Infectious Diseases Society of America, Oct. 26-30
The annual meeting of the Infectious Diseases Society of America was held from Oct. 26 to 30 in New Orleans and attracted more than 5,000 participants from around the world, including scientists, physicians, and other health care professionals. The conference featured education courses and comprehensive educational programs that focused on the latest advances in the diagnosis, treatment, and prevention of infectious diseases.
In one study, Deverick J. Anderson, M.D., M.P.H., of the Duke University Medical Center in Durham, N.C., and colleagues found that organisms move around the "transmission triangle" between the patient, the health care provider, and the hospital environment regularly.
The investigators identified a total of 23 confirmed transmission events using molecular techniques to compare bacterial isolates. Specifically, 12 of these events involved the nurse becoming contaminated and 11 involved the environment becoming contaminated.
"Of note, the nurses could be contaminated by either the patient or the health care environment. In fact, 30 to 40 percent of the confirmed transmission events to the nurse came from the environment," Anderson said. "Our data reiterate the idea that simply going into a patient room should be considered a risk for potential contamination. Otherwise, the study confirms that we need to re-emphasize adherence to basic/standard infection prevention strategies like hand hygiene and, when appropriate, using gown and gloves."
One author disclosed financial ties to the pharmaceutical industry.
In another study, Michelle Doll, M.D., of the Virginia Commonwealth University in Richmond, and colleagues used a nationally representative survey that incorporates information on health care and dental usage, in order to determine if dental care can impact an individual's pneumonia risk. While controlling for factors known to be associated with pneumonia such as age and comorbidities, the investigators found an 85 percent increased risk of pneumonia in those who never went to the dentist compared to those who visited the dentist at least twice a year.
"Those who visit the dentist less than once a year were also at a significantly increased risk of pneumonia. This is not surprising given what is already known about oral health and pneumonia prevention in high-risk groups, but this study offers evidence that even those at lower risk may benefit," Doll said. "Oral health is increasingly recognized as important for overall health and well-being. Dental care may represent a concrete behavior that promotes oral health and can thus protect from systemic conditions such as pneumonia."
Thomas Herchline, M.D., of Wright State University Boonshoft School of Medicine in Dayton, Ohio, and Peter Greene, of Public Health-Dayton & Montgomery County, found that local susceptibility patterns of gonorrhea may differ greatly from national data.
"Antimicrobial resistance increased over a relatively short time frame. For many years, ciprofloxacin remained a reasonable alternative therapy for gonorrhea in the Dayton area despite significant resistance elsewhere in the country. This is no longer true," Herchline said. "Clinicians should be aware of local susceptibility patterns. When available, this information is most likely to be obtained through the local health department."
Sarah Scarpato, M.D., of the University of Pennsylvania in Philadelphia, and colleagues evaluated antibiotic prescribing practices upon hospital discharge.
"We found that 22.7 percent of patients who were discharged had no evidence of infection but were discharged with antibiotics regardless. In addition, 70 percent of patients discharged had an error in antibiotic administration, whether it was the antibiotic choice, dose, duration, or indication. We also found that 55 percent of patients prescribed antibiotics had a duration that was too long," Scarpato said. "What was most compelling is that 76 percent of errors in prescriptions were either due to patients being prescribed an antibiotic in the absence of infection and/or for a duration that was too long. We also found that patients were prescribed an average of 3.8 days of unnecessary antibiotics."
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