We evaluated the prevalence of colonization with all gram-negative bacilli (GNB) and with ciprofloxacin-resistant GNB among nursing home residents with and without indwelling devices. We found that device presence increases the risk of colonization with all GNB and with ciprofloxacin-resistant GNB. Colonization with ciprofloxacin-resistant GNB increases with decreasing functional status.

Commercially available UV powder was applied weekly to high-risk objects within patient rooms and inspected after 48 hours. We found a baseline cleaning rate of 41.8% that increased up to 80% (P < .001) after the institution of weekly electronic feedback (unit rates and rankings) to environmental services, hospital leadership, and unit administrators.

Optimizing employee influenza vaccination rates has become a healthcare focus. We detail an approach involving a strong requirement for unvaccinated workers to wear a face mask and a super-convenient vaccination process. Our major teaching hospital achieved 95% compliance in 2009, and our health system reached 90% and 92% compliance for 2 years.

We sought to determine the frequency of horizontal transmission of antibiotic-resistant gram-negative bacilli (ARGNB) in a pediatric intensive care unit during a nonoutbreak period. Among 5,300 admissions over 39 consecutive months, 13 ARGNB clusters involving 35 children were identified by pulsed-filed gel electrophoresis analysis, which suggests that person-to-person transmission was uncommon.

For 74 patients with Clostridium difficile infection, the quality and frequency of bathing was often limited because of such factors as the presence of devices, decreased mobility, and pain. Routine bathing practices had limited efficacy in decreasing the burden of spores on skin; however, showers were more effective than bed baths.

We prospectively evaluated all oncology inpatients for 2009 H1N1 influenza virus. All patients recovered completely. Evaluating all oncology patients with fever for influenza involved overtreatment of influenza-negative patients and involved a significant infection control burden. However, early antiviral intervention could have contributed to a favorable outcome.

We collected serial blood samples from children in the intensive care unit who underwent daily bathing with 2% Chlorhexidine gluconate (CHG)-impregnated cloths. Low concentrations of CHG were detected in a few blood samples, indicating absorption through intact skin. There was no suggestion that CHG accumulated in the blood with repeated exposures.

We surveyed infectious disease physicians to determine their preoperative Staphylococcus aureus screening and decolonization practices. Sixty percent reported preoperative screening for S. aureus. However, specific screening and decolonization practices are highly variable, are focused almost exclusively on methicillin-resistant S. aureus, and do not include testing for mupirocin or chlorhexidine resistance.

For a healthcare worker seasonal influenza vaccination quality improvement project, interventions included support of leadership, distribution of vaccine kits, grand rounds, an influenza website, a Screensaver, e-mails, phone messages, and audit feedback. Vaccination rates increased from 58.8% to 76.6% (P < .01). Quality improvement increased the voluntary vaccination rate but did not achieve a rate more than 80%.

Little is known about the epidemiology of nosocomial urinary tract-related bloodstream infection. In a case series from an academic medical center, Enterococcus (28.7%) and Candida (19.6%) species were the predominant microorganisms, which suggests a potential shift from gram-negative microorganisms. A case-fatality rate of 32.8% highlights the severity of this condition.

We show that respiratory fluoroquinolone use is extremely seasonal and that fluoroquinolone use is strongly associated with influenza. In our time series model, instantaneous influenza activity was a significant predictor of use (P< .0001). Also, we estimated that reducing influenza activity by 20% would reduce prescriptions by 8%.

Infrared thermal detection systems (ITDSs) have been utilized in several countries to screen for fever in travelers. Since fever screening with an ITDS is rapid and noninvasive, this technology may be useful as an infection control measure in clinical settings during a pandemic.

This study evaluated the use of pulsed-xenon ultraviolet (PX-UV) room disinfection by sampling frequently touched surfaces in vancomycin-resistant enterococci (VRE) isolation rooms. The PX-UV system showed a statistically significant reduction in microbial load and eliminated VRE on sampled surfaces when using a 12-minute multiposition treatment cycle.

In an effort to improve the selection of appropriate empiric gram-negative therapy for pneumonia, we examined intensive care unit-specific combination antibiograms. These antibiograms were able to predict appropriate empiric gram-negative therapy. Empiric combination therapy based on unit-specific combination antibiograms may aid in the selection of therapy for gram-negative pneumonia.

In a study of 40 methicillin-resistant Staphylococcus aureus (MRSA) carriers, hand contamination was equally likely after contact with commonly examined skin sites and commonly touched environmental surfaces in patient rooms (40% vs 45%). These findings suggest that contaminated surfaces may be an important source of MRSA transmission.

We evaluated hepatitis B vaccination coverage and documentation of antibody to hepatitis B surface antigen (anti-HBs) concentration among a cohort of healthcare students. Of 4,075 students, 59.8% had documentation of vaccination and 83.8% had anti-HBs concentration greater than or equal to 10 mIU/mL. Documenting hepatitis B vaccination and anti-HBs concentration among healthcare students is needed to prevent transmission in healthcare settings.