Availability of personal protective equipment and infection prevention supplies during the first month of the COVID-19 pandemic: A national study by the APIC COVID-19 task force.

BACKGROUND: SARS-CoV-2, the virus that causes COVID-19 disease was first discovered in China in December, 2019. The disease quickly spread globally, with the first US case identified in January, 2020; it was declared a pandemic on March 11, 2020. Soon after, anecdotal reports indicated that many US hospitals and healthcare facilities were running low on personal protective equipment (PPE) and supplies. METHODS: An online survey was administered to all Association for Professionals in Infection Control and Epidemiology members in March, 2020 to assess access to PPE, hand hygiene products, and disinfection supplies. RESULTS: In all, 1,201 infection preventionists participated. Participants reported running a bit low to almost being out of all PPE types. More had sufficient gloves (63.4%) compared to all other PPE types (P < .001 for all). Face shields and N95 respirators were the least available (13.6% and 18.2% had sufficient supplies, respectively; p < .001 for all). Many (66.9%) had sufficient hand soap, but far fewer had sufficient hand sanitizer (29.5%, X2 = 211.1, P < .001). Less than half (45.4%, n = 545) had sufficient disinfection supplies. CONCLUSIONS: Many US healthcare facilities had very low amounts of PPE, hand hygiene products, and disinfection supplies early on during the pandemic. A lack of these supplies can lead to occupational exposures and illness as well as healthcare-associated transmission of COVID-19 and other diseases.

The master of public health graduate as infection preventionist:Navigating the changing landscape of infection prevention.

Infection prevention is a rapidly changing field with regulatory requirements and emerging global public health threats. Infection preventionists (IPs) must use advanced epidemiologic skills for health care-associated infection investigation and prevention. A potential talent pool for IPs is the Master of Public Health graduate. Those hiring IPs should consider master of public health graduates as candidates who can help drive the future of this profession.

Degowning the controversies of contact precautions for methicillin-resistant Staphylococcus aureus: A review.

BACKGROUND: Contact precautions (CPs) are recommended to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission in institutions. Rising doubts about CP effectiveness and recognition of unintended consequences for patients have raised questions about the benefit. The objective of this study was to evaluate the effectiveness and adverse outcomes associated with CPs for prevention of MRSA transmission. METHODS: We searched PubMed, Embase, and the Cochrane Library for articles related to effectiveness and adverse outcomes of CPs in patients with MRSA. Criteria for inclusion included the following: articles conducted in the United States, articles performed in an acute care setting, articles that were not a case series or review, and those with standardized collection of data or inclusion of case and control groups. Results were summarized and examined for potential limitations. Recommendations were based on our findings. RESULTS: CPs reduced MRSA transmission in epidemic settings and in instances with high compliance, but a decrease in infection rates was not shown. Unintended consequences of CPs include decreased health care provider (HCP) time spent with patients, low HCP compliance, decreased perceptions of comfort from patients, and greater likelihood of patient complaints and negative psychologic implications. CONCLUSION: In endemic settings, there are few data to support routine use of CPs to control the spread of MRSA. Education should be performed in hospitals to improve patients' perception of care and understanding of CPs when implemented and HCPs' adherence to good hand hygiene and standard precautions practices.

Clostridium difficile: improving the prevention paradigm in healthcare settings.

Clostridium difficile infection (CDI) is a major public health problem worldwide with significant morbidity and mortality that is spread by spores and fecal oral transmission. A variety of risk factors have been identified. Some risk factors such as age, are not amenable to change, while others such as antimicrobial utilization have resulted in broadly implemented antimicrobial stewardship programs. New risk factors are emerging such as proton pump inhibitor (PPI) use, irritable bowel disease (IBD) and obesity, with others yet to be determined. Prevention of spread of CDI is imperative, since therapy remains imperfect. We review established and emerging risks for CDI and offer potential preventative strategies with the use of a multidisciplinary CDI prevention bundle checklist.