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Selected Category: Healthcare-associated infections

Important Reminder: Wear Facemasks During Spinal Injection Procedures

Categories: Healthcare-associated infections, Injection Safety

Amit Chitnis, MD, MPH

Amit Chitnis, MD, MPH

Author – Amit Chitnis, MD, MPH
CDC Epidemic Intelligence Officer
Division of Healthcare Quality Promotion

Today, CDC is reminding clinicians to use facemasks when injecting medicine or inserting catheters into epidural or subdural spaces of the spine. This includes “epidurals” during childbirth labor and injection of contrast dye during imaging procedures.

We are concerned that despite 2007 recommendations aimed at preventing these infections, outbreaks of infections continue to occur among patients undergoing spinal injection procedures. As a CDC Epidemic Intelligence Service Officer, I investigated the most recent outbreak of bacterial meningitis among patients who had undergone a spinal injection during the course of their medical care. Our findings from this investigation, as well as from previous CDC investigations, have helped us answer the following questions:

First, who is at risk? Anyone receiving spinal injection procedures may be at risk of contracting an infection if proper infection control techniques are not in place.  In the most recent investigation, all the cases of bacterial meningitis occurred among patients who underwent myelography (a spinal procedure requiring injection of contrast dye) at an outpatient imaging facility. However, in previous investigations, cases were detected primarily among hospital patients who received spinal anesthesia or epidural anesthesia.

Media Reports about Drug-Resistant Infections

Categories: Antimicrobial Resistance, Gram negatives, Healthcare-associated infections, HICPAC, Long Term Care (LTC)

Arjun Srinivasan, MD

Arjun Srinivasan, MD

Author – Arjun Srinivasan, MD
CDC’s Division of Healthcare Quality Promotion

You probably have seen the media reports this week about drug-resistant infections in California healthcare facilities, specifically those in Los Angeles County. What we know, however, is that carbapenem-resistant Klebsiella pneumoniae (CRKP) actually exists in at least 36 states. Originally identified in 1999, CRKP may be present in the other 14 states as well, just not yet reported to CDC. 

CRKP is a Gram-negative bacteria and part of a family called Enterobacteriaceae. Carbapenem-resistant Enterobacteriaceae (or CRE) are able to fight off our last-resort antibiotics and have become an important public health issue resulting in high mortality (death) in patients. 

How can we stop these bugs?  CDC released prevention guidelines on multi-drug resistant organisms in 2006 and guidelines specifically targeting CRE in 2009. [See my previous blog posts on how to prevent CRE.] 

New Clinical Guidelines for MRSA Treatment

Categories: Antimicrobial Resistance, Healthcare-associated infections, MRSA

Catherine Liu, MD

Catherine Liu, MD

Author – Dr. Catherine Liu
Assistant Clinical Professor, Division of Infectious Diseases, University of California

Methicillin-resistant Staphylococcus aureus (MRSA) – both healthcare- and community-associated – has become an enormous public health problem. MRSA is responsible for about 60 percent of skin and soft tissue infections seen in emergency rooms, and invasive MRSA kills about 18,000 people annually. Clinicians often struggle with how best to treat MRSA, resulting in wide variations in approaches to therapy. The growing clinical impact of MRSA, particularly community-acquired infections, prompted the Infectious Diseases Society of America to develop its first treatment guidelines for MRSA. Charged with reviewing the evidence and developing the guidelines, my coauthors and I aimed to create a framework to help clinicians evaluate and treat uncomplicated and invasive MRSA infections. As with all IDSA guidelines, they are voluntary and are not meant to replace clinical judgment, but rather synthesize the available evidence and support the decision-making process, which must be individualized for each patient.

$10 Million Dollars to Save Countless Lives

Categories: Antibiotic use, BSIs, CLABSI, Healthcare-associated infections, MRSA

John A. Jernigan, MD, MS

John A. Jernigan, MD, MS

Author – John Jernigan, M.D.
CDC’s Division of Healthcare Quality Promotion

Today, I am proud to announce that my office is awarding $10 million for new research to five academic medical centers as part of our Prevention Epicenter grant program.  This program supports efforts to develop and test innovative approaches to reducing infections in healthcare settings. It is more than research – we are taking novel discoveries and translating them into clinical practice.  These efforts save lives.

We founded the Prevention Epicenter program in 1997.  CDC staff work closely with academic investigators to discover solutions, and refine them so they can work to prevent infections for all healthcare settings.  It has been thrilling over the years to watch the innovations in infection prevention that have come out of this program.  Some of our biggest breakthroughs in infection prevention and strategies to save lives have been rooted in research of the Prevention Epicenter program.

Some of the breakthroughs that I have been particularly proud of are:

  • using skin antiseptic in routine bathing of patients to prevent HAIs, including the use of chlorhexidine to prevent Methicillin-Resistant Staphylococcus Aureus (MRSA) infections,
  • developing cutting edge methods for detecting HAIs such as using computer algorithms to detect  bloodstream infections, and
  • pioneering a new method for determining the effectiveness of HAI prevention strategies among a large group of hospitals. 

Infections in ICUs Plummeting, Too Many Remain in Hospitals and Dialysis Clinics

Categories: Antimicrobial Resistance, BSIs, CLABSI, Dialysis, Gram negatives, Healthcare-associated infections, MRSA, NHSN

Arjun Srinivasan, MD

Arjun Srinivasan, MD

Author – Arjun Srinivasan, MD
CDC’s Division of Healthcare Quality Promotion

As you know, bloodstream infections in patients with central lines can be deadly, killing as many as 1 in 4 patients who gets them. The newest edition of the CDC Vital Signs reports a major decrease in central-line associated bloodstream infections (CLABSIs) in intensive care unit (ICU) patients. This is an important triumph for patient safety and brings me a renewed sense of hope toward the elimination of HAIs. It also solidifies an expectation that infection prevention should be a priority in order to improve the safety of patients.

While progress is promising, about 60,000 bloodstream infections in patients with central lines still occurred outside of ICUs and in dialysis centers, according to our report. Much of this is preventable harm. We have to make every effort to ensure patients are protected in all healthcare facilities, all the time. So, how do we do that?
The good news is that everyone can contribute to preventing CLABSIs, no matter where the patient receives care.

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