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 epocrates’ director of clinical communications, is a board-certified family physician with 10 years of primary-care practice experience before joining the company in 2012. Prior to his medical training, he earned a pharmacy degree. At epocrates, he oversees developing and curating core clinical content such as diseases, labs, guidelines, and decision tools. He also provides clinical oversight for all medical news content in the app.

Lyme disease, caused by Borrelia bacteria and transmitted by black-legged ticks, demands vigilant prevention, timely diagnosis, and effective treatment to minimize health and public safety risks.

Lyme Disease Prevention and Antibiotic Usage

'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

A new study finds nearly 80% of hospitals lack sufficient infection prevention staffing

Study Links Inadequate Infection Prevention Staffing to Higher Infection Rates

How many infection professionals should be employed at a health care facility? A study published in the 

 reveals a direct correlation between inadequate infection prevention and control (IPC) staffing levels and higher health care-associated infections (HAIs) rates. Conducted by the Association for Professionals in Infection Control and Epidemiology (APIC) Center for Research, Practice & Innovation, the study underscores the critical need for tailored staffing solutions to enhance patient safety.

executive director of APIC’s Center for Research, Practice, and Innovation, and lead author of the study.

 director of research for APIC’s Center for Research, Practice, and Innovation, and an 

 is the chief technology officer for APIC.

 spoke with Crapanzano-Sigafoos about the study.

The pilot project evaluated a novel online staffing calculator designed to provide customized recommendations for IP staffing levels. Findings showed that 79.2% of 390 acute care hospitals surveyed had insufficient staffing, correlating with significantly higher rates of HAIs such as central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), 

 infections, and surgical site infections.

“The way the calculator works is it starts out with the IP-to-bed ratio, and if you look into the literature, all that's out there,” Crapanzano-Sigafoos said. “Either an IP-to-bed ratio or IP-to-hospital ratio. And we know it's not sufficient because if you have a hospital that's 150 beds and has no ICU and no emergency department, their needs are going to be different than a hospital that [has] 150 beds has both of those things and a burn unit. The infection prevention needs vary based on the services offered and the patient population. The calculator takes into consideration those factors, and so we start with the ratio, and then the number of beds in the ratio goes up and down based on those risk factors, things like, do you have an emergency department? Do you have an ICU? Do you have a burn unit, an inpatient rehab unit, et cetera? And so, based on the responses that the infection preventionist enters, then it gives a customized staffing ratio based on those needs.”

For instance, 25% of facilities with below-expected staffing levels reported elevated CAUTIs rates, compared to just 7% of adequately staffed hospitals. Historically, hospitals relied on outdated "one size fits all" benchmarks, such as 1 infection preventionist (IP) per 69 to 100 beds, which fail to account for modern health care complexities.

In response, APIC's predictive staffing calculator provides tailored recommendations based on hospital-specific factors, including emergency department presence, specialized units, and service complexity.

The study emphasizes that modern, data-driven staffing models are indispensable for infection control in today’s health care landscape.

A new study finds nearly 80% of hospitals lack sufficient infection prevention staffing, linking understaffing to increased health care-associated infections and highlighting a need for reform.

is an emerging global infectious disease threat, and screening practices for identification of 

 are inconsistent across health care facilities,” the authors of a new study wrote.

American Journal of Infection Control (AJIC)

, highlights the effectiveness of expanded screening protocols for detecting 

, a drug-resistant fungal pathogen, is highly transmissible in hospital settings, making early detection crucial for infection prevention. Triggered by a 2022 outbreak investigation involving 9 cases, the hospital revised its protocols to screen all patients admitted from skilled nursing facilities or those with recent stays.

Under the new protocols, 591 patients were screened, compared to just 34 under the old system. The positivity rate rose from 1.8% to 2.4%, with 8 additional cases identified that would have been missed using the previous approach. Early detection enabled the hospital to implement isolation and disinfection measures quickly, preventing further spread of 

Expanded screening flagged lower-risk patients while isolating only high-risk cases.

Test results returned within 3 days minimized delays in infection control.

More expansive screening identified 8 cases that posed significant risks to patient safety and the hospital environment.

This method highlights the necessity of proactive screening to lessen the risk of 

, improve patient safety, and minimize hospital outbreaks.

) contacted Waleed Javaid, MD, MBA, MS, FACP, FIDSA, FSHEA, a member of this study.

: What prompted Mount Sinai Brooklyn to adjust its

screening protocols, and what were the biggest challenges in implementing the new, broader screening approach?

Waleed Javaid, MD, MBA, MS, FACP, FIDSA, FSHEA: Prompt to Adjust Screening protocols

: Mount Sinai Brooklyn decided to adjust its 

 screening protocols following an outbreak investigation in September 2022. A patient admitted from a skilled nursing facility (SNF) developed a bloodstream infection with 

 but did not meet the existing high-risk screening criteria. The subsequent investigation revealed multiple colonized cases and highlighted the need for earlier identification to prevent nosocomial transmission.

: Can you explain how the expanded screening protocols have impacted patient outcomes and overall infection prevention in the hospital?

WJ: Impact on patient outcomes and infection prevention

 The expanded screening protocols have significantly impacted infection prevention. By identifying more colonized patients earlier, the hospital reduced the risk of nosocomial transmission and limited the need for extensive outbreak investigations. The approach also improved the hospital’s ability to implement timely isolation and disinfection measures, which helped prevent further spread within the facility.

: What were the key differences between the old screening criteria and the new protocols, and why were these changes considered necessary?

WJ: Key differences between old and new protocols

 The original screening criteria focused on patients admitted from a limited number of ventilator-capable SNFs, primarily those with tracheostomies or ventilator-dependent. The new protocol broadened the scope to include all patients admitted from any SNF, regardless of ventilator status. This change was crucial because it addressed the detection of additional colonization cases that could contribute to environmental and patient-to-patient transmission.

: Given the resource-intensive nature of broader screening, how did the hospital balance practicality with thorough patient safety measures?

WJ: Balancing practicality and patient safety

 Given the resource demands of expanded screening, the hospital adopted a 2-tiered risk stratification system. High-risk patients (with tracheostomies or ventilator dependency) were placed on strict transmission-based precautions, while low-risk patients were not isolated but still screened. This approach allowed efficient use of resources while maintaining a focus on patient safety and infection control.

: Were there any surprises during the studies? What were they?

 One unexpected finding was the identification of colonized patients who did not exhibit traditional high-risk characteristics (such as being ventilator-dependent or having a tracheostomy). Additionally, the study found a significant reduction in secondary colonization cases linked to clinical 

 cases after the expanded screening was implemented.

: What lessons or insights from this study could be valuable for other healthcare facilities aiming to improve their screening and prevention measures for drug-resistant pathogens like

WJ: Valuable insights for other facilities

 Other health care facilities can learn from the importance of early and comprehensive screening to prevent outbreaks of drug-resistant pathogens like 

. Collaboration across clinical, laboratory, and administrative teams is critical for a successful protocol. Additionally, tailoring screening strategies to local prevalence and risk factors while maintaining operational efficiency is a key takeaway.

Mount Sinai Brooklyn’s expanded Candida auris screening protocols identified more cases, enabling timely isolation and disinfection measures to prevent outbreaks and enhance patient safety in hospital settings.

Expanded Screening Protocols Improve Early Detection of Candida auris at Mount Sinai Brooklyn

In 2024, US Antibiotic Awareness Week (USAAW), observed from November 18–24, brings together individuals and organizations to highlight the importance of appropriate antibiotic and antifungal use and the growing threat of antimicrobial resistance (AMR).

“Fighting Antimicrobial Resistance Takes All of Us,”

 emphasizes a One Health approach, recognizing the interconnected health of people, animals, plants, and the environment. 

, contributing to over 1.27 million deaths annually worldwide, including nearly 48,000 in the US when 

 is included. Preventing infections and ensuring the responsible use of antibiotics and antifungals are critical to slowing resistance.

To learn more about antimicrobial-resistant infections and the USAAW, 

) connected with Michael Craig, MPP, CDC’s AMR Coordination and Strategy Unit Director.

: What are the key objectives of this year’s US Antibiotic Awareness Week, and how does the theme “Fighting AMR Takes All of Us” reflect the CDC’s broader strategy?

 (USAAW) is a nationwide effort seeking to raise awareness of the importance of appropriate antibiotic and antifungal use and bring focus to the threat AMR poses to people, animals, plants, and our shared environment. Antimicrobial resistance (AMR) happens when pathogens (germs) like bacteria and fungi develop the ability to defeat the drugs designed to kill them. That means the pathogens are not killed and continue to grow. Resistant infections can be difficult, and sometimes impossible, to treat.

AMR can affect anyone, anywhere, at any stage of life. Antimicrobial-resistant infections are estimated to kill more than 1 million globally each year—more than HIV/AIDS or malaria. To protect everyone, we must slow the development and spread of AMR by preventing infections from happening in the first place. Access to clean water and adequate sanitation, vaccination coverage, and access to quality health care can prevent infections and the spread of AMR worldwide. We must also improve antibiotic and antifungal use and increase awareness and understanding of what everyone can do to fight AMR.

This year’s theme, "Fighting AMR Takes All of Us,” highlights the importance of using a 

 approach to combat AMR, which recognizes people's health is closely connected to the health of animals and our shared environment. Working together, we can improve the global prescribing and use of antibiotic and antifungal drugs and invest in global actions to prevent the spread of AMR across humans, animals, plants, and the environment (soil, water).

: AMR is often described as a silent pandemic. What progress has been made globally since the last United Nations High-level Meeting on AMR, and how does the CDC contribute to these efforts?

 Global leaders gathered in New York City in September 2024 for the second United Nations General Assembly (UNGA) High-level Meeting on AMR. This important meeting provided the CDC and global partners with the platform to continue working together to identify and commit to actions needed to combat AMR. Global leaders adopted a 

 establishing global goals, commitments, and targets, including a significant goal of reducing global deaths associated with bacterial AMR by ten percent by 2030.

The political declaration also identified and highlighted the importance of specific prevention interventions in health care and communities, including:

Immunization (reduces infections and antimicrobial use)

The CDC’s US Antibiotic Awareness Week emphasizes a One Health approach, uniting humans, animals, and environmental health to fight antimicrobial resistance and promote responsible antibiotic use.

Walt Hadikin, MD

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