The Christmas BMJ usually has something to do with infection or infection control. But this year it has excelled, with an article all about bacterial contamination of coffee machines! So, next time you press the magic button for a caffeine hit in the staff room, do you need to think twice? Well, not really – whilst a few possible pathogens were identified, your coffee isn’t likely to give you an antibiotic-resistant bacterium for Christmas!
Continue readingYear: 2023
Screening and contact precautions reduces the risk of MRSA HCAI
Remember all of those difficult decisions during the worst of the COVID-19 pandemic? Which patient gets the ventilator? Who gets the single room? What has to stop to keep on top of the continuous flow of new SARS-CoV-2 results to investigate? Well, one of those difficult decisions was whether or not to continue with screening and contact precautions to prevent the spread of MRSA. A US team made a compelling “natural experiment” out of the discontinuation of screening and contact precautions for MRSA, showing that this was associated with an increased risk of MRSA HCAI.
Continue readingEvaluating the transmission dynamics of Omicron SARS-CoV-2 vs. previous variants in hospitalised inpatients
Colleagues from GSTT in collaboration with the Royal Free and St. George’s have just published a new paper evaluating the transmission dynamics of Omicron SARS-CoV-2 vs. previous variants in hospitalised inpatients in Infection Prevention in Practice. The key finding is that the median days to inpatient contact conversion were significantly fewer for Omicron SARS-CoV-2 when compared with previous variants (median 3 days for Omicron vs. 4 days for previous variants).
Continue readingThe “top 10” scientific articles influencing our IPC practice over the past year
I had the pleasure of doing a talk at Infection Prevention 2023 in Liverpool today, running down the top 10 scientific articles influencing our IPC practice over the past year. You can download my slides here.
I had some trouble selecting just 10 papers from the past year, and felt a strong sense of my own bias and limitations when going through the selection process. I have my own research and clinical interests, I don’t read anywhere near as many papers as I’d like, and 10 papers really isn’t that many! Also, I tried to countdown the papers from 10 to 1 with some kind of hierarchy. After a couple of false starts here (including the most read, most controversial, best designed), I settled on the most influential in terms of challenging our thinking or modifying our practice.
So, here goes…
Continue readingWater-free critical care demands our attention
This post follows hot on the heels of several other posts highlighting the potential benefits of water free care. A new retrospective cohort study in German ICUs has concluded that patients cared for in ICU single rooms or bays without sinks have fewer HCAI. Another nail in the coffin for sinks!
Continue readingCPE and plasmid transfer in hospitals – what can we do? A rapid reflection from ICPIC 2023
I’ve had the pleasure of a few days in Geneva enjoying some fine Swiss hospitality, and fine science at ICPIC 2023. Here’s rapid reflection on scaling the risks attached to plasmid-mediated transmission of CPE, and what we can do about it (or not…!).
Continue readingEmbracing patients as effective hand hygiene observers
We can have a long discussion about whether we should routinely collect observational hand hygiene compliance information – I think we should, but others take a different view. But if we decide to collect routine hand hygiene compliance information, there are limitations of what is achievable. A recent study in JHI evaluated using patients as hand hygiene observers in an outpatient setting, which seemed to work pretty well.
Continue readingWe might need Mr Motivator to really improve hand hygiene behaviours
Working in IPC, you get interested in hand hygiene compliance, whether you like it or not! I was struck by a recent quanti/quali (yes, qualitative!) study in the Journal of Hospital Infection exploring drivers towards hand hygiene compliance. The key findings is that, all other things considered, individual motivation is the biggest driver towards hand hygiene compliance. So, perhaps we need to enlist the services of Mr Motivator*?!
Continue readingBundles of success in SSI prevention?
Surgical site infection (SSI) frustrates me. When we undertake elective procedures, we have much more control over processes and patient flows than in most other aspects of hospital life. We have a range of evidence-based interventions, and we know that if we get them right, the risk of SSI is reduced hugely. And yet, preventable SSIs continue to occur because we don’t always get the bundle of interventions implemented. And so patients suffer harm, our theatres and precious beds have to do subsequent procedures related to SSI, costs ramp up, and we have to use more and more antibiotics. I gave a webinar last week providing an overview of the bundle of interventions at our disposal to reduce the risk of SSI.
Having a nose into nasal photodisinfection
When’s the last time you picked your nose? If you’re an adult, it was very probably earlier today – the average adult picks their nose around 4 times per day (eew). And that’s picking – touching is much more frequent: on average, we touch our eyes, mouth, nose, or chin a staggering 20 times per hour (with some estimates even higher). We’ve known for a while that nasal decolonisation is a vital component in reducing the risk of staphylococcal infection. But using mupirocin as the nasal decolonisation agent has important limitations in terms of spectrum of microbiological efficacy, compliance, and antibiotic resistance. I’ve recently come across a newer technology for nasal decolonisation: nasal photodisinfection. It’s been around for ages, but hasn’t really been adopted widely. This blog provides an overview of three studies that suggest nasal photodisinfection may have a role in reducing the risk of SSI, and in preventing and treating SARS-CoV-2 infection.
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Reflections on Infection Prevention and Control 