Category Archives: Infection Control

National and State Healthcare-associated Infection (HAI) Progress Report from the CDC 2019

Between 2016 and 2017, healthcare-associated infections decreased in the United States, according to the most recent National and State HAI Progress Report   from the CDC.

The report includes a summary of rates for select HAIs across four settings: acute care hospitals, critical access hospitals, inpatient rehabilitation facilities and long-term acute care hospitals.

Key findings from the report include:

1. Central line-associated bloodstream infections saw a 9 percent decrease, with the largest decrease occurring in hospital wards.

2. Catheter-associated urinary tract infections dropped by 5 percent, with ICUs showing the largest decrease of 8 percent.

3. Methicillin-resistant Staphylococcus aureus bacteremia declined by 8 percent and Clostridioides difficile events reduced by 13 percent.

4. Ventilator-associated events and surgical site infections both decreased, by 3 percent and 1 percent respectively. The decrease in SSIs was related to 10 procedures tracked in the report.

5. There were no significant decreases or increases in abdominal hysterectomy SSIs and colon surgery SSIs.

 

Source:  https://www.beckershospitalreview.com/quality/hais-decreased-in-2017-c-diff-down-13-mrsa-down-8.html

SAVE LIVES: Clean YOUR Hands WHO Global Annual Campaign Kicks Off On May 5th

“Clean care for all – it’s in your hands” — this year’s slogan

SAVE LIVES: Clean YOUR Hands  global annual campaign kicks off on May 5th.

As the World Health Organization shared in their newsletter;   “Being “campaign active” is an important part of improving hand hygiene and Infection Prevention and Control (IPC)  in health care.”

 

 

“Health facilities should always be places of healing. No one should get sick while seeking care. Achieving universal health coverage means quality care for everyone, everywhere. And quality care is clean care. We all have a part to play; hand hygiene is one of the most basic elements of infection prevention and control.” Dr Tedros Adhanom Ghebreyesus, WHO Director-General, advocacy video (https://youtu.be/nw9TMfqc3cE).

The following WHO campaign resources are now available on the 5 May 2019 web page (https://www.who.int/infection-prevention/campaigns/clean-hands/5may2019/en/)

Visit the WHO website to gain access to the resources available and being “campaign active” to share the high levels of the importance of this life-saving intervention across the globe.

 

Global Antibiotic Research and Development Partnership (GARDP) – GARDP is a non-profit research and development organization initiated by WHO and the Drugs for Neglected Disease initiative, that addresses global public health needs by developing and delivering new or improved antibiotic treatments, while endeavouring to ensure their sustainable access. GARDP recently launched the COHERENCE (COmbination tHERapy to treat sepsis due to carbapenem-resistant Gram negative bacteria in adult and paediatric population: EvideNCE and common practice) project. As a first activity, COHERENCE launched a survey assessing the prescription habits and attitudes of clinicians who normally deal with the treatment of carbapenem-resistant Gram negative bacteria in adult and paediatric populations worldwide. Please promote the survey and participate here (https://www.surveymonkey.com/r/GARDP-COHERENCE)! By completing the survey, you will have a chance to win a complimentary registration for the 2020 ECCMID Congress in Paris.

News from stakeholders:
European Centre for Disease Prevention and Control (ECDC)
In support of 5 May hand hygiene campaign activities, ECDC will be promoting reports and materials including:
•       a short video on the importance of clean hands (ttps://www.youtube.com/watch?v=Sbx5ZZYNxzg)
•       infographics:
       – Antibiotic resistance – an increasing threat to human health (https://antibiotic.ecdc.europa.eu/en/publications-data/antibiotic-resistance-increasing-threat-human-health)
       – Healthcare-associated infections – a threat to patient safety in Europe (https://antibiotic.ecdc.europa.eu/en/publications-data/healthcare-associated-infections-threat-patient-safety-europe)
•       Highlights of the PPS published on Euro-surveillance:
       – Antimicrobial use in European acute care hospitals: results from the second point prevalence survey of healthcare-associated infections and antimicrobial use, 2016-2017 (https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.23.46.1800393).
       – Antimicrobial use in European long-term care facilities: results from the third point prevalence survey of healthcare-associated infections and antimicrobial use, 2016-2017 (https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2018.23.46.1800394).
       – Prevalence of healthcare-associated infections, estimated incidence, and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016-2017 (https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2018.23.46.1800516).

 

 

Resources:  World Health Organization

Updated 2019

 

Study Finds C.diff. Infections Could Be Reduced by 13% In Hospital Transfers

“We defined a patient transfer as a patient discharged from one hospital and then admitted to another hospital on the same day.”

The study findings reinforce that infection prevention and control strategies should be conducted at the regional level to better minimize the spread of HAIs, Sewell and colleagues said.

Study findings showed that hospital transfers cause a “minority but substantial burden” of Clostridioides difficile infections in California and that the burden could be reduced by 13% statewide if contamination from hospital transfers was eliminated.

Hospital transfers are known to be associated with the spread of pathogens like C. difficile and MRSA, but researchers said it is critical to better understand the role that hospital transfers play in the spread of hospital-acquired infections, or HAIs.

“The relationship between hospital transfers and higher levels of HAIs is unclear, as is the public health significance of this relationship,” Daniel K. Sewell, PhD, assistant professor of biostatistics in the University of Iowa College of Public Health, and colleagues wrote.

They conducted a retrospective observational study using data collected between 2005 and 2011 from the Healthcare Cost and Utilization Project California State Inpatient Database.

“We were able to discern transfers between hospitals by considering patients who had common discharge and admission dates involving two distinct hospitals,” Sewell and colleagues wrote. “We defined a patient transfer as a patient discharged from one hospital and then admitted to another hospital on the same day.”

According to the study, Sewell and colleagues identified 26,878,498 admissions and 532,925 patient transfers across 385 hospitals. They found that 13% of C. difficile infections (CDIs) were a result of patient transfers (95% CI, 7.6%-18%). Additionally, the researchers observed CDI cases increase at receiving hospitals when the number of transfer patients increased or when the CDI rate at the transferring hospital increased, or both.

“Transfers of patients demonstrate the interconnectedness of health care systems,” they wrote. “Accordingly, efforts to control the spread of infections at one facility may benefit others, and the less rigorous infection control efforts at some hospitals may impact the infection rates at other hospitals within a transfer network.” – by Marley Ghizzone

 

 

 

 

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

 

https://www.healio.com/infectious-disease/nosocomial-infections/news/online/%7B7bc8ae6c-fcc3-4ca6-a625-29301eb6535a%7D/eliminating-contamination-from-hospital-transfers-could-reduce-cdi-cases-by-13

Path03Gen Is Taking a Step In the Right Direction to Reduce Healthcare-Associated Infections (HAI’s)

Amazing research and developments are taking place all across the globe.

In St. Petersburg, Florida there is an organization dedicated in fighting  harmful pathogens and the St. Pete Catalyst’s Journalist Margie Manning had the following to report on the “Green Earth Medical Solutions” technology company:

Green Earth Medical Solutions developed technology that kills germs on the bottom of shoes, which often are overlooked as a source for bacteria, virus and other disease-causing microorganisms.

The company’s PathO3Gen sanitizing stations combine UVC, a type of ultraviolet light, and ozone, to sanitize shoes. Anyone entering a healthcare facility or a critical care area steps on the station and waits for about six seconds. When they step off, 99.9 percent of the deadly pathogens have been eliminated, said chief operating officer Scott Beal.

Healthcare acquired infections, or HAIs, cause about 100,000 deaths every year, according to the Centers for Disease Control and Prevention. There’s been a lot of attention paid to infection control in healthcare, most of it focused on hand washing and cleaning high-touch surfaces. A 2017 clinical study showed 77 percent of the soles of shoes walking into a hospital contained superbugs such as MRSA and C. difficile, or a combination of the two.

“Initially, clinicians said ‘we don’t operate on the floors, those are not areas of concern,’” Beal said. “But the infection control community and stakeholders have been coming out with more and more published credible studies that say what is tracked in on the floor is getting airborne and aerosolized, and makes it to high-touch areas, which then cause HAIs.”

Reducing pathogens tracked in by shoes also increases the efficacy of other sanitizing methods, because the building is not being overrun by germs, Beal said.

Hospitals have financial reasons to reduce hospital-acquired infections. Beginning in 2015, federal reimbursements to hospitals were directly affected by their HAI rates.

AdventHealth Connerton, an acute-care specialty hospital in Pasco County, is testing the technology.

“The sanitizing stations allow us to establish new protocols that proactively prevent infections to ensure the best possible outcomes for patients while they’re in our care,” Debi Martoccio, chief operating officer at AdventHealth Connerton, said in a statement.

With any new technology, gaining traction and changing minds are tough to do, Beal said.

“It’s important to have someone the size and scope and reputation of AdventHealth that sees the benefit of what we are trying to accomplish,” he said.

There also are foot sanitizing stations at Cypress Creek Assisted Living in Sun City Center.

There are competitors that use UVC to disinfect shoes, Beal said. None of those companies combine UVC with ozone, a combination initially created by Asher Gil, an Israeli aeronautical engineer. Gil tested his combination of UVC and ozone at University of South Florida. Gil was bought out about three years ago by his partners, who further developed the technology and ran clinical tests. The product went to market in the fourth quarter of 2018.

Those initial owners and one outside investor have provided the capital for Green Earth Medical, now in its second round of fundraising, Beal said.

The company is headquartered in downtown St. Petersburg. It has four full-time employees, and contracts with distributors to market the sanitizing stations. There are about 25 to 30 representatives in the field marketing the product, and the company is in the early stages of talks with more healthcare facilities, as well as clean rooms and labs, Beal said.

The sanitizing stations are the only product right now, but other products are in the process of being patented, he said. He expects to ramp up development on those once the company gains traction.

“We are out trying to market, educate, change perceptions and shift the paradigms that exist around infection controls,” Beal said. “Our goal is to reduce bioburden in every facility that has an immune-compromised population.”

RESOURCE;  https://stpetecatalyst.com/st-pete-tech-company-steps-into-hospital-safety/

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ABC ACTION NEWS INTERVIEW WITH DEBI MORTOCCIO, COO – ADVENTHEALTH  CONNERTON

 

 

Case Study Investigators Utilized a Bleach Product That Showed Significant Reduction In Contamination

 

 

By:Saskia v. Popescu Saskia v. Popescu, MPH, MA, CIC, is a hospital epidemiologist and infection preventionist with Phoenix Children’s Hospital. During her work as an infection preventionist she performed surveillance for infectious diseases, preparedness, and Ebola-response practices. She is currently a PhD candidate in Biodefense at George Mason University where her research focuses on the role of infection prevention in facilitating global health security efforts. She is certified in Infection Control.

Clostridium difficile (C diff) infections are pretty much a nightmare for infection preventionists. They cause horrible illness in patients and the spore is environmentally hardy, which makes disinfection efforts extremely challenging. The US Centers for Disease Control and Prevention (CDC) estimates that, in the United States, half a million cases of C diff occur every year, and roughly 15,000 people die due to the infection. As a result of the severity of these infections and the challenges for infection control, it’s not surprising that surveillance and reporting is required not only by many state laws, but also reimbursement regulations through the Centers for Medicare and Medicaid Services (CMS). All of these factors make C diff prevention a major focus for hospitals.

Since the C diff spores are so environmental hardy, cleaning and disinfecting is particularly challenging. Bleach products are required to combat the spread of the spores on surfaces and fomites while soap and water is required for hand hygiene instead of alcohol-based hand sanitizer. These cleaning requirements pose problems though; sometimes bleach can be corrosive on medical equipment if manufacturer guidelines aren’t followed. Moreover, C diff can easily spread if patients aren’t isolated appropriately, if the room isn’t cleaned effectively, if hygiene failures occur, etc. One of the tough aspects of infection control in the face of C diff is the role of the asymptomatic carrier (i.e. the patient who is not experiencing symptoms that would trigger testing and isolation precautions but has the capacity to shed the spores).

A new study in the American Journal of Infection Control sought to address this often undervalued vector for transmission and the true burden of C diff spores in rooms after they were cleaned post-discharge and did not house a C diff patient. Investigators used the Louis Stokes Cleveland Veterans Affairs Medical Center, a 215-bed acute care facility, to test whether cleaning with bleach products in non-C diff rooms would impact contamination.

Prior to their study, daily and discharge cleaning for C diff rooms utilized bleach wipes, while a quaternary ammonium disinfectant was used for non-C diff rooms. Investigators used Clorox Healthcare Fuzion Cleaner, which is a bleach spray that has less corrosive effects. Although cleaning efficacy had previously been measured with fluorescent markets, the team relied on cultures to identify both C diff spore and methicillin-resistant Staphylococcus aureus (MRSA) contamination for this study.

Non-C diff rooms were tested for 3 weeks before the switch to the bleach-spray disinfectant and then, after the swap, tested again after cleaning of the room but before admission of a new patient. Ultimately, the goal was to determine how many rooms had environmental contamination with C diff spores before and after the change in disinfectants.

There were 51 non-C diff rooms tested after the post-discharge cleaning and prior to the switch to the bleach spray, and 39 non-C diff rooms were cultured after switching to the bleach product. The results were pretty astounding and definitely make the case for using bleach-based products in all post-discharge rooms.

Prior to switching products, 24% (12/51) of the rooms had contamination of at least one site (room and/or bathroom) and 10% had MRSA contamination. When cleaning practices were switched to use the bleach spray, the rate of contamination severely dropped—2 of 39 rooms. This trend was statistically significant and also seen in the MRSA contamination.

In this case, the investigators found that by using the bleach-based spray for the post-discharge cleaning of a non-C diff patient’s room, they reduced the contamination from 24% to 5%.

Although the study is limited to a single hospital, it encourages further investigation into general C diff contamination throughout hospitals and whether bleach-based cleaning should be performed upon all discharges, regardless of patient diagnosis with C diff infections.

As C diff continues to grow as a public health and health care concern, the role of environmental contamination will only become more critical. This study sheds light on a new cleaning strategy for hospital-wide disinfecting efforts to reduce microbial burden and C diff contamination. 

To view article in its entirety – please click on the following link to be redirected:

https://www.contagionlive.com/contributor/saskia-v-popescu/2019/02/fighting-c-diff-contamination-with-a-different-cleaning-approach?fbclid=IwAR3YS1CoSTiCyQ-FJ11N2UHWAMmzGUKnCLp7Uy2MxysbtZfAGTQ2EJANILU

It Takes a Team Approach To Break the Chain of Infections and Decrease Infection Rates

Reduce the Risk to Patients, Staff and Visitors

A comprehensive approach to C. diff can break the chain of infection and help to decrease the spread of this organism throughout your hospital. There are many paths of transmission that contribute to the spread of C. diff from infected patients to the hands of healthcare workers, visitors and the environment. Progressive distribution of spores happens through multiple contacts to multiple surfaces and people. Ensure your staff is trained to identify patients exhibiting C. diff symptoms.

To guard against C. diff, follow three key environmental and hand hygiene workflows to help ensure your facility breaks the chain of infection and improves patient outcomes.

  1. Identify and Communicate Risk. Communications remains key to controlling the spread of C. diff during complex interactions and location changes in hospitals. Proper communication protocols better support the tracking and reporting of infections and prevention efforts.
  2. Assess Appropriate and Timely Environmental Hygiene. Implement a strong process to regularly audit the adequacy of room cleaning, so you know before you have an issue. Audits and processes will also help you proactively identify where your staff can improve. Stay ahead of potential outbreaks through proactive daily use of a sporicidal disinfectant with good material compatibility for daily cleaning and disinfection of surfaces.
  3. Implement Hand Hygiene Practices. Hands are the main pathways for germ transmission during healthcare. Practicing good hand hygiene is key to mitigating the spread of C. diff. The ability to accurately monitor hand hygiene in your hospital can drive positive change, decrease the risk of HAIs and improve patient outcomes. With the more stringent interpretation of the hand hygiene policy issued by the Joint Commission in January 2018, immediate citations will be issued for any single instance of a healthcare worker’s non-compliance during a patient interaction.

Transform the way your hospital assesses, communicates, tracks and reports C. diff and other HAIs to drive and sustain better patient outcomes and increase compliance. To learn how to implement these workflows into your hospital program and to gain insightful technology tips, visit www.ecolab.com/healthcareinsightscenter.

 

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

http://www.modernhealthcare.com/article/20180703/SPONSORED/180709972

 

 

Researchers Find Inpatients Were Most Likely to Acquire a C.diff. Infection When Census Was Between 25-75% Capacity

In a study of more than 550,000 patient discharges from 327 California hospitals, researchers found that patients were most likely to contract Clostridium difficile (C.diff., CDI, C.difficile) —a stubborn and potentially deadly hospital-associated infection (HAI) —when inpatient wards were in the “middle range” of capacity, or between 25% and 75% full.

“Our hypothesis going in was essentially that when hospitals are busier, perhaps care quality is compromised,” Mahshid Abir, M.D., assistant professor of emergency medicine at UM Medical School and the study’s lead author, told FierceHealthcare. “Certainly when we saw these findings, we were surprised.”

Overall, more than 2,000 patients included in the study, which looked at discharges between 2008 and 2012, contracted C. diff during their hospital stay. Hospitals often struggle to control C. diff infections, and a significant number of readmissions can be linked to such infections.

By basing the study around a model that accounts for seasonal staffing changes or unit closure, for example, researchers were better able to filter out infections that a patient had before arriving at the hospital, she said. Calculating occupancy in this way could also help providers identify potential risk factor for infection, according to the study.

Patients admitted to a unit that was at between 25% and 75% capacity were three times more likely to contract C. diff compared to those in units at below 25% or above 75% capacity, according to the study.

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

https://www.fiercehealthcare.com/hospitals-health-systems/study-explores-link-between-hospital-occupancy-infection-rates