Reduced Clostridioides difficile infection in a pragmatic stepped-wedge initiative using admission surveillance to detect colonization.

Background: Clostridioides difficile Infection (CDI) is a persistent healthcare issue. In the US, CDI is the most common infectious cause of hospital-onset (HO) diarrhea.

Objective: Assess the impact of admission testing for toxigenic C.

Multidrug-resistant organisms contaminating supply carts of contact isolation patients.

Contamination of supply carts stored within rooms of patients on contact isolation for multidrug-resistant organisms was assessed. Despite the presence of environmentally persistent organisms, very little contamination occurred to these carts or the supplies stored within them. A single isolate containing a multidrug-resistant Acinetobacter baumannii was isolated, representing 1.

Significant impact of terminal room cleaning with bleach on reducing nosocomial Clostridium difficile.

Background: We were alerted to increased rates of Clostridium difficile-positive tests at all 3 hospitals in our health care system by MedMined Data Mining Surveillance Service, CareFusion (San Diego, CA). In response, an intervention of terminal room cleaning with dilute bleach was instituted to decrease the amount of C difficile environmental spore contamination from patients with C difficile infection (CDI).

Methods: The intervention consisted of replacing quaternary ammonium compound as a room cleaning agent with dilute bleach to disinfect rooms of patients with CDI upon discharge.

The electronic medical record as a tool for infection surveillance: successful automation of device-days.

Background: Manual collection of central venous catheter, ventilator, and indwelling urinary catheter device-days is time-consuming, often restricted to intensive care units (ICU) and prone to error.

Methods: We describe the use of an electronic medical record to extract existing clinical documentation of invasive devices. This allowed automated device-days calculations for device-associated infection surveillance in an acute care setting.

A laboratory-based, hospital-wide, electronic marker for nosocomial infection: the future of infection control surveillance?

Faced with expectations to improve patient safety and contain costs, the US health care system is under increasing pressure to comprehensively and objectively account for nosocomial infections. Widely accepted nosocomial infection surveillance methods, however, are limited in scope, not sensitive, and applied inconsistently. In 907 inpatient admissions to Evanston Northwestern Healthcare hospitals (Evanston, IL), nosocomial infection identification by the Nosocomial Infection Marker (MedMined, Birmingham, AL), an electronic, laboratory-based marker, was compared with hospital-wide nosocomial infection detection by medical records review and established nosocomial infection detection methods.

Management of outbreaks of methicillin-resistant Staphylococcus aureus infection in the neonatal intensive care unit: a consensus statement.

Objective: In 2002, the Chicago Department of Public Health (CDPH; Chicago, Illinois) convened the Chicago-Area Neonatal MRSA Working Group (CANMWG) to discuss and compare approaches aimed at control of methicillin-resistant Staphylococcus aureus (MRSA) in neonatal intensive care units (NICUs). To better understand these issues on a regional level, the CDPH and the Evanston Department of Health and Human Services (EDHHS; Evanston, Illinois) began an investigation.

Design: Survey to collect demographic, clinical, microbiologic, and epidemiologic data on individual cases and clusters of MRSA infection; an additional survey collected data on infection control practices.

Direct detection of Staphylococcus aureus from adult and neonate nasal swab specimens using real-time polymerase chain reaction.

Nasal carriage of Staphylococcus aureus is considered a source of subsequent infection in health care settings. Utilization of real-time polymerase chain reaction (PCR) for detection of S. aureus has the potential to dramatically affect infection control practice by rapidly identifying S.

Microbiologic surveillance using nasal cultures alone is sufficient for detection of methicillin-resistant Staphylococcus aureus isolates in neonates.

During an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in the neonatal intensive care units at two hospitals, we assessed several sites for detection of MRSA colonization. Nasal cultures found 32 of 33 MRSA-colonized patients (97%). Rectal cultures detected 29% of 24 MRSA-colonized patients identified by paired rectal and nasal samples and axillary samples found 22% of 9 MRSA-colonized patients identified by axillary samples paired with nasal swabs.