On February 5, 2021, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr).Approximately 41% of adults aged 18-24 years in the United States are enrolled in a college or university (1). Wearing a face mask can reduce transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (2), and many colleges and universities mandate mask use in public locations and outdoors when within six feet of others. Studies based on self-report have described mask use ranging from 69.1% to 86.1% among adults aged 18-29 years (3); however, more objective measures are needed. Direct observation by trained observers is the accepted standard for monitoring behaviors such as hand hygiene (4). In this investigation, direct observation was used to estimate the proportion of persons wearing masks and the proportion of persons wearing masks correctly (i.e., covering the nose and mouth and secured under the chin*) on campus and at nearby off-campus locations at six rural and suburban universities with mask mandates in the southern and western United States. Trained student observers recorded mask use for up to 8 weeks from fixed sites on campus and nearby. Among 17,200 observed persons, 85.5% wore masks, with 89.7% of those persons wearing the mask correctly (overall correct mask use: 76.7%). Among persons observed indoors, 91.7% wore masks correctly. The proportion correctly wearing masks indoors varied by mask type, from 96.8% for N95-type masks and 92.2% for cloth masks to 78.9% for bandanas, scarves, and similar face coverings. Observed indoor mask use was high at these six universities with mask mandates. Colleges and universities can use direct observation findings to tailor training and messaging toward increasing correct mask use.Direct in-person observation is used in health care settings to measure adherence to infection prevention and control recommendations, such as hand hygiene and the correct use of personal protective equipment (4). A similar approach was used to directly observe mask use at universities, using a protocol and sampling methodology based on one from Resolve to Save Lives, an initiative promoting the measuring and adoption of face mask use to reduce transmission of . CDC staff members discussed the direct observation protocol

Antimicrobial resistance is a growing global health issue. It is also a recognised problem in veterinary medicine. Between September and December 2015 the authors administered a cross-sectional survey to licensed veterinarians in Washington State to assess factors affecting antimicrobial prescribing practices among veterinarians in Washington State. Two hundred and three veterinarians completed the survey. The majority of respondents (166, 82 per cent) were engaged in small animal or exotic animal practice. 24 per cent of respondents reported not ordering culture and sensitivity (C/S) testing in practice. Of the 76 per cent of veterinarians who reported ordering C/S tests, 36 per cent reported ordering such testing 'often' or 'always' when treating presumptive bacterial infections. Most respondents (65 per cent) mentioned cost as the most common barrier to ordering a C/S test. Only 16 (10 per cent) respondents reported having access to or utilising a clinic-specific antibiogram. This survey demonstrated that while antimicrobials are commonly used in veterinary practice, and veterinarians are concerned about antimicrobial resistance, cost is a barrier to obtaining C/S tests to guide antimicrobial therapy. Summaries of antimicrobial resistance patterns are rarely available to the practising veterinarian. Efforts to promote antimicrobial stewardship in a 'One Health' manner should address barriers to the judicious use of antimicrobials in the veterinary practice setting.

Background Meticillin‐resistant Staphylococcus pseudintermedius (MRSP) infections in companion animals are increasing and are difficult to treat. Environmental contamination with MRSP in small animal primary care hospitals may pose an exposure risk to animal patients. Methods This longitudinal study assessed the genotypic relationships of MRSP isolated from 39 environmental samples collected from six private small animal primary care hospitals, in the north‐eastern United States, between August 2018 and April 2019. Results Of the 39 bacterial isolates, 18 unique pulsotypes were identified based on pulsed‐field gel electrophoresis, including six clusters of two or more indistinguishable isolates. Single pulsotypes were frequently detected from multiple hand‐contact and animal‐contact surfaces within a hospital during a single sampling event, but detection of a single pulsotype within the same hospital on subsequent visits was infrequent. However, one pulsotype was recovered from three separate hospitals, which suggests that either MRSP transmission between hospitals may have occurred via people, animals, or fomites or that there was a dominant community strain. Conclusions Single strains of MRSP were isolated from various hand‐contact and animal‐contact surfaces within hospitals, indicating the important role of humans, animals and the environment in MRSP transmission. Additionally, the detection of a single strain between hospitals and over time suggests that either MRSP transmission between hospitals may have occurred via people, animals or fomites or that there was a dominant community strain.

Background: In April 2015, the Missouri Department of Health and Senior Services identified a cluster of four Salmonella enterica serovar Oranienburg infections among residents of the St. Louis metro area. Clinical isolates from those patients shared an indistinguishable pulsed-field gel electrophoresis (PFGE) pattern. Methods and Findings:The ensuing outbreak investigation included epidemiological, laboratory, and environmental investigations. Clinical and environmental isolates were subtyped by PFGE pattern and whole genome sequencing (WGS). Eggs from a single poultry farm and processing facility were identified as the likely source of this outbreak based on the epidemiologic data, highly related Salmonella isolates from the farm and processing facility, and clinical isolates from patients. The egg farm operations were suspended, and the producer issued a voluntary recall of all eggs produced up to the time of the recall.Conclusions: WGS is a valuable tool for Salmonella Oranienburg infection outbreak investigation. Early prospective application of WGS enhances several aspects of the outbreak investigation. A thorough analysis of combined epidemiological, traceback, and advanced molecular laboratory data is needed for the proper management of foodborne outbreak investigation.