A retrospective review of secondary injury data was used to evaluate the characteristics of percutaneous injuries from safety-engineered sharp devices. Injury rates and safety device activation rates differed by healthcare provider type. Approximately 22.8%–32% of injuries could have been prevented had an available safety feature been activated after use.

Surveillance for pandemic H1N1 influenza was conducted between June 1, 2009, and May 31, 2010, among adults at 40 participating hospitals in the Canadian Nosocomial Infection Surveillance Program. The first wave was characterized by a higher proportion of Aboriginals and pregnant women as well as severe outcomes, compared to the second wave.

Infect Control Hosp Epidemiol 2012;33(10):1043-1046

We report a large scabies outbreak occurring in Tilburg, Netherlands, which affected several different healthcare settings that provide care to the elderly and the mentally disabled. The outbreak demonstrated how the complex system of care provision to vulnerable groups facilitated extensive scabies transmission among multiple linked healthcare settings and the community.

Infect Control Hosp Epidemiol 2012;33(10): 1047-1050

Infectious complications of cardiac surgery are often severe and life threatening. Statins having both immunomodulatory and anti-inflammatory effects were intuitively thought to influence the development of postsurgical infections. We sought to systematically examine whether any association exists between statin use and risk of infectious complications in patients undergoing cardiac surgery. We searched Ovid MEDLINE, Ovid EMBASE, Thomson Scientific Web of Science, and Elsevier Scopus from inception through February 2011 for comparative studies examining the association between statin use and risk of postoperative infections in patients undergoing cardiac surgery. We contacted a study's author for missing information. We conducted a random-effects meta-analysis of individual studies' odds ratios (adjusted for potential confounders). We identified 6 cohort studies for inclusion, 3 of which were conducted in Canada and 3 of which were conducted in the United States. Four were single-center studies, and 2 were population based. Exposure ascertainment was based on a review of admission medication list or prescription databases. Infectious outcomes were heterogeneous and included surgical site infections within 30 days, serious infections (sepsis), or any other postoperative infection. Statin use in the preoperative period was associated with a trend toward reduction in the incidence of postoperative infections in patients who underwent cardiac surgery (odds ratio, 0.81 [95% confidence interval, 0.64–1.01]; P = .06; I2 = 75%). Heterogeneity was explained by country effect. Studies performed in Canada showed weaker associations than studies performed in the United States. This difference could not be attributed to study quality alone. We did not find good evidence to support an association between statin use and postoperative infectious complications. However, the trend toward statistical significance for this association indicates that further investigation is warranted.

The financial impact of an antimicrobial stewardship program in operation for more than 11 years was determined by calculating the reduction in antimicrobial expenditures minus program labor costs. Depending on the method of inflation adjustment used, the program was associated with average cost savings of $920,070 to $2,064,441 per year.

We tested the effectiveness of disinfectants and wipe methods against Clostridium difficile spores. Wiping with nonsporicidal agents (physical removal) was effective in removing more than 2.9 log10C. difficile spores. Wiping with sporicidal agents eliminated more than 3.90 log10C. difficile spores (physical removal and/or inactivation). Spraying with a sporicide eliminated more than 3.44 log10C. difficile spores but would not remove debris.

We reviewed US state and territorial healthcare-associated infection (HAI) laws, specifically addressing 3 legal requirements: data submission, reporting of data to the public, and inclusion of facility identifiers in public reports. The majority of US states and territories have HAI laws. The 3 studied legal provisions are all commonly included in state HAI laws in varying forms; however, only a minority of states and territories specifically mandate all 3 legal requirements. The laws of the remaining states vary considerably.

Infect Control Hosp Epidemiol 2012;33(1):75-80

To understand the feasibility of implementing a standardized performance measure for collecting and reporting influenza vaccination rates among healthcare personnel, qualitative, semistructured interviews were conducted with key informants in 32 healthcare facilities. Despite practical and logistical challenges to implementing the measure, respondents perceived clear benefits to its use.

We describe the incidence rates of home healthcare-associated infections (HHAIs) in a pediatric home healthcare service (PHHCS). The overall incidence density of HHAIs was 11.1 infections per 1,000 patient-days. Average incidence density of ventilator-associated pneumonia (VAP) was 6.8 per 1,000 ventilator-days. Strategies for control of VAP should be prioritized in PHHCSs.

Multiple cultures were positive for Bacillus cereus during routine quality assurance testing of a pharmacy robot that prepares intravenous medications. An investigation confirmed bacterial contamination of the robot as well as drug product made by the robot. The process and outcomes of the investigation are described in this report.

The rates of nosocomial seasonal (January 2008 to March 2009) and 2009 A/H1N1 (April 2009 to December 2010) influenza infections in a children's hospital were compared. Droplet precautions were used. The rates were similar during both periods, suggesting that use of droplet precautions did not result in a higher rate of influenza A/H1N1 infection.

Infect Control Hosp Epidemiol 2012;33(3):292-294

The bloodstream infection surveillance system proposed by the Centers for Disease Control and Prevention (CDC) was prospectively conducted in a pediatric hemodialysis unit. Thirty patients were included; 73% had a catheter for vascular access at enrollment. Vascular access infection rate was 21.1 per 100 patient-months, well above those observed in adult patient surveys. Staphylococcus aureus was most frequently isolated (23%).

Tetanus, diphtheria, and pertussis (Tdap) vaccine is recommended for all healthcare personnel who provide direct patient care unless medically contraindicated. Our university hospital made employment conditional upon receipt of Tdap vaccine. Implementation for newly hired employees quickly resulted in complete compliance, but achieving adherence among current workers required setting a termination date for noncompliance.

Infect Control Hosp Epidemiol 2012;33(1):81-83