We report a surveillance method for influenza that is based on automated hospital laboratory and pharmacy data. During the 2009 H1N1 influenza pandemic, this method was objective, easy to perform, and utilized readily available automated hospital data. This surveillance method produced results that correlated strongly with influenza-like illness surveillance data.

We report an outbreak of Bacillus bacteremia among premature infants during a construction project. Our investigation revealed potential environmental sources. After replacement of air filters, cleaning of the unit, emphasis on hand hygiene, and relocation of the loading dock for linen and supply delivery, no further cases were detected.

We examined the association between an increase in episodes of observed bacteriuria and adverse clinical outcomes among nursing home residents without catheters. Although bacteriuria was not associated with hospitalization for urinary tract infection (UTI) or change in mental status, it was associated with use of antibiotics to treat UTI and with isolation of multidrug-resistant gram-negative rods from urine specimens, which suggested a causal relationship.

We sought to determine the burden of nosocomial Clostridium difficile infection in comparison to other healthcare-associated infections (HAIs) in community hospitals participating in an infection control network. Our data suggest that C. difficilehas replaced MRSA as the most common etiology of HAI in community hospitals in the southeastern United States.

We conducted an observational study to identify predictors of hand hygiene (HH) in the emergency department. Compliance with HH was 89.7% over 5,865 opportunities. Observation unit, hallway or high-visibility location, glove use, and worker type predicted worse HH. Hallway location was the strongest predictor (relative risk, 88.9% [95% confidence interval, 85.9%–92.1%]).

US health professional schools with student immunity requirements for recommended vaccines frequently accept evidence of immunity other than vaccination but vary widely on the types of evidence that are accepted. Exemptions for nonmedical reasons and, to a lesser extent, medical reasons are often obtainable by a student-written document.

Surgical site infections (SSIs) occur in approximately 2%–5% of patients undergoing surgery in the acute care setting in the United States. These infections result in increased length of stay, higher risk of death, and increased cost of care compared with that in uninfected surgical patients. Given the inclusion of maintenance of perioperative normothermia for all major surgeries as a means of lowering the risk of infection in the Surgical Care Improvement Project 2009, we prepared a summary of the literature to determine the strength and quantity of the evidence underlying the performance measure. Although the data are generally supportive of perioperative normothermia as a means of reducing the risk of SSIs, a more rigorous approach using standard SSI definitions as well as standardized temperature measurements (and timing thereof) will further delineate the role played by temperature regulation in SSI development.

An observational study was performed on 2 wards in a tertiary hospital to determine staff awareness, knowledge, and documentation of catheter use and the effects these have on duration of catheterization. Overall, there was poor knowledge of the indications and date of catheterization. Doctor awareness decreases duration of catheterization.

In a survey of patients with short-term indwelling urinary catheters, 47% were aware that catheters cause urinary tract infections, 89% believed that catheters were not overused, and 68% preferred catheter placement rather than use of a bedside commode, bedpan, or diaper. Patient education is needed regarding the risks of urinary catheters.

Recent surveillance from US hospitals shows that more than 99.5% of vancomycin-resistant enterococci (VRE) isolates remain susceptible to daptomycin. This report describes emergence of daptomycin-resistant VRE at a major cancer center. The percentage of patients with daptomycin-resistant VRE bacteremia increased from 3.4% in 2007 to 15.2% in 2009 (P = .03). Without susceptibility data, empiric daptomycin therapy for VRE infections should be used with caution.

Data from a case-control study were used to derive and internally validate a prediction rule for identifying fluoroquinolone resistance in healthcare-acquired gram-negative urinary tract infection. This prediction rule has an excellent sensitivity and specificity (C-statistic, 0.816). External validation is necessary before implementing this rule to optimize empirical antibiotic use in clinical practice.

At a major referral hospital in the Southern Hemisphere, the 2009 influenza A (H1N1) pandemic brought increased critical care demand and more unscheduled nursing absences. Because of careful preparedness planning, including rapid expansion and redistribution of the numbers of available beds and staff, hospital surge capacity was not exceeded.

A Web-based training course with embedded video clips for reducing central line-associated bloodstream infections (CLABSIs) was evaluated and shown to improve clinician knowledge and retention of knowledge over time. To our knowledge, this is the first study to evaluate Web-based CLABSI training as a stand-alone intervention.

In the fall of 2009, our hospital introduced a surveillance system to monitor the increase in cases of H1N1 pandemic influenza A virus infection. The system involved tracking cases of influenza-like illness in the emergency department, the outpatient clinics, and the inpatient wards as well as specimens with positive polymerase chain reaction results reported by the microbiology laboratory. Our data correlated well with national and regional data.

During 2008, a point-prevalence survey of healthcare-associated infections (HAIs) was conducted in 36 Vietnamese hospitals. Of 7,571 inpatients, 590 (7.8%) had HAIs, including pneumonia (41.9%) and surgical-site infections (27.5%). Device use was a significant risk factor; gram-negative microorganisms predominated. A national reporting system needs to be established for monitoring HAIs and enhancing patient outcomes.

We evaluated the prevalence of colonization with all gram-negative bacilli (GNB) and with ciprofloxacin-resistant GNB among nursing home residents with and without indwelling devices. We found that device presence increases the risk of colonization with all GNB and with ciprofloxacin-resistant GNB. Colonization with ciprofloxacin-resistant GNB increases with decreasing functional status.