This recent study from the Donskey group could provide hospital cleaning staff with a powerful visual cue to help assure adequate disinfectant coverage. The addition of a chemical widget to bleach solution gives it a bright blue hue when applied to surfaces, so allowing a cleaner to track their progress visually!
Author: Jon Otter (@jonotter)
The Truth About Hawaii
I caught the 15 minute drama on BBC R4 today (The Truth About Hawaii) and, to my surprise, it was a post-antibiotic apocalypse story. A ten year old girl gets a scratch on the knee that develops into a serious infection that without antibiotics has become life threatening. The Prime Minister is personally involved in enforcing a restriction policy for the last remaining antibiotic. And, as with pretty much every other Radio 4 drama, a happy ending seems unlikely.
Do single rooms prevent HCAI? This suggest suggests YES for norovirus, but no for C. difficile infection and E. coli BSI
There are pros and cons of increasing the proportion of single rooms. One of the commonly-cited pros is a reduction in HCAI. A recent UK study provides some evidence that C. difficlie infection, and MSSA / E. coli BSIs are not reduced by a move to a hospital with more single rooms, but that norovirus control is more effective when you have more single rooms.
Top 10 reflections from 2017
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!
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?
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.)
Reflections on Infection Prevention and Control 