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1.
Infect Control Hosp Epidemiol ; 44(8): 1351-1354, 2023 08.
Article in English | MEDLINE | ID: mdl-35652600

ABSTRACT

We describe COVID-19 cases among nonphysician healthcare personnel (HCP) by work location. The proportion of HCP with coronavirus disease 2019 (COVID-19) was highest in the emergency department and lowest among those working remotely. COVID-19 and non-COVID-19 units had similar proportions of HCP with COVID-19 (13%). Cases decreased across all work locations following COVID-19 vaccination.


Subject(s)
COVID-19 , Humans , Iowa/epidemiology , COVID-19 Vaccines , Health Personnel , Workplace , Delivery of Health Care
2.
Article in English | MEDLINE | ID: mdl-36483395

ABSTRACT

We analyzed blood-culture practices to characterize the utilization of the Infectious Diseases Society of America (IDSA) recommendations related to catheter-related bloodstream infection (CRBSI) blood cultures. Most patients with a central line had only peripheral blood cultures. Increasing the utilization of CRBSI guidelines may improve clinical care, but may also affect other quality metrics.

3.
Am J Infect Control ; 50(3): 277-282, 2022 03.
Article in English | MEDLINE | ID: mdl-35000801

ABSTRACT

BACKGROUND: The COVID-19 pandemic has affected infection prevention and control (IPC) programs worldwide. We evaluated the impact of COVID-19 on the University of Iowa Hospitals & Clinics IPC program by measuring the volume of calls to the program, changes in healthcare-associated infection rates, and team member perceptions. METHODS: We retrieved the IPC call log and healthcare-associated infection trends for 2018-2020. We defined 2 periods: pre-COVID-19 (2018-2019) and COVID-19 (January-December 2020). We also conducted one-on-one interviews and focus group interviews with members of the IPC program and describe changes in their working conditions during the COVID-19 period. RESULTS: A total of 6,564 calls were recorded during 2018-2020. The pre-COVID-19 period had a median of 71 calls and/or month (range: 50-119). During the COVID-19 period, the median call volume increased to 368/month (range: 149-829), and most calls were related to isolation precautions (50%). During the COVID-19 period, the central line-associated bloodstream infection incidence increased significantly. Infection preventionists reported that the ambiguity and conflicting guidance during the pandemic were major challenges. CONCLUSIONS: Our IPC program experienced a 500% increase in consultation requests. Planning for future bio-emergencies should include creative strategies to increase response capacity within IPC programs.


Subject(s)
COVID-19 , COVID-19/prevention & control , Humans , Infection Control , Iowa/epidemiology , Pandemics/prevention & control , SARS-CoV-2
4.
Infect Control Hosp Epidemiol ; 43(12): 1948-1950, 2022 12.
Article in English | MEDLINE | ID: mdl-34396947

ABSTRACT

We described the epidemiology of bat intrusions into a hospital and subsequent management of exposures during 2018-2020. Most intrusions occurred in older buildings during the summer and fall months. Hospitals need bat intrusion surveillance systems and protocols for bat handling, exposure management, and intrusion mitigation.


Subject(s)
Chiroptera , Animals , Humans , Aged , Tertiary Care Centers , Iowa
5.
Infect Control Hosp Epidemiol ; 43(8): 974-978, 2022 08.
Article in English | MEDLINE | ID: mdl-34169812

ABSTRACT

OBJECTIVE: Patients admitted to the hospital may unknowingly carry severe acute respiratory coronavirus virus 2 (SARS-CoV-2), and hospitals have implemented SARS-CoV-2 admission screening. However, because SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) assays may remain positive for months after infection, positive results may represent active or past infection. We determined the prevalence and infectiousness of patients who were admitted for reasons unrelated to COVID-19 but tested positive for SARS-CoV-2 on admission screening. METHODS: We conducted an observational study at the University of Iowa Hospitals & Clinics from July 7 to October 25, 2020. All patients admitted without suspicion of COVID-19 were included, and medical records of those with a positive admission screening test were reviewed. Infectiousness was determined using patient history, PCR cycle threshold (Ct) value, and serology. RESULTS: In total, 5,913 patients were screened and admitted for reasons unrelated to COVID-19. Of these, 101 had positive admission RT-PCR results; 36 of these patients were excluded because they had respiratory signs/symptoms on admission on chart review. Also, 65 patients (1.1%) did not have respiratory symptoms. Finally, 55 patients had Ct values available and were included in this analysis. The median age of the final cohort was 56 years and 51% were male. Our assessment revealed that 23 patients (42%) were likely infectious. The median duration of in-hospital isolation was 5 days for those likely infectious and 2 days for those deemed noninfectious. CONCLUSIONS: SARS-CoV-2 was infrequent among patients admitted for reasons unrelated to COVID-19. An assessment of the likelihood of infectiousness using clinical history, RT-PCR Ct values, and serology may help in making the determination to discontinue isolation and conserve resources.


Subject(s)
COVID-19 , Academic Medical Centers , COVID-19/diagnosis , COVID-19/epidemiology , Female , Hospitalization , Humans , Iowa/epidemiology , Male , Middle Aged , SARS-CoV-2
6.
Infect Control Hosp Epidemiol ; 43(12): 1910-1913, 2022 12.
Article in English | MEDLINE | ID: mdl-34250882

ABSTRACT

The incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure in shared patient rooms was low at our institution: 1.8 per 1,000 shared-room patient days. However, the secondary attack rate (21.6%) was comparable to that reported in household exposures. Lengthier exposures were associated with SARS-CoV-2 conversion. Hospitals should implement measures to decrease shared-room exposures.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , SARS-CoV-2 , Incidence , Patients' Rooms , Iowa/epidemiology , Tertiary Care Centers
7.
Am J Infect Control ; 49(12): 1567-1568, 2021 12.
Article in English | MEDLINE | ID: mdl-34400244

ABSTRACT

We compared the incidence of Clostridioides difficile infection before and after the discontinuation of Ultraviolet light used in addition to bleach in terminal disinfection of hospital rooms. We found no difference in C. difficile infection rates but found a decreased turn over time. The benefit of Ultraviolet light may be diminished in hospitals with a high thoroughness of manual cleaning.


Subject(s)
Clostridioides difficile , Cross Infection , Clostridioides , Cross Infection/epidemiology , Cross Infection/prevention & control , Disinfection , Humans , Iowa , Tertiary Care Centers , Ultraviolet Rays
10.
Clin Infect Dis ; 73(9): e3116-e3119, 2021 11 02.
Article in English | MEDLINE | ID: mdl-33103196

ABSTRACT

We implemented serial coronavirus disease 2019 testing for inpatients with a negative test on admission. The conversion rate (negative to positive) on repeat testing was 1%. We identified patients during their incubation period and hospital-onset cases, rapidly isolated them, and potentially reduced exposures. Serial testing and infectiousness determination were resource intensive.


Subject(s)
COVID-19 , COVID-19 Testing , Hospitals , Humans , SARS-CoV-2
11.
J Wildl Dis ; 51(4): 821-32, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26251992

ABSTRACT

Rabies virus (RABV) infects multiple bat species in the Americas, and enzootic foci perpetuate in bats principally via intraspecific transmission. In recent years, bats have been implicated in over 90% of human rabies cases in the US. In Tennessee, two human cases of rabies have occurred since 1960: one case in 1994 associated with a tricolored bat (Perimyotis subflavus) RABV variant and another in 2002 associated with the tricolored/silver-haired bat (P. subflavus/Lasionycteris noctivagans) RABV variant. From 1996 to 2010, 2,039 bats were submitted for rabies testing in Tennessee. Among 1,943 bats in satisfactory condition for testing and with a reported diagnostic result, 96% (1,870 of 1,943) were identified to species and 10% (196 of 1,943) were rabid. Big brown (Eptesicus fuscus), tricolored, and eastern red (Lasiurus borealis) bats comprised 77% of testable bat submissions and 84% of rabid bats. For species with five or more submissions during 1996-2010, the highest proportion of rabid bats occurred in hoary (Lasiurus cinereus; 46%), unspecified Myotis spp. (22%), and eastern red (17%) bats. The best model to predict rabid bats included month of submission, exposure history of submission, species, and sex of bat.


Subject(s)
Chiroptera , Rabies/veterinary , Animals , Female , Humans , Male , Rabies/epidemiology , Species Specificity , Tennessee/epidemiology , Time Factors
12.
Public Health Rep ; 124(2): 212-6, 2009.
Article in English | MEDLINE | ID: mdl-19320362

ABSTRACT

An outbreak of foodborne hepatitis A infection compelled two regional health departments in eastern Tennessee to implement an emergency mass clinic for providing hepatitis immune serum globulin (ISG) to several thousand potentially exposed people. For the mass clinic framework, we utilized the smallpox post-event clinic plans of the Centers for Disease Control and Prevention (CDC), although the plans had only been exercised for smallpox. Following CDC's guidelines for staffing and organizing the mass clinic, we provided 5,038 doses of ISG during a total of 24 hours of clinic operation, using 3,467 person-hours, or 1.45 ISG doses per person-hour-very close to the 1.58 doses per person-hour targeted in CDC's smallpox post-event clinic plans. The mass clinic showed that CDC's smallpox post-event clinic guidelines were feasible, practical, and adaptable to other mass clinic situations.


Subject(s)
Ambulatory Care Facilities/organization & administration , Disaster Planning/organization & administration , Disease Outbreaks/prevention & control , Food Contamination/analysis , Hepatitis A Antibodies/administration & dosage , Hepatitis A/epidemiology , Immune Sera/administration & dosage , Immunologic Factors/administration & dosage , Public Health Administration , Public Health Practice , Centers for Disease Control and Prevention, U.S. , Hepatitis A/diagnosis , Hepatitis A/prevention & control , Hepatitis A Antibodies/blood , Hepatitis A Virus, Human/immunology , Hepatitis A Virus, Human/isolation & purification , Humans , Immunoglobulin M/blood , Immunologic Factors/blood , Injections , Personnel Staffing and Scheduling , Restaurants , Tennessee/epidemiology , United States/epidemiology
13.
Vaccine ; 24(9): 1354-8, 2006 Feb 27.
Article in English | MEDLINE | ID: mdl-16297510

ABSTRACT

Current recommendations have not resulted in routine vaccination of correctional facility inmates for hepatitis B. We investigated two hepatitis B outbreaks. Outbreak 1 involved 4 cases epidemiologically linked to persons who had been in jail. Outbreak 2 involved 48 community cases; 69% had a history of incarceration. Two-thirds of the cases in these outbreaks might have been prevented by a program of routine vaccination of local jail inmates. Priority should be given to developing and supporting practical programs to vaccinate the high-risk populations in correctional facilities against hepatitis B.


Subject(s)
Disease Outbreaks , Hepatitis B Vaccines/administration & dosage , Hepatitis B/epidemiology , Prisoners , Adolescent , Adult , Aged , Disease Outbreaks/prevention & control , Female , Health Policy , Hepatitis B/prevention & control , Humans , Male , Middle Aged , United States/epidemiology
14.
J Infect Dis ; 192(8): 1323-30, 2005 Oct 15.
Article in English | MEDLINE | ID: mdl-16170748

ABSTRACT

BACKGROUND: Molecular epidemiologic investigations can link geographically separate foodborne hepatitis A outbreaks but have not been used while field investigations are in progress. In 2003, outbreaks of foodborne hepatitis A were reported in multiple states. METHODS: Case-control studies were conducted in 3 states. Hepatitis A virus was sequenced from serologic specimens from individuals associated with outbreaks and from individuals concurrently ill with hepatitis A in non-outbreak settings in the United States and Mexico. RESULTS: Case-control studies in Tennessee (TN), North Carolina (NC), and Georgia (GA) found green onions to be associated with illness among restaurant patrons (TN: odds ratio [OR], 65.5 [95% confidence interval {CI}, 8.9-482.5; NC: OR, 2.4 [95% CI, 0.3-21.9]; GA: OR, 20.9 [95% CI, 3.9-110.3]). Viral sequences from TN case patients differed by 2 nt, compared with those from case patients in NC and GA. A third sequence, differing from the TN and GA/NC sequences by 1 nt, was identified among case patients in a subsequent outbreak in Pennsylvania. Each outbreak sequence was identical to > or =1 sequence isolated from northern Mexican resident(s) with hepatitis A. The sources of green onions served in restaurants in TN and GA were 3 farms in northern Mexico. CONCLUSIONS: Ongoing viral strain surveillance facilitated the rapid implementation of control measures. Incorporation of molecular epidemiologic methods into routine hepatitis A surveillance would improve the detection of hepatitis A outbreaks and increase our understanding of hepatitis A epidemiology in the United States.


Subject(s)
Disease Outbreaks , Food Microbiology , Hepatitis A virus/genetics , Hepatitis A/epidemiology , Case-Control Studies , Disease Outbreaks/statistics & numerical data , Food Handling , Foodborne Diseases/epidemiology , Foodborne Diseases/virology , Hepatitis A/etiology , Hepatitis A/mortality , Hepatitis A virus/isolation & purification , Humans , Molecular Epidemiology , United States/epidemiology
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