A rather disturbing NEJM case report to kick us off for 2025 – a previously healthy 13 year old girl with severe respiratory infection due to influenza A (H5N1) bird flu in Canada. The girl came through ECMO and survived. But it’s a salutary lesson of what influenza – and especially H5N1 influenza – can do! There’s a lot of flu around at the moment (of various types), so please get your flu vaccine if you haven’t done so already – it’s good for you and those around you if you do.
Continue readingAuthor: Jon Otter (@jonotter)
Farewell 2024 – ESPAUR helps us to set priorities for 2025
As we bid farewell to 2024, a time for reflection, objective setting, and the odd new years resolution to break early in 2025. The latest ESPAUR report was published a few months ago, and helps us to set some priorities for 2025 and beyond. As ever, there’s a mixture of good news and bad news in the report, but mostly I’m grateful that we have sufficient data and co-ordination to give us this level of detail about the current and emerging threats related to HCAI and AMR in the UK.
Continue readingAre we ready for automated hand hygiene monitoring?
Have you ever read an IPC report that says something along the lines of “we did lots of observational hand hygiene compliance auditing, and compliance was 99%”? Well, we know that back in the real world hand hygiene compliance is typically 40%. Whilst we can do better with observational hand hygiene compliance audits, and make them a realistic starting point for improvement, there’s a real opportunity for automated hand hygiene monitoring systems to come in and shake up our understanding of hand hygiene compliance in a really positive way. But are the systems up to it? And are we ready for them? Today’s study in Infection Prevention in Practice from Denmark shows that an automated hand hygiene system can be implemented and generate some really useful hand hygiene surveillance information.
Continue readingIPC training: there has to be a better way than “death by powerpoint”!
I was on the train last week on the way to work knowing that my first task of the day was to deliver a lecture on “Creative IPC Issues” to some student nurses. I reviewed the 60-strong slide deck that I’ve run through before and, honestly, my heart sank at the thought of running through them again. If that’s how I was feeling about the session, how could I possibly have delivered effective education? So, slightly impulsively, I threw out the slides and created some interactive scenarios to give an illustration of what it’s like to work in IPC (covering various microbial threats, risk identification and management, staffing challenges, relationship with partners, the regulatory environment, and quality improvement). Whilst I haven’t actually received formal feedback from the group, everybody seemed interested and engaged (in contrast to the previous 60-slide-death-by-powerpoint version!) – and if nothing else, I enjoyed it (which is an important part of delivering effective education.
Continue readingC. auris – overview of an emerging threat
Useful Candida auris review just published in NEJM. Well worth a read. Here are some brief highlights and points for discussion.
Continue readingAntimicrobial surfaces: time to rethink surface disinfection?
As we enter World AMR Awareness Week for 2024, there is an increasing recognition that we are coming towards the end of antibiotics in some settings. Prevention is undoubtedly better than cure. Developing whole new classes of antimicrobial agents is unlikely to dig us out of the AMR mire, but getting better at preventing them is a hugely important part of our response to the AMR threat. Into this context lands today’s study – a randomised intervention study on the impact of introducing an antimicrobial surface coating in an Emergency Department setting. The results were positive, with the antimicrobial surface coating associated with lower levels of microbial contamination. Does this prompt a rethink of our approach to surface disinfection? A reminder that this paper will be the subject of tomorrow’s Journal Club (register here).
Continue readingMpox clade Ib: the next pandemic?
The Mpox outbreak in the Democratic Republic of Congo (DRC) continues, with the latest estimates suggesting that there have been >25,000 cases and >700 deaths since the beginning of 2023. There have been three cases of confirmed Clade Ib Mpox reported in the UK in the past week. I posted recently with some background info on the epi of Mpox. Today’s post is based on an epi modelling study exploring key epidemiological parameters of Clade I Mpox based on historical data to inform our understanding of the Clade Ib outbreak: the incubation period, serial interval, generation interval, and reproduction number. There will be an IPC Partners Journal Club on this study next week on Weds 13th November (register here).
Continue readingAn update on UV room disinfection and HCAI
I was interested to read a randomised controlled trial of pulsed xenon UV (PX-UV) for room disinfection in Clinical Infectious Diseases. In this study, PX-UV was not associated with a reduction in HCAI. Some may be quick to say that this provides evidence that “automated room disinfection systems don’t work”, but there are important differences in the technologies involved as well as the usual strengths and limitations of the study methodology that could explain this outcome.
Continue readingWant to reduce HCAI? Then employ a few more staff in your infection prevention department!
A useful US study has explored the ratio between infection prevention staffing levels, facility size, and HCAI-related outcomes. The reassuring news is that there was some correlation between IPC staffing levels in HCAI-related outcomes, suggesting that we are doing something right as a profession!
Continue readingPeripheral vascular access: we can do better!
We know all about reducing risks from central venous catheters (CVCs). Matching Michigan. High Impact Interventions. And reductions in CVC-associated BSIs. But we don’t spend enough time or effort in addressing risks associated with peripheral venous catheters. Infection Prevention in Practice recently published an expert opinion piece about achieving best practice in the use of PVCs.
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Reflections on Infection Prevention and Control 