Trends in US antibiotic use: we’re creating a monster!

Always great to see infection-related data in the top medical journals, like the recent overview of antibiotic use in the US published recently in JAMA Internal Medicine. There’s good news and bad news in the article: overall use of antibiotics in data from 300 US hospitals did not increase between 2006 and 2012. However, the use of key broad spectrum agents did increase significantly, including the carbapenems. I am sure that many of these uses of ‘top shelf’ agents is indicated by the resistance patterns of the organisms being treated, but the net effect is perpetuating the antibiotic-resistant monster! Continue reading

Probiotics vs C. difficile

probiotics

C. difficile infection is a disease of dysbiosis – the most common pathology is that antibacterial agents disturb the balance of micro-organisms in the gut leaving C. difficle the ecological space to produce toxin and cause diseases. So, could it be that ‘probiotics’ could fill the ecological space and reduce the risk of CDI? Despite numerous trials, the jury is out!

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“HCAI”

Airquotes

I read a Controversies blog today, reflecting on a recent editorial suggesting that, because of frequent over-diagnosis, we should use quote marks every time we write “CAUTI” – and even use air quotes every time we say it! But why stop at CAUTI? Should we be talking about “CLABSI”, “CDI”, “SSI” and, well, any “HCAI” really?

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All BSIs are expensive, not just antimicrobial resistant ones

bsi

Eurosurveillance have recently published a study from the TIMER group evaluating the impact of antimicrobial resistance on hospital mortality, excess length of stay (LOS), and cost of BSI in European hospitals. The study highlights the high cost of BSIs, especially when antimicrobial resistant.

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Cleaning and disinfection survey

See below details of a survey that you may find interesting to complete. I had a small role in providing some feedback on an earlier version of this survey and I hope it will serve to highlight areas that require more thought and / or research…

On behalf of the International Society of Chemotherapy (ISC)  working group on Infection Prevention we would be grateful if you could complete this anonymous survey.

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Back to the floor..

flooringA little while ago I blogged about the excellent study from Nottingham that demonstrated significant VRE and MRSA contamination on socks used to prevent falls in the hospitalised elderly. This has been followed by another paper suggesting that shoe coverings undurprisingly become contaminated. So, what? How does this really impact on transmission? A new study from Curtis Donskey’s group has looked at hand contamination in patients directly relating to floor contamination. Continue reading

CPE carriage: a rare event in London?

My old CIDR team have just published a study in JAC reporting a very low rate of carriage of CPE in patient admitted to a hospital in central London (just 5 (0.1%) of 4006 patients). This was a lot lower than we expected! Despite the very low rate of carriage, overseas hospitalisation was a significant risk factor for CPE carriage, and supports that we should be screening patients with recent overseas hospitalisation for CPE carriage.

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