From collateral damage to collateral sensitivity

“Every disadvantage has an advantage” is one of the many brilliant quotes from the late Dutch philosopher Johan Cruijff. This now also seems to hold for antibiotic resistance. The conventional belief is that resistance development is unidirectional: pathogens cumulatively acquire resistance traits, until being a multidrug resistant superbug. This now seems not always true; resistance development to antibiotic A, may – at the same time – increase susceptibility to antibiotic B, a phenomenon called “collateral sensitivity” that may help us in treating chronic infections. Continue reading

Advertisements

Do single rooms prevent HCAI? This suggest suggests YES for norovirus, but no for C. difficile infection and E. coli BSI

There are pros and cons of increasing the proportion of single rooms. One of the commonly-cited pros is a reduction in HCAI. A recent UK study provides some evidence that C. difficlie infection, and MSSA /  E. coli BSIs are not reduced by a move to a hospital with more single rooms, but that norovirus control is more effective when you have more single rooms.

Continue reading

What’s up for 2018?

I hope you enjoyed Christmas time and wish you all the best for this year. From my side, I will continue to reflect what I meet professionally, what surprises me, confirms what I thought to know or what confirms my ignorance. In 2017 I did that 41 times (a surprise to me!) and here are some trending topics that will most likely return in 2018. Continue reading

Santa’s little helper: engaging children to create information for patients

A cracker in the Christmas BMJ reports the insightful use of children to help create patient information leaflets. Whilst the article is tongue-in-cheek, in the spirit of the Christmas BMJ, there may just be something in it!

Continue reading

Fear and hierarchy as drivers for antimicrobial prescribing

Surgical antimicrobial prophylaxis (SAP) is one of the areas of strength in the infection prevention literature: we have high quality evidence that it works, and evidence-based guidance on how to do it effectively. And yet, you don’t have to spend long in an operating theatre to see that it’s not always done according to local guidelines. So, why are these evidence-based guidelines for SAP not implemented effectively? A short review in the Journal of Hospital Infection highlights social factors, specifically fear and hierarchy, as important drivers of antimicrobial prescribing.

Continue reading