We evaluated the impact of nursing education and stewardship interventions on Clostridium difficile testing and treatment appropriateness. Diarrhea documentation increased for those with positive tests (45% to 70%); pretreatment laxative use decreased (50% to 19%). Appropriate treatment increased for severe infection (57% to 93%), but all asymptomatically colonized patients were treated.

Infect Control Hosp Epidemiol 2014;00(0): 1–5

Across 366 California hospitals, we identified hospital-level characteristics predicting increased hospital-associated Clostridium difficile infection (HA-CDI) rates including more licensed beds, teaching and long-term acute care (LTAC) hospitals, and polymerase chain reaction testing. Adjustment for these characteristics impacted rankings in 24% of teaching hospitals, 13% of community hospitals, and 11% of LTAC hospitals.

Infect Control Hosp Epidemiol 2015;00(0): 1–3

Healthcare personnel often find themselves on the frontlines of any epidemic, and may be at particularly high risk of acquiring respiratory viral illnesses when compared to the general population. Many aspects dictate how respiratory viruses spread both inside the hospital and out: Elements to consider include the specific type of virus being targeted for prevention, as well as environmental conditions and host factors, such as age and immune status. Due to the diverse nature of these agents, multiple modes of transmission, including contact, droplet, aerosol, and transocular, must be considered when designing an effective infection prevention program. In this review, we examine the data behind current theories of respiratory virus transmission and key elements of any respiratory illness prevention program. We also highlight other influences that may come into play, such as the cost-effectiveness of choosing one respiratory protection strategy over another.

Infect Control Hosp Epidemiol 2014;00(0): 1–10

The performance of a hospital- and community-onset Clostridium difficile infection definition using administrative data with a present-on-admission indicator was compared with definitions using clinical surveillance. For hospital-onset C. difficile infection, there was moderate sensitivity (68%) and high specificity (93%); for community-onset, sensitivity and specificity were high (both 85%).

Infect Control Hosp Epidemiol 2015;36(7):838–840

Funguria rarely represents true infection in the urinary tract. Excluding yeast from the catheter-associated urinary tract infection (CAUTI) surveillance definition reduced CAUTI rates by nearly 25% in community hospitals and at an academic, tertiary-care medical center.

Infect Control Hosp Epidemiol 2015;00(0): 1–3

The impact of the 2013 NHSN CAUTI definition on CAUTI rates was analyzed. A total of 107 CAUTI episodes were identified; 60 according to NHSN 2013 definitions only and 47 according to the 2012 and 2013 definitions. Physician-diagnosed “other infections” were more common among patients who had CAUTI only according to NHSN 2013 definitions (P<.001).

Infect Control Hosp Epidemiol 2014;00(0): 1–4

We reviewed patient discharges with outpatient parenteral antimicrobial therapy (OPAT) to determine whether outpatient parenteral antimicrobial therapy was modifiable or unnecessary at a large tertiary care children’s hospital. At least one modification definitely or possibly would have been recommended for 78% of episodes. For more than 40% of episodes, outpatient parenteral antimicrobial therapy was potentially not indicated.

Infect Control Hosp Epidemiol 2014;00(0):1–3

We assessed frequency and predictors of seasonal influenza vaccination acceptance among inpatients at a large tertiary referral hospital, as well as reasons for vaccination refusal. Over 5 seasons, >60% of patients unvaccinated on admission refused influenza vaccination while hospitalized; “believes not at risk” was the reason most commonly given.

Infect Control Hosp Epidemiol 2015;36(7):841–843

We surveyed 571 US hospitals about practices used to prevent Clostridium difficile infection (CDI). Most hospitals reported regularly using key CDI prevention practices, and perceived their strength of evidence as high. The largest discrepancy between regular use and perceived evidence strength occurred with antimicrobial stewardship programs.

Infect. Control Hosp. Epidemiol. 2015;36(8):969–971

Bacterial contamination of duodenoscopes is attributed to difficulties with reprocessing the Albarran lever. Routine microbiologic surveillance data of endoscopes with Albarran lever retrospectively collected from November 2004 through March 2015 revealed no growth of microorganism at this specific site. Transmission of endoscope-associated infection is avoidable by following validated reprocessing procedures.

Infect Control Hosp Epidemiol 2015;36(10):1233–1235

Isolates from patients who acquired vancomycin-resistant enterococci (VRE) were examined for the frequency of genetically indistinguishable strains on leukemia and stem cell transplant units at a major cancer center for 1 year. A total of 14 strains recurred, primarily on the same floor and in the same service unit an average of 49 days apart.

Infect. Control Hosp. Epidemiol. 2015;36(12):1461–1463

Validation of the number of central line–days by hospitals is required by the National Healthcare Safety Network. A prospective study that compared a daily report of such days generated by an electronic medical record with observational audits by nurses revealed that the report was 100% sensitive and 99.9% specific.

Infect. Control Hosp. Epidemiol. 2015;36(9):1098–1099

To determine the optimal number of specimens for virus detection in a respiratory outbreak, laboratory results from 2 Canadian public health laboratories were reviewed. The evidence suggests that 3 specimens are sufficient for detection of a virus in >95% of outbreaks, thereby reducing laboratory costs.

Infect. Control Hosp. Epidemiol. 2015;36(11): 1344–1347

Central venous catheter (CVC) day definitions do not consider concurrent CVCs. We examined traditional CVC day counts and resultant central line-associated bloodstream infection (CLABSI) rates with a CVC day definition that included concurrent CVCs. Accounting for concurrent CVCs increased device day counts by 8.5% but only mildly impacted CLABSI rates.

Infect Control Hosp Epidemiol 2015;36(1): 107–109

Using the Veterans’ Health Administration MRSA Directive as a platform to collect methicillin-resistant Staphylococcus aureus (MRSA) colonization isolates and an active MRSA infection surveillance program, the genetic relatedness of colonization and infection isolates was evaluated. Infection and colonization strain concordance was found in 85.7% of patients. The USA 500 MRSA strain was identified in 31.8% of patients.

Infect Control Hosp Epidemiol 2015;00(0): 1–3