We reported 2009 H1N1 influenza infections among healthcare workers (HCWs) and inpatients and the prevention measures instituted in a large Chinese hospital. In total, 171 HCWs and 89 inpatients tested positive for H1N1. Sixteen HCWs had known hospital exposure, among whom only 7 had working-contact exposure. There was no influenza outbreak.

Infect Control Hosp Epidemiol 2012;33(3):295-298

We surveyed patient access managers on the impact of contact precautions (CP) for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE) on time to bed assignment, and we investigated the factors influencing infection control policies allowing for discontinuation of CP. The majority of respondents reported an increase in time to bed assignment for patients with a history of MRSA and/or VRE infection or colonization.

We compared cleaning rates associated with use of a white ultraviolet (UV) powder versus a transparent UV gel among units with various degrees of previous experience with UV powder. The study outcome was the presence of discordant cleaning (removal of powder without the removal of gel, or vice versa). We found higher frequency of discordance in high-experience units (31%) than in no-experience units (8%) (P<.001). In 92% of discordant findings, the powder was removed but not the gel (P< .001). These findings suggest preferential cleaning of visible UV targets among units with high levels of previous experience with powder.

Infect Control Hosp Epidemiol 2012;33(2):192-195

Care-related infections are a major public health concern. Their transmission can be associated with environmental factors. This study looks at air contamination around 45 patients colonized with multidrug-resistant organisms (MDROs). We found that 30 hospital rooms (67%) were contaminated with MDRO species and 10 rooms (22%) were contaminated with at least 1 MDRO.

We describe an outbreak of methicillin-resistant Staphybcoccus aureus (MRSA) ST398 in a nursing home in the Netherlands. Seven residents and 4 healthcare workers were identified with MRSA ST398, but 2 of the healthcare workers carried other strains. This study demonstrates that MRSA ST398 can spread in nursing homes.

We compared the observations of nearly 1,400 hand-hygiene-related events recorded by an automated system and by human observers. Observation details differed for 38% of these events. Two likely explanations for these inconsistencies were the distance between the observer and the event and the busyness of the clinic.

Mandatory infectious disease consultation for parenteral antimicrobials at hospital discharge resulted in avoiding postdischarge parenteral antimicrobials in 28% of patients. No emergency department visit or rehospitalization within 30 days for these patients was a consequence of parenteral antimicrobial avoidance. Antimicrobial stewardship at transition of care is effective in reducing unnecessary antimicrobial use.

We evaluated A/H1N1 influenza in healthcare workers (HCWs) and in a flu room during the 2009 pandemic. The flu room aided HCW care and management by facilitating rapid diagnosis and treatment. Absence of fever was common, and symptoms were nonspecific. A higher rate of H1N1 occurred in HCWs deployed in acute services.

Infect Control Hosp Epidemiol 2012;33(2):196-199

We surveyed physicians in a national occupational medicine society regarding diagnosis of latent tuberculosis infection in healthcare workers. Most respondents used a combination of skin testing and interferon gamma release assays. Respondents integrating interferon gamma release assays into screening placed greater importance on employee acceptability and convenience.

We surveyed Ronald McDonald Houses (RMHs) to assess infection prevention and control (IPC) practices. A diverse patient population is served by RMH. Most sites have locally written IPC guidelines, and consultation resources vary, increasing the potential for inconsistent IPC practices. RMH would benefit from a standardized IPC guideline.

Infect Control Hosp Epidemiol 2012;33(3):299-301

Antimicrobial drug shortages continue to increase, with few new therapeutic options available. Nationally, proposals have been offered to alleviate drug shortages; however, these recommendations are unlikely to effect change in the near future. Thus, antimicrobial stewardship leaders in acute care hospitals must develop a prospective management strategy to lessen the impact of these shortages on patient care. Herein, we describe several resources available to aid professionals in antimicrobial stewardship and healthcare epidemiology to manage drug shortages. An effective approach should include prospectively tracking shortages and maximizing inventory by appropriately managing usage. Several tenets should underpin this management. Alternative agents should be rationally chosen before the inventory of the primary agent has reached zero, ethical considerations should be taken into account, and timely notification and communication with key stakeholders should occur throughout the prescribing and dispensing process.

We implemented an antimicrobial stewardship program at an urban, 60-bed long-term acute care hospital using a strategy of weekly postprescriptive chart audit with intervention and feedback. The results for the first 15 months demonstrated 80% acceptance of recommendations, a 21% reduction in use, and a 28% reduction in cost per patient-day.

Five hundred five blood cultures collected through a peripheral intravenous catheter (PIV) in an emergency department were matched to cultures obtained by dedicated venipuncture from the same patient within 10 minutes. The relative risk of contamination for cultures collected through PIVs compared with dedicated venipuncture was 1.83 (95% confidence interval, 1.08–3.11).

A Web-based electronic health record (EHR) system was compared with traditional paper-based documentation and vaccination tracking during the 2009 H1N1 influenza pandemic. In a cohort of 8,411 healthcare network employees, EHRs improved completeness of self-reported contraindication data and reduced medical discrepancies. Vaccination program quality and accuracy are enhanced by EHRs.

Infect Control Hosp Epidemiol 2012;33(1):84-86

We reviewed a nationwide retail pharmacy chain's centralized needlestick injury reports. From 2000 to 2011, 33 needlestick injuries were reported by 31 different pharmacy locations and were likely preventable. The annual incidence of needlestick injuries ranged from 0 to 3.62 per 100,000 vaccinations and ranged from 0 to 5.65 per 1,000 immunizing pharmacists.

Outbreaks by carbapenem-resistant Providencia stuartii (CRPS) are rarely described. Clinical characteristics of patients with CRPS in an intensive care unit and resistance mechanisms were investigated. Carbapenemase production and/or outer membrane alterations were not detected; only CTX-M-2 and AmpC hyperproduction were noted. The outbreak was ultimately controlled in a 3-month period.