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NEWS FEATURES
LEGISLATIVE/REGULATORY NEWS/QUESTION OF THE MONTH
NEWS AND ANNOUNCEMENTS
COURSES FOR THE INFECTION CONTROL PROFESSIONAL
The Centers for Disease Control and Prevention (CDC) has recently published its new draft guideline for the prevention of Surgical Site Infections (Federal Register June 17, 1998, available via CDC web page, www.CDC.gov). The last time the Guideline was completed updated was in 1985.
Among the changes in the new Guideline are specific recommendations on the optimal use of prophylactic antibiotics (PA). CDC recommends the following: 1) Select PA based on efficacy of the most common pathogens causing the SSI for a specific operation; 2) Do not routinely use vancomycin; 3) Begin PA within 30 minutes of incision to ensure an adequate microbiocidal tissue concentration; and, 4) Do not routinely extend PA beyond the surgery. The CDC Guidelines provide guidance of proper OR attire: arm and hand jewelry should be avoided, artificial should not be allowed, but there is not recommendation regarding the use of nail polish. This Guidelines includes many other important recommendations regarding the pre-operative preparation of the patient, the surgical team, the surgical technique, and post-operative care and flash sterilization (use for emergency situation only). It should be read by all inflection control professions.
The CDC Guidelines for Isolation Precautions in Hospitals recommends patients known or suspected to be infected or colonized with epidemiologically important organisms that can be transmitted by direct contact or indirect contact should be placed on Contact Isolation. The issue is how to define these epidemiologically important organisms. In addition to MRSA and VRE, UNC Hospitals recently defined when other organisms require Contact Precautions for the institution's Isolation/Precaution Policy. First, pseudomonas organisms that are resistant to more than one of the following antibiotics classes, either (1) beta-lactams (i.e. penicillins, cephalosporins, and carapenems) or (2) aminoglycosides or (3) quinolones. Second, enteric pathogens (i.e., E. Coli, Klebsiella, Enterobacter, Proteus, Serratia) that are resistant to more than three of the following five classes of antibiotics (1) penicillins, (2) cephalosporins, (3) carapenems, (4) aminoglycosides, or (5) quinolones. Finally, B. cepacia that is resistant to more than four of the following six classes of antibiotics (1) penicillins, (2) cephalosporins, (3) carapenems, (4) aminoglycosides, (5) quinolones or (6) antimetabolites). This policy was amended from the Cystic Fibrosis Society guidelines.
Several companies are promoting their services for reprocessing, refurbishing, and remarketing medical devices. Are there any regulations or practice guidelines for companies that health care facilities should know about?
A: On December 23, 1997, the U.S. Food and Drug Administration (FDA) published an Advance Notice of Proposed Rulemaking (ANPR) that officially announced the agency's exploration into the regulation of device servicing, remarketing, refurbishing and reconditioning. To further this task, the Association for the Advancement of Medical Instrumentation (AAMI) and the FDA are cosponsoring a conference in Reston, Virginia on September 17 - 18, 1998 to provide a forum for healthcare professionals from all of the potentially affected industry segments to discuss the need, if any, for additional regulatory controls and what form those controls could take. FDA representatives will provide background on the current regulatory initiative, why current practice may indicate the need for additional controls, the types of controls being considered and how they may be implemented. Immediately following the conference, representatives from participating organizations will meet with FDA officials to review the outcomes of the conference and identify potential areas of agreement regarding what, if any, additional regulatory controls should be implemented. For more information call (800) 332-2264, ext 260 or (703) 525-4890.
NEWS AND ANNOUNCEMENTS
The Centers for Disease Control and Prevention "Guidelines for Infection Control in Health Care Personnel, 1998" was published simultaneously in the American Journal of Infection Control (1998;26:289-354) and Infection Control and Hospital Epidemiology (1998;19:407-63). Available on the internet: go to the SPICE home page at www.unc.edu/depts/spice and choose "Guidelines and Recommendations."
On July 10, 1998, US Health and Human Services Secretary announced the appointment of Jeffrey P. Koplan, MD, MPH, to be director of the Centers for Disease Control and Prevention. Koplan will assume the post October 5, 1998.
COURSES FOR THE INFECTION CONTROL PROFESSIONAL
"Infection Control in Home Health and Hospice" will be held September 28, 1998 at the Sheraton (formerly Omni) Chapel Hill Hotel.
"Infection Control Part II: The ICP as an Environmentalist will be held October 12-16, 1998 at the Holiday Inn in Chapel Hill.
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spice@unc.edu
Report of the Month is also available on the home page of the Statewide Program for Infection Control and Epidemiology at http://www.unc.edu/depts/spice/
The Statewide Program for Infection Control and Epidemiology (SPICE) is funded by the General Assembly of North Carolina to serve the State. SPICE is not a regulatory agency but provides education and consultation to North Carolina healthcare facilities.
Copyright 1998 Statewide Program for Infection Control and Epidemiology