Infection Control Matters

In this episode, Phil, Brett and Martin dicuss more sessions from ESCMID Global (Barcelona, 2024). We talk about sessions on cleaning the occupied bed space, SSI prevention and the difficulty of designing and executing good studies in IPC. We were particularly interested in papers from Italy on the use of probiotics in IPC and some papers from Prof Cassini's group are highlighted below. https://www.ncbi.nlm.nih.gov/pubmed/37881619https://www.ncbi.nlm.nih.gov/pubmed/36991513https://www.ncbi.nlm.nih.gov/pubmed/35208679https://www.ncbi.nlm.nih.gov/pubmed/32959791|https://www.ncbi.nlm.nih.gov/pubmed/26886448

In this episode, Brett, Martin and Phil mull over the newly published WHO discussion document on respiratory particles and Martin catches up with Prof Cath Noakes from the School of Engineering in Leeds, UK to get her take on it. You can download the document we are discussing here https://www.who.int/publications/m/item/global-technical-consultation-report-on-proposed-terminology-for-pathogens-that-transmit-through-the-air

In this podcast, Brett and Martin reflect on the "Infection Control Papers of the Year" presented at ECCMID (AKA ESCMID Global) 2024. Here are a selection of some of the papers mentioned: Decolonization in Nursing Homes to Prevent Infection and Hospitalization https://pubmed.ncbi.nlm.nih.gov/37815935/ Reducing Hospitalizations and Multidrug-Resistant Organisms vi a Regional Decolonization in Hospitals and Nursing Homes https://pubmed.ncbi.nlm.nih.gov/38557703/ Prevention of non-ventilator-associated hospital-acquired pneumonia in Switzerland: a type 2 hybrid effectiveness-implementation trial https://pubmed.ncbi.nlm.nih.gov/36893785/ Skin Antisepsis before Surgical Fixation of Extremity Fractures https://www.nejm.org/doi/full/10.1056/NEJMoa2307679 Trial of Vancomycin and Cefazolin as Surgical Prophylaxis in Arthroplasty https://www.nejm.org/doi/full/10.1056/NEJMoa2301401 https://www.ajicjournal.org/article/S0196-6553(22)00468-0/abstractEnvironmental cleaning to prevent hospital-acquired infections on non-intensive care units: a pragmatic, single-centre, cluster randomized controlled, crossover trial comparing soap-based, disinfection and probiotic cleaning https://pubmed.ncbi.nlm.nih.gov/37089619/

In our first episode from ECCMID Global 2024, Martin and Brett reflect on the session on design of the healthcare environment sessions from Profs Hilary Humphries and Cath Noakes and a flash poster session featuring VRE Reservoirs in the environment and a tremendous piece of Burkolderia sleuthing from the UKHSA

In this podcast, we chat with Dr Brian Forde about HAIviz. HAIviz an interactive dashboard for visualising and integrating healthcare-associated genomic epidemiological data. HAIviz displays and links the outbreak timeline, building map, phylogenetic tree, patient bed movements, and transmission network on a single interactive dashboard. You can view and use the tool for free at Permana, B., Harris, P. N., Roberts, L. W., Cuddihy, T., Paterson, D. L., Beatson, S. A., & Forde, B. M. (2024). HAIviz: an interactive dashboard for visualising and integrating healthcare-associated genomic epidemiological data. Microbial Genomics, 10(2), 001200.

In this episode, Martin Kiernan talks to Mitch Clarke, Clinical Lead and Deputy Director of Infection Prevention and Control at Nottingham University Hospitals in the UK. We discuss an outbreak with a unique NDM CPE infection and look at where the investigations went, including a new reservoir that is a potential source - the floor scrubber. Papers underpinning this work are here: 1. Benbow A, Clarke M, Yates C, Montgomery R, Staniforth K, Boswell T, et al. Hospital-wide healthcare-associated carbapenemase-producing Enterobacterales outbreak: risks of electric floor scrubbers in catering facilities and kitchens. J Hosp Infect. 2024;146:59-65. https://www.ncbi.nlm.nih.gov/pubmed/38341149 2. Prescott K, Billam H, Yates C, Clarke M, Montgomery R, Staniforth K, et al. Outbreak of New Delhi Metallo-Beta-lactamase Carbapenemase Producing Enterobacterales on a bone marrow transplant unit: Role of the environment. Infect Prev Pract. 2021;3:100125. https://www.ncbi.nlm.nih.gov/pubmed/34368742

In this episode, Martin Talks to Dr Mark Wilcox OBE, Professor of Microbiology at the University of Leeds, Head of Microbiology Research & Development at Leeds University Hospitals NHS Trust and National Clinical Director for Infection Prevention and Control at NHS England. We mull over the possible reasons for the increase in hospital-onset, hospital attributed cases in England, including ribotypes and antibiotic use. Given that the NHS is under great stress, we discuss the damage potential from a ribotype 955 which shares some genetic characteristics with the 027 ribotype that caused so many problems in the UK and worldwide in the early 2000s. One thing that we agree on is that reductions targets (with teeth) have been very successful in the past and should we venture in that direction again? Information on data collection, hospital and national typing reports for England can be found here: https://www.gov.uk/government/collections/clostridium-difficile-guidance-data-and-analysis#epidemiology

In this episode, after an interesting discovery when searching Youtube, Brett and Martin mull over whether toilet plume is a risk factor for hospital-acquired pneumonia and C. difficile infections. The papers we discuss are listed below. https://doi.org/10.1016/j.ajic.2023.11.020https://doi.org/10.1016/j.jhin.2011.08.010https://doi.org/10.1111/ina.12406

We chat with Dr Deirdre Fitzgerald-Hughes and Aoife Kearney about a national survey undertaken in Ireland. In the survey, they explored CPE knowledge and practices of healthcare workers, including infection prevention and control staff. There were some interesting findings that may be useful in informing IPC education and training, including convincing people that they need to know more. The paper we discuss is: Kearney, A., Humphreys, H., & Fitzgerald-Hughes, D. (2023). Infection prevention and control policy implementation for CPE: A cross-sectional national survey of healthcare workers reveals knowledge gaps and sub-optimal practices. Journal of Hospital Infection. https://doi.org/10.1016/j.jhin.2023.12.007

In this episode, Martin Kiernan and Phil Russo talk to Professor Michael Borg of the Faculty of Medicine & Surgery in the Medical School at the University of Malta and Head of Department (Infection Control) at Mater Dei Hospital in Malta. We discuss a recent paper desctibing the stages that brought about a 90% reduction in MRSA bloodstream infections over a ten-year period. The main paper we discuss: Borg MA, Suda D, Tartari E, Farrugia C, Xuereb D, Borg Inguanez M. Preventing healthcare-associated MRSA bacteremia: getting to the root of the problem. Antimicrob Steward Healthc Epidemiol 2023;3(1):e248. https://doi.org/10.1017/ash.2023.518 Other papers by Michael include: https://doi.org/10.1016/j.jhin.2021.03.024https://doi.org/10.1016/j.jhin.2018.04.024https://doi.org/10.1016/j.jhin.2014.12.015https://doi.org/10.1016/j.jhin.2013.12.006https://doi.org/10.1016/j.jhin.2013.10.007https://doi.org/10.1016/j.jhin.2014.05.00

In this week's episode, Martin talks to Dr Tina Joshi, Associate Professor of Molecular Microbiology in Peninsula Dental School at the University of Plymouth, UK. We discuss her longstanding interest in Clostridioides difficile and her many publications, one of which on the effectiveness of hypochlorite (or lack of it) on spores has been widely covered in the media. We chat about spore attachment to surfaces, the effect of disinfectants and the differences between strains. Some of Tina's papers are listed here. https://doi.org/10.1128/AEM.01862-12https://doi.org/10.1111/lam.12768https://doi.org/10.1128/AEM.01090-19https://doi.org/10.1099/jmm.0.001550https://doi.org/10.1099/mic.0.001418

In our usual Christmas episode, Brett, Phil and Martin choose our papers and podcasts of 2023. Also this time, Martin set the three of us a challenge: to find an interesting IPC-related paper from the years of our birth (more challenging for some than others..). Martin also reveals the No 1 single in our respective countries on the day of our birth. For Martin, a near miss. For Phil, a very apt song and for Brett... well, his karaoke debut cannot be far off.. Happy holidays everyone! Martin's 1955 paper: Lowbury, E. J. (1955). "Cross-infection of wounds with antibiotic-resistant organisms." Br Med J 1(4920): 985-990. https://doi.org/10.1136/bmj.1.4920.985 Phil's 1964 paper: Murray, D. G. (1964). "Wound Infections after Surgery for Fractured Hip. A Follow-up Study." JAMA 190: 505-508. https://doi.org/10.1001/jama.1964.03070190025005 Brett's 1979 paper: Ehrenkranz, N. J. and S. J. Pfaff (1979). "Growth of hospital infection control programme and the infection control nurse." J R Soc Med 72(12): 888. https://doi.org/10.1177/014107687907201204 Our top papers Martin's favourite paper: Wolfensberger, A., L. Clack, S. von Felten, M. Faes Hesse, D. Saleschus, M. T. Meier, K. Kusejko, R. Kouyos, L. Held and H. Sax (2023). "Prevention of non-ventilator-associated hospital-acquired pneumonia in Switzerland: a type 2 hybrid effectiveness-implementation trial." Lancet Infect Dis 23(7): 836-846. https://doi.org/10.1016/S1473-3099(22)00812-X Phil's favourite paper: Peel, T. N., S. Astbury, A. C. Cheng, D. L. Paterson, K. L. Buising, T. Spelman, A. Tran-Duy, S. Adie, G. Boyce, C. McDougall, R. Molnar, J. Mulford, P. Rehfisch, M. Solomon, R. Crawford, T. Harris-Brown, J. Roney, J. Wisniewski, R. de Steiger and A. T. Group (2023). "Trial of Vancomycin and Cefazolin as Surgical Prophylaxis in Arthroplasty." N Engl J Med 389(16): 1488-1498. https://doi.org/10.1056/NEJMoa2301401 Brett's favourite paper: Seidelman, J. L., C. R. Mantyh and D. J. Anderson (2023). "Surgical Site Infection Prevention: A Review." JAMA 329(3): 244-252. https://doi.org/10.1001/jama.2022.24075

In this week's episode Phil and Brett mull over their wishlists for what they would want in a perfect IPC world. They turn out to be a pretty undemanding pair.. not. However they both see a future in which their wishes could become true. Unsurprisingly AI and automated surveillance loom large in their thoughts.

In this episode, Brett and Martin discuss a paper they were recently involved with - a systematic review and meta-analysis on prior room occupancy and the risk to the next person. This paper has been recently published in Infection, Disease and Health. Findings provide some evidence to help inform a risk management approach when determining patient room allocation. The risk of pathogen acquisition appears to remain high, supporting the need for continued investment in this area. Here is a link to the paper. In our discussion, we also mentioned a paper about nurses views on the environment and risk: Mitchell, B. G., Russo, P. L., Kiernan, M., & Curryer, C. (2021). Nurses' and midwives’ cleaning knowledge, attitudes and practices: An Australian study. Infection, disease & health, 26(1), 55-62. Link here: Nurses' and midwives’ cleaning knowledge, attitudes and practices: An Australian study

In this week's episode, Martin talks to Dr Jon Otter, epidemiologist, scientst, blogger and Joint Director of Infection Prevention and Control at Guy's and St Thomas' NHS Foundation Trust in the UK. We discuss a session at the recent ICPIC conference on the problems posed by plasmids in terms of outbreak detection, increasing antimicrobial resistance and environmental reservoirs. You can read more about Jon's thoughts in his excellent blog post at https://reflectionsipc.com/2023/09/14/cpe-and-plasmid-transfer-in-hospitals-what-can-we-do-a-rapid-reflection-from-icpic-2023/#more-5141 A paper we discuss from Kalisvar Marimuthu and colleagies can be found here https://www.nature.com/articles/s41467-022-30637-5 You can listen to Kalis discussing it on a previous podcast in our genomics collection here: https://infectioncontrolmatters.com/topics/methodology/

In this episode, Brett talks to Martin about a recent paper on the potential pitfalls of ice machines and following manufactures' instructions. The paper we discuss is called "How clean is your ice machine?" This paper was published in the journal of hospital infection: https://www.sciencedirect.com/science/article/abs/pii/S0195670123002700

In this episode, Martin talks to Dr Jinny Moore from the National Health Security Agency in England about detecting pathogens in the ICU environment. They discuss a recent paper where whole-genome sequencing (WGS) on presumptive S. capitis NRCS-A isolates was collected from infants admitted to nationwide NICU and from environmental sampling in two distinct NICUs. The discussion includes details on the approach to sampling (neonates and environment). Papers discussed: Detection, survival, and persistence of Staphylococcus capitis NRCS-A in neonatal units in England https://www.journalofhospitalinfection.com/article/S0195-6701(23)00234-7/fulltext Other papers of interest: Laurent F, Butin M. Staphylococcus capitis and NRCS-A clone: the story of an unrecognized pathogen in neonatal intensive care units. Clin Microbiol Infect. 2019;25:1081-5. https://www.ncbi.nlm.nih.gov/pubmed/30928561 Butin M, Martins-Simoes P, Rasigade JP, Picaud JC, Laurent F. Worldwide Endemicity of a Multidrug-Resistant Staphylococcus capitis Clone Involved in Neonatal Sepsis. Emerg Infect Dis. 2017;23:538-9.https://www.ncbi.nlm.nih.gov/pubmed/28221122 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5382751/pdf/16-0833.pdf Butin M, Martins-Simoes P, Pichon B, Leyssene D, Bordes-Couecou S, Meugnier H, et al. Emergence and dissemination of a linezolid-resistant Staphylococcus capitis clone in Europe. J Antimicrob Chemother. 2017;72:1014-20. https://www.ncbi.nlm.nih.gov/pubmed/27999045 Van Der Zwet WC, Debets-Ossenkopp YJ, Reinders E, Kapi M, Savelkoul PH, Van Elburg RM, et al. Nosocomial spread of a Staphylococcus capitis strain with heteroresistance to vancomycin in a neonatal intensive care unit. J Clin Microbiol. 2002;40:2520-5. https://www.ncbi.nlm.nih.gov/pubmed/12089273 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC120592/pdf/1550.pdf

This week, Martin talks to Dr Jennifer Meddings, Associate Professor at University of Michigan Health and Internist at Ann Arbor about a recently published survey looking at what interventions are commonly used to prevent device-associated infections. We discuss the findings and focus in on prevention of urinary catheter-associated infections and new devices that may have an impact. The paper can be found here: Saint, S., M. T. Greene, S. L. Krein, K. E. Fowler, K. A. Linder, D. Ratz & J. Meddings (2023) What US hospitals are doing to prevent common device-associated infections during the coronavirus disease 2019 (COVID-19) pandemic: Results from a national survey in the United States. Infect Control Hosp Epidemiol, 10.1017/ice.2023.65, 1-7. https://www.ncbi.nlm.nih.gov/pubmed/37259703 Other areas and papers that we discuss are here: New tools that have been developed and piloted in a large surgical collaborative in Michigan, in our project called SUCCESS: Surgical Urinary Catheter Care Enhancement Safety Study, which has focused on improving urinary catheter safety even beyond CAUTI prevention, including focus on reducing unnecessary use for several common elective procedures, standardizing diagnosis and management of urinary retention, and practices to reduce traumatic injury from catheters and improve success on first catheterization attempt: https://msqc.org/success/. Kuriyama, A., K. E. Fowler, J. Meddings, H. Irie, D. Kawakami, H. Iwasaki, M. Sakuraya, K. Katayama, Y. Tokuda & S. Saint (2019) Reducing unnecessary urethral catheter use in Japanese intensive care units: A multicenter interventional study. Infect Control Hosp Epidemiol, 40, 1272-1274. https://www.ncbi.nlm.nih.gov/pubmed/31558172 Patel, P. K., A. Gupta, V. M. Vaughn, J. D. Mann, J. M. Ameling & J. Meddings (2018) Review of Strategies to Reduce Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) in Adult ICUs. J Hosp Med, 13, 105-116. https://www.ncbi.nlm.nih.gov/pubmed/29154382 Patel, P. K., A. Gupta, V. M. Vaughn, J. D. Mann, J. M. Ameling & J. Meddings (2018) Review of Strategies to Reduce Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) in Adult ICUs. J Hosp Med, 13, 105-116. https://www.ncbi.nlm.nih.gov/pubmed/29154382 Meddings, J., S. Saint, S. L. Krein, E. Gaies, H. Reichert, A. Hickner, S. McNamara, J. D. Mann & L. Mody (2017) Systematic Review of Interventions to Reduce Urinary Tract Infection in Nursing Home Residents. J Hosp Med, 12, 356-368. https://www.ncbi.nlm.nih.gov/pubmed/28459908

In this episode, Martin Kiernan talks to Dr Giorgia Gon, Assistant Professor of Epidemiology, London School of Hygiene and Tropical Medicine about a briefing paper that identifies research priorities for healthcare cleaning in resource-limited settings. We discuss the process of determining the priorities, the groups involved and the final areas that should be targeted with research funding, including cost-effectiveness, the use of biocides or detergents and minimum requirements. You can find a copy of the CLEAN Briefing here Other papers of interest: 1. Cross S, Gon G, Morrison E, Afsana K, Ali SM, Manjang T, et al. An invisible workforce: the neglected role of cleaners in patient safety on maternity units. Glob Health Action. 2019;12:1480085. https://www.ncbi.nlm.nih.gov/pubmed/31154993 2. Gon G, Kabanywanyi AM, Blinkhoff P, Cousens S, Dancer SJ, Graham WJ, et al. The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals. Antimicrob Resist Infect Control. 2021;10:8. https://www.ncbi.nlm.nih.gov/pubmed/33413647 3. Storr J, Kilpatrick C, Lee K. Time for a renewed focus on the role of cleaners in achieving safe health care in low- and middle-income countries. Antimicrob Resist Infect Control. 2021;10:59. https://www.ncbi.nlm.nih.gov/pubmed/33762000

In this episode, Martin talks to Giovanni-Battista Fucini about a recent paper from Germany that examined infection rates in critical care in which it was reported that hospitals without sinks in patient rooms have lower infection rates. Newer hospitals in Germany tend not to have sinks in the patient rooms in ICU. The paper we discuss is here: Giovanni-Battista, F., C. Geffers, F. Schwab, M. Behnke, W. Sunder, J. Moellmann & P. Gastmeier (2023) Sinks in patient rooms in the ICU are associated with higher rates of hospital-acquired infections. A retrospective analysis of 552 ICUs. J Hosp Infect, 10.1016/j.jhin.2023.05.018. https://doi.org/10.1016/j.jhin.2023.05.018 Other papers of interest are: https://www.ncbi.nlm.nih.gov/pubmed/32224328https://www.ncbi.nlm.nih.gov/pubmed/32553019https://www.ncbi.nlm.nih.gov/pubmed/29409044https://www.ncbi.nlm.nih.gov/pubmed/29738784https://www.ncbi.nlm.nih.gov/pubmed/28235877https://www.ncbi.nlm.nih.gov/pubmed/36870392