#109 – IDWeek 2024 Recap: Practice Changing Papers and ID Potpourri
Dec 27, 2024
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Dive into the latest breakthroughs in infectious disease research! Discover how AI is revolutionizing the detection of hospital-acquired infections and learn about groundbreaking HIV prevention strategies for young women. The conversation also covers innovative vaccination techniques, new antifungal therapies, and advancements in pediatric care. Plus, explore the exciting developments in EBV treatments post-transplant. It's a treasure trove of insights for anyone passionate about infectious diseases!
Generative AI shows promise in accurately detecting hospital-acquired infections such as CAUTI and CLABSI, enhancing patient care efficiency.
The CDC is developing a new metric for tracking hospital-onset bacteremia and fungemia, which may standardize infection monitoring practices across hospitals.
Recent studies challenge the necessity of contact precautions for MRSA, potentially leading to policy changes and resource savings in healthcare settings.
Deep dives
Generative AI in Infection Detection
The use of generative artificial intelligence (AI) for detecting hospital-acquired infections has been highlighted as a promising development in healthcare. Studies reviewed showcased AI's capability to identify conditions such as catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) with high sensitivity and specificity. For CAUTI detection, one study reported an overall sensitivity of 83% and specificity of 96% when utilizing fictional case data. The potential for AI to provide objective assessments for healthcare-associated infections could lead to more efficient and accurate patient care in the future.
Hospital-Onset Bacteremia and Fungemia Metric
A new metric for tracking hospital-onset bacteremia and fungemia (HOB) is set to be developed by the CDC, marking an important shift in how infections are monitored in hospitals. Research revealed that the most common sources of HOB were gastrointestinal or abdominal, in contrast to the more familiar urinary sources often associated with community-acquired infections. The metric will consider preventability, excluding patients whose infections are deemed non-preventable, and is anticipated to begin voluntary reporting soon. This approach could lead to standardized data collection and eventual mandatory requirements for hospitals to benchmark their infection rates.
Reevaluation of Contact Precautions for MRSA
The efficacy and necessity of contact precautions for Methicillin-resistant Staphylococcus aureus (MRSA) have come under scrutiny, as recent studies suggest they may no longer be essential for infection control. Research points to significant burdens placed on healthcare providers by the implementation of these precautions, with some facilities already discontinuing them without noticeable increases in MRSA transmission. The environmental impact, such as the high volume of personal protective equipment used, has also been raised as a concern. As facilities weigh the evidence, there may be widespread changes in policies regarding MRSA precautions in the near future.
Enhanced Cleaning Protocols and Infection Rates
A recent study known as the CLEAN trial demonstrated that intensified cleaning protocols in healthcare settings can significantly reduce the incidence of healthcare-associated infections (HAIs). By hiring additional cleaning staff and increasing cleaning hours, researchers observed a measurable decrease in HAIs from 14.9% to 9.8%. Despite the promising outcomes, the feasibility of sustaining such rigorous cleaning practices remains a challenge for many healthcare systems. Continued exploration into cost-effective sanitation strategies is essential to improve patient safety without overburdening resources.
Innovative Approaches to Antimicrobial Stewardship
New strategies in antimicrobial stewardship have emerged from recent research aimed at improving the appropriate use of antibiotics, particularly in outpatient settings. One study indicated that multimodal interventions in outpatient clinics led to a notable reduction in the prescription of second-line antibiotics for urinary tract infections. Additionally, efforts to streamline antibiotic administration through clinical decision support tools showed promising results, enhancing the effectiveness of existing stewardship programs. These findings suggest that a combination of education, awareness, and technology is key to optimizing antibiotic prescribing practices.
We are back with more exciting IDWeek 2024 content. In this episode, Breakpoints hostesses Drs. Erin McCreary, Julie Ann Justo, Jeannette Bouchard, and Megan Klatt highlight more of our favorite sessions and posters at IDWeek, this episode is a must listen if you are an IDWeek nerd like us!
References:
Perret et al. Application of OpenAI GPT-4 for the retrospective detection of catheter-associated urinary tract infections in a fictitious and curated patient data set. 10.1017/ice.2023.189
Wiemken et al. Assisting the infection preventionist: Use of artificial intelligence for health care–associated infection surveillance. 10.1016/j.ajic.2024.02.007
Leekha et al. Evaluation of hospital-onset bacteraemia and fungaemia in the USA as a potential healthcare quality measure: a cross-sectional study. 10.1136/bmjqs-2023-016831
Diekema et al. Are Contact Precautions "Essential" for the Prevention of Healthcare-associated Methicillin-Resistant Staphylococcus aureus? 10.1093/cid/ciad571
Martin et al. Contact precautions for MRSA and VRE: where are we now? A survey of the Society for Healthcare Epidemiology of America Research Network. 10.1017/ash.2024.350
Browne et al. Investigating the effect of enhanced cleaning and disinfection of shared medical equipment on health-care-associated infections in Australia (CLEEN): a stepped-wedge, cluster randomised, controlled trial. 10.1016/S1473-3099(24)00399-2
Protect trial: Decolonization in Nursing Homes to Prevent Infection and Hospitalization. 10.1056/NEJMoa2215254
Aldardeer et al. Early Versus Late Antipseudomonal β-Lactam Antibiotic Dose Adjustment in Critically Ill Sepsis Patients With Acute Kidney Injury: A Prospective Observational Cohort Study. 10.1093/ofid/ofae059
Schmiemann et al. Effects of a multimodal intervention in primary care to reduce second line antibiotic prescriptions for urinary tract infections in women: parallel, cluster randomised, controlled trial. 10.1136/bmj-2023-076305
Vernacchio et al. Improving Short Course Treatment of Pediatric Infections: A Randomized Quality Improvement Trial. 10.1542/peds.2023-063691
Advani et al. Bacteremia From a Presumed Urinary Source in Hospitalized Adults With Asymptomatic Bacteriuria. 10.1001/jamanetworkopen.2024.2283
Saif et al. Clinical decision support for gastrointestinal panel testing. 10.1017/ash.2024.15
Bekker et al. Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention in Cisgender Women. 10.1056/NEJMoa2407001
Montini et al. Short Oral Antibiotic Therapy for Pediatric Febrile Urinary Tract Infections: A Randomized Trial. 10.1542/peds.2023-062598
Nielsen et al. Oral versus intravenous empirical antibiotics in children and adolescents with uncomplicated bone and joint infections: a nationwide, randomised, controlled, non-inferiority trial in Denmark. 10.1016/S2352-4642(24)00133-0
Kaasch et al. Efficacy and safety of an early oral switch in low-risk Staphylococcus aureus bloodstream infection (SABATO): an international, open-label, parallel-group, randomised, controlled, non-inferiority trial. 10.1016/S1473-3099(23)00756-9
AMIKINHAL: Inhaled Amikacin to Prevent Ventilator-Associated Pneumonia. 10.1056/NEJMoa2310307
PROPHY-VAP: Ceftriaxone to prevent early ventilator-associated pneumonia in patients with acute brain injury: a multicentre, randomised, double-blind, placebo-controlled, assessor-masked superiority trial. 10.1016/S2213-2600(23)00471-X
AVENIR: Azithromycin to Reduce Mortality — An Adaptive Cluster-Randomized Trial. 10.1056/NEJMoa2312093
Thomas et al. Comparison of Two High-Dose Versus Two Standard-Dose Influenza Vaccines in Adult Allogeneic Hematopoietic Cell Transplant Recipients. 10.1093/cid/ciad458
Schuster et al. The Durability of Antibody Responses of Two Doses of High-Dose Relative to Two Doses of Standard-Dose Inactivated Influenza Vaccine in Pediatric Hematopoietic Cell Transplant Recipients: A Multi-Center Randomized Controlled Trial. 10.1093/cid/ciad534
Mahadeo et al. Tabelecleucel for allogeneic haematopoietic stem-cell or solid organ transplant recipients with Epstein-Barr virus-positive post-transplant lymphoproliferative disease after failure of rituximab or rituximab and chemotherapy (ALLELE): a phase 3, multicentre, open-label trial. 10.1016/S1470-2045(23)00649-6
Khoury et al. Third-party virus-specific T cells for the treatment of double-stranded DNA viral reactivation and posttransplant lymphoproliferative disease after solid organ transplant. 10.1016/j.ajt.2024.04.009
Spec et al. MSG-15: Super-Bioavailability Itraconazole Versus Conventional Itraconazole in the Treatment of Endemic Mycoses—A Multicenter, Open-Label, Randomized Comparative Trial. 10.1093/ofid/ofae010
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