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K. Healthcare-Associated and Surgical Infections and Clinical Epidemiology

 

Meet-the-Experts

 

Antimicrobial Resistance and Antimicrobial Stewardship in Non-Hospital Settings

This meet the expert session will provide the participant with an update on antimicrobial resistance and antimicrobial stewardship in non-hospital settings. It will also provide practical suggestions for attendees who are working to control antimicrobial resistance and/or antimicrobial use in settings such as long-term care facilities and long-term acute-care facilities. Participants will be able to ask questions and share their own experiences.

Upon completion of this Meet-the-Experts Session, the participant should be able to:

• Identify issues regarding antimicrobial resistance and antimicrobial stewardship in non-hospital settings that are specific to these settings;
• Identify resources that are helpful for addressing antimicrobial resistance and antimicrobial stewardship in non-hospital settings; and 
• Identify one intervention they can use in their own practice. 

Experts:
L. Silvia Munoz-Price, MD; Jackson Mem. Hosp., Univ. of Miami, Miami, FL.
Maria Luisa Moro, MD; Agenzia Sanitaria e Sociale Regione Emilia-Romagna, Bologna, Italy.

 

Challenging Issues in Pediatric Infection Prevention and Control

This session will discuss the epidemiology of healthcare-associated infection in pediatric patients and preventive strategies to be implemented in this setting.

Upon completion of this Meet-the-Experts Session, the participant should be able to:

• Discuss the epidemiology of healthcare-associated infections in neonatal and pediatric patients;
• Describe effective strategies for the prevention and control of infection in pediatric care settings; and 
• Describe the best evidence-based strategies to apply in the pediatric setting. 

Experts:
Walter Zingg, MD; Univ. of Geneva Hosp., Geneva, Switzerland.
Lisa Saiman, MD, MPH; Columbia Univ. Med. Ctr., New York, NY.

 

Environmental Cleaning and Infection Prevention

This meet-the-expert session will provide the participant with an update on studies: linking environmental cleaning and healthcare-associated infections (HAIs), evaluating the efficacy of cleaning interventions on preventing HAIs, and assessing methods of evaluating cleaning effectiveness. It will also provide practical suggestions for attendees who are trying to improve cleaning and decrease HAIs in their facilities. Participants will be able to ask questions and share their own experiences.

Upon completion of this Meet-the-Experts Session, the participant should be able to:

• Discuss the evidence linking environmental contamination and HAIs;
• Identify methods that assess environmental cleaning; and 
• Identify one intervention they can use in their own practice. 

Experts:
John M. Boyce, MD; Hosp. of Saint Raphael, New Haven, CT.
Markus Dettenkofer, MD; Inst. für Umweltmedizin und Krankenhaushygiene, Univ. Sklinikum Freiburg, Freiburg, Germany.

 

Infection Prevention and Control in Low- and -Middle-Resource Settings

This session will provide an overview on the challenges of healthcare-associated infections in countries with limited resources. It will address specifically the burden of endemic healthcare-associated infections in these countries and highlight possible preventive and surveillance strategies to be implemented in these settings.

Upon completion of this Meet-the-Experts Session, the participant should be able to:

• Measure the importance of infection prevention in countries with limited resources;
• Discuss possible surveillance strategies to be implemented in countries with limited resources; 
• Identify the most frequent healthcare-associated infections in countries with limited resources; and 
• Discuss the barriers to infection control in countries with limited resources. 

Experts:
Benedetta Allegranzi, MD; World Hlth. Organization, Geneva, Switzerland.
Shaheen Mehtar, MD; Stellenbosch Univ., Tygerberg, South Africa.

 

Issues in the Diagnosis and Management of Prosthetic Joint Infections

Prosthetic joint infections represent an important cause of morbidity and mortality, and the number of infections is likely to grow in the coming years as the population ages and the number of prosthetic joint replacement procedures increases. Diagnosis and management of such infections can by challenging to clinicians. The speaker will provide an up-to-date review of the literature surrounding the topic, and will make themselves available to answer questions from the attendees.
Upon completion of this Meet-the-Experts Session, the participant should be able to:

• Discuss the latest understanding of the pathogenesis of prosthetic joint infection;
• Identify the advantages and disadvantages of various diagnostic strategies; and 
• Assess optimal operative and non-operative management strategies for prosthetic joint infections. 

Experts:
Andrej Trampuz, MD; Univ. Hosp. Lausanne, Lausanne, Switzerland.
Adolf W. Karchmer, MD; Beth Israel Deaconess Med. Ctr., Harvard Med. Sch., Boston, MA.

 

MDRO Control: What to Do When Basic Prevention Measures Don’t Work?

Upon completion of this Meet-the-Experts Session, the participant should be able to:

• Discuss the basic preventive measures which are generally taken as the first tier measures;
• Identify possible measures which are generally taken as the second tier measures; and 
• Assess the strengths and weaknesses of the different second tier measures and when to apply them for the different MDROs. 

Experts:
Alexander J. Kallen, MD, MPH; CDC, Atlanta, GA.
Po Ren Hsueh, MD; Natl. Taiwan Univ. Hosp., Natl. Taiwan Univ. Coll. of Med., Taipei, Taiwan.
Paul A. Tambyah, MD; Natl. Univ. Hosp., Singapore, Singapore.

 

Preventing Line-Associated Bloodstream Infection: Which Measures are Essential?

Central venous catheters are those most commonly associated with bloodstream infections, resulting in increased hospital stay and treatment costs. This session provides an overview of infection control and prevention measures for the prevention of line-associated bloodstream infection, including the bundle approach.

Upon completion of this Meet-the-Experts Session, the participant should be able to:

• Identify the most effective measures to prevent bloodstream infection;
• Explain the importance of adhering to evidence-based practice recommendations to prevent bloodstream infection; and 
• Discuss why a continuous monitoring of review of processes is essential to maintain a low infection rate. 

Experts:
Dennis Maki, MD; Univ. of Wisconsin Sch. of Med. and Publ. Health, Madison, WI.
Andreas Widmer, MD, MS; Univ. Hosp., Basel, Switzerland.

 

Top Papers in Infection Prevention and Control, 2011-2012

This session will provide an overview of the top papers at the cutting edge of infection prevention and control, 2011-2012, and discuss how to identify these kinds of papers and why these publications are important.

Upon completion of this Meet-the-Experts Session, the participant should be able to:

• Provide a critical review of recently published papers in the field;
• Prioritize information in the literature; and 
• Summarize changes in practice and novel discoveries in the field. 

Experts:
Andreas Voss, MD, PhD; Canisius-Wilhelmina Hosp. & RUNMC, Nijmegen, Netherlands.
Loreen Herwaldt, MD; Univ. of Iowa Coll. of Med., Iowa City, IA.

 

Symposia

 

A Multifaceted Approach to Preventing Surgical Site Infections

This symposium will address methods for preventing surgical site infections (SSI) including implementing bundles of evidence-based practices, perioperative prophylaxis, and screening for Staphylococcus aureus carriage. The speakers will discuss recent developments in this field including the results of an unpublished metaanalysis on preoperative screening for S. aureus, peroperative decolonization of carriers, and perioperative prophylaxis for patients carrying methicillin-resistant S. aureus. In addition, one of the speakers will present the revised ASHP/SHEA/IDSA/SIS guidelines for perioperative prophylaxis and discuss the most important changes. Another speaker will discuss how to develop a bundle for preventing SSI and describe preliminary results of implementing such a bundle.

Upon completion of this Symposium Session, the participant should be able to:

• Discuss pros and cons of including specific interventions in a bundle to prevent SSIs;
• Discuss the evidence supporting screening patients undergoing cardiac or orthopedic procedures for Staphylococcus aureus; 
• Discuss the evidence addressing whether perioperative prophylaxis for non-abdominal procedures should include coverage for gram-negative organisms; and 
• Discuss important changes in the ASHP/SHEA/IDSA/SIS guidelines for perioperative antimicrobial prophylaxis. 

Conveners:
Loreen Herwaldt, MD; Univ. of Iowa Coll. of Med., Iowa City, IA.
Jan Kluytmans, MD; Amphia Hosp., Breda, Netherlands.

Presentations:
Implementing a Bundle Strategy to Prevent Surgical Site Infections
Jan Kluytmans, MD, PhD; Amphia Hosp., Breda, Netherlands.

Meta-Analysis of Studies Evaluating Preoperative Screening for S. aureus, Decolonization of Carriers, and Perioperative Antimicrobial Prophylaxis
Marin Schweizer, PhD; Carver Coll. of Med., Iowa City, IA.

Should Perioperative Prophylaxis for Non-Abdominal Procedures Include Coverage for Gram-Negative Organisms?
Andreas Widmer, MD, MS; Univ. Hosp., Basel, Switzerland.

The New ASHP/SHEA/IDSA/SIS Guidelines for Surgical Prophylaxis
E. Patchen Dellinger, MD; Univ. of Washington, Seattle, WA.

 

Are Prevalence Surveys Still Useful for Healthcare-Associated Infection Surveillance?

Upon completion of this Symposium Session, the participant should be able to:

• Identify the most recent utilizations of the prevalence survey in HAI surveillance;
• Discuss examples of effective application of the prevalence survey data in HAI surveillance; and 
• Identify the recent tools available to enhance the use of the prevalence survey. 

Conveners:
Wing Hong Seto, MD; Queen Mary Hosp., Hong Kong, China.
Gary French, MD, FRCPath; King's Coll., London, United Kingdom.

Presentations:
Period vs Point Prevalence Surveys: What is the Difference?
Walter Zingg, MD; Univ. of Geneva Hosp., Geneva, Switzerland.

Prevalence Surveys: New Insights From the UK Experience
Gary French, MD; King's Coll., London, United Kingdom.

The Use of Prevalence Surveys in Europe
Carl Suetens, MD; ECDC, Stockholm, Sweden.

Prevalence Surveys in Asia-Pacific: Effective Tracking of Care Practices
Benjamin J. Cowling, PhD; The Univ. of Hong Kong, Hong Kong, Hong Kong.

New Prevalence Survey Tools from the CDC
Shelley Magill, MD, PhD; CDC, Atlanta, GA.

 

Preventing Spread of M. tuberculosis in Healthcare Facilities

This symposium will describe the challenge of controlling tuberculosis worldwide and suggest changes in current approaches to controlling spread of M. tuberculosis that are necessary to stop spread of this organism. This symposium will also discuss rapid diagnostics and a novel approach to screening sputum specimens for M. tuberculosis. It will also describe healthcare workers’ risk of acquiring M. tuberculosis infection and approaches to screening healthcare workers for this infection. One goal of this symposium is to challenge attendees to think beyond our current approaches and to identify and implement novel methods of preventing and identifying M. tuberculosis infections.

Upon completion of this Symposium Session, the participant should be able to:

• Describe two approaches that will be essential for controlling spread of M. tuberculosis in the 21st century;
• Describe the pros and cons of current rapid diagnostic tools; 
• Describe a possible method for second-line screening for M. tuberculosis in resource limited countries; and 
• Describe the pros and cons of different methods for screening healthcare workers for tuberculosis. 

Conveners:
Loreen Herwaldt, MD; Univ. of Iowa Coll. of Med., Iowa City, IA.
Arthur l. Reingold, MD; Univ. of California, Berkeley, CA.

Presentations:
TB Infection Control Reconsidered
Edward Nardell, MD; Harvard Med. Sch., Harvard Sch. of Publ. Health, Brigham & Women's Hosp., Boston, MA.

Rapid Diagnostics: State-of-the-Art
Adithya Cattamanchi; San Francisco Gen. Hosp., Univ. of California, San Francisco, CA.

Thinking Out of the Box: Using Giant Gambian Pouched Rats for Second-Line Screening in Low- and Medium-Income Countries
Amanda D. Mahoney, MS; APOPO, Warren, MI.

Heathcare Worker’s Risk of Acquiring Tuberculosis and Screening Healthcare Workers for Tuberculosis
Arthur l. Reingold, MD; Univ. of California, Berkeley, CA.

 

Regional Approaches to Prevention of Healthcare-Associated Antimicrobial Resistance

Recent epidemiologic information suggests that the problem of healthcare-associated multidrug-resistant organisms (MDROs) is amplified by movement of MDRO-infected and colonized patients across the spectrum of healthcare delivery within a region (e.g. transfer of patients between long-term and acute care settings). Mathematical modeling evidence suggests that prevention strategies are most likely to be successful if these epidemiologic features are taken into account, and when prevention strategies are coordinated among healthcare facilities that share patient populations within a region. The speakers will review the scientific rationale for regional approaches to MDRO prevention and review data from several regions in which such strategies are being actively implemented. 

Upon completion of this Symposium Session, the participant should be able to:

• Discuss the scientific rationale for the regional approach to prevention of antimicrobial resistance;
• Describe how certain healthcare facilities may serve as reservoirs of transmission to other facilities in a region; and 
• Review the national experience with prevention of carbapenem-resistant Enterobacteriaceae in Israel.

Convener:
John Jernigan, MD; CDC, Atlanta, GA.

Presentations:
Sharing Patients Among Healthcare Facilities in a Region: Implications for Control of Multidrug-Resistant Organisms
Susan S. Huang, MD, MPH; Univ. of California, Orange, CA.

Using Local Epidemiology to Guide Control Strategies for Carbapenem-Resistant Enterobacteriaceae
Mary Hayden, MD; Rush Univ. Med. Ctr., Rush Med. Coll., Chicago, IL.

Follow-Up on the National Carbapenem-Resistant Enterobacteriaceae Intervention in Israel
Mitchell Schwaber, MD, MSC; Israel Ministry of Hlth., Tel Aviv, Israel.

 

Interactive Symposia

 

Challenges in Infection Control

This session provides a pro-con debate on today’s challenges in infection control, in particular the advantages/disadvantages of the use of mathematical models to predict outcome and the use of infection prevention bundles to produce a sustained decrease in the occurrence of catheter-associated bloodstream infections.

Upon completion of this Interactive Symposium Session, the participant should be able to:

• Discuss the advantages/disadvantages of MRSA prevention strategies in the ICU setting;
• Describe the concept of mathematical modeling , including its value and shortcomings in infection control; 
• Identify the concept of bundles and its role to help improve processes of care and patient outcomes; and 
• Identify the most effective components to be included in infection control bundles for a sustained effect. 

Conveners:
Didier Pittet, MD; Univ. of Geneva Hosp., Geneva, Switzerland.
Jean-Francois Timsit, MD, PhD; CHU A. Michallon, Univ. Joseph Fourier, Grenoble, France.

Panelists:
A) Reality Check for Mathematical Models: Is MRSA Decolonization in the ICU a Viable Pption? PRO
Ben Cooper, PhD, Mahidol Univ., Bangkok, Thailand.

A) Reality Check for Mathematical Models: Is MRSA Decolonization in the ICU a Viable Option? CON
Stephan Harbarth, MD, MS; Univ. of Geneva Hosp., Geneva, Switzerland.

B) Do Bundles of Infection Prevention Measures Produce Sustained Reductions in Catheter-Associated Bloodstream Infections? PRO
Brian S. Koll, MD, FACP; Beth Israel Med. Ctr., New York, NY.

B) Do Bundles of Infection Prevention Measures Produce Sustained Reductions in Catheter-Associated Bloodstream Infections? CON
Jean-Francois Timsit, MD, PhD; CHU A. Michallon, Univ. Joseph Fourier, Grenoble, France.

 

Evidence-Based Infection Prevention and Control: Answering Key Questions

This session will provide an overview regarding the evaluation of the evidence supporting current prevention and control infection practices in healthcare settings. It will address specifically certain areas, such as the transmission of respiratory viruses and the role of environmental disinfection.

Upon completion of this Interactive Symposium Session, the participant should be able to:

• Identify the evidence base to determine which host, viral, or environmental characteristics increase or decrease the risk of infection in healthcare settings;
• Analyze the efficacy of evidence-based management strategies used for key healthcare-associated infection outbreaks; 
• Review evidence-based changes in the epidemiology of key outbreaks; and 
• Summarize lessons learned from key outbreaks and their direct impact on infection control practices today. 

Conveners:
Didier Pittet, MD; Univ. of Geneva Hosp., Geneva, Switzerland.
John Conly, MD; Univ. of Calgary, Calgary, Canada.

Presentations:
Effective Infection Prevention and Control Measures in Europe: An EU-Sponsored Meta-Analysis
Alison Holmes, MD; Imperial Coll., London, United Kingdom.

Isolation for Respiratory Viruses: The Cochrane Systematic Review and Others
Klara M. Posfay-Barbe, MD; Univ. of Geneva Hosp., Geneva, Switzerland.

Aerosol-Generating Procedures: A Systematic Review
John Conly, MD; Univ. of Calgary, Calgary, Canada.

The Role of Environmental Disinfection: A Systematic Review
Wing Hong Seto, MD; Queen Mary Hosp., Hong Kong, China.