To reduce the number of patients with known methicillin-resistant Staphylococcus aureus (MRSA) colonization who are repeatedly placed in isolation on hospital readmission, we screened patients who had no positive results for MRSA culture in the previous 6 months. Twenty-one (21%) of 98 patients were no longer colonized and were removed from contact precautions.

The H1N1 influenza pandemic provided a real-world test of hospital disaster plans. Challenges to hospitals included inconsistent use of isolation precautions; changing and conflicting guidelines; lack of available supplies, including N95 respirators and medications; and overwhelming amounts of information that required sifting. Further research is needed regarding pandemic planning.

In December 2008, bronchoalveolar lavage fluid samples obtained from 3 patients were positive for Burkholderia cepacia complex on culture. Samples obtained from bronchoscopes and rinse-water samples obtained from the washer-disinfector were found to be positive for B. cepacia complex. The cause of this pseudo-outbreak was that the washer-disinfector was installed without the required antibacterial filter.

We conducted a case-control study of 46 hospitalized pediatric patients with healthcare-associated laboratory-confirmed influenza (HA-LCI). We sought to determine the characteristics and outcomes of children with HA-LGI and to identify risk factors for HA-LCI. Although we failed to identify any differences in clinical exposures during the 3 days prior to onset of HA-LCI, multivariate analysis showed that asthma was an independent risk factor for HA-LCI (odds ratio, 3.49 [95% confidence interval, 1.25–9.75]).

Prospective observations and adenosine triphosphate bioluminescence assays were used to evaluate daily cleaning practices in a university-affiliated hospital. Substantial variations were found in the amount of time spent cleaning high-touch surfaces, in the number of disinfectant wipes used in each room, and in the level of cleanliness achieved by housekeepers.

We compared surveillance of surgical site infection (SSI) after major breast surgery by using a combination of International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes and microbiology-based surveillance. The sensitivity of the coding algorithm for identification of SSI was 87.5%, and the sensitivity of wound culture for identification of SSI was 78.1%. Our results suggest that SSI surveillance can be reliably performed using claims data.

Clostridium difficile infection (CDI) is a potentially serious disease for which the epidemiology has recently changed, because of an emerging drug-resistant strain of the pathogen. Metronidazole and oral vancomycin are the primary treatment agents.2 Metronidazole has been historically favored as the first-line agent, partly to reduce the selection pressure for vancomycin-resistant enterococci (VRE), although metronidazole can also select for VRE. Vancomycin was traditionally reserved for metronidazole treatment failure or life-threatening disease. In a study conducted before emergence of the epidemic strain, vancomycin was reported to be superior for the initial treatment of severe CDI and for treatment of CDI that does not respond to metronidazole. Expert opinion calling for the use of vancomycin as first-line therapy, especially for severe CDI emergence of the epidemic strain, and reports of decreased metronidazole efficacy may have impacted CDI treatment practices. The purpose of this study was to characterize trends in CDI treatment in US hospitals.

The role of suction regulators in nosocomial infections has, to our knowledge, not been studied. A sampling of devices used in hospitals was conducted. Many regulators (173 [37%] of 470) were found to be colonized. A suction circuit model revealed that pathogens can disseminate throughout the circuit (retrograde and antegrade), colonizing an experimental patient stomach.

Definitions of ventilator-associated pneumonia do not note a preferred daily time for obtaining denominator data. We examined collecting data on the number of ventilator-days at different times of day in 7 intensive care units. Rates of ventilator-associated pneumonia did not significantly differ when denominator data were collected at midnight, 8 AM, or 4 PM, supporting standard definitions.

Differences in reported hand hygiene compliance rates were assessed on the basis of the unit affiliation of observers. In 2 hospitals, unit-based observers more often reported higher compliance rates than did non-unit-based observers (79% vs 58.6%; difference, 20.4%; P<.001). Nonstandardized data collection methods contribute to the variability in hand hygiene compliance rates.