In this prospective study, we monitored 4 epidemiologically important pathogens (EIPs): methicillin-resistane Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Clostridium difficile, and multidrug-resistant (MDR) Acinetobacter to assess the effectiveness of 3 enhanced disinfection strategies for terminal room disinfection against standard practice. Our data demonstrated that a decrease in room contamination with EIPs of 94% was associated with a 35% decrease in subsequent patient colonization and/or infection.

We evaluated rates of clinically confirmed long-term-care facility-onset Clostridium difficile infections from April 2014 through December 2016 in 132 Veterans Affairs facilities after the implementation of a prevention initiative. The quarterly pooled rate decreased 36.1% from the baseline (P<.0009 for trend) by the end of the analysis period.

Infect Control Hosp Epidemiol 2018;39:343–345

Smartphones are increasingly used to access clinical decision support, and many medical applications provide antimicrobial prescribing guidance. However, these applications do not account for local antibiotic resistance patterns and formularies. We implemented an institution-specific antimicrobial stewardship smartphone application and studied patterns of use over a 1-year period.

Patient days and days present were compared to directly measured person time to quantify how choice of different denominator metrics may affect antimicrobial use rates. Overall, days present were approximately one-third higher than patient days. This difference varied among hospitals and units and was influenced by short length of stay.

Infect Control Hosp Epidemiol 2018;39:612–615

In this single-center study, the standardized antimicrobial administration ratio (SAAR) for total antimicrobial use decreased in response to a stewardship intervention. Antimicrobial prescribing and clinical outcomes were stable or improved during the period of lower SAARs. Our findings suggest that SAAR values of ~0.8 can be safely achieved.

We examined vancomycin-resistant enterococci (VRE)-directed antimicrobial use and VRE bacteremia in a cohort of allogeneic hematopoietic cell transplantation patients from a center where VRE screening is standard prior to transplant. In this cohort, VRE bacteremia (VREB) was infrequent. In patients without VREB, colonized patients received VRE therapy more often than noncolonized patients.

Infect Control Hosp Epidemiol 2018;39:730–733

Two distinct clusters of gastroenteritis due to Salmonellae and Entamoeba histolytica (EH) were identified using a multiplex gastrointestinal pathogen panel (GPP) at a tertiary-care cancer center. Despite temporo-spatial overlap, our investigation did not corroborate transmission or true infection. In clinical practice, GPPs may render false-positive results.

Infect Control Hosp Epidemiol 2018;867–870

The correlations between census-derived sociodemographic variables and hospital-onset methicillin-resistant Staphylococcus aureus bacteremia (HO-MRSAB) rates were examined at the US state level. On multivariable analysis, only percent African American remained statistically significant. This finding highlights an important disparity and suggests that risk adjustment is needed when comparing HO-MRSAB rates among US states.

Infect Control Hosp Epidemiol 2018;39:479–481

We report daptomycin minimum inhibitory concentrations (MICs) for vancomycin-resistant Enterococcus faecium isolated from bloodstream infections over a 4-year period. The daptomycin MIC increased over time hospital-wide for initial isolates and increased over time within patients, culminating in 40% of patients having daptomycin-nonsusceptible isolates in the final year of the study.

Infect Control Hosp Epidemiol 2018;39:226–228

We evaluated the ability of high-intensity visible violet light with a peak output of 405 nm to kill epidemiologically important pathogens. The high irradiant light significantly reduced both vegetative bacteria and spores at some time points over a 72-hour exposure period.

A point-prevalence survey of mothers and neonates admitted to an obstetrics emergency hospital in Port-au-Prince, Haiti, revealed that 13 of 127 gram-negative bacteria isolates (10%) from rectal swabs were ESBL-positive in women and 30 of 59 gram-negative bacteria isolates (51%) from rectal swabs were ESBL-positive in neonates. Length of hospital stay and antibiotic consumption were risk factors for ESBL colonization.

We prospectively evaluated direct costs of contact precautions using on-site observation. Additional mean costs per patient day were calculated for extra materials used, increased workload, and one-off isolation activities. The cost of contact precautions was $158.90 (95% confidence interval, $124.90‒$192.80) per patient day.

Infect Control Hosp Epidemiol 2018;39:101–103

Bloodstream infection (BSI) occurred in 21 of 121 patients (17%) receiving venovenous extracorporeal membrane oxygenation within the median time of 6 days after initiation (interquartile range, 4–19 days). Longer duration of arterial catheterization and more blood transfusions were independently associated with BSI, which is associated with poor clinical outcomes.

Infect Control Hosp Epidemiol 2018;1–4

A metric was developed to identify hospital proportion of carbapenem consumption (PoCC) among antipseudomonal antibiotics. The PoCC varied significantly among academic medical centers by Census Bureau geographic division after adjusting for patient mix. This metric may be useful in identifying disproportionate carbapenem use and potential carbapenem overuse.

Infect Control Hosp Epidemiol 2018;39:229–232

Vancomycin is a commonly prescribed empiric antibiotic used when methicillin-resistant Staphylococcus aureus (MRSA) infection is suspected. In this study, we aimed to determine the rate of culture-positive infection requiring vancomycin therapy.

We surveyed resident physicians at 2 academic medical centers regarding urinary testing and treatment as they progressed through training. Demographics and self-reported confidence were compared to overall knowledge using clinical vignette-based questions. Overall knowledge was 40% in 2011 and increased to 48%, 55%, and 63% in subsequent years (P<.001).

Infect Control Hosp Epidemiol 2018;39:616–618

In hospital sinks, a novel plastic drain cover was effective in preventing dispersal of gram-negative bacilli and fluorescent gel associated with splattering of flowing water. Our findings suggest that the sink drain covers could provide a simple means to reduce dissemination of pathogens from contaminated sinks.

Adequate facepiece fit of N95 filtering facepiece respirators (FFRs) is crucial for optimal protection against airborne pathogens. The quantitative fit test (QNFT) pass rates of the 4 N95 FFR models commonly used in Korea were below 50%. Male sex was identified as a single independent predictive factor for QNFT pass.

Infect Control Hosp Epidemiol 2018;39:104–107

We conducted a quality improvement project at a large public tertiary-care academic hospital to reduce reported hospital-acquired Clostridium difficile infection (CDI) rates. We introduced diagnostic stewardship and provider education, resulting in a 2-fold reduction in C. difficile nucleic acid amplification test (NAAT) orders and markedly lower hospital CDI rate.

Infect Control Hosp Epidemiol 2018;39:734–736

We measured the disinfection of MRSA and Clostridium difficile spores using an ultraviolet C (UV-C) device, and we correlated those results to measurements and computer simulations of UV-C surface intensity. The results demonstrate both large differences in UV light intensity across various surfaces and how this leads to significant differences in disinfection.