Coronavirus Disease 2019 Serial Testing Among Hospitalized Patients in a Midwest Tertiary Medical Center, July-September 2020.

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.

Coronavirus disease 2019 (COVID-19) among nonphysician healthcare personnel by work location at a tertiary-care center, Iowa, 2020-2021.

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.

Blood culture practices in patients with a central line at an academic medical center-Iowa, 2020.

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.

Bat intrusions at a tertiary care center in Iowa, 2018-2020.

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.

Coronavirus disease 2019 (COVID-19) incidence after exposures in shared patient rooms in a tertiary-care center in Iowa, July 2020-May 2021.

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.

Stable Clostridioides difficile infection rates after the discontinuation of ultraviolet light for terminal disinfection at a tertiary care center, Iowa 2019-2020.

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.

RABIES SURVEILLANCE AMONG BATS IN TENNESSEE, USA, 1996-2010.

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.

Two community hepatitis B outbreaks: an argument for vaccinating incarcerated persons.

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.