There has been much discussion about the risk of Mycobacterium chimaera infections associated with contaminated heater-cooler units (HCUs) used in cardiothoracic surgery. A study published recently in CID explores the risk in the UK, and provides further evidence to link these tricky-to-treat infections to contaminated HCUs.
The World Health Organisation has updated its 2009 Guidelines on Core Components of Infection Prevention and Control Programmes. The report highlights eight ‘core components’ for IPC:
WARNING: This isn’t a heart-warming Christmas tale. It’s actually rather sad.
In Christmas BMJ classic, a team of US researchers have explored associations with Sanda Claus not visiting paediatric wards over Christmas 2015. Whilst I am pleased to report that Santa made an appearance on 90% of the wards overall, heart-wrenchingly, Santa was least likely to visit paediatric wards in the most deprived areas.
The risk of interspecies transmission of carbapenemase genes is a real concern. We can barely get our heads around many different types of carbapenemase in a whole host of Gram-negative bacteria (compare the relative simplicity of methicillin resistance in S. aureus: a single gene, in a single species). Throw in interspecies horizontal transmission of carbapenemases and things get really tricky! Do we implement different control strategies to try to interrupt the transmission of carbapenemases (in contrast to the organisms themselves)? Could you have a multispecies outbreak of a carbapenemase on your hands and not even realise it?
What do you do to prevent VRE transmission?
…you are not alone, if the answer to this question is ‘nothing special’, based on survey published in ARIC! Dale Fisher’s team in Singapore put together a simple survey, asking the global IPC community what measures they have in place to prevent the transmission of VRE. There was a huge degree of variability, ranging from ‘nothing special’ to ‘the kitchen sink’!
An interesting review article examines the relationship between three related variables: the proportion of single rooms, the size of the patient room and patient proximity, and the availability of antiseptic hand rub, with various HCAI indicators. The bottom line is that both a move towards a higher proportion of single rooms and larger patient rooms are associated with reduced HCAI, and making hand gels more available improves compliance with their use (unsurprisingly).
I am just getting around to reading (well detail-scanning the exec summary) of the ESPAUR report. My main reflection is what a fantastic resource this reporting stream offers us: to have freely accessible, regular, accurate, national data on antimicrobial resistance and usage, and other related indicators is pretty unique!
The Department of Health announced last week their intention to halve the rate of E. coli BSI by 2020. Whilst this is a move that should be embraced, it will be an enormous challenge to achieve. The reduction that has been delivered with MRSA BSI could be seen as a model for success (and I suspect that if you were a politician, you would see it this way). However, it is vital to recognise that E. coli BSI and, more broadly, Gram-negative BSI (GNBSI) are not the same as MRSA BSI, and will require a different reduction strategy.
The Royal Brompton in London report a 50 case outbreak of C. auris, and a range of IPC measures that you would expect to prevent further transmission, but failed to do so. What’s so special about Candida auris? Is it a superfungus?
A very enjoyable few days in Edinburgh this week for the Federation of Infection Societies / Healthcare Infections Society (FIS/HIS) meeting. Some reflections follow…
Reflections on Infection Prevention and Control 