Reducing central line-associated bloodstream infections (CLABSI) by improved identification of primary infection sites through preliminary blood culture notifications.

Central line-associated bloodstream infections (CLABSI) pose a significant patient risk. To address incorrect classifications of infectious events as CLABSI, the surveillance process was changed from using finalized blood culture to preliminary blood culture results as trigger of timely, in-depth reviews. This improved the detection of true CLABSI events.

Detection of Environmental Spread of SARS-CoV-2 and Associated Patient Characteristics.

Understanding transmission of severe acute respiratory syndrome coronavirus 2 informs infection prevention practices. Air sampling devices were placed in patient hospital rooms for consecutive collections with and without masks. With patient mask use, no virus was detected in the room.

Removal of SARS-CoV-2 bioaerosols using ultraviolet air filtration.

Engineering controls play an important role in reducing the spread of severe acute respiratory coronavirus virus 2 (SARS-CoV-2).1 Established technologies such as air filtration, and novel approaches such as ultraviolet (UV)-C light or plasma air ionization, have the potential to support the fight against the coronavirus disease 2019 (COVID-19) pandemic.2 We tested the efficacy of an air purification system (APS) combining UV-C light and high-efficiency particulate air (HEPA) filtration in a controlled environment using SARS-CoV-2 as test organism.

Coronavirus disease 2019 (COVID-19) research agenda for healthcare epidemiology.

This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials.

Successful control of a methicillin-resistant Staphylococcus aureus outbreak in a burn intensive care unit by addition of universal decolonization with intranasal mupirocin to basic infection prevention measures.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is frequently implicated in health care-associated outbreaks in burn intensive care units, incurring substantial morbidity and mortality to these high-risk patients and excess costs to health care systems.

Methods: MRSA health care-associated infections (HAIs) were noted before and after the implementation of basic infection prevention measures and the subsequent implementation of universal decolonization with intranasal mupirocin. Pulsed-field gel electrophoresis was used to determine the relatedness of clinical isolates.

How well do N95 respirators protect healthcare providers against aerosolized influenza virus?

N95 respirator masks are recommended for protection against respiratory viruses. Despite passing fit-testing 10% of N95 respirator users encountered breakthroughs with exposure to influenza virus compared to full protection provided by a powered air purifying respirator. The current recommendation of N95 respirators should be evaluated for endemic and emerging scenarios.

Detection of Measles Virus RNA in Air and Surface Specimens in a Hospital Setting.

Measles virus (MeV) is known to be highly contagious, with an infectious period lasting from 4 days before to 4 days after rash onset. An unvaccinated, young, female patient with measles confirmed by direct epidemiologic link was hospitalized on day 5 after rash onset. Environmental samples were collected over the 4-day period of hospitalization in a single room.

Infrequent air contamination with Acinetobacter baumannii of air surrounding known colonized or infected patients.

Using a validated air sampling method we found Acinetobacter baumannii in the air surrounding only 1 of 12 patients known to be colonized or infected with A. baumannii. Patients' closed-circuit ventilator status, frequent air exchanges in patient rooms, and short sampling time may have contributed to this low burden.

Heat index in migrant farmworker housing: implications for rest and recovery from work-related heat stress.

Although the health risk to farmworkers of working in hot conditions is recognized, potential for excessive heat exposure in housing affecting rest and recovery has been ignored. We assessed heat index in common and sleeping rooms in 170 North Carolina farmworker camps across a summer and examined associations with time of summer and air conditioning use. We recorded dangerous heat indexes in most rooms, regardless of time or air conditioning.

Exposure to influenza virus aerosols during routine patient care.

Background: Defining dispersal of influenza virus via aerosol is essential for the development of prevention measures.

Methods: During the 2010-2011 influenza season, subjects with influenza-like illness were enrolled in an emergency department and throughout a tertiary care hospital, nasopharyngeal swab specimens were obtained, and symptom severity, treatment, and medical history were recorded. Quantitative impaction air samples were taken not ≤0.

Cooking and eating facilities in migrant farmworker housing in North Carolina.

Objectives: We sought to (1) describe observed cooking and eating facilities in migrant farmworker camps, (2) compare observed conditions with existing farmworker housing regulations, and (3) examine associations of violations with camp characteristics.

Methods: We collected data in 182 farmworker camps in eastern North Carolina during the 2010 agricultural season. We compared our observations with 15 kitchen-related housing regulations specified by federal and state housing standards.

The quality of drinking water in North Carolina farmworker camps.

Objectives: The purpose of this study was to assess water quality in migrant farmworker camps in North Carolina and determine associations of water quality with migrant farmworker housing characteristics.

Methods: We collected data from 181 farmworker camps in eastern North Carolina during the 2010 agricultural season. Water samples were tested using the Total Coliform Rule (TCR) and housing characteristics were assessed using North Carolina Department of Labor standards.

Safety, security, hygiene and privacy in migrant farmworker housing.

Safety, security, hygiene, and privacy in migrant farmworker housing have not previously been documented, yet these attributes are important for farmworker quality of life and dignity. This analysis describes the safety, security, hygiene, and privacy of migrant farmworker housing and delineates camp characteristics that are associated with these attributes, using data collected in 183 eastern North Carolina migrant farmworker camps in 2010. Migrant farmworker housing is deficient.

Migrant farmworker housing regulation violations in North Carolina.

Background: The quality of housing provided to migrant farmworkers is often criticized, but few studies have investigated these housing conditions. This analysis examines housing regulation violations experienced by migrant farmworkers in North Carolina, and the associations of camp characteristics with the presence of housing violations.

Methods: Data were collected in183 eastern North Carolina migrant farmworker camps in 2010.

Transocular entry of seasonal influenza-attenuated virus aerosols and the efficacy of n95 respirators, surgical masks, and eye protection in humans.

Background: The efficacy of barrier precautions to prevent influenza transmission is unknown.

Methods: Twenty-eight participants were exposed to monodispersed live attenuated influenza vaccine (LAIV) particles (4.9 μm) in 6 groups: group 1, no precautions; group 2, ocular exposure only; group 3, surgical mask without eye protection; group 4, surgical mask with eye protection; group 5, fit-tested N95 respirator without eye protection; and group 6, fit-tested N95 respirator with eye protection.

HIV and sexually transmitted disease risk among male Hispanic/Latino migrant farmworkers in the Southeast: Findings from a pilot CBPR study.

Background: Little is known about the HIV and sexually transmitted disease (STD) risk behaviors of Hispanic/Latino farmworkers. This study was designed to describe risk factors for HIV and STD infection, explore personal characteristics associated with condom use, and evaluate the feasibility of collecting self-report and biomarker data from farmworkers.

Methods: Self-report and biomarker data were collected from a sample of male farmworkers living in 29 camps in North Carolina during the 2008 growing season.

Transmission route of rhinovirus type 39 in a monodispersed airborne aerosol.

The common cold affects millions of people. Unfortunately, it remains unknown whether cold viruses enter the respiratory tract only through the nose and mouth or whether they can also enter through the tear ducts. Transocular exposure to an airborne infectious dose of human rhinovirus did not lead to infection.

Preventing the airborne spread of Staphylococcus aureus by persons with the common cold: effect of surgical scrubs, gowns, and masks.

Objective: Transmission of Staphylococcus aureus via air may play an important role in healthcare settings. This study investigates the impact of barrier precautions on the spread of airborne S. aureus by volunteers with experimentally induced rhinovirus infection (ie, the common cold).

"Gesundheit!" sneezing, common colds, allergies, and Staphylococcus aureus dispersion.

Background: Staphylococcus aureus is among the most important pathogens in today's hospital setting.

Methods: The effects of sneezing on the airborne dispersal of S. aureus and other bacteria were assessed in 11 healthy nasal S.

Dispersal of Staphylococcus aureus into the air associated with a rhinovirus infection.

Objective: To determine whether healthy adult nasal carriers of Staphylococcus aureus can disperse S. aureus into the air after rhinovirus infection.

Design: We investigated the "cloud" phenomenon among adult nasal carriers of S.

Airborne dispersal as a novel transmission route of coagulase-negative staphylococci: interaction between coagulase-negative staphylococci and rhinovirus infection.

Objective: To investigate whether rhinovirus infection leads to increased airborne dispersal of coagulase-negative staphylococci (CoNS).

Design: Prospective nonrandomized intervention trial.

Setting: Wake Forest University School of Medicine, Winston-Salem, North Carolina.