1. Part III Key Strategies for Combating Resistance

3. DETECT in Healthcare Settings Surveillance to identify cases Testing to confirm Identify who is higher risk Wounds/Skin breakdown Indwelling lines Ventilated/Trach High care needs/Assistance with ADLs Incontinence

4. PROTECT in Healthcare Settings http://www.tpchd.org/files/library/acd8d09cb3afd04b.pdf Lab to facility Bedside staff to physician, IP, other staff

5. PREVENT in Healthcare Settings Recommended vaccines for adults 60 years or older ―Influenza ―Td or Tdap ―Pneumococcal ―Zoster

6. Colonization of Nursing Home Residents with Epidemiologically Important Organisms Of 213 NH residents, 62% colonized with SA, 40% with MRSA, higher in those with indwelling devices 1 Of 404 NH residents, with 500 hospital admissions, 4.6% with CR-Gram negative carriage, 1.4% with CRE, 0.4% with CP-CRE 2 25-55% of NH residents colonized with C. difficile 3 1 Mody L, et.al. CID 2008;46(9):1368-1373. 2 Cunha CB, et al. AJIC 2016;44:126-30. 3 Riggs MM, et.al. CID 2007;45:992-8.

7. http://www.cdc.gov/longtermcare/ 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings SHEA/APIC Guideline: Infection Prevention and Control in the Long- Term Care Facility CDC/SHEA Surveillance Definitions of Infections in Long-Term Care Facilities: Revisiting the McGeer Criteria The Core Elements of Antibiotic Stewardship for Nursing Homes Infection Prevention and Control Guidance for LTCFs

8. Thank you for your attention! marisa.dangeli@DOH.wa.govmarisa.dangeli@DOH.wa.gov, 206-418-5595