March/April 2021 · Volume 12, Issue 84

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Antimicrobial Resistance (AR)   Healthcare-Associated Infection (HAI)
Virginia Department of Health (VDH)     United States (US)
Centers for Disease Control & Prevention (CDC)

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• New Team Member
• Project Firstline
• Antibiograms
• Flu Update
• COVID-19 & TB Testing
• Latent TB Testing & Treatment
• IP Hiring Announcement
• Ebola
• One Health
• NHSN Updates
• Relevant Research
• IP Podcast
• Save the Dates

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News in Virginia

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Welcome New Team Member! We would like to welcome and introduce a VDH Regional Infection Preventionist (IP), Wendy Fariss, BSN, RN, CIC.  Wendy Fariss is one of many regional IPs positioned across Virginia to provide infection prevention and control consultation in healthcare and congregate settings.  We're thankful to have such amazing talent join our HAI/AR Program!

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Coming Soon: Call for Hospital Antibiograms. The Virginia Healthcare-Associated Infections Advisory Group will be sending out a request for hospitals to submit their 2019 antibiograms to be included in the next update of the Virginia State and Regional Cumulative Antibiogram project.  A representative from your antimicrobial stewardship program will be provided more details in the coming weeks.  The 2017 and 2018 Virginia State and Regional Antibiograms can be found here.

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Hiring Continues to Bolster Infection Prevention Resources in Virginia. The VDH Division of Clinical Epidemiology continues to seek Regional Infection Preventionists for the northern and eastern regions of Virginia to provide infection prevention and control consultation for healthcare-associated infections both proactively and in response to outbreaks in hospitals, long-term care facilities, and other healthcare and congregate settings. These positions will support implementation of numerous patient safety initiatives for COVID-19 and other emerging pathogens by performing on site infection prevention and control assessments, providing health education to public health staff, and serving as experts in infection control issues. To apply, send your cover letter and/or resume to lindsey.lambert@vdh.virginia.gov.

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Ebola. On February 24, 2021, CDC issued Level 3 travel warnings to avoid all nonessential travel to Democratic Republic of the Congo (DRC) and Guinea due to Ebola outbreaks in these countries.  Beginning March 5, 2021, VDH staff began monitoring the health of travelers arriving in Virginia who were in the DRC or Guinea in the previous 21 days. VDH will refer ill travelers who develop EVD-related symptoms for appropriate clinical evaluation.  Visit the VDH Ebola Virus Disease website for more resources.

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• The deadline to enter 2020Q3 data into NHSN for the CMS Quality Reporting Programs for participating acute care hospitals, long-term acute care facilities, inpatient rehabilitation facilities, and cancer hospitals has been extended to March 18, 2021. To ensure your data have been correctly entered into NHSN, please verify that: 1) your monthly reporting plans are complete, 2) you have entered appropriate summary and event data or checked the appropriate no events boxes, and 3) you have cleared all alerts from your NHSN facility homepage. Hospitals that have conferred rights to VDH will be receiving a quality assurance report in the second week of March, so please be sure to check your email and acknowledge receipt and review. Please remember to update the HAI/AR Program with any IP contact changes. For additional guidance on ensuring your data are accurately sent to CMS for Quality Reporting purposes, please visit the NHSN website and navigate to the appropriate section(s) for your facility type: http://www.cdc.gov/nhsn/cms/index.html.
• Since NHSN will not hold an in-person annual training for 2021, NHSN subject matter experts created training videos covering several topics including LabID event reporting, CAUTI updates, SSI updates, facility-wide antibiogram report, and more. NHSN will also host follow-up Q&A sessions starting March 17, 2021. The 2021 NHSN Training videos, Q&A session registration, question form, and continuing education information can be accessed here.
• In November 2020, CDC published the 2019 NHSN Antimicrobial Use Option Report. This report is the first national summary of SAAR distributions and percentages of use for adult, pediatric, and neonatal locations. It provides data for action for Antimicrobial Stewardship Programs (ASPs), helping inform stewardship efforts by enabling hospitals to see how their SAARs compare to the national distribution. Further, the percentage of antimicrobial use by class and drug within a SAAR antimicrobial agent category provides insight to prescribing practices across differing patient care locations. The data tables can be found here.
• NHSN updated the Supplies and Personal Protective Equipment pathway in the LTCF COVID-19 Module to include the optimization strategies that LTCFs are using regarding their PPE supply items. Reporting for the updated data elements will begin the week of March 8, 2021. 
  
  • In addition, a new section called, Need for Government Support or Assistance was added to offer facilities a new option to indicate they would like outreach from state or local government to discuss COVID-19 assistance needs related to staffing shortages, personal protective equipment shortages, SARS-CoV-2 (COVID-19) testing supply shortages, infection control/outbreak management, staff training, and COVID-19 vaccination for residents and/or staff. VDH will use affirmative (“Yes”) responses to this question as another way to monitor assistance needs that facilities face and to prioritize outreach and response actions.

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Hand Hygiene. A recent study in the American Journal of Infection Control identified that patients, visitors, and families at a hospital had low rates of performing hand hygiene. This group preferred washing hands with soap and water over using alcohol-based hand rub and reported higher hand hygiene rates than were actually observed. Acute healthcare settings should focus on communicating consequences of failing to perform hand hygiene and correcting misconceptions when designing interventions to improve hand hygiene.

Lessons Learned from Candida auris Outbreaks in the US. Interviews with healthcare facilities, organizations, and public health departments in New York, California and Illinois were conducted between 2019-2020.  Interviews of those who have responded to cases and outbreaks of C. auris found key lessons related to surveillance and laboratory capacity, communication, infection prevention and control, environmental cleaning, clinical management of cases, and media concerns. Read more here.

SARS-CoV-2 Air Contamination in Hospital Settings. A systematic review of 24 studies found that air close to and distant from patients with COVID-19 was sometimes contaminated with SARS-CoV-2 RNA, but few of these samples contained viable viruses. However, more attention may be needed in bathrooms, staff areas and public hallways, where higher viral loads were found. Read more here.

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Prefer to Listen? Check out Infection Prevention Spotlight, a podcast from the American Journal of Infection Control. A recent episode highlights a conversation with infection prevention pioneer Dr. Elaine Larson, in which Dr. Larson discusses how far the field of infection prevention has come and what lies ahead. Other episodes have featured:  innovation in disinfection, care bundles to prevent SSIs, cost-effectiveness of infection prevention, hand hygiene best practices, and more.

National Patient Safety Awareness Week: March 14-20, 2021. This is an annual initiative sponsored by the Institute for Healthcare Improvement that highlights the need for improving the safety of patients and healthcare workers. Reducing the occurrence of HAIs by following adequate infection prevention and control practices is just one of the ways healthcare professionals can do so.

World Tuberculosis Day: March 24, 2021. A day to raise public awareness about the devastating health, social and economic consequences of TB, and to step up efforts to end the global TB epidemic. Click here for more information.

National Public Health Week: April 5-11, 2021. The 2021 theme for NPHW is “Building Bridges to Better Health.” Each day of National Public Health Week will focus on a specific public health topic. Click here for more information.