I am currently reading ‘The Drugs Don’t Work’ by Professor Dame Sally Davies, Dr Jonathan Grant and Professor Mike Catchpole (yes, I know I’m several years late to this particular party). I might do a book review for the blog once I’ve finished it – but an interesting question emerged in the early chapters. The author seem to make a point of referring to ‘antimicrobials’ rather than ‘antibiotics’ in the early part of the book, but later on, antibiotics appears as a common term. Which got me to thinking about what is the most appropriate generic term for what most people would term ‘antibiotics’ (what your GP gives you when you’ve got a snuffle, I mean potentially serious bacterial infection)?
A really important point prevalence survey of CPE carriage in inpatients in a hospital in Manchester has just been published in the Journal of Hospital Infection. Important because of the high rate of carriage (11% of 662 patients included). Important because for every 1.6 known cases of CPE, there was an undetected case lurking, despite an extensive screening programme. Important because the lack of significant risk factors associated with CPE carriage suggests that it is distributed homogeneously, endemic in the population. And important because this is the first citable publication suggesting that Manchester has a problem with CPE, despite us having known about it for years via professional networks.
We have blogged before how CAUTI is rather ‘unloved’ as an HCAI prevention target. CLABSI reduction, on the other hand, is all the rage. Now, there is a key reason why this makes sense: outcome! A CLABSI is much worse news for a patient than a CAUTI. However, this doesn’t mean we should turn a blind eye to CAUTI, especially since CAUTI is a common root cause for CLABSI! In the US there is an addiional driver for preventing CAUTI: the costs associated with CAUTI are no longer reimbursed by insurers (since 2008). With this in mind, it was great to see a CAUTI reduction study published in NEJM recently (and see some interesting analysis on the Controversies blog).
Working on the principle that what goes up must come down is logical and I was interested to see the result of a small investigation into non-slip socks, currently in vogue for reducing harm due to falls. Nik Mahida and Tim Boswell collected socks from seven wards over two hospitals, collecting 54 pairs and sampling them the same day. The results were interesting. Continue reading
I found out about a new free online antimicrobial stewardship course yesterday. The course is a collaboration between the the University of Dundee and the British Society for Antimicrobial Chemotherapy, and comes highly recommended. The course is designed for healthcare professionals.
If anybody completes the course, I’d be interested to hear your feedback.
This study has just been published in the Journal of Hopsital Infection, showing that the introduction of hydrogen peroxide vapour (HPV) for the terminal disinfection of rooms vacated by patients with CDI was assocaited with a significant reduction in the rate of CDI, from 1.0 to 0.4 cases per 1000 patient days.
We welcome another guest post from Prof Peter Collignon (bio below) on the risk of antibiotic resistance in the food chain…
Codex has recently announced they are doing more work on antimicrobial resistance. This is an opportunity get Codex to have a couple of standards to better protect public health from one of the worst types of antibiotic resistance that might develop in the next few years or decade. Specifically to help prevent carbapenem-resistant bacteria transferring to people via the food chain including via imported foods into countries (some useful background on this issue from European Food Safety Authority (EFSA) here).