Transcript File - Working Toward Zero HAIs

Unit Based Champions
Infection Prevention
eBug Bytes
November 2012
Multistate Outbreak of Salmonella Serotype
Bovismorbificans Infections Associated with
Hummus and Tahini - 2011
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22 patients with exposure information, 20 (91%) reported eating at a
restaurant in the DC metropolitan area. Among 15 patients asked about
Mediterranean-style restaurant exposure, 14 (93%) indicated that they had
eaten at a Mediterranean-style restaurant in the DC area, including six
restaurants in DC and two in northern Virginia. Nine (69%) of 13 patients
reported eating at restaurants A, B, or C, and three of eight reported eating
at DC restaurants, before symptom onset. Sixteen (84%) of 19 patients
reported eating Mediterranean-style food; 10 (67%) of 15 patients reported
eating hummus. Other commonly reported foods eaten were lettuce (11 of
14; 79%), chicken (11 of 15; 73%), tomato (11 of 15; 73%), and cucumber
(nine of 11; 82%). On May 30, 2012, trac eback by FDA suggested that tahini
(sesame seed paste) used in hummus was a plausible source for Salmonella
infections. The trace back revealed tahini used at the different restaurants in
the DC area came from a common foreign manufacturer from Lebanon
associated with recent Salmonella outbreaks in Canada. FDA issued a
mandate that all products imported from this manufacturer undergo
Salmonella testing before entry into the US. MMWR: November 23, 2012 /
61(46);944-947
Hospital cleaning protocol
ineffective against A. Baumannii
Current hospital cleaning protocol may be inadequate to rid patient
rooms of multidrug-resistant (MDR) Acinetobacter baumannii,
according to a study in the December issue of the American Journal
of Infection Control APIC).
A team of researchers from the University of Maryland collected 487
cultures from 32 hospital rooms occupied by just-discharged patients
with a known history of MDR A. baumannii both before and after
terminal cleaning of the rooms. Over half of the rooms positive for
the A. baumannii bacteria prior to cleaning remained contaminated
after terminal cleaning had occurred. Fifteen rooms (46.9 percent) and
41 sites (n=268, 15.3 percent) tested positive for MDR A. baumannii
before cleaning. Post-cleaning, eight rooms (25 percent) and 12 sites
(n=219, 5.5 percent) still tested positive for the pathogen.
Sites with post-cleaning contamination included the floor (12.5
percent), call button (10 percent), door handle (9.4 percent) bedside
table (7.4 percent), and supply cart (3.8 percent).
“The effect of terminal cleaning on environmental contamination rates of multidrug-resistant
Acinetobacter Baumannii” by Paula Strassle, Kerri A. Thom, J. Kristie Johnson, Surbhi Leekha,
Matthew Lissauer, Jingkun Zhu and Anthony D. Harris appears in the American Journal of Infection
Control, Volume 40, Issue 10 (December 2012
Flu season arrives early,
and could be bad
Flu season arrived early this year. according to the U.S. Centers for Disease
Control and Prevention, it's shaping up to be a bad one. CDC director Dr.
Thomas Frieden announced today that Tennessee, Mississippi, Alabama,
Louisiana and Texas have reported enough seasonal flu cases to officially
mark the beginning of the flu season. "We're seeing the beginning of the
uptick start at least a month before we'd generally see it," Frieden said,
explaining that flu rates typically start to rise in early January.
Missouri and Georgia are also well on their way to meeting the critical
threshold number of cases. And as the season progresses, the infection is
expected to spread across the nation.
"It looks like it's shaping up to be a bad flu season," Frieden said, explaining
that the predominant flu subtype being passed around - H3N2 - is known to
cause more severe illness. H3N2 was the predominant subtype in 20032004, the last time the flu season arrived this early.
But there's some good news: It appears the circulating strains are "a great
match" for this year's vaccine, according to Frieden.
No vaccination, no job, some
hospitals say: It's civil rights
versus health of patients
As hospitals in recent years have stepped up their efforts to persuade the
public to get annual flu vaccinations, their employees haven't always
heeded the call. But federal health authorities believe that hospital
workers who are anywhere near patients should be vaccinated for their
welfare, as well as patients'. And with the government dangling the carrot
of Medicare reimbursement money, hospital administrators are wielding
the stick.
The list of staff affected by these policies is broad. It includes not only
doctors and nurses and others directly involved in patient care but also
housekeeping and maintenance workers.
The Joint Commission, the top healthcare accreditation agency in the
nation, this year enacted a plan to have hospitals train and educate their
staffs about the benefits of flu vaccines.
Although it is not demanding mandatory vaccinations, the commission is
requiring hospitals to show they are progressing toward 90 percent
compliance by 2020.
College Students Report
Low Flu Vaccination Rate
In a study, believed to be the first multi-university study to assess seasonal flu
vaccine coverage, a total of 4,090 college students participated in a
confidential, web-based survey in late October and November 2009
regarding whether they had received a flu shot.
Overall, 20 percent of the students reported they had been vaccinated during
a year in which significant media attention focused on both seasonal and
H1N1 flu. The seasonal vaccine coverage varied across the eight universities
from 14 percent to 30 percent, which was considerably less than half of the
U.S. Department of Health and Human Services' 2020 Healthy People goal of
80 percent coverage for healthy persons 18 to 64 years of age.
In addition, the researchers found that students more often reported
receiving the vaccine from a private physician or clinic rather than from
student health services, even though it was available free of charge.
Co-authors of the study are Jill Blocker, MS, Edward Ip, PhD, Timothy Peters,
MD and Mark Wolfson, PhD, of Wake Forest Baptist.
AAMI Offers Webinar on Updates to
ST79 Steam Sterilization Standard
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The Association for the Advancement of Medical Instrumentation (AAMI)
will host a webinar that discusses the recent amendments and updates to
AAMI's landmark recommended practice for hospital steam sterilization,
ANSI/AAMI ST79, Comprehensive guide to steam sterilization and sterility
assurance in healthcare facilities.
This webinar will be held on Tuesday, Jan. 15, 2013, from 12 p.m. to 1:30 p.m.
ET. The speaker is Martha L.Young, BS, MS, CSPDT, of Martha L.Young, LLC.
The most recent amendment replaces the term "flash sterilization" with
"immediate use steam sterilization" to better reflect current practice;
provides guidance to sterile processing professionals on the different ways
that chemical indicators may be classified; and adds, deletes, or updates
definitions to reflect changes elsewhere in the document. The amendment
also provides updates to the design considerations section, updates
recommendations in the personnel considerations section, updates the
section on handling, collection, and transportation of contaminated items,
and updates the section on cleaning and other decontamination processes.
Former Exeter Hospital Employee
Indicted in Connection With
Hepatitis C Outbreak
David M. Kwiatkowski, 33, a former employee of Exeter Hospital, has been
indicted for his alleged role in causing the hepatitis C outbreak that
infected patients in New Hampshire as well as other states.
Kwiatkowski has been charged with seven counts of tampering with a
consumer product and seven counts of obtaining controlled substances by
fraud. The charges relate to suspected thefts of the controlled substance
fentanyl, a powerful anesthetic used in various medical procedures. In
addition to stealing fentanyl and depriving patients in his care of the
intended analgesic effect of the drug, Kwiatkowski allegedly caused over
30 individuals in New Hampshire and elsewhere to become infected with
hepatitis C, a bloodborne virus that can cause serious damage to the liver.
According to the indictment, Kwiatkowski was employed for several years
as a healthcare worker in Michigan. Beginning in 2007, he became a
traveling health care technician, employed in various states, including New
York, Pennsylvania, Maryland, Arizona, Kansas, Georgia and New
Hampshire.
Studies Prove Copper Kills Bacteria,
Provides Viable Solution to the Problem
of HAIs
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Preliminary results of a Department of Defense (DoD) study have shown
that Antimicrobial Copper reduces HAIs by 41 percent through continuously
killing bacteria on touch surfaces, such as IV poles and bedrails. This same
study demonstrated that copper reduces the bacteria in intensive care units
(ICUs) by 83 percent. After rigorous testing, copper alloys have been
registered with the Environmental Protection Agency (EPA) to kill greater
than 99.9 percent of Staph and E. coli, as well as the superbugs MRSA,VRE
and others. However, only 16 percent of U.S. adults polled in the Harris
survey are aware of the proven power of antimicrobial copper to kill
bacteria.
“Antimicrobial copper healthcare equipment offers patients an added line of
protection when they visit a healthcare facility for treatment,” says Dr.
Archelle Georgiou, a physician who has practiced as a clinician and corporate
managed care executive for nearly two decades. “Utilizing antimicrobial
copper touch surfaces in simple ways such as on handrails, overbed trays and
IV poles could go a long way to reducing the huge burden HAIs place on the
healthcare system and the patients who need treatment.”
CDC Offers Tips for Safe
Holiday Meal Preparation
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Safe Thawing: Thawing turkeys must be kept at a safe temperature. The "danger zone" is
between 40 and 140°F — the temperature range where foodborne bacteria multiply rapidly.
While frozen, a turkey is safe indefinitely, but as soon as it begins to thaw, bacteria that may have
been present before freezing can begin to grow again, if it is in the "danger zone." There are
three safe ways to thaw food: in the refrigerator, in cold water, and in a microwave oven.
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Safe Preparation: Bacteria present on raw poultry can contaminate your hands, utensils, and
work surfaces as you prepare the turkey. If these areas are not cleaned thoroughly before
working with other foods, bacteria from the raw poultry can then be transferred to other
foods. After working with raw poultry, always wash your hands, utensils, and work surfaces
before they touch other foods.
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Safe Stuffing: For optimal safety and uniform doneness, cook the stuffing outside the turkey
in a casserole dish. However, if you place stuffing inside the turkey, do so just before cooking,
and use a food thermometer. Make sure the center of the stuffing reaches a safe minimum
internal temperature of 165°F. Bacteria can survive in stuffing that has not reached 165°F,
possibly resulting in foodborne illness. Follow the FSIS' steps to safely prepare, cook, remove,
and refrigerate stuffing; Spanish language instructions are available.
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Safe Cooking: Set the oven temperature no lower than 325°F and be sure the turkey is
completely thawed. Place turkey breast-side up on a flat wire rack in a shallow roasting pan 2 to
2-1/2 inches deep. Check the internal temperature at the center of the stuffing and meaty
portion of the breast, thigh, and wing joint using a food thermometer. Cooking times will vary.
The food thermometer must reach a safe minimum internal temperature of 165°F. Let the
turkey stand 20 minutes before removing all stuffing from the cavity and carving the meat.