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28 INFECTION PREVENTION & PATIENT SAFETY Sepsis Redefined: JAMA Articles Update Guidance for the First Time Since 2001 By Max Green A series of articles published in JAMA based on National Institutes of Health-funded re- search update the definition of sepsis and provide a more robust framework for cli- nicians and patients to treat the common hospital-acquired infection. is is the first major revision of sepsis and septic shock definitions since 2001. "Considerable advances have been made in the study and care of sepsis and septic shock in the past 15 years, and there is an urgent need to help the medical community do a better job identifying septic patients quickly and start life-saving treatment," Derek C. Angus, MD, chair of the University of Pittsburgh School of Medicine's critical care medicine depart- ment, said in a statement. "Put simply, sepsis is a life-threatening organ dysfunc- tion due to a dysregulated response of the patient's immune system to infection. Our intent is that this definition results in greater consistency for epidemiologic studies, clinical trials and — perhaps most important — better recognition and more timely management of patients with, or at risk of developing, sepsis." In 2014, the Society of Critical Care Medicine and the European Society of Intensive Care Medicine curated a task force to re-examine the definition of sep- sis based on advances in the condition's epidemiology and management. e up- dated definition the task force produced is designed to help providers get to a diagnosis more quickly, according to the researchers. e new criteria include a sepsis-re- lated organ failure assessment based on three symptoms — altered mental status, fast respiratory rate and low blood pressure — that do not require time-in- tensive blood tests and enable treat- ment to begin sooner. is system was developed through a review of more than 800,000 EHRs at 177 hospitals across the world. n How Clean is Clean- Shaven? Study Finds Beardless Healthcare Workers Carry More Bacteria on Their Faces By Max Green A clean-shaven face may be de- ceptive, at least when it comes to the "clean" part, according to a Journal of Hospital Infection study that found healthcare workers with beards carried fewer harmful bacteria than those with less facial hair. While there wasn't a huge dif- ference between clean-shaven and bearded individuals, notable bacteria like methicillin-resistant Staphylo- coccus aureus were more present on workers without facial hair. The authors suggest this may be be- cause small cuts and micro-abrasions sustained during shaving support bacterial colonization. n Major C. diff Collaboration Reduces Infections by 36% By Max Green A collaboration between four New York state hospitals aimed at reducing Clostridium difficile infections resulted in a 36 percent drop in rates of the common hospital-acquired infection in Sep- tember 2015, compared with 2011 levels, according to a Wall Street Journal report. The four hospitals, which are now a part of two healthcare systems — the University of Rochester Medical Center and Rochester Regional Health System — had been strug- gling to combat the infections on their own. Additionally, they realized they were trying to eliminate C. diff in the same patient population — patients discharged from one of their facilities would often be admit- ted to another. To tackle the problem, the four hospitals began by evaluating clean- ing protocols, including retraining staff on hand hygiene and implement- ing thorough inspections of cleaned rooms. Hospitals in the collaboration shared strategies as they determined their efficacy through trial and error. One institution found that after C. diff patients were discharged, it took twice as long as previously thought to properly clean and disinfect their rooms, a practice later adopted by the other hospitals. Later components of the col- laboration included implement- ing policies for limiting use of broad-spectrum antibiotics that can create an environment where C. diff can flourish and publishing new guidelines for determining which patients are likely more susceptible to infections. Currently, physicians involved in the collaboration are working to expand their best practices to clinics and offices external to the hospi- tals while continuing to monitor their own infection data, according to WSJ. n