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Authors

Bernard A. Cohen, MD, Pediatric Dermatology, Section on Dermatology, American Academy of Pediatrics.  

Unlike hospitals, ambulatory settings have traditionally lacked adequate infrastructure and resources to support infection prevention and monitoring.

Infection Control and Prevention in the Outpatient Physical Office Setting

'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

IDWeek 2024 continues to provide more and more infection control and prevention studies to improve lives. 

) presents interviews with CSL Seqirus and Shionogi about their presentations at IDWeek.

These studies were presented at IDWeek, the joint annual meeting of the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the HIV Medicine Association, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists in Los Angeles from October 16 to 19, 2024.

CSL Seqirus presented groundbreaking data at IDWeek 2024, showcasing the urgent need to increase influenza vaccination rates in the US and the advantages of cell-based vaccines in reducing influenza- (flu-) related complications. 

According to a dynamic model, increasing vaccination rates to at least 45% could alleviate pressure on hospital systems, particularly intensive care units (ICUs), during peak flu seasons. With vaccination rates currently at approximately 35%, experts warn that the health care system faces significant strain.

The studies also demonstrated the superior effectiveness of cell-based influenza vaccines compared to egg-based alternatives. Real-world evidence (RWE) from the 2022-23 flu season revealed that cell-based vaccines were more effective at preventing outpatient-confirmed influenza across all age groups, including children as young as six months. Modeling estimates suggest switching to cell-based vaccines could significantly reduce flu-related illnesses, hospitalizations, and costs.

"In the face of declining seasonal influenza immunization rates, our dynamic model analysis shared at IDWeek 2024 highlights a pressing and critical need to elevate US vaccination rates,” said Joaquin Mould-Quevedo, the senior director of global health economic and value strategy at CSL Seqirus to 

. “Evidence shows that higher influenza vaccination rates significantly reduce serious health consequences, including severe illness, hospitalizations, and death. Last season’s rates dropped, increasing the risk of our health care system becoming overwhelmed. These data underscore an urgent need to increase vaccination rates to at least 45% to avoid overburdening our health systems and ensure that our hospital resources, especially ICU beds, are not overwhelmed.”

Experts at CSL Seqirus emphasized the critical role of cell-based vaccines in protecting vulnerable populations and improving public health outcomes. The company’s innovative digital tools, like the Polyphonic ecosystem, aim to enhance patient monitoring and vaccination reporting. The findings underscore the importance of improving flu vaccination rates and adopting advanced vaccine technologies to ease health care system burdens and improve patient care globally.

"Real-world evidence is an important consideration in vaccine research as it provides insights that extend beyond the controlled settings of clinical trials, capturing the true impact of vaccines in diverse environments,” said Mendel Haag, the senior director of the Center of Outcomes Research & Epidemiology at CSL Seqirus.

Our data presented at IDWeek demonstrates the potential benefits that cell-based influenza vaccines can offer over traditional egg-based alternatives across all age groups. In addition, first-season findings from our study offer critical insights into the comparative effectiveness of adjuvanted and high-dose vaccines for adults aged 65 and older. This ongoing, multiseason study is pivotal in advancing our mission to enhance and protect public health on a broader scale."

Innovative treatments like cefiderocol have become critical in the fight against serious Gram-negative bacterial infections. 

® (ICT®) interviewed Simon Portsmouth, MD, FRCP, senior vice president and head of clinical development at Shionogi Inc., to discuss the groundbreaking findings from the PROVE (retrospective cefiderocol chart review) study.

Portsmouth discusses the importance of real-world evidence in complementing randomized controlled trial data, the methodology behind the study, and the promising results showing the efficacy and safety of cefiderocol in treating difficult-to-treat Gram-negative infections. With insights into its effectiveness across infection types and its potential against resistant pathogens, this interview offers valuable perspectives for health care professionals tackling the challenges of antimicrobial resistance.

: What was the primary motivation or research question that led you to conduct this study, and why is it important?

 The primary goal of the PROVE (retrospective cefiderocol chart review) study was to evaluate how patients with certain serious Gram-negative (GN) bacterial infections respond to cefiderocol in real-world clinical settings.

While randomized controlled trials (RCTs) are the basis for approval of treatment options, they can be difficult to conduct for antibiotics and present limitations in understanding the impact of these treatments in real-life clinical settings.

 Real-world evidence, such as that from the PROVE study, can complement clinical trial data by helping us in our clinical decision-making and a better understanding of responses to cefiderocol in diverse patient populations, including across different infection sites and pathogens.

: Can you briefly explain the methodology you used in the study

PROVE is a retrospective, real-world study that analyzed clinical outcomes in 1,075 seriously ill, hospitalized patients treated with cefiderocol for certain GN bacterial infections.

 The study aimed to capture a broad, real-world patient population, reflecting the diversity of infection types and sites, disease severity, and geographic locations.

Most participants had infections caused by bacteria in the World Health Organization’s list of priority pathogens.

 To be included in the study, patients had to receive at least 72 hours of cefiderocol for the first time for a documented GN bacterial infection.

 Additionally, participants had to have information about cefiderocol starting dose, description of the GN bacterial infection, and discharge data after hospitalization.

By including different infection sites and pathogens, the study provided comprehensive insights into the effectiveness of cefiderocol across patient populations, complementing clinical trial data with real-world evidence.

: What were the key findings of your study, and how do they contribute to the existing body of knowledge in your field?

 The key finding from the PROVE study showed the majority (75.1%) of patients had a clinical response to cefiderocol at the end of treatment.

 Clinical response was defined as the resolution or improvement of signs and symptoms of the infection, as judged by the physician at the end of cefiderocol treatment (EOT). Looking at the breakdown by top primary infection sites, we saw high response rates, including 71.6% for respiratory tract infections, 74.1% for bloodstream infections, and 91.2% for urinary tract infections.

Cefiderocol was generally well-tolerated, with 13 patients discontinuing treatment due to adverse reactions.

 Twenty-nine adverse drug reactions in 25 of 1,075 patients were reported, three of which were serious.

 These findings further build on our clinical trial data for cefiderocol by supporting its use in seriously ill patients with certain difficult-to-treat GN infections in both controlled clinical trials and real-world settings.

 studies that showed cefiderocol had activity against resistant GN bacteria that show high degrees of cross-resistance to contemporary beta-lactam/beta-lactamase inhibitor (BL/BLI) combinations.

 Cross-resistance occurs when bacteria are resistant to multiple distinct antibiotics through the same mechanism(s), and it can further limit treatment options for multidrug-resistant bacteria.

 studies that showed cefiderocol maintained activity against highly resistant metallo-beta-lactamase-producing bacteria.

 Metallo-beta-lactamases (MBLs) are enzymes that can inactivate most beta-lactams, the most commonly used antibiotics around the world, and their increasing prevalence worldwide is adding to the growing challenge of antibiotic resistance.

 activity does not necessarily correlate with clinical efficacy, we believe these data highlight the utility of cefiderocol for drug-resistant infections, including isolates that showed resistance against BL/BLI combinations or those carrying MBL genes, which have limited options and are difficult to treat.

Clancy C, et al. Real-world effectiveness and safety of cefiderocol in the treatment of patients with serious gram-negative bacterial infections: Results of the PROVE Chart Review Study. Poster presented at IDWeek 2024.

Redell M. Real-world evidence studies of oritavancin use in gram-positive infections augment randomized controlled trials to address clinical and economic outcomes. 

Paterson DL, Sulaiman HB. "Real-world" evidence, target trial emulation, and randomized clinical trials—Which data should clinicians rely on when choosing antibiotics? 

. 2024;7(1):e2352250. doi:10.1001/jamanetworkopen.2023.52250.

. 2023;37(1):25-36. doi:10.1007/s40290-022-00456-6. Epub January 5, 2023. PMID: 36604368; PMCID: PMC9815890.

Williams DM, et al. The evolution of real-world evidence in healthcare decision-making. 

. 2023;22(6):443-445. doi:10.1080/14740338.2023.2224559.

World Health Organization. WHO bacterial priority pathogens list, 2024. Accessed September 2024. http://iris.who.int/bitstream/handle/10665/376776/9789240093461-eng.pdf?sequence=1. 

DeJonge B, et al. Cefiderocol retains in vitro activity against Enterobacterales non-susceptible to β-lactam-β-lactamase inhibitor combinations. Talk presented at IDWeek 2024.

Nguyen S, et al. Evaluation of phenotypic cross-resistance between cefiderocol and β-lactam/β-lactamase inhibitor combinations against 

 isolates from US medical centers. Poster presented at IDWeek 2024.

Colclough A, Corander J, Sheppard SK, Bayliss SC, Vos M. Patterns of cross-resistance and collateral sensitivity between clinical antibiotics and natural antimicrobials. 

. 2019;12(5):878-887. doi:10.1111/eva.12762. PMID: 31080502; PMCID: PMC6503891.

Anderson M, et al. Challenges and opportunities for incentivizing antibiotic research and development in Europe. 

. 2023;22:100586. doi:10.1016/j.lanepe.2023.100586.

Mendes RE, et al. Cefiderocol activity against 

 clinical isolates carrying metallo-β-lactamase genes in United States and European hospitals (2020–2023). Poster presented at IDWeek 2024.

Mendes RE, et al. Cefiderocol activity against clinical Enterobacterales isolates carrying metallo-β-lactamase genes in United States and European hospitals (2020–2023). Poster presented at IDWeek 2024.

Boyd SE, et al. Metallo-β-lactamases: Structure, function, epidemiology, treatment options, and the development pipeline. 

. 2020;64(10):e00397-20. doi:10.1128/AAC.00397-20. PMID: 32690645; PMCID: PMC7508574.

Bertagnolio S, et al. Antimicrobial resistance: Strengthening surveillance for public health action. 

. 2023;20(7):e1004265. doi:10.1371/journal.pmed.1004265.

Kanannejad Z, et al. Diagnosis and selection of alternative antibiotics in beta-lactam hypersensitivity reactions: Current recommendations and challenges. 

. 2023;122:110573. doi:10.1016/j.intimp.2023.110573.

IDWeek 2024 continues to give encouraging studies. Check out several more from CSL Seqirus and Shionogi.

Even More Studies From IDWeek 2024 to Improve Lives: CSL Seqirus and Shionogi

Shahbaz Salehi, MD, MPH, MSHIA, is the Infection Control Today 2024 Educator of the Year.

. This prestigious honor recognizes and celebrates his extraordinary contributions to infection prevention, education, and mentorship. With more than 20 years of experience, Salehi’s journey from a sterile processing (instrument) technician to a visionary leader in infection control demonstrates his passion for advancing health care education and fostering the next generation of infection preventionists.

Salehi has significantly contributed to infection education by teaching the course Infection Control in a Hospital Setting at UCLA Extension

which offers one of the few infection control certificate programs in the US. He also serves as a university subject matter expert, reviewing public health courses and evaluating their sepsis training. Additionally, he reviews and analyzes certification and exam questions for the Healthcare Sterile Processing Association, the leading medical and surgical sterile processing organization.

Salehi’s impact began in 2016 when Prime Healthcare, in Ontario, California, recruited him to develop and expand its infection control program. Under his leadership, the infection prevention infrastructure grew to include more than 60 professionals across 44 hospitals. His mentorship programs brought individuals from diverse health care backgrounds—nursing, laboratory sciences, and physical therapy—into the specialized field of infection prevention and control (IPC). He created a sustainable pipeline of infection preventionists capable of driving change by providing targeted training and guidance.

Shahbaz Salehi, MD, MPH, MSHIA, is the Infection Control Today 2024 Educator of the Year. He is celebrated for his leadership, mentorship, and transformative contributions to infection prevention education and patient safety.


Bernard A. Cohen, MD

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