CDC infographicToday, the Centers for Disease Control and Prevention (CDC) has released two new reports showing progress in prevention efforts aimed at healthcare-associated infections (HAIs). However, despite success shown by the reports, more work is needed to meet new challenges.

The reports detail the estimates of HAIs occurring throughout the nation, and also report on national and state-specific progress in the prevention of HAIs.

“Although there has been some progress, today and every day, more than 200 Americans with healthcare-associated infections will die during their hospital stay,” said CDC Director Tom Frieden, M.D., M.P.H. “The most advanced medical care won’t work if clinicians don’t prevent infections through basic things such as regular hand hygiene. Health care workers want the best for their patients; following standard infection control practices every time will help ensure their patients’ safety.”

Major findings of the reports include:

  • 1 in 25 hospitalized patients will experience at least one HAI
  • Approximately 75,000 hospital patients with HAIs died during their hospitalizations
  • Progress has been made in preventing certain infections.  This includes central line-associated bloodstream infections, infections related to 10 types of surgery, hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections, and hospital-onset Clostridium difficile infections.
  • The most common germs causing HAIs were C. difficileStaphylococcus aureus, including MRSA; KlebsiellaE. coli; Enterococcus; and Pseudomonas.

The reports and additional data can be found by clicking on the following links:

Photo: CDC Infographic.  What Patients Can Do: Six Ways To Be A Safe Patient.

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Evelyn McKnight HONOReformThe following is a guest post by Dr. Evelyn McKnight, founder and president of HONOReform (Hepatitis Outbreaks’ National Organization for Reform).

I remain troubled by the news that 4,277 patients on Long Island, because of improper use of an insulin pen, have been placed in harm’s way (“Nassau hospital’s call to test injected patients seen as opportunity,” March 15, Newsday). These men and women are in my thoughts and prayers.

I joined the CDC and its partners in 2008 to launch the One and Only Campaign. Because of troubling patient notifications and devastating outbreaks that have occurred in the last six years, our work on the campaign has expanded. We developed extraordinary resources on proper use of the insulin pen, for instance. I encourage healthcare workers throughout New York and the area—and throughout the country—to please take time to reeducate themselves on all injection safety fundamentals.

In addition to my encouragement to healthcare workers to always give a safe injection, I encourage them to be unafraid in addressing each other directly, anytime injection safety standards are violated—or seem to be.

I was one of 99 people in Fremont, Nebraska, who was infected with hepatitis C while receiving treatment for cancer at an outpatient clinic in 2002. Syringes were reused, and the saline flush was used improperly. Not only does an outbreak of hepatitis C affect patients, it affects an entire community. Notifications like the current one on Long Island chip away at a community’s confidence in its medical care.

Did anyone speak up, when my fellow patients and I, people who were fighting one fatal disease only to have to take on another, were being violated through unsafe injection practices? Sadly, the answer is no.

In the recent reports, it appears an unnamed healthcare worker did make a stand. According to recent reports, he or she heard a colleague say it’s okay to reuse an insulin pen on more than one patient. As we know, blood can become trapped in the reservoir and, if the device is reused, cause an infection. As it states in the One and Only Campaign materials, “Insulin pens that contain more than one dose of insulin are only meant for one person. “

To the healthcare worker who said to his or her colleague, “No, that is not how it is done,” we issue our thanks. I expect this person will not perceive himself or herself as strong or brave or innovative. I expect he or she would say, if I had a chance to provide a commendation, “I was just doing my job.”

However, speaking up to a coworker or colleague, and especially to a person of higher rank, clearly does not occur as often as it should in healthcare. I am one of many people throughout the United States who has been deeply affected by ongoing, unchecked unsafe injection practices.

On behalf of my fellow patients, and with the patients from Long Island in our minds and hearts, I urge healthcare workers to be unafraid to say, “Stop.” To say, “No…Let’s talk.” Lives depend on you.

Evelyn McKnight is the founder and president of HONOReform (Hepatitis Outbreaks’ National Organization for Reform) and the co-author of A Never Event: Exposing the Largest Outbreak of Hepatitis C in American Healthcare History.

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The Centers for Disease Control and Prevention (CDC) has released its 2013 Prevention Status Reports (PSRs) highlighting policies and practices aimed at preventing or reducing problems affecting public health.  Individual reports are available for all 50 states and the District of Columbia on various health topics, including healthcare-associated infections (HAIs).

The individual state HAI PSRs provide information about the status of state health department HAI prevention efforts.

The individual state reports can be found by visiting the CDC’s Healthcare-Associated Infections PSR 2013 webpage.

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The U.S. Senate Committee on Health, Education, Labor & Pensions will be holding a full committee hearing on U.S. efforts to reduce healthcare-associated infections (HAIs).

The committee hearing will take place on Tuesday, September 24, 2013.

Witness speakers include:

  • Patrick Conway, MD, MSc , Chief Medical Officer and Director, Center for Clinical Standards and Quality, and Acting Director, Center for Medicare and Medicaid Innovation, Baltimore, MD
  • Beth Bell, MD, MPH , Director, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
  • Ciaran Staunton , The Rory Staunton Foundation, New York, NY
  • Jonathan B. Perlin, MD, PhD, MSHA, FACP, FACMI , President, Clinical and Physician Services & Chief Medical Officer, HCA/Hospital Corporation of America, Nashville, TN
  • Joe Kiani , Founder, the Patient Safety Movement, Irvine, CA

Click here to view the committee notice.

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Lauren Lollini and Evelyn McKnight of HONOReform are calling attention to unsafe injection practices with their new “Survivor Stories Blog.”

According to the CDC, since 1999, “more than 125,000 patients in the United States have been notified of potential exposure to hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV due to unsafe injection practices. Many of these incidents involved healthcare providers reusing syringes, resulting in contamination of medication vials or containers which were used then on subsequent patients.”

As patients who contracted Hepatitis C from unsafe medical injections, Lauren and Evelyn know from firsthand experience how these exposures impact patient’s lives:

As survivors ourselves, we know firsthand how pervasively an outbreak affects lives. Everything changes for victims – their health, family life, ability to work, emotional well being. The community in which they live reels from the resulting litigation and damage to the medical community’s reputation.

Through the Survivor Stories Blog, Evelyn and Lauren hope to bring focused attention to the issue of unsafe injections in our healthcare system:

Along with telling survivors’ stories, we will share the educational, engineering and policy efforts in place and those proposed to prevent unsafe injections. Guest bloggers will frequently join us to comment on injection safety – and tell their stories. We want to use these stories and information to foster a healthcare system in which no American will have a story to tell about going to the doctor seeking good health, but coming away with a deadly disease.

For more information, visit the HONOReform Survivor Stories Blog.  If you have a personal experience involving unsafe injections and you would like to share that information, email evelyn@HONOReform.org.

For more information about injection safety, visit http://www.oneandonlycampaign.org or http://www.cdc.gov/injectionsafety/unsafepractices.html.

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HIV occupational exposure, federal guidelinesNew federal guidelines for managing occupational exposures to HIV have been published online today in the journal Infection Control and Hospital Epidemiology.  The guidelines recommend the immediate use of an HIV postexposure prophylaxis (PEP) regimen consisting of three or more antiretroviral drugs following any occupational exposure to HIV.

Previous recommendations involved an assessment of the level of risk associated with individual exposures for deciding on the number of recommended drugs for PEP.  The new recommendations eliminate this previous recommendation.

Click here to view the new recommendations.  An infographic from the CDC is also available.  The infographic provides a “plain language” version of the main points provided by the guidelines.

Photo credit:  Centers for Disease Control and Prevention.  Infographic, Exposed to HIV? The Clock is Ticking.

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Jersey Shore University Medical Center, clostridium difficile infection, vaccine clinical trialThe Jersey Shore University Medical Center in Neptune, New Jersey has announced it will be participating in a Phase III Trial of an investigational vaccine to prevent Clostridium difficile infections.

The clinical study will evaluate the “safety, immunogenicity and efficacy of an investigational vaccine for the prevention of primary symptomatic” Clostridium difficile infection (CDI).

Click here to read the Jersey Shore University News Release.

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C. difficile bacteria.  Photo credit: CDC

Rebiotix Inc. has announced it has received FDA approval on its Investigational New Drug (IND) application to begin a Phase 2 clinical study of a treatment of recurrent Clostridium difficile infection (CDI).

The treatment, RBX2660, is a “preparation containing live microbes designed to rebuild a healthy intestinal micro biome.”  If successful, the treatment will become the first FDA-approved drug based on the human microbiome, according to the press release.

“IND approval represents a significant milestone for Rebiotix, and continues our progress toward developing and commercializing a new therapy to treat patients with this debilitating and potentially life-threatening disease,” said Rebiotix CEO Lee Jones. “We are working quickly to get the clinical trial running and to recruit patients.” Jones also noted that Rebiotix is committed to conducting a full program of clinical trials to expand treatment options for recurrent CDI and to explore additional indications for its microbiota restoration therapy.

Click here to read the Rebiotix press release.

Photo: C. difficile bacteria. Photo credit: CDC

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Webbertraining.com is offering a great lineup of courses for the month of August.  Click on the links below for more information.

August 7
(FREE WHO Teleclass … North America).
Decontamination of High-Touch Environmental Surfaces in Healthcare: A Critical Look at Current Practices and Newer Approaches.
With Prof. Syed Sattar, University of Ottawa, Canada
Teleclass sponsored by WHO Clean Care is Safer Care

August 22
The Infectious Disease Fallout Following Natural Disasters — The Hurricane Sandy Story
With Dr. Michael Tapper, Lenox Hill Hospital, New York

August 22
(FREE South Pacific Teleclass … Broadcast live from the IPCNC conference in New Zealand)
From Little Things Big Things Grow: The Importance of Leadership Skills in Infection Prevention
Prof. Cathryn Murphy, Infection Control Plus, Australia
Teleclass broadcast sponsored by Johnson & Johnson Medical (www.jnj.com)

August 29
(FREE Teleclass)
Decontamination of High-Touch Environmental Surfaces in Healthcare: A Critical Look at Current Practices and Newer Approaches
With Dr. Shams B. Syed, WHO African Partnerships for Patient Safety, Geneva

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iowa dental board Jay BuckleyAn Iowa dentist has been fined $5,000 for poor infection control practices, including the failure to change gloves between patients according to the Iowa Des Moines Register.

An investigation was launched after a dental assistant working for Dr. Jay Buckley informed state regulators that Buckley was violating proper infection protocols. For example, instead of changing gloves between patients, the dentist would wash them with soap and water. Other investigation findings included poor cleaning of exam rooms and issues with equipment sterilization.

According to the Des Moines Register article, the Iowa Dental Board ruled as follows:

Buckley “repeatedly and willfully failed to maintain safety and sanitary conditions in his dental practice.” The board noted that Buckley disputed the allegations, but it said his “statements and testimony denying the violations were filled with inconsistencies and self-serving statements.” Besides levying the fine, the board ordered the Buckley to serve five years probation; to have infection-control training for himself and his staff; and have another dentist monitor his practice.

Buckley’s lawyer intends to appeal the board’s decision saying the decision was built around a disgruntled employee who was fired.

Click here to view the original Notice of Hearing and Statement of Charges against Dr. Buckley.

Photo: Iowa Dental Board.

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North Carolina healthcare-associated infections reportThe North Carolina Department of Health Prevention Program has issued it’s latest healthcare-associated infection (HAI) quarterly report.

The prevention program issues year-to-date statistical updates on a quarterly basis.  This newest report contains hospital-specific data from North Carolina short-term acute care hospitals, long-term acute care hospitals and inpatient rehabilitation facilities.  The data contained in the report is from the time period of January to March 2013.

Two versions are available: Healthcare Consumer Version and Healthcare Provider Version.

Photo: North Carolina Department of Health and Human Services.  Healthcare-Associated Infections (HAIs), Facts and Figures.  Available at http://epi.publichealth.nc.gov/cd/hai/figures.html.  Accessed July 24, 2013.

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Cyclospora InfectionThe U.S. Food and Drug Administration (FDA) has stated it is investigating a multi-state outbreak of Cyclospora infections. The investigation is being conducted along with the Centers for Disease Control and Prevention (CDC) and state and local officials.

According to the statement, the CDC and several state health departments have reported infections. As of July 18, 2013, more than 200 cases of Cyclospora infection have been reported in Iowa, Nebraska, Texas, and Wisconsin. Illinois has also reported one case that may have been acquired out of state.

Officials are still investigating the possible sources of the outbreak.

Click here to view the FDA Statement.

Photo: Moser, Melanie.  Centers for Disease Control and Prevention.  Public Health Image Library.  Cyclospora cayetanensis oocysts.  

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Pseudomonas aeruginosa bacteriaAccording to a press release issued by the Society for Healthcare Epidemiology of America (SHEA), a 2011 healthcare-associated outbreak of P. aerugenosa has been linked to contaminated ultrasound gel.

Investigators at Beaumont Health System near Detroit, Michigan determined the source of the bacteria causing the healthcare-associated infection was indeed contaminated ultrasound gel.  The findings were published in the August issue of SHEA’s journal Infection Control and Hospital Epidemiology (ICHE). The study underscores the need for increased scrutiny of contaminated medical products.

“Ultrasound is a critical healthcare tool used every day in both diagnostic and interventional procedures,” said Paul Chittick, MD, lead author of the study. “Although contaminated gel has been the cause of several documented outbreaks of infection, its potential role as a vehicle for spreading infections to patients is frequently overlooked.”

In December 2011, researchers uncovered an unusual cluster of P. aeruginosa in the cardiovascular surgery intensive care unit during routine infection control surveillance. The bug is known to increase the risk of bloodstream and respiratory infections in immune-compromised individuals. Sixteen patients became colonized or infected with the bacteria, with all cases occurring in the respiratory tract. The outbreak was found to have stemmed from bottles of ultrasound transmission gel used during cardiovascular surgery. Following replacement of this gel with a sterile product, no further cases occurred.

Cultures of gel from a bottle in use in the operating room grew P. aeruginosa that was identical to the outbreak strain. It was originally thought that the gel had likely become contaminated during use. However, sealed bottles of gel grew the same P. aeruginosa strain, proving that the product was contaminated during the manufacturing process at the plant of Pharmaceutical Innovations.

The FDA has subsequently issued a warning about the gel, alerting practitioners to the risk of infection.  The Beaumont Health System investigators have also recently published proposed guidelines in ICHE for the use of sterile versus non-sterile ultrasound gel.  The guidelines stress the importance of sterile, single-dose ultrasound gel to be used for all invasive procedures.  The guidelines also provide the appropriate storage and warning methods for the gel.

Photo: Centers for Disease Control and Prevention, Janice Haney Carr.

According to the CDC, Pseudomonas aeruginosa infection “is caused by strains of bacteria found widely in the environment; the most common type causing infections in humans is called Pseudomonas aeruginosa.” “Serious Pseudomonas infections usually occur in people in the hospital and/or with weakened immune systems. Infections of the blood, pneumonia, and infections following surgery can lead to severe illness and death in these people.”

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Beth Carey, LPN, Tyrone Hospital, Infection Prevention Today

Congratulations to Beth Carey, LPN, Infection Prevention Coordinator at Tyrone Hospital for being nominated and elected for Infection Prevention Today’s National list of Who’s Who in Infection Prevention for 2013.

Mrs. Carey was recognized for her hard work to maintain the standards for isolation and surveillance, being very proactive and innovative in the promotion of hand washing – most recently initiating and championing Tyrone Hospital’s “Don’t Bug Me Hand Hygiene Campaign”, spearheading a committee of peer champions to promote hand washing, initiating numerous infection prevention policies and developing an employee seasonal influenza vaccine campaign that helped Tyrone Hospital exceed the requirements of the Pennsylvania Department of Health, raising Tyrone Hospital’s compliance rate to 93 percent for the 2012-2013 influenza season.

“I was very surprised and overwhelmed when I learned about this recognition,” said Mrs. Carey. “Providing and maintaining a safe environment, and the best care possible for our patients can be challenging. Without the cooperation from administration and hospital staff, my job would be impossible. It is truly a team effort.”

Photo: Tyrone Hospital.  National Recognition Extended to Tyrone Hospital’s Infection Prevention Coordinator.

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Julie ReaganA new webinar created by Julie Reagan of HAI Focus and offered through ComplianceOnline is currently available.

The majority of U.S. states have responded to the occurrence of HAIs by implementing state-level HAI prevention and public reporting programs. Most states have also enacted legislation and promulgated administrative regulations placing mandates on hospitals and other healthcare facilities to report data on HAIs. In addition, the Centers for Medicare and Medicaid Services (CMS) has implemented its HAI reporting program requiring reporting of HAI data by Medicare certified facilities.

This 90-minute online webinar will provide an overview of the regulatory landscape applicable to HAI data reporting and infection prevention. For those individuals not familiar with HAIs, the webinar will begin with an overview of the various infections that may be acquired in the healthcare setting and will provide a basic introductory overview of the regulatory landscape applicable to HAI public reporting and prevention. The course will provide a current and comprehensive review of U.S. state laws applicable to HAIs as well as a detailed discussion of federal CMS reporting requirements.

The training is scheduled for July 12, Friday, 10:00 AM PDT / 1:00 PM EDT. Cost: $149.00 per attendee. Group rates are available.

Click here to register for the course.

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The New York One & Only Campaign has released the latest issue of its Injection Safety Newsletter.

In this issue, you will find information about:

This is a highly informative newsletter providing a wealth of information.  To access the newsletter, click here.

The One and Only Campaign is a public health campaign aimed at raising awareness among the general public and healthcare providers about safe injection practices.  Visit http://www.oneandonlycampaign.org for more information.

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According to a press release issued by the European Centre for Disease Prevention and Control, a new report containing the results of a point prevalence survey of healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals reveals that HAIs are a major public health problem in Europe.

The survey, the first Europe-wide point prevalence survey of HAIs, reveals that approximately 80,000 patients — or one in 18 patients — will contract at least one HAI.

Over 1000 hospitals in 30 European countries were surveyed, providing the most comprehensive information about HAIs in European acute care hospitals to date.

The data are published in a report and are also available online as an interactive database.

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The Hospitals Contribution Fund of Australia (HCF) has developed a new web-based search engine allowing patients to compare certain quality indicators of Australian hospitals.

The new web-based search engine allows consumers to compare the information of up to 10 hospitals at a time.  The site provides information about hand hygiene and Staphylococcus Aureus Bacteremia (SAB) or Golden Staph).

The information is collated from information contained in another web-based site maintained by the National Health Performance Authority (NHPA).  That site, www.myhospitals.gov.au, provides more extensive hospital information.

The National Health Performance Authority (NHPA) has recently released a report about healthcare-associated Staphylococcus aureus bloodstream infections occurring in Australian hospitals in 2011-2012.  That report, issued in May 2013, details how “Australia’s biggest public hospitals account for a disproportionate share of reported healthcare-associated S. aureus bloodstream infections.”

 

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MMWR, Morbidity and Mortality Weekly Report.  Notifiable diseases

 

 

The July 5, 2013 issue of the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR) presents a Summary of Notifiable Diseases — United States, 2011.

The report contains the official statistics for the occurrence of notifiable infectious diseases reported in the United States in 2011.  The statistical data presented in the report originate from reports sent by individual state health departments and territories to the National Notifiable Diseases Surveillance System (NNDSS).  That system is operated by the CDC in conjunction with the Council of State and Territorial Epidemiologists (CSTE).

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Hawaii healthcare-associated infections report

In a new report issued on June 30, 2013, the Hawaii State Department of Health (HDOH) presents information about healthcare-associated infections (HAIs) among patients treated in Hawaii’s acute care facilities.

This is the first report containing HAI data issued by the state since the Hawaii legislature passed legislation in 2011 requiring HAI public reporting.

The report contains data reported during calendar year 2012 for central Line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) in intensive care units (ICU).   It also presents all inpatient surgical site infections (SSI) for abdominal hysterectomies and colon surgeries.

Photo: Hawaii State Department of Health.  Healthcare-Associated Infections in Hawaii, 2012 Report.  June 30, 2013.

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