Offering the Influenza Vaccine in a Pediatric Hand Surgery Clinic Increases Vaccination Rates.

PURPOSE: The purpose of this study was to evaluate the utility of providing immediate access to the influenza vaccination for patients seen in a pediatric hand surgery clinic. Our hypothesis was that providing access would increase the rate of vaccination. METHODS: This pilot study was a randomized, controlled, prospective clinical trial that included all patients seen by a single surgeon, on a single day each week, in a hospital-based pediatric hand surgery practice clinic from October 18, 2016, to March 14, 2017. All patients between 6 months and 18 years of age seen during their initial visit during the study period were included. All patients were questioned on their vaccine status. For the intervention group, the influenza vaccine was offered. If requested, after providing educational materials, written consent from the parent or guardian was obtained. The vaccine was given by the registered nurse ordinarily assigned to the clinic. Demographic information and vaccine status for both groups at the end of clinic, including the date of receiving the vaccine, were recorded. RESULTS: Similar proportions of patients in each group had received the vaccine prior to being seen in the clinic. In the intervention group, 80 children (67%) had received the vaccine by the end of clinic, compared with 29 (25%) in the control group. Patients who were offered the vaccine had a statistically significant higher vaccination rate. Of the 80 patients in the intervention group who received the vaccine, 47 (59%) received it in the hand clinic. CONCLUSIONS: This project demonstrated that offering the influenza vaccine in a nontraditional setting, an outpatient hand surgery clinic, increased the proportion of patients receiving the vaccine. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic I.

A large outbreak of Trichophyton tonsurans among health care workers in a pediatric hospital.

BACKGROUND: Although Trichophyton tonsurans remains a major cause of dermataophytoses in US children, nosocomial spread may go unrecognized in health care settings. We describe a staff outbreak of T tonsurans infection among health care workers in a freestanding pediatric hospital. METHODS: Epidemiologic evaluation (retrospective and prospective) was performed in the health care providers and ancillary staff assigned to a 27-bed inpatient medical unit in which the suspected outbreak occurred. RESULTS: Twenty-one individuals, including staff, a hospital volunteer, and a patient, developed tinea corporis during a 5-month period. All infections coincided with multiple admissions of a 2-year-old suspected index patient who demonstrated persistent infections of the scalp and arm. Fungal isolates obtained from the index patient and affected staff (when available) were subjected to multilocus strain typing, which revealed an identical genetic match between the index case and infected hospital personnel. CONCLUSION: T tonsurans can spread widely among staff members caring for children with recalcitrant dermatophyte infections. Recognition that workplace transmission may be the etiology of a succession of infections occurring in a single inpatient unit is necessary to limit the number of infected individuals.