An interesting publication on the control of CPE last week. Not in Nature, Science of Journal of Hospital Infection, but in the “Staatsblad van het Koninkrijk der Nederlanden”. The paper, “Besluit van 26 april 2019, houdende aanpassing van het Besluit publieke gezondheid vanwege een meldingsplicht voor Carbapenemaseproducerende Enterobacteriaceae”, with King Willem-Alexander as first author, implies that on April 26th it was decided that from July 1st 2019 on, by law, all CPE detected in the Netherlands must be notified, see. A next step in our war against CPE.
Year: 2019
Make sure a (CPE) iceberg doesn’t sink your ship
An interesting modelling study has quantified the size of the CPE iceberg lurking under the water when CPE is only detected by clinical cultures and no active screening is done. And the CPE iceberg is larger than you may think!
The challenges of detecting colistin resistance in CPE
Colistin resistance in CPE is bad news. Colistin is an older antibiotic that has been effectively brought out of retirement to tackle CPE infections. We have first-hand experience of witnessing the emergence and spread of colistin resistance in CPE – and it’s not a pretty sight. Colistin susceptibility testing is very tricky from a diagnostic laboratory viewpoint – and so I was interested in this recently published paper from colleagues at Imperial evaluating a rapid MALDI-TOF based approach to detecting colistin resistance, which looks very promising indeed.
We need to win hearts and minds to improve hand hygiene practice
I listened to Reflections’ very own Martin Kiernan share his wisdom on the challenges around hand hygiene improvement this week, and thought I’d share my own reflections on his talk. The key point seemed to be that we have some way to go in winning the hearts and minds of our frontline clinical colleagues if we are to improve hand hygiene practice across the board.
CPE in drains: a light at the end of the drain pipe?
We have been posting for a while about the emerging recognition of CPE contamination of drains in clinical settings, which seems to be fueling some CPE transmission. Until now, there’s been plenty of publications identifying the problem, but very few presenting a solution. In fact, attempts to tackle CPE contamination of drains have had moderate impact, at best. A new short study in ICHE illustrates the potential of a foaming hydrogen-peroxide based disinfectant to tackle contamination with resistant Gram-negative bacteria in drains.
Four little words…Clean care for all
Guest bloggers Claire Kilpatrick and Julie Storr (hand hygiene consultants at the WHO, @safesafersafest) post…
Three little words, behind which lay 40 years of a global aspiration. Health for all. Last year the world recommitted to Alma Ata and renewed the global focus on health as a fundamental human right. In 2019, WHO’s 5 May global hand hygiene campaign evokes the spirit of health for all with its own four words: Clean care for all. How is this relevant to infection prevention and control (IPC) on a day to day basis, particularly for the other 364 days of the year?
Persistence and transmission of Candida auris on and from gloves
Interesting results from Jabeen et al. that many of us might have missed, as they are published in a mycology journal and not in an infection control journal. Persistence of Candida spp. on latex and nitrile gloves was highest for C. auris and C. parapsilosis. Interestingly, persistence on nitril gloves was generally less than on latex gloves. Transmission of Candida spp. from gloves (latex, nitril not tested) to urinary catheter surface was most effective for C. auris and C. albicans.
To be frank, the chosen methods and set-up of the experiments leave quite some room for improvement, but the basic idea of the experiment and the message it conveys are – while not new – of importance: Glove use can be an important factor in the spread of all microorganisms, and in this case, especially C. auris.
Previously it has been shown that glove-use may negatively effect hand hygiene behavior. After years of focusing our attention on hand hygiene compliance and hand-rub technique, this publication is an important reminder, to not forget about adequate glove-use.
Jabeen K, Mal PB, Tharwani A,Hashmi M, Farooqi J. Persistence of Candida auris on latex and nitrile gloves with transmission to sterile urinary catheters. Medical Mycology, 2019, 0, 1–5 doi: 10.1093/mmy/myz033 Advance Access Publication Date: 0 2019
“It’s in Your Hands” – time to sing along
Friends and colleagues in Geneva have just released a song written and performed for the upcoming World Hand Hygiene Day. It’s a catchy tune with a nicely produced video – and a strong message in the chorus:
‘Hands are such a simple thing, but our hands can change most everything. Keep care safe and take a stand, clean care for all – it’s in your hands.”
Have a listen and see what you think:
The winner takes it all for S. aureus
As usual, some of the most interesting presentations at ECCMID were in the late-breakers “clinical trials” session. Four of 5 presentations were on treatment or prevention of S. aureus infection, the other one on oral treatment in patients with refractory fungal disease. With all respect to fungi, the meat was in the aureus, with nothing less than a Shakespearian tragedy. Continue reading
The continuous need of outcome data of continuous beta-lactam infusion (or not?)
When I received this invitation for a PRO-CON, I accepted within 1 minute. Only later to realize that it was on “Optimised dosing according to PK/PD principles in patients – does it improve the efficacy of antibiotics?” Luckily I was given the CON, but I was in a poor position upfront: In a twitter poll 93% of voters were PRO (bias not excluded) and my opponent was Jason Roberts. So, this was my line of reasoning: Continue reading
Reflections on Infection Prevention and Control 