A helpful new study has combined shoe-leather epi and WGS to establish a transmission rate of CPE in hospitalised patients. Overall, 3 (2%) of 152 exposed patients ended up colonised with the same CPE from 47 index patient exposures. None of the 54 exposed staff ended up colonised with CPE. This transmission rate is a bit lower than I would have expected, but it’s also not zero!Continue reading
“Gonna take you right in to the sink splash zone” (duh duh duh)
A great new little study has just been published in Infection Prevention in Practice by Mark Garvey and colleagues up in Birmingham investigating the sink splash zone in the ICU. The study certainly does identify elements of danger in the sink splash zone, and provides evidence of tangible transmission risk for Pseudomonas and other water-borne pathogens in the ICU.Continue reading
What the Cochrane “masks don’t work” review does (and does not) tell us
You may have seen some commentary and debate on a recently updated Cochrane review on physical interventions to interrupt the spread of respiratory viruses. I’m stepping into the debate only to clarify a few small points – and to provide an overview of what the review does (and does not) tell us. However, my firm advice is to read the review for yourself and come to your own conclusions.Continue reading
How often does colonization precede infection with MDR-GNB and VRE?
Ever found yourself wondering how often colonization precedes infection with MDR-GNB and VRE? A new systematic review and meta-regression in Lancet ID gives us a pretty solid answer: about 14% of MDR-GNB and 8% for VRE. This information is helpful for us to qualify the significance of acquiring these organisms in healthcare settings.Continue reading
HCAI and AMR point prevalence from Ukraine
JHI have just published an interesting point prevalence HCAI and AMR study from Ukraine. Headlines are that rates of both HCAI and AMR are higher than you’d hope to see, especially with rates of resistant to carbapenems in Gram-negative bacteria and meticillin in S. aureus.Continue reading
Comparing SARS-CoV-2 air and surface contamination in the first vs. second waves
Way back during the first wave of COVID-19 (April 2020), we got our swabs out and sampled surfaces and air across a range of settings in the hospital. This cross-sectional study identified SARS-CoV-2 RNA on a rather startling 52% of surfaces and 45% of air samples collected from across the hospital and some public areas. During the second wave (January 2021), we undertook a similar exercise, and identified a vastly different level of contamination with SARS-CoV-2 RNA: 5% of surfaces and 4% of air samples. What had changed between April 2020 and January 2021 to explain this difference? A whole host of things, and we don’t know for sure – but I suspect that improved testing availability and the introduction of masks for staff and patients were the most important factors.Continue reading
Omicron and the diminishing spectre of long COVID
As we move on the journey to ‘Living with COVID’ and in doing so tolerate a greater risk of transmission of SARS-CoV-2 in society and in our hospitals, one of the issues is the threat of “long COVID”. A recent study suggests that long COVID is less common with Omicron than with previous variants, and that vaccination is effective in preventing long COVID.Continue reading
Antibiotic allergy labelling: addressing an important public health issue
As we hear about rises in iGAS, the issue of antibiotic allergy – and specifically penicillin allergy – labelling comes to the fore. A good review here outlines some of the issues in this complex space, and makes some helpful suggestions about how this could be improved.Continue reading
Finally, an RCT comparing N95s and medical masks to protect healthcare staff from COVID-19
Annals of Internal Medicine today published an RCT comparing the effectiveness of N95s vs. medical masks to protect healthcare staff from COVID-19. It’s a great piece of work, conducted over many years, and whilst the study has some important limitations, suggests that N95s don’t offer significantly increased protection than medical masks for healthcare staff caring for patients with confirmed or suspected COVID-19.Continue reading
Three key headlines from ESPAUR 2022
Great to see another fantastic annual ESPAUR report. It really is marvellous to have such a clear picture of HCAI and AMR related trends. As ever, there is some good news and some not so good news. Here three key headlines:
- Trends in bloodstream infection, antimicrobial resistance, and antimicrobial prescribing have changed during the pandemic.
- Tackling deprivation is tackling HCAI and AMR.
- We need to keep an eye on CPE