SSIs – time to de-invest in laminar flow?

Laminar flow is a very embedded technology for the prevention of SSI in some types of surgery (especially hip and knee arthroplasty). However, it seems from a recent Lancet ID review that this widely adopted practice is way ahead of the evidence supporting it: the bottom line finding of the review is we should stop wasting time and money on laminar flow theatres for some procedures, and focus on basic prevention initiatives (especially getting antibiotic prophylaxis right) in all surgical categories.

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More coffee = less AMR?

This one is for lovers of the brown stuff (no, the other brown stuff). I was taken by a large impressive epi study published in AIM showing that coffee consumption is associated with reduced all-cause mortality. Part of this seems to be tied up in a modified inflammatory response. Whilst the study didn’t mention infection specifically, clearly infection and inflammation are closely linked. So, this got me to asking whether anybody has looked at coffee consumption and infection / AMR outcomes?

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The anatomy of a good blog

ICHE recently published an unusual article (which other article has ‘the world wide web’ as their setting) on blogging in ID and clinical micro. The article reviewed around 100 blogs and rated them using a multifaceted tool. The article has some useful qualitative feedback from bloggers and readers, and identifies some gaps in the blogosphere (especially around antimicrobial stewardship). Rachael Troughton, one of the study authors, recently published a post on the article – and here’s my take on it.

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The ethics of MDRO screening

I heard an interesting talk by Dr Michael Miller last week on the ethics of screening for MDROs. Whilst we need to think carefully about the ethics of all medical procedures (great and small), I think the benefits to the individual and the population generally outweigh downsides for MDRO screening programmes.

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CPE screening Q&A: the who, when, and how

I gave a talk yesterday as part of a PHE London event on the whys and wherefores of screening for MDROs – my talk was focussed on CPE, and you can download my slides here: “CPE: seek and ye shall find”. I thought a quick Q&A would be the best way to summarise the content.

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Does reducing spore contamination on high-touch surfaces reduce C. difficile transmission?

Curtis Donskey’s group recently published a multicentre randomised trial in 16 US hospitals to evaluate the impact of an enhanced cleaning programme (including fluoruescent markers, environmental cultures, and feedback to cleaners) on the transmission of C. difficile. The intervention resulted in an increase in the removal of fluorescent markers, a reduction in environmental contamination with C. difficile, but no reduction in healthcare-associated CDI!

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Take care. Not antibiotics.

Mindful of our need to up our game in terms of communication to non-experts around AMR-related issues, I have been scouting around for a good video to portray the basic of AMR, and came across this by Health Education England. It’s not the best animation that I have seen, but I quite like it – and the strap line at the end is interesting (“Take care. Not antibiotics”). I’d be interested in your views on this video, and please feel free to flag any other good ones out there.