Becker's Clinical Quality & Infection Control

7 INFECTION CONTROL and healthcare worker safety," Dr. Ravin said. "I saw a group of deeply thoughtful professionals in healthcare epidemiology doing their best to create guidance that would truly work in the real world — guidance that was sensitive to various populations and practical for healthcare workers." e CDC said it shut down the 11-person committee to be in compliance with President Donald Trump's "continuing the reduction of the federal bureaucracy" executive order, a spokesperson for HHS told Becker's. e committee was working on a number of guidelines before the shut down, including dra isolation precaution guidelines for healthcare facilities. Now, some members and association leaders fear those guidelines will be lost to time. "At some point, when things need to change, the guidelines likely won't change, and then people will be sort of flying by the seat of their pants," Connie Steed, a HICPAC member since 2023 and former president of the Association for Professionals in Infection Control and Epidemiology, told NBC. Reactions For those who worked closely with the committee, the decision to end it was not a shock, as many suspected it might be coming based on the CDC's behavior leading up to the final decision. In the weeks leading up to the announcement, the CDC had sent termination letters to several members of the committee and canceled some long-standing meetings. "Still, I was angry," Dr. Ravin said. "Angry about the lack of understanding regarding what HICPAC actually is and the incredibly important role it's played in healthcare supporting institutions across the country. It's frustrating and disappointing." Since the committee was cut, a number of national healthcare associations have released statements showing their displeasure with the decision. "We were disappointed," David Weber, MD, president of the Society for Healthcare Epidemiology of America Board of Trustees, told Becker's. "We believe it will negatively impact public health." HICPAC guidelines played a significant role in reducing infection morbidity and mortality among patients, as well as protecting healthcare personnel when exposed to diseases. "It's disheartening that the CDC currently lacks the ability to convene this kind of expert advisory group to guide them in developing those essential recommendations," Dr. Weber said. e absence of this committee is creating a "significant void in the field" and "puts patients at risk," according to a May 7 joint statement from the Infectious Diseases Society of America, Society for Healthcare Epidemiology of America, PIDS and Association for Professionals in Infection Control and Epidemiology. "HICPAC is an essential component of patient safety, and its contributions cannot be replicated by the private sector," the joint statement said. "Disbanding HICPAC jeopardizes decades of progress in preventing healthcare-associated infections." e potential impacts A few weeks aer HICPAC was disbanded, theories about the long- term implications are still circulating. IDSA, among other associations, said the disbandment "creates a preventable gap in national preparedness and response capacity, leaving healthcare facilities without timely, evidence-based and expert-driven recommendations at a time when threats from emerging pathogens and antimicrobial resistance are on the rise." Jane omason, the lead hygienist at National Nurses United, told NBC the change removes important public transparency. "Without HICPAC's public meetings, there is no longer any public access to the process for draing CDC guidance on infection control for healthcare settings," she told NBC. "is further undermines safety for patients, nurses and other healthcare workers." Hospitals are evaluated based on their compliance with the guidelines HICPAC would set, and their compliance had impacts on accreditation by Medicare and Medicaid. "So, without this committee, we lose a valuable structure that has helped keep patient care safe and consistent for decades," Dr. Weber said. "Speaking on behalf of my professional organization, I hope that once we have a confirmed CDC director, they'll take the time to recognize the impact and importance of HICPAC and reinstitute a similar expert advisory group. We need a team with diverse perspectives and deep experience to continue this work. Reinstating that structure should be a near-term priority." n 90% of sepsis patients may be overtreated: Study By Mariah Taylor A recent study found that up to 90% of sepsis patients may be overtreated. The study, published April 15 in Clinical Infectious Diseases and led by researchers from Brigham's Women's Hospital and Harvard Medical School, both in Boston, analyzed medical records of 600 randomly selected adults that were treated for suspected sepsis in seven emergency departments between 2019 and 2022. Here are four findings: 1. Of patients, 68.5% had definite or probable bacterial infections and 31.5% had possible but less likely or definitely no bacterial infections. 2. Among patients with definite or probable infections, 79.1% received overly broad antibiotics. 3. About 17% of patients developed potential antibiotic-associated complications within 90 days, most commonly a new infection or colonization with organisms resistant to first-line agents. 4. Mortality was higher for patients with less likely and definitely no bacterial infection at 9%, compared to 4.9% for those with definite or probable infection. "Our findings support the concern that in the setting of sepsis policies that require rapid administration of broad- spectrum antibiotics, empiric antibiotics for suspected sepsis are often unnecessary or broader than necessary in retrospect," the study authors wrote. "These findings have important implications for antibiotic stewardship efforts in the face of ongoing quality improvement and policy initiatives that seek to speed delivery of broad-spectrum antibiotics for patients with suspected sepsis." n

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