Finally, the outbreak of meetings!

We’ve done a lot of blogging about the insidious M. chimaera outbreak linked to heater-cooler units (HCUs). Still, the general awareness of this problem lags, despite the fact that an untold number of HCUs are affected, and an unknown number of people are suffering with an undiagnosed granulomatous inflammatory process that has a crude mortality rate in excess of 50%. We heard excellent talks about the issue at SHEA 2016 from Emily Cooper at Wellspan (10 cases, 6 deaths), from Dr. Ray Chinn in the “Challenging Cases in Infection Prevention” session, and I gave a late-breaker on Friday evening (slides to follow in an upcoming post). By the way, SHEA 2016 was EXCELLENT, and the slide image above is from Bob Weinstein’s talk in the SHEA/CDC Training Course. 

Well, the FDA is hosting a meeting on this problem, details of which can be found here. I will be presenting about our experience at Iowa, but others with more expertise will be there as well, from US and Europe. I’m hoping to come away with a better sense of the way forward, which in my view must address (1) better case finding: improved clinician awareness via national patient and provider notifications, so that clinicians everywhere recognize exposure to cardiopulmonary bypass as a risk factor for disseminated MAC infection among patients with implants (valves, grafts), and creative approaches to identify potential cases who currently carry other diagnoses (e.g. sarcoidosis); (2) improved management of existing cases: we desperately need more clinical information about management approaches and outcomes, to help guide decision making for patients and their physicians; and (3) prevention of additional cases: the HCU has been revealed to be a bioaerosol generator that is too risky to share air with an open chest—the make/model implicated in this particular outbreak must obviously be removed from ORs, and other devices that include fans and water sources should also be scrutinized for the risk they may pose.

SHEA Spring Meetings 2007, 2011, 2015 and Beyond?

A decade ago, I was a young associate professor of Epidemiology at the University of Maryland School of Medicine in Baltimore. One afternoon I received a call from Dr. Trish Perl, then President of SHEA and crosstown colleague. Two years earlier, she and I had met when we assisted with the infection control of Bob, an Atlantic Bottlenose Dolphin at the National Aquarium, who had been diagnosed with Mycobacterium abscessus pneumonia. She was not calling about marine mammals this time, but rather was asking me to serve on the 2007 SHEA Annual Meeting Planning Committee, as the local "Baltimore" representative. It was an amazing experience. For one, it was when I met future colleague, friend and co-blogger Dan Diekema and other mentors and colleagues - see the 2007 AMPC roster below.

Over the years I've been asked to serve on many other meeting committees including the last old format SHEA Scientific Meeting in Dallas (2011) and the first combined meeting, IDWeek 2012. As 2016 represents my last year on the SHEA Program Planning Committee, I've been looking back over the old committee rosters and reminiscing. What struck me most, besides the amazing colleagues I've crossed paths with, is the overwhelming presence of MDs, specifically ID-trained, on the committees. Looking at the rosters from 2007 (above) and 2011 (right) and excluding SHEA staff, 94% were ID physicians over both years.

The preponderance of ID physicians is not surprising, given that SHEA was founded by ID physicians and our board of directors roster is made up of ID physicians. However, the science and practice of infection prevention and stewardship is evolving into a broader multidisciplinary effort. We now frequently collaborate and learn from a variety of well-trained scientists and clinicians including medical sociologists, medical anthropologists, epidemiologists, biostatisticians, human-factors engineers, infection preventionists, general internists, MBAs, health economists, pharmacists, microbiologists and health psychologists among others.

When faced with the daunting task of walking in the footsteps of prior co-chairs, Lindsay Nicolle, Scott Fridkin, Charlie Huskins and Dan, we recognized that we had an opportunity to broaden the appeal of the conference and strive towards a truly multidisciplinary program. So in 2015, working with the SHEA board and staff, Susan Huang and I convened a Program Planning Committee (figure below) with 42% of its members trained in fields other than infectious diseases. 

This is not to imply that ~40% is the correct balance. Maybe it should be closer to the 15% of 2016. Perhaps future spring meetings will have an implementation focus and over 50% of the planning committee could be experts outside of infectious diseases and other years the focus could be diagnostics and the committee could be loaded with microbiologists. 

The important thing is that we realize that clinical and scientifically, SHEA and our meeting should not be defined by what we were (ID physicians) and what we are not (APIC), they should be defined by what we hope to achieve. And if we truly hope to prevent healthcare-associated infections and the emergence of antimicrobial-resistant pathogens, we need more than ID physicians. Plus, I think it will be a lot of fun!

SHEA Abstract Deadline - January 29, 2016

Good morning!


I'm sure that you all have plenty of time on your hands with Ebola and contact precautions all but eliminated! Nice that most of us infection prevention and control types finally have some valuable time on our hands to do science!

SHEA now accepts abstracts with original data and last year over 200 abstracts were presented in Orlando. (I think it was closer to 250, but I've lost my notes) Anyway, get into your data and start writing - you only have until January 29th!

See you in Atlanta in May!

SHEA/CDC/AMDA Sponsored Post-Acute and Long-Term Care Certificate Course

The SHEA/CDC/AMDA infection prevention in Post-Acute and Long-Term Care certificate course will take place during the first 2 days of the SHEA 2016 meeting.

Q: What will the SHEA/CDC/AMDA Post-Acute and Long-Term Care course cover?

     A: Starting with an overview of healthcare epidemiology, the course will go over surveillance definitions and how surveillance data can be put to good use (beyond satisfying checkboxes on surveyors’ clipboards). The speakers will also discuss aspects of infection prevention that are unique to skilled nursing facilities, where residents enjoy shared dining, recreation and rehabilitation experiences. Sessions will also address occupational health concerns in long-term care, including outbreaks that affect both staff and residents, such as influenza and norovirus. (Did you know that a box of chocolates is a great vector for norovirus? Poor Forrest Gump…..). The course will also emphasize opportunities to reduce unnecessary and inappropriate antimicrobial use. Speakers will specifically discuss communication at care transitions and ways to educate talking with concerned family members, who may have been taught myths and misinformation about antibiotic use for UTI management (e.g., bad dreams are an indication for treating a positive urine culture with antibiotics). Really.

Q: What does the SHEA/CDC/AMDA Post-Acute and Long-Term Care certificate look like?

     A:

Q: Where can I sign up for SHEA 2016 and the Certificate Course?

     A: At the SHEA 2016 meeting website: here

Q: Is there an early bird discount?

     A: Yes! Register before February 15, 2016

Start planning now for SHEA Spring Meeting 2016!

What follows is a guest post from the co-chairs of the SHEA Spring Meeting 2016 planning committee, Silvia Munoz-Price and Tom Talbot (I added the video at the end despite their protestations):

We want to encourage everyone interested in healthcare epidemiology and antibiotic stewardship to plan on attending the SHEA Spring Meeting 2016 in Atlanta. Titled “Science Guiding Prevention,” the planning committee has built on last year’s successful meeting to add more cutting edge, provocative, and diverse topics and speakers to advance key issues surrounding the field. 

In addition to being an outstanding networking platform, this year we will also have: 

1. A new Antibiotic Stewardship track chaired by Drs. Sara Cosgrove and Kavita Trivedi designed to provide intensive training for directors of stewardship programs. 
2. Featured plenaries focused on partnership in preventing HAIs with leaders from a wide range of perspectives, including the media, quality improvement scientists, and patient safety advocates. 
3. The return of the Post-Acute Care/Long Term Care training course, which is now co-organized by SHEA, CDC, and AMDA and chaired by Dr. Nimalie Stone (CDC) and Dr. Robin Jump (representing AMDA). A certificate of participation will be given at the completion of the track (perfect for framing!!!). 
4. The tried and true SHEA-CDC Training Course in Healthcare Epidemiology, a jam-packed primer on important issues in healthcare epidemiology. Chaired by Dr. Sarah Haessler, this certificate course is perfect for persons new to the field as well as those needing a booster of healthcare epidemiology training. 
5. The SHEA Foundation Dinner (separate ticketed event) returns with featured speakers Dr. Julie Gerberding and Dr. David Henderson.
6. Abstract presentations for targeted topics specific to healthcare epidemiology – mark your calendars for the January 29, 2016 submission deadline! 
7. The launching of the SHEA Mentorship Program.
8. Finally, we’ve brought back the well-received "Women in Epi" networking event – this year, it will be an evening activity...with drinks instead of bagels!!! 

We’re very excited about the program and hope to see you in Atlanta next spring!