S4 Oral Abstracts / American Journal of Infection Control 47 (2019) S2−S14
compared to SMP2. There was 3.4 times higher views (range 2.8, 5) when
comparing SMP1 without paid advertising to SMP2.
CONCLUSIONS: Utilizing a social media platform with multiple ways
to post content resulted in the greatest viewership. Paid advertising
increased viewership significantly. Reactions to the videos have
been positive.
Presentation Number ASR-5
Creating Meaningful Meetings: A Rural
Health Approach for Engagement in
Antimicrobial Stewardship and Multidrug
Resistant Organism Tracking
Martha Jaworski MS, RN, CIC - Quality Improvement Principal,
Comagine Health; Susan Heppler BSN, RN; Matthew C. Burns BS
BACKGROUND: In response to the Center for Disease Control and
Prevention’s (CDC) Antibiotic Resistance Threats Report in 2013,
the National Strategy for Combating Antibiotic-Resistant Bacteria
provided recommendations to decrease the burden of multi-drug
resistant organisms (MDROs). These recommendations included
support for antimicrobial stewardship (AMS) programs across set-
tings as well as improved surveillance of MDROs. Our goal was to
set up regional meetings to 1) engage healthcare providers from
diverse, rural settings on AMS and infection prevention topics and
provide a forum for collaboration; 2) encourage submission of car-
bapenem-resistant organisms (CROs) and antibiogram data to the
state laboratory; 3) identify opportunities for goal-setting and allo-
cation of state-level resources.
METHODS: A Quality Innovation Network-Quality Improvement Orga-
nization collaborated with three programs within the state Department
of Health (Healthcare Associated Infection (HAI), Medicare Beneficiary
Quality Improvement Program (MBQIP) and the Bureau of Laboratories)
to hold a series of four face-to-face, cross-setting regional meetings.
Meeting satisfaction was evaluated by a brief on-site survey. CRO sam-
ple and antibiogram submissions were tracked before and after the
meetings. Meeting discussions were documented and grouped by topic.
RESULTS: Four regional meetings were completed between April-Sep-
tember, 2018 with 103 attendees representing 21 hospitals, 17 long-
term care facilities and 6 ambulatory settings. Overall participant satis-
faction was 4.35/5. The number of CRO isolates that were tested in our
state laboratory increased by 200% and the number of organizations
that agreed to submit antibiogram data increased from three to 10
(233% increase) following the events. Major areas of concern identified
by participants were: 1) care transitions; 2) physician AMS education;
3) public education on MDRO risk and the role of AMS.
CONCLUSIONS: Regional meetings that uniquely align infection pre-
vention, pharmacy and laboratory are a highly effective forum to pro-
mote cross-setting engagement and collaboration in a rural state
with limited resources.
Antisepsis/Disinfection/Sterilization
Presentation Number ADS-6
Beyond the Naked Eye: Biofilms and
Microbial Diversity in Re-laundered Mops
and Towels Used in Healthcare Facilities
Mark Wiencek PhD, T-CHEST - Lead Microbiologist, Contec, Inc.
BACKGROUND: Most Environmental Services departments have
switched from cotton-based mops and towels to microfiber products
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to clean floors and high-touch surfaces. The debate has now shifted
as to whether the laundering processes can effectively and consis-
tently remove bioburden and return the textiles to a state of "hygien-
ically clean", or if disposable, single-use products are necessary to
reduce the risk of cross-contamination. To better understand the
risks, mops and towels returned from institutional laundry facilities
were assessed for total bioburden, genetic diversity of contamination,
and the presence of biofilm.
Methods: Samples of mops and towels were retrieved from
several different healthcare facilities. Portions of each sample were
assessed using standard methods to determine the total aerobic
microorganisms and fungi and the bacterial microbiome. Select
samples with confirmed contamination were examined for
biofilm structures using confocal microscopy before and after
hydration. Unused non-relaunderable mops served as negative
controls.
RESULTS: Several samples of relaundered mop pads and towels con-
tained diverse populations of bacteria with levels in some samples
exceeding 10,000 total microorganisms. Analysis of the microbiome
revealed over a dozen genera or families of bacteria, including species
known to cause healthcare-acquired infections. Although typical bio-
film structures were difficult to differentiate from debris entrapped in
dry samples, examination after rehydration revealed clear evidence of
biofilms. No viable microbes were recovered from unused, non-relaun-
derable mops.
CONCLUSIONS: Results indicate that mops and towels can be contam-
inated with a diverse community of microbes, especially bacteria. The
microbial populations included bacteria that can cause infections. At
least some of the microbes survive the laundering process by forming
biofilms on debris entrapped in the textiles. It is recommended to
consider alternatives such as disposable, single-use mops and towels
rather than rely on the laundry process to effectively clean and disin-
fect textiles after use.
Presentation Number ADS-7
Evaluation of High-level Disinfection
Processes for Linear Endoscopic
Ultrasound Scopes Following New Delhi
Metallo-beta-lactamase Carbapenem-
resistant Enterobacteriaceae bacteremia
Emily Moulton MSN, RN - Infection Preventionist, Inova Fairfax
Medical Campus; Regan Trappler MPH, RN, CIC; Lucy He MLS(ASCP)
CM; Holly Taylor MPH, CIC - System Director, Infection Prevention
and Control, Inova Health System; Deeb Oweis RN, CNOR
BACKGROUND: A patient with New Delhi metallo-beta-lactamase
(NDM) carbapenem-resistant Enterobacteriaceae (CRE) bacteremia
was readmitted four days following a procedure with a linear endo-
scopic ultrasound scope (EUS) and duodenoscope. Prior outbreaks of
CRE have been linked to the elevator mechanism in duodenoscopes.
An elevator mechanism is also present in linear EUS and contributes
to the complexity of cleaning and disinfection. However, EUS are not
included in the FDA supplemental measures for duodenoscope
reprocessing. This study aims to evaluate need for standardized
cleaning and disinfection recommendations for all endoscopes with
an elevator mechanism.
METHODS: High level disinfection (HLD) processes were evaluated
via direct observation and culturing endoscopes used on the
index patient. The EUS and duodenoscope were sequestered
following the isolation of CRE and reprocessed prior to culture.
FDA guidance for duodenoscope surveillance culturing was fol-
lowed. Cultures were processed by a certified environmental test-
ing laboratory.