An outbreak of acute respiratory disease due to human adenovirus and a resulting increase in mortality occurred in a long-term care facility for the elderly. By use of viral culture and polymerase chain reaction, not a rapid antigen test, the virus was detected. Human adenovirus infection can occur in elderly individuals, but detection by rapid antigen testing may be limited.

After an educational intervention in 3 intensive care units, 34 central line-associated bloodstream infections occurred in 11,582 central venous catheter [CVC]-days, compared with 45 episodes in 10,661 CVC-days before intervention (4.22 vs 2.94 episodes per 1,000 CVC-days [30.9% reduction]; P = .03, Wilcoxon rank sum test; P = .11, Poisson regression analysis).

At a nursing home in France, 1 year after a first case of a cluster of urinary tract infections caused by an extended-spectrum β-lac-tamase-producing strain of Escherichia coli, 9 (22%) of 49 residents were colonized with the outbreak strain. Colonization was associated with poor state of health (P = .04), incontinence (P = .007), and recent treatment with fluoroquinolones and/or cephalosporins (P = .003).

Gram-negative bacilli are an important cause of infection in healthcare and community settings. Antimicrobial resistance, including resistance to multiple antimicrobial classes, is an ongoing problem among gram-negative bacilli. This synopsis reviews the incidence of multidrug resistance among gram-negative bacilli in the United States and describes emerging issues in their epidemiology.

The distribution of influenza A subtypes was studied in specimens recovered from patients in long-term care facility (LTCF) outbreaks and in non-LTCF outbreaks in Alberta, Canada, for 3 years before the influenza pandemic of 2009. We found that H3 but not HI was associated with infection in older adults. Therefore, H3 was more commonly found than HI in outbreaks in LTCFs.

An anonymous survey of 1143 employees in 17 nursing facilities assessed knowledge of, attitudes about, self-perceived compliance with, and barriers to implementing the 2002 Centers for Disease Control and Prevention hand hygiene guidelines. Overall, employees reported positive attitudes toward the guidelines but differed with regard to knowledge, compliance, and perceived barriers. These findings provide guidance for practice improvement programs in long-term care settings.

Vaccination of healthcare workers (HCWs) is an important strategy in the control and prevention of hospital outbreaks. The decision to vaccinate is often based on self-report of vaccination status. Self-report of previous receipt of tetanus-diphtheria or tetanus toxin vaccination was validated using an electronic medical record. Results showed that HCWs' self-report is reliable during a vaccination campaign.

We describe 22 patients from a multistate outbreak of Serraría marcescens bacteremia that was linked to contaminated prefilled syringes of heparin and saline supplied by 1 manufacturer. Contents of unused syringes were cultured in pools samples from 25 (5.3%) of 472 syringes grew S. marcescens. Despite good clinical outcomes overall, patients had substantial morbidity.

We describe the investigation and control of a Klebsiella pneumoniae carbapenemase-producing K. pneumoniae outbreak in a 20-bed surgical intensive care unit during the period from January 1, 2009 through January 1, 2010. Nine patients were either colonized or infected with a monoclonal strain of K. pneumoniae. The implementation of a bundle of interventions on July 2009 successfully controlled the further horizontal spread of this organism.

We examined the Clostridium difficile infection rate and risk factors in an outpatient dialysis cohort. The Cox proportional hazard for developing C. difficile infection was significantly higher with high comorbidity index and low serum albumin level. Conversely, it was lower for patients who had frequent bloodstream and dialysis access-related infections.

The common cold affects millions of people. Unfortunately, it remains unknown whether cold viruses enter the respiratory tract only through the nose and mouth or whether they can also enter through the tear ducts. Transocular exposure to an airborne infectious dose of human rhinovirus did not lead to infection.

The characteristics of nosocomial bloodstream infections (BSIs) in a neurosurgical department were studied over a 5-year period. The rate of nosocomial BSI was 3.0%. Gram-negative bacteria were the most commonly isolated pathogens (65.9% of isolates). For all the pathogens isolated, the rate of resistance to commonly used antimicrobial agents was high. Of the 101 patients with nosocomial BSI, 50 (49.5%) died during their stay at the Department of Neurosurgery. At the same time, overall mortality rate among neurosurgical inpatients without nosocomial BSI was 5.4% (ie, 175 of 3,216 patients died).

Our case-control study sought to identify risk factors for colonization with methicillin-resistant Staphylococcus aureus (MRSA) at hospital admission among patients with no known healthcare-related risk factors. We found that patients whose most recent hospitalization occurred greater than 1 year before their current hospital admission were more likely to have MRSA colonization. In addition, both the time that elapsed since the most recent hospitalization and the duration of that hospitalization affected risk.