A common type of fungal disease investigation involves hospital-associated clusters of invasive mold infections (IMIs), which typically occur among immunocompromised patients. Responding to IMI clusters can be challenging for public health and hospital personnel for several reasons such as difficulty of confirming the existence of an outbreak, difficulty of determining source. Although many resources exist to guide patient notification about healthcare incidents (eg, bloodborne exposures, disease outbreaks), IMI clusters involve special considerations related to the complex diseases, uncertain exposures, and differential benefits and risks of notification. Early, nuanced communication about hospital-associated IMI clusters is almost always the best course of action to help reduce risks to patients’ health and foster trust between patients and hospitals.
In this article, a cluster of Delftia acidovorans infections among patients undergoing hemodialysis at an outpatient unit (Facility A) were investigated. The cluster of D. acidovorans infections was most likely due to indirect exposures to contaminated wall boxes and possibly saline prime buckets due to poor hand hygiene and station disinfection.
In March 2018, an investigation of an outbreak of Burkholderia cepacia complex (Bcc) infections was launched after sixty infections were identified in California, New Jersey, Pennsylvania, Maine, Nevada and Ohio. The infections were linked to a no-rinse cleansing foam product (NRCFP), produced by Manufacturer A, used for skin care of patients in healthcare settings. FDA inspected Manufacturer A's production facility (manufacturing site of over-the-counter drugs and cosmetics), reviewed production records and collected product and environmental samples for analysis. FDA's inspection found poor manufacturing practices. Manufacturer A conducted extensive recalls, FDA issued a warning letter citing the manufacturer's inadequate manufacturing practices, and federal, state and local partners issued public communications to advise patients, pharmacies, other healthcare providers and healthcare facilities to stop using the recalled NRCFP. This investigation highlighted the importance of following appropriate manufacturing practices to minimize microbial contamination of cosmetic products, especially if intended for use in healthcare settings.
This study aimed to identify the source of infection and medical costs for a respiratory infection outbreak in a facility for patients with severe motor and intellectual disabilities (SMID). The cause of this outbreak was healthcare workers’ presenteeism. To prevent outbreaks, such facilities should address the causative factors. Presenteeism refers to a situation wherein a person continues going to work despite being ill.
This article describes experience with a REDCap (Research Electronic Data Capture) tool that was designed to help identify healthcare personnel with possible exposure to monkeypox, to perform exposure risk assessment and stratification for postexposure prophylaxis (PEP), and to conduct symptom monitoring during the exposure window. Enhancements included dashboards for HCP tracking and short message service (SMS text) reminders for symptom monitoring.
This article describes an outbreak of Stenotrophomonas maltophilia involving over 100 patients infected in a tertiary hospital in Turkey. The authors concluded that a contaminated commercial needless blood gas injector was responsible for the outbreak and noted device safety concerns stemming from detection of S. maltophilia in extracorporeal membrane oxygenation (ECMO) water heater devices.
CDC released a new report finding that much of the progress made in the United States in previous years combating antimicrobial resistance (AR) was lost, in large part, due to the effects of the COVID-19 pandemic. This report concludes that the threat of antimicrobial-resistant infections is not only still present but has gotten worse—with resistant hospital-onset infections and deaths both increasing at least 15% during the first year of the pandemic.
This article determined the incidence, management, and outcomes of respiratory syncytial virus nosocomial infection (RSVNI) outbreaks in neonatal intensive care units. Outbreaks were principally managed by conventional protective measures, neonatal intensive care unit closure, and visitor restriction. Palivizumab was used to control RSVNI in 10 studies. The study concludes the use of palivizumab should be a multidisciplinary decision, based on rapidly spreading infection. Prospective studies are essential to determine the cost-benefit of palivizumab versus standard prevention control for an RSVNI outbreak.
This article describes an outbreak of mupirocin-resistant MRSA, molecular epidemiology of isolates and control. Medical record review of personnel contact with infants were used and MRSA isolates were analyzed by whole genome sequencing (WGS); and single nucleotide polymorphisms (SNPs) were identified. During a recrudescent MRSA outbreak due to a clonal strain, both contact with a colonized staff member and a putative environmental or personnel reservoir were associated with MRSA acquisition.
This article describes a large SARS-CoV-2 outbreak involving an acute care hospital emergency department during December 2020 and January 2021, in which 27 healthcare personnel worked while infectious, resulting in multiple opportunities for SARS-CoV-2 transmission to patients and other healthcare personnel. Included in this article are recommendations for improving infection prevention and control.
