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, an assistant professor at the University of Pittsburgh’s Division of Infectious Diseases, Center for Genomic Epidemiology, is dedicated to advancing the field of outbreak detection and investigation in health care settings through his research and utilization of whole genome sequencing surveillance. He is also an 

Health care linens are critical yet overlooked infection risks. Ensure proactive management by auditing laundering processes to prevent contamination and safeguard patient health across care settings. Read this article by Alexander Sundermann, DrPH, CIC, FAPIC.

Health Care Linens: An Underrecognized Risk in  Infection Prevention and Control

's) Editorial Board members—a diverse group of professionals dedicated to advancing infection prevention and control practices. This series highlights each member's unique expertise and contributions to the field.

From groundbreaking research to innovative strategies, these experts are at the forefront of enhancing health care safety. Join us as we learn their insights, experiences, and visions for the future, providing valuable knowledge and inspiration to elevate infection control protocols.

In this installment, we hear from Tabrikah Mohammed, MSc, BSN, CIC, CPHQ, FAPIC, senior infection control officer, MSc, BSN, TQM, CIC, CPHQ, FAPIC. 

Tabrikah Mohammed, MSc, BSN, CIC, CPHQ, FAPIC, is an accomplished nursing professional with a diverse educational background and vast experience in infection control. She obtained a bachelor of nursing degree from Sharjah University in 2011 and a master of health care administration from the Royal College of Surgeon Ireland in 2013.

Tabrikah has furthered her expertise by obtaining certification as a CIC in 2018 and a CPHQ in 2021. She is also the founder of the IPQ Academy, where she imparts her knowledge and experience to other health care professionals. As the cofounder, head of the scientific committee, and infection control expert at the 

Middle East North Africa Federation for Hospital Sterilization Sciences

 (MENA FHSS), she has significantly contributed to the healthcare sector.

Emirates Infection Prevention and Sterilization Society

 (EIPSS), a nonprofit organization dedicated to advancing knowledge in infection prevention and sterilization practices in the United Arab Emirates. EIPSS operates under the 

Currently, Tabrikah serves as a senior infection control officer in 

, where she applies her skills and knowledge to ensure the safety of patients and healthcare workers. She is also a member of the 2023 editorial advisory board for 

, a testament to her reputation as an expert in infection control.

Tabrikah's contributions to infection control have been recognized through several awards, including the 

IP Idol from Certification Board of Infection Control and Epidemiology, Inc

 by Saudi Society for Infection Prevention and Control in 2023. She is also an international speaker at various conferences and conducts workshops.

Tabrikah sees these topics as trending right now:

These programs aim to optimize the use of antibiotics to combat antibiotic resistance. They involve the proper selection, dosage, and duration of antibiotic treatment to minimize resistance and adverse effects.

: Real-time data and advanced analytics track infection trends and outbreaks within healthcare facilities, allowing quicker and more effective responses.

Artificial intelligence and machine learning

: These technologies are applied to predict outbreaks and optimize infection control strategies.

Personal Protective Equipment (PPE) Innovation

: PPE is continually being innovated, with improvements in comfort, durability, and protection levels. Reusable PPE is also being developed to address supply chain issues and sustainability concerns.

Infection Control in Nonhospital Settings

: Infection prevention in long-term care facilities has become a major focus, particularly due to residents' vulnerability to infections like COVID-19 and influenza.

: There’s increased attention to infection prevention in schools, workplaces, and other community settings.

: Online platforms for infection prevention training have expanded, making education more accessible and scalable.

: There’s a growing emphasis on interprofessional education and collaboration in infection prevention, recognizing that effective infection control requires teamwork across various healthcare disciplines.

: Educating patients and their families on infection prevention practices, such as hand hygiene and recognizing signs of infection, is becoming more prevalent.

: There is a trend towards involving patients in their care, including infection prevention measures, to improve outcomes.

: There is an increasing focus on sustainable practices in infection prevention, such as reducing single-use plastics and developing environmentally friendly disinfectants.

Infection Prevention in Nonhospital Settings:

There is a growing focus on infection prevention in long-term care facilities, outpatient clinics, and community settings. Tailored infection control measures are being developed for these environments.

Telehealth services have expanded significantly, reducing the need for in-person visits and thereby lowering the risk of infection transmission. Remote monitoring of patients helps in managing infections and chronic conditions more effectively.

could focus on a range of timely and impactful topics. Here are her suggestions:

1. Emerging Infectious Diseases and Global Threats

 Coverage of the latest research and developments regarding new viruses or bacteria, particularly those with pandemic potential.

 Updates on global efforts to prevent and control infectious diseases, including responses to outbreaks and lessons learned from recent events.

 New technologies, treatments, and policies to mitigate the rise of drug-resistant infections.

 Strategies for improving AMR monitoring in healthcare settings.

3. Infection Control in Special Populations

 Best practices for preventing infections in nursing homes and other long-term care settings.

 Specialized approaches to infection control in pediatric units.

4. Health Care-Associated Infections (HAIs)

 Latest strategies, protocols, and technologies for preventing HAIs, with a focus on surgical site infections, catheter-associated infections, and ventilator-associated pneumonia.

 Case studies and lessons learned from recent HAI outbreaks.

5. Environmental Hygiene and Disinfection

 New products, technologies, and practices in environmental cleaning and disinfection.

Role of air quality in infection control:

 Research on the impact of ventilation and air purification in preventing the spread of infections.

 Strategies for healthcare professionals to address vaccine hesitancy and counter misinformation.

 Updates on new vaccines and vaccine delivery methods.

7. Technology and Digital Health in Infection Control

AI and machine learning in infection prevention:

 How artificial intelligence predicts and prevents outbreaks in healthcare settings.

 The role of telehealth in infection control, especially in managing patients with infectious diseases remotely.

 How the pandemic has changed infection control practices permanently.

 Future-proofing infection control protocols.

9. Infection Control in Nonhospital Settings

Infection prevention in outpatient clinics:

 Best practices for clinics, dental offices, and other non-hospital healthcare settings.

 Strategies for preventing infections in schools and workplaces, especially with the increasing focus on respiratory illnesses.

Continuing education for healthcare workers:

 New programs, tools, and certifications in infection prevention.

 How to involve patients and their families in infection prevention efforts.

Meet the experts shaping infection prevention: Infection Control Today's Editorial Board members share insights, experiences, and cutting-edge strategies to enhance health care safety and quality. Meet Tabrikah Mohammed, MSc, BSN, CIC, CPHQ, FAPIC.

Meet Infection Control Today's Editorial Board Member: Tabrikah Mohammed, MSc, BSN, CIC, CPHQ, FAPIC

Damaged mattresses are common in hospitals and can potentially place patients at increased risk for infection. These are the findings of a 

Infection Control & Hospital Epidemiology

. The investigators assessed the conditions of beds and mattresses in 4 hospitals in midwestern United States. Investigators evaluated 727 beds and mattresses, finding that 523 (72%) had damage, 340 (47%) required mattress cover replacement, and 183 (25%) required replacement of the entire mattress.

“The results of this study reaffirm what previous research has shown–that cleaning methods used at hospitals today are inadequate, potentially endangering patients,” Edmond A. Hooker, MD, DrPH, author of the study and a professor at Xavier University, said in a statement.

For the study, each of the 727 beds and mattresses were examined by opening the mattress, then the mattress core was visually evaluated for evidence for damage. Next an LED light was used to identify smaller punctate defects in the cover. Finally, the bed frames were visually examined for evidence of rust.

The investigators collected data on mattress model, bed model, and mattress date of manufacture (if tag was present). They also noted stains present on the mattress cover (external surface of the bottom cover, inside top of cover, inside of bottom cover), damage to zipper or outside air connections. Punctate defects in cover were found with and without LED light, holes in the fire barrier, foam damage (compression, tearing, or crumbling), damage to inside air connections, unacceptable gel compression (greater than 3.2 cm), and rust visible on bed deck.

The majority of the beds needed a replacement of the entire mattress: 174( 95%) had large staining (greater than 15.2cm) visibly present. Of the remaining mattresses, 6 mattresses had gel failure, and 3 mattresses had no reason recorded. A total of340 covers needed replacement,176 (52%) of which had visible holes or staining of the inside of the cover. The firebarrier had damage in 79 (11%) of the beds. The investigators found beddeck rust on 175 beds (24%) and widespread rust on 65 beds (9%).

Hooker reports in the study that it “showed that most beds (72%) in a hospital system in the midwestern  United States had damage. This research is the first to demonstrate that many of the failed mattresses wereless than 4 years old and that the prevalence of rust on the beddecks was substantial.”

Due to infection risk, the Centers for Disease Control and Prevention, the US Food and Drug Administration, and mattress manufacturers recommend replacement of damaged mattresses and covers. The American Hospital Association states that the life of the mattress is 5 years, and mattress manufacturers maintain that the expected life of the mattress is only 1 to 3 years.

Hooker cited some limitations of the study beginning with where the beds were located. Although hospitals were involved in the study, they were all part of a single health  care system. Second, the beds and mattresses were primarily from a single manufacturer. Fewer than half the 727 mattresses (300, 41%) had tags denoting manufacturing dates. Replacement of the cover in 151 (50%) mattresses was necessary due to damage; 123 (81%) of those mattresses were less than 4 years old. Complete replacement, including cover and core, from damage was necessary in 58 (19%), of which 33 (57%) were less than 4 years old.

Because mattresses are the highest-touch element for a hospitalized patient, the risk of infection is potentially higher with a damaged mattress. The results of this study indicate that regular inspections of all mattresses and bed frames—regardless of age—must be conducted to minimize infection risks for patients. 

Patients can potentially be at increased risk for infection from damaged hospital mattresses and beds. More diligent and frequent cleaning must be done to keep patients safer.  


Hospital Mattress Failure Is a Potential Threat to Patient Safety 

Mounting evidence is supporting the spread of SARS-CoV-2 in animals. The latest report is from Ontario, Canada, and has added to the 

 that white-tailed deer can become infected with SARS-CoV-2. This report comes on the heels of another 

 documenting spread of the Omicron variant in Staten Island deer. SARS-CoV-2 was 

 to infect white-tailed deer on January 12, 2021. This first report was also from Ontario, Canada. 

 have found SARS-CoV-2 in up to 82.5% of deer (80 of 97 samples) in Iowa; and in 

 in Michigan, Pennsylvania, Illinois, and New York.
 


The recent study from Ontario presents several disturbing findings. The SARS-CoV-2 virus found in the deer was a highly mutated virus, with 49 mutations compared with the closest known strain in humans. This is “suggestive of sustained viral transmission.” In other words, the virus may have found a stable host or reservoir in the white-tailed deer population. The authors also point out that there are significant human-to-deer interfaces, along with interfaces with other wildlife.
 
The authors believe the newly detected Ontario white-tailed deer virus (Ontario WTD) may have its distant ancestor from a lineage identified in Michigan. Thus, the Ontario WTD likely represents a case of spread from humans to deer.

Of concern is that the authors also presented information that supports a case of deer-to-human spread of this highly divergent variant. The human case had “highly similar mutations” as the Ontario WTD virus, occurred in the same region as the infected animals, and the patient also had known close contact with white-tailed deer.
 


 animal SARS-CoV-2 infections and the possibility of animal hosts on August 5, 2021. Spread of the virus in animal hosts was 1 of mechanisms of virus evolution, which was 

 by the United Kingdom’s Scientific Advisory Group for Emergencies (SAGE).

We cannot assume that white-tailed deer are the only animal hosts (or virus reservoirs) or that deer were exposed directly from humans. There could be an intermediate host. Dogs, cats, bears, gorillas, baboons, snow leopards, minks, and rodents 

 in the emergence of the Omicron variant (this variant carries 7 out of the 7 mutations that promote transmission in rodents).
 
There are several important lessons here:
1. The virus is spreading easily outdoors among deer. The same should be true with mankind. Droplet spread can still occur outdoors if you are within 6 feet of someone.
2. An animal host all but guarantees that herd immunity in humans will not eradicate the virus.
3. The variants arising in animals will have no regard for the lethality in humans. Thus, increases and decreases in the variant’s human case fatality rate will be random. The virus does not need humans to live and evolve.
 
Above all, the report by Bradley Pickering et al underscores the importance of 

, the idea that animals and mankind live in the same biosphere and you cannot optimally promote health in mankind without also addressing the health and spread of disease in animals. It is unlikely we can stop the emergence of future dangerous variants by vaccinating all of mankind. We must also address the health of animals and modify how we interact with domesticated and wild species.

The virus may have found yet another stable host in the white-tailed deer population. 

Mutated SARS-CoV-2 Detected in White-Tailed Deer in Ontario

’s wide-ranging coverage of the infection prevention and control world. Everything from interviews with known opinion leaders to the news that infection preventionists and other health care professionals can use on their jobs.

1. Pandemic Places Importance of Preventing Environmental Infection at Center Stage

IPs can provide valuable input on construction projects, water safety, and ventilation.

Rethinking the application of air disinfection in the era of COVID-19.

3. Second Booster Shot Authorized by FDA for Patients 50 and Over

The dose is half the antigen amount for adults but with similar amount of titers..

4. The IP Relationship With Clinical Staff Is a Critical Partnership

The COVID-19 pandemic strengthened the relationship between infection preventionists and clinicians, but how can both parties ensure continued collaboration?

5. Bug of the Month: I'm Mostly Harmless, Until I Contaminate Your Food

Bug of the Month helps educate readers about existing and emerging pathogens of clinical importance in healthcare facilities today.

Take 5 minutes to catch up on Infection Control Today’s highlights for the week ending April 1. 

Weekly Rounds: Highlights From April's Issue, COVID-19 Boosters, and More

®’s wide-ranging coverage of the infection prevention and control world. Everything from interviews with known opinion leaders, to the news that infection preventionists and other health care professionals can use on their jobs.

N95 Respirators Prove Effectively Disinfected With Ultraviolet Radiation

Remembering the COVID-19 pandemic and supply chain issues, investigators study the efficacy of reusing N95 FFRs.

Conference Highlights, Annual Goals, and More: A Conversation With AORN’s New President

After an Expo like no other, Dennis looks forward to the 70th year of advocacy for perioperative nurses.

2022 AORN Conference Presentations Focus on Pressure Site Injuries, Surgical Site Infections

Susan “Suzy” Scott, MSN, RN, WOC Nurse, also speaks to 

 about incident tracking and electronic medical records.

Prevention Strategies of SSIs for the Elderly Require More Attention

Most information on SSI risk factors in the elderly is more than 10 years old.

Protecting Children From COVID-19 Had Unintended Negative Consequences

Despite some benefits, challenges continue with implemented mitigation strategies for children and IPs.

Take 5 minutes to catch up on Infection Control Today’s highlights for the week ending April 15.


Weekly Rounds: Disinfecting N95s, AORN and SHEA Conference Coverage, and More

Daily and regular use of hydrogen peroxide (HP) as an antiseptic is demonstrated to give protection against COVID-19 curtails health care-acquired spread of SARS-CoV-2.

in health care workers (HCW) in 2 hospitals, the Shai-Osudoku Hospital (SODH), Dodowa, and the Mount Olives Hospital (MOH), Techiman, Ghana, between May 2020 and December 2021. The study, “Further observations on hydrogen peroxide antisepsis (HPA) and COVID-10 cases among healthcare workers and inpatients” was recently published in the 

“The significant clinical evidence of HP protection against COVID-19, and likewise considering that it is also quite safe, inexpensive, and readily available, makes it a valuable prophylaxis to be recommended to protect HCW, inpatients, and all vulnerable groups against COVID-19,” the investigators noted in the study. “These vulnerable groups might include the unvaccinated, the elderly, those in long term care facilities or homes, sportsmen and sportswomen, teachers, students, front-line security service personnel, airline crew, pregnant and lactating women.”

The investigators’ observations indicated that daily and regular use for 1 minute duration of HP in low concentrations as a 1% mouthwash and throat gargle, and 0.5% for nasal rinse for the same amount of time, effectively protects against SARS-CoV-2 infections. This imitates HP’s mode of action when used on inanimate surfaces to inactivate coronaviruses. The investigators say that HP, therefore, has the potential to mitigate this pandemic, a solution simpler than had been imagined when it had been proposed previously.

“HP could further mitigate the pandemic when used by both symptomatic and asymptomatic COVID-19 patients, by inactivating the viruses these patients shed,” the investigators wrote.

The numbers are clear in the study: HPA demonstrated protection against SARS-CoV-2. At SODH from May to December 2020, 62 (13.5%) COVID-19 cases were noted among 458 HCW not on HPA, but none among 8 on HPA (

= 0.622). Between January and March 2021, 10 (2.7%) of 372 HCW had COVID-19, but none among 94 HCW on HPA (

At MOH, prior to HPA, 17 (20.2%) of 84 HCW and 5 (1.4%) of 370 inpatients had COVID-19 in July 2020. From August 2020 to March 2021, 2 of 54 (3.7%) who discontinued HPA had COVID-19; 0 of the 32 staff not on HPA contracted it. At SODH from April to December 2021, none of 23 unvaccinated HCW on HPA had COVID-19; 35 (64%) of 55 not on HPA contracted it (

< 0.0001). None of 34 vaccinated HCW on HPA contracted COVID-19, compared with 53 (13.6%) of 390 not on HPA who had it (

= 0.015). No inpatient on HP prophylactic antisepsis (total 7736) contracted COVID-19.

The investigators describe this study as “real-world observational study,” and they collected no personal data, such as age, gender, co-morbidities, or clinical information from HP-HCW, NHP-HCW, vaccinated, unvaccinated, or in inpatients. They did not consider the influence of co-variates nor was the HPA randomized, as the decision to use HPA was personal at SODH and persuaded by management and not the investigative team at MOH.

“The study, nevertheless, provides useful information of evidential value to fill a knowledge gap of clinical evidence that HPA protects against SARS-CoV-2 infections,” the investigators noted in the article.

Regardless of vaccination status, health care workers were protected with daily and regular hydrogen peroxide antisepsis. 


Alexander Sundermann, DrPH, CIC, FAPIC

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