Category Archives: C.diff. in the news

Researchers Suggest a Portion Of C. diff. Cases In Europe Involve Infections Associated With Other Sources Outside of Healthcare-Associated Infections

As part of a multicenter study, investigators from the University of Oxford, the University of Leeds, Astellas Pharma Europe, and elsewhere used a combination of ribotyping, sequencing, phylogenetics, and geographic analyses to retrace the genetic diversity and potential sources of C. difficile isolates involved in infections in European hospitals.

Recent research suggests a proportion of Clostridium difficile cases in Europe involve not only hospital-acquired infections but also infections associated with other sources, such as food.

As stated in the article:

https://www.genomeweb.com/sequencing/clostridium-difficile-genetic-patterns-europe-point-possible-infection-sources-beyond?utm_source=Sailthru&utm_medium=email&utm_campaign=GWDN%20Mon%20PM%202017-04-24&utm_term=GW%20Daily%20News%20Bulletin

David Eyre, a clinical lecturer at the University of Oxford, was slated to present the work at the European Congress of Clinical Microbiology and Infectious Diseases annual 2017 meeting in Vienna this past weekend. The study was funded by Astellas Pharma’s Europe, Middle East, and Africa (EMEA) program.

“We don’t know much about how C. difficile might be spread in the food chain, but this research suggests it may be very widespread,” Eyre said in a statement. “If that turns out to be the case, then we need to focus on some new preventative strategies such as vaccination in humans once this is possible, or we might need to look at our use of animal fertilizers on crops.”

“This study doesn’t give us any definitive answers,” he explained, “but it does suggest other factors [than hospital infections] are at play in the spread of C. difficile and more research is urgently needed to pin them down.”

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Some of the strains clustered by locale, consistent with spread from one individual to the next, for example in a healthcare setting. But more unexpectedly, the team also saw strains smattered across seemingly unconnected sites. And because at least one of those strains had previously been linked to pig farming, the researchers speculated that some infections may have been transmitted through food sources.

 

To read the article in its entirety click on the following link:

https://www.genomeweb.com/sequencing/clostridium-difficile-genetic-patterns-europe-point-possible-infection-sources-beyond?utm_source=Sailthru&utm_medium=email&utm_campaign=GWDN%20Mon%20PM%202017-04-24&utm_term=GW%20Daily%20News%20Bulletin

Contagion Live Shared Interview With Belinda Ostrowsky, MD, How to Be Smarter About C. difficile Testing

 How to Be Smarter About Testing for C. difficile
APR 03, 2017

Belinda Ostrowsky, MD, MPH, Health Systems Director of Epidemiology, Antimicrobial Stewardship & Infection Prevention, Montefiore Medical Center, and Associate Professor of Clinical Medicine, Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, explains how to be more sensible when it comes to testing for Clostridium difficile.

http://www.contagionlive.com/videos/how-to-be-smarter-about-testing-for-c-difficile

Recurrent Clostridium difficile (C.diff.) Bezlotoxumab For the Prevention of Recurrent CDI

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Abstract Published: 2017 Jan 26

Bezlotoxumab for Prevention of Recurrent Clostridium difficile Infection.

 

Recurrent Clostridium difficile Prevention

Wilcox MH1, Gerding DN1, Poxton IR1, Kelly C1, Nathan R1, Birch T1, Cornely OA1, Rahav G1, Bouza E1, Lee C1, Jenkin G1, Jensen W1, Kim YS1, Yoshida J1, Gabryelski L1, Pedley A1, Eves K1, Tipping R1, Guris D1, Kartsonis N1, Dorr MB1; MODIFY I and MODIFY II Investigators.
Author information
Abstract

Background Clostridium difficile is the most common cause of infectious diarrhea in hospitalized patients. Recurrences are common after antibiotic therapy.

Actoxumab and bezlotoxumab are human monoclonal antibodies against C. difficile toxins A and B, respectively.

Methods –  We conducted two double-blind, randomized, placebo-controlled, phase 3 trials, MODIFY I and MODIFY II, involving 2655 adults receiving oral standard-of-care antibiotics for primary or recurrent C. difficile infection. Participants received an infusion of bezlotoxumab (10 mg per kilogram of body weight), actoxumab plus bezlotoxumab (10 mg per kilogram each), or placebo; actoxumab alone (10 mg per kilogram) was given in MODIFY I but discontinued after a planned interim analysis.

The primary end point was recurrent infection (new episode after initial clinical cure) within 12 weeks after infusion in the modified intention-to-treat population.

Results In both trials, the rate of recurrent C. difficile infection was significantly lower with bezlotoxumab alone than with placebo (MODIFY I: 17% [67 of 386] vs. 28% [109 of 395]; adjusted difference, -10.1 percentage points; 95% confidence interval [CI], -15.9 to -4.3; P<0.001; MODIFY II: 16% [62 of 395] vs. 26% [97 of 378]; adjusted difference, -9.9 percentage points; 95% CI, -15.5 to -4.3; P<0.001) and was significantly lower with actoxumab plus bezlotoxumab than with placebo (MODIFY I: 16% [61 of 383] vs. 28% [109 of 395]; adjusted difference, -11.6 percentage points; 95% CI, -17.4 to -5.9; P<0.001; MODIFY II: 15% [58 of 390] vs. 26% [97 of 378]; adjusted difference, -10.7 percentage points; 95% CI, -16.4 to -5.1; P<0.001). In prespecified subgroup analyses (combined data set), rates of recurrent infection were lower in both groups that received bezlotoxumab than in the placebo group in subpopulations at high risk for recurrent infection or for an adverse outcome.

The rates of initial clinical cure were 80% with bezlotoxumab alone, 73% with actoxumab plus bezlotoxumab, and 80% with placebo; the rates of sustained cure (initial clinical cure without recurrent infection in 12 weeks) were 64%, 58%, and 54%, respectively.

The rates of adverse events were similar among these groups; the most common events were diarrhea and nausea.

Conclusions Among participants receiving antibiotic treatment for primary or recurrent
C. difficile infection, bezlotoxumab was associated with a substantially lower rate of recurrent infection than placebo and had a safety profile similar to that of placebo.

The addition of actoxumab did not improve efficacy. (Funded by Merck; MODIFY I and MODIFY II ClinicalTrials.gov numbers, NCT01241552 and NCT01513239 .).
Also Resource:

https://www.ncbi.nlm.nih.gov/pubmed/28121498

Bezlotoxumab – A New Agent for Clostridium difficile Infection. [N Engl J Med. 2017]

Infection Prevention – Patient Safety – Prior And During A Hospital Stay

safetyfirstsign

This is a patient – safety article and quite informative and beneficial for everyone.  The topics are highlighted on how to prevent infections prior and during a hospital stay.

 

The most pertinent information to review and share with others is as follows:

1. Check Up on Your Hospital
See how it compares with others on central line, C. diff, and MRSA infections, as well as other measures of patient safety. To compare hospitals in your area at preventing infections, use our hospital ratings.

2. Have a Friend or Family Member With You
That person can act as your advocate, ask questions, and keep notes. A Consumer Reports survey of 1,200 recently hospitalized people found that those who had a companion were 16 percent more likely to say that they had been treated respectfully by medical personnel. The most important times to have a companion for preventing infections and other medical errors are on nights, weekends, and holidays, when staff is reduced, and when shifts change.

3. Keep a Record
Keep a pad and pen nearby so that you can note what doctors and nurses say, which drugs you get, and questions you have. If you spot something worrisome, such as a drug you don’t recognize, take a note or snap a picture on your phone. You can also use your phone to record thoughts or conversations with staff. Though some may object, “explain that you are recording so you remember later,” McGiffert says.

4. Insist on Clean Hands
Ask everyone who enters your room whether they’ve washed their hands with soap and water. Alcohol-based hand sanitizer is not enough to destroy certain bacteria, such as the dangerous C. diff. Don’t hesitate to say: “I’m sorry, but I didn’t see you wash your hands. Would you mind doing it again?”

https://cdifffoundation.org/hand-washing-updates/

 

5. Keep It Clean
Bring bleach wipes for bed rails, doorknobs, the phone, and the TV remote, all of which can harbor bacteria. And if your room looks dirty, ask that it be cleaned.

6. Cover Wounds
Some hospitals examine incisions daily for infection, but opening the bandage exposes the area to bacteria. Newer techniques—sealing the surgical site with skin glue (instead of staples, which can harbor bacteria) and waterproof dressings that stay on for one to three weeks without opening—are effective at preventing infection.

7. Inquire Whether IVs and Catheters Are Needed
Ask every day whether central lines, urinary catheters, or other tubes can be removed. The longer they’re left in place, the greater the infection risk.

8. Ask About Antibiotics
For many surgeries, you should get an antibiotic 60 minutes before the operation. But research suggests that the type of antibiotic used or the timing of when it’s administered is wrong in up to half of cases.

Listen to one of the educational Podcasts:  Using antibiotics wisely, How to help in the fight against antibiotic resistance  with Guests Dr. Arjun Srinivassan, MD and Dr. Lauri Hicks, DO

https://www.voiceamerica.com/episode/93656/encore-using-antibiotics-wisely-how-you-can-help-in-the-fight-against-antibiotic-resistance

9. Postpone Surgery If You Have an Infection
That increases your risk of developing a new infection and worsening an existing one. So if you have any other type of infection—say, an abscessed tooth—then the surgery should be postponed, if possible, until it’s completely resolved.

10. Say No to Razors
Removing hair from the surgical site is often necessary, but doing that with a regular razor can cause nicks that provide an opening for bacteria. The nurse should use an electric trimmer instead.

11. Question the Need for Heartburn Drugs
Some patients enter the hospital taking heartburn drugs such as Nexium, lansoprazole (Prevacid) or omeprazole (Prilosec) or are prescribed one after they’re admitted. But these drugs, called proton-pump inhibitors, increase the risk of intestinal infections and pneumonia, so consider stopping them before admission and, once there, ask whether you really need one.

12. Test for MRSA
Ask your surgeon to screen you for MRSA, a potentially deadly bacteria that’s resistant to antibiotics, either before you enter or on admission, so that you can address the problem and hospital staff can take extra steps to protect you and others.

13. Watch for Diarrhea
Get tested for C. diff. infection  if you have three loose stools within 24 hours. If you test positive, expect extra precautions for preventing infections from spreading to others.

14. Quit Smoking, Even Temporarily
You won’t be allowed to smoke in the hospital anyway, and stopping as long as possible beforehand cuts the risk of infection. Read our advice on how to stop smoking.

15. Wash Up the Night Before Surgery
Ask about taking precautions before entering the hospital, such as bathing with special soap or using antiseptic wipes.

To read the article in its entirety click on the following link to be redirected:

MGB Biopharma Announced That the US FDA Has Granted Qualified Infectious Disease Product Designation For Treatment Of Clostridium difficile-associated Diarrhea (CDAD)

MGB Biopharma, a biopharmaceutical company developing a novel class of anti-infectives to address the major global problem of antibiotic resistance, announced that the US Food and Drug Administration (FDA) has granted MGB-BP-3, MGB Biopharma’s lead product, Qualified Infectious Disease Product (QIDP) designation for the treatment of Clostridium difficile-associated Diarrhoea (CDAD). The FDA grants QIDP designations to drugs intended to treat serious or life-threatening infections, caused by “qualified pathogens”.

MGB-BP-3 is an antibiotic that has shown to be active against a broad range of important multi-resistant and susceptible Gram-positive pathogens. The oral formulation of MGB-BP-3 is being developed by MGB Biopharma specifically for the treatment of Clostridium difficile, a Gram-positive bacterium responsible for the majority of cases of infectious hospital-acquired diarrhoea in developed countries.

Successful completion of the clinical phase I study of MGB-BP-3 confirmed the compound was well tolerated in healthy volunteers, was not systemically absorbed, had no effect on intestinal permeability, and had a noted effect on the Clostridium class of normal gut flora. MGB is preparing to initiate the phase II clinical study for MGB-BP-3 and investigate the safety and efficacy in patients with CDAD, caused by the most virulent ribotype of C. difficile B1/NAP1/027. This ribotype is shown to cause the highest morbidity and mortality in CDI patients, where the current therapy has only moderate efficacy.

Dr Miroslav Ravic, CEO of MGB Biopharma, said, “We are very pleased with the FDA’s decision to grant QIDP designation to MGB-BP-3 as we believe this drug has the potential to provide a significant benefit in the treatment of Clostridium difficile-associated Diarrhoea (CDAD). Granting of the QIDP designation highlights the potential of MGB-BP-3 to address serious and life-threatening infections and is an important milestone in the development of our lead product, as we prepare to initiate the phase II clinical trial.”

Dr Ravic, added, “Around the world, governments and global organisations are calling for new anti-bacterial drugs and are introducing incentives to reward companies for delivering these products; only last week antimicrobial resistance (AMR) was on the agenda of the G20 Summit. Our MGB-based anti-infectives have the potential to deliver significant advantages over current approaches.”

While pursuing its clinical development activities, MGB Biopharma is now evaluating partnering and funding sources for its lead compound MGB-BP-3, which has the potential to offer a clear differentiated treatment option for patients with life threatening infections caused by resistant and susceptible Clostridium difficile strains.

 

To read article in its entirety click on the following link:

http://www.pharmabiz.com/NewsDetails.aspx?aid=97421&sid=2

Centers for Disease Control and Prevention (CDC) Provides Updates On C. difficile Infection Management and Treatment

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According to the Centers for Disease Control and Prevention (CDC), Clostridium difficile infection (C. difficile) “has become the most common microbial cause of healthcare-associated infections in U.S. hospitals and costs up to $4.8 billion each year in excess health care costs for acute care facilities alone.”

Statistics provided by the CDC suggest that C. difficile cause nearly 500,000 infections in patients in the US annually.

In one study noted by the CDC, among infected patients, nearly 29,000 died within 30 days of being diagnosed, and more than half of those deaths (15,000) were directly attributable to C. difficile infection.

With C. difficile infection prevention being declared a national priority by the CDC, researchers, public health officials, infectious disease specialists, and others continue to research more effective ways to combat this microbe. Below, we’ve collected links and information on several recent developments.

THE GOOD NEWS
The Center for Infectious Disease Research and Policy (CIDRAP) recently -hospital-stewardship-lowers-antibiotic-use-infections”>reported some good news about the effectiveness of antibiotic stewardship programs (ASPs) in reducing antibiotic usage, especially among patients in the intensive care unit.

Citing the results of a meta-analysis published in Antimicrobial Agents and Chemotherapy, the CIDRAP report noted that, following the implementation of an ASP, “hospital antimicrobial consumption across all studies declined by 19.1%, and antibiotic costs fell by 33.9%. Though a modest decrease of 12.1% in antimicrobial use occurred in general medical wards, antimicrobial use in ICUs fell by 39.5% across the four studies that looked at that parameter.”

The meta-analysis also found that ASPs were effective in curbing the use of non-antibiotic therapies. In the six studies that also monitored antifungal prescription rates, the authors reported a 39.1% decline after ASP initiation.

The use of third- and fourth generation antibiotics (such as cephalosporins, vancomycin, tigecycline, linezolid, imipenem, meropenem, and fluoroquinolones) declined by 26.6% in facilities that implemented an ASP.

The meta-analysis found that bacteria infection rates declined 4.5% in the studies that measured clinical outcomes, and length of hospital stay fell by nearly 9% in studies that measured that metric.

However, the CIDRAP report noted that ASP implementation was not “associated with declining risks for Clostridium difficile (C diff) infections.” The authors of the meta-analysis did note that, in three studies that evaluated C difficile rates, “significant publication bias favored studies that reported ASPs’ negative effects.”

Let’s just get right to the heart of this report from Reuters:

“Fifteen years after the U.S. government declared antibiotic-resistant infections to be a grave threat to public health, a Reuters investigation has found that infection-related deaths are going uncounted, hindering the nation’s ability to fight a scourge that exacts a significant human and financial toll. Even when recorded, tens of thousands of deaths from drug-resistant infections – as well as many more infections that sicken but don’t kill people – go uncounted because federal and state agencies are doing a poor job of tracking them.

The Centers for Disease Control and Prevention (CDC), the go-to national public health monitor, and state health departments lack the political, legal and financial wherewithal to impose rigorous surveillance.”

The report goes on to outline how incomplete, “patchwork” infection reporting requirements for hospitals, and lax requirements in many states regarding physicians’ responsibilities when filling out death certificates, have led to deaths caused by (or at the very least associated with) MRSA and other drug-resistant pathogens to be “grossly under-reported.”

For example, according to Reuters, only 17 states require notification of C. difficile infections. Only two of the so-called “superbug” infections (MRSA bacteremia and C. difficile) are required to be reported to the CDC’s National Healthcare Safety Network surveillance program.

As they say, read the whole thing.

The authors of an article published in Clinical Microbiology and Infection  reported on a study that compared treatment with tigecycline to standard therapy in adult patients with severe C. difficile infection (sCDI).

The retrospective cohort study compared outcomes in patients with sCDI who received tigecycline alone to outcomes in patients who received standard oral vancomycin combined with intravenous metronidazole.

The primary study outcome was clinical recovery (as determined by European Society of Clinical Microbiology and Infectious Diseases guidelines); secondary outcomes were “in-hospital and 90-day all-cause mortality and relapse, colectomy and complication rates.”

A total of 90 patients with sCDI were treated (45 in each group). Patients treated with tigecycline monotherapy tended to do better in terms of cure rate, complicated disease, and CDI sepsis.

The authors reported that, compared to the group that received standard therapy, the tigecycline group had “significantly better outcomes of clinical cure (34/45, 75.6% vs. 24/45, 53.3%; p=0.02), less complicated disease course (13/45, 28.9% vs. 24/45, 53.3%; p=0.02) and less CDI sepsis (7/45, 15.6% vs. 18/45, 40.0%; p=0.009).”

Rates of mortality, disease relapse, and other measures were similar between the groups.

These results led the researchers to conclude that “tigecycline might be considered as a potential candidate for therapeutic usage in cases of sCDI refractory to standard treatment.”

Our good friends at Contagion Live recently reported on a study that has uncovered how the C. difficile bacteria produces toxins, which could aid the development of nonantibiotic drugs to fight C. difficile infection.

According to Contagion Live, C. difficile produces two toxins, toxin A and toxin B, that “cause life-threatening diarrhea as well as pseudomembranous colitis, toxic megacolon, perforations in the colon, sepsis and rarely death.”

Researchers at the University of Texas found that strains of C. difficile with a mutation in a particular Agr locus in their genome could not produce the toxins.

“Identifying a pathway responsible for activating the production of the toxins… opens up a unique therapeutic target for the development of a novel nonantibiotic therapy for C. difficile infections,” said the study authors.

The Contagion Live article includes a quote from author Charles Darkoh, PhD, on the potential implications of these findings.

“By crippling their toxin-making machinery, C. diff cannot make toxins and thus cannot cause disease. My laboratory is already working on this and was awarded a 5-year National Institutes of Health grant to investigate and develop an oral compound we have identified that inactivate the toxins and block the toxin-making machinery of C. diff by targeting this pathway,” he said.

 

 

To read article in its entirety click on the link below:

 http://www.hcplive.com/medical-news/latest-news-and-updates-on-c-difficile-infection-management-and-treatment/P-4#sthash.iDm6FgAP.dpuf

 

Perspective and Key Issues Regarding Healthcare Textiles and Infection Prevention Q&A With Infection Control Today + Healthcare Laundry Accreditation Council

SAFETY

Infection Control Today (ICT) asked board members of the Healthcare Laundry Accreditation Council (HLAC) for their perspectives on key issues relating to infection prevention and healthcare textiles management.

 

 

Q: What are the gaps in research that are needed to advance healthcare textile science?
A: We view gaps as opportunities for advancements in healthcare textile science, and these opportunities are in large part being driven by infection prevention’s changing landscape. Growing drug resistance, the threat of pandemics and the cost of healthcare-associated infections (HAIs) require that we gain a much better understanding of the morphology of organisms as it relates to their resistance and the chain of transmission. The list of infectious agents continues to grow and include prions, Clostridium difficile (C. diff.), Severe Acute Respiratory Syndrome (SARS), Ebola, etc. Each is unique and presents its own challenges for healthcare textiles, including the need to protect patient and staff from exposure situations (e.g., via personal protective equipment), assisting in patient-care activities (from exam gowns to incontinence products), and ultimately the need for them to be effectively cleaned/sanitized for reuse. The emergency guidelines issued by the Centers for Disease Control and Prevention (CDC) for Ebola highlight the point: all items including textiles exposed to an Ebola patient must be incinerated. Though it is a very pragmatic and understandable decision, it is not an effective or sustainable one.
A better understanding of these infectious agents will allow for:
– The development of barrier fabrics that include chemical finishes that offer better and more specialized protection for the wearer
– Optimized cleaning and sanitizing conditions in the reprocessing of reusable products
– The use of scientifically based guidelines (not emotional ones) that effectively mitigate (not displace) infection risk in the handling contaminated textiles – (i.e., exposure of waste handlers vs. handling by trained reprocessing professionals).
— Bradley J. Bushman, vice president of technical affairs, Standard Textile Co. Inc., Cincinnati, Ohio

Q: What are the imperatives about proper healthcare laundry processes that infection preventionists (IPs) must know?
A: IPs must be well-versed in the end-to-end healthcare laundry process, especially in the context of potential infection risks from contaminated healthcare textiles (HCTs). Contamination risks extend well beyond the actual wash process. While it is imperative to have a validated wash process that consistently produces hygienically safe and clean textiles, close attention must be paid to the many contamination risks after the wash process. HCT contamination after the wash process is just as dangerous as contamination from improperly washed HCTs.
Key areas to look for potential HCT contamination include:
– Dirty finish surfaces that may touch clean HCTs
– Carts, after being loaded, that are improperly stored outside on a loading dock
– HCT transfer carts that are not protected from the environment via fluid-proof covers or doors
– Dirty hands of laundry workers handling clean HCTs
– Dirty/linty equipment used to process HCTs
– The presence of dirty/soiled HCTs in an area with clean HCT
– Contaminated air flowing into a clean HCT area.
Also, it’s imperative to ensure that laundry workers are well-trained in hygiene concepts such as proper hand hygiene; proper environmental cleaning; the importance of functional separation of soiled and clean; and proper HCT sorting, washing, drying, and finishing.
— Gregory Gicewicz, HLAC immediate past president; president, Sterile Surgical Systems, Tumwater, Wash.

Q: How important is it for healthcare laundry personnel to work with IPs and other stakeholders to achieve good outcomes?
A: It is very important. It’s essential to have open communication and collaboration between the healthcare IP and the laundry profession. There must be a sharing of knowledge and operational details, both the laundry operations and the healthcare facility operation, for each professional to be able to positively interact with each other.
The IP is involved in and responsible for observation, or surveillance, of aspects relating to both patient safety and infection prevention. This includes the collection and analysis of infection prevention and control data; review of products and procedures; follow-up on infection risk; prevention and control approaches; educational interventions to avoid or mitigate infection; and the application of changes mandated by regulatory and licensing agencies such as the Occupational Health and Safety Administration (OSHA). The more knowledge the IP has concerning the operations of a laundry, the more epidemiological principles can be applied to improve patient care outcomes.
In welcoming the IP, a bond can be established that allows both entities to address ongoing issues with desired outcomes. Utilizing observation to follow the laundry progression of textiles in a step-by-step process will enable the IP to determine if there are perceived breaches in the process and can share these concerns with the laundry operator and personnel. In turn, the healthcare laundry operator may notify the healthcare facility administration and IP of concerns they may encounter in the healthcare laundry.
— Joan Blanchard, RN, MSS, CNOR, CIC, infection prevention assistant, Littleton Adventist Hospital, Littleton, Colo.

Q: What are some ways that IPs can help facilitate dialogue and collaboration with healthcare laundry professionals?
A: We encourage IPs to have a strong, trusted partnership with their healthcare laundry vendor. A good practice is for the hospital IP team members to treat their healthcare laundry professionals as part of their extended team, where there’s an ongoing sharing of updates in infection control and prevention efforts and in the regulatory and licensing arenas. By establishing a working relationship with healthcare laundry personnel, problems that arise with the laundry process or the healthcare facility process can be more readily corrected and unresolved issues can be more directly addressed.
Important to this team-style relationship is for the IP to visit the healthcare laundry to become acquainted with the personnel responsible for administering the laundry. In fact, the laundry should be open to at least yearly visits from their IPs. These visits are more productive when they’re treated collaboratively. The purpose of visits is to ensure that the processes used by the healthcare laundry is safe and supported by research*. Utilizing HLAC’s Standards Checklist (available at www.hlacnet.org) as a guideline during these visits ensures that a thorough over-view of the laundry process is accomplished.
— Gregory Gicewicz, HLAC immediate past president; president, Sterile Surgical Systems, Tumwater, Wash.; and Joan Blanchard, RN, MSS, CNOR, CIC, infection prevention assistant, Littleton Adventist Hospital, Littleton, Colo.

Q: What are the unresolved key issues related to infection prevention and healthcare textiles that remain for the future?
A: Without education and awareness, the same myths about healthcare laundry that have persisted for a long time will continue. For example:
– Myth: The laundry industry is regulated – by someone.
– Myth: The laundry industry is regulated by the government.
– Myth: If the hospital is accredited then so is the laundry.
– Myth: All textiles are washed the same.
– Myth: When it comes to knowing all about laundry matters, the hospital IP is on top of it.
– Myth: Every healthcare laundry is accredited.
Only the education of healthcare professionals, including IPs, can overcome these myths.
Furthermore, in the expanding world of pathogens, we will continue to see more bacteria and viruses developing more lethal strains and antibiotics becoming less and less effective. HLAC believes that going forward we should be striving for a more robust, collaborative effort among healthcare laundries, IPs, environmental services, laundry departments, quality management, and healthcare resource and materials management professionals.
Another point: It’s not unrealistic for hospitals to begin to look at healthcare textiles as an investment in quality patient outcomes and not just an expense. Bear in mind that the processing of healthcare textiles is a reimbursable expense by CMS because healthcare textiles have a direct impact on patient outcomes.
Because of these issues, we believe that every laundry that is providing healthcare textile processing services should be HLAC-accredited. Doing so would ensure that all patients receive textiles that are processed to the highest level, thus safeguarding that three of the four major principles of medical ethics are afforded of all patients: Justice, beneficence, and non-maleficence. We believe that there is a moral and ethical obligation to do the right thing for patients and processing healthcare textiles to the highest level possible helps to fulfill those obligations. We believe that working collaboratively, IPs and laundry operators will be key players in this process.
— Joan Blanchard, RN, MSS, CNOR, CIC, infection prevention assistant, Littleton Adventist Hospital, Littleton, Colo.; and John Scherberger, HLAC board president; president, Healthcare Risk Mitigation, Spartanburg, S.C.

References:
1. Centers for Medicare/Medicaid Services. CMS Hospital Infection Control Worksheet. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/GenInfo/Downloads/Survey-and-Cert-Letter-15-12-Attachment-1.pdf Accessed July 14, 2016.
2. Occupational Safety and Health Administration. Toxic and Hazardous Substances: Bloodborne Pathogens, 29 CFR § 1030 (2012). Occupational Safety and Health Administration.
3. Siegel JD, Rhinehart E, Jackson M, Chierello L. the Healthcare Infection Control Practices Committee. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. 2007.
4. Accreditation Standards for Processing Reusable Textiles for use in Healthcare Facilities. 2016 ed Frankfort, IL. Health care Laundry Accreditation Council. 2016.
5. Protecting Workers Families—DHHS(NIOSH) Pub No. 1002-113. National Institute for Occupational Safety and Health.
6. AINSI/AAMI ST65 2008/R 2013 Processing of Reusable Surgical Textiles for Use in Healthcare Facilities. 2013. Arlington, VA.: Association for the Advancement of Medical Instrumentation: 2013.
7. Guideline for Surgical Attire. In: Guidelines for Perioperative. Denver, CO: AORN, Inc.: 2016.

RESOURCE:

http://www.infectioncontroltoday.com/articles/2016/09/hlac-board-members-address-imperatives-related-to-healthcare-textiles.aspx