Using a rigorously collected data set of antimicrobial use among patients receiving chronic hemodialysis, antimicrobial use was calculated using 3 different methodologies: daily defined dose, days of therapy, and start–stop days. Estimates of antimicrobial use varied by as much as 10-fold, depending on the type of antimicrobial.

Infect Control Hosp Epidemiol 2017;38:360–363

We assessed the appropriateness of initiating antibiotics in 49 nursing home (NH) residents receiving antibiotics for urinary tract infection (UTI) using 3 published algorithms. Overall, 16 residents (32%) received prophylaxis, and among the 33 receiving treatment, the percentage of appropriate use ranged from 15% to 45%. Opportunities exist for improving UTI antibiotic prescribing in NH.

Infect Control Hosp Epidemiol 2017;38:998–1001

Annual surveillance data (2007–2015), collected continuously in 132 German hospitals, was evaluated for development of alcohol-based hand-rub consumption (AHC) as a surrogate parameter for hand hygiene adherence. Overall, the median increase in AHC was 94%. The increases over 9 years were significant in all units and quartiles of AHC at baseline.

Infect Control Hosp Epidemiol 2017;38:870–872

Application of the new 2015 NHSN definition of catheter-associated urinary tract infection (CAUTI) in intensive care units reduced CAUTI rates by ~50%, primarily due to exclusion of candiduria. This significant reduction in CAUTI rates resulting from the changes in the definition must be considered when evaluating effectiveness of CAUTI prevention programs.

Infect Control Hosp Epidemiol 2017;38:239–241

Healthcare-associated infection reporting validation is essential because this information is increasingly used in public healthcare quality assurances and care reimbursement. Washington State’s validation of central line-associated bloodstream infection reporting applies credible quality sciences methods to ensure that hospital reporting accuracy is maintained. This paper details findings and costs from our experience.

Infect Control Hosp Epidemiol 2017;38:489–492

More than 90% of Thai hospitals surveyed reported implementing environmental cleaning and disinfection (ECD) protocols. Hospital epidemiologist presence was associated with the existence of an ECD checklist (P=.01) and of ECD auditing (P=.001), while good and excellent hospital administrative support were associated with better adherence to ECD protocols (P<.001) and ECD checklists (P=.005).

Infect Control Hosp Epidemiol 2017;38:1250–1253

Peer comparison has potential as an effective antimicrobial stewardship intervention in the inpatient setting. We report a new metric, days of therapy per 100 service days, for comparing antibiotic utilization. Among 14 prescribers on the primary infectious diseases service during a 6-month period, we identified 1 outlier for each anti-MRSA agent.

Infect Control Hosp Epidemiol 2017;38:1506–1508

A nonrandomized, retrospective comparison of Staphylococcus aureus bacteremia between an academic hospital setting (n=53) and a community hospital setting (n=245) within a single healthcare system was performed. Despite infectious disease consultations, S. aureus bacteremia management recommendations based on Infectious Diseases Society of America (IDSA) guidelines were not followed as closely in the community hospital setting. The community hospital setting requires management standardization for patients with S. aureus bacteremia.

Infect Control Hosp Epidemiol 2017;38:740–742

An ethanol-based spray disinfectant significantly reduced bacteriophage MS2 contamination on material from gowns meeting ASTM standard 1671 for resistance to blood and viral penetration and on a cover gown worn by personnel. Effectiveness of disinfection was affected by the type of gown material and the correctness of fit.

Infect Control Hosp Epidemiol 2017;38:364–366

Given steam-quality challenges at our facility, the financial impact of options for reopening the sterile processing service unit were explored; duration of closure was the major driver of costs. Other potential negative effects of operating-room shutdowns include injury to facility reputation, loss of staff, loss of reimbursements, and harm to residency programs.

Infect Control Hosp Epidemiol 2017;38:1002–1004

The impact of computerized order-entry bundles on timing of contact precaution initiation for C. difficile infection (CDI) remains largely unexplored. Implementation of an electronic CDI prevention and management bundle that included an automatic isolation component significantly reduced time to initiation of contact precautions from 33.7 to 22.4 hours.

Infect Control Hosp Epidemiol 2016;242–244

Occupancy has been associated with risk for healthcare-associated infections, yet its definition varies widely. Occupancy can be modeled as a function of census, acuity of the patient care unit, staffing ratio, or some combination. This article discusses the appropriate parameterization of these measures and how to interpret their impact.

Infect Control Hosp Epidemiol 2016:1–3

Most recent infection outbreaks caused by unsafe injection practices in the United States have occurred in ambulatory settings. We utilized direct observation and a survey to assess injection practices at 31 clinics. Improper vial use was observed at 13 clinics (41.9%). Pharmacy support and healthcare worker education may improve injection practices.

Infect Control Hosp Epidemiol 2017;38:614–616

Hospital use of chlorhexidine (CHX) containing antiseptics to decrease nosocomial infections may promote CHX resistance among pathogenic organisms. Nosocomial bloodstream-infecting Staphylococcus aureus isolates from before and after adoption of hospital-wide CHX bathing were tested for CHX susceptibility, and no decreased susceptibility or resistance-promoting genes were discovered.

Infect Control Hosp Epidemiol 2017;38:873–875