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August 2016

e-Bulletin Newsletter



Contact us

VICNISS Healthcare Associated Infection Surveillance Coordinating Centre
792 Elizabeth Street
Melbourne 3000
Victoria Australia
Phone: +61 3 9342 9333
Fax: +61 3 9342 9355
Email: VICNISS @


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Reminders - Data:

Recent changes to VICNISS Team

VICNISS welcomed Jenny Bradford back from her secondment to the HH project.  She resumed her VICNISS role on 27 June.  The team are very happy to have Jenny back in her role which she has settled into very quickly.  

Unfortunately this meant Liz Orr's contract ended which was for the duration of Jenny's secondment.   During Liz's time with VICNISS Liz very quickly become a valuable part of the VICNISS team, participating in all the changes, and her adeptness and bubbly nature will be greatly missed by everyone.  Best wishes to Liz in her new role.



CPE surveillance

Point Prevalence Survey

CPE Point Prevalence Surveys (PPS)

The Victorian Guideline on CPE requires all hospitals conduct a CPE PPS every 6 months in all ICU’s, organ transplant wards & haematology wards. If your hospital does not have these ward types a PPS is not required. A web form, as well as instructions for completion of the form and a list of frequently asked questions, are all available on the VICNISS website

The Victorian Department of Health & Human Services requires hospitals (with high risk wards listed above) to submit the PPS data via the VICNISS User Portal. First submission was due Sunday 31 July 2016.

CPE Resources

All CPE forms and other resources e.g. surveillance forms (hardcopy), PPS protocol & FAQs. instructions for PPS form, education tools and information sheets for patients/clinicians can be found on the VICNISS website, see modules > carbapenemase-producing enterobacteriaceae. ( )  

National Hand Hygiene Initiative Update

Gold Standard Auditor (GSA) Workshop

Currently there are no more GSA workshops scheduled for 2016, but if you are interested in training as a GSA please register at the following link: and you will be notified when a workshop is available.

Learning Management System

There are still some ongoing issues around accessing the new LMS.  The main issues noted have been around registration.  All users are required to register if this is their first time accessing the new LMS.  It is not the HHCApp login.  The other issue is with selection of the correct learning package.  If you are completing your annual auditor validation, you need to browse the catalogue, select HH Auditors Modules, then select Auditor Annual Validation. The other packages including Nursing/Midwifery package does not meet the needs of annual auditor validation.  If you have any queries please email

Auditing Using iPade minis ('Toolkits')

If you have any issues with your iPad minis ('Toolkits') i.e. passwords, removing restrictions, removing HHA Apple ID etc. please contact If you are having other issues i.e. syncing, error messages etc. please refer to the iPad troubleshooting guides for apple devices and android devices (new).  

2016 HCW Influenza Vaccination Module

The 2016 HCW Influenza Vaccination campaign is well underway, with some hospitals already winding down their active promotion.

The Department of Health and Human Services, ‘High-performing health services, Victorian health service performance monitoring framework 2016-2017’, includes a state-wide target of 75 per cent of health service staff employed during the influenza period to be vaccinated.

The data collection period for 2016 is 18th April 2016 to 19th August 2016. Data are to be submitted to VICNISS by 2 September 2016. The webform will be available on the VICNISS website by early August 2016.

Type 1 Surveillance Update

2016-17 Surveillance Plans

Surveillance plans for 2016-2017 were due on June 30 2016. If not already submitted please submit to VICNISS ASAP.  The surveillance plan (both pdf and word versions) can be accessed on the VICNISS website under manuals, VICNISS participation requirements and the pdf version can be accessed here. Please ensure you meet the VICNISS participation requirements as per the performance requirements.

Submitted Electronic SSI Data to VICNISS

For those hospitals submitting SSI data in an electronic format to VICNISS there will be a new upload portal on the website shortly.  All data submitted through this portal will be required to meet the updated specifications for column names and data types. If you would like to know more about submitting data through this portal please contact us:

VICNISS Type 1 Education Workshop

This is a workshop designed for surveillance newcomers or ICPs that would like a refresher on VICNISS surveillance principles and any changes to the program. The workshop will be held on:

Date:  Tuesday 16th August

Time: 0900-1630 hours

Venue: Doherty Institute, Mezzanine, 792 Elizabeth St, Melbourne  VIC 3000

RSVP: by COB Friday 5th August to

Morning tea and lunch will be provided.  Venue is readily accessible by public transport.  Car parking and other travel costs are at you own expense.  If you have further queries please don't hesitate to contact me. Please feel free to forward this email to anyone that may be interested.


Type 2 Surveillance Update

The submission of Occupational Exposure (OE) data is no longer 'required '  but instead is 'optional' for Type 2 Hospitals. Could all ICPs working in Type 2 hospitals please let VICNISS know if they wish to continue (or not) collecting data for this module. 

2016-2017 Surveillance Plans -

There are a number of smaller hospitals who have not yet submitted the Annual Surveillance Plan for 2016-2017.  ALL hospital sites/facilitites participating in VICNISS surveillance must complete a separate surveillance plan surveillance plan form.   Please complete the form, which has to be signed by your hospital / health services(s) Executive Sponsor as well as the Infection Control Consultant, and fax to VICNISS asap.

2016 Point Prevalence Survey - Hepatitis B

As noted in the Performance Indicators for Hospitals Participating in the VICNISS Small Hospitals (<100 beds) Surveillance Program, Type 2 Hospitals are required to complete a point prevalence survey each surveillance year. For the 2016-17 surveillance year the HCW Hepatitis B immunity module will be the required point prevalence survey. Hospitals can nominate any quarter during the 2016-2017 surveillance year to complete the HCW Hepatitis B immunity PPS. Those hospitals participating in the Quality Assurance Project (see below) are exempt from completing the HCW Hepatitis B PPS, as are hospitals that recently completed the online BBV survey for the DHHS.  Hospitals are, however, encouraged to complete the HCW Hepatitis B Immunity module if possible as this is valuable information.  Most Hospitals that completed the BBV survey reported that they have electronic staff health databases.


HCW Hepatitis B and Measles Immunity modules

Both these modules have recently been revised. The new protocol, hard copy forms & instuctions are now available on the VICNISS website. The web forms for both modules will be available from Quarter 1, 2016-2017.

MRSA & VRE modules

The webform for the reviewed MRSA module is now available on the VICNISS website. You will be notified by email when the VRE webform has been developed. A hard copy of the VRE data collection form will be available to download and fax to VICNISS.

VICNISS Quality Assurance Project for Smaller Hospitals 

This QA project aims to determine the accuracy and completeness of required surveillance modules of the small acute care Victorian hospitals (0 – 99 beds). This onsite survey and audit process is a tool to assess accuracy of submitted data. This will  identify any areas that require additional education and training.

A special thanks to those who have agreed to participate and who have already participated in this project.  The exercise had proved valuable so far, and the site visits are always a learning experience for all involved - it is a good reminder for VICNISS staff of what goes on "at the coalface". A timely reminder that if any of you would like a site visit at any time then just let us know.

Update SSI Web Form - Type 1 and Type 2

Refer above to Type 1 Surveillance Update.


The official Aged Care National Antibiotic Prescribing Survey (acNAPS) time period has been extended until Friday September 9th.  This means data for the acNAPS can be collected and entered on any single day up until this date.

We have received much feedback that many staff working in aged care find interpreting microbiology reports difficult.  As a result the National Centre for Antimicrobial Stewardship and VICNISS have developed some 'information sheets' that explain how to interpret sputum, urine and wound swab reports.  These can be accessed via the VICNISS website and the NAPS website (scroll down the resources page).

Infection Control Literature Review - August 2016

Using Staphylococcus aureus bacteraemia surveillance to develop targeted prevention programs

Staphylococcus aureus bacteraemia (SAB) is associated with significant mortality and is frequently regarded as preventable in settings where onset of infection is associated with delivery of healthcare. As such, mandatory reporting of SAB has occurred in Scotland since 2001. In the setting of apparent inability to reduce the number of SAB episodes in Scotland, enhanced surveillance was instituted in 2009. Morris AK and Russell CD (J Hosp Infect 2016; 93:169-174) report the value of enhanced surveillance to suitably inform infection prevention programs in a single health region in Scotland (Fife).

Prospective surveillance was performed in Fife between 2009 and 2014. The region contains one acute hospital with a single diagnostic laboratory. A clinical microbiologist reviewed all SAB events at the bedside to determine the origin and source of infection, collect demographic data, and formulate a management plan. Each episode of SAB was classified as hospital-acquired infection, healthcare-associated infection, community-acquired infection or non-hospital-acquired.

In total, 556 SAB episodes occurred during the studied period. Seventy-two (12.9%) were due to methicillin-resistant S. aureus. The 30-day all-cause mortality was 22.7%. Most SAB episodes were hospital-acquired (46.9%) or healthcare-associated (37.6%), with only 14.4% acquired in the community. Community-acquired events had 30-day mortality of 8.7%, whereas mortality rates in healthcare-associated and hospital-acquired groups were 16.3% and 31.4%, respectively. The source of SAB was identified in 88.1% of events. SAB related to intravenous drug use was the most frequent cause of community-acquired events, and episodes related to respiratory tract and skeletal/joint infections were more likely in community-acquired events. For hospital-acquired infections, the most frequent source was a vascular access device (46.4%), and peripheral venous cannulae accounted for most of these (43.9%). Healthcare-associated infections were most frequently associated with medical devices other than venous access devices.

Enhanced surveillance to determine SAB origin of infection and source of bacteraemia effectively provides data to directly inform prevention activities. Methods employed in this study would be of benefit in Australian facilities currently performing SAB surveillance, to enable development of targeted quality improvement programs.


Is Pneumocystis jirovecii a transmissible organism in healthcare settings?

Pneumocystis jirovecii pneumonia (PCP) results in morbidity and mortality in immunocompromised patients. A range of predisposing conditions has been associated with infection, including malnutrition, HIV infection, renal transplantation, haematological malignancy and connective tissue disorders. Some reports of individual outbreaks have suggested a common-source with confirmation by molecular typing. Yiannakis EP and Boswell TC (J Hosp Infect 2016; 93:1-8) sought to identify and evaluate all published clusters and outbreaks of PCP, to determine the evidence for different modes of transmission (including inter-human transmission).

A systematic review of literature published between 1980 and 2015 was performed. Studies were eligible for inclusion if they described the occurrence of PCP in excess of what would normally be expected in the defined adult or paediatric population. Standardised data were collected from eligible studies, including features of the outbreak, the outbreak setting, application of molecular typing methods, and results of environmental sampling (if performed).

Of 177 articles initially identified, 22 were found to fulfil inclusion criteria, and a further 7 articles were found by secondary search methods (total of 29 studies included). These described a total of 30 outbreaks. Twenty-one (70%) occurred in Europe, and the median number of patients affected in outbreaks was 12.5. Predominantly, adult patients were affected, with only 3 outbreaks reported in paediatric populations. In the majority, patients had undergone solid organ transplantation, predominantly renal transplantation. Genotyping was performed in 16 (57%) of studies, and a single/predominant strain was identified in 13/16 (81%). Environmental sampling was conducted in only 5 outbreaks, with Pneumocystis isolated from the environment in 3 instances. In all outbreaks, patients had received either no or suboptimal PCP prophylaxis. Outbreaks were managed by initiation of chemoprophylaxis in the affected patient cohort. In only 2 instances, isolation of symptomatic patients was also performed.

Overall, findings suggest the existence of healthcare-associated Pneumocystis jirovecii infections. However, potential limitations of this systematic review must be acknowledged, including publication bias and lack of population studies to determine relative prevalence of Pneumocystis subtypes in community and non-hospitalised settings. Notwithstanding these limitations, current guidelines of the Centers for Disease Control and Prevention appear to be justified, at least for renal transplant units. These include the avoidance of placement of a patient with PCP in the same room as an immunocompromised patient. Future studies must focus upon the role of asymptomatic carriers, and the potential role of environmental sources of infection.