Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their surgical site infection (SSI) prevention efforts. This document updates “Strategies to Prevent Surgical Site Infections in Acute Care Hospitals,” published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.

/pdf/strategies-to-prevent-surgical-site-infections-in-acute-care-3247lhu8t7.pdf

Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update

http://www.mtpinnacle.com/pdfs/Role-of-hospital-surfaces-in-transmission-of-emerging-health%20care-associated-pathogens.pdf

Role of hospital surfaces in the transmission of emerging health care-associated pathogens: norovirus, Clostridium difficile, and Acinetobacter species.

The aim of this paper is to provide a survey of plasma sources at atmospheric pressure used for microbicidal treatment. In order to consider the interdisciplinary character of this topic an introduction and definition of basic terms and procedures are given for plasma as well as for microbicidal issues. The list of plasma sources makes no claim to be complete, but to represent the main principles of plasma generation at atmospheric pressure and to give an example of their microbicidal efficiency. The interpretation of the microbicidal results remain difficult due to the non-standardized methods used by different authors and due to the fact that small variations in the setup can change the results dramatically.

https://hal.archives-ouvertes.fr/hal-00585169/document

Low temperature atmospheric pressure plasma sources for microbial decontamination

Infusion Nursing Standards of Practice

SUMMARY Health care-associated infections (HAIs) have become more common as medical care has grown more complex and patients have become more complicated. HAIs are associated with significant morbidity, mortality, and cost. Growing rates of HAIs alongside evidence suggesting that active surveillance and infection control practices can prevent HAIs led to the development of hospital epidemiology and infection control programs. The role for infection control programs has grown and continues to grow as rates of antimicrobial resistance rise and HAIs lead to increasing risks to patients and expanding health care costs. In this review, we summarize the history of the development of hospital epidemiology and infection control, common HAIs and the pathogens causing them, and the structure and role of a hospital epidemiology and infection control program.

Hospital Epidemiology and Infection Control in Acute-Care Settings

Disinfection, Sterilization Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008

BACKGROUND
Infections are an important cause of morbidity and mortality after burn injuries. Here, we describe the time line of infections and pathogens after burns.


METHODS
A retrospective study was performed in a large tertiary care burn center from 2004-2013. Analyses were performed on health care-associated infections (HAIs) meeting Centers for Disease Control and Prevention criteria and on all positive cultures. Incidence rates per 1,000 days were calculated for specific HAI categories and pathogens and across hospitalization time (week 1, weeks 2-3, and week ≥4).


RESULTS
Among 5,524 patients, the median burn size was 4% of total body surface area (interquartile range, 2%-10%). Of the patients, 7% developed an HAI, of whom 33% had >1 HAI episode. Gram-positive bacteria were isolated earlier, and gram-negative bacteria were isolated later during hospitalization. Of 1,788 bacterial isolates, 44% met criteria for multidrug resistance, and 23% met criteria for extensive drug resistance. Bacteria tended to become increasingly resistant to antibiotics as time from admission increased.


CONCLUSIONS
We observed differences in infection type, pathogen, and antibiotic-resistant bacterium risk across time of hospitalization. These results may guide infection prevention in various stages of the postburn admission.

Iconography : Timeline of health care–associated infections and pathogens after burn injuries

Background The impact of routine, opt-out HIV testing programs in clinical settings is inconclusive. The objective of this study was to estimate the impact of an expanded, routine HIV testing program in North Carolina sexually transmitted disease (STD) clinics on HIV testing and case detection. Methods Adults aged 18 to 64 years who received an HIV test in a North Carolina STD clinic from July 1, 2005, through June 30, 2011, were included in this analysis, dichotomized at the date of implementation on November 1, 2007. HIV testing and case detection counts and rates were analyzed using interrupted time series analysis and Poisson and multilevel logistic regression. Results Preintervention, 426 new HIV-infected cases were identified from 128,029 tests (0.33%), whereas 816 new HIV-infected cases were found from 274,745 tests postintervention (0.30%). Preintervention, HIV testing increased by 55 tests per month (95% confidence interval [CI], 41–72), but only 34 tests per month (95% CI, 26–42) postintervention. Increases in HIV testing rates were most pronounced in women and non-Hispanic whites. A slight preintervention decline in case detection was mitigated by the intervention (mean difference, 0.01; 95% CI, −0.02 to 0.05). Increases in case detection rates were observed among women and non-Hispanic blacks. Conclusions The impact of a routine HIV screening in North Carolina STD clinics was marginal, with the greatest benefit among persons not traditionally targeted for HIV testing. The use of a preintervention comparison period identified important temporal trends that otherwise would have been ignored.

/pdf/impact-of-a-routine-opt-out-hiv-testing-program-on-hiv-7zykpja2o2.pdf

Impact of a routine, opt-out HIV testing program on HIV testing and case detection in North Carolina sexually transmitted disease clinics.

Laboratory monitoring of HIV-infected children is the current standard of care in the United States to guide the appropriate use of antiretroviral therapy (ART) Although ART is becoming a reality in some developing countries, laboratory monitoring of ART is costly, necessitating creative approaches to monitoring As an initial step to guide monitoring of HIV progression in low resource settings, we assessed the utility of the physical examination to predict clinical progression of HIV We conducted a retrospective cohort study of HIV-infected children using data from Pediatric AIDS Clinical Trials Group Protocol 300 We developed a clinical predictive model, and compared the utility of the clinical model to the change in HIV RNA viral load as diagnostic tests of ART failure The clinical model incorporated treatment regimen, age, and height velocity: a three-level clinical predictive model provided likelihood ratios of 03, 39, and 14 For decline in RNA the likelihood ratios were 02 (> 1 log decline), 14, and 35 (> log increase) We developed a simple clinical predictive model that was able to predict clinical progression of HIV after initiation of new ART The clinical model performed similarly to using changes in HIV RNA viral load These data should be validated internationally and prospectively, because the test subjects were from a resource rich environment and growth patterns in undernourished children may be impacted differently by HIV and its treatment The model was most pertinent to children 36 months of age or younger, and was conducted in children receiving monotherapy and dual therapy

David J. Weber

Papers

Disinfection, Sterilization Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008

Iconography : Timeline of health care–associated infections and pathogens after burn injuries

Impact of a routine, opt-out HIV testing program on HIV testing and case detection in North Carolina sexually transmitted disease clinics.

Growth patterns reflect response to antiretroviral therapy in HIV-positive infants: potential utility in resource-poor settings.

Vaccines for health care personnel