Download File - Working Toward Zero HAIs

Unit Based Champions
Infection Prevention
eBug Bytes
September 2012
New 'SARS-like' respiratory
illness identified
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The World Health Organization has issued an international alert after the
discovery of a new respiratory illness similar to the SARS virus which
swept the world in 2002. The disease was identified in a 49-year-old man in
Qatar, who is now being treated in a London hospital. Another sufferer
from Saudi Arabia has since died. There have been reports of a small
number of other cases of serious respiratory illness in the Middle East
over the past three months. The Qatari man was first reported ill on 3
September, and was transferred to the UK a week later. He had previously
visited Saudi Arabia. The UK's Health Protection Agency conducted
laboratory tests and has confirmed the presence of a new coronavirus.
Coronaviruses are a large family of viruses which includes those that cause
the common cold and SARS. This new virus, however, is different from any
previously identified in humans. Symptoms include fever, cough, shortness
of breath, and breathing difficulties, and there are as yet no specific
recommendations on treatment.
The HPA says that the disease is unlikely to be easily transmitted, as, if it
were, more cases would have been expected. The incubation period is
believed to be about seven days.
H3N2 – Cases on the Rise
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SAN FRANCISCO ID News — The number of influenza H3N2
variant virus infections in the United States has reached 302, officials
from the CDC reported at the 52nd Interscience Conference on
Antimicrobial Agents and Chemotherapy. First reported to the public in
early August, the last number of cases reported by Infectious Disease
News was 145 on August 9. There has since been 1 death related to the
virus, according to Lyn Finelli, DrPH, Lead of the Surveillance and
Outbreak Response Team, Influenza Division, National Center for
Immunization and Respiratory Diseases of the CDC. “We’re interested
in these infections because sustained and efficient transmission of these
viruses represents opportunities for pandemics, just like we saw with
H1N1 in 2009,” Finelli said during a press briefing. Finelli said that 16 of
the cases resulted in hospitalizations. The patient that died was an older
adult with several underlying conditions. All of the cases reported
contact with swine at local county fairs. There has been little report of
human-to-human transmission, Finelli said. Children appear to be the
most susceptible. The immunity profile shows no immunity to the virus
in children and moderate immunity in young and older adults.
Antibiotic Use Aids MRSA Spread in Hospital
and Infection Control Measures Do Little to
Prevent It
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The use of a commonly prescribed antibiotic is a major contributor to the
spread of infection in hospitals by the 'superbug' MRSA. A study also found
that increasing measures to prevent infection -- such as improved hygiene
and hand washing -- appeared to have only a small effect on reducing MRSA
infection rates during the period studied. The researchers tracked MRSA
infection over 10 years from 1999 to 2009 at St George's Hospital, London,
looking at how it has adapted to survive in a hospital environment and at
factors that affected its prevalence. They found that a significant drop in
MRSA rates coincided with a reduction in hospital prescriptions of
ciprofloxacin, the most commonly prescribed antibiotic of the
fluoroquinolone family. As ciprofloxacin prescriptions fell from 70-100 daily
doses for every 1000 occupied beds to about 30 doses, the number of
patients identified by the laboratory to be infected with MRSA fell by half,
from an average of about 120 a month to about 60. Following this, over the
last two years of the study both the drug prescription level and MRSA
rates remained at these reduced levels. Journal of Antimicrobial Chemotherapy,
2012; 67 (10): 2514
Xenex device eliminates 95% of
C. diff from hospital rooms
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Evidence continues to mount that hospital cleanliness plays a role
in the spread of HAIs, which are caused by deadly pathogens such as
C. diff, MRSA,VRE and Acinetobacter. Hospital cleaning teams are not able
to disinfect all the surfaces in patient rooms in the allotted time, with
research showing that more than half of the surfaces remain untouched.
Additionally, "superbugs" such as C. diff are showing resistance to cleaning
fluids, making them even more difficult to remove and eliminate.
Xenex Healthcare Services recently participated in a study conducted at
The University of Texas MD Anderson Cancer Center to evaluate the
efficacy of its pulsed xenon UV light disinfection system versus bleach in
a hospital setting. Shashank Ghantoji, M.D., M.P.H., a postdoctoral fellow,
presented the poster, "Comparison of Pulsed Xenon UV to Bleach for
the Decontamination of C. difficile from Surfaces in the Patient
Environment" at the recent ICAAC conference in San Francisco.
"The study showed a 95 percent reduction in C. diff when the rooms
were cleaned with the device(s)," said Roy F. Chemaly, M.D., M.P.H.,
associate professor in MD Anderson's Department of Infectious
Diseases, Infection Control and Employee Health. Yahoo Finance 9-18-12
Vaccine for MRSA being
tested
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Pfizer Inc. and GlaxoSmithKline Plc, are each testing novel vaccines to halt
methicillin-resistant Staphylococcus aureus, or MRSA, long a dangerous
infection in hospitals and nursing homes and which is now increasingly
finding its way into daycare centers, schools and prisons.
The vaccines are in early studies and years away from possible approval.
Two other drug companies have already tried and failed to make an
effective vaccine, most recently Merck & Co. in 2011. Mostly benign
Staphylococcus aureus bacteria live widely on people's skin and in their
nasal passages. About 1 percent of those with the bacteria carry MRSA, a
toxic form of the illness that enters the bloodstream and is resistant to
most treatments. MRSA, which kills more than 11,400 Americans a year,
can enter the body through a cut, a sore, a catheter or a breathing tube.
In hospitals, a vaccine would be used for patients going into surgery or
those with compromised immune systems. Beyond hospitals, people could
get routine vaccinations to help protect them against proliferating staph
bacteria in places like daycare centers for children and gym locker rooms
www.bloomberg.com Sept 17 2012
Feds wrap up investigation
at VA hospital
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The federal government has closed its investigation of the Veterans
Administration hospital in St. Louis, citing "vast improvements" in its
sterilization procedures. The Department of Veterans Affairs' Office of
Inspector General issued the report last week, more than two years after
sterilization concerns were first raised at John Cochran VA Medical
Center.
"The facility has made vast improvements in its reusable medical
equipment-related policies and practices over the past 6 months and the
central issue of patient safety during dental procedures has been
addressed," the report's executive summary said.
In 2010, faulty sterilization at the center's dental clinic raised concerns that
1,812 veterans were potentially exposed to hepatitis and HIV. Subsequent
testing found no link to hepatitis or HIV in patients.
Investigators came to the hospital in January but found that sterilization
technique problems persisted. Among the problems: Contamination tests
were not recorded; floors were dirty; surgical implants were not sterilized
for the required 48 hours. www.columbiatribune.com Sept 14, 2012
CDC: Multistate E. coli O145
Outbreak Has Sickened 14
in 6 States
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Today the U.S. Centers for Disease Control and Prevention announced
that the E. coli O145 outbreak that killed a young girl in Louisiana has
sickened at least 14 people in six states: Georgia (5 illnesses), Louisiana
(4), Alabama (2), California (1), Florida (1) and Tennessee (1). Three
people have been hospitalized.
The source of the contamination remains unknown.
Illness onset dates range from April 15 to May 12. Infections that began
after May 12 may not have been reported yet. The most recent case
was reported on June 4.
A 21-month-old girl in Louisiana died from her infection on May 31
after falling ill several weeks earlier. This outbreak has no connection to
the May 26 death of a 6-year-old Massachusetts boy suffering from an E.
coli O157:H7 infection.
Report Finds HAI Under Reported in CA
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California public health authorities who reviewed 100 hospitals found that
the facilities failed to report as many as a third of the infections they should
have reported in 2011 under the state's public reporting law..
The reviews, completed last year, consisted of one- to two-day
examinations by public health authorities at 100 hospitals that volunteered;
there are more than 400 hospitals in the state. Reviewers examined
infection data that was reported in 2011 and compared that with medical
lab findings and patient records. Results for individual hospitals were not
tracked. Reviewers took a close look at hospital reporting practices of
infections including VRE, or vancomycin-resistant enterococci, C. Dif., or
Clostridium difficile, and MRSA, or methicillin-resistant Staphylococcus
aureus and central lines. Reviewers found that hospitals failed to report
about 150 out of 577 C. difficile infections. Among central-line infections,
hospitals missed reporting 68 out of 180 verified infections. For VRE,
hospitals also missed about a quarter of the 149 reportable cases, and for
C. Dif, hospitals missed nearly 10 percent of 2,338 reportable cases.
Underreporting was often a result of confusion about complex instructions
on identifying which infections were caused by hospital practices.
Source: August 10, 2012 www.californiawatch.org
CDC: Cases of new swine flu
strain rising
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A new strain of swine flu in humans continues to spread, health officials
said Thursday, with more than 100 cases reported.
The Centers for Disease Control and Prevention says 145 cases of the
influenza A (H3N2) variant have been found in four states since midJuly: 113 in Indiana, 30 in Ohio, one in Illinois and one in Hawaii.
The CDC says it expects the case count to increase. Two people were
hospitalized, but both have been released, officials said. The CDC says
people exposed to pigs should take precautions to protect themselves
from this new strain of flu, namely:
• Wash your hands with soap and water before and after touching pigs.
• Don't drink or eat near pigs, and don't take food into animal areas.
• Avoiding contact with animals such as pigs may be the best protection
Even though the regular seasonal flu vaccine contains a strain of the Aflu virus group, it will not prevent you from getting sick if you come into
contact with the new flu strain. CDC is taking preliminary steps to
develop an H3N2 vaccine.
Wal-Mart, Indiana grower
cantaloupe after outbreak
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An unidentified farm in southwestern Indiana is withdrawing cantaloupe
from the marketplace following a salmonella outbreak that has sickened
141 people and killed two in 20 U.S. states, federal regulators said.
Wal-Mart Stores Inc. also began contacting outlets and instructing them
to withdraw cantaloupe grown in southwestern Indiana as a precaution.
. As a result of initial investigations by state health departments, a farm in
southwestern Indiana has contacted distributors and is withdrawing its
cantaloupe from the marketplace, the Centers for Disease Control and
Prevention in Atlanta said last night. The farm has agreed to cease
distributing cantaloupes for the rest of the growing season. Consumers
who recently bought cantaloupes grown in southwestern Indiana are
being advised not to eat them and to discard any remaining fruit, the CDC
said.
Among those sickened, 31 were hospitalized, the U.S. Food and Drug
Administration said yesterday in a statement. Kentucky had the most
reports of illness, 50, followed by Illinois with 17 and Indiana with 13,
according to the statement.
Daily Disinfection of High Touch
Surfaces Reduces Hand Contamination
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New research demonstrates that daily cleaning of high-touch surfaces in
isolation rooms of patients with Clostridium difficile (C. difficile) or
methicillin-resistant Staphylococcus aureus (MRSA) significantly reduces the
rate of the pathogens on the hands of healthcare personnel. The findings
underscore the importance of environmental cleaning for reducing the
spread of difficult to treat infections.
Researchers from the Cleveland Veterans Affairs Medical Center conducted
a prospective, randomized trial comparing regular cleaning protocols of
housekeeping staff with daily disinfection of high-touch surfaces performed
by researchers (i.e., bed rail and bedside tables, call button and phone, and
toilet seat, and bathroom hand rail) in 34 C. difficile and 36 MRSA isolation
rooms. The study assessed hand contamination of physicians, nurses, and
research staff six to eight hours after disinfection procedures. In rooms with
daily disinfection, there were significant reductions in the amount and
frequency of pathogens on the hands of investigators and healthcare
personnel caring for the patients (6.4 percent with daily disinfection versus
30 percent with standard cleaning).
Source: Oct 2012 issue of Infection Control and Hospital Epidemiology