National partnerships address critical needs in infection prevention and control.

The COVID-19 pandemic highlighted gaps in infection control knowledge and practice across health settings nationwide. The Centers for Disease Control and Prevention, with funding through the American Rescue Plan, developed Project Firstline. Project Firstline is a national collaborative aiming to reach all aspects of the health care frontline.

Exploration of the Current State of Peripheral Intravenous Catheter Complications and Documentation: A Point Prevalence Study.

Peripheral intravenous catheters (PIVCs) are the most commonly used invasive devices in acute care hospitals, with nurses being primarily responsible for the insertion and care of these devices. This point prevalence study aimed to describe current PIVC status and nursing documentation in a large, regional health care system and to explore variables associated with PIVC complications. The study was conducted with adult inpatients.

An electronic medical record-based intervention to improve hepatitis A vaccination rates in the emergency department during a regional outbreak.

Background: In response to the severe hepatitis A outbreak that occurred in Michigan between August 2016 and September 2019, our multihospital health system implemented an electronic medical record (EMR)-based vaccination intervention across its nine emergency departments (EDs). The objectives were to explore the impact of this intervention on increasing vaccination rates among high-risk individuals and to assess the barriers to use of a computerised vaccine reminder system.

Methods: All patients who were 18 years or older were screened using an electronic nursing questionnaire.

blood stream infection in severe COVID-19 pneumonia.

Severe coronavirus disease (COVID-19) associated pneumonia leads to acute respiratory distress syndrome and emerging data suggest fungal coinfections also contribute to mortality in this patient population. Aspergillus ventilator associated pneumonia is increasingly recognized. We describe a case of likely reactivation of community acquired in a patient with severe COVID-19.

Assessment of Testing and Treatment of Asymptomatic Bacteriuria Initiated in the Emergency Department.

Background: Reducing antibiotic use in patients with asymptomatic bacteriuria (ASB) has been inpatient focused. However, testing and treatment is often started in the emergency department (ED). Thus, for hospitalized patients with ASB, we sought to identify patterns of testing and treatment initiated by emergency medicine (EM) clinicians and the association of treatment with outcomes.

A Deeper Dive Into Antibiotic Stewardship Needs: A Multihospital Survey.

In a 2016 survey of 46 Michigan hospitals, we identified four key needs for antibiotic stewardship: clinically-relevant antibiotic data, monitoring compliance, syndrome-specific interventions, and discharge stewardship. A stewardship initiative now addresses these needs within the Michigan Hospital Medicine Safety Consortium.

Risk Factors and Outcomes Associated With Treatment of Asymptomatic Bacteriuria in Hospitalized Patients.

Importance: Treatment of asymptomatic bacteriuria (ASB) with antibiotics is a common factor in inappropriate antibiotic use, but risk factors and outcomes associated with treatment of ASB in hospitalized patients are not well defined.

Objective: To evaluate factors associated with treatment of ASB among hospitalized patients and the possible association between treatment and clinical outcomes.

Design, Setting, And Participants: A retrospective cohort study was conducted from January 1, 2016, through February 1, 2018, at 46 hospitals participating in the Michigan Hospital Medicine Safety Consortium.

Excess Antibiotic Treatment Duration and Adverse Events in Patients Hospitalized With Pneumonia: A Multihospital Cohort Study.

Background: Randomized trials demonstrate no benefit from antibiotic treatment exceeding the shortest effective duration.

Objective: To examine predictors and outcomes associated with excess duration of antibiotic treatment.

Design: Retrospective cohort study.

Improving PICC use and outcomes in hospitalised patients: an interrupted time series study using MAGIC criteria.

Background: Although important in clinical care, reports of inappropriate peripherally inserted central catheter (PICC) use are growing.

Objective: To test whether implementation of the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) can improve PICC use and patient outcomes.

Design: Quasi-experimental, interrupted time series design at one study site with nine contemporaneous external controls.

Predictors of Clostridium difficile infection-related mortality among older adults.

Background: Over 90% of annual deaths caused by Clostridium difficile infection (CDI) occur in persons aged ≥65 years. However, no large-scale studies have been conducted to investigate predictors of CDI-related mortality among older adults.

Methods: This case-control study included 540 CDI patients aged ≥60 years admitted to a tertiary care hospital in Detroit, Michigan, between January 2005 and December 2012.

Major variation in MICs of tigecycline in Gram-negative bacilli as a function of testing method.

Tigecycline is one of the few remaining therapeutic options for extensively drug-resistant (XDR) Gram-negative bacilli (GNB). MICs of tigecycline to Acinetobacter baumannii have been reported to be elevated when determined by the Etest compared to determinations by the broth microdilution (BMD) method. The study aim was to compare the susceptibility of GNB to tigecycline by four different testing methods.

Contact precautions: more is not necessarily better.

Objective: To determine whether increases in contact isolation precautions are associated with decreased adherence to isolation practices among healthcare workers (HCWs).

Design: Prospective cohort study from February 2009 to October 2009.

Setting: Eleven teaching hospitals.

Infectious complications after kidney transplantation: current epidemiology and associated risk factors.

Background: The impact of newer immunosuppressive and antimicrobial prophylactic agents on the pattern of infectious complications following kidney transplantation has not been well studied.

Methods: This is an observational study in 127 adult recipients transplanted from 2001 to 2004. Patients received thymoglobulin (ATG) (50%) or basiliximab (50%) for induction and were maintained on mycophenolate mofetil, either tacrolimus (73%) or sirolimus (SRL) (27%), and prednisone (79%).

Effect of promoter region mutations and mgrA overexpression on transcription of norA, which encodes a Staphylococcus aureus multidrug efflux transporter.

NorA is a Staphylococcus aureus multidrug transporter that confers resistance to structurally distinct compounds. The MgrA global regulatory protein is reported to augment norA expression when mgrA is overexpressed from an undefined plasmid-based promoter. Further details about norA regulatory mechanisms are scant.