The Infectious Diseases Society of America, Oct. 7-11
The annual meeting of the Infectious Diseases Society of America was held October 7-11 in San Diego 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 and provided insight into emerging infections, new diagnostics, vaccines, and therapeutic interventions.
In one study, Jean Wiedeman, M.D., Ph.D., of the University of California, Davis Medical Center in Sacramento, and colleagues found that an antibiotic stewardship program that reduced antibiotic use saved the hospital 20 percent in costs.
The primary methods used were prospective audit with feedback to prescribing physicians and requirement of approval from an infectious disease specialist for restricted antibiotics. An infectious disease physician worked with an infectious disease pharmacist to review all children in the hospital who were receiving antimicrobials. The team evaluated for appropriate use and discussed interventions with the prescribing physician when antimicrobial use needed to be improved.
"Stewardship focuses on appropriate use of antimicrobials by avoiding misuse and overuse. We have shown this leads to improved quality of care with a threefold decrease in C. diff disease and a 20 percent cost savings of antimicrobials," said Wiedeman. "Our data argue strongly for the benefits of applying stewardship to all patients. Looking forward, it is our hope that pediatric stewardship can be addressed nationwide in medical policy."
As part of the ResPECT study, which looked at different ways to protect health care workers during flu season, John Frederick, of the VA New York Harbor Healthcare System, and colleagues performed a sub-study to evaluate how mandatory versus nonmandatory flu vaccination impacts absenteeism among health care workers.
The investigators found that sites with mandatory influenza vaccination policies had significantly lower percentages of people taking sick days than those without mandatory influenza vaccination policies, including Department of Veterans Affairs (VA) sites. Specifically, the investigators used a sick day ratio (SDR) that counted the number of self-reported days absent from work that were specifically due to cold- or flu-like symptoms and divided that number by the number of participants at that site. They found that sites that had mandatory influenza vaccination programs and high influenza vaccine rates had lower SDRs.
"The difference in SDRs for VA and MVP (mandatory vaccination policy) sites may also stem from other variables such as geographical region, patient/HCP (health care personnel) population, and burden of disease. These findings warrant further investigation of the role of vaccine mandates and clinical outcomes in healthcare settings," the authors write.
In another study, Nicola Thompson, Ph.D., of the Centers for Disease Control and Prevention in Atlanta, and colleagues evaluated nearly 3,000 patients at 120 hospitals in seven states and found that individuals with a health-care-associated infection (HAI) have an increased risk of mortality within 90 days of being released from the hospital as compared with individuals without an HAI.
Specifically, after adjusting for age, gender, intensive care unit stay, and use of medical devices, the investigators found that individuals with an HAI had a 21.6 percent risk of mortality within 90 days of being released from the hospital as compared with 14.7 percent of individuals without an HAI.
"Additional work to determine the impact of HAIs on post-discharge mortality is necessary. These findings will inform HAI mortality measurement for subsequent PS (prevalence survey) and more accurate estimation of HAI burden," the authors write.