Infection Control Today® Editorial Staff

’s wide-ranging coverage of the infection prevention and control world. Everything from interviews with known opinion leaders, to the news that infection preventionists and other health care professionals can use on their jobs.

Even in Shadow of COVID-19, Influenza Poses Pandemic Threat

The ability of any infectious agent to maintain constant transmission enables it to be an ongoing threat to public health. Few pathogens have achieved greater success at ongoing transmission potential than the influenza virus.

Infection preventionists and other health care providers need masks that can easily be fit-tested or are more moldable to ensure a good seal—Saskia v. Popescu, PhD, MPH, MA, CIC.

As COVID-19 infection, hospitalization, and mortality rates head downward, pediatric SARS-CoV-2 rates rise, and nursing homes can again become disaster zones. And remember: Winter is coming.

COVID-19 Vaccine Hesitancy Among Health Care Workers: Why?

Vaccine hesitant health care professionals are most likely to be persuaded by fellow workers. Meanwhile, mandates can backfire.

Twofer Vaccine in the Making Works Against ‘Twindemic’ of Flu, COVID-19

A one-and-done vaccine that prevents both influenza and COVID-19 might help alleviate vaccine hesitancy for both conditions.

Articles

Take 5 minutes to catch up on Infection Control Today’s highlights for the week ending October 15.

Weekly Rounds with Infection Control Today: Battling COVID and Flu, Fixing Masking Problems, Vaccine Hesitancy in Health Care Workers

Viewpoint: Here’s Why COVID-19 Is Much Worse Than Flu

Unlike influenza, SARS-CoV-2 uses ACE2 receptors to infiltrate cells. Similar to HIV, SARS-CoV-2 can silently spread throughout the host’s body and attack almost every organ.

Welcome to ID Week, Infection Preventionists

Joshua Nosanchuk, MD, Programs Chairperson for ID Week: “What the infection preventionists are doing I think is a true blessing for our community. And not always as well recognized as it should be…. I just want to say thank you to all the people that are doing this work.”

Long COVID-19 Spreads Wide Toxic Net That Includes Kids

A huge peer reviewed study in PLOS Medicine underscores just how much of a threat long COVID-19 presents: 1 in 3 survivors display symptoms of the disease 3 to 6 months after initial infection.

Without an Engaged Community, Infection Prevention Can Flounder

Coupling risk communication and effective engagement with the community can provide opportunities to change behavior and shape awareness of basic practices that can break the chain of transmission for many diseases.

Discussing Pros, Cons of Universal Masking Post-COVID 19

Pro: Health care professionals work around vulnerable patients, and in environments that might be contaminated by COVID-19. Con: Patients want to see their caregiver’s face.

Take 5 minutes to catch up on Infection Control Today’s highlights for the week ending October 1.

Weekly Rounds with Infection Control Today: COVID-19’s Much Worse Than Flu, Long COVID’s Effect on Kids, Universal Masking

COVID-19 Surges Stress Infection Preventionists to the Breaking Point

Infection preventionists across health care settings struggle with a myriad of problems during this pandemic. IPs at nursing homes have it particularly hard.

$2.1 Billion To Be Invested for Infection Prevention and Control Efforts

The allocations are scheduled to begin next month, with initial awards totaling $885, of which $500 million will go to what the CDC calls “strike teams” that will focus on nursing homes and other long-term care facilities.

CDC Chief Vetoes Advisors: Health Care Workers Can Get Booster Shots

In a highly unusual move, CDC Director Rochelle Walensky, MD, overruled the agency’s panel of experts, saying that health care workers should get COVID-19 booster shots.

Surging or Shackled? Flu Season Could Go Either Way

The season of respiratory tract infections is upon us. Influenza, rhinovirus, respiratory syncytial virus, and pertussis—as well as COVID-19—once again are attacking many individuals across the US and worldwide.

CDC Gives Guidance On COVID-19 Isolation, Precautions

CDC: “For most children and adults with symptomatic SARS-CoV-2, the virus that causes COVID-19, infection, isolation, and precautions can be discontinued 10 days after symptom onset and after resolution of fever for at least 24 hours and improvement of other symptoms.”

Take 5 minutes to catch up on Infection Control Today’s highlights for the week ending September 24.

Weekly Rounds with Infection Control Today: COVID Stress, Infection Prevention Funding, Booster Shots Debate

The faster patients suffering from sepsis get antibiotics the better the chance for survival, but there still needs to be concern about possible side effects from the medications and the overall problem of contributing to antibiotic resistance, that could possibly 

 in the future. That’s one of the findings in a large cohort 

, the other major finding being that the median time-to-antibiotics for sepsis declined by over by 9 minutes per year during the course of the study.

Source: Centers for Disease Control and Prevention. A close view of the dorsal aspect of a patient’s right hand. Note the swelling and erythema, in the location of the fourth metacarpophalyngeal (MP) joint, which had been caused by a systemically disseminated gonococcal infection, referred to as gonococcal sepsis.

Also, investigators with the University of Michigan and the Department of Veterans Affairs (VA) found that there didn’t seem to be a standardized approach concerning when to administer antibiotics. The study included 111,385 hospitalizations for sepsis at 130 VA hospitals from 2013 to 2018. The primary outcome was time-to-antibiotics across study periods, hospitals and patient subgroups based on presenting temperature and blood pressure.

“While time-to-antibiotics declined overall and in nearly every hospital during the study, there remained more than 2-fold variation in median time-to-antibiotics in the most recent study years,” the study states.

The variation remained even after investigators adjusted the data to account for different patient characteristics.

“This may represent a potential opportunity for practice improvement going forward, but the benefits of further accelerating time-to-antibiotics must be balanced against the risk of driving antibiotic overuse in patients with noninfectious illness,” the study states.

A good place to start would be better monitoring of patients with abnormally low blood pressure—hypotension.

The study states that “time-to-antibiotics was faster for patients with fever and normal blood pressure than for patients without fever but with hypotension, suggesting that obvious signs of infection are a stronger trigger to prescribe antibiotics than shock or that competing treatments for patients with hypotension (eg, starting vasopressors) are prioritized before antibiotics, even though antibiotic delays are associated with greater mortality risk in patients with shock or hypotension.”

Most patients (68.7%) received their first dose of antibiotics in the emergency department. A total of 7574 patients (6.8%) died in the hospital, and longer time-to-antibiotics was associated with higher in-hospital mortality. A total of 13,855 patients (12.4%) died within 30 days of discharge.

The median time-to-antibiotics (adjusted for patient characteristics) declined by 9 minutes per calendar year but varied significantly between hospitals, with average time-to-antibiotics in the most recent time period ranging from 3.1 hours to 6.7 hours. Overall, the unadjusted median time-to-antibiotics decreased from 4.5 hours in the first year of the study to 3.5 hours in the most recent year.

Max Wayne, MD, fellow in pulmonary and critical care medicine at the University of Michigan, told 

 that “our findings suggest that patients with more obvious signs of infection get antibiotics faster. However, it is important to be cognizant that some patients with subtle findings can nonetheless still be very sick due to infection and warrant early antibiotics.”

The study also states that “slope of change over time varied across hospitals in this initiative, resulting in a growing disparity in time-to-antibiotics by race as hospitals treating higher proportions of Black patients experienced less decrease over time.”

For patients in hospitals with faster time-to-antibiotics, the odds of receiving antibiotics within 3 hours increase by 65%. Median time-to-antibiotics during the most recent year of the study (3.9 hours) varied depending on presenting characteristics.

Wayne said that “fever seemed to be a stronger driver of rapid antibiotics than low blood pressure.”

A version of this article originally appeared in 

Patients with abnormally low blood pressure were less likely to receive antibiotics even though they could benefit from such treatment, according to a recent study.

Infection Control Today® Editorial Staff

Articles

Weekly Rounds with Infection Control Today: Battling COVID and Flu, Fixing Masking Problems, Vaccine Hesitancy in Health Care Workers

Weekly Rounds with Infection Control Today: COVID-19’s Much Worse Than Flu, Long COVID’s Effect on Kids, Universal Masking

Weekly Rounds with Infection Control Today: COVID Stress, Infection Prevention Funding, Booster Shots Debate

Sepsis Sufferers Getting Antibiotics Quicker