Top 5 Contagion&reg News Articles for July 2017

The relationship between temperature and incidence of surgical site infections, progress towards an HIV vaccine, the cleanliness of your stethoscope, an explanation on how infection rates at Stanford Hospital are a canary in a coal mine, and an interactive visual map that depicts the HIV epidemic in the United States, make up the Top 5 news articles for the month of July 2017.

#5: As the Temperature Rises, So Does Incidence of Surgical Site Infections

The implications of these findings point to the possibility that “a 25% reduction in the average number of at-risk surgeries in the months of July and August would be associated with a decrease of nearly 1,700 surgical site infections (SSIs)” annually, according to the study authors.

Furthermore, according to Christopher A. Anthony, MD, first author of the study and surgery resident physician at the University of Iowa Roy J. and Lucille A. Carver College of Medicine,

“These results tell us that we need to identify the patients, surgeries, and geographic regions where weather-related variables are most likely to increase patients’ risk for infections after surgery.” He continued, “This way, we can identify the patients at the greatest risk for surgical site infections during warmer summer months.”

The authors stress in their article that “more granular data including exact surgery date and specific procedures” is needed to “help determine whether shifting the timing of some surgeries away from peak SSI months can help reduce SSIs in patients with specific procedures.”

Learn more about the relationship between temperature and SSIs, here.

#4: HIV Vaccine Moves One Step Closer to Becoming Reality

Scientists from The Scripps Research Institute and the La Jolla Institute for Allergy and Immunology may have found the best delivery mode for a vaccine against HIV. The results of their new study show that “optimizing the mode and timing of vaccine delivery is crucial to inducing a protective immune response in a practical model,” according to a press release on the study.

For their study, published in the journal, Immunity, the scientists found that, “administering the vaccine candidate subcutaneously and increasing the time intervals between immunizations improved the efficacy of the experimental vaccine and reliably induced neutralizing antibodies.” These antibodies are key in promoting an effective immune response as they inactivate an invading virus before it is able to set up shop in the body. According to the press release, these neutralizing antibodies, “have been notoriously difficult to generate for HIV.”

Continue reading about the progress towards an HIV vaccine, here.

#3: How Clean is Your Stethoscope?

Most practitioners do not give the cleanliness of their stethoscopes much thought, but the results of a new study from the American Journal of Infection Control (AJIC) are going to want to make them rethink their disinfection practices.

Hand hygiene remains the main focus of many infection control and prevention programs; however, according to the AJIC study, “microbiology data have shown that stethoscope contamination after a single exam is comparable to that of the physician's dominant hand.” The types of bacteria the scope could be contaminated with can include: Staphylococcus aureus, Pseudomonas aeruginosa, Clostridium difficile, and even vancomycin-resistant enterococci.

Previous studies have shown that hand sanitizer used to clean clinicians’ hands between encounters is also able to effectively clean stethoscopes. Still, “healthcare providers rarely perform stethoscope hygiene between patient encounters, despite its importance for infection prevention, [and the fact that] the Centers for Disease Control and Prevention state that re-usable medical equipment, such as stethoscopes, must undergo disinfection between patients,” according to a recent email press release on the study. In fact, a previous study the researchers highlight found that stethoscope hygiene was performed in, “an observed rate of 4.6% of trainees at 3 academic medical centers for nonisolation rooms over an 11-month period.”

Read more about the cleanliness of your stethoscope, here.

#2: Stanford Hospital—A Canary in A Coal Mine

Sure, all the data is reported through the National Healthcare Safety Network and made publicly available, but few people even bother to research and read the data prior to seeking medical care. Those hospitals who do not meet the requirements may even be hit with CMS reimbursement penalties, but when this happens (and it happens a lot), it typically doesn’t receive much media attention. Of the handful of infection preventionists I’ve talked to about this report, not one was surprised. Sadly, it’s common practice that patients aren’t properly isolated or that signage isn’t up all the time. And, although some hospitals are utilizing newer and more effective technologies such as UV-disinfection equipment to help disinfect rooms, this practice still adds time to the clock between patient discharge and the next admission.

The healthcare industry is always in a battle against cutting costs, keeping patients safe, and maintaining high patient satisfaction; all while following federal regulations and requirements. Despite the alarmist nature that comes across in the media coverage on the Stanford case, we need to realize that this is only a glimpse through the window that is healthcare infection control and the struggle to follow best practices while working in an increasingly stressful environment. In this case, Stanford Health Care is the canary in the coal mine, alerting us that there’s a problem. They just happened to get the media scrutiny that comes with being pulled into a union debate involving the safety of employees.

Unfortunately, Stanford Health Care is not the only canary—in fact, it is only one in a whole flock who have been giving us warnings of infection control and patient safety failures for decades. The question is, are we finally ready to listen?

Learn more about the Stanford Hospital report, here.

#1: US HIV Epidemic Goes Visual with Interactive Map

HIV surveillance data from the Centers for Disease Control and Prevention is being used to populate an interactive map, capable of depicting the impact of HIV and mortality in the United States on national, state, and local levels.

The interactive map, AIDSVu, illustrates higher rates of infection and death in Southern States; racial disparities in HIV infection; and a rise in HIV diagnoses among the youth. In addition, according to a press release on the map, “two-thirds of all new HIV diagnoses in 2015 occurred in 2.5% of US counties."

The South accounts for nearly 37% of the country’s population and more than half of all new diagnoses and deaths among individuals diagnosed with HIV. Five US cities—–all located in the South––had the highest rates of new diagnoses: Miami, FL; Jackson, MS; New Orleans, LA; Baton Rouge, LA; and Atlanta, GA.

Although the overall rate of new HIV infection is steadily declining, certain demographic groups and the opioid epidemic have played a role in HIV infections, according to the authors.

Continue reading about the new interactive map of the US HIV epidemic, here.