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U.S. Antibiotic Awareness Week, formerly known as "Get Smart About Antibiotics Week," aims to raise awareness of the threat of antibiotic resistance and the importance of appropriate antibiotic prescribing. This year, U. S. Antibiotic Awareness Week occurs during November 13-19, 2017. The observance is a key component of Centers for Disease Control and Prevention (CDC) efforts to support antibiotic stewardship, the process of improving how we use antibiotics. Antibiotic Awareness Week hopes to advance antibiotic stewardship in communities, healthcare facilities, and on the farm in collaboration with state-based programs, nonprofit partners, and for-profit partners.
Although antibiotics are life-saving tools for preventing and treating infections, widespread use and misuse of antibiotics has led to increases in antibiotic-resistant infections. Antibiotic resistance is one of the most urgent threats to the public's health. Each year in the U.S., at least 2 million people develop an antibiotic-resistant infection, and at least 23,000 people die as a result.
Up to 50% of all antibiotics prescribed in health care settings are not necessary or are inappropriately prescribed. A concerted effort to eliminate inappropriate antibiotic use is necessary. It is crucial for everyone to take part in antibiotic stewardship to help reduce the emergence and impact of antibiotic-resistant pathogens.
 How YOU can help prevent antibiotic resistance:
- Follow clinical guidelines when prescribing antibiotics.
- Help your facility establish processes that enable prescribers to know when antibiotic use is needed and to use the right antibiotics, at the right dose, and for the right duration.
- Prevent infections by hand washing, vaccination, and using safe food handling practices.
- Communicate with patients as to why antibiotics are unnecessary for viral infections and what alternatives they can use for symptom relief.
- Talk to patients about possible harmful side effects from antibiotics, such as allergic reaction, Clostridium difficile infection, and antibiotic-resistant infection.
- Publicly display your facility's commitment to antibiotic stewardship by using the Minnesota Antibiotic Stewardship Commitment Toolkit.
- Hospitals can achieve statewide recognition for antibiotic stewardship by applying for the Minnesota Antibiotic Stewardship Honor Roll.
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 More resources are available from the Minnesota Department of Health in regards to Antibiotic Resistance and Antibiotic Stewardship, and the CDC offers resources about U.S. Antibiotic Awareness Week.
The Infection Control Assessment and Response (ICAR) team has provided assistance to update Appendix L: Infection Surveillance Line List Template in the Minnesota Antimicrobial Stewardship Program Toolkit for Long-term Care Facilities. There is now an accompanying instruction sheet to help guide you through the line list. The updated line list can assist facilities in tracking resident illnesses and use of antibiotics on a monthly basis. There are auto calculation features that should be helpful in summarizing data.
For questions, concerns, or comments regarding the tool please email health.HAI@state.mn.us or call 651-201-5414.
After seven years of FluSafe, MDH will be taking the 2017-18 season off to evaluate the program and consider improvements. Throughout this season, we’ll be contacting health care facilities and partner organizations to get input - please look out for these opportunities to help shape the future of this program! We plan to return in the 2018-19 season with a more comprehensive and sustainable program to support health care personnel vaccination. If you have any questions about FluSafe, please email health.flusafe@state.mn.us.
In the meantime, you can continue to use the Minnesota Immunization Information Connection (MIIC) to submit, track, and pull reports on your facility’s flu and other health care personnel immunizations. You can submit immunizations to MIIC by manually entering them into MIIC records, setting up an electronic interface between your EMR/EHR and MIIC, or filling out and uploading the FluSafe spreadsheet. Note: All MIIC features that are used for FluSafe, including the spreadsheet and the FluSafe Report, will remain available during the 2017-18 season. Find instructions for these features at Participate in FluSafe. If you have questions about MIIC, please contact the MIIC Help Desk at health.miichelp@state.mn.us or 651-201-5207.
Shoulder injuries like bursitis and tendinitis resulting from improper injection technique are errors that can easily be avoided. Due to the increase in reporting of these injuries shoulder injury related to vaccine administration (SIRVA) has been added to the Vaccine Adverse Events Reporting System (VAERS) . The reports are related to influenza vaccinations. These errors are more likely to occur among adults than children and are 100% avoidable.
In a series of 13 cases among adult patients published by the Vaccine Injury Compensation Program (Atanasoff S, et al. Vaccine. 2010;28:8049-8052), shoulder pain was noted immediately after vaccination in 50% of cases, and pain developed in 90% within 24 hours. The most common findings on physical examination were painful and limited range of motion. Arm weakness and sensory changes were uncommon. Deep tendon reflexes were normal. Symptoms persisted six months to several years, and 30% of patients required surgery.
 The CDC You Call the Shots module on vaccine administration (Immunization: You Call the Shots Module Five - Influenza) is a resource you can use for staff training. Continuing education credits are available after viewing the module and completing an evaluation.
As part of their campaign to promote safe vaccination practices by educating and reminding providers about proper influenza vaccine administration technique CDC has created an infographic for healthcare providers, Know the Site. Get it Right! CDC: You Call the Shots Infographic.
Thank you for making all injections safe!
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A recent study published in JAMA Internal Medicine Using Spatial and Temporal Mapping to Identify Nosocomial Disease Transmission of Clostridium difficile from researchers at the University of California at San Francisco used location and time stamps entered in patients' electronic health records (EHR) to track the source of Clostridium difficile (CDI), the leading cause of hospital-acquired infections. The study found that a significant source of these infections was a certain CT scanner in the emergency department. The findings revealed that patients had a more than doubled risk of becoming infected with the bacterium if they entered that scanner within 24 hours after CDI-positive patients used the device. You can read more about this at UCSF Uses EHR Data to Track Hospital-Acquired Infections.
The
Minnesota Department of Health’s Infection Prevention and Control Division
works in collaboration with partners across the continuum of care to prevent Healthcare-Associated Infections.
For purposes of surveillance and prevention, MDH has access to certain data submitted to the National Healthcare Safety Network (NHSN). The access is governed by a data use agreement (DUA) which is now being updated. The Centers for Disease Control and Prevention (CDC) will be hosting a webinar to explain the contents of the DUA and the process for its approval.
This DUA will continue to prohibit certain uses of the data. MDH cannot use the data for any regulatory purposes or to publicly report facility-level results. The updated DUA will allow access to some additional hospital data, and adds some data submitted from Outpatient Dialysis Centers and Ambulatory Surgery Centers. All interested parties from these settings are encouraged to attend. To register go to: DUA webinar registration. For more information, including how information can be obtained after the webinar see: National Healthcare Safety Network (NHSN)
In a Centers for Disease Control and Prevention blog 341 Days Without a C. difficile Infection: How Mercy Health – St. Anne Hospital Reduced C. difficile Infection Rates to Zero this month, an infection preventionist describes how a multipronged approach to Clostridium difficile infection (CDI) prevention resulted in her facility not only being able to reduce its high incidence of hospital-associated CDIs but to go almost a year with no cases of CDI at all. Through improving environmental cleaning, staff education, and implementing an antimicrobial stewardship program, the 100-bed community hospital was successful in getting their CDI rate to zero!
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