Dentist Infection Control

Infection Control Consulting Services Blog


Ebola Claims More Than 25 Lives in Congo; Vaccination Campaign Underway

An outbreak of Ebola has now claimed the lives of 27 people in the Democratic Republic of the Congo, according to the latest figures released by the World Health Organization (WHO).

As of May 21, there were 58 total likely cases of Ebola: 28 confirmed (which includes the 27 deaths), 21 probable and nine suspected.

In an effort to control the outbreak, high-risk populations are receiving an experimental "ring vaccination." As the WHO reported, more than 7,500 doses of the rVSV-ZEBOV Ebola vaccine have been deployed to the northwestern Equator Province of the Congo.

As an ABC News report notes, ring vaccination is an approach used to control smallpox in the 1970s. The first batch of vaccines will go to healthcare workers caring for infected patients, followed by people who know someone with an infection. The vaccine will then go to individuals who know those people, continuing outward in this "ring" fashion.

The vaccine was demonstrated to be highly protective against Ebola in a major trial in 2015 in Guinea. More than 5,800 people who came into contact with patients who had confirmed cases of Ebola received the vaccine. No Ebola cases were recorded nine days or more after vaccination. The rVSV-ZEBOV vaccine is awaiting review by regulatory authorities.

In 2014, an Ebola outbreak in West Africa ended with more than 28,600 cases and 11,325 deaths, according to the Centers for Disease Control and Prevention (CDC).


Hospital Reduces Hysterectomy SSIs With Prevention Bundle

A Connecticut hospital significantly decreased surgical site infections associated with hysterectomies through the use of a multi-step prevention bundle, according to a study published in Obstetrics & Gynecology and Medscape report on the research.

The bundle included the following components:
  • chlorhexidine-impregnated preoperative wipes provided to patients;
  • standardized aseptic surgical preparation of the abdomen, vagina, and perineum;
  • standardized antibiotic dosing before and during surgery;
  • maintenance of intraoperative normothermia;
  • surgical dressing maintenance 24 to 48 hours postoperatively; and
  • provision of direct feedback from peers to physicians and other staff when the protocol was breached.
Hospital staff received education about the bundle prior to its implementation.

During the 33-month study period, Yale New Haven Hospital in New Haven, Conn., performed 2,099 hysterectomies. There were 61 SSIs (4.51%) prior to implementation of the full bundle and 14 SSIs (1.87%) following implementation of the full bundle.

According to the Medscape report, the authors concluded the following: "Although additional analyses are needed to further elucidate the relationships among adherence rates, specific bundle components, hysterectomy routes, length of hospital stay and [SSI] reduction and overall surgical costs, we believe that a multidisciplinary, gynecology-specific approach to implementation and maintenance of the SSI prevention bundle serves patients well and will become a mainstay of gynecologic surgical care."


CDC: With "Nightmare Bacteria" on the Rise, Labs Vital to Containment

In a recent report, the Centers for Disease Control and Prevention (CDC) highlighted the critical role labs and laboratory professionals play in protecting the population from antibiotic resistance (AR).

Laboratorians, CDC notes, play a key role in finding "unusual" AR before it becomes common. This helps response teams investigate in an effort to stop spread and protect people from difficult-to-treat infections. More than 23,000 Americans die annually from infections caused by antibiotic-resistant germs.

A recent CDC Vital Signs report highlights the importance of rapid detection by laboratorians, the critical first step in containing novel or targeted multidrug-resistant organisms (MDROs).

Within this report is data from the CDC's AR Lab Network, a resource established in 2016 designed to help identify and characterize resistance in threats like "nightmare bacteria" carbapenem-resistant Enterobacteriaceae (CRE), emerging fungal threats like Candida auris and other pathogens.

The AR Lab Network helped uncover unusual resistance genes in nightmare bacteria more than 220 times in 2017.


Leapfrog: Poorer-Performing Hospitals Struggle with Infection Control

The Leapfrog Group recently announced its spring "2018 Leapfrog Hospital Safety Grades." One of the key takeaways: Infection control is a significant challenge for hospitals receiving lower scores.

There were approximately 2,500 hospitals receiving grades in the latest version of the report. Of these, 30% earned an "A" grade, 28% a "B," 35% a "C," 6% a "D" and 1% an "F."

As a FierceHealthcare report notes, of the more than 1,000 hospitals receiving a "C" grade or worse, infection control is a "top pain point."

The report says Leapfrog CEO Leah Binder told FierceHealthcare that while each of the low-graded hospitals face their own specific challenges, some hospitals struggle consistently with meeting infection control measures outlined by the Centers for Medicare & Medicaid Services (CMS).

The Leapfrog Hospital Safety Grade is updated every six months — once in the fall and once in the spring.


Study: 20% Efficacy Predicted for 2018 Flu Vaccine

A new study predicts that the vaccine used to provide immunity against this fall's flu will have an efficacy around 20%.

This means that 20% fewer vaccinated people will get the flu compared to unvaccinated people. The efficacy rate is similar to that of the vaccine administered in 2016 and 2017.

This is despite the fact that the 2018 vaccine is a new H3N2 formulation for the first time since 2015. As one of the researchers noted in a news release, "The vaccine has been changed for 2018-19, but unfortunately it still contains two critical mutations that arise from the egg-based vaccine production process."

Most flu vaccines are produced by culturing viruses in chicken eggs. The researchers note that mutations which reduce the vaccine efficacy are unavoidable through the egg-based production process.

The study was conducted by Rice University, with its findings published in Clinical Infectious Diseases. Researchers used the pEpitope method to gauge the effectiveness of the new flu vaccine. The method calculates a measure of antigenic distance between two strains of influenza. The study demonstrated that the pEpitope method has accurately predicted flu vaccine efficacy rates for more than 40 years.


FDA Warns Against Use of 24-Hour Multi-Patient Use Endoscope Connectors

The U.S. Food & Drug Administration (FDA) has issued an alert to healthcare providers and facilities advising them against using "24-hour multi-patient use endoscope connectors" because of the risk of cross-contamination.

These are connectors labeled for use with multiple patients over the course of 24 hours without reprocessing. The FDA says it is recommending against their use because it has not received "acceptable testing to demonstrate the safe use of these products."

Endoscope connectors are accessories that attach the auxiliary water channel of flexible gastrointestinal endoscopes to a water source and irrigation tubing. The FDA recommends using connectors with features that prevent patient fluids from flowing backwards into endoscopes to reduce the risk of cross-contamination and infection between patients.

More specifically, FDA encourages providers to use single-use endoscope connectors with backflow prevention features or reusable endoscope connectors with backflow prevention features, and ensure reusable connectors are reprocessed according to their instructions.

The FDA noted that one manufacturer, Erbe USA, currently markets a 24-hour multi-patient use endoscope connector. Called the ERBEFLO port connector, the FDA stated the accessory does not include a backflow prevention feature.


Joint Commission: Infection Control Standard is "Most Challenging" for Office-Based Surgery Practices

For Joint Commission-accredited office-based surgery practices, no standard proved more difficult in 2017 than one concerning infection prevention and control, according to Ambulatory Buzz.

Standard IC.02.02.01 — The organization reduces the risk of infections associated with medical equipment, devices and supplies. — took the first spot on The Joint Commission's annual list of the top 10 challenging standards for office-based surgery practices. It had a reported 63% non-compliance. This standard saw an increase in non-compliance in 2017, up from 57% in 2016.

Also on the 2017 list: IC.02.01.01 — The organization implements infection prevention and control activities. The standard was fifth on the 2017 list, coming in at 27% non-compliance. It also saw an increase in non-compliance in 2017, up from 24% in 2016. On a positive note, two infection control standards on the 2016 list — IC.01.05.01 and IC.02.04.01 — did not appear in the 2017 list.

The standards compliance data used to put together the 2017 top 10 list for office-based surgery practices were derived from an average of 104 applicable surveys.

Note: Read about the top 10 challenging standards in 2017 for Joint Commission-accredited ambulatory healthcare organizations by clicking here.