Category Archives: Infection Control

What is a true penicillin allergy?

Did you know that most patients who give a history of “penicillin allergy” do not have a true allergy? Most of them will tolerate more effective and less expensive agents without issues.

For more information see the recently updated policy.

Weekly Flu Activity – CDC

New – Interpretation of Clostridium difficile testing

Sometimes interpretation of Clostridium difficile testing can be confusing. See this page which helps interpret the test.

It will be located under “Infection Prevention” => Interpretation of Clostridium difficile testing.

Oral and Nasopharyngeal Specimen Collection


This is a brief list of oral and nasopharyngeal specimen collection procedures.

MRSA

  • Location: Anterior nares
  • Swab: Routine cotton culture swab

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Influenza

  • Location: Posterior nasopharynx
  • Swab: Routine cotton culture swab
  • Wear a surgical mask, protective eye wear and gloves while collecting the specimen
  • Place the patients head on the bed pillow or against a wall so that they do not move backwards
  • The swab will go straight backwards like placing an NG tube, it should go the distance between the nostril and the ear into the throat.
  • The swab is rotated for a bout 5–10 seconds to get enough epithelial cells on it
  • Remove the swab and place it in the transport media and sent it to lab

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Pertussis

The PCR assay reuires a special swab, made of aluminum with a nylon tip. Traditional cotton tip swabs interfere with the test

  • Location: Posterior nasopharynx
  • A special transport media is needed- call the lab for it
  • Wear a surgical mask, protective eye wear and gloves while collecting the specimen
  • Place the patients head on the bed pillow or against a wall so that they do not move backwards
  • The swab will go straight backwards like placing an NG tube, it should go the distance between the nostril and the ear into the throat. This is different from a nasal swab for MRSA or influenza
  • The swab is rotated for a bout 5–10 seconds to get enough epithelial cells on it
  • Remove the swab and place it in the transport media and sent it to lab

Pertussis-2

Here is a video on specimen collection

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Mumps

  • Location: Specimen is collected from the parotid duct secretions preferrably within 9 days of symptoms.
  • Swab: Routine cotton swab. Specimen is sent in a viral transport media.
  • Steps
    • Massage the parotid gland for 30 seconds. Note that it is just in front of the ear lobe. CDR742039
    • Specimen should be collected from the parotid duct opening just next to the second molar.
      mumps-cavity

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Increase in pertussis cases in Harvard, IL

McHenry County Department of Health (MCDH) has noticed an increase on cases of pertussis in Harvard IL.  Please be aware of this vaccine preventable disease when evaluating any child or adult with acute cough like illness characterized by dry hacking cough which may be worse at night associated with paroxysms, a whoop or post tussle gagging or vomiting. Especially if symptoms are lasting greater than 2 weeks.

Please remember to start treatment even before laboratory confirmation

Preferred treatment included – azithromycin, erythromycin or clarithromycin.

Please note the correct way to collect specimen as shown in this video

Pertussis cases should be reported to the county health department using the attached Pertussis_Reporting_Form.

CHS 2015 antibiograms are now online

The 2015 CHS antibiograms are now available under Departments => Infection control => Antibiograms. The direct link is here.

Antibiograms updated

2014 updates to the antibiograms for both CHM and CHW are now posted here. Antibiograms provide information regarding local microbiologic susceptibility patterns.