Study: Patient Hand Hygiene in ICUs Essential to Reducing HAIs

The results of a new study demonstrate the critical importance of patient hand hygiene in the ongoing effort to reduce hospital-acquired infections (HAIs).

The study, published in The Society for Healthcare Epidemiology of America (SHEA) journal Infection Control & Hospital Epidemiology, was conducted in three intensive care units (ICUs) at a tertiary care center, according to a research brief. It involved 56 patients and was conducted over a 10-week period.

Researchers found that of these patients, seven had at least one aerobic pathogenic bacteria on a hand. Of these seven patients, four patients had at least one multidrug-resistant organism (MDRO). Two of the patients had methicillin-resistant Staphylococcus aureus (MRSA), one had vancomycin-resistant Enterococcus and one had ciprofloxacin-resistant gram-negative bacteria.

What makes these results concerning is that, as the researchers note, "… current best practice recommendations do not provide a strong guidance regarding patient hand hygiene."

Infection Control Consulting Services (ICCS) encourages facilities to continue monitoring hand hygiene, ensuring that feedback is provided to staff at least monthly and sharing "real-time" deficiencies in private and as close to the time the suboptimal practice occurred. Monitoring must be an ongoing process measure that, regardless of success, should not be dismissed at any time.

Improve Staph Infection Preparation With New CDC Interactive Case

The Centers for Disease Control and Prevention (CDC) has collaborated with Medscape to release a new interactive case challenge designed to help healthcare providers protect patients from Staphylococcus aureus (staph) infections.

The scenario — accessible here (free account required) — follows a patient's death from a bloodstream staph infection and a provider's realization that their facility's staph infection rate is higher than the national rate. By reviewing this case, providers can challenge themselves to see if they know how to properly respond to protect patients from serious staph infections.

CDC recently reported that nearly 120,000 people suffered from bloodstream staph infections in the United States in 2017, with nearly 20,000 dying.

CDC is calling on facilities, providers and administrators to protect patients from staph infections and released a framework of strategies intended to help reduce device- and procedure-related infections. CDC has also recommended that all facilities perform ongoing staph infection data assessments and implement prevention actions.

Study: Decolonizing Parents Could Reduce Staph Risk for Newborns

The results of a new clinical trial indicate that treating parents with short-course intranasal mupirocin and topical chlorhexidine bathing can reduce the risk of transmitting Staphylococcus aureus (S aureus) to newborns in intensive care units (ICUs).

The randomized trial, which had its findings published in JAMA, included 190 neonates with parents colonized with S aureus. Parents were treated with intranasal mupirocin and chlorhexidine-impregnated cloths or placebo (petrolatum intranasal ointment and nonmedicated soap cloths).

The findings revealed that the use of the impregnated cloths "… significantly reduced the hazard of acquiring colonization with a parental S aureus strain."

The authors note that this trial suggests parents represent a "major reservoir" from which neonates acquire S aureus in the neonatal intensive care unit (NICU). Neonates are unique because they an immature microbiome upon NICU admission and rarely have preexisting S aureus colonization. Rather, neonates acquire S aureus colonization in the NICU from exposure to people and objects.

S aureus, the authors note, is a leading cause of healthcare-associated infections in the NICU. Parents with S aureus may expose neonates to S aureus colonization, which is a well-established predisposing factor to invasive S aureus disease. As the Centers for Disease Control and Prevention notes, staph infections can be serious or fatal and the risk of more serious staph infection is higher for patients in ICUs.

The randomized trial had a study period of November 2014 through December 2018. It was conducted by conducted by clinicians and researchers at Baltimore's Johns Hopkins University School of Medicine and Johns Hopkins Bloomberg School of Public Health.