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.)
The next iteration of the annual ESPAUR report has been published. It’s a comprehensive, epic tome (almost 200 pages, plus an online appendix if that’s not enough for you!) so, I’ve summarised a few key points here – but the whole report is well worth a read. The number of Gram-negative BSIs is increasing (and we don’t know why); overall antibiotic prescribing is down driven by GP reductions; there’s a small increase in antibiotic prescribing in hospitals overall but early success in reducing broad spectrum agents (pip/tazo and carbapenems); and the results of the national PPS are out!
A quick post to highlight that it’s International Infection Prevention Week (IIPW). IPS and APIC have published a few useful resources:
I heard an eye-opening talk at IPS about the cost of HCAI-related litigation to the NHS. This is something that gets talked about a lot in economic analyses (“these figures do not include the cost of litigation”), but it is difficult to find accurate figures on the scale of the expense. Data from NHS Resolution* suggests that HCAI-related litigation costs the NHS in the region of £60m per annum, which accounts for around 4% of all harm settlements from NHS Resolution each year.
There has been a lot of concern in scientific journals and the mainstream media about colistin resistance in Enterobacteriaceae caused by plasmid-mediated resistance genes (the mcr genes). However, an article published today by our group suggests that mutational colistin resistance rather than plasmid-mediated mcr genes is a more pressing clinical threat.