Dentist Infection Control

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International Infection Prevention Week Puts Spotlight on Antibiotic Resistance

International Infection Prevention Week (IIPW) 2017 is underway, and this year's theme is antibiotic resistance.

With such a theme, IIPW represents an opportunity for healthcare providers to evaluate their efforts in developing an antimicrobial stewardship program.

IIPW, which takes place October 15-21, is also a week designed to further stress the importance of an infection prevention program that promotes patient and staff safety.

IIPW was established in 1986 by President Ronald Reagan.

For more information on IIPW and to access IIPW promotional tools and resources, visit the APIC website.

In conjunction with IIPW, the Centers for Disease Control and Prevention launched new Get Ahead of Sepsis materials help healthcare professionals and patients prevent infections that can lead to sepsis. These materials are as follows:
Sepsis is the body's extreme response to an infection, including those caused by drug-resistant bacteria.


Australia's Spike in Influenza Cases May Foreshadow Difficult U.S. Flu Season

A review of the "flu season" in Australia indicates it is suffering through one of its worst in recent years, according to a Today report." Health officials reported more than 168,000 influenza cases so far in 2017, compared to just under 91,000 in 2016 and 100,000 in 2015.

The reason for a severe flu season in the Southern Hemisphere may be two-fold: 1) There is an increase in the number of patients being tested as rapid testing has become convenient and provides an immediate conclusion, thereby separating the true flu cases from other viruses, and 2) The predominant flu strain — H2N3 — is known to be severe.

Experts say what is happening in Australia may foretell what is likely to happen in the United States.

"There is every reason to expect that we could have a severe flu season this year," said Dr. Robert Atmar, an infectious diseases expert at Baylor, in the report. "It's always hard to predict what is going to happen, but people should be prepared."

Unfortunately, one of the flu's primary characteristics is its unpredictability in terms of ability to mutate and render the flu shot less effective than initially expected. However, that should never deter people from being vaccinated as research has shown that some protection is better than none. Officials are urging everyone, including the most vulnerable (e.g., babies, elderly), to obtain a flu shot as there are additional protective advantages regardless of how effective it is this upcoming season.

The vaccine is readily available and suggested for people six months of age and older. The Flumist nasal spray vaccine is no longer available for children due to its ineffectiveness in the past.

Several types of intramuscular vaccines are available this year, including the trivalent (3-strains), quadrivalent (4 strains) and the high-dose trivalent (for people over the age of 65 who may not mount the best response with a lower dose vaccine).

The Centers for Disease Control and Prevention recommends that healthcare consumers speak with their healthcare provider about the most appropriate shot and should not wait until well into the season to receive the vaccine as it takes a few weeks for the development of antibodies.


WHO Report: World Crisis Developing Due to Lack of Antibiotics

A new report launched by the World Health Organization reveals a growing global challenge concerning antibiotics.

The report — titled "Antibacterial agents in clinical development – an analysis of the antibacterial clinical development pipeline, including tuberculosis" — indicates there is a significant lack of new antibiotics under development that can help combat the increasing threat posed by antimicrobial resistance.

Findings include the following:
  • Most drugs in the clinical pipeline are modifications of existing classes of antibiotics and represent short-term solutions.
  • There are few potential treatment options for antibiotic-resistant infections posing the greatest threat to health, including drug-resistant tuberculosis.
  • WHO identified 12 other classes of priority pathogens increasingly resistant to existing antibiotics.
  • Of the 51 new antibiotics and biologicals in clinical development to treat priority antibiotic-resistant pathogens, only eight are classed by WHO as innovative treatments that will add value to the current antibiotic treatment arsenal.
  • There is a great lack of treatment options for multidrug- and extensively drug-resistant M. tuberculosis and gram-negative pathogens (e.g., Acinetobacter, Enterobacteriaceae). These can cause severe infections that pose a specific threat in hospitals and long-term care facilities (e.g., nursing homes).
  • There are few oral antibiotics in development.
"Antimicrobial resistance is a global health emergency that will seriously jeopardize progress in modern medicine," says Dr. Tedros Adhanom Ghebreyesus, director-general of WHO, in a news release. "There is an urgent need for more investment in research and development for antibiotic-resistant infections including tuberculosis, otherwise we will be forced back to a time when people feared common infections and risked their lives from minor surgery.

The U.S. government and private organizations require healthcare facilities to develop and maintain antimicrobial stewardship (AMS) programs. This includes, but is not limited, to the Centers for Medicare & Medicaid Services (CMS) and The Joint Commission (TJC).

Antimicrobial stewardship programs include a multi-disciplinary approach that promotes the appropriate use of medications, including antibiotics, to fight infections. The goal of these programs is multi-factorial and includes the reduction of drug resistance amongst microbes, improving patient outcomes (less morbidity and mortality associated with injudicious use of antimicrobials) and an attempt to decrease the risk of transmission of infection caused by multidrug-resistant organisms. 

Infection Control Consulting Services (ICCS) provides assistance with development and implementation of AMS programs for various settings, including nursing homes, hospitals and surgery centers. To learn more, visit the ICCS website.


Campylobacter Infections in People Linked to Puppies

The Centers for Disease Control and Prevention (CDC), along with other agencies, is investigating a multistate outbreak of human Campylobacter infections.

The infections are linked to puppies sold through a national pet store chain.

The outbreak includes 39 people with laboratory-confirmed Campylobacter infections or symptoms consistent with Campylobacter infection. They live in seven states — Florida, Kansas, Missouri, Ohio, Pennsylvania, Tennessee and Wisconsin — and were exposed to puppies sold through the chain. Campylobacter can spread through contact with dog feces.

Most people who become ill with campylobacteriosis, the infectious disease caused by bacteria of the genus Campylobacter, get diarrhea, cramping, abdominal pain and fever within two to five days after exposure to the organism. The illness typically lasts about one week. Some infected persons do not have any symptoms.

In persons with compromised immune systems, Campylobacter occasionally spreads to the bloodstream and can cause a life-threatening infection.

For assistance with developing and implementing effective infection prevention policies and procedures, contact Infection Control Consulting Services (ICCS). ICCS is a nationally renowned firm providing veterinary infection prevention services and such services to other types of organizations, including surgery centers, hospitals and medical groups.


Study: Failure of Nursing Home Workers to Change Gloves Increases Infection Risks

A new study shows that when workers in nursing homes fail to change gloves appropriately, harmful pathogens can easily be spread to patients, potentially leading to healthcare-associated infections (HAIs).

The study, titled "Exploring inappropriate certified nursing assistant glove use in long-term care," is published in the September issue of the American Journal of Infection Control, the journal of the Association for Professionals in Infection Control and Epidemiology (APIC).

A researcher examined the degree of inappropriate glove use in a random sample of 74 certified nursing assistants (CNAs) performing toileting and perineal care at a long-term care facility (LTCF). She observed frequent "inappropriate glove use," defined as a failure to change gloves and when surfaces were touched with contaminated gloves.

As the Centers for Disease Control and Prevention (CDC) notes, 1 to 3 million serious infections occur every year in nursing homes, skilled nursing facilities and assisted living facilities, collectively known as LTCFs. Infections include urinary tract infection, diarrheal diseases, antibiotic-resistant staph infections and many others. As many as 380,000 people die of the infections in LTCFs every year.

"Gloves are an essential component of standard precautions, and proper use of gloves is a critical component of best practices to prevent HAIs," said Linda Greene, RN, MPS, CIC, FAPIC, 2017 APIC president, in a news release. "This is especially important in long-term care, where residents are more vulnerable to infection and stay for extended periods. Facilities must continually educate healthcare providers about the importance of appropriate glove use to prevent infection and monitor adherence to this practice."

Recommendations from the Food & Drug Administration (FDA) on when to use medical gloves and what you should know before using medical gloves include the following:
  • Use medical gloves when your hands may touch someone else's body fluids (e.g., blood, respiratory secretions, vomit, urine, feces), certain hazardous drugs or some potentially contaminated items.
  • Wash your hands before putting on sterile gloves.
  • Make sure your gloves fit properly for you to wear them comfortably during all patient care activities.
  • Be aware that sharp objects can puncture medical gloves.
  • Change your gloves if they rip or tear.
  • After removing gloves, wash your hands thoroughly with soap and water or alcohol-based hand rub.
  • Never reuse medical gloves.
  • Never wash or disinfect medical gloves.
  • Never share medical gloves with other users.
Infection Control Consulting Services (ICCS) is a leading provider of nursing home infection control consulting services and has been providing written infection control programs and services to LTCFs since 2005. If you are in need of a LTCF infection control expert, please contact ICCS today.


American Dental Association Issues Statement on Infection Control

The American Dental Association (ADA) has issued a statement concerning infection control in dental settings.

Topics highlighted in the statement include the following:
  • Requirements for practicing dentists, dental team members and dental laboratories, including using standard precautions described in the Center for Disease Control and Prevention's (CDC) Guidelines for Infection Control in Dental Health Care-Settings and following Occupational Safety and Health Administration (OSHA) procedures.
  • Example of dental infection control practices, including use of personal protective equipment, disinfectants, sterilizing reusable dental devices and hand hygiene.
  • Proper room cleaning and decontamination practices between patients.
  • Rules concerning re-use of non-disposable and disposable items.
Dental infection prevention and control are under close scrutiny, as was discussed in a Special Report from Infection Control Consulting Services (ICCS) on dental infection outbreaks.

Earlier in the year, CDC's Division of Oral Health contributed an article to Medscape discussing the prevention of disease transmission in dental settings. The column offered dental disease transmission prevention on topics that include administering of local anesthesia, use of multi-dose vials, cleaning and heat-sterilizing of handpieces, sterilizer monitoring and water standards.

Need assistance with your dental infection control program? Contact ICCS, a leading national provider of infection control and prevention services for dental offices and oral surgery centers.


Study: Antimicrobial Scrubs Do Not Prevent Contamination

A new study shows that wearing scrubs with antimicrobial properties is ineffective at preventing bacterial contamination.

For the study, Duke University Hospital researchers followed 40 nurses wearing three different types of scrubs — 1) traditional cotton-polyester scrubs; 2) scrubs with embedded silver-alloy; and 3) scrub treated with a combination of antibacterial materials — over three consecutive shifts. Researchers took a series of cultures from each nurse, the healthcare environment, and patients during each shift.

Analyses of nearly 3,000 cultures from the environment (bed rails, beds and supply carts in each room) and nearly 2,200 from the nurses' scrubs (sleeve, abdomen and pocket) revealed that scrub type was not associated with a change in clothing contamination.

The study is titled "The Antimicrobial Scrub Contamination and Transmission (ASCOT) Trial: A Three-Arm, Blinded, Randomized Controlled Trial With Crossover Design to Determine the Efficacy of Antimicrobial-Impregnated Scrubs in Preventing Healthcare Provider Contamination." It appeared in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA).

"There is no such thing as a sterile environment," said Deverick Anderson, MD, MPH, director of the Center for Antimicrobial Stewardship and Infection Prevention at Duke University Medical Center and lead author of the study, according to a SHEA news release. "Bacteria and pathogens will always be in the environment. Hospitals need to create and use protocols for improved cleaning of the healthcare environment, and patients and family members should feel empowered to ask healthcare providers if they are doing everything they can to keep their loved one from being exposed to bacteria in the environment."

The authors offered the following key takeaways from the study:
  • Scrubs were likely ineffective at reducing pathogens because of low-level disinfectant capabilities of the textiles and repeated exposure in a short timeframe.
  • Antimicrobial-impregnated textiles might be effective if used in bed linens and patient gowns.
  • Diligent hand hygiene is recommended following all patient room entries and exits.
  • When appropriate, use of gowns and gloves is recommended to reduce risk of clothing contamination, even if no direct patient care is performed.
Infection Control Consulting Services urges facilities to empower their clinical staff to follow nationally recognized guidelines and standards. These include the Centers for Disease Control and Prevention's (CDC) 2007 "Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings." Within the guideline is a section relating to standard precautions which highlights the need to protect clothing when encountering or anticipating encountering blood and body fluids or other sources that could potentially contaminate healthcare workers' clothing.