding HIV/AIDS of nursing students in Singapore. We aimed to identify factors assoc...

Standard for using a fluorescent marker

American Journal of Infection Control — Thu, 22 Sep 2011 04:00:00 +0100

In Australia, there is no commercially available fluorescent marker that can be used to demonstrate where cleaning has been undertaken. To overcome this, a fluorescent marker standard has been developed with instructions for using an existing and readily available product. (Source: American Journal of Infection Control)

Home health agency’s pandemic preparedness

American Journal of Infection Control — Fri, 16 Sep 2011 04:00:00 +0100

The report on the problem of home health agency’s pandemic preparedness is very interesting. It seems that the small size agency might have the problem in preparedness and can be the problematic foci in case of outbreak of 2009 H1N1 influenza. It is no use to know only that the present problem exists, but it is more useful to find the solution for the problem. A recent concept of telehealth infection control might be a possible solution. This is concordant with the fact that “health care transitions to the home environment.” (Source: American Journal of Infection Control)

Assessment beyond central line bundle: Audits for line necessity in infected central lines in a surgical intensive care unit

American Journal of Infection Control — Mon, 12 Sep 2011 04:00:00 +0100

Central line-associated bloodstream infection (CLABSI) is a major health care burden in the intensive care unit (ICU) setting. Many risk factors associated with central lines have been studied with mixed results. Although it has long been accepted that increased duration of a central line leads to higher infection rates, little attention beyond central line bundle is paid to the factors contributing to CLABSI development. Recently, more attention has focused on reminding staff to remove lines that are not medically necessary using a daily goals checklist. Audits of line necessity with feedback to staff may have a desirable impact on staff behavior but are not routinely performed. We performed a retrospective audit of patients with CLABSI in a surgical ICU at a large academic teaching cente...

Mobile phone usage in the clinical setting: Evidence-based guidelines for all users is urgently required

American Journal of Infection Control — Mon, 12 Sep 2011 04:00:00 +0100

We commend the recent article that adds to the compelling body of evidence that suggests mobile phones as communication devices in the clinical environment are popular and regularly utilized by patients and health care workers. (Source: American Journal of Infection Control)

Patient awareness of the risks of central venous catheters in the outpatient setting

American Journal of Infection Control — Fri, 09 Sep 2011 04:00:00 +0100

Bloodstream infection remains the most common life-threatening complication of central venous access. Central venous catheters (CVCs) are the most frequent cause of nosocomial bloodstream infection with 250,000 to 500,000 episodes occurring in the United States annually. In the last several years, widespread implementation of evidence-based interventions to prevent central line-associated bloodstream infection (CLABSI) in the intensive care unit has been undertaken with commensurate reduction in CLABSI rates. Nonetheless, CLABSI remains one of the most important life-threatening complications of central venous access. Patient education regarding CVC insertion and risk of CLABSI has been recommended, as outlined in the 2011 Patient Safety goals from the Joint Commission. However, data on pa...

Viral study on a ventilation filter from a public building

American Journal of Infection Control — Wed, 07 Sep 2011 04:00:00 +0100

We read the recent article by Goyal et al reporting a viral study on a ventilation filter from a public building with great interest. The authors concluded that “existing building HVAC filters may be used as a method of detection for airborne viruses” and proposed that the assessement “can inform the development of methods to prevent airborne transmission of viruses and possible deterrents against the spread of bioterrorism agents.” Indeed, the finding of virus in filters can be expected. Further investigations should address the possibility of spreading the virus to people in the building. Also, detection of the virus at high levels also spells danger for the general population in the area around the building. (Source: American Journal of Infection Control)

Epidemiologic surveillance of postoperative endophthalmitis in a specialized ophthalmologic center in São Paulo, Brazil

American Journal of Infection Control — Fri, 02 Sep 2011 04:00:00 +0100

This article describes a postoperative endophthalmitis (POE) surveillance system in place in a specialized ophthalmologic center in São Paulo, Brazil. The study involved a review of medical records from 2004-2009, during which a total of 31,999 intraocular surgeries were performed. Nineteen of these cases fulfilled the criteria for POE, for an infection rate of 0.06%. The main etiologic agent causing POE was Pseudomonas aeruginosa, identified in 42.1% of the cases (8/19). (Source: American Journal of Infection Control)

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American Journal of Infection Control — Sat, 27 Aug 2011 16:34:11 +0100

(Source: American Journal of Infection Control)

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American Journal of Infection Control — Sat, 27 Aug 2011 16:34:11 +0100

(Source: American Journal of Infection Control)

APIC Masthead

American Journal of Infection Control — Sat, 27 Aug 2011 16:34:11 +0100

(Source: American Journal of Infection Control)

Editorial Board

American Journal of Infection Control — Sat, 27 Aug 2011 16:34:11 +0100

(Source: American Journal of Infection Control)

American Journal of Infection Control — Sat, 27 Aug 2011 16:34:11 +0100

(Source: American Journal of Infection Control)

Bedpan washer disinfectors: An in-use evaluation of cleaning and disinfection

American Journal of Infection Control — Sat, 27 Aug 2011 16:34:09 +0100

Conclusion: Users should thoroughly evaluate the in-use efficacy of BPDs and use a step-wise approach to identify and correct both human and equipment deficiencies. Forced function and compliance features for correct loading of machines, detergent and rinse agent dispensing, and ability to operate the machine only when detergent is present should be integral to the BPD design. (Source: American Journal of Infection Control)

Nursing and physician attire as possible source of nosocomial infections

American Journal of Infection Control — Sat, 27 Aug 2011 16:34:08 +0100

Conclusion: Up to 60% of hospital staff’s uniforms are colonized with potentially pathogenic bacteria, including drug-resistant organisms. It remains to be determined whether these bacteria can be transferred to patients and cause clinically relevant infection. (Source: American Journal of Infection Control)

APIC ANYWHERE™ puts infection prevention resources at your fingertip

American Journal of Infection Control — Sat, 27 Aug 2011 16:34:07 +0100

The APIC ANYWHERE™ Online Education Center provides the most comprehensive health care-associated infections reduction strategies, education, and training available. With content developed by leading infection prevention experts in a user-friendly format, APIC ANYWHERE™ puts the infection prevention resources you need to educate yourself, other health care professionals, and the public at your fingertip! (Source: American Journal of Infection Control)

An effective intervention to limit the spread of an epidemic carbapenem-resistant Klebsiella pneumoniae strain in an acute care setting: From theory to practice

American Journal of Infection Control — Wed, 24 Aug 2011 04:00:00 +0100

Conclusions: A comprehensive infection control program can contain an outbreak of the CRKP KPC-3 strain in acute care hospitals during a nationwide outbreak of this strain. (Source: American Journal of Infection Control)

Outbreak of bloodstream infections because of Serratia marcescens in a pediatric department

American Journal of Infection Control — Fri, 19 Aug 2011 04:00:00 +0100

Conclusion: Prompt recognition and strict adherence to infection control measures are of paramount importance in combating an outbreak of S marcescens bloodstream infection. (Source: American Journal of Infection Control)

Catheter management in neonates with bloodstream infection and a percutaneously inserted central venous catheter in situ: Removal or not?

American Journal of Infection Control — Tue, 16 Aug 2011 04:00:00 +0100

Conclusions: PICCs should be removed in neonates with BSI, because retention of PICCs for more than 3 days is associated with delayed resolution of clinical sepsis and a higher incidence of recurrence within 1 month. (Source: American Journal of Infection Control)

Cost-effectiveness of interferon-γ release assay versus chest X-ray for tuberculosis screening of employees

American Journal of Infection Control — Tue, 16 Aug 2011 04:00:00 +0100

Conclusion: The QFT strategy is currently robust for screening Bacille Calmette-Guérin– vaccinated employees in Japan. There appears to be little role for CXR. These findings may be applicable to other countries in terms of choosing optimal TB screening for employees. (Source: American Journal of Infection Control)

Disinfection of an infrared coagulation device used to treat hemorrhoids

American Journal of Infection Control — Fri, 12 Aug 2011 04:00:00 +0100

Infrared coagulation devices are used to treat internal hemorrhoids, and as semicritical items should undergo high-level disinfection between patients. We developed and validated a method for disinfecting an infrared coagulation device that cannot be immersed in disinfectant solution. (Source: American Journal of Infection Control)

Outbreak of acute hepatitis B virus infections associated with podiatric care at a psychiatric long-term care facility

American Journal of Infection Control — Fri, 12 Aug 2011 04:00:00 +0100

Conclusions: Of the multiple potential transmission modes identified, exposure to HBV during podiatry was likely the dominant mode in this outbreak. Long-term care facilities should ensure compliance with infection control standards among staff and consulting health care providers. (Source: American Journal of Infection Control)

Effect of interventions in reducing the rate of infection after cesarean delivery

American Journal of Infection Control — Fri, 12 Aug 2011 04:00:00 +0100

Conclusions: The interventions implemented at our institution led to a considerable decline in post-CD infectious morbidity. (Source: American Journal of Infection Control)

Antimicrobial resistance in pathogens causing nosocomial bloodstream infections in university hospitals in Egypt

American Journal of Infection Control — Fri, 12 Aug 2011 04:00:00 +0100

Conclusions: High rates of β-lactamase resistance and methicillin-resistant S aureus were found in the 3 Egyptian university hospitals studied. This study highlights the need for strengthening infection prevention and control programs, monitoring AMR at each facility, and developing policies for antibiotic use. (Source: American Journal of Infection Control)

Successful control of a norovirus outbreak among attendees of a hospital teaching conference

American Journal of Infection Control — Fri, 05 Aug 2011 04:00:00 +0100

We report an outbreak of norovirus gastroenteritis after a hospital teaching conference, and describe the specific measures instituted by the infection control team. No secondary cases of norovirus infection were identified among hospital staff or patients. In a case-control study, we identified multiple food source contamination as the source of the outbreak. Our report highlights the potential success of a multifaceted infection control strategy in preventing the transmission of norovirus in health care settings. (Source: American Journal of Infection Control)

Accuracy of a urinary catheter surveillance protocol

American Journal of Infection Control — Thu, 04 Aug 2011 04:00:00 +0100

Conclusions: Individual chart review in the electronic medical record provided very accurate data on urinary catheter use. (Source: American Journal of Infection Control)

Inappropriate use of urinary catheters: A prospective observational study

American Journal of Infection Control — Mon, 01 Aug 2011 04:00:00 +0100

Conclusions: Significant rates of inappropriate urinary catheter use and a trend toward longer duration of hospitalization with inappropriate catheter use were observed. These findings underscore the importance of establishing guidelines and effective policy implementation for the appropriate use of urinary catheters in hospitalized patients. (Source: American Journal of Infection Control)

Nosocomial Escherichia coli pacemaker pocket infection

American Journal of Infection Control — Mon, 01 Aug 2011 04:00:00 +0100

We present a rare case of nosocomial Escherichia coli pacemaker pocket infection complicated by bacteremia. (Source: American Journal of Infection Control)

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American Journal of Infection Control — Sun, 31 Jul 2011 23:00:00 +0100

(Source: American Journal of Infection Control)

Information for Readers

American Journal of Infection Control — Sun, 31 Jul 2011 23:00:00 +0100

(Source: American Journal of Infection Control)

APIC Masthead

American Journal of Infection Control — Sun, 31 Jul 2011 23:00:00 +0100

(Source: American Journal of Infection Control)

Editorial Board

American Journal of Infection Control — Sun, 31 Jul 2011 23:00:00 +0100

(Source: American Journal of Infection Control)

American Journal of Infection Control — Sun, 31 Jul 2011 23:00:00 +0100

(Source: American Journal of Infection Control)

Individual differences in judgments of hand hygiene risk by health care workers

American Journal of Infection Control — Sun, 31 Jul 2011 23:00:00 +0100

Conclusion: Our data describe the individual differences of HCWs related to hand hygiene in ways that can be used to create targeted interventions and products to improve hand hygiene. (Source: American Journal of Infection Control)

Comparative studies of hand disinfection and handwashing procedures as tested by pupils in intervention programs

American Journal of Infection Control — Sun, 31 Jul 2011 23:00:00 +0100

Conclusion: Intervention with mandatory HW may have a lasting pedagogical effect in reducing absenteeism because of infectious illness when exposed to role models. HD could be effective in reducing absenteeism because of infectious illness and a well-placed supplement to HW. (Source: American Journal of Infection Control)

APIC Text Online

American Journal of Infection Control — Sun, 31 Jul 2011 23:00:00 +0100

In a world of constant change, new regulations, and advancing technologies, APIC strives to consistently bring its members the most credible, up-to-date, critical information and training in infection prevention. One such resource is the APIC Text Online, the collaborative result of more than 180 authors, editors, and reviewers. This invaluable tool is the go-to reference for those new to infection prevention, the most seasoned professional, and individuals working toward certification. (Source: American Journal of Infection Control)

Bloodstream infections with OXA-23-producing Acinetobacter baumannii isolates in a university-affiliated hospital in Brazil: Epidemiology and clinical outcomes

American Journal of Infection Control — Tue, 26 Jul 2011 04:00:00 +0100

Acinetobacter spp is a leading cause of nosocomial bacteremia. Carbapenems have been the drugs of choice for those infections. However, the emergence of carbapenem-hydrolyzing class D β-lactamases has jeopardized the clinical usefulness of these antimicrobial agents. (Source: American Journal of Infection Control)

Local factors affecting cost/benefit of methicillin-resistant Staphylococcus aureus screening, a study from a low-income country

American Journal of Infection Control — Tue, 26 Jul 2011 04:00:00 +0100

Methicillin-resistant Staphylococcus aureus (MRSA) strains comprise 40% of all Staphylococcus aureus infections in the United States, and, also, it has been the most prevalent multidrug-resistant organism in Asia, Africa, the Middle East, and Europe. Moreover, it causes high rate of mortality and morbidity worldwide. Each year, excess cost burden because of antibiotic resistance imposes $100 million to $30 billion annually on US hospitals. (Source: American Journal of Infection Control)

Mycobacterium fortuitum misidentified as Corynebacterium jeikeium in catheter-related bloodstream infection

American Journal of Infection Control — Tue, 26 Jul 2011 04:00:00 +0100

We report a case of catheter-related bloodstream infection (CRBSI) caused by a rapidly growing nontuberculous mycobacterium initially misidentified as Corynebacterium jeikeium using anaerobe and Corynebacterium (ANC) identification cards for the Vitek 2 system (bioMérieux, Durham, NC). A 41-year-old woman with a history of invasive ductal breast carcinoma diagnosed in 2009 and treated with a 10 month-course of neoadyuvant radiotherapy and chemotherapy was admitted to our hospital. At the time of admission, because of prolonged fever she was on tamoxifen therapy. She had an indwelling central venous catheter in place (port-a-cath [PAC]), which had been inserted at the time of cancer diagnosis. (Source: American Journal of Infection Control)

Infection control through the ages

American Journal of Infection Control — Mon, 25 Jul 2011 04:00:00 +0100

To appreciate the current advances in the field of health care epidemiology, it is important to understand the history of hospital infection control. Available historical sources were reviewed for 4 different historical time periods: medieval, early modern, progressive, and post–World War II. Hospital settings for the time periods are described, with particular emphasis on the conditions related to hospital infections. (Source: American Journal of Infection Control)

Health care-associated infections and visiting policy in an intensive care unit

American Journal of Infection Control — Mon, 25 Jul 2011 04:00:00 +0100

A frequent objection to the unrestricted visiting policy in intensive care units (ICUs) is the risk of acquired infections. In a mixed 8-bed ICU, an adopted shift from a restricted to a partially unrestricted visiting policy did not result in an increase in ICU-acquired infections. (Source: American Journal of Infection Control)

Concerns about screening intensive care unit patients for methicillin-resistant Staphylococcus aureus

American Journal of Infection Control — Sun, 24 Jul 2011 23:00:00 +0100

To the Editor: I read the recent article “Cost of screening intensive care unit patients for methicillin-resistant Staphylococcus aureus” by Nyman et al with great interest. The authors conclude that “because of the high cost of caring for a MRSA patient, interventions that reduce the spread of infections—such as screening intensive care unit patients upon admission studied here—are likely to pay for themselves.” I would like to share some thoughts on this topic. I agree that the screening seems to be useful and cost-effective; nevertheless, in analyses of effectiveness, concerns regarding the diagnostic properties, accuracy, and turnaround time of the investigation should be kept in mind, because these directly affect the outcomes and success of the screening protocols. In ad...

An unexpected increase in catheter-associated bloodstream infections at a children’s hospital following introduction of the Spiros closed male connector

American Journal of Infection Control — Fri, 22 Jul 2011 04:00:00 +0100

Conclusion: This case study highlights the utility of statistical process control in the surveillance and investigation of CA-BSI. (Source: American Journal of Infection Control)

An unusual cause of continuous ambulatory peritoneal dialysis–associated outpatient peritonitis: Stenotrophomonas maltophilia

American Journal of Infection Control — Thu, 21 Jul 2011 23:00:00 +0100

To the Editor: Stenotrophomonas maltophilia (SM) is a nonfermentative aerobic, gram-negative bacillus formerly known as Pseudomonas maltophilia or Xanthomonas maltophilia. Because of its low virulence, SM rarely infects healthy people. Infections caused by SM are mostly hospital-acquired; SM peritonitis is a rare complication of chronic peritoneal dialysis that sometimes results in mortality or loss of the dialysis catheter. (Source: American Journal of Infection Control)

How many bacteria live on the keyboard of your computer?

American Journal of Infection Control — Thu, 21 Jul 2011 23:00:00 +0100

To the Editor: The ever-increasing use of computers in all fields of health care has led to several recent studies on the role of keyboard contamination as a vehicle to transmit hospital infections. Fewer studies have been conducted in nonhospital environments, where the use of computers is widespread and the same keyboard may be used by several people, thereby becoming a possible vehicle for infection transmission. The fact that many people eat at their workstation also must be considered; crumbs remaining on the keyboard may form a medium favoring the growth of microbes. Keyboard contamination may be viewed as a direct index of hygiene, especially of community hand hygiene, that can be used to plan strategies to promote and improve protection of workers’ health. (Source: American Jour...

Infection or colonization and antimicrobial susceptibility of Enterococcus spp at a regional hospital in Queretaro, Mexico

American Journal of Infection Control — Thu, 21 Jul 2011 23:00:00 +0100

To the Editor: The first reports of vancomycin-resistant Enterococcus (VRE) infection in Europe and the United States in the 1980s heralded a new era in the epidemiologic surveillance of this gram-positive coccus, which demonstrates high levels of multidrug resistance. Since then, there has been a significant increase in VRE prevalence in the United States. The most frequently isolated strains are E faecalis and E faecium, with the latter considered the vancomycin van A- and van B-resistant phenotype reservoir. Despite the low prevalence of this nosocomial infection in Mexico, VRE strains have been reported since 1996. (Source: American Journal of Infection Control)

Reducing health care-associated infections (HAIs): Lessons learned from a national collaborative of regional HAI programs

American Journal of Infection Control — Thu, 21 Jul 2011 04:00:00 +0100

Conclusion: Despite the diversity of hospital settings, cultures, personnel, and HAI reduction projects, we found that hospitals encounter similar challenges and facilitators across projects. We offer a model of 7 process elements shown to be important to successful implementation. (Source: American Journal of Infection Control)

Hand hygiene in developing nations: Experience at a busy level-1 trauma center in India

American Journal of Infection Control — Thu, 21 Jul 2011 04:00:00 +0100

We read with great interest the article published by Sahay et al in American Journal of Infect Control. Their study addresses an important issue in today’s era of multidrug resistance. Hand decontamination has proven to be an efficient way to prevent the cross-transmission of nosocomial pathogens. Hand hygiene is a behavioral practice, which requires much evidence-based education and motivation. The success of the World Alliance for Patient Safety’s first challenge, which emphasizes hand hygiene as the cornerstone for “clean care is safer care,” could well depend on its acceptance and implementation in the populous developing nations. Thus, more studies are needed from developing nations like India, which has a very high rate of antimicrobial resistance. Simple interventions are ur...

Horizontal transmission of Streptococcus pneumoniae in the surgical ward: A rare source of nosocomial wound infection

American Journal of Infection Control — Mon, 18 Jul 2011 04:00:00 +0100

We report an outbreak of 4 nosocomial-acquired surgical site infections due to S pneumoniae after retropubic simple prostatectomy. The likely source was detected in the rhinopharynx of the surgeon. After the implementation of recommendations, no new cases have been recorded. (Source: American Journal of Infection Control)

Face mask decontamination and reuse: Is it ok?

American Journal of Infection Control — Sun, 17 Jul 2011 23:00:00 +0100

To the Editor: I read the recent article by Heimbuch et al on decontamination and reuse of of N95 filtering facepiece respirators (FFRs) with great interest. The authors concluded that microwave-generated steam, warm moist heat, or ultraviolet germicidal irradiation could be effective options for decontaminating FFRs to allow reuse. I have some questions regarding this conclusion. First, there is no doubt that the proposed decontamination techniques can destroy viruses, but whether these techniques also threaten the FFRs’ structural integrity is unclear. Alterations in FFR structure might significantly decrease the device’s protective action. Second, the effectiveness of the proposed techniques in destroying other viruses and pathogens that might contaminate FFRs should be assessed as...

Community-acquired versus nosocomial Legionella pneumonia: Lessons learned from an epidemiologic investigation

American Journal of Infection Control — Fri, 15 Jul 2011 04:00:00 +0100

Epidemiologically, the peak incidence of legionella community-acquired pneumonia (CAP) is in the summer/fall, but cases may occur anytime during the year. The peak age incidence of Legionnaire’s disease is in the elderly population, but Legionella CAP occurs in all age groups. The incubation period for Legionnaire’s disease is 2 to 10 days. Typically, legionella CAP occurs sporadically. Clinical presentation of Legionnaire’s disease is independent of legionella species and Legionella nosocomial pneumonia (NP) is indistinguishable clinically from legionella CAP. (Source: American Journal of Infection Control)

A prospective study of central venous catheters placed in a tertiary care emergency department: Indications for use, infectious complications, and natural history

American Journal of Infection Control — Mon, 11 Jul 2011 04:00:00 +0100

Despite successful efforts to improve overall central line-associated bloodstream infections (CLABSI) rates, little is known about CLABSI rates or even central venous catheter insertion practices in the Emergency Department. We sought to determine the baseline CLABSI rate for Emergency Department-inserted central venous catheters and to describe indications for placement, duration of use, and the natural history of these devices. (Source: American Journal of Infection Control)

Lower associated costs using rifampicin-miconazole‒impregnated catheters compared with standard catheters

American Journal of Infection Control — Mon, 11 Jul 2011 04:00:00 +0100

Previous cost-effectiveness analyses found that antibiotic-impregnated catheters decrease the incidence of catheter-related bloodstream infection (CRBSI) as well as the costs related to central venous catheter (CVC) use, including increased hospital length of stay. The effect varied greatly among the studies, however. In this retrospective cohort study, compared with standard catheters, the use of rifampicin-miconazole–impregnated catheters was associated with lower CRBSI incidence and immediate CVC-related costs (taking into account only the costs of CVC, diagnosis, and treatment of CRBSI) (P < .001). Our data indicate that the use of rifampicin-miconazole–impregnated catheters can save associated costs. (Source: American Journal of Infection Control)

Protecting patients from harm: Design and implementation of an institutional bloodborne pathogen protocol

American Journal of Infection Control — Mon, 11 Jul 2011 04:00:00 +0100

Conclusions: The resources to devise policies regarding BBP exposure to patients are available but require distillation of complex scientific data and social and/or legal opinion or precedent. We offer Geisinger Health System’s policy as a workable and readily accessible model that defines the obligations of providers to protect patients in the event of a BBP exposure. (Source: American Journal of Infection Control)

Infection control implications of influenza A and influenza B: Coinfection or cocirculating strains?

American Journal of Infection Control — Mon, 11 Jul 2011 04:00:00 +0100

During the swine influenza (H1N1) pandemic, it quickly became apparent that there were problems with sensitivity/specificity rapid influenza diagnostic tests (RIDTs). In admitted adults with influenza-like illnesses (ILIs), ie, with fever, dry/minimally productive cough, and positive RIDTs for influenza A or B correlated well with influenza A or B positivity on the respiratory viral fluorescent antibody (FA) panel or polymerase chain reaction (PCR) H1N1 testing. However, it was found that negative RIDTs did not rule out swine influenza A (H1N1). For this reason, in hospitalized adults at our hospital admitted with an ILI and having negative RIDTs, we obtained nasopharyngeal swabs for respiratory viral FA panel and H1N1 testing. The respiratory viral FA panel has the advantage of detecting ...

Post‒cataract surgery endophthalmitis outbreak caused by multidrug-resistant Pseudomonas aeruginosa

American Journal of Infection Control — Fri, 08 Jul 2011 04:00:00 +0100

In June 2010, a severe outbreak of 13 cases of post–cataract surgery endophthalmitis caused by multidrug-resistant Pseudomonas aeruginosa occurred. Pulse-field gel electrophoresis in eye isolates found 95% genetic similarity; however, extensive environmental and carriage investigation revealed no source of infection. (Source: American Journal of Infection Control)

Assessing the infection prevention components of home health emergency management plans

American Journal of Infection Control — Fri, 08 Jul 2011 04:00:00 +0100

Conclusion: Home health disaster planners or managers should use this article as an assessment tool for evaluating their agency’s emergency management plan and for developing policies and procedures that will decrease the risk of infection transmission during a mass casualty event. (Source: American Journal of Infection Control)

Measuring compliance with transmission-based isolation precautions: Comparison of paper-based and electronic data collection

American Journal of Infection Control — Fri, 08 Jul 2011 04:00:00 +0100

Conclusion: Simple electronic forms can significantly decrease the required resources for monitoring HCW adherence to hospital policies. Use of the WBF decreased the observation time by 60%, allowing for increases in the frequency and intensity of surveillance activities. (Source: American Journal of Infection Control)

Femoral central venous catheters are not associated with higher rates of infection in the pediatric critical care population

American Journal of Infection Control — Mon, 27 Jun 2011 04:00:00 +0100

Conclusion: Femoral CVCs are not associated with higher rates of infection in the PICU. In addition, the presence of CVC infection does not affect mortality, but is associated with longer PICU admission. (Source: American Journal of Infection Control)

Personal protective equipment use and allocation in home health during disasters

American Journal of Infection Control — Mon, 27 Jun 2011 04:00:00 +0100

Conclusion: Having access to the correct types and quantities of PPE during a disaster will be essential to home health agencies. The information presented in this article can assist home health agencies in developing emergency management plans that address planning issues related to PPE. (Source: American Journal of Infection Control)

Preventing catheter-associated urinary tract infection in the zero-tolerance era

American Journal of Infection Control — Mon, 27 Jun 2011 04:00:00 +0100

Conclusion: Our findings suggest that reducing CAUTI rates in the ICU setting is a complex process that involves multiple performance measures and interventions that can be applied to SDU settings as well. (Source: American Journal of Infection Control)

Detection and spread of carbapenem-resistant Citrobacter freundii in a teaching hospital in China

American Journal of Infection Control — Mon, 27 Jun 2011 04:00:00 +0100

Conclusion: The spread of carbapenem-hydrolyzing C freundii isolates has emerged in regional hospitals in China. Multidrug-resistant mechanisms of strains severely hamper control efforts. Our findings should alert clinicians to issues involved with preventing the spread of carbapenem-resistant C freundii. (Source: American Journal of Infection Control)

Spread of multidrug carbapenem-resistant Acinetobacter baumannii in different wards of an Italian hospital

American Journal of Infection Control — Mon, 27 Jun 2011 04:00:00 +0100

Conclusion: The results of the present study reveal the importance of strict adherence to control measures by all health care personnel and highlight the fact that regular staff training and frequent revision of control measures are essential to the successful management of an outbreak. (Source: American Journal of Infection Control)

Bacterial reduction of alcohol-based liquid and gel products on hands soiled with blood

American Journal of Infection Control — Mon, 27 Jun 2011 04:00:00 +0100

The antibacterial efficacy of three alcohol-based products (liquid and gel) were tested on the hands with blood and contaminated with Serratia marcescens (ATCC 14756), using EN 1500 procedures in 14 healthy volunteers. The alcohol-based products tested, either gel or liquid-based, reached bacterial reduction levels higher than 99.9% in the presence of blood and did not differ significantly (ANOVA test; P = 0.614). (Source: American Journal of Infection Control)

Lumen claims of the STERRAD 100NX sterilizer: Testing performance limits when processing equipment containing long, narrow lumens

American Journal of Infection Control — Mon, 27 Jun 2011 04:00:00 +0100

Conclusion: The findings of our current study emphasize the importance of a thorough validated cleaning of medical devices as well as timing for cleaning and decontamination before being exposed to the H2O2 sterilization process and, furthermore, the need for strict adherence to manufacturer’s recommendations. (Source: American Journal of Infection Control)

Effectiveness of preventive measures for hemato-oncologic patients undergoing stem cell transplantation during a period of hospital construction

American Journal of Infection Control — Mon, 27 Jun 2011 04:00:00 +0100

Conclusion: Although our data cannot demonstrate the efficacy of infection control measures during construction work, it can be concluded that excavation work close to immunocompromised patients is safe if a bundle of preventive measures is implemented before groundwork. (Source: American Journal of Infection Control)

Hand hygiene in pediatric and neonatal intensive care unit patients: Daily opportunities and indication- and profession-specific analyses of compliance

American Journal of Infection Control — Mon, 27 Jun 2011 04:00:00 +0100

Conclusion: This study provides the first data on opportunities for and compliance with hand hygiene in pediatric/neonatal patients encompassing the whole day and night activities and including a comparison of observed and calculated compliance rates. Observation revealed high compliance especially in nurses and in situations of greatest impact. The data provide a detailed characterization of hand hygiene performance in the neonatal/pediatric ICU setting. (Source: American Journal of Infection Control)

Group B Streptococcal sepsis: An old or ongoing threat?

American Journal of Infection Control — Mon, 27 Jun 2011 04:00:00 +0100

Conclusion: The implementation of additional infection control measures was able to stop the diffusion of infection; however, clusters like this should remind us the ongoing threat of GBS for the small NICU patients. (Source: American Journal of Infection Control)

Health Care-Associated Infections Studies Project: An American Journal of Infection Control and National Healthcare Safety Network Data Quality Collaboration Case Study 6

American Journal of Infection Control — Sun, 26 Jun 2011 23:00:00 +0100

Welcome to the sixth publication of a joint effort between the American Journal of Infection Control and the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN). This collaboration is a series of case studies representing surveillance scenarios faced everyday by infection preventionists (IPs) using NHSN definitions. (Source: American Journal of Infection Control)

Glucose meters and opportunities for in-hospital transmission of infection: Quantitative assessment and management with and without patient assignment

American Journal of Infection Control — Fri, 24 Jun 2011 04:00:00 +0100

Conclusion: Use of glucose meters was associated with a high number of opportunities to transmit infections, and those opportunities were reduced only when glucose meters were assigned to individual patients. Recent guidance from the Centers for Disease Control and Prevention and the US Food and Drug Administration to assign glucose meters to individual persons whenever possible is relevant to inpatient care. (Source: American Journal of Infection Control)

Hepatitis A antibody seroprevalence among medical school students

American Journal of Infection Control — Thu, 23 Jun 2011 04:00:00 +0100

A total of 324 first- to third-year medical school students were examined for anti-hepatitis A virus IgG. Of these 324 students, 37 were found to be anti-hepatitis A virus IgG positive (11.4%). Mass screening of medical students for seropositivity and vaccination of nonimmune students should be considered before starting medical clerkships. (Source: American Journal of Infection Control)

Conventional and sharp safety devices in 6 hospitals in British Columbia, Canada

American Journal of Infection Control — Thu, 23 Jun 2011 04:00:00 +0100

Conclusion: More than 1 year after legislation was passed mandating the use of sharp safety devices in British Columbia hospitals, the risk from sharps remains excessive because of the ongoing use of conventional sharp devices and nonactivation of safety devices. (Source: American Journal of Infection Control)

A controlled crossover human volunteer study of the in vivo filtration efficacy of a high-efficiency particulate air–filtering oxygen mask

American Journal of Infection Control — Mon, 13 Jun 2011 04:00:00 +0100

Nosocomial airborne disease transmission can be important in some epidemics. An oxygen mask incorporating a high-efficiency particulate (HEPA) filter may reduce the chance of inhaling airborne particles. In a randomized controlled crossover volunteer study, the median ratio of ambient:intramask 0.02 to 1-μ particles was significantly higher for the HEPA oxygen mask than for a Hudson-type mask (P < .001), and was ≥100 in 59%-64% of subjects. The use of HEPA masks may protect patients receiving supplementary oxygen against airborne pathogens. (Source: American Journal of Infection Control)

Improving central venous catheter insertion documentation to facilitate electronic surveillance of bundle compliance

American Journal of Infection Control — Mon, 13 Jun 2011 04:00:00 +0100

We developed an electronic surveillance system and modified electronic medical record and documentation practices to allow automated tracking of the central line bundle documentation with the insertion of central venous catheters. Despite significant improvements in documented use of the central line bundle in >80% of insertions, our central line‒associated bloodstream infection rate remained unchanged, suggesting the need to further improve compliance toward a goal of 100% of central line insertions, as well as training and education on proper line maintenance for catheters that are medically required for prolonged periods. (Source: American Journal of Infection Control)

Outbreak of Burkholderia cepacia complex among ventilated pediatric patients linked to hospital sinks

American Journal of Infection Control — Mon, 13 Jun 2011 04:00:00 +0100

We investigated a cluster of Burkholderia cepacia complex colonization in ventilated pediatric patients. Isolates from 15 patients, 2 sink drains, and several ventilator components were found to belong to a single B cenocepacia clone. Hospital tap water used during oral and tracheostomy care was identified as the most likely mechanism for transmission. (Source: American Journal of Infection Control)

A home health agency’s pandemic preparedness and experience with the 2009 H1N1 pandemic

American Journal of Infection Control — Mon, 13 Jun 2011 04:00:00 +0100

Conclusion: There are gaps in US home health agency pandemic preparedness, including surge capacity and participation in disaster drills, that need to be addressed. (Source: American Journal of Infection Control)

Practically speaking: Rethinking hand hygiene improvement programs in health care settings

American Journal of Infection Control — Mon, 13 Jun 2011 04:00:00 +0100

Conclusion: This article describes a novel approach to measuring, monitoring, and ultimately increasing hand hygiene compliance at our hospital. Our objective is to provide concrete, practical strategies for other institutions faced with the challenge of building or revamping their own hand hygiene programs. (Source: American Journal of Infection Control)

A comparative study to evaluate surface microbial contamination associated with copper-containing and stainless steel pens used by nurses in the critical care unit

American Journal of Infection Control — Mon, 13 Jun 2011 04:00:00 +0100

A clinical study was undertaken to compare the surface microbial contamination associated with pens constructed of either a copper alloy or stainless steel used by nurses on intensive care units. A significantly lower level of microbial contamination was found on the copper alloy pens. (Source: American Journal of Infection Control)

Clinical characteristics and outcomes of hospitalized patients with 2009 H1N1 influenza in a large acute care tertiary hospital, Singapore

American Journal of Infection Control — Mon, 13 Jun 2011 04:00:00 +0100

This study describes the clinical characteristics and outcomes of hospitalized patients with 2009 H1N1 influenza in a large, acute care, tertiary hospital in Singapore. Of the 265 hospitalized patients with laboratory-confirmed 2009 influenza A (H1N1) during the height of the H1N1 flu pandemic, 13% (35) suffered severe outcomes including a mortality rate of 4.5% (12). Severe outcomes were associated with patients aged 40 years or more, underlying comorbidities, and complicated by pneumonia. (Source: American Journal of Infection Control)

Adherence to hand hygiene and risk factors for poor adherence in 13 Ontario acute care hospitals

American Journal of Infection Control — Mon, 13 Jun 2011 04:00:00 +0100

Multicenter studies assessing hand hygiene adherence and risk factors for poor performance are scarce. In an observational study involving 13 hospitals across Ontario, Canada, we found a mean adherence rate of 31.2%, and that adherence was positively associated with nurses, single rooms, contact precautions, and the availability of alcohol hand rub dispensers. (Source: American Journal of Infection Control)

Attempts to change culture in a line-obsessed pediatric world: The Riley Heart Center line initiative

American Journal of Infection Control — Mon, 13 Jun 2011 04:00:00 +0100

Interventions to reduce central line-associated bloodstream infections in pediatric patients have not yet been validated. Unique approaches to reducing infection rates may be warranted in this population. (Source: American Journal of Infection Control)

A national collaborative for reducing health care‒associated infections: Current initiatives, challenges, and opportunities

American Journal of Infection Control — Mon, 13 Jun 2011 04:00:00 +0100

This study was conducted to assess current strategies and efforts of HAI reduction initiatives in hospitals. HAI reduction initiatives and factors influencing institutional participation in these initiatives were categorized. Data were collected via open-ended questions on surveys performed in 5 different HAI collaboratives. Thematic analysis of the coded qualitative data was conducted. A total of 1,212 health care professionals from 33 different hospitals participated. Improving hand hygiene was the most frequently mentioned HAI reduction initiative implemented in the previous year. Initiatives for reducing central line or central venous catheter infections and ventilator-associated pneumonia also were commonly cited. The most frequently mentioned challenges to implementing HAI reduction...

Room ventilation and the risk of airborne infection transmission in 3 health care settings within a large teaching hospital

American Journal of Infection Control — Fri, 10 Jun 2011 04:00:00 +0100

Conclusion: Given the absence of definitive ventilation guidelines for hospitals, air-exchange measurements combined with modeling afford a useful means of assessing, on a case-by-case basis, the suitability of room ventilation for preventing airborne disease transmission. (Source: American Journal of Infection Control)

Trial to control an outbreak of Panton-Valentine leukocidin–positive methicillin-resistant Staphylococcus aureus at a boarding school in Japan

American Journal of Infection Control — Fri, 10 Jun 2011 04:00:00 +0100

Conclusion: This first report of a PVL-positive CA-MRSA outbreak in Japan demonstrates systematic management of dissemination by conducting surveillance in a closed community. (Source: American Journal of Infection Control)

Hepatitis B outbreak associated with a hematology-oncology office practice in New Jersey, 2009

American Journal of Infection Control — Fri, 10 Jun 2011 04:00:00 +0100

Conclusion: Systematic breaches in infection control led to ongoing transmission of HBV infection among patients undergoing invasive procedures at the office practice. This investigation underscores the need for improved regulatory oversight of outpatient health care settings, improved infection control and injection safety education for health care providers, and the development of mechanisms for ongoing communication and cooperation among public health agencies. (Source: American Journal of Infection Control)

A pledge to hand hygiene commitment

American Journal of Infection Control — Thu, 09 Jun 2011 23:00:00 +0100

To the Editor: I am writing to celebrate the influx of handwashing (HW) campaigns over the past decade. As a practitioner, graduate nursing student, and patient, I have been engaged in the battle for HW compliance on a very personal level. HW has been recognized as a necessity for centuries, but barriers of various magnitudes, including lack of resources and challenges in changing poor hand hygiene behavior, existed then and continue to exist now. (Source: American Journal of Infection Control)

Association between risk of bloodstream infection and duration of use of totally implantable access ports and central lines: A 24-month study

American Journal of Infection Control — Wed, 08 Jun 2011 23:00:00 +0100

Conclusion: Use of an AP for more than 33 days and a CL for more than 10 days may carry an increased risk of device-associated BSI. These cutoff periods are longer than those expected at the time of device placement and indicate the importance of postplacement care. (Source: American Journal of Infection Control)

Expressed breast milk on a neonatal unit: A hazard analysis and critical control points approach

American Journal of Infection Control — Mon, 06 Jun 2011 04:00:00 +0100

With the increasing use of human milk and growing evidence of the benefits of mother’s milk for preterm and ill newborns, guidelines to ensure its quality and safety are an important part of daily practice in neonatal intensive care units. Operating procedures based on hazard analysis and critical control points can standardize the handling of mother’s expressed milk, thereby improving nutrition and minimizing the risk of breast milk–induced infection in susceptible newborns. Because breast milk is not sterile, microorganisms can multiply when the milk is not handled properly. Additional exogenous contamination should be prevented. Strict hygiene and careful temperature and time control are important during the expression, collection, transport, storage, and feeding of maternal milk....

Mumps exposure of a health care provider working in a neonatal intensive care unit leads to a hospital-wide effort that prevented an outbreak

American Journal of Infection Control — Mon, 06 Jun 2011 04:00:00 +0100

Conclusion: Infection control efforts, including vaccinating susceptible HCPs and instituting droplet precautions, might have prevented mumps infection in the NICU patients. (Source: American Journal of Infection Control)

Reduction in the microbial load on high-touch surfaces in hospital rooms by treatment with a portable saturated steam vapor disinfection system

American Journal of Infection Control — Mon, 06 Jun 2011 04:00:00 +0100

Conclusion: The steam vapor system reduced bacterial levels by >90% and reduced pathogen levels on most surfaces to below the detection limit. The steam vapor system provides a means to reduce levels of microorganisms on hospital surfaces without the drawbacks associated with chemicals, and may decrease the risk of cross-contamination. (Source: American Journal of Infection Control)

Economic impact of use of chlorhexidine-impregnated sponge dressing for prevention of central line-associated infections in the United States

American Journal of Infection Control — Mon, 06 Jun 2011 04:00:00 +0100

Conclusion: CHG-impregnated sponge dressing is a cost-effective CR-BSI prevention treatment option for patients requiring CVCs. The importance of these results should be considered in the context of federal government and insurance company policies that no longer permit enhanced reimbursement for CR-BSI. (Source: American Journal of Infection Control)

Reduction of catheter-related bloodstream infections through the use of a central venous line bundle: Epidemiologic and economic consequences

American Journal of Infection Control — Mon, 06 Jun 2011 04:00:00 +0100

Conclusion: Preventing CRBSIs can improve patient care while reducing hospital stays, costs, and possible mortality. CVL bundles are fairly easy to perform with reproducible results. (Source: American Journal of Infection Control)

The long-term outcome of a multifaceted intervention to reduce ventilator-associated pneumonia: Can zero really be achieved?

American Journal of Infection Control — Sun, 05 Jun 2011 23:00:00 +0100

In this study, a sustain “zero” VAP rate was defined as no VAP for > 12 consecutive months. Data collected included demographics, underlying diseases, severity of illness, VAP onset, VAP process of care, compliance with components of “WHAP VAP” bundle, total number of ventilator-days, and VAP rates. Multivariate analysis was performed to evaluate factors associated with VAP among MICU patients during both study periods. (Source: American Journal of Infection Control)

Bacterial contamination of glucose test strips: Not to be neglected

American Journal of Infection Control — Sun, 05 Jun 2011 23:00:00 +0100

To the Editor: The role of fomites in bacterial transmission is still debated and need further investigations. Involved in hepatitis C and B virus infection, the glucose meters have also been reported to be contaminated during outbreak by multidrug-resistant (MDR) bacteria as Acinetobacter baumannii. However, the potential role of glucose test strips (GTS) manipulation in the transmission of micro-organisms was poorly studied. We investigated the bacterial contamination of GTS in our 400-bed teaching hospital. During January 2010, a new glucose meter was introduced (Nova StatStrip Xpress; Nova Biomedical, Courtaboeuf, France) in our hospital; presumably for economic purposes, the corresponding test strips were no longer unitarily packaged but were in a 50-unit container. During 6 consecut...

Study on the effectiveness of disinfection with wipes against methicillin-resistant Staphylococcus aureus and implications for hospital hygiene

American Journal of Infection Control — Sun, 05 Jun 2011 23:00:00 +0100

Conclusion: The presence of MRSA in the proximity of the patient, ie, the bed rails as well as the cleaning tool (the wipe), was demonstrated in this study. If thorough rinsing was not conducted between wiping, bacteria accumulated on the wipes, which can result in cross transmission. (Source: American Journal of Infection Control)

Effectiveness of a hand hygiene promotion strategy using alcohol-based handrub in 6 intensive care units in Colombia

American Journal of Infection Control — Fri, 03 Jun 2011 04:00:00 +0100

Conclusion: Improved hand hygiene measured by increased ABHR consumption resulted in CLABSI reduction. Low nurse-to-patient ratio is independently associated with HAI in an upper-middle income country. (Source: American Journal of Infection Control)

Before influenza tests results are available, can droplet precautions be instituted if influenza is suggested by leukopenia, relative lymphopenia, or thrombocytopenia?

American Journal of Infection Control — Thu, 02 Jun 2011 23:00:00 +0100

To the Editor: Since the swine influenza (H1N1) pandemic, there has been increased awareness of the importance of instituting droplet precautions in adults hospitalized with influenza-like illnesses (ILIs) and possible influenza. The current influenza season, in our area, has been primarily because of human seasonal influenza (H3N2) as well as swine influenza (H1N1). Two practical problems have emerged. First, clinicians often fail to recognize the patient has influenza, which requires droplet precautions. Droplet precautions are not required for ILIs, only for influenza. The institution of droplet precautions on admission is important to prevent nosocomial spread of influenza. Second, rapid influenza diagnostic tests (RIDTs) are unreliable predictors of influenza A. Positive RIDTs indica...

Glove removal method and distance: What else can affect contamination?

American Journal of Infection Control — Thu, 02 Jun 2011 23:00:00 +0100

To the Editor: Editor, I read the recent published work on glove removal method and distance with a great interest. Lai et al concluded that “The impact of the glove removal procedure and the distance to the bin in which used gloves are discarded should be taken into consideration on a daily basis”. I would like to add some more factors that are reported to be relating to the hand contamination in glove usage. Olsen et al published in JAMA that latex gloves were less frequently associated with hand contamination. The environment in a room occupied by a patient colonized by bacteria is also another factor that affects the hand contamination. Finally, although the use of florescent staining is a good contamination determination technique, there are some technical issues of concern. Thi...

Benchmarking of percutaneous injuries at a teaching tertiary care center in Saudi Arabia relative to United States hospitals participating in the Exposure Prevention Information Network

American Journal of Infection Control — Thu, 02 Jun 2011 23:00:00 +0100

Conclusion: We have lower rates of PIs at KAMC-R relative to US EPINet hospitals. Whereas it is difficult to fully explain such differences, this could be due to variations in health care systems, underreporting, or the impact of the PIs prevention activities. (Source: American Journal of Infection Control)

Occupational exposure to blood in workers in a Greek hospital

American Journal of Infection Control — Thu, 02 Jun 2011 23:00:00 +0100

To the Editor: Health care workers are at risk for occupational exposure to bloodborne pathogens, including hepatitis B virus, hepatitis C virus, and HIV. Exposures occur through needlesticks or cuts from other sharp instruments contaminated with an infected patient’s blood or through contact of the eye, nose, mouth, or skin with a patient’s blood. The risk of acquiring hepatitis C infection following a needlestick injury is estimated at approximately 3%, hepatitis B is 30%, and HIV is 0.3%. (Source: American Journal of Infection Control)

Information for Authors

American Journal of Infection Control — Mon, 30 May 2011 17:35:01 +0100

(Source: American Journal of Infection Control)

Information for Readers

American Journal of Infection Control — Mon, 30 May 2011 17:35:01 +0100

(Source: American Journal of Infection Control)

APIC Masthead

American Journal of Infection Control — Mon, 30 May 2011 17:35:01 +0100

(Source: American Journal of Infection Control)

Editorial Board

American Journal of Infection Control — Mon, 30 May 2011 17:35:01 +0100

(Source: American Journal of Infection Control)

American Journal of Infection Control — Mon, 30 May 2011 17:35:01 +0100

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Future APIC Annual Conference Dates and Locations

American Journal of Infection Control — Mon, 30 May 2011 17:35:01 +0100

Annual Conference 2012 San Antonio, TX (Source: American Journal of Infection Control)

Authors with Disclosures

American Journal of Infection Control — Mon, 30 May 2011 17:35:01 +0100

The following authors provided disclosures Key: author’s last name is followed by first initial, disclosure information and publication number(s). (Source: American Journal of Infection Control)

Author Index - 2011 Abstracts

American Journal of Infection Control — Mon, 30 May 2011 17:35:01 +0100

Abdelnasser, M, 7-061 Abreu, M, 14-184 (Source: American Journal of Infection Control)

Electronic Application Utilization for Attaining Reliable and Robust Post Discharge SSI Surveillance

American Journal of Infection Control — Mon, 30 May 2011 17:35:01 +0100

Due to decreasing length of postoperative hospitalizations, detecting SSIs continues to be challenging and the need for conducting post discharge SSI surveillance is crucial. Methodologies utilized for post discharge surveillance have commonly included paper-based patient and surgeon surveys delivered by mail or fax and telephone calls. There is no existing gold standard and post discharge SSI surveillance remains variable. Can a healthcare system create and implement an electronic application to replace paper-based post discharge SSI surveillance and tracking in nine acute care hospitals performing approximately 93,000 inpatient surgeries a year? (Source: American Journal of Infection Control)

A Comparison of CAUTI Rates Using NNIS and NHSN Definitions

American Journal of Infection Control — Mon, 30 May 2011 17:35:01 +0100

Changes in CDC definitions for CAUTI surveillance have resulted in confusion and questions of accuracy among Infection Preventionists and those with whom data is shared. With the approaching mandates for public reporting and requests for benchmarking against nationally-reported data, we reviewed our CAUTI surveillance data during 2005, 2006, 2008 and 2010 to determine how the changes in definitions affected rates of CAUTI. (Source: American Journal of Infection Control)

A Preliminary Assessment of the National Data Quality Collaboration: The Case Studies

American Journal of Infection Control — Mon, 30 May 2011 17:35:00 +0100

Definitions for healthcare-associated infections (HAIs) developed by the National Healthcare Safety Network (NHSN) are used by infection preventionists (IPs) for surveillance activities and are utilized with increasing frequency as a part of state-mandated reporting (SMR). The accuracy with which IPs apply these definitions and the impact of SMR on this accuracy may vary. (Source: American Journal of Infection Control)

Clostridium difficile Infection Surveillance in Long Term Acute Care Hospitals of a Single Healthcare System

American Journal of Infection Control — Mon, 30 May 2011 17:35:00 +0100

Long term acute care hospitals (LTACHs) are post-acute care facilities which care for medically complex patients in whom MDRO's are highly prevalent and which have high reported rates of device and antibiotic use. There are limited data on current rates of Clostridium difficile Infection (CDI) in this setting. The CDI surveillance options of the MDRO and CDAD Module of NHSN are (1) the scoring of a proxy measure for CDI [a laboratory identified (LabID) event] or (2) the scoring of clinical disease and complications. (Source: American Journal of Infection Control)

Development of a Standardized Process for Conducting Large-Scale Epidemiologic Lookback Investigations Following Improper Reprocessing of Reusable Medical Equipment

American Journal of Infection Control — Mon, 30 May 2011 17:35:00 +0100

The Veterans Health Administration (VHA) operates 152 inpatient and 951 outpatient facilities, providing healthcare to over 5 million Veterans. As the largest healthcare system in the United States, VHA reprocesses large numbers of reusable medical equipment (RME) each year. Although the risk of transmission of blood-borne viruses from RME is reported to be very low, the degree to which improper reprocessing techniques can increase that risk is unknown. Therefore, a standardized approach to managing the risks associated with breaches in reprocessing of RME is needed. (Source: American Journal of Infection Control)

Pseudo-Outbreak Highlights Value of Open Communication and Transparency Within a Four Hospital Healthcare System

American Journal of Infection Control — Mon, 30 May 2011 17:35:00 +0100

Our four hospital, 1423 bed, system has adopted a culture of patient safety first with accountability, open communication, transparency, teamwork, implementing highly reliable processes, and sharing of best practices. In June of 2010 we were able to quickly identify a pseudo-outbreak of bacteria in tissue cultures, take corrective action to make sure that the patients received proper treatment and change policies and procedures to prevent similar incidences in the future. (Source: American Journal of Infection Control)

Cost-Effectiveness Analysis of Active Surveillance Screening for Methicillin-resistant Staphylococcus aureus in a Tertiary Hospital Setting

American Journal of Infection Control — Mon, 30 May 2011 17:35:00 +0100

Methicillin-resistant Staphylococcus aureus (MRSA) places an increasing financial burden on hospitals as well as causes significant morbidity and mortality as the most prevalent antibiotic-resistant, healthcare-associated pathogen in the U.S. Active surveillance screening upon hospital admission is one of prevention methods for MRSA health-care associated infections (HAIs) through early detection and isolation of colonized patients. The issue of whether active surveillance screening is a cost-effective strategy at reducing the incidence of MRSA HAIs remains unresolved. (Source: American Journal of Infection Control)

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