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54 ANTIBIOTIC RESISTANCE & STEWARDSHIP Inpatient HAI risk jumps 5-fold with infected rommates, former bed occupants By Anuja Vaidya A study published in Infection Control & Hospital Epidemiology examined the link between having a prior bed occupant or roommate with a healthcare-associated infection and a sub- sequent infection with the same organism. Researchers conducted the study at four New York City-based hospitals. They studied 761,426 inpatients discharged from 2006 to 2012 to identify cases of patients who developed a healthcare-associated infection with: • Staphylococcus aureus • Acinetobacter baumannii • Streptococcus pneumoniae • Pseudomonas aeruginosa • Klebsiella pneumoniae • Enterococcus faecalis • Enterococcus faecium They matched infected patients to controls by fiscal quarter, hospital and length of stay. For beds with an infected study partic- ipant, they collected microbiology results for assigned roommates and the patient who occupied the bed immediately prior. In all, researchers identified 10,289 HAIs. A multivariable analysis showed the odds of infected patients having been exposed to a prior bed occupant with the same organism were 5.83 times that of controls. Addition- ally, the odds of infected patients having been exposed to a roommate with the same organism were 4.82 times that of controls. "Infected or colonized roommates and prior occupants do pose a risk, which may warrant enhanced terminal and intermittent cleaning measures," study authors concluded. n Consultations significantly reduce 30- day death rates for some drug-resistant infections By Anuja Vaidya A study published in Open Forum Infectious Diseases examined the association between infectious disease consultations and death following multidrug-resistant organism infections. Researchers conducted the study at an academic tertiary referral center, identifying 4,214 patients with multidrug-resistant organism infections in a sterile site or bronchoalveolar lavage/bronchial wash culture. They also examined mortality and readmissions, as well as the association of infec- tious disease consultations with these outcomes. The study shows infectious disease consultations were significantly associated with reductions in 30-day and one-year mortality for resistant S. aureus and Enterobacteriaceae. These types of consultations were also associated with reductions in 30-day mortality for polymicrobial infections. Infectious disease consultations were associated with reduced 30-day readmission for resistant Enterobacteriaceae. However, infectious disease consultations were not associated with 30- day mortality reductions for Acinetobacter or Pseudomonas. "Our results suggest that ID consultation may be beneficial for patients with some MDRO infections," study authors concluded. n 3 ways interpersonal relationships influence preventive antibiotic treatment By Anuja Vaidya A study published in the American Journal of Infection Control exam- ined the way interpersonal relationships influence decision-making regarding surgical antibiotic prophylaxis. Researchers conducted in-depth semistructured interviews on antibiotic prescribing with 20 surgeons and anesthetists. The study shows there are three ways in which interpersonal relationships influence surgical antibiotic prophylaxis: • Relationship dynamics between the surgeon and the anesthetist determine appropriateness of surgical antibiotic prophylaxis. • Perceived hierarchies within, and between, surgical and anesthetist specialties influence antibiotic prescribing decisions. • Surgical distance from the antimicrobial stewardship team influences use of antimicrobial stewardship principles. "Interventions to optimize [surgical antibiotic prophylaxis] are more likely to be effective in enacting sustained change if they consider the interper- sonal and social contexts, including issues of familiarity and cohesiveness, hierarchical patterns, and sense of place within a team," study authors concluded. n