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  • 17: Breaking the Silence: How to Talk About HIV and PrEP Without Fear

    17: Breaking the Silence: How to Talk About HIV and PrEP Without Fear
    2025/11/05
    Few issues embody the intersection of prevention, compassion, and communication more than HIV and PrEP (pre-exposure prophylaxis)—subjects that remain clouded by stigma, even decades after the epidemic’s darkest days. I recently spoke with Cariane Morales Matos, MD, medical director at Hope & Help of Central Florida, about how health care providers, parents, and infection preventionists can approach these conversations, especially with teens, with clarity and empathy.

    “Fear and stigma get attached to subjects related to sexual health,” Morales began. “We need to move away from the fear and the stigma and just start having these conversations like we would talk about anything related to our general health maintenance.”

    That normalization, she explained, is key. The US Preventive Services Task Force recommends HIV screening for everyone between the ages of 18 and 65, which is a higher rating than even routine blood pressure checks. Yet HIV is still often whispered about, creating unnecessary barriers to prevention. “It should be exactly the same,” Morales said. “We need to take the fear away from it so that we can start having conversations that are solely based on prevention and just trying to set us up for a successful, healthy life.”

    For those unfamiliar, Morales offered a quick refresher:
    “HIV is a sexually transmitted infection… The only way that you can get this infection is through sharing bodily fluids that have high amounts of the virus.” AIDS, she noted, is the advanced form that develops only without treatment. “Right now, we have so many great therapies that even if you were to get diagnosed with HIV, you can have a healthy, long life…by just taking one pill a day.”

    She went on to explain PrEP, preexposure prophylaxis, a medication that reduces the risk of infection by up to 99%. “We have 2 approved oral medications and 2 injectable medications… there’s literally an option for everybody,” she said. “It’s about starting this conversation with your provider and finding the right fit for your lifestyle.”

    Still, starting that conversation, especially with adolescents, can be daunting. “The first step… is reckoning with what you think these issues are, and finding what your biases might be,” she advised parents, educators, and health care professionals. “If you have doubts or uncomfortable feelings, that’s going to translate. Once you’re able to talk about this like you’re talking about going out to dinner or seeing friends—that’s the level of comfort you need.”

    She also emphasized that HIV does not discriminate. “It has nothing to do with who you’re having sex with,” she said. “If you are somebody who’s having unprotected sex, that is your risk factor. We have to move away from, ‘I’m not that person.’”

    For reliable information, Morales recommended the CDC’s HIV and PrEP resources, or local organizations like Hope & Help, which host community sessions and provide educational materials.

    Her final message was simple but powerful: “It’s okay to be uncomfortable, it’s okay to be fearful, but it’s important not to shy away from asking these important questions. Knowing your status is the first step.”

    In the end, talking about HIV and PrEP is not just about science; it is about breaking the silence. As Morales reminded Infection Control Today’s audience, information saves lives, but conversation opens the door.
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    19 分
  • 16: Veteran Infection Preventionists Chat: What Are The Soft Skills That Make Strong IPs?

    16: Veteran Infection Preventionists Chat: What Are The Soft Skills That Make Strong IPs?
    2025/11/01
    When most people think of infection prevention, they picture data dashboards, surveillance reports, and regulatory checklists. But ask any experienced infection preventionist (IP) what really determines success, and you’ll hear something different—it is the people skills. During a recent Infection Control Today® roundtable, veteran infection prevention professionals representing diverse roles and backgrounds reflected on the nonclinical skills that shaped their careers, the lessons learned the hard way, and the advice they would give to new IPs entering the field. Their message was clear: Technical expertise may get you in the door, but emotional intelligence, communication, and systems thinking keep the door open. Learning to Communicate Upward — and Effectively “Short and sweet and to the point,” began Joi A. McMillon, MBA HA, BSN, CRRN, WCC, CIC, CJCP, HACP-CMS, AL-CIP, the CEO of JAB Infection Control Experts. “I wish I had understood better how to communicate effectively.” She was reflecting on the early days of her career. “When I came in, I was very young and very passionate, but I didn’t have a mentor. I didn’t have anyone to help me translate that passion into communication that resonated with leadership,” she said. “When you’re not able to communicate effectively, you’re not just holding yourself back, you’re holding the entire program back.” Her experience underscores a common challenge for new IPs who may know the science inside out but struggle to gain traction with the C-suite. Infection prevention is a field where evidence meets advocacy, and communication gaps can mean stalled initiatives or lost resources. Emotional Intelligence: The Quiet Skill That Changes Everything ICT contributing editor Carole W. Kamangu, MPH, RN, CIC, the CEO, founder, and principal infection prevention strategist for Dumontel Healthcare Consulting, took that point further, stressing the importance of self-awareness and emotional intelligence. “I wish I had realized earlier that I needed emotional intelligence,” she said. “I was naturally good at challenging the status quo, but early on, I wasn’t doing it effectively. I knew what I wanted to change, but I didn’t always communicate it in a way that kept people engaged. When someone pushed back, I would take it personally and have the worst day.” It took her years, she admitted, to learn to pause before entering a unit and ask herself: How am I feeling? How are they likely to react? That reflection transformed her interactions from combative to collaborative. “It’s about being aware of your own emotions before you even start the conversation,” she said. “That’s when productive dialogue can actually happen.” Don’t Take It Personally — Take It Professionally Lerenza L. Howard, DHSc, MHA, CIC, LSSGB, manager of infection prevention and quality improvement at La Rabida Children’s Hospital in Chicago, added another layer to the conversation: perspective. “In the professional world, don’t take it personal,” she advised. “As IPs, we’re partnering with a multitude of stakeholders, all with competing priorities. You need emotional intelligence and effective communication to empathize with that, and still strategically navigate your initiative to the finish line.” She emphasized systems thinking — understanding how infection prevention fits into the larger operational web of a hospital. “Knowing where your department fits in helps you propose initiatives and request resources more effectively,” she said. “It’s not just about infection control. It’s about how infection control supports the system as a whole.” Top Three Skills for Every IP When asked for her essentials, Nathaniel Napolitano, MPH, the CEO of Nereus Health Consulting and a health care epidemiologist for Harborview Medical Center in Seattle, Washington, didn’t hesitate. “Interpersonal communication for relationship management — that’s number 1. Otherwise, nothing gets done, or it gets done painfully,” she said. “Number 2: confidence in decision-making. Trust your gut. And number 3: creative problem-solving. Because you will face problems you never imagined would fall within your scope.” Kamangu quickly added with a laugh, “Nathan is a very creative person. I love working with him,” highlighting that creativity isn’t just a “nice to have” in infection prevention; it’s survival. The Ripple Effect of Systems Thinking Echoing earlier remarks, Missy Travis, MSN, RN, CIC, FAPIC, a consultant for IP&C Consulting and a former nurse, described the “ripple effect” mindset as essential. “Realize it’s not all about you,” she said. “What you do has a ripple effect. We’re all connected. What I do affects you, and what you do affects me. That awareness changes how you communicate — it makes you listen as much as you speak.” Her point struck a chord with the group: ...
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    15 分
  • 15: Bug of the Month: I'm Older Than Empires

    15: Bug of the Month: I'm Older Than Empires
    2025/10/31
    Bug of the Month helps educate readers about existing and emerging pathogens of clinical importance in health care facilities today. Each column explores the Bug of the Month's etiology, the infections it can cause, the modes of transmission, and ways to fight its spread. The pathogen profiles will span bacterial, viral, fungal, and parasitic species. We encourage you to use Bug of the Month as a teaching tool to help educate health care personnel and start a dialogue about microbiology-related imperatives.

    Find more Bug of the Month articles on www.infectioncontroltoday.com!
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    4 分
  • 14: NDM-CRE Surge Demands Stronger Infection Prevention and Testing Strategies, Study's Author Says

    14: NDM-CRE Surge Demands Stronger Infection Prevention and Testing Strategies, Study's Author Says
    2025/10/31
    In the second part of our conversation with Danielle Rankin, PhD, MPH, CIC, epidemiologist with the CDC, she expanded on the infection prevention strategies and surveillance needs surrounding the rise of New Delhi metallo-β-lactamase carbapenem-resistant Enterobacterales (NDM-CRE). She is the lead author of a recent study published in the Annals of Internal Medicine.

    Rankin emphasized that early infection control measures are critical when a case is detected. “It’s really important that IPs work with their state and local health care-associated infections and antimicrobial resistance programs to prevent spread,” she said. Patients hospitalized with NDM-CRE should be placed on contact precautions, while long-term care residents require enhanced barrier precautions. She also underscored the basics: “Reinforce the importance of hand hygiene…before touching a patient, before performing an aseptic task, after contact with bodily fluids, and, of course, after glove removal.”

    Environmental hygiene remains equally vital. High-touch surfaces, such as bed rails, call buttons, and light switches, should be disinfected regularly. Additionally, shared equipment like portable X-ray machines must be cleaned thoroughly between patients. “You also want to make sure that staff are not pouring patient waste down sink drains,” Rankin cautioned, citing sinks as a known environmental reservoir.

    Hand hygiene options prompted a practical discussion. “Hand sanitizer should be used and can be used in all instances except if a provider’s hands are contaminated from blood or bodily fluids—then they need to actually perform hand washing,” Rankin explained.

    Beyond daily practices, Rankin highlighted the importance of timely surveillance and mechanism-specific testing. “The primary need is to really obtain prompt mechanism testing for CRE so this information can be used for treatment selection,” she said. Yet she acknowledged barriers, including the lack of guaranteed reimbursement for clinical laboratories. Expanding testing capacity while maintaining strong public health laboratory support is essential for rapid response.

    Her message for infection preventionists and epidemiologists was clear: “Historically, the most common carbapenemase was KPC [Klebsiella pneumoniae carbapenemase], but now we’re seeing this surge of NDM-CRE in the United States, which really threatens to reverse years of stable or declining CRE rates.” With only 2 approved beta-lactam drugs effective against NDM-CRE, Rankin urged facilities to integrate mechanism testing into their workflows and use the CDC’s AR Lab Network when local resources are unavailable.

    “Infection control interventions must be timely,” Rankin concluded, “to ensure patients receive appropriate therapy and facilities can prevent further spread.”

    Read Rankin and her colleagues’ study published in the Annals of Internal Medicine here.

    Find the first installment of the interview here.
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    7 分
  • 13: At IDWeek, Dr Tom Frieden Urges a Simple Formula to Tackle Outbreaks and Drug Resistance: “See. Believe. Create.”

    13: At IDWeek, Dr Tom Frieden Urges a Simple Formula to Tackle Outbreaks and Drug Resistance: “See. Believe. Create.”
    2025/10/31
    Amid the bustle of IDWeek in Atlanta, Georgia, held from October 19 to 22, 2025, former CDC director Tom Frieden, MD, MPH, now president and CEO of Resolve to Save Lives, laid out a crisp playbook for infectious-disease professionals: a 3-step formula he says can prevent outbreaks, reverse drug resistance, and save “millions of lives.” In a conversation with Infection Control Today, before the conference, Frieden previewed the themes of his new book, The Formula for Better Health: How to Save Millions of Lives, Including Your Own, and the talks he gave at the meeting. “I’ll be talking in a couple of presentations about a new approach,” he said. “It’s an approach that can prevent and stop outbreaks, that can prevent and reverse drug resistance, and that can save millions of lives. It is, ‘see, believe, create’—a 3-step formula for a healthier world.” Step 1: See the Invisible Frieden argues that public health’s “superpower” is the ability to detect what others miss and then turn those insights into action. “First, see the invisible,” he said. “See not just the numbers and drug resistance or things like the genomic epidemiology to understand the spread; see also the path to progress and see whether our programs are succeeding or failing. This is public health’s superpower.” That vision, he added, requires nimble use of surveillance data, feedback loops that measure performance at the bedside, and the willingness to change tactics when results lag. It also means recognizing that many infections we accept as inevitable are, in fact, preventable. Step 2: Believe Change Is Possible The second step is psychological but no less essential. “Believe that we can change it. Believe the impossible,” Frieden said. “All too often, we assume that things are inevitable, when in fact, we can change them.” That mindset shift is especially important for health care-associated infections (HAIs). “I’m confident that in 20, 30, 40 years, we will look back on the burden of hospital-associated infections in the US today and think, ‘How could they have let that happen?’” he said. “This is not a criticism of any 1 individual. We have great tools to have a better understanding to see the invisible, how infections are spreading in hospitals and other healthcare facilities.” Step 3: Create a Disciplined, Organized Response The third step turns belief into execution. “Work together to create a healthier future with organized, simple, well-communicated strategies that overcome the barriers to progress,” Frieden said. He pointed to practical elements that high-reliability organizations embrace checklists, empowered infection-prevention units that track and reduce infections, and clear communication with patients, frontline staff, and leadership. “Systematically overcoming the barriers…including inertia…is the path to lower infection rates,” he added. A Lineage That Began in 1662 Frieden’s formula is anchored in history as much as modern analytics. “One thing that surprised me was that public health surveillance actually started in 1662, with a cloth merchant named John Grant,” he said, describing what is widely regarded as the first epidemiologic analysis of community health. Grant “described emerging diseases such as rickets” and even the economic implications of epidemics. Plague, Grant showed, sometimes killed most of a community, but other fevers were “more economically disruptive, because they caused so much illness that they were, as he put it, ‘scarce hands enough to bring in the harvest.’” For Frieden, the lesson is timeless: measure what matters, then act. From Multidrug-Resistant Tuberculosis to Carbapenem-Resistant Enterobacterales: Lessons Learned Frieden’s stance is shaped by hard-won experience. “Over the past decades, I’ve worked on issues like multidrug-resistant tuberculosis, Ebola, the spread of Carbapenem-resistant Enterobacterales and other resistant organisms,” he said. The through line: when leaders see clearly, believe improvement is possible, and create a disciplined plan, progress follows. The 7-1-7 Target: “Find a Problem, Fix a Problem” Frieden’s company, Resolve to Save Lives, has translated that mindset into a measurable target for outbreak detection and control. “The policy is 7-1-7—7 days to find every outbreak after it emerges, 1 day to report it to public health, and 7 days to have all essential control measures in place,” Frieden explained. “What we’re finding is that the 7-1-7 approach allows a ‘find a problem, fix a problem’ kind of worldview. Every single outbreak is an opportunity for continuous improvement with a simple yes/no—was it met or not? If not, not a blame to anyone—identify the bottlenecks and enablers and use that data to improve performance.” What This Means for IPC Leaders For infection preventionists, epidemiologists, environmental services ...
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    8 分
  • 12: Clean Hospitals Day 2025: A Discussion With Alexandra Peters, PhD, the New CEO

    12: Clean Hospitals Day 2025: A Discussion With Alexandra Peters, PhD, the New CEO
    2025/10/17
    Join the Movement: Clean Hospitals Day is October 20, 2025 On October 20, hospitals around the world will pause to spotlight a truth we all know but rarely celebrate out loud: Environmental hygiene saves lives. Clean Hospitals Day 2025 is your chance to rally teams, thank the environmental services (EVS) professionals who keep care spaces safe, and set new habits that last long after the balloons come down. Infection Control Today® (ICT®) spoke Alexandra Peters, PhD, CEO of Clean Hospitals and a member of ICT's Editorial Advisory Board. Speaking of environmental hygiene quality throughout the world, "If we raise the level everywhere, everyone wins." Peters discusses how Clean Hospitals invites participation via email or its website: Hospitals can become members with access to think tanks and scientific sessions, while ethically aligned industry sponsors (capped at about 50 and evidence-driven) help fund the initiative. The coalition aims to raise environmental hygiene standards globally by breaking silos between academia, industry, and care delivery, and by collaborating with associations and ministries of health in symbiotic, nonmembership alignments (eg, sharing activities and materials). Because pathogens ignore borders, the program stresses international cooperation—amplifying messages like Clean Hospitals Day—to protect patients, support health care workers, and lift practices everywhere. “Clean Hospital Day is vital. EVS and their role in keeping patients safe are vital, and they deserve to be honored and recognized for their contribution to patient care,” said Brenna Doran, PhD, MA, ACC, CIC, another member of ICT’s Editorial Advisory Board. “And while they are the people behind the scenes who are making sure things are clean and trash is picked up, they are paramount in the ability of frontline staff to do the work that they do. We cannot function without EVS. And Clean Hospitals Day is our opportunity to really recognize and show the value and the impact that these amazing, hard-working, dedicated, passionate professionals have in our health care space.” Why This Year Matters This year’s theme, Human Factors & Collaboration, centers on the people behind safe care. It recognizes environmental services (EVS) teams as health care workers and calls on leaders to integrate EVS fully into interdisciplinary care: shared goals, shared data, shared wins. Clean Hospitals is offering free, multilingual materials—posters, screensavers, social tiles, and talking points—so any facility, of any size and budget, can host a meaningful event. A Simple Plan You Can Run With 1) Host a 60-minute kickoff huddle (Oct 20). 10 min — Welcome & purpose: “EVS is clinical safety.”15 min — Micro-teach: human factors that help (clear workflows, stocked carts, good signage).15 min — Barrier busting: quick roundtable on top two friction points; assign owners.10 min — Recognition: shout-outs and “in-the-room” thank-yous.10 min — Photo & pledge: team picture and a one-sentence commitment. 2) Lift up your experts. Invite an EVS lead to co-present with infection prevention (IP). Make it crystal clear: Cleaning is care, and EVS are part of the clinical team. 3) Run a “See One, Fix One” sprint. All week, encourage staff to report one barrier (empty dispenser, missing wipes, unclear IFU) and fix one they can resolve on the spot. Track quick wins on a whiteboard. 4) Measure something that matters. Pick a fast, visible metric: percent of rooms with stocked hygiene supplies, percent of high-touch surfaces verified by fluorescent gel/marker, or time-to-isolation signage. Share before/after results at shift change. 5) Celebrate people, not just policies. Hand out “I keep patients safe” buttons or badge tags.Spotlight EVS pros on your intranet and digital boards.Deliver coffee rounds to night shift. Have senior leaders shadow a terminal clean. Communication you can copy-paste Talking point: “Environmental hygiene is a clinical intervention. When we clean well, we prevent infections, shorten stays, and protect staff and families.” Pledge: “I will make the next patient’s room safer than I found it.” Hashtags: #CleanHospitalsDay #EnvironmentalHygiene #EVSareHealthcare Ideas for Every Department Nursing: Standardize where wipes live, and who leads the room-ready check. Facilities: Map ‘last 10 feet’ workflow so EVS carts, water, and waste routes reduce cross-traffic. Supply Chain: Confirm uninterrupted stock for wipes, mops, and PPE; replace any “shared bottle” practices with single-patient items. Quality/IP: Publish a one-page playbook for high-touch surfaces in your setting (ICU, OR, ED). Leadership: Add EVS metrics to the safety dashboard and quarterly town hall. Make It Last Clean Hospitals Day is a launchpad, not a one-off. Convert your wins into standard work, schedule brief monthly barrier reviews, and keep recognizing catches. Small, ...
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    17 分
  • 11: Rising Threat of NDM-CRE: CDC Epidemiologist Highlights Urgent Infection Prevention Priorities

    11: Rising Threat of NDM-CRE: CDC Epidemiologist Highlights Urgent Infection Prevention Priorities
    2025/10/07
    Carbapenem-resistant Enterobacterales (CRE) carrying New Delhi metallo-β-lactamase (NDM) are on the rise across the US, posing a growing challenge for hospitals, infection preventionists, and public health officials. In a recent interview, Danielle Rankin, PhD, MPH, CIC, an epidemiologist with the CDC, discussed her recently published study, which underscored the scale of the problem and the need for coordinated action.

    “NDM is a type of carbapenemase, which is an enzyme that can inactivate carbapenems and other beta-lactam antibiotics,” Rankin explained. “Carbapenemase, like NDM, can share [its] genetic code with other bacteria, even if they were previously susceptible, rapidly spreading resistance.” Transmission most often occurs in health care settings, through direct contact, contaminated medical equipment, or environmental reservoirs such as sink drains and toilets.

    CDC surveillance data revealed a dramatic rise in NDM-CRE. “Through the Antimicrobial Resistance Laboratory Network data, we recognized that NDM was actually increasing,” Rankin said. The CDC created a cohort of 29 states to analyze CRE isolates and track carbapenemase trends systematically. Results show NDM-CRE incidence has surged by more than 460%.

    For clinicians, these shifts complicate empiric therapy. “There’s really not a one-size-fits-all approach,” Rankin noted. Facilities must foster close collaboration among microbiology labs, pharmacists, infectious disease specialists, and public health departments to adapt local guidelines.

    Testing capacity also remains a bottleneck. Carbapenemase mechanism testing is often unavailable at the local level, leading to delays. “Clinical laboratories that perform inhouse testing have a marked advantage, with turnaround times around 6 days faster than public health labs,” she said. “By enhancing local testing capabilities, we can improve the timeliness of results and facilitate more effective and targeted patient care in the face of multidrug-resistant organisms.”

    Infection preventionists must prepare for what Rankin described as a “poly-carbapenemase landscape,” where multiple resistance mechanisms, including OXA-48, may coexist. Vigilance is essential: “It’s important to remain suspicious if you’re seeing a rise in a single mechanism, even across different organisms.”

    Environmental hygiene is another critical front. Rankin warned that sink biofilms can serve as hidden reservoirs: “If a faucet is directly over a sink drain, it can splash into that drain and then onto items around the sink,” enabling horizontal transmission to patients.

    As NDM-CRE becomes more common, outbreak detection strategies must evolve beyond case-by-case responses. Whole genome sequencing and targeted screening of high-risk patients are among the tools CDC is piloting. “To prevent outbreaks,” Rankin emphasized, “facilities should continue monitoring hand hygiene, [personal protective equipment] use, and environmental cleaning and disinfection as well as sink hygiene.”

    Read Rankin and her colleagues’ study published in the Annals of Internal Medicine here.
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    16 分
  • 10: Evidence, Trust, and Prevention: David J. Weber, MD, MPH, on CDC Leadership and Public Health

    10: Evidence, Trust, and Prevention: David J. Weber, MD, MPH, on CDC Leadership and Public Health
    2025/09/09
    The sudden departure of the CDC director with several other top leaders has raised urgent questions about the stability of the nation’s leading public health agency and its ability to provide consistent, evidence-based guidance. In an interview with Infection Control Today®(ICT®), David J. Weber, MD, MPH, president of the Society for Healthcare Epidemiology of America, and the medical director of the Department of Infection Prevention at UNC Medical Center, emphasized why strong leadership, scientific integrity, and prevention-focused strategies are essential for protecting both patients and communities.

    “The Centers for Disease Control in the United States has been not only the leading public health agency within the United States, but look to worldwide,” Weber said. It “provides crucial guidelines for us in infection prevention, vaccines, but many other aspects of public health,” and serves as a vital conduit for federal support: “It serves as a pass-through for congressional funds…to state and local health departments to provide public health interventions.”

    For Weber, the compass is clear: “We believe in public health guidelines should be evidence-based on peer-reviewed published literature.” The CDC’s surveillance role allows health systems to “direct the resources to the areas that are most impacted,” while transparent guidance spans prevention in hospitals and community vaccination. He underscored historic gains: “The two most important public health interventions in the last 150 years have been a safe drinking water supply and second, vaccines,” noting we have “eliminated smallpox… eradicated two of the three types of polio…and dramatically decreased…mumps, rubella, whooping cough, and…measles.” CDC laboratories also safeguard against the rare and the dangerous, from “human rabies” to “Ebola and Lassa.”

    Selecting a new director demands depth and credibility. “That person should be a physician…[with] substantial experience in…public health,” and “enough of a scientific background…to follow the best evidence-based practice.”

    Funding cuts, Weber warned, ripple locally. “Only about 5% or less is staff…but still, the majority of money is just a pass-through to state and local governments.” Proposed reductions “will…affect every person in the United States,” because they would “dramatically affect…city, county and state public health departments.”

    At the bedside, fundamentals still save lives. “Proper hand hygiene before and after each patient in contact,” surface disinfection, and appropriate precautions are “the very basic things we do.” The economics align with the ethics: “For every dollar we spend on infection prevention, we save more money than we spend… Prevention is always better than treatment.”

    The charge to clinicians is unambiguous: “We need to be the proponents for a safe and effective therapies…to counter both misinformation and disinformation.”
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    34 分