Infection Control & Hospital Epidemiology; 05/01/2014:

• Introduction to “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014 Updates”. Yokoe, Deborah S.; Anderson, Deverick J.; Berenholtz, Sean M.; Calfee, David P.; Dubberke, Erik R.; Ellingson, Katherine; Gerding, Dale N.; Haas, Janet; Kaye, Keith S.; Klompas, Michael; Lo, Evelyn; M
• Maintaining the Momentum of Change: The Role of the 2014 Updates to the Compendium in Preventing Healthcare-Associated Infections. Septimus, Edward; Yokoe, Deborah S.; Weinstein, Robert A.; Perl, Trish M.; Maragakis, Lisa L.; Berenholtz, Sean M.
• Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals: 2014 Update. Lo, Evelyn; Nicolle, Lindsay E.; Coffin, Susan E.; Gould, Carolyn; Maragakis, Lisa L.; Meddings, Jennifer; Pegues, David A.; Pettis, Ann Marie; Saint, Sanjay; Yokoe, Deborah S.
• The Evolving Landscape of Healthcare-Associated Infections: Recent Advances in Prevention and a Road Map for Research. Safdar, Nasia; Anderson, Deverick J.; Braun, Barbara I.; Carling, Philip; Cohen, Stuart; Donskey, Curtis; Drees, Marci; Harris, Anthony; Henderson, David K.; Huang, Susan S.; Juthani-Mehta, Manisha; L
• Preventable Proportion of Severe Infections Acquired in Intensive Care Units: Case-Mix Adjusted Estimations from Patient-Based Surveillance Data. Lambert, Marie-Laurence; Silversmit, Geert; Savey, Anne; Palomar, Mercedes; Hiesmayr, Michael; Agodi, Antonella; Van Rompaye, Bart; Mertens, Karl; Vansteelandt, Stijn
• Descriptive Epidemiology and Attributable Morbidity of Ventilator-Associated Events. Klompas, Michael; Kleinman, Ken; Murphy, Michael V.
• Healthcare-Associated Bloodstream Infections in a Neonatal Intensive Care Unit over a 20-Year Period (1992-2011): Trends in Incidence, Pathogens, and Mortality. Verstraete, Evelien; Boelens, Jerina; De Coen, Kris; Claeys, Geert; Vogelaers, Dirk; Vanhaesebrouck, Piet; Blot, Stijn
• Multidrug-Resistant Gram-Negative Bloodstream Infections among Residents of Long-Term Care Facilities. Venkatachalam, Indumathi; Hsu Li Yang; Fisher, Dale; Lye, David C.; Ling Moi Lin; Tambyah, Paul; Perl, Trish M.
• Does Colonization with Methicillin-Susceptible Staphylococcus aureus Protect against Nosocomial Acquisition of Methicillin-Resistant S. aureus? Landelle, Caroline; Iten, Anne; Uckay, Ilker; Sax, Hugo; Camus, Veronique; Cohen, Gilles; Renzi, Gesuele; Schrenzel, Jacques; Pittet, Didier; Perrier, Arnaud; Harbarth, Stephan
• A Missed Tuberculosis Diagnosis Resulting in Hospital Transmission. Medrano, Belinda A.; Salinas, Gloria; Sanchez, Connie; Miramontes, Roque; Restrepo, Blanca I.; Haddad, Maryam B.; Lambert, Lauren A.

Infection Control Today

• Weekly Emails to Hospital C-Suite Halt 2 Decades of Superbug Outbreak Efforts to reduce and stop the spread of infections caused by a highly resistant organism, carbapenem-resistant Acinetobacter baumannii, at a large Florida hospital proved ineffective until they added another weapon – weekly emails from the medical director of infection control to hospital leadership, according to a study published in the…
• Slide Show: Infection Prevention in the OR Perioperative professionals participating in ICT’s annual survey indicate that problems still exist in areas such as traffic control in the operating room, lack of proper patient bathing prior to surgery, as well as overall lack of compliance with evidence-based practices and standards.

Controversies in Hospital Infection Prevention:

• How does a study become an internet meme? According to the internet the steps to starting an internet meme are: (1) have an idea, (2) find a picture that reflects what you want to imply and (3) “now this is where the skill comes in.”  The first two steps are pretty easy to understand, but I’m currently trying to sort out what step 3 actually means.
• WHO: Antimicrobial Resistance Last week the WHO released a report covering global surveillance for antimicrobial resistant bacterial pathogens. The report starts off by highlighting the major gaps in knowledge about the magnitude of the MDR-bacterial problem and suggests that the post-antibiotic era is a very real threat. While the levels of resistance in the report are very alarming, the authors also note that worldwide surveillance lacks coordination, so it’s likely we’re only seeing the very tip of the iceberg.  One interesting aspect of Dr. Fukuda’s introduction was his acknowledgment that TB, malaria and HIV have much better surveillance systems and should serve as models for MDR-bacterial surveillance.
• Clean Hands Save Lives – and now there’s a book to prove it! As most of you know, 5 May is the WHO World Hand Hygiene Day. This year’s campaign is called “SAVE LIVES: Clean Your Hands campaign – ’No action today; no cure tomorrow – make the WHO 5 Moments for Hand Hygiene part of protecting your patients from resistant germs.”  In honor of 5th of May and to further promote hand hygiene and the concept “Economy of Peace,” French author Thierry Crouzet has authored a book describing the journey of Didier Pittet and WHO in promoting hand hygiene internationally. The book is available for purchase in print or epub and also for free in 6 languages (no Croatian?!). In addition, this group has created a new website/organization calledCleanHandsSaveLives.org. For hand hygiene fans, after you read the late Sherwin Nuland’s story of Ignac Semmelweis, this could be next on your list.
• Vancomycin-resistant S. aureus (VRSA) update The time intervals between introduction of penicillin and the emergence of penicillin-resistant S. aureus, and between the introduction of methicillin and the emergence of MRSA, were very short (3-5 years), and were followed by rapid emergence and spread of the resistant strains. For unclear reasons, the same hasn’t been true for VRSA. Vancomycin was introduced in the 1950s, and use of the drug increased almost exponentially during the advance of MRSA as a hospital pathogen in the 1980s. Yet it wasn’t until 2002 that the first VRSA infection was reported. As soon as it was recognized that plasmid-mediated transfer of the vanA gene to MRSA was responsible, many considered the rapid spread of VRSA to be inevitable. 
• Wash your Hands – it just makes sense. This video was made by Seema Marwaha and the CICC at Toronto General Hospital, University Health Network to encourage hand washing amongst care-providers.

In other sources:

• Early identification and treatment of sepsis. Nursing Times; 110: 4, 14-17.Sepsis is a potentially fatal condition and is becoming increasingly frequent, yet health professionals are often unable to recognise its symptoms. It is the body’s exaggerated response to infection and, if left untreated, will lead to severe sepsis, multi-organ failure and death. Nurses play a vital role in identifying patients with sepsis and starting essential treatment. This article looks at how sepsis can be identified and effectively treated to improve survival.
• Do ward and department managers know their responsibilities in relation to the management of sharps, and is this reflected in the way that they practise sharps management? Journal of Infection Prevention May 2014 vol. 15 no. 3 99-103 Needlestick injuries (NSIs) involving hollowbore needles are the most commonly reported occupational exposure within the healthcare sector in the United Kingdom (HPA, 2012). It is estimated that at least 100,000 NSIs occur each year but due to under-reporting the figure may be much higher (RCN, 2008).  Many strategies aimed at preventing NSIs have been implemented in the healthcare environment, including administrative controls, safer work practices and engineering controls, but despite these measures NSIs remain a serious health and safety threat (EU, 2010).
• Identification and control of a gentamicin resistant, meticillin susceptible Staphylococcus aureus outbreak on a neonatal unit  Journal of Infection Prevention May 2014 vol. 15 no. 3  104-109 We describe the identification and control of an outbreak of gentamicin resistant, meticillin susceptible Staphylococcus aureus (GR-MSSA) on a 36-bed neonatal unit (NNU) in London. Control measures included admission and weekly screening for GR-MSSA, cohorting affected babies, environmental and staff screening, hydrogen peroxide vapour (HPV) for terminal disinfection of cohort rooms, and reinforcement of hand hygiene. Seventeen babies were affected by the outbreak strain over ten months; seven were infected and ten were asymptomatic carriers. The outbreak strain was gentamicin resistant and all isolates were indistinguishable by pulsed-field gel electrophoresis. The outbreak strains spread rapidly and were associated with a high rate of bacteraemia (35% of 17 affected patients had bacteraemia vs. 10% of 284 patients with MSSA prior to the outbreak, p=0.007). None of 113 staff members tested were colonised with GR-MSSA. GR-MSSA was recovered from 11.5% of 87 environmental surfaces in cohort rooms, 7.1% of 28 communal surfaces and 4.1% of 74 surfaces after conventional terminal disinfection. None of 64 surfaces sampled after HPV decontamination yielded GR-MSSA. Recovery of GR-MSSA from two high level sites suggested that the organism could have been transmitted via air. Occasional breakdown in hand hygiene compliance and contaminated environmental surfaces probably contributed to transmission.
• Implementation of a patient-held urinary catheter passport to improve catheter management, by prompting for early removal and enhancing patient compliance  Journal of Infection Prevention May 2014 vol. 15 no. 3 88-92 Over the past few years a number of strategic initiatives to improve catheter management and reduce associated infections have been introduced. This paper details the introduction of a patient-held catheter passport and an improved documentation record using the PDSA (Plan, Do, Study, Act) cycle of change implementation in one large acute National Health Service (NHS) trust and local health economy (NHS Institute for Innovation and Improvement, 2008)