Guest blogger, Dr Phil Norville (bio below) writes…
Wastewater systems (sinks, showers and more recently toilets) are attracting attention as their role in healthcare associated infections (HCAIs) continues to gathers evidence. In this blog we take a closer look at toilets and their potential role in transmission, as well highlighting some of the current challenges facing healthcare organisations around wastewater management.
Continue readingI have posted before about the “postcode lottery” and it’s influence on rates of MRSA, affecting deprived postcodes (or zipcodes!) more than others. But this issue is wider than regional influence. On an international scale, your changes of a bad outcome from infectious disease varies, sometimes wildly, by where you happen to be in the world. A new article in CID on clinical outcomes from carbapenem-resistant Acinetobacter baumannii infections bears this out.
Continue readingI’ve never been terribly good at philosophy but I’m going to have a go, because this is a conversation that we need to have, especially as we see the re-emergence of measles. This post has been inspired by a fascinating opinion piece in the Lancet Microbe called “Embracing the monsters: moving from infection control to microbial management”. I think the ideas are crystallised into something like this: it’s futile to aim for “pathogen eradication” – “microbial management” is a better approach to juggling our resources to get to the best overall population health outcomes.
Continue readingRead an interesting study in JHI with a novel design that I thought I’d share. The study team evaluated the scale of COVID-19 outbreaks across three hospitals in Wales based on characteristics of the ward. When controlling for the things that you think might predict the scale of COVID-19 outbreaks (like speciality, number of toilets, patient age), the thing that came out as the biggest drive of outbreak size was how many patient transfers occurred into the ward. This suggests that the advice from “central command” to minimise patient moves made sense, and still makes sense to reduce the risk of transmissible infectious diseases in our hospitals.
Continue readingA new study in JHI uses a pragmatic time series analysis to provide some data to suggest that stopping a universal mask mandate at St. George’s Hospital in London did not result in an increase in healthcare-associated SARS-CoV-2. The authors were careful to point out that the findings do not show that “masks don’t work”, but rather that in this setting, at this time of the pandemic, removing a universal masking mandate didn’t result in a detectable increase in the rate of healthcare-associated SARS-CoV-2.
Continue readingThe Christmas BMJ usually has something to do with infection or infection control. But this year it has excelled, with an article all about bacterial contamination of coffee machines! So, next time you press the magic button for a caffeine hit in the staff room, do you need to think twice? Well, not really – whilst a few possible pathogens were identified, your coffee isn’t likely to give you an antibiotic-resistant bacterium for Christmas!
Continue readingRemember all of those difficult decisions during the worst of the COVID-19 pandemic? Which patient gets the ventilator? Who gets the single room? What has to stop to keep on top of the continuous flow of new SARS-CoV-2 results to investigate? Well, one of those difficult decisions was whether or not to continue with screening and contact precautions to prevent the spread of MRSA. A US team made a compelling “natural experiment” out of the discontinuation of screening and contact precautions for MRSA, showing that this was associated with an increased risk of MRSA HCAI.
Continue readingColleagues from GSTT in collaboration with the Royal Free and St. George’s have just published a new paper evaluating the transmission dynamics of Omicron SARS-CoV-2 vs. previous variants in hospitalised inpatients in Infection Prevention in Practice. The key finding is that the median days to inpatient contact conversion were significantly fewer for Omicron SARS-CoV-2 when compared with previous variants (median 3 days for Omicron vs. 4 days for previous variants).
Continue readingI had the pleasure of doing a talk at Infection Prevention 2023 in Liverpool today, running down the top 10 scientific articles influencing our IPC practice over the past year. You can download my slides here.
I had some trouble selecting just 10 papers from the past year, and felt a strong sense of my own bias and limitations when going through the selection process. I have my own research and clinical interests, I don’t read anywhere near as many papers as I’d like, and 10 papers really isn’t that many! Also, I tried to countdown the papers from 10 to 1 with some kind of hierarchy. After a couple of false starts here (including the most read, most controversial, best designed), I settled on the most influential in terms of challenging our thinking or modifying our practice.
So, here goes…
Continue readingThis post follows hot on the heels of several other posts highlighting the potential benefits of water free care. A new retrospective cohort study in German ICUs has concluded that patients cared for in ICU single rooms or bays without sinks have fewer HCAI. Another nail in the coffin for sinks!
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Reflections on Infection Prevention and Control 