As we come towards the end of 2017, we’d like to take the opportunity to thank you all for reading Reflections: we hope you have enjoyed reading it as much as we have enjoyed writing it!
Year: 2017
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!
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.
Online HCAI / IPC / AMR / AMS / training resources
I am on the hunt for some free online training resources for HCAI / IPC / AMR / AMS / IPC, at a basic, intermediate, or advanced level. Here’s a summary of what I’ve unearthed so far.
CPE guidelines galore: ECDC and ACSQH join the party
I recently posted on the WHO CPE guidelines. A couple of people have alerted me to two other recently published guidelines, one from ECDC, and the other from Australian Commission on Safety and Quality in Healthcare. So, we now have a wealth of guidelines to prevent and control CPE. But how to they compare?
The prevention paradox: E. coli versus Klebsiella
The prevention paradox, as described in 1981, is the “seemingly contradictory situation where the majority of cases of a disease come from a population at low or moderate risk of that disease, and only a minority of cases come from the high risk population (of the same disease). This is because the number of people at high risk is small”, see. In our world this reflects the question how to prevent transmission of ESBL-producing E. coli (ESBL-EC) or K. pneumoniae (ESBL-KP), or both. A new study may help to decide. Continue reading
What about E. coli ST131?
One of the faces of the global antibiotic resistance crisis is Escherichia coli ST131, frequently portrayed as a pandemic clone, combining hypervirulence, ciprofloxacin resistance and ESBL production. A recent study in Genome Research, a journal you may not read every month, though, sheds a whole new light on this “superbug”. Continue reading
Mapping C. dfficile hospital acquisition: short-stay diagnostic areas are important!
Recent genomic studies have concluded that hospital-acquired acquisition of C. difficile is rare, suggesting that acquisition of C. difficile outside of hospitals followed by hospital-onset disease is the most common explanation for C. difficile infection. These studies hinge on an assumption that in-hospital patient contact occurs due to shared or recent stay on the same hospital ward. A short publication in JAMA Internal Medicine eloquently challenges this assumption, suggesting that hospital contact that we would usually assume to be casual and not a risk for acquisition of hospital pathogens (e.g. short-stay diagnostic areas such as ultrasound and endoscopy) can be an important source of acquisition.
The importance of patient sharing between hospitals on MRSA transmission
In a remarkable quirk of academic publishing, two virtually identical studies by separate research groups in the UK (one in London, and one in Cambridge) published a week apart have come to the same conclusion: that we are missing a sizable portion of MRSA transmission by focussing solely on wards in a single hospital. A referral-network level view is required for an accurate picture of MRSA transmission. (You may have seen some press about the Cambridge article, e.g. on the BBC here.)
WHO guidelines for the prevention and control of carbapenem-resistant organisms
WHO have just released some guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aerugionsa. This guideline builds on the excellent WHO core components for IPC guidelines.
Reflections on Infection Prevention and Control 