Evaluation of Far Ultraviolet-C Light for Decontamination of Organisms in Whole Milk and Chicken Manure.

Background: The dissemination of highly pathogenic avian influenza (HPAI) A(H5N1) in US poultry and dairy cows poses a public health threat. Farm workers caring for infected animals are at risk to acquire infections due to exposure to contaminated milk or poultry feces and secretions. Far ultraviolet-C (UV-C) light could provide continuous decontamination of surfaces and air in agricultural settings, but efficacy against organisms in whole milk or chicken manure is unclear.

Impact of High-Titer Convalescent Plasma on Clinical and Virologic Outcomes Among Veterans Hospitalized With SARS-CoV-2 Infection: VA CoronavirUs Research and Efficacy Studies-1 (VA CURES-1).

In the initial absence of proven therapies, empirical COVID-19 convalescent plasma (CCP) was rapidly introduced for individuals hospitalized for COVID-19. Seventy-five participants were randomized from November 2020 to June 2021 in a double-blind, multi-site, placebo-controlled, randomized trial (VA CURES-1) evaluating the impact of CCP vs. saline in Veterans hospitalized with COVID-19 with hypoxemia.

Risk factors for Clostridioides difficile infection caused by ribotype 027 strains in the Veterans Affairs Healthcare System: a matched case-control study.

Background: In case-control studies, a variety of factors have been associated with Clostridioides difficile infection (CDI) due to the epidemic ribotype 027 strain. However, many studies have been limited due to small sample size and inclusion of only one facility.

Methods: Using a nationwide cohort of hospitalized patients in the Veterans Affairs (VA) Healthcare System, we conducted a retrospective, 1:3 matched case-control study of patients with CDI due to the ribotype 027 strain versus non-027 strains from October 1, 2008, to September 30, 2020.

Targeted and Non-Targeted Metabolomic Evaluation of Cerebrospinal Fluid in Early Phase Schizophrenia: A Pilot Study from the Hopkins First Episode Psychosis Project.

(1) Background: The lack of reliable biomarkers remains a significant barrier to improving outcomes for patients with schizophrenia. While metabolomic analyses of blood, urine, and feces have been explored, results have been inconsistent. Compared to peripheral compartments, cerebrospinal fluid (CSF) more closely reflects the chemical composition of brain extracellular fluid.

Impact of tebipenem pivoxil on the intestinal microbiota and on establishment of colonization with carbapenem-resistant in mice.

Tebipenem pivoxil has potent activity against pathogens, but requires combination with β-lactamase inhibitor to achieve activity against carbapenemase producers, including metallo-β-lactamases (MBLs). Herein, we evaluate the potential of tebipenem pivoxil, alone and in combination with the prodrug of the experimental MBL inhibitor CS319 (CS319-piv-SAc), to disrupt the indigenous mice microbiota of the colon and promote colonization by pathogens. The effect of antibiotic treatment (daily for 3 days with subcutaneous saline [control], subcutaneous clindamycin, oral tebipenem pivoxil alone and in combination with CS319-piv-Sac, or oral CS319-piv-Sac) on the intestinal microbiota was assessed by culture for enterococci and facultative Gram-negative bacilli and by 16S rRNA amplicon sequencing.

Emergence and Spread of Clostridioides difficile Isolates With Reduced Fidaxomicin Susceptibility in an Acute Care Hospital.

Background: There have been several recent reports of Clostridioides difficile infection (CDI) due to isolates with reduced fidaxomicin susceptibility (minimum inhibitory concentration [MIC] ≥ 2 µg/mL). However, the clinical implications are uncertain because fidaxomicin achieves high concentrations in the intestinal tract.

Methods: In an acute care hospital, we conducted a 3-year cohort study of patients with CDI to determine the frequency of infection with isolates with reduced fidaxomicin susceptibility and the impact on response to fidaxomicin treatment.

Bacteria invade the brain following intracortical microelectrode implantation, inducing gut-brain axis disruption and contributing to reduced microelectrode performance.

Brain-machine interface performance can be affected by neuroinflammatory responses due to blood-brain barrier (BBB) damage following intracortical microelectrode implantation. Recent findings suggest that certain gut bacterial constituents might enter the brain through damaged BBB. Therefore, we hypothesized that damage to the BBB caused by microelectrode implantation could facilitate microbiome entry into the brain.

An ultraviolet-C (UV-C) light device is effective for low-level disinfection of surgical site marking pens with UV-C transmissible caps.

Single-use plastic pens are commonly used to mark surgical sites on the skin of patients. In laboratory testing, an ultraviolet-C (UV-C) light device was effective for decontamination of marking pens with plastic caps designed to allow transmission of UV-C. Decontamination of marking pens could reduce plastic and carbon footprints.

Evaluation of a new technology for terminal sterilization of flexible endoscopes using hydrogen peroxide gas plasma.

In laboratory testing, a novel hydrogen peroxide gas plasma endoscope sterilizer consistently reduced vegetative organisms, but not bacterial spores, to undetectable levels in the presence of high organism load (≥6.5 log) and organic material and salts. These findings highlight the importance of meticulous cleaning of endoscopes prior to sterilization.

Does routine use of sporicidal disinfectants for all postdischarge hospital rooms reduce environmental contamination with Clostridioides difficile spores?

In a culture survey of 30 hospitals, rates of Clostridioides difficile spore contamination after cleaning and disinfection of non-C difficile infection rooms were lower in facilities using sporicidal disinfectants in all postdischarge rooms versus only in C difficile infection rooms (3.6% vs 5.1%, respectively), but the difference was not statistically significant.

Evaluation of a far ultraviolet-C device for decontamination of portable equipment in clinical areas.

Contaminated portable equipment may contribute to transmission of health care-associated pathogens. We demonstrated that a wall-mounted far ultraviolet-C light technology that delivers far ultraviolet-C only when people are not present was effective in reducing contamination on in-use patient transport chairs and physical therapy equipment in equipment rooms. The technology could potentially be used as an adjunctive measure for decontamination of portable equipment in clinical areas.

Do blood contamination reduction devices work? A single institution comparison.

We compare two initial specimen diversion devices evaluated over 3 months to investigate their utility in lowering blood culture contamination rates at or below 1%. Overall contamination rates during trial periods were 2.46% and 2.

Dilution dysfunction: evaluation of automated disinfectant dispenser systems in 10 hospitals demonstrates a need for improved monitoring to ensure that correct disinfectant concentrations are delivered.

Automated dispensers that dilute concentrated disinfectants with water are commonly used in healthcare facilities. In a point-prevalence product evaluation, 9 of 10 (90%) hospitals using dilutable disinfectants had 1 or more malfunctioning dispensers. Twenty-nine of 107 (27.

Incubation period of infection in hospitalized patients and long-term care facility residents: a prospective cohort study.

Background: The incubation period for infection (CDI) is generally considered to be less than 1 week, but some recent studies suggest that prolonged carriage prior to disease onset may be common.

Objective: To estimate the incubation period for patients developing CDI after initial negative cultures.

Methods: In 3 tertiary care medical centers, we conducted a cohort study to identify hospitalized patients and long-term care facility residents with negative initial cultures for followed by a diagnosis of CDI with or without prior detection of carriage.

Effect of Ceftaroline, Ceftazidime/Avibactam, Ceftolozane/Tazobactam, and Meropenem/Vaborbactam on Establishment of Colonization by Vancomycin-Resistant Enterococci and in Mice.

Background: The potential for promotion of intestinal colonization with healthcare-associated pathogens by new antibiotics used to treat infections due to multidrug-resistant Gram-negative bacilli is unclear.

Methods: Mice treated for 3 days with daily subcutaneous phosphate-buffered saline (control), ceftazidime/avibactam, ceftolozane/tazobactam, ceftaroline, and meropenem/vaborbactam were challenged with 10,000 colony-forming units (CFU) of vancomycin-resistant (VRE) resistant to each of the antibioics or carbapenemase-producing 1 day after the final treatment dose. The concentrations of VRE or in stool were measured on days 1, 3, 6, and 15 after challenge.

Evaluation of an automated far ultraviolet-C light technology for decontamination of surfaces and aerosolized viruses in bathrooms.

Background: Aerosols generated during toilet flushing are a potential source for transmission of viral and bacterial pathogens in bathrooms. However, manual decontamination of bathrooms after each use is not feasible.

Methods: We tested the efficacy of a wall-mounted far ultraviolet-C (UV-C) light technology that only delivers far UV-C when people are not present for decontamination of surfaces and aerosolized viral particles in an unoccupied hospital bathroom.

A far ultraviolet-C light technology is effective for decontamination of items in proximity to sinks and is enhanced by a far UV-C reflective surface.

Background: Dispersal of gram-negative bacilli from sink drains has been implicated as a source of transmission in multiple outbreaks.

Methods: In an acute care hospital, we assessed how often patient care supplies and other frequently touched items were within 1 meter of sink drains. We tested the efficacy of a ceiling-mounted far ultraviolet-C (UV-C) light technology for decontamination of sink bowls and surfaces near sinks with and without a wall-mounted film that reflects far UV-C light.

A novel approach for safe and automated implementation of far ultraviolet-C light decontamination in clinical areas.

A novel wall-mounted far ultraviolet-C (UV-C) light technology providing automated delivery of far UV-C only when people are not present reduced methicillin-resistant in a patient room and equipment room. The safety feature that discontinues far UV-C output when people are detected was effective in preventing far UV-C exposure.

Evaluation of a wall-mounted far ultraviolet-C light device used for continuous air and surface decontamination in a dental office during routine patient care.

A wall-mounted far ultraviolet-C light device used for continuous air and surface decontamination in a dental office reduced aerosolized bacteriophage MS2 and methicillin-resistant on steel disks by >3 log in 2 hours in unshaded areas in a procedure room. Far ultraviolet-C delivery was substantially reduced in shaded areas.

CLOVER (CLOstridium difficile Vaccine Efficacy tRial) Study: A Phase 3, Randomized Trial Investigating the Efficacy and Safety of a Detoxified Toxin A/B Vaccine in Adults 50 Years and Older at Increased Risk of Clostridioides difficile Infection.

Background: Clostridioides difficile infection (CDI) causes substantial mortality and healthcare burden. We assessed the detoxified toxin-A/B PF-06425090 vaccine for primary CDI prevention.

Methods: This phase 3 observer-blinded study randomized (1:1) ≥50-year-olds at increased CDI risk (N = 17 535) to receive 3 PF-06425090 or placebo doses (0, 1, and 6 months).

Impact of a Switch From Ciprofloxacin to Ceftriaxone Prophylaxis on Infectious Complications After Transrectal Ultrasound-Guided Biopsy of the Prostate.

In a 12-year single-center quasi-experimental study, a switch from ciprofloxacin to ceftriaxone prophylaxis for transrectal ultrasound-guided prostate biopsy procedures was associated with a significant reduction in 30-day postprocedure urinary tract infection, urinary tract infection-related hospitalizations, antibiotic prescriptions, and isolation of fluoroquinolone-resistant organisms from urine or blood cultures.

Identifying and Remediating Super-splasher Sinks to Reduce Dispersal of Pathogens From Sink Drains.

Testing for dispersal of fluorescent gel from sink drains was sensitive for detection of sinks that dispersed gram-negative bacilli outside the bowl. Reducing the flow rate of sinks with rapid water inflow and/or elimination of obstruction leading to slow outflow was effective in preventing dispersal of fluorescence and gram-negative bacilli.

A coronavirus disease 2019 outbreak in a residential living facility with suboptimal ventilation in resident rooms.

We report a large outbreak of severe acute respiratory syndrome coronavirus 2 in a residential living facility. Measurements of carbon dioxide levels, aerosol particle clearance, and airflow were used to identify and remediate areas with suboptimal ventilation. A simple intervention involving continuous operation of bathroom fans was effective in significantly improving ventilation in resident rooms.

Molecular Epidemiology of Colonization in Families With Infants.

Background: Community-associated infection is a major public health hazard to adults and older children. Infants frequently excrete toxigenic asymptomatically in their stool, but their importance as a community reservoir of is uncertain.

Methods: Families of healthy infants were recruited at the baby's 4-month well child visit and were followed longitudinally until the baby was approximately 9 months old.