The Centers for Disease Control and Prevention estimates that approximately 2 million patients admitted to acute-care hospitals in the United States each year acquire infections that were not related to the condition for which they were hospitalized. These infections result in about 100,000 deaths and add between $4.5 billion and $5.7 billion to patient care costs every year.
Although the precise causes of hospital-acquired infections (HAIs) are difficult to identify, experts believe that about one-third could be prevented using current recommendations. The goal of Memorial Sloan Kettering’s Infection Control program is to provide the safest healthcare environment for our patients by using existing guidelines to prevent HAIs and to engage in research to further the mission of infection prevention.
Infection Control team members participate in several collaborative performance improvement initiatives and conduct research on the epidemiology and prevention of hospital-acquired infections.
We accomplish these goals through real-time surveillance, data collection, review of trends, outbreak investigation, implementing interventions, and auditing compliance. Members of the team also work to develop evidence-based prevention policies such as central-line insertion and maintenance practices.
Through federal grant funding, institutional support, and collaboration with peer cancer centers, our infection control program is actively engaged in numerous projects on several aspects of the epidemiology and prevention of HAIs. Our research focuses on defining rates of HAIs across centers to establish reliable benchmarks and measure performance, study novel interventions to reduce HAIs, and elucidate transmission patterns of epidemiologically relevant nosocomial pathogens. Examples of ongoing projects in these areas include:
- prevention of central venous catheter infection and surgical-site infections
- resource utilization and cost effectiveness of active surveillance for select multidrug-resistant organisms
- application of genotyping techniques to understand transmission of C. difficile in high-risk settings
- studying the impact of newer technologies for environmental disinfection, such as ultraviolet light, to limit the spread of C. difficile.
Our Infection Control program involves collaboration with many departments, programs, services, and settings throughout the hospital to develop, implement, and evaluate the program. The design and scope of our program are based on the risk that the hospital faces related to the acquisition and transmission of infectious diseases. As the continuum of care has transferred to the ambulatory area, we have increased the program’s presence. We visit all ambulatory sites, conduct an annual risk assessment, and audit compliance with infection-control standards.
Additional initiatives include collaborative projects with MSK’s Employee Health and Wellness Service, including studies of rates of needlesticks and other occupational exposures, as well as tuberculin reactivity rates among healthcare workers. Annually, the flu vaccination program is reviewed and supported by Infection Control.
In collaboration with the microbiology laboratory, we have established molecular typing services. Genotyping for epidemiologically significant organisms such as C. difficile is routinely performed to inform infection control practices. The integration of cutting-edge molecular techniques for diagnosis and genotyping enables robust surveillance and allows for identification of epidemiologic trends, early detection, and control of outbreaks.
Our Infection Control team consists of infection control practitioners, an epidemiologist, and surveillance specialists with expertise in various areas of healthcare, including:
- surveillance for multidrug-resistant organisms
- surgical site and device-related infections
- infection prevention in acute and ambulatory care settings
- environmental hygiene
- infection risk related to hospital construction
Mini Kamboj, MD
Chief Medical Epidemiologist, Infection Control
Elizabeth Robilotti, MD, MPH
Janet Eagan, RN, CIC, MPH
Integration of whole-genome sequencing into infection control practices: the potential and the hurdles.
Robilotti E, Kamboj M.
J Clin Microbiol. 2015 Apr;53(4):1054-5. doi: 10.1128/JCM.00349-15. Epub 2015 Feb 11.
PMID: 25673795 [PubMed - in process]
Clostridium difficile infection after allogeneic hematopoietic stem cell transplant: strain diversity and outcomes associated with NAP1/027.
Kamboj M, Xiao K, Kaltsas A, Huang YT, Sun J, Chung D, Wu S, Sheahan A, Sepkowitz K, Jakubowski AA, Papanicolaou G.
Biol Blood Marrow Transplant. 2014 Oct;20(10):1626-33. doi: 10.1016/j.bbmt.2014.06.025. Epub 2014 Jun 25.
PMID: 24973628 [PubMed - in process]
Clostridium difficile Infection (CDI) in Solid Organ and Hematopoietic Stem Cell Transplant Recipients.
Alonso CD, Kamboj M.
Curr Infect Dis Rep. 2014 Aug;16(8):414. doi: 10.1007/s11908-014-0414-0.
PMID: 24893981 [PubMed]
Estimating risk of C. difficile transmission from PCR positive but cytotoxin negative cases.
Kamboj M, Babady NE, Marsh JW, Schlackman JL, Son C, Sun J, Eagan J, Tang YW, Sepkowitz K.
PLoS One. 2014 Feb 11;9(2):e88262. doi: 10.1371/journal.pone.0088262. eCollection 2014.
PMID: 24523882 [PubMed - indexed for MEDLINE]
Real-time cellular analysis coupled with a specimen enrichment accurately detects and quantifies Clostridium difficile toxins in stool.
Huang B, Jin D, Zhang J, Sun JY, Wang X, Stiles J, Xu X, Kamboj M, Babady NE, Tang YW.
J Clin Microbiol. 2014 Apr;52(4):1105-11. doi: 10.1128/JCM.02601-13. Epub 2014 Jan 22.
PMID: 24452160 [PubMed - indexed for MEDLINE]
What is the source of bloodstream infection due to vancomycin-resistant enterococci in persons with mucosal barrier injury?
Kamboj M, Blair R, Bell N, Sun J, Eagan J, Sepkowitz K.
Infect Control Hosp Epidemiol. 2014 Jan;35(1):99-101. doi: 10.1086/674406. No abstract available.
PMID: 24334811 [PubMed - indexed for MEDLINE]
Hospital-onset Clostridium difficile infection rates in persons with cancer or hematopoietic stem cell transplant: a C3IC network report.
Kamboj M, Son C, Cantu S, Chemaly RF, Dickman J, Dubberke E, Engles L, Lafferty T, Liddell G, Lesperance ME, Mangino JE, Martin S, Mayfield J, Mehta SA, O’Rourke S, Perego CS, Taplitz R, Eagan J, Sepkowitz KA.
Infect Control Hosp Epidemiol. 2012 Nov;33(11):1162-5. doi: 10.1086/668023. Epub 2012 Sep 24.
PMID: 23041818 [PubMed - indexed for MEDLINE]
Central line-associated bloodstream infection surveillance outside the intensive care unit: a multicenter survey.
Son CH, Daniels TL, Eagan JA, Edmond MB, Fishman NO, Fraser TG, Kamboj M, Maragakis LL, Mehta SA, Perl TM, Phillips MS, Price CS, Talbot TR, Wilson SJ, Sepkowitz KA.
Infect Control Hosp Epidemiol. 2012 Sep;33(9):869-74. doi: 10.1086/667378. Epub 2012 Jul 24.
PMID: 22869259 [PubMed - indexed for MEDLINE]
Comparison of the Luminex xTAG RVP Fast assay and the Idaho Technology FilmArray RP assay for detection of respiratory viruses in pediatric patients at a cancer hospital.
Babady NE, Mead P, Stiles J, Brennan C, Li H, Shuptar S, Stratton CW, Tang YW, Kamboj M.
J Clin Microbiol. 2012 Jul;50(7):2282-8. doi: 10.1128/JCM.06186-11. Epub 2012 Apr 18.
PMID: 22518855 [PubMed - indexed for MEDLINE]
Clinical and laboratory characteristics of Clostridium difficile infection in patients with discordant diagnostic test results.
Kaltsas A, Simon M, Unruh LH, Son C, Wroblewski D, Musser KA, Sepkowitz K, Babady NE, Kamboj M.
J Clin Microbiol. 2012 Apr;50(4):1303-7. doi: 10.1128/JCM.05711-11. Epub 2012 Jan 11.
PMID: 22238444 [PubMed - indexed for MEDLINE]