The Infectious Diseases Society of America annual meeting (IDWeek 2017)
IDWeek 2017 was held from October 4 to 8 in San Diego and attracted more than 5,000 participants from around the world including scientists, physicians, and other health care professionals. IDWeek is the combined annual meeting of the Infectious Diseases Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA), and the Pediatric Infectious Diseases Society (PIDS). 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, Amirta John, M.B.S.S., of University Hospitals Case Medical Center in Cleveland, and colleagues performed a randomized crossover trial involving simulated patient care interactions using a DNA marker as a surrogate for pathogen transmission. Health care personnel were randomized to either long- or short-sleeved coats.
The investigators found that there was an increased likelihood of detection of the DNA marker on sleeves or wrists when long-sleeved coats were worn. No transmission occurred when short-sleeved coats were worn.
"Current United Kingdom guidelines and expert guidance from Society for Healthcare Epidemiology of America suggest that bare below the elbows might be an intervention to decrease the spread of hospital-acquired infections. However, this policy is largely based on biological plausibility and low likelihood of harm," said John. "Our study provides support for the statement that short-sleeved clothing in clinical settings might be helpful in reducing pathogen transmission."
Abstract No. 996
In another study, Alejandro Diaz, M.D., of Nationwide Children's Hospital in Columbus, Ohio, and colleagues showed, for the first time, the effect of secondhand smoke exposure at the systemic host response level in infants with respiratory syncytial virus (RSV) bronchiolitis.
Specifically, the investigators found that hair nicotine was detected in 64.2 percent of infants with RSV. They also found significantly greater overexpression of genes related to apoptosis, inflammation, and cell death and greater suppression of T and B cell-related genes in RSV infants exposed to secondhand smoke versus those not exposed.
"Secondhand smoke exposure measured by hair nicotine concentrations, which reliably reflects smoke exposure, contributed in part to the increased inflammation and decreased activation of T and B cell genes that we have observed in children with RSV bronchiolitis," said Diaz. "Severe RSV infection is associated with an impaired immune response in infants. What we found is that indeed, this modifiable risk factor enhances the already impaired immune response to the infection."
Two study authors disclosed financial ties to the pharmaceutical industry.
Abstract No. 1002
Shelley S. Magill, M.D., Ph.D., of the Centers for Disease Control and Prevention in Atlanta, and colleagues found that efforts aimed at reducing health care-associated infections (HAIs), including urinary tract and surgical site infections, were having a positive impact.
"Compared to a previous survey conducted in 2011, in which approximately 4 percent of patients had at least one HAI, data from the survey conducted in 2015 showed that the proportion of patients with HAIs was significantly lower, at approximately 3.2 percent. This was largely due to decreases in surgical site infections and urinary tract infections," said Magill.
However, the investigators found that the proportions of patients with other infections such as pneumonia and Clostridium difficile infection did not change substantially between 2011 and 2015.
"Even after we accounted for other factors such as patient age and the presence of certain medical devices, patients surveyed in 2015 were at significantly lower risk of having an HAI than patients in the 2011 survey. The most common HAI overall in the 2015 survey was pneumonia, followed by gastrointestinal and surgical site infections. Clostridium difficile was the most common pathogen causing HAIs in this survey, as it was in the 2011 survey," said Magill. "Physicians and other health care providers can help reduce the occurrence of HAIs by following infection control and prevention guidelines and practicing good antibiotic stewardship."
Abstract No. 1768
Stacy Holzbauer, D.V.M, M.P.H., of the Minnesota Department of Health in St. Paul, and colleagues found that antibiotics prescribed by dentists may be contributing to Clostridium difficile infections. In this study, 1,626 people with community-associated Clostridium difficile between 2009 and 2015 were interviewed. Of those, 926 (57 percent) reported they had been prescribed antibiotics, 136 (15 percent) of those for a dental procedure.
"Of those who had received antibiotics for a dental procedure, 85 percent were prescribed antibiotics only for dental reasons and 34 percent had no mention of antibiotics in their medical charts, illustrating a disconnect between dental and medical care," said Holzbauer. "We found that patients who were prescribed antibiotics for dental procedures tended to be older and more likely to receive clindamycin, an antibiotic that is often associated with Clostridium difficile infection."
The primary reasons for antibiotic prescriptions were treatment for tooth infections or abscesses and prophylaxis for oral surgery or dental cleaning.
"While this study cannot quantify the national magnitude of Clostridium difficile infections related to antibiotics from dental procedures, it does identify that dental prescribing is playing a role in illness," said Holzbauer. "Dentists have often been overlooked as major partners in programs that promote appropriate antibiotic use, and it is critical dentists are included in efforts to improve antibiotic prescribing. All prescribers, including dentists, should examine prescribing behaviors for appropriateness."
Abstract No. 78
IDSA: Surgical Site Infections Up With Reported Penicillin Allergy
MONDAY, Oct. 9, 2017 (HealthDay News) -- Patients with penicillin allergy have increased odds of surgical site infection (SSI), according to a study published online Oct. 9 in Clinical Infectious Diseases to coincide with presentation at IDWeek, the combined annual meeting of the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the HIV Medicine Association, and the Pediatric Infectious Diseases Society, held Oct. 4 to 8 in San Diego.
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IDSA: Small Drop in MMR Vaccination Rate Would Be Costly
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