Tag Archives: Healthcare Education Nursing

The Society for Healthcare Epidemiology of America (SHEA) Issued Contact Precautions Guidelines On Multidrug-resistant Infections and C. difficile Infections

The Society for Healthcare Epidemiology of America (SHEA) January 2018 issued guidelines on how long hospitals should continue contact precautions for multidrug-resistant infections and Clostridium difficile infections to avoid the spread of potentially deadly organisms through hospitals.

“Because of the virulent nature of multi-drug resistant infections and C. difficile infections, hospitals should consider establishing policies on the duration of contact precautions to safely care for patients and prevent spread of these bacteria,” said David Banach, MD, MPH, an author of the study and hospital epidemiologist at the University of Connecticut Health Center in Farmington, in a society news release. “Unfortunately, current guidelines on contact precautions are incomplete in describing how long these protocols should be maintained. We outlined expert advice for hospitals to consider in developing institutional policies to more effectively use contact precautions to safely care for patients.”

Dr Banach and members of the SHEA Guidelines Committee, which includes experts in infection control and prevention, studied available evidence and practical considerations and surveyed SHEA members to develop the updated guidance document. The available evidence, however, is insufficient to issue a formal guideline.

The recommendations were published online January 11 in Infection Control & Hospital Epidemiology.

The guidance, which covers methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and carbapenem-resistant Enterobacteriaceae, as well as C difficile, emphasizes the need for clinicians to consider the amount of time since the last positive sample. Specific recommendations include:

  • For patients not receiving antibiotics with activity against methicillin-resistant S aureus ((MRSA), the committee recommends using negative screening cultures to decide when to stop contact protocols. The optimal number of negative cultures is unclear, but 1 to 3 are often used. Hospitals may want to extend contact precautions for high-risk patients with chronic wounds and those from long-term care facilities. The ideal length of extension is unknown, but 6 months is common.
  • For highly resistant Enterobacteriaceae, such as carbapenemase-producing carbapenem-resistant Enterobacteriaceae, or Enterobacteriaceae with few treatment options, hospitals should maintain contact precautions indefinitely.
  • For C difficile infections, contact precautions should be continued for at least 48 hours after the resolution of diarrhea, and clinicians should consider extending precautions if C difficile infection rates remain high despite appropriate prevention and control measures.
  • With cases of vancomycin-resistant enterococci (VRE)  infection, negative stool or rectal swab cultures should be used to determine when to discontinue precautions. One to three negative cultures at least 1 week apart are commonly used.

The authors note that there was insufficient evidence to formally recommend use of molecular testing to help guide decisions on length of contact precautions. However, they said they assume that polymerase chain reaction tests have better sensitivity compared with culture.

Hospitals should carefully gauge their own risks, priorities, and resources when adopting policy on duration of precautions, as costs and practicality of implementation differ, the authors note. In addition, guidance should be reevaluated by infection control leadership, especially when there are outbreaks.

“The duration of contact precautions can have a significant impact on the health of the patient, the hospital, and the community,” coauthor Gonzolo Bearman, MD, MPH, from the Division of Infectious Diseases at Virginia Commonwealth University, Richmond, said in the news release. “This guidance is a starting point, however stronger research is needed to evaluate and optimize the use.”

The guidance was endorsed by the Association for Professionals in Infection Control and Epidemiology, the Society of Hospital Medicine, and the Association of Medical Microbiology and Infectious Disease Canada.

This study was supported in part by the SHEA Research Network. Various coauthors report ties to Springer Nature for book and journal editing and grants from the National Institutes of Health, the Agency for Healthcare Research and Quality, Veterans Affairs’ Health Services Research and Development, the Centers for Disease Control and Prevention, Medimmune, Nanosphere Inc, Techlab, The Children’s Hospital of Philadelphia, Premier EHEC and CHRO-Magar 0157, Pfizer, and the University of Louisville. Coauthors also report consultant roles or fees with Xenex/Clorox, Ecolab and Gilead.

 

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

https://www.medscape.com/viewarticle/891242

C Diff Foundation Welcomes Linda Jablonski, MS, BSN, RN-BC – Director Of Nursing

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WELCOME

We are pleased to welcome Linda Jablonski, MS, BSN, RN-BC, to the C Diff Foundation.   Linda presides as the Director of Nursing of the C Diff Foundation’s Global Community Education & Outreach Program

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Linda Jablonski has been in the Nursing profession for over 22 years. A Graduate from Fairleigh Dickinson University and Masters at Kean College of New Jersey. Linda was a Special Education Instructor and Counselor prior to entering Nursing and her Thesis was on Preventing Violence Through Education or PTE. The major component of her thesis was Community Outreach. Linda worked her way through school as a Certified Nurses Aide and Home Health Aid which developed the experience and passion in the Home Care setting. Today Linda is a Director of Nursing for a Home Health agency and works at providing quality care, continued education to staff, and speaking to community groups to provide education in Infection Prevention (C.diff., MRSA & Superbugs) and Antibiotic Resistance Awareness and Stewardship Programs.

Summit Therapeutics plc Outlines Phase 3 Program for Novel C. difficile Infection Antibiotic Ridinilazole

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Clostridium difficile Treatment – Phase 3 program outline —

 

SUMMIT OUTLINES PHASE 3 PROGRAMME FOR NOVEL CDI ANTIBIOTIC RIDINILAZOLE FOLLOWING FDA AND EMA REGULATORY MEETINGS

Oxford, UK, On 1 February 2017 – Summit Therapeutics plc
the drug discovery and development company advancing therapies for Duchenne muscular dystrophy and C. difficile infection (‘CDI’),  outlines its Phase 3 programme for its novel antibiotic, ridinilazole, following recent regulatory meetings with the US Food and Drug Administration (‘FDA’) and European Medicines Agency (‘EMA’).

With input from the FDA and EMA, Summit intends to design the Phase 3 clinical programme to evaluate superiority of ridinilazole over standard of care in the treatment of C. diffiicle Infection (CDI).

A positive Phase 3 result on superiority has the potential to support the commercial launch of ridinilazole as a differentiated therapy that can both treat initial CDI and reduce disease recurrence.

Mr Glyn Edwards, Chief Executive Officer of Summit commented: “The constructive end of Phase 2 meetings with the US and European regulators have enabled us to design a Phase 3 programme that focuses on evaluating ridinilazole’s superiority over standard of care. This is something we believe would help differentiate our novel class antibiotic from currently marketed CDI treatments and those in late-stage development. Superiority in the combined measure of treatment of initial infection and importantly, reduction in recurrence, could position ridinilazole for front-line treatment of CDI.”
Summit discussed its Phase 3 development programme with the FDA at an End of Phase 2 meeting and through a scientific advice process with EMA. With input from both agencies, the Phase 3 programme is expected to include two trials evaluating ridinilazole as compared to the standard of care, vancomycin, each of which would enrol approximately 700 patients with CDI with the primary endpoint being superiority in sustained clinical response (‘SCR’). Other planned endpoints will include health economic outcome measures. The Phase 3 trial designs are consistent with the successful proof of concept Phase 2 trial, CoDIFy, in which ridinilazole achieved statistical superiority over vancomycin in SCR. SCR is a combined endpoint that measures cure at the end of treatment and a lack of recurrence in the 30 days after treatment. FDA also confirmed that ridinilazole would be eligible for Priority Review based on its QIDP designation.
Mr Edwards continued: “As we continue to evaluate our options to maximize the value of ridinilazole, our stronger financial position following the DMD programme partnership with Sarepta Therapeutics, Inc. means Summit has more time to fully explore all options. These include potentially entering into a collaboration with a third party or securing meaningful non-dilutive funding from government and charitable organizations. In parallel, activities

About Ridinilazole
Ridinilazole is an orally administered small molecule antibiotic that Summit is developing specifically for the treatment of CDI.

In preclinical efficacy studies, ridinilazole exhibited a narrow spectrum of activity and had a potent bactericidal effect against all clinical isolates of C. difficile tested. In a Phase 2 proof of concept trial in CDI patients, ridinilazole showed statistical superiority in sustained clinical response (‘SCR’) rates compared to the standard of care, vancomycin. In this trial, SCR was defined as clinical cure at end of treatment and no recurrence of CDI within 30 days of the end of therapy. Ridinilazole has received Qualified Infectious Disease Product (‘QIDP’) designation and has been granted Fast Track designation by the US Food and Drug Administration. The QIDP incentives are provided through the US GAIN Act and include an extension of marketing exclusivity for an additional five years upon FDA approval.

About Summit Therapeutics
Summit is a biopharmaceutical company focused on the discovery, development and commercialization of novel medicines for indications for which there are no existing or only inadequate therapies. Summit is conducting clinical programs focused on the genetic disease Duchenne muscular dystrophy and the infectious disease C. difficile infection.

Resources:

http://www.summitplc.com/media/press-releases/

MD Peer Exchange Focus On Clostridium difficile Infections

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Courtesy of MDMag .com

MD Magazine

 

 

Listen and View Panelists:  Peter L. Salgo, MD; Erik Dubberke, MD; Lawrence J. Brandt, MD; Dale N. Gerding, MD; and Daniel E. Freedberg, MD, MS,

Topic of discussion:  Understanding Why Clostridium difficile Infections (CDI) Occur In the Community

The second video the panelists discuss:

The Pathophysiology of Clostridium difficile Infection (CDI)  and Its Impact On the Gastrointestinal System.

See more at: http://www.mdmag.com/peer-exchange/clostridium-difficile-infections/understanding-why-clostridium-difficile-infections-occur-in-the-community#sthash.r4Z6jNwk.dpuf

 

 

September Is SEPSIS Awareness Month; Learn More With the CDC and Worldwide Organizations Raising Awareness; It’s A Race Against Time

Sepsis With The CDC; It’s A Race Against Time

Sepsis Awareness Month is in September. SEP for Sepsis.
SEP for September – making September the perfect month for Sepsis Awareness Month 

30 Days to Highlight Sepsis

September is Sepsis Awareness Month and for 30 days, Sepsis Alliance www.sepsis.org and sepsis advocates pull out all the stops to spread the word about what sepsis is, what it does, and how we can make a difference and save lives.

Faces of Sepsis:

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http://www.sepsis.org/faces/michael-j-caralla-sr/

Sepsis hits home and is no stranger to the Foundress of the C diff Foundation or to the millions of families who have lost loved ones from Sepsis.  Loosing a loved one from Septic Shock with C.diff. involvement is devastating for any family.  The C Diff Foundation supports and joins the organizations raising Sepsis awareness worldwide and we encourage everyone to join in the global efforts being made to help save lives.

Click on the Logo below to listen to the Podcast from a live broadcast on “C. diff. Spores and More” Global Broadcasting Network  “Sepsis; Number One Preventable Cause of Death Worldwide”  with guests  Dr. Tex Kissoon, MD,a well-known doctor from Canada, will provide us with the insight into the global phenomenon of Sepsis. Sepsis affects more than 30 million lives per year yet it is almost unknown to the general public and is quite often misdiagnosed by medical professionals worldwide. The reasons of why that is with the “why” Sepsis is so deadly, and what you can do to increase Sepsis awareness– will be discussed in the next 60 minutes. Dr. Kissoon is joined by Ray Schachter, a Sepsis survivor who has dedicated all of his available time to combating and raising awareness of Sepsis worldwide. Both are members of the Global Sepsis Alliance, which has established World Sepsis Day on September 13th every year to raise awareness for Sepsis worldwide.

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World Sepsis Day is September 13th

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Free online congress on September 8- 9, 2016
Register now!

http://www.world-sepsis-day.org/?MET=HOME&vLANGUAGE=EN

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SepsisCDC710

 

Saving patients from sepsis is a race against time

CDC calls sepsis a medical emergency; encourages prompt action for prevention, early recognition

Sepsis is caused by the body’s overwhelming and life-threatening response to an infection and requires rapid intervention. It begins outside of the hospital for nearly 80 percent of patients. According to a new Vital Signs report released by CDC, about 7 in 10 patients with sepsis had used health care services recently or had chronic diseases that required frequent medical care. These represent opportunities for healthcare providers to prevent, recognize, and treat sepsis long before it can cause life-threatening illness or death.

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“When sepsis occurs, it should be treated as a medical emergency,” said CDC Director Tom Frieden, M.D., M.P.H. “Doctors and nurses can prevent sepsis and also the devastating effects of sepsis, and patients and families can watch for sepsis and ask, ‘could this be sepsis?’”   

Certain people with an infection are more likely to get sepsis, including people age 65 years or older, infants less than 1 year old, people who have weakened immune systems, and people who have chronic medical conditions (such as diabetes). While much less common, even healthy children and adults can develop sepsis from an infection, especially when not recognized early. The signs and symptoms of sepsis include: shivering, fever, or feeling very cold; extreme pain or discomfort; clammy or sweaty skin; confusion or disorientation; shortness of breath and a high heart rate.

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According to the Vital Signs report, infections of the lung, urinary tract, skin, and gut most often led to sepsis. In most cases, the germ that caused the infection leading to sepsis was not identified. When identified, the most common germs leading to sepsis were Staphylococcus aureus, Escherichia coli (E. coli), and some types of Streptococcus.

 

Health care providers, patients and their family members can work as a team to prevent sepsis.

Health care providers play a critical role in protecting patients from infections that can lead to sepsis and recognizing sepsis early. Health care providers can:

·         Prevent infections. Follow infection control requirements (such as handwashing) and ensure patients to get recommended vaccines (e.g., flu and pneumococcal).

·         Educate patients and their families. Stress the need to prevent infections, manage chronic conditions, and, if an infection is not improving, promptly seek care. Don’t delay.

·         Think sepsis. Know the signs and symptoms to identify and treat patients earlier.

·         Act fast. If sepsis is suspected, order tests to help determine if an infection is present, where it is, and what caused it. Start antibiotics and other recommended medical care immediately.

·         Reassess patient management. Check patient progress frequently. Reassess antibiotic therapy 24-48 hours or sooner to change therapy as needed. Determine whether the type of antibiotics, dose, and duration are correct.

CDC is working on five key areas related to sepsis:

·         Increasing sepsis awareness by engaging clinical professional organizations and patient advocates.

·         Aligning infection prevention, chronic disease management, and appropriate antibiotic use to promote early recognition of sepsis.

·         Studying risk factors for sepsis that can guide focused prevention and early recognition.

·         Developing tracking for sepsis to measure impact of successful interventions.

·         Preventing infections that may lead to sepsis by promoting vaccination programs, chronic disease management, infection prevention, and appropriate antibiotic use.

To read the entire Vital Signs report visit: www.cdc.gov/vitalsigns/sepsis.

For more information on sepsis and CDC’s work visit: www.cdc.gov/sepsis.

U.S. Department of Health and Human Services

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CDC works 24/7 protecting America’s health, safety and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, stem from human error or deliberate attack, CDC is committed to respond to America’s most pressing health challenges.