Last data update: Apr 22, 2024. (Total: 46599 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Shrivastwa N [original query] |
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Remote Infection Control Assessments of US Nursing Homes During the COVID-19 Pandemic, April to June 2020.
Walters MS , Prestel C , Fike L , Shrivastwa N , Glowicz J , Benowitz I , Bulens S , Curren E , Dupont H , Marcenac P , Mahon G , Moorman A , Ogundimu A , Weil LM , Kuhar D , Cochran R , Schaefer M , Slifka KJ , Kallen A , Perz JF . J Am Med Dir Assoc 2022 23 (6) 909-916 e2 BACKGROUND: Nursing homes (NHs) provide care in a congregate setting for residents at high risk of severe outcomes from SARS-CoV-2 infection. In spring 2020, NHs were implementing new guidance to minimize SARS-CoV-2 spread among residents and staff. OBJECTIVE: To assess whether telephone and video-based infection control assessment and response (TeleICAR) strategies could efficiently assess NH preparedness and help resolve gaps. DESIGN: We incorporated Centers for Disease Control and Prevention COVID-19 guidance for NH into an assessment tool covering 6 domains: visitor restrictions; health care personnel COVID-19 training; resident education, monitoring, screening, and cohorting; personal protective equipment supply; core infection prevention and control (IPC); and communication to public health. We performed TeleICAR consultations on behalf of health departments. Adherence to each element was documented and recommendations provided to the facility. SETTING AND PARTICIPANTS: Health department-referred NHs that agreed to TeleICAR consultation. METHODS: We assessed overall numbers and proportions of NH that had not implemented each infection control element (gap) and proportion of NH that reported making ≥1 change in practice following the assessment. RESULTS: During April 13 to June 12, 2020, we completed TeleICAR consultations in 629 NHs across 19 states. Overall, 524 (83%) had ≥1 implementation gaps identified; the median number of gaps was 2 (interquartile range: 1-4). The domains with the greatest number of facilities with gaps were core IPC practices (428/625; 68%) and COVID-19 education, monitoring, screening, and cohorting of residents (291/620; 47%). CONCLUSIONS AND IMPLICATIONS: TeleICAR was an alternative to onsite infection control assessments that enabled public health to efficiently reach NHs across the United States early in the COVID-19 pandemic. Assessments identified widespread gaps in core IPC practices that put residents and staff at risk of infection. TeleICAR is an important strategy that leverages infection control expertise and can be useful in future efforts to improve NH IPC. |
Notes from the Field: Hospital water contamination associated with a pseudo-outbreak of Mycobacterium porcinum - Wisconsin, 2016-2018
Kloth H , Elbadawi LI , Bateman A , Louison L , Shrivastwa N . MMWR Morb Mortal Wkly Rep 2019 68 (49) 1149 During January–December 2017, a hospital laboratory in Wisconsin identified a cluster of seven isolates that tested positive for a rapidly growing nontuberculous mycobacterium, Mycobacterium porcinum, which is associated with infections of the respiratory tract, bloodstream (caused by pathogen-contaminated intravenous catheters and equipment), surgical sites, and soft tissue (1–3). All clinical isolates were obtained from respiratory cultures (sputum, bronchoalveolar lavages, or bronchial aspirates) from patients in the hospital’s intensive care units. No associated clinical infections were reported. Because M. porcinum is rarely encountered, a concern that these isolates represented laboratory contamination was raised, and the hospital infection prevention team began an internal investigation. During this time, the hospital’s infection prevention team and the Wisconsin State Laboratory of Hygiene (WSLH) investigated possible infection control breaches and laboratory workflow processes. Following the identification of four additional isolates in January 2018, all patient specimens submitted for acid-fast bacteria culture were routed directly to WSLH for testing beginning February 12. WSLH identified three additional positive M. porcinum isolates from patients, suggesting that the organism was not a hospital laboratory contaminant. On March 16, the hospital notified the Wisconsin Division of Public Health of the cluster of M. porcinum–positive respiratory isolates. By April 12, a total of 20 isolates had been obtained from 16 patients. A retrospective chart review demonstrated that none of the isolates were associated with a clinical infection; other infections accounted for all patients’ illnesses. |
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