A Blogger's Return: Relishing the Wave of Infection Prevention Science

Apologies, Faithful Readers (who do I think I am, Stan Lee (R.I.P.)?).  The day-to-day life of a hospital epidemiologist, IDWeek planner, dad and spouse have pulled me away from contributions to the blog.  But, like a bad rash, I'm back!  I was prompted to post not because of a single study or bit of news but because of a thought I had when I received the TOC for the latest issue of Infection Control and Hospital Epidemiology (Disclaimer:  I am a member of the editorial board but did not review any of the articles in this issue including those noted below).  I was struck once again at the diversity of topics and the increasingly strong science that's being performed in our field.   Makes me happy to be a hospital epidemiologist for sure!  A few highlights:

• A systematic review/meta-analysis examining whether evidence supports use of cefazolin for surgical prophylaxis in hysterectomy.  The authors noted a significantly higher SSI risk with cefazolin vs. cefoxitin or cefotetan (risk ratio, 1.7; 95% CI, 1.04–2.77; p = 0.03) and highlighted numerous limitations with the existing clinical studies.
• A human factors analysis of PPE doffing that identified 103 failure modes with PPE removal (including issues related to the person, the place, the equipment, and the training).
• An analysis of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data to examine if placement in isolation adversely affected the patient experience (while isolation patients noted worse experience in the general ranking of overall care and in aspects of staff responsiveness, experience was similar in all other domains).
• A thoughtful commentary on defining antimicrobial never events that include inappropriate surgical prophylaxis, use of antibiotics for viral URI, and use of antibiotics for asymptomatic bacteriuria (as my hospital uses a Patient Harm Index of raw events for our quality goals, I love this concept, as it gives antibiotic stewardship some clear measures that fall into that framework).
• Another nice analysis illustrating that claims-based billing code data are not useful to assess infection rates (this time: SSI) when compared to NHSN surveillance gold standard.  Use to rank hospital quality is even stickier, as illustrated by the finding that 65% of hospitals in the best quartile by claims data were ranked in worse quartiles by NHSN data.

And there are so many more excellent studies and manuscripts, so check it out (and keep pushing the IP evidence base forward)!