Effect of non-payment on nosocomial infection rates

This large analysis of almost 400 hospitals found non-payment for catheter associated vascular catheter infection and catheter associated UTIs did not appear to affect overall rates, compared to VAP (which currently continues to be reimbursed by Medicare). The Medicare "HAC" non-payment does not appear to have had any affect on nosocomial infection rates (abstract)

Influenza vaccine efficacy

In this large case-control study, researchers found the overall efficacy of the influenza vaccine for the 2010-2011 season was 60%. It was highest in children age 6mo-8 years (69%) and lowest in elderly>age 65 (38%) (abstract).

Fungal outbreak continues

The CDC update on the aspergillus outbreak currently stands at 137 cases, in 10 states, with 12 deaths. The outbreak is the result of a compound pharmacy in Massachusetts which dispensed contaminated methylprednisolone, resulting in several types of infections depending on the site of injection (meningitis, epidural abcess, vertebral osteomyelitis, and joint infections). There are 14,000 potentially exposed patients from 23 states (CDC site)

Healthcare workers decline flu vaccinces

According to a survey by the CDC, 86% of physicians and 78% of nurses received a flu vaccine during last flu season. Vaccine rates were 95% among healthcare workers in hospitals that required the vaccine. The most common reasons cited for not getting vaccinated included the belief that it was not necessary, and concerns about efficacy and side effects. All hospitalists should get annual flu vaccination unless contraindicated (CDC site)

Conservative antibiotics in surgical ICU patients

In this before-after observational cohort of surgical ICU patients with suspected infection, those that received aggressive antibiotics (started with suspected infection after cultures were sent) had significantly higher adjusted mortality (odds ratio 2.5, CI 1.5 to 4.0) compared to those that received conservative antibiotics (started only after objective confirmation of infection) . The conservative antibiotic group also had a shorter mean duration of therapy, and higher initial appropriate therapy. Conserving antibiotics for only patients with confirmed infection may improve outcomes in surgical ICU patients (abstract)