Transcript File - Working Toward Zero HAIs

Unit Based Champions
Infection Prevention
eBug Bytes
May 2012
Investigators Trace of Role Reusable
Grocery Bag in Norovirus Outbreak
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In the study, Kimberly K. Repp, PhD, MPH, of Oregon Health and Sciences
University, and William E. Keene, PhD, MPH, of the Oregon Public Health
Division in Portland, investigated an outbreak in a group of 17 Oregon girls,
13-14 years old, and their four adult chaperones attending a soccer
tournament in Washington state. All had traveled in private automobiles,
shared hotel rooms, and eaten at local restaurants. Eight cases were
identified, including the index patient who was presumably infected prior to
the trip. There was no direct contact between the original patient and her
teammates after her symptoms began; before her overt symptoms began she
left her room and moved in with a chaperone. The girl subsequently began
vomiting and having diarrhea in the chaperone's bathroom. The outbreak
affecting the rest of the team began several days later; they were exposed by
handling a bag of snacks that unfortunately had been stored in the hotel
bathroom.Virus aerosolized within the bathroom likely settled onto the
grocery bag and its contents. Matching viruses were found on the reusable
shopping bag two weeks later.
The investigation confirmed the great potential for contamination of
surfaces. Source:
Whooping cough epidemic
declared in Washington state
Washington state's worst outbreak of whooping cough in decades has
prompted health officials to declare an epidemic, seek help from federal
experts and urge residents to get vaccinated amid worry that cases of the
highly contagious disease could spike much higher.
It's the first state to declare a whooping cough, or pertussis, epidemic
since 2010, when California had more than 9,000 cases, including 10
deaths. Washington has had 10 times the cases reported in 2011, and so
has Wisconsin with nearly 2,000 cases this year, though that state has not
declared an epidemic.
In Washington, about 1,280 cases have been reported in 2012, and officials
believe the state could see as many as 3,000 cases by year's end. State
officials have asked hospitals to vaccinate every adult who goes home
with a new baby, and urged businesses to encourage their employees to
get the adult booster shot. Washington already requires a booster shot
for middle- and high-school students.
Superbug Spreads from Big City Hospitals
to Regional Health Centers, Study Suggests
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Hospitals in large cities act as breeding grounds for the superbug MRSA prior to it
spreading to smaller hospitals, a study suggests. Researchers found evidence that
shows for the first time how the superbug spreads between different hospitals
throughout the country.
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The University of Edinburgh study involved looking at the genetic make-up of more
than 80 variants of a major clone of MRSA found in hospitals . Scientists were able
to determine the entire genetic code of MRSA bacteria taken from infected patients.
They then identified mutations in the bug which led to their emergence of new
MRSA variants and traced their spread around the country.
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"We found that variants of MRSA circulating in regional hospitals probably originated
in large city hospitals. The high levels of patient traffic in large hospitals means they
act as a hub for transmission between patients, who may then be transferred or
treated in regional hospitals. “ MRSA -- methicillin-resistant Staphylococcus aureus -first started to appear around 50 years ago following the introduction of antibiotics,
to which the bacteria has become increasingly resistant.
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Journal Reference:
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P. R. McAdam, K. E. Templeton, G. F. Edwards, M. T. G. Holden, E. J. Feil, D. M. Aanensen, H. J. A. Bargawi, B. G.
Spratt, S. D. Bentley, J. Parkhill, M. C. Enright, A. Holmes, E. K. Girvan, P. A. Godfrey, M. Feldgarden, A. M. Kearns,
A. Rambaut, D. A. Robinson, J. R. Fitzgerald. Molecular tracing of the emergence, adaptation, and
transmission of hospital-associated methicillin-resistant Staphylococcus aureus. Proceedings of the
National Academy of Sciences, 2012; DOI: 10.1073/pnas.1202869109
C. difficile Infections Pose Big Risks
in ICUs
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In March, the Centers for Disease Control and Prevention reported that
“the incidence, deaths, and excess health-care costs resulting from C. difficile
infections in hospitalized patients are all at historic highs.
Prevention is the cornerstone of any effort to stem infections. Most
important is to limit antibiotic exposure for patients, both in terms of the
numbers of antibiotics they receive, as well as the spectrum and duration of
exposure. Patients who have contracted or are suspected of having the
bacterial infection should be isolated promptly. Thorough environmental
cleaning and hand washing among health care workers also are important
components of prevention. The presence of a C. difficile outbreak,
disinfecting gels containing alcohol should not be used. Soap and water is
the best and only way to get rid of C. difficile spores on people’s hands.
Hospital-wide antibiotic stewardship programs to address the spread of C.
difficile and other emerging infections, and to stem antimicrobial resistance.
It’s not an inexpensive disease – the infection costs the country $1 billion
to $3 billion annually, and each case costs about $6,000 and three
additional days of hospitalization.
Superbugs spread to 40 nations
threatening India medical tourism
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A new type of superbug (NMD-1)is spreading faster, further and in more
alarming ways than any they've encountered. Researchers say the epicenter
is India, where drugs created to fight disease have taken a perverse turn by
making many ailments harder to treat. India's $12.4 billion pharmaceutical
industry manufactures almost a third of the world's antibiotics, and people
use them so liberally that relatively benign and beneficial bacteria are
becoming drug immune in a pool of resistance that thwarts even highpowered antibiotics, the so-called remedies of last resort.
Poor hygiene has spread resistant germs into India's drains, sewers and
drinking water, putting millions at risk of drug-defying infections. Antibiotic
residues from drug manufacturing, livestock treatment and medical waste
have entered water and sanitation systems, exacerbating the problem. As
the super bacteria take up residence in hospitals, they're compromising
patient care and tarnishing India's image as a medical tourism destination.
The new superbugs are multiplying so successfully because of a gene
dubbed NDM-1. That's short for New Delhi metallo-beta-lactamase-1, a
reference to the city where a Swedish man was hospitalized in 2007 with
an infection that resisted standard antibiotic treatments.
Researchers Compare Hydrogen
Peroxide Vapor to Tru-D Smart UVC
Disinfection in Patient Rooms
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John M. Boyce, MD, et al conducted an observational study to compare the
microbiological efficacy of automated "no-touch" decontamination systems: an HPV
system with that of an automated UVC system (Tru-D Total Room Ultraviolet
Disinfection) for room decontamination.
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The study recorded before-and-after aerobic colony counts for five high-touch sites
in 15 patient rooms: the bedside rail, over-bed table, TV remote, bathroom grab bar
and toilet seat. Earlier published research indicates that frequently touched
environmental surfaces can be contaminated with epidemiologically important
microbes (such as C. diff,VRE and MRSA) that contribute to cross-transmission of
patients by contaminating the hands of healthcare workers.
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For this comparison, HPV and UVC processes were performed using Clostridium
difficile carrier disks. The researchers concluded, "We found that both HPV and
UVC decontamination reduce bacterial contamination in patient rooms ... Of the
two technologies, UVC decontamination was easier to use and had significantly
shorter cycle times, can be administered by personnel with only limited training,
and does not require monitoring by personnel during the process.”
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Reference: 1. Havill NL, Moore BA, Boyce JM; Comparison of Microbiological Efficacy of Hydrogen Peroxide
Vapor and Ultraviolet Light Processes for Room Decontamination. Infect Control Hosp Epidem. 2012;33.
Where the Germs Are: New Study Finds
Office Kitchens, Break Rooms are Crawling
with Bacteria
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According to the study, which was carried out in consultation with Charles
Gerba, PhD, professor of microbiology at the University of Arizona, the
percentage of the office surfaces tested and found to have high levels of
contamination (an ATP count of 300 or higher), includes:
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- 75 percent of break room sink faucet handles
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- 48 percent of microwave door handles
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- 27 percent of keyboards
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- 26 percent of refrigerator door handles
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- 23 percent of water fountain buttons
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- 21 percent of vending machine buttons
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. The results reinforce the crucial role of contract cleaners, whose services
go a long way in successfully disinfecting office common areas at the end of
every day. However, because kitchens and personal work spaces can
become instantly re-contaminated, employers need to arm their employees
with the knowledge and tools necessary to reduce the spread of germs.
For more information on Kimberly-Clark Professional and The Healthy
Workplace Project, visit: www.healthyworkplaceproject.com
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