Transcript File - Working Toward Zero HAIs

Unit Based Champions
Infection Prevention
eBug Bytes
October 2012
Superbugs Ride Air Currents
Around Hospital Units


University of Leeds research showed that coughing, sneezing or simply
shaking the bed linens can send superbugs into flight, allowing them to
contaminate recently cleaned surfaces. PhD student Marco-Felipe King
used a biological aerosol chamber, one of a handful in the world, to replicate
conditions in one- and two-bedded hospital rooms. He released tiny aerosol
droplets containing Staphyloccus aureus from a heated mannequin
simulating the heat emitted by a human body. He placed open petri dishes
where other patients’ beds, bedside tables, chairs and washbasins might be
and then checked where the bacteria landed and grew.
The results confirmed that contamination can spread to surfaces across a
ward. “The level of contamination immediately around the patient’s bed was
high but you would expect that. Hospitals keep beds clean and disinfect the
tables and surfaces next to beds,” says Dr. Cath Noakes, from the
University’s School of Civil Engineering, who supervised the work.
“However, we also captured significant quantities of bacteria right across the
room, up to 3.5 meters away and especially along the route of the airflows
in the room.” Reference: M.F. King, C.J. Noakes, P.A. Sleigh, M.A. Camargo-Valero. Bioaerosol
Deposition in Single and Two-Bed Hospital Rooms: A Numerical and Experimental Study.
Building and Environment. 2012
Effect of Nonpayment for
Preventable Infections in U.S. Hospitals



Using a quasi-experimental design with interrupted time series with
comparison series, we examined changes in trends of two health care–
associated infections that were targeted by the CMS policy (CLABSI and
CAUTI as compared with an outcome that was not targeted by the policy
(VAP). Hospitals participating in the NHSN and reporting data on at least
one health care–associated infection before the onset of the policy were
eligible to participate. Data from January 2006 through March 2011 were
included.
A total of 398 hospitals contributed 14,817 to 28,339 hospital unit–months,
depending on the type of infection. We observed decreasing secular trends
for both targeted and nontargeted infections long before the policy was
implemented. There were no significant changes in quarterly rates of
CLABSI, CAUTI, or VAP after the policy implementation. Our findings did
not differ for hospitals in states without mandatory reporting, nor did it
differ according to the quartile of percentage of Medicare admissions or
hospital size, type of ownership, or teaching status.
Reference: N Engl J Med 2012; 367:1428-1437 October 11, 2012
Study finds credit cards
contaminated



New results from a scientific study for Global Handwashing Day reveal
that one in 10 bank cards (10%) and one in seven notes (14%) were found
to be contaminated with fecal organisms. The nationwide study carried out
by researchers from the London School of Hygiene & Tropical Medicine
and Queen Mary, University of London investigated levels of bacterial
contamination on the hands, credit cards and currency of various sample
sizes in East and West London, Birmingham and Liverpool to raise
awareness of Global Handwashing Day. The research highlights the
importance of handwashing with soap before eating and after using the
toilet.
The research also revealed that over a quarter of hands sampled (26%)
showed traces of fecal contamination including bacteria such as E. coli.
More significantly, out of the samples taken, 11% of hands, 8% of cards and
6% of notes showed gross contamination - where the levels of bacteria
detected were equal to that you would expect to find in a dirty toilet
bowl.
http://www.lshtm.ac.uk/newsevents/news/2012/dirty_money.html
Hospital food
contaminated with C. diff



Oct. 19, 2012 -- A new report suggests that hospital food is frequently
contaminated with the dangerous diarrhea bug Clostridium difficile (C. diff).
Houston researchers found that about one-fourth of nearly 100 hospital
food samples they tested were positive for C. diff. Among the worst
culprits: turkey, chicken, and egg products, vegetables and fruits, and
desserts. Almost all were cooked. C. diff has been recovered from pigs,
cows, and chickens, and the bug has been found in retail meat and salad
greens. It's only one hospital. And no cases of human infection were
linked to the food. But together with past research, the findings suggest
that contaminated food may be an important route of spread of C. diff in
hospitals, says researcher Hoonmo Koo, MD, an infectious diseases
specialist at Baylor College of Medicine in Houston, Texas.
Moreover, the temperatures at which hospital foods are cooked may be
too low to kill the bug, he says. An infectious diseases expert not involved
with the research says the major C. diff strains that contaminate food are
different from the ones responsible for human disease.
IDSA meeting – October 19, 2012
Study Shows Universal Decolonization
of ICU Patients Reduces Bloodstream
Infections by 44 Percent




The REDUCE MRSA study proved convincingly that universal decolonization
is the best practice to prevent infection from MRSA and other antibioticresistant bacteria in high risk ICU patients. The study, which involved nearly
75,000 patients and more than 280,000 patient days in 74 adult ICUs located
in 16 states, compared the results of three approaches in ICUs:
- Screen all patients and isolate MRSA carriers
- Targeted decolonization after screening
- Universal decolonization
Investigators found that using universal decolonization reduced the number
of patients harboring MRSA by 37 percent. All bloodstream infections
decreased by 44 percent. The researchers noted that this trial took place in
HCA facilities, mostly in community hospitals, rather than academic
institutions and was conducted by hospital personnel rather than specially
trained research staff. Therefore, unlike some clinical studies, these results
are likely to be applicable to nearly all U.S. hospitals.
Source: Presented at IDWeek 2012
Study Examines Microorganism Kill in
the Presence of Blood on Surgical
Instruments
U.S. concern over compounders
predates outbreak of meningitis


A year before people began dying of meningitis caused by a tainted drug
from a compounding pharmacy in Massachusetts, the Food and Drug
Administration worried that compounders across the country might be
selling another substandard drug, one possibly made with unapproved
Chinese ingredients. But when the FDA began seeking samples to test, the
trade group representing compounding pharmacists went on the offensive.
Instead of encouraging members to help the agency determine if the
injectable drug, used to reduce the risk of premature birth, was
substandard, the group tutored pharmacists on how to sidestep requests.
In Texas, a hub of compounding pharmacies, random tests by the state's
pharmacy board over the last several years found that as many as one in
four compounded drugs was either too weak or too strong.
The FDA said on Friday that investigators did not believe that original
ingredients used by the Massachusetts pharmacy, the New England
Compounding Center in Framingham, were the source of the crisis
unfolding in 16 states, where at least 297 people have contracted
meningitis and 23 have died.