The effect of cyclosporine A (CyA) on the ability of the human immunodeficiency virus type 1 (HIV-1) to infect the H-9 T-cell leukemic line, as well as interleukin-2 (IL-2)-grown human peripheral blood- derived lymphocytes, has been studied. Pretreatment of H-9 cells and human lymphocytes with CyA over 24 hours completely prevented viral infection over a 21-day period, whereas the addition of drug at two hours postinfection with HIV-1 had a significant inhibitory effect on viral replication and expression of the virus-specific antigens p17 and p24. However, if CyA was added at later times to these lymphocytic cells, this inhibitory effect was lost. Indeed, the removal of CyA from cultures that had been treated from two hours after infection led to the rapid production of progeny virus. HIV-1 was able to infect peripheral blood lymphocytes obtained from each of four kidney allograft recipients on long-term CyA antirejection therapy, as long as drug was not included in the culture medium. In addition, we asked what effect pretreatment with CyA of cells of the U-937 monocytic line and primary cultures of human monocytes/macrophages might have on infection by HIV-1. CyA had no demonstrable effect on the ability of HIV-1 to infect cells of either type.

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BackgroundThe current hand hygiene (HH) auditing and feedback strategy include anonymized data collection using direct observation and feedback of aggregated data. We aimed to evaluate whether an anonymous (without wearable device) HH electronic monitoring system (EMS) could detect patterns associated with individual healthcare workers (HCWs) and estimate their relative HH performance.MethodsObservational study of HH compliance via an EMS in 10 rooms in a tertiary care hospital. The EMS measures HH product dispenser activation (an indicator of HH events) as well as entries and exits from patient rooms (a surrogate of HH opportunities). HH rates were obtained by dividing the number of HH events by the number of opportunities. HH rates were aggregated at room-shift level (i.e., an 8-hour period for a single room). For each room-shift, the HH rate was converted to a Z score, which was then associated with the individual HCW assigned to that room-shift. The relative HH performance of individual HCWs was estimated by comparing the mean Z scores of each HCW with the rest of the group by the Student T-test, with a level of significance set at P < 0.001 after adjustment by Bonferroni’s correction. To investigate whether any association could be due to chance, we looked into the potential association between average Z scores and calendar days, as a counterexample.ResultsOver a 100-day period, there were 45 775 HH events and 136 821 opportunities (global compliance, 33%). Schedules were available for 2980 room-shifts. Fifty-four individual HCWs took part in at least one room-shift (average per HCW, 52 room-shifts; range 1–140). Eight HCWs (15%) had a mean Z score significantly above the group average (Figure 1, green boxes; mean Z score 0.71; range, 0.52 to 0.86; P < 0.001), whereas 9 HCWs (17%) had a significantly inferior Z score (Figure 1, red boxes; mean Z score -0.47, range -0.58 to -0.31, P < 0.001). In contrast, there was no significant difference in Z scores between calendar days (Figure 2; p >0.001).ConclusionCross-linking a high-volume HH database with HCW schedules identified a significant association between individual HCWs and HH compliance in the rooms to which they were assigned. If confirmed in further studies, anonymous EMS could be used to provide HCWs with personalized relative HH compliance feedback. Disclosures All authors: No reported disclosures.

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