Real-time virtual infection prevention and control assessments in skilled nursing homes, New York, March 2020-A pilot project.

OBJECTIVE: To describe a pilot project infection prevention and control (IPC) assessment conducted in skilled nursing facilities (SNFs) in New York State (NYS) during a pivotal 2-week period when the region became the nation's epicenter for coronavirus disease 2019 (COVID-19). DESIGN: A telephone and video assessment of IPC measures in SNFs at high risk or experiencing COVID-19 activity. PARTICIPANTS: SNFs in 14 New York counties, including New York City. INTERVENTION: A 3-component remote IPC assessment: (1) screening tool; (2) telephone IPC checklist; and (3) COVID-19 video IPC assessment (ie, "COVIDeo"). RESULTS: In total, 92 SNFs completed the IPC screening tool and checklist: 52 (57%) were conducted as part COVID-19 investigations, and 40 (43%) were proactive prevention-based assessments. Among the 40 proactive assessments, 14 (35%) identified suspected or confirmed COVID-19 cases. COVIDeo was performed in 26 (28%) of 92 assessments and provided observations that other tools would have missed: personal protective equipment (PPE) that was not easily accessible, redundant, or improperly donned, doffed, or stored and specific challenges implementing IPC in specialty populations. The IPC assessments took ∼1 hour each and reached an estimated 4 times as many SNFs as on-site visits in a similar time frame. CONCLUSIONS: Remote IPC assessments by telephone and video were timely and feasible methods of assessing the extent to which IPC interventions had been implemented in a vulnerable setting and to disseminate real-time recommendations. Remote assessments are now being implemented across New York State and in various healthcare facility types. Similar methods have been adapted nationally by the Centers for Disease Control and Prevention.

The ubiquitin-proteasome system as a transcriptional regulator of plant immunity.

The ubiquitin-proteasome system (UPS) has been shown to play vital roles in diverse plant developmental and stress responses. The UPS post-translationally modifies cellular proteins with the small molecule ubiquitin, resulting in their regulated degradation by the proteasome. Of particular importance is the role of the UPS in regulating hormone-responsive gene expression profiles, including those triggered by the immune hormone salicylic acid (SA). SA utilizes components of the UPS pathway to reprogram the transcriptome for establishment of local and systemic immunity. Emerging evidence has shown that SA induces the activity of Cullin-RING ligases (CRLs) that fuse chains of ubiquitin to downstream transcriptional regulators and consequently target them for degradation by the proteasome. Here we review how CRL-mediated degradation of transcriptional regulators may control SA-responsive immune gene expression programmes and discuss how the UPS can be modulated by both endogenous and foreign exogenous signals. The highlighted research findings paint a clear picture of the UPS as a central hub for immune activation as well as a battle ground for hijacking by pathogens.

Investigation of the First Seven Reported Cases of Candida auris, a Globally Emerging Invasive, Multidrug-Resistant Fungus - United States, May 2013-August 2016.

Candida auris, an emerging fungus that can cause invasive infections, is associated with high mortality and is often resistant to multiple antifungal drugs. C. auris was first described in 2009 after being isolated from external ear canal discharge of a patient in Japan (1). Since then, reports of C. auris infections, including bloodstream infections, have been published from several countries, including Colombia, India, Israel, Kenya, Kuwait, Pakistan, South Africa, South Korea, Venezuela, and the United Kingdom (2-7). To determine whether C. auris is present in the United States and to prepare for the possibility of transmission, CDC issued a clinical alert in June 2016 informing clinicians, laboratorians, infection control practitioners, and public health authorities about C. auris and requesting that C. auris cases be reported to state and local health departments and CDC (8). This report describes the first seven U.S. cases of C. auris infection reported to CDC as of August 31, 2016. Data from these cases suggest that transmission of C. auris might have occurred in U.S. health care facilities and demonstrate the need for attention to infection control measures to control the spread of this pathogen.

Healthcare-Associated Transmission of Plasmodium falciparum in New York City.

A patient with no risk factors for malaria was hospitalized in New York City with Plasmodium falciparum infection. After investigating all potential sources of infection, we concluded the patient had been exposed to malaria while hospitalized less than 3 weeks earlier. Molecular genotyping implicated patient-to-patient transmission in a hospital setting. Infect. Control Hosp. Epidemiol. 2015;37(1):113-115.

Utilization of an incident command system for a public health threat: West Nile virus in Nassau County, New York, 2008.

The summer of 2008 in Nassau County, New York, was marked by a historic season of human West Nile virus illness and West Nile virus activity in mosquitoes. The commissioner of Health of the State of New York declared a public health threat, and a decision was made to use adulticide for mosquito control. In contrast to prior years, the Nassau County Department of Health utilized the Incident Command System (ICS) to coordinate a multidisciplinary and multidepartment response to this public health threat. Implementing the ICS ensured coordination and communication between multiple county departments and organizations in the community. The effective response demonstrated that a local health department can mobilize to meet the needs of a public health threat through the use of the ICS. Nassau County Department of Health learned that the ICS is ideal for complex, multidisciplinary operations because of its clear chain of command, transparent organization structure, and flexibility.

False recognition of emotional word lists in aging and Alzheimer disease.

OBJECTIVE: To examine 3 different aspects of the emotional memory effect in aging and Alzheimer disease (AD): item-specific recollection, gist memory, and recognition response bias. METHOD: Younger adults, older adults, and patients with AD performed a false recognition memory test in which participants were tested on "lure" items that were not seen at study, but were semantically related to the study items. Participants were tested on 5 emotional and 5 non-emotional lists. RESULTS: In addition to finding an increase in true recognition for emotional versus non-emotional items in healthy younger and older adults but not in patients with AD, and confirming that emotional items led younger adults to shift their response bias to a more liberal one, 3 novel findings were observed. First, the emotional effect on response bias was also observed in healthy older adults. Second, the opposite emotional effect on response bias was observed in patients with AD. Third, emotional items did not lead to an improvement in item-specific recollection or gist memory. CONCLUSIONS: Although healthy older adults show the normal amygdala-modulated criterion shift for emotional items-influencing their subjective feeling that information has been previously encountered, the amygdala pathology present in early AD may disrupt this influence.