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NY State collaborative – a groundbreaking Antimicrobial Stewardship Project for hospitals and long-term care

Categories: Antimicrobial Resistance, Healthcare-associated infections, State HAI Prevention

David P. Calfee, MD, MS

David P. Calfee, MD, MS

Author – David P. Calfee, MD, MS
Associate Professor of Medicine and Public Health at Weill Cornell Medical College,
Chief Hospital Epidemiologist at New York-Presbyterian Hospital/Weill Cornell in New York City

The GNYHA, UHF, and NYSDOH Antimicrobial Stewardship Project

While most discussions of antibiotic resistance and improving antibiotic prescribing practices (“antimicrobial stewardship”) focus on hospitals, antibiotic resistance and inappropriate antibiotic use are also prevalent in long-term care facilities (LTCFs). In fact, antibiotic resistance rates in LTCFs are often higher than in hospitals. Consequently, in 2009 the Greater New York Hospital Association, United Hospital Fund, and New York State Department of Health launched the Antimicrobial Stewardship Project.

The project pursued effective strategies for antimicrobial stewardship programs in LTCFs to demonstrate that beneficial activities could be performed without significant investment in new resources, and to demonstrate the value of hospital-LTCF partnerships in antimicrobial stewardship activities. Another goal was to develop tools and materials to assist project participants and other healthcare facilities to develop and manage their antimicrobial stewardship programs.

Time to rethink antibiotic use in long-term care facilities

Categories: Antibiotic use, Antimicrobial Resistance

Nimalie Stone, MD

Nimalie Stone, MD

Author — Nimalie Stone, M.D.
Medical Epidemiologist
CDC’s Division of Healthcare Quality Promotion

With increasing drug-resistant bacteria and complicating conditions from antibiotic use like diarrhea from C. difficile on the rise, we must look at every opportunity available to improve how antibiotics are being used in healthcare settings. This year as part of CDC’s Get Smart About Antibiotics Week, in addition to our ongoing focus on improving antibiotic use in hospitals, we invite partners who deliver care in long-term care facilities (e.g., nursing homes and skilled nursing facilities) to also join in the Get Smart for Healthcare campaign.

Antibiotics are some of the most frequently prescribed medications in long-term care facilities. Studies estimate that between 50-70% of residents will receive at least 1 course of antibiotics every year. Over time, that adds up to a lot of medication exposure. All this antibiotic use also drives the development of resistant bacteria making future infections far more difficult and costly to treat. One of the biggest challenges facing long-term care facilities is the prevention and control of C. difficile infections and relapses. These infections are more severe in people over age 65 resulting in hospitalizations and sometimes death.

Government Takes Action to Combat Antibiotic Resistance

Categories: Antimicrobial Resistance, Healthcare-associated infections

Steve Solomon, MD

Steve Solomon, MD

Author – Steve Solomon, MD
Director of the Office of Antimicrobial Resistance,
Division of Healthcare Quality Promotion,
National Center for Emerging and Zoonotic Infectious Diseases,
Office of Infectious Diseases, CDC.

Antimicrobial resistance is a world-wide problem and increases the difficulty of treating a variety of infections. Each day, every year in the United States, millions of Americans face a major threat from infections caused by bacteria that are resistant to antibiotics. Studies to obtain precise estimates for all types of resistant infections is are ongoing, but we do know that every year, almost 90,000 people become ill with serious infections caused by one of these resistant bacteria—methicillin-resistant Staphylococcus aureus or MRSA. Of these people, over 15,000 die.

Tremendously effective strategies have been developed to prevent infections, especially those likely to be caused by resistant bacteria. Readers of this blog are very familiar with the wide range of evidence-based, proven-effective interventions that reduce the incidence of infections and prevent the transmission of dangerous pathogens between people, especially hospitalized patients who are most at risk.

Protect Cancer Patients from Infections

Categories: Antibiotic use, Healthcare-associated infections, Outpatient Care

Alice Guh, M.D, MPH

Alice Guh, M.D, MPH

Author: Alice Guh,
CDC medical officer and co-lead of Preventing Infections in Cancer Patients initiative

As clinicians, we know that the nearly one million patients who receive outpatient cancer treatment each year are at risk for serious infections that may lead to hospitalization, disruptions in chemotherapy schedules, and in some cases, death. Even so, it appears that outpatient oncology facilities may vary greatly in their attention to infection prevention. As one example – at an oncology clinic in Nebraska, it was discovered that syringes were reused to access bags of saline that were shared among multiple patients. This unsafe practice led to the transmission of hepatitis C virus to at least 99 cancer patients, resulting in one of the largest healthcare-associated outbreaks of its kind.

To help address this problem, CDC is launching a new program called Preventing Infections in Cancer Patients, featuring tools to help both clinicians and patients prevent infections.

As a cornerstone of this new initiative, CDC worked with partners to develop a Basic Infection Control and Prevention Plan for Outpatient Oncology Settings, which can be used by outpatient oncology facilities to standardize – and improve – infection prevention practices.

International Infection Prevention Week Celebrates a Milestone

Categories: Healthcare-associated infections

Russell N. Olmsted, MPH, CIC

Russell N. Olmsted, MPH, CIC

Author: Russell N. Olmsted, MPH, CIC
2011 President, APIC
Director, Infection Prevention & Control Services, St. Joseph Mercy Health System,
Ann Arbor, Michigan

International Infection Prevention Week (IIPW), which occurs October 16–22, 2011, represents the 25th anniversary of the commemoration of the importance of infection prevention around the globe.  It does not seem possible that 25 years have passed since the launch of this important event.

Under the theme of “infection prevention is everyone’s business,” this annual recognition allows APIC the opportunity to strengthen relationships with other organizations actively engaged in infection prevention and to broaden the understanding of how we all work together to protect patients. To date, nearly 30 associations and half of U.S. states have pledged their support for IIPW.

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