Infection control and healthcare epidemiology in the real world
Creators: name: Kanamori, Hajime
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2012

description: This master’s paper entitled “Infection control and healthcare epidemiology in the real world” includes the following sections: 1) Infection control and healthcare epidemiology in the Department of Hospital Epidemiology, University of North Carolina (UNC) Health Care, including 1-1) Lessons learned through my practicum experience in UNC; 1-2) Descriptive analyses of healthcare-associated infections other than bloodstream, respiratory, urinary tract or surgical site; and 2) Infection control activities after the Great East Japan Earthquake, including 2-1) Infection control campaign at evacuation centers in Miyagi Prefecture; 2-2) Latent tuberculosis infection in nurses exposed to tuberculous patients cared for in rooms without negative pressure. I visited the UNC Hospital Epidemiology Department to do a practicum in infection control and healthcare epidemiology. In UNC hospitals, the Epidemiology Department has conducted comprehensive surveillance for healthcare-associated infections (HAI). I participated and observed data collection and analysis, and infection control intervention programs to reduce HAI. I learned how UNC hospitals reduced HAI and gained an understanding of infection control issues in UNC and learned the basic skills of hospital epidemiology through this practicum. As a result of this practicum experience I applied this knowledge to my work in Japan. I have summarized this knowledge and work in my master’s paper and, as described above, this has led to several different studies and associated publications, coauthored by UNC faculty. It is estimated that HAI accounts for approximately 1.7 million infections and 99,000 deaths in US hospitals. Standardized surveillance of HAI and intervention programs have focused on surgical site, respiratory tract, bloodstream, and urinary tract infections. In this study, I conducted descriptive analysis of HAI other than those infections through comprehensive hospital-wide surveillance. Other types of HAI were found in 9-17% of all HAI each year (2001-2011), demonstrating the substantial burden due to “other” HAI and the necessity of broad infection control efforts. The Great East Japan Earthquake and subsequent tsunami on March 11, 2011 occurred while I was enrolled in the MPH Distance Education Leadership concentration of the Public Health Leadership Program. I was directly involved in infection control and other public health activities following the earthquake. After the earthquake, many survivors were obliged to reside in evacuation centers and suffered from unsanitary conditions due to poor environmental maintenance. There is a public health concern about the increased risk of infectious diseases after natural disasters. I conducted infection control activities at evacuation centers for control and prevention of infectious diseases. One goal of this paper is to introduce my activities as Tohoku regional infection control network to the world, and provide recommendations based on my experience obtained in such a difficult situation. Healthcare personnel are at risk for tuberculosis exposure and infection when they care for patients in healthcare settings. There are no data assessing the importance of negative pressure rooms in the airborne transmission of tuberculosis following a natural disaster. I examined latent tuberculosis infection in nurses who were exposed to patients with active tuberculosis housed in rooms that could not be maintained under negative pressure room after the Great East Japan Earthquake. Through my practicum at UNC I was better able to understand the role of infection control and outbreak investigation in challenging situations such as the Great East Japan Earthquake. One outcome of this study was a better understanding of the importance of ventilation systems and airborne precautions in healthcare settings during natural disasters. As a result of my experience with the Great East Japan Earthquake and my practicum at UNC the following scientific papers have been published or submitted for publication: 1. Kanamori H, Kunishima H, Tokuda K, Kaku M. Infection control campaign at evacuation centers in Miyagi prefecture after the Great East Japan Earthquake. Infection Control and Hospital Epidemiology 2011;32:824-826. 2. Kanamori H, Aso N, Weber DJ, Koide M, Sasaki Y, Tokuda K, Kaku M. Latent tuberculosis infection in nurses exposed to tuberculous patients cared for in rooms without negative pressure after the 2011 great east Japan earthquake. Infection Control and Hospital Epidemiology 2012;33:204-206. 3. Kanamori H, Weber DJ, Sickbert-Bennett EE, Brown V, Kaku M, Rutala WA. Descriptive analysis of healthcare-associated infections other than bloodstream, respiratory, urinary tract or surgical site, 2001-2011. Infection Control and Hospital Epidemiology (submitted on March 17, 2012).