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Infection Prevention eBug Bytes December 2015


Clostridium difficile Infection Prevention eBug Bytes December 2015 – PowerPoint PPT presentation

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Title: Infection Prevention eBug Bytes December 2015

Infection PreventioneBug BytesDecember 2015
Clostridium difficile
Harmful Bacteria Can Survive in Sandwich
Crackers, Cookies for Months
  • Researchers at the University of Georgia found
    that pathogens, like salmonella, can survive for
    at least six months in cookies and crackers. The
    recent study was prompted by an increased number
    of outbreaks of foodborne diseases linked to
    low-water-activity, or dry, foods. Researchers
    found that not only can harmful bacteria survive
    in dry foods, like cookie and cracker sandwiches,
    but they can also live for long periods of time.
    For the recent study, published in the Journal of
    Food Protection, researchers used five different
    serotypes of salmonella that had been isolated
    from foods involved in previous foodborne
  • Focusing on cookie and cracker sandwiches, the
    researchers put the salmonella into four types of
    fillings found in cookies or crackers and placed
    them into storage. The researchers used cheese
    and peanut butter fillings for the cracker
    sandwiches and chocolate and vanilla fillings for
    the cookie sandwiches. These "are the kind that
    we find in grocery stores or vending machines,"
    After storing, the UGA scientists determined how
    long salmonella was able to survive in each
    filling. There was survival in all types but
    salmonella survived longer in some types of the
    fillings than in others. The salmonella didn't
    survive as well in the cracker sandwiches as it
    did in the cookie sandwiches. In some cases, the
    pathogen was able to survive for at least to six
    months in the sandwiches. http//www.?ncbi.?nlm.?n

Drug-resistant bacteria carried by nursing home
patients focus of study
  • Miriam Hospital study found that a small
    percentage of nursing home patients carrying
    multi drug-resistant bacteria are admitted to
    hospitals without showing symptoms caused by the
  • The research, published in the American Journal
    of Infection Control, highlights the importance
    of hospital and nursing home infection control
    practices. Controlling the spread of such
    bacteria is paramount since infections caused by
    these microorganisms are associated with
    increased morbidity, mortality and cost. Mermel
    and colleagues documented patients admitted to
    Rhode Island Hospital and The Miriam Hospital
    from area nursing homes in 2012. They screened
    these patients for the presence of
    carbapenem-resistant Enterobacteriaceae (CRE)
    since there is little data in the medical
    literature regarding how prevalent these
    drug-resistant bacteria are among asymptomatic
    nursing home patients at the time of admission to
  • The researchers identified highly resistant
    bacteria in 23 of the 500 acute care hospital
    admissions from the nursing homes, seven of these
    were carbapenem-resistant Enterobacteriaceae.
    They found that the use of a feeding tube was
    associated with gastrointestinal carriage of
    these bacteria.
  • Source Screening of nursing home residents for
    colonization with carbapenem-resistant
    Enterobacteriaceae admitted to acute care
    hospitals Incidence and risk factors. American
    Journal of Infection Control Dec (2015)

Rigid containers allowed bacterial contamination,
while wrapped instrument trays tested had no
detectable contamination
  • According to a new scientific study published in
    the December publication of the American Journal
    of Infection Control, 87 percent of tested
    sterilized rigid containers - used in the
    sterilization of surgical instruments - allowed
    ingress of aerosolized bacteria under the test
    conditions used. This study calls into question
    the assumption that rigid containers, regardless
    of duration of use, can maintain the sterility of
    their contents post-sterilization. The two
    primary types of sterile packaging systems (SPS)
    include rigid containers and sterilization wrap.
    Rigid containers are reusable and come in a
    variety of materials (various metals, aluminum
    and polymers) and sizes, while single-use
    sterilization wrap is often composed of
    polypropylene. The study used a dynamic aerosol
    test method that allowed for air exchanges to
    occur in SPSs that may simulate normal air
    exchanges in hospital settings. The study found
    that  1) Rigid containers, both used and unused,
    failed to maintain barrier performance under
    these test conditions 87 percent (97 out of 111)
    of the rigid containers failed to maintain
    barrier performance, allowing ingress of the
    challenge microorganism. 2) Rigid containers with
    5-9 years of use were significantly more likely
    to have bacterial ingress than unused rigid
    container. 3) Sterilization wraps provided no
    detectable ingress of bacteria 100 percent (161
    out of 161) of the wrapped trays using
    sterilization wrap maintained barrier
    performance, preventing any bacterial ingress and
    protecting sterility.

    Source Sterility
    Maintenance Study Dynamic Evaluation of
    Sterilized Rigid Containers and Wrapped
    Instrument Trays to Prevent Bacterial Ingress
    AJIC Dec 15

Nurse with TB may have exposed over
1,000 people, including 350 infants at
Santa Clara Valley Medical Center
As many as 350 infants, 308 employees and 368
parents may have been exposed to tuberculosis
after a San Jose, Calif-based Santa Clara Valley
Medical Center maternity wing nurse was diagnosed
with the disease, according to a news release
from the hospital. "While it is very unlikely
that infants who may have been exposed will come
down with the disease, the consequences of
infection in infants can be serious," the news
release reads. "SCVMC will provide both
diagnostic testing and preventative daily
treatments of isoniazid, an antibiotic that kills
tuberculosis and can successfully prevent infants
from becoming ill. The 350 infants that may have
been exposed will be monitored closely for signs
of active tuberculosis. Moms and employees who
may have been exposed will be screened and
provided preventative treatment if needed. The
hospital was notified mid-November that the nurse
was suspected of having active tuberculosis, and
the employee was placed on leave at that time.The
patients the hospital is notifying of possible
exposure are those who were in SCVMC's Mother
Infant Care Center between mid-August and
mid-November of this year. The bacteria is
contracted through the air, but only active
strains are able to spread. Source
Shingles isn't just nasty. It could kill you,
  • Shingles isn't just a nasty and extremely painful
    experience. It can also cause strokes and heart
    attacks. Researchers found elderly people who
    suffered a bout of the excruciating blisters were
    more than twice as likely to have a stroke in the
    first week after an attack started, and nearly
    twice as likely to have a heart attack. Shingles,
    also called herpes zoster, is a souvenir of
    childhood chicken pox infection. Both are caused
    by the same virus, although it's called varicella
    when it causes chicken pox. Like all herpes
    viruses, it stays in the body forever, moving
    along the nerves. Usually the immune system can
    control it after the first outbreak of chicken
    pox, but as people get older, or if they get
    cancer or another condition that depresses the
    immune system, it can erupt in a band of
    blisters. Unlike itchy chicken pox, shingles can
    cause months of pain after the blisters heal.
    Researchers from the London School of Hygiene and
    Tropical Medicine looked at the medical records
    of more than 67,000 U.S. Medicare patients who
    had shingles and suffered either a stroke or
    heart attack within a year afterwards. There are
    two possible causes, they said. The virus may be
    replicating inside the walls of the arteries,
    causing fatty buildups to break off and cause a
    stroke or heart attack. Or it might be the risks,
    the researchers said.

Wipes in the pipes 'Flushable' wipes causing
major plumbing problems
  • Holland, Mich. Dont flush those wipes! Waste
    water officials are warning consumers that
    flushable wipes arent so flushable. Tissues,
    paper towels and flushable wipes all remain
    intact to one degree or another and can clog up
    home drains and sewer lift stations, pumps and
    other areas down the line.
  • Over the past five to 10 years, the Holland Board
    of Public Works has seen an increase in
    maintenance at its lift stations as a direct
    result of wipes binding up the works, according
    to Waste Water Treatment Plant Superintendent
    Joel Davenport. Three years ago, the municipal
    utility replaced its headworks facility at a cost
    of 5.3 million. The headworks sifts out large
    pieces of debris such as wipes. In the past two
    fiscal years, the headworks has removed about 450
    tons (900,000 pounds) of material. Pumps
    partially plugged will continue to run, but are
    much less efficient, according to BPW documents.
    This requires them to run longer and increases
    the wear on the equipment. Toilet paper disperses
    after about 20 seconds, while wet wipes remained
    intact after 24 hours, according to a 2012
    experiment by the Orange County California
    Sanitation District.
  • Flushable has no legal definition, and the
    Federal Trade Commission does not regulate what
    products can carry the label. Both the wipes
    industry and utilities organizations are working
    to establish standards.
  • Anything made of paper or cloth, the BPW terms
    rags. Paper towels, flushable wipes, even
    diapers and cloth towels are found in the sewer,
    Davenport said.
  • I dont think most people realize toilet paper
    is designed so that as soon as you flush, its
    gone, Davenport said. The more durable it is
    when you use it, the harder its going to be to

Air travel and communicable diseases
Comprehensive federal plan needed for
U.S. aviation system's preparedness
  • A national aviation-preparedness plan would
    provide airports and airlines with an adaptable
    and scalable framework with which to align their
    individual plans-to help ensure that individual
    airport and airline plans work in accordance with
    one another. DOT and CDC officials agree that a
    national plan could add value. Such a plan would
    provide a mechanism for the public-health and
    aviation sectors to coordinate to more
    effectively prevent and control a communicable
    disease threat while minimizing unnecessary
    disruptions to the national aviation system.
  • Employees at aviation services firms that GAO
    spoke with-including contract workers who clean
    aircraft-raised concerns about the availability
    of training and access to equipment to control
    exposure to communicable diseases. Some airports
    GAO reviewed developed additional mechanisms to
    ensure adequate training and preparation during
    the Ebola threat. A national aviation-preparedness
    plan could serve as the basis for testing
    communication mechanisms among responders to
    ensure those mechanisms are effective prior to a
    communicable disease outbreak as well as to
    provide the basis for ensuring that airport and
    airline staff receive appropriate training and
    equipment to reduce their risk of exposure to
    communicable diseases during an outbreak.

Our water pipes crawl with millions of bacteria
  • Researchers from Lund University in Sweden have
    discovered that our drinking water is to a large
    extent purified by millions of "good bacteria"
    found in water pipes and purification plants. So
    far, the knowledge about them has been
    practically non-existent, but this new research
    is about to change that. A glass of clean
    drinking water actually contains ten million
    bacteria. But that is as it should be -- clean
    tap water always contains harmless bacteria.
    These bacteria and other microbes grow in the
    drinking water treatment plant and on the inside
    of our water pipes, which can be seen in the form
    of a thin, sticky coating -- a so-called biofilm.
    All surfaces from the raw water intake to the tap
    are covered in this biofilm. The diversity of
    species of bacteria in water pipes is huge, and
    that bacteria may play a larger role than
    previously thought. Among other things, the
    researchers suspect that a large part of water
    purification takes place in the pipes and not
    only in water purification plants. A previously
    completely unknown ecosystem has revealed itself
    to us. Formerly, you could hardly see any
    bacteria at all and now, thanks to techniques
    such as massive DNA sequencing and flow
    cytometry, we suddenly see eighty thousand
    bacteria per millilitre in drinking water. We
    suspect there are 'good' bacteria that help
    purify the water and keep it safe -- similar to
    what happens in our bodies. Our intestines are
    full of bacteria, and most the time when we are
    healthy, they help us digest our food and fight
    illness. Although the research was conducted in
    southern Sweden, bacteria and biofilms are found
    all over the world, in plumbing, taps and water
    pipes. This knowledge will be very useful for
    countries when updating and improving their water
    pipe systems. Source Microbes and
    Environments 2015 30 (1) 99

28 states ill-prepared for infectious disease
  • The report graded states on 10 key indicators
    surrounding various types of outbreaks, including
    flu vaccination rates and vaccine requirements
    for schools, HIV/AIDS surveillance, climate
    change adaptation plans and E. coli testing
  • Five states Delaware, Kentucky, Maine, New York
    and Virginia tied for the high score of passing
    eight of the 10 indicators.
  • But 28 states and the District of Columbia fared
    much worse. Below is a breakdown of their scores
  • Five out of 10 Arizona, Colorado, Connecticut,
    Georgia, Hawaii, Mississippi, Missouri, Montana,
    Pennsylvania, Rhode Island, Texas, Washington
  • Four out of 10 Alabama, the District, Florida,
    Indiana, Louisiana, Nevada, South Carolina, South
    Dakota, Tennessee, Wyoming
  • Three out of 10 Idaho, Kansas, Michigan, Ohio,
    Oklahoma, Oregon, Utah
  • "We need to reboot our approach so we support the
    health of every community by being ready when new
    infectious threats emerge," said Paul Kuehnert, a
    RWJF director. Source http//

2 states report whooping cough outbreaks
  • Areas of Minnesota and New Mexico are in the
    midst of pertussis, or whooping cough, outbreaks,
    according to their departments of public health.
    Minnesota public health officials reported to
    WCCO that there have been 36 confirmed cases in
    Olmsted County in the last six weeks. Olmsted
    County contains Rochester, where the Mayo Clinic
    is located. The number of cases jumps to 76 when
    confirmed, probable and suspected whooping cough
    cases are included. In New Mexico, officials
    have recorded seven confirmed and probable cases
    of the illness and 11 more suspected cases in San
    Juan County, according to the Albuquerque
    Journal. Whooping cough cases appear to be on the
    rise across the country, according to CDC data.
    In 2014, there were 32,971 confirmed cases of
    pertussis reported to the agency, a 15 percent
    increase from 2013. Last year, California
    experienced a major whooping cough outbreak,
    consisting of 9,935 cases reported in the state
    from Jan. 1 to Nov. 26. Officials from the
    state's department of public health blamed the
    epidemic on fewer people receiving the whooping
    cough vaccine. Pertussis can be a serious
    illness in babies, children, teens and adults,
    according to the CDC. The agency says the most
    effective way to prevent whooping cough is
    through vaccination.

Chipotle hit with another E. Coli outbreak
  • The Centers for Disease Control and Prevention
    (CDC) said Monday it is investigating another
    recent E. coli outbreak linked to Chipotle.
  • Five people have been infected with a different,
    rare E. coli strain, health officials said. All
    of them reported eating at the Mexican grill
    chain in the week before coming down with the
    illness in November. The cases were identified in
    Kansas, North Dakota and Oklahoma, the CDC said.
  • It's unclear if the infections are related to the
    earlier outbreak, which has affected 53 people in
    nine states, health officials said. At least 43
    of them had reported eating at Chipotle in the
    week leading up to their illness.
  • Chipotle has increased its food safety measures,
    which include testing all local produce before it
    gets to the restaurants and testing the quality
    of ingredients throughout their shelf life.
  • http//

How a medical device maker kept U.S. hospitals
in the dark about deadly infections
  • The hunt for a deadly superbug that sickened 22
    patients at a Dutch hospital began just before
    noon on a spring day in 2012. Inside a lab in the
    tiny hamlet of Zoeterwoude, a technician
    carefully peeled back the tip of a state-of-the
    art medical scope. Watching him intently was a
    small group of hospital officials and executives
    from Olympus Corp., the maker of the device. The
    Olympus technician found trouble right away. He
    spotted a brown, grimy film inside parts of the
    flexible, snake-like scope - parts that were
    supposed to be sealed. A rubber ring designed to
    keep bacteria out was cracked and worn. The same
    bacteria that had sickened the patients were
    found on the scope. An investigator hired by
    Olympus and the hospital concluded that the
    scope's design could allow blood and tissue to
    become trapped, spreading bacteria from one
    patient to another. In his report, he called on
    Olympus to conduct a worldwide investigation and
    recall all its scopes if similar problems turned
    up. Over the next three years, 21 people died and
    at least two dozen more became ill from
    infections related to scopes in Pittsburgh,
    Seattle and Los Angeles. An unknown number of
    other patients have been infected. The Food and
    Drug Administration has identified 10 outbreaks,
    seven of which involve Olympus scopes.
  • After each outbreak, Olympus contended that its
    scopes did not cause the infections and blamed
    the hospitals for not cleaning them properly. The
    company treated each case as an isolated
    incident, not telling the U.S. hospitals that
    they weren't alone.
  • Source http//

Costco E. coli outbreak appears to be over
according to CDC
  • An outbreak of E. coli linked to rotisserie
    chicken salad sold by warehouse club operator
    Costco Wholesale Corp appears to be over, the
    U.S. Centers for Disease Control (CDC) said on
    Tuesday. The most recent illness in this outbreak
    reported to CDC started on Nov. 3. The U.S. Food
    and Drug Administration conducted a trace back
    investigation to determine which ingredient was
    linked to the illnesses, but the probe could not
    identify a common source of contamination, the
    CDC said. Five of the 19 sickened people were
    hospitalized and two developed a type of kidney
    failure associated with the E. coli strain, STEC
    O157H7. No deaths were reported and the
    infections occurred in Montana, Utah, Colorado,
    California, Missouri, Virginia and Washington,
    the CDC said. The Costco outbreak was initially
    traced to a celery-and-onion mix made by Taylor
    Farms Pacific Inc used in making the chicken
    salad. Taylor Farms, a major producer of
    fresh-cut vegetables and bagged salads, last
    month recalled more than 154,000 lots of numerous
    products from various grocery store chains in 17
    states "out of an abundance of caution". Products
    were recalled from chains including Costco,
    Safeway, Starbucks Corp, Wal-Mart Stores Inc, and
    Target Corp. Source http//

CDC Source of UPMC mold that killed 3 could not
be found
  • Pennsylvania Secretary of Health Karen Murphy
    issued a statement on the CDC preliminary report
    on an infection cluster found at the University
    of Pittsburgh Medical Center (UPMC). In September
    2015, the Department of Health asked the CDC to
    investigate a cluster of four cases of
    mucormycosis, a rare infection caused by a group
    of environmental molds. The infections occurred
    over the course of a year among organ transplant
    recipients at the University of Pittsburgh
    Medical Center (UPMC). These infections are not
    spread person to person and are usually acquired
    through inhaling mold spores in the air.
    Transplant patients are at increased risk of
    infection because their immune systems have been
    suppressed or weakened. The on-site investigation
    conducted by the CDC in collaboration with the
    state Department of Health and Allegheny County
    Department of Health was completed on October 7.
    No additional infections were identified, and no
    single source has thus far been found to account
    for all four reported cases. Three of the four
    infected patients spent a significant amount of
    their hospitalizations in the same intensive care
    unit room. The room was known as a "negative
    pressure room," which is designed to draw air
    from outside the room into the room and may have
    exposed patients to mold spores that were present
    in the surrounding environment. Environmental
    testing of the room by the CDC team identified
    some common environmental molds but no
    mucormycetes. The unit in which the room was
    located had already been closed at the time of
    the investigation and was undergoing remediation
    to address any potential mold sources that
    limited the testing that could be performed.
    Source http//
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