Sepsis Program Activities in Acute Care Hospitals - National Healthcare Safety Network, United States, 2022.

Sepsis, life-threatening organ dysfunction secondary to infection, contributes to at least 1.7 million adult hospitalizations and at least 350,000 deaths annually in the United States. Sepsis care is complex, requiring the coordination of multiple hospital departments and disciplines. Sepsis programs can coordinate these efforts to optimize patient outcomes. The 2022 National Healthcare Safety Network (NHSN) annual survey evaluated the prevalence and characteristics of sepsis programs in acute care hospitals. Among 5,221 hospitals, 3,787 (73%) reported having a committee that monitors and reviews sepsis care. Prevalence of these committees varied by hospital size, ranging from 53% among hospitals with 0-25 beds to 95% among hospitals with >500 beds. Fifty-five percent of all hospitals provided dedicated time (including assigned protected time or job description requirements) for leaders of these committees to manage a program and conduct daily activities, and 55% of committees reported involvement with antibiotic stewardship programs. These data highlight opportunities, particularly in smaller hospitals, to improve the care and outcomes of patients with sepsis in the United States by ensuring that all hospitals have sepsis programs with protected time for program leaders, engagement of medical specialists, and integration with antimicrobial stewardship programs. CDC's Hospital Sepsis Program Core Elements provides a guide to assist hospitals in developing and implementing effective sepsis programs that complement and facilitate the implementation of existing clinical guidelines and improve patient care. Future NHSN annual surveys will monitor uptake of these sepsis core elements.

Evaluation of the reproducibility of a serological test for antibodies to Chlamydia trachomatis pgp3: A potential surveillance tool for trachoma programs.

PURPOSE: Serological testing for antibodies to Chlamydia trachomatis pgp3 is being evaluated as a tool to use for trachoma surveillance. There are limited data on the reproducibility of the test results using a multiplex platform. METHODS: We tested the reproducibility of a serologic test for C. trachomatis pgp3 in 6 dried blood spots collected from a random sample of 45 children from a trachoma endemic area. The spots were tested on a multiplex bead array platform, using one bead set twice, using another bead set at the same time as the first, and using the same bead set twice on different days separated by several months. Seropositivity was defined using ROC analyses from the same external controls for both bead sets. We compared the mean fluorescent intensity unit minus background (MFI-BG) results using the intraclass correlation coefficient (ICC), and analyzed the concordance of seropositivity designation using the kappa statistic. RESULTS: The tests using the same bead set were highly correlated, ICC = 0.997 (0.995-1.00). Even tested months apart, the slight loss of signal was not statistically significant (p = 0.06). The test of the two different bead sets showed high correlation, but the differences in MFI-BG was statistically significant. However, the serostatus of the children was unchanged comparing the seropositivity using one bead set compared to a second bead set. CONCLUSION: The reproducibility of the multiplex bead array for serological testing of antibodies to Chlamydia trachomatis pgp3 is high when the same bead set is used for testing.

Longitudinal change in the serology of antibodies to Chlamydia trachomatis pgp3 in children residing in a trachoma area.

A serologic test for antibodies to chlamydial antigen pgp3 may be a useful tool for trachoma surveillance. However, little is known about the stability of antibody status over time, or factors associated with seroreversion/conversion. A cohort of 2,111 children ages 1-9 years in Tanzania were followed for one year in the absence of mass azithromycin. At baseline and follow-up, they were evaluated for trachoma, chlamydial infection, and antibodies to chlamydial antigen pgp3. At baseline, 31% of children were seropositive for pgp3 antibodies and 6.4% seroreverted to negative over one year. Of those seronegative, 9.8% seroconverted over the year. The seroreverters had lower baseline mean fluorescence intensity (MFI-BG) values compared to the seropositives who remained positive (Odds Ratio = 0.04 for every unit increase in log10MFI-BG, 95% CI = 0.02-0.09), and were more likely to live in communities with trachoma <5% (p < 0.008). While seroconversion was expected, seroreversion was unexpected. The low seroprevalence rate reported from low endemic areas may be due to seroreversion as well as lack of exposure.