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In 2015, The Association for Professionals in Infection Control and Epidemiology (APIC) conducted the first MegaSurvey of its members to understand key aspects of their practice. Given the evolving role of Infection preventionists (IPs), it is important to understand changes in and the current practice environments of IPs, their demographics, the organizations in which they practice and the relative importance of different domains of IP practice.The MegaSurvey 2020 was a cross-sectional, electronic survey of IPs conducted by APIC between January 21 and February 28, 2020. Descriptive statistics were calculated to describe the participants in terms of their characteristics, practice setting, compensation and IP competencies.2,030 APIC members (response rate 13%) participated in the study. Results indicated that the demographic characteristics of IPs remained the same between the 2015 and 2020 surveys. Similar to 2015 data, slightly less than half of respondents are currently certified and plan to recertify. Less than 50% of IPs reported feeling adequately satisfied with their overall compensation. IPs reported spending the largest proportion of their time on surveillance and epidemiologic investigations and the least amount of time on employee and occupational health, cleaning and sterilization and education/research.As the healthcare industry continues to evolve, public health emergencies persist, and regulatory requirements expand, the results of the APIC MegaSurvey can inform future educational initiatives, the development of programs and ongoing hiring and retention strategies for this critical profession.

Background There is a pervasive view among some nurses and health care disciplines that antibiotic stewardship (AS) is solely a physician or pharmacist responsibility. There is an urgent need to alter this view so that nurses can seize every opportunity to prevent patient harm from antibiotics and optimize antibiotic use. One challenge to achieving full nurse engagement as equal members of the AS team is lack of an organizing framework to illustrate relationships of phenomena and concepts inherent to adoption of AS nursing practices. Methods We sought to create a framework derived from the peer-reviewed literature, systematic and scoping reviews, and professional standards, consensus statements and white papers. The emerging framework went through multiple iterations as it was vetted with nurse clinicians, scholars and educators, physicians, pharmacists, infection preventionists and AS subject matter experts. Results Our evidence-based Antibiotic Stewardship Nursing Practice SCAN-P Framework provides the much-needed context and clarity to help guide local-level nurses to participate in and lead AS nursing practice. Conclusions Nurses worldwide are ideally situated to provide holistic person-centered care, advocate for judicious use of antibiotics to minimize antibiotic resistance, and be AS educators of their patients, communities and the general public. The Antibiotic Stewardship Nursing Practice SCAN-P Framework provides a tool to do so.

Background/Objectives: Home health care (HHC) agencies provide an important role in helping to transition patients from acute care to independent residential living. Telehealth has the potential to transform care delivery in HHC, however the majority of studies in HHC have focused on the use of telemonitoring for patients with specific chronic conditions. The objective of this study was to examine reasons HHC patients use acute care services and assess the acceptability of on-demand telehealth services among HHC patients, caregivers and personnel to help alleviate the need for seeking in-person acute care. Design/Setting/Participants/Measures: This study was a secondary analysis of qualitative data from in-depth interviews of 30 HHC personnel, patients and caregivers from a Medicare-certified HHC agency affiliated with a large healthcare system from January through May 2020. A conventional content analysis approach was used to identify themes. Results: Themes associated with reasons for seeking acute care included: sense of urgency, behavioral and psychosocial factors, and access to care. Participants described their perceptions of the benefits, usability and acceptability and barriers to using telehealth. Patients and HHC personnel agreed that on-demand telehealth should not replace in-person visits but all identified roles that on-demand telehealth services could play in improving communication and access to care. The biggest barriers to use of telehealth identified by HHC personnel were cost, access and ability to use technology by HHC patients. Conclusion: This study identified reasons HHC patients seek unscheduled acute care and the usability and acceptability of on-demand telehealth services to increase access to care among HHC patients. These findings underscore the need to improve communication and coordination between patients, HHC personnel, and primary care providers and the role that on-demand telehealth services can have in transforming HHC.

Melanoma in childhood is rare and its diagnosis is more difficult than in adults, as it often presents histologic features overlapping with the Spitz nevus. The authors report the case of a 17-year old boy who was first diagnosed with Spitz nevus, however, the final diagnosis made after the excision of the tumor arising in the scar was changed to melanoma. The case in this present study emphasizes the importance of the differential diagnosis of skin tumors in young patients.

The primary job responsibility of infection preventionists (IPs) is to lead organizational initiatives that prevent and control health care-associated infections. Increasingly, IPs are participating in activities that support antimicrobial stewardship programs (ASPs). We conducted a survey of Association of Professionals in Infection Control and Epidemiology members practicing in acute care facilities to determine the degree of their involvement in ASP activities.

Infection preventionist (IP) staffing in nursing homes (NHs) is now required as part of new federal regulations. In this study, we examined IP staffing changes from 2014 to 2018 and found relatively few changes over time. IP staffing in NHs remains low but does vary between for profit and non-profit facilities.

Background Currently, most US states have adopted legislation requiring hospitals to submit health care–associated infection (HAI) data. We evaluated the perceived impact of state HAI laws on infection prevention and control (IPC) departments. Methods A web-based survey of a national sample of all non-veteran hospitals enrolled in the National Healthcare Safety Network was conducted in fall 2011. Variations in IPC department resources and characteristics in states with and without laws were compared by use of χ², Mann-Whitney (Wilcoxon), and Student t tests. Multinomial logistic regression was used to identify increases or decreases, versus no change, in perceived resources, time, influence, and visibility of the IPC department in states with and without HAI laws. Results Overall, 1,036 IPC departments provided complete data (30% response rate); 755 (73%) were located in states with laws. Respondents in states with reporting laws were more likely to report less time for routine IPC activities (odds ratio, 1.61; 95% confidence interval, 1.12-2.31) and less visibility of the IPC department (odds ratio, 1.70; 95% confidence interval, 1.12-2.58) than respondents in states without laws, after controlling for geographic region, setting, and the presence of a hospital epidemiologist. Conclusions Respondents in states with laws reported negative effects on their IPC department, beyond what was required by federal mandates. Further research should examine resources necessary to comply with state HAI laws and evaluate unintended consequences of state HAI laws.

Background Previous literature has linked the level and types of staffing of health facilities to the risk of acquiring a health care–associated infection (HAI). Investigating this relationship is challenging because of the lack of rigorous study designs and the use of varying definitions and measures of both staffing and HAIs. Methods The objective of this study was to understand and synthesize the most recent research on the relationship of hospital staffing and HAI risk. A systematic review was undertaken. Electronic databases MEDLINE, PubMed, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for studies published between January 1, 2000, and November 30, 2015. Results Fifty-four articles were included in the review. The majority of studies examined the relationship between nurse staffing and HAIs (n = 50, 92.6%) and found nurse staffing variables to be associated with an increase in HAI rates (n = 40, 74.1%). Only 5 studies addressed non-nurse staffing, and those had mixed results. Physician staffing was associated with an increased HAI risk in 1 of 3 studies. Studies varied in design and methodology, as well as in their use of operational definitions and measures of staffing and HAIs. Conclusion Despite the lack of consistency of the included studies, overall, the results of this systematic review demonstrate that increased staffing is related to decreased risk of acquiring HAIs. More rigorous and consistent research designs, definitions, and risk-adjusted HAI data are needed in future studies exploring this area.

Background Given the changing nature of infection prevention and control (IPC), appropriate infection preventionist (IP) staffing needs to be established. In this study, we aimed to describe current IP staffing levels and IPC department resources in U.S. acute care hospitals. Methods These data came from the 2015 MegaSurvey conducted by the Association of Professionals in Infection Prevention and Epidemiology. Descriptive statistics and bivariate analyses were conducted to examine differences in respondent, facility, and department characteristics by facility size (average inpatient census ≤100 vs >100). Results Data from 1623 respondents were included. Most (72%) had single-site responsibilities and dedicated 76%-100% of their job to IPC (68%). The overall median IP staffing was 1.25 IPs per 100 inpatient census (interquartile range = 1.81). Almost half (46%) represented facilities with daily inpatient census ≤100; the average number of IPs in these facilities was 1.1 (standard deviation = 0.7). The reported number of IPs increased steadily with higher patient census. Significant differences were observed in IP staffing, responsibilities, and support to the IPC department between smaller and larger hospitals. Conclusions This study represents the current snapshot of IP staffing and IPC resources in acute care hospitals. Findings indicate important differences between large and small facilities in staffing and IPC resources. The field of infection prevention would benefit from a comprehensive assessment of IPC department staffing and resource needs.

A bstract A series of new N'-(2-alkylthio-4-chloro-5-methylbenzenesulfonyl)-1-(5-phenyl-1H-pyrazol-1-yl)amidine derivatives have been synthesized and evaluated in vitro by MTT assays for their antiproliferative activity against cell lines of colon cancer HCT-116, cervical cancer HeLa and breast cancer MCF-7. The studied compounds display selective activity mainly against HCT-116 and HeLa cells. Thus, five compounds show selective cytotoxic effect against HCT-116 (IC50 = 3–10 μM) and HeLa (IC50 = 7 μM). Importantly, the noticed values of IC50 for four compounds are almost 4-fold lower for HeLa than non-malignant HaCaT cells. More-in-depth biological research revealed that the treatment of HCT-116 and HeLa with active compound resulted in increased numbers of cells in sub-G1 phase in a time dependent manner, while non-active derivative does not influence cell cycle. Metabolic stability assays using liver microsomes and NADPH provide important information on compounds susceptibility to phase 1 biotransformation reactions.

This paper describes a simple method focused on detection of roasted pork patties prepared from meat that was spoiled mainly by Rahnella aquatilis. The method includes application of PCR with species-specific primers differentiating R. aquatilis from other meat-spoiling Enterobacteriaceae and an electronic nose (E-nose) based on ultra-fast gas chromatography (UFGC). The volatile compound profile of R. aquatilis after heat treatment was described and compared to the volatile compound profile of minced pork patties that were stored up to 8 days. The results demonstrated that decreased relative content of trimethylamine and propanal in addition to the presence of benzeneacetaldehyde in odour of patties was linked to R. aquatilis – induced product spoilage.

Background In recent years, there has been a significant shift of health care delivery to nonacute care settings. However, research on staffing and resources dedicated to infection prevention and control (IPC) in these settings is lacking. Methods The data for this analysis come from the 2015 APIC MegaSurvey. Descriptive statistics were computed to describe infection preventionists (IPs) employed in nonacute care settings. Bivariate analyses were conducted to examine differences in facility and demographic characteristics by type of nonacute care setting. Results In total, 861 IPs represented ambulatory surgical centers (33%), long-term care facilities (23%), long-term acute care facilities (20%), inpatient behavioral or mental health care (12%), clinic or outpatient services (10%), and home health care (3%). Few (15%) were Certified in Infection Control. Most (58%) reported that less than half of their job was officially dedicated to IPC. On average, respondents reported spending the largest proportion of their time on surveillance and epidemiologic investigation (19%). IPs lacked support for secretarial functions (23%), data management (14%), and electronic medical records (32%). IPC activities, staffing, and resources differed significantly by type of nonacute care facility. Conclusions This study indicates that resources directed to IPC in nonacute care settings may be lacking and identifies important areas for IPC education and program improvement. Research is needed to further examine staffing and IPC resources in these settings, which represent unique challenges to infection prevention and control.

The study compared the slaughter value and meat quality of heifers and once-calved heifers slaughtered at the age of 18 and 28months, respectively. The once-calved heifers at the age of 15months, were bred with semen of Limousine bulls and following the calving they fed their offspring and then they were slaughtered. There were no differences in the carcass conformation and fatness between the treatments. Once-calved heifers' carcasses had a higher proportion (P

Objectives The objectives of this study were to (1) obtain a national perspective of the current state of nursing home (NH) infection prevention and control (IPC) programs and (2) examine differences in IPC program characteristics for NHs that had and had not received an infection control deficiency citation.

Background Home healthcare (HHC) is becoming a leading source of post-acute services. Currently, most HHC patients have multiple chronic conditions, thereby increasing their risk of infections and rehospitalizations. With a nationally-representative survey, we aimed to better understand the current state of infection prevention and control (IPC) at HHC agencies. Methods A national survey, directed at administrators and clinical managers, was conducted from October 2018 to November 2019. Agencies were recruited from a national HHC conference, and a national random sample of 1,505 agencies stratified by census region, ownership status and rural/urban location. Questions were asked about IPC staffing, IPC compliance and training, and current IPC policies and procedures. Descriptive statistics were computed using Stata 13. Results 575 HHC agencies (35% response rate) responded; 63% had for-profit ownership. At responding agencies, 35.4 % of staff members in charge of IPC had received no specific IPC training, and 5.6% reported that they currently did not have a staff member in charge of IPC. Over 60% of agencies provided staff training on IPC topics either annually or at new employee orientation. 82.3% reported measuring adherence to hand hygiene policies; policy adherence was measured by shadowing (84.9%) and knowledge assessments (71.8%). Most HHC agencies (87.6%) reported collecting and reviewing infection data to identify trends. Overall, only 31% of agencies required staff influenza vaccination; however, a majority (61.4%) offered free influenza vaccinations to their staff. During the past influenza season, 62.7% of agencies had 75% or more of their employees vaccinated for influenza, and 9% reported not tracking that data. Conclusions This national study examining the current state of IPC in HHC can be used as a benchmark for quality improvement initiatives. Particularly, we learned that staff training around IPC and policies and procedures related to staff vaccination are currently inadequate.

Background Sharps disposal containers are ubiquitous in health care facilities; however, there is paucity of data on their potential role in pathogen transmission. This study assessed the relationship between use of single-use versus reusable sharps containers and rates of Clostridium difficile infections in a national sample of hospitals. Methods A 2013 survey of 1,990 hospitals collected data on the use of sharps containers. Responses were linked to the 2012 Medicare Provider Analysis and Review dataset. Bivariate and multivariable negative binomial regression were conducted to examine differences in C difficile rates between hospitals using single-use versus reusable containers. Results There were 604 hospitals who completed the survey; of these, 539 provided data on use of sharps containers in 2012 (27% response rate). Hospitals had, on average, 289 beds (SD ± 203) and were predominantly non-for-profit (67%) and nonteaching (63%). Most used reusable sharps containers (72%). In bivariate regression, hospitals using single-use containers had significantly lower rates of C difficile versus hospitals using reusable containers (incidence rate ratio [IRR] = 0.846, P = .001). This relationship persisted in multivariable regression (IRR = 0.870, P = .003) after controlling for other hospital characteristics. Conclusion This is the first study to show a link between use of single-use sharps containers and lower C difficile rates. Future research should investigate the potential for environmental contamination of reusable containers and the role they may play in pathogen transmission.

Background Knowing the temporal trend central line–associated bloodstream infection (CLABSI) rates among U.S. pediatric intensive care units (PICUs), the current extent of central line bundle compliance, and the impact of compliance on rates is necessary to understand what has been accomplished and can be improved in CLABSI prevention. Methods This is a longitudinal study of PICUs in National Healthcare Safety Network hospitals and a cross-sectional survey of directors and managers of infection prevention and control departments regarding PICU CLABSI prevention practices, including self-reported compliance with elements of central line bundles. Associations between 2011-2012 PICU CLABSI rates and infection prevention practices were examined. Results Reported CLABSI rates decreased during the study period, from 5.8 per 1,000 line days in 2006 to 1.4 in 2011-2012 ( P Conclusion There was a nonsignificant trend in decreasing CLABSI rates as PICUs improved bundle policy compliance. Given that few PICUs reported full compliance with these policies, PICUs increasing their efforts to comply with these policies may help reduce CLABSI rates.

Influenza vaccination remains the cornerstone of influenza prevention, yet national goals for nursing home residents and staff vaccination have not been met. Few studies have examined associations between facility and resident characteristics; employee processes, such as staff vaccination policies; and resident influenza vaccination. In this national survey of nursing homes, employee processes were not associated with resident influenza vaccination; however, various facility and resident characteristics were.

A series of novel N 4 -substituted 4-(2-aminoethyl)benzenesulfonamides 5 – 17 have been synthesized and investigated as inhibitors of four isoforms of zinc enzyme carbonic anhydrase (CA, EC 4.2.1.1), that is the cytosolic CA I and II, and tumor-associated isozymes CA IX and XII. Against the human CA I investigated compounds displayed K I values from 96.3 to 3520 nM, toward hCA II at range of 18.1–2055 nM, while against hCA IX ranging from 5.9 to 419 nM and against hCA XII in the range of 4.0–414 nM. The very good inhibitory activity against tumor-associated hCA IX and hCA XII was found. The six new compounds displayed a powerful inhibitory potency toward hCA IX ( K I = 5.9–10.7 nM) in comparison with the clinically used CAIs AAZ , MZA , EZA , DCP and IND (24–50 nM). The most potent hCA IX and hCA XII inhibitors 11 and 12 ( K I : 5.9 and 6.2 nM for hCA IX and 4.3 and 4.0 nM for hCA XII, respectively) belonged to the compounds with cationic character and presented meaningful affinity to the transmembrane isoforms hCA IX and XII than to physiologically dominant isozymes hCA I and II with the selectivity ratios hCA IX versus hCA II and hCA XII versus hCA II for 11 and 12 in the range of 10–15.