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?
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.
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.
A 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
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.
We have precious little data on what works to prevent the transmission of MDR-GNR. An interesting article published recently in CID provides invaluable data that an infection control programme aimed at reducing MRSA (and succeeding) was also effective in reducing GNR BSI!
It’s great to be able to report some much-need progress on the drug discovery front, with a Nature paper about a new antibacterial, lugdunin. Lugdunin is produced by S. lugdunensis and probably explains why this organism can out-compete S. aureus to colonise the nasal passages. Whilst the research has generated a great deal of positive press coverage – and so it should – but much like teixobactin, it will not go far to alleviate our problems with anti-infective-resistant bacteria.
Guest blogger Dr Tim Rawson (bio below) writes…
With antimicrobial resistance taking its place alongside climate change on the global political agenda, the role of antimicrobial stewardship in healthcare has come to the forefront. Being a good steward of antibiotics goes beyond simply possessing the technical ability to maintain the effectiveness of antimicrobials. It requires an understanding of why we all, as healthcare providers, should practice stewardship and an ability to confront many of the social and behavioural barriers preventing good practice. Whilst the infection community and some policy makers are now highly engaged with antimicrobial resistance, there is very little evidence to support engagement with AMS-AMR within other clinical specialties.
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.
Reflections on Infection Prevention and Control 