There has been a lot of excitement about the prospects of whole genome sequencing (WGS) to support infection prevention and control in a really meaningful way over the past decade or two. But to me this potential seems largely unfulfilled. WGS remains largely the domain of reference and research laboratories, and has not transitioned effectively to support IPC daily decision making. A recent review highlights the potential of WGS to support IPC, and identifies some of the barriers to be overcome if WGS really is to be a big part of our future in IPC.
Continue readingAuthor: Jon Otter (@jonotter)
Making peripheral vascular access a central focus
I did a talk at the Infection Prevention 2024 conference in Birmingham earlier in the week on ‘making peripheral vascular access a central focus’. Understandably for many reasons, much of our vascular access infection prevention effort is focussed on central lines. But this means we probably don’t spend enough time considering infection (and other complication) risks from peripheral vascular access and what we can do to prevent these.
Continue readingAvian influenza: it’s in the (waste)water
There is a sense of steadily building concern around avian influenza, remembering that an avian influenza outbreak would knock spots off COVID-19 (especially the modern variants) in terms of bad clinical outcomes. A letter in the NEJM relates wastewater surveillance in the state of Texas that has identified H5N1 avian influenza in all 10 cities in the surveillance programme since March 2024. This suggests that avian influenza is out there, and flying under the radar in animal populations. So, now would be a good time to dust down your pandemic influenza preparedness documents…
Continue readingImproving cleaning and disinfection of shared medical equipment: it’s time to ‘CLEEN between’
A fantastic new study from Brett Mitchell’s prolific group in Australia has recently been published in Lancet Infectious Diseases and the results are pretty spectacular. A fairly low cost intervention of an extra 3 hours of cleaning and disinfecting shared medical equipment each day resulted in a whopping 35% reduction in HCAI in a randomised controlled trial. I’m delighted to say that Prof Brett Mitchell will be introducing an IPC Journal Club on this study next Wednesday (register here).
Continue readingMpox: situation overview and IPC implications
I gave an mpox webinar yesterday, to focus on the new threat from the Clade Ib outbreak of mpox currently going on in the Democratic Republic of Congo (DRC), which has prompted the WHO to declare a public health emergency of international concern.
Continue readingJournal Club Hacks
Later on this week, I’ll be doing a Journal Club on Journal Clubs (on Weds 21st at 1500 UK time – register here)! The aim of this Journal Club is to provide a bit of a ‘how-to’ guide on identifying and critically analysing good studies. Clearly, the definition of a “good” study will very much depend on your point of view and your interests. For example, a very well designed and conducted study in one journal may be of far less interest to you than a less well designed and / or conducted study on a more relevant topic. I picked up this BMJ Evidence Based Medicine article on Journal Clubs from 2017, which I’ve suggested as reading material before the Journal Club.
Continue readingExploring barriers to “water free” care
There is an increasingly strong rationale for going “water free” (or at least “water lite”) in our delivery of critical care to reduce the risk of antibiotic-resistant Gram-negative infections. But it’s a challenging concept in quite a few ways. In fact, when I’ve suggested it in the past, there has been a palpable gasp and quite a few objections raised! So I was struck by a recent JHI study exploring barriers to implementing water free care.
Continue readingLongitudinal environmental sampling in a paediatric BMT unit identifies computer equipment as the most contaminated site!
A new study in JHI reports the findings of longitudinal environmental sampling in a paediatric BMT unit. Perhaps unsurprisingly, sites associated with frequent contact by staff (especially computer equipment) had the highest bacterial counts. These sites also had the highest bacterial diversity suggesting they are accumulating contamination from multiple sources, and acting as a bacterial possible interchange. But computer equipment is diligently cleaned and disinfected after each use, right…?
Continue readingAnnouncing: IPC Journal Club
I’m excited to let you know about a new (free!) virtual IPC Journal Club! The first event, hosted by IPC Partners, will be led by fellow Reflections blogger Phil and me, and take place next Wednesday 3rd July at 3-3.30 pm (UK time); you can register for the Journal Club here. The plan is for this to become a regular and interactive virtual forum to cover some breaking news in the world of IPC. The topic will be this study in the Journal of Hospital Infection (see Phil’s post on the study here), using whole genome sequencing to provide transmission insights into Pseudomonas aeruginosa, and evaluating the role of wastewater in transmission. Please do have a read of the paper before the session (or at least give the abstract a scan!) and come with your questions. Hope you will be able to join us next week.
“Through the air”
There has been a huge amount of debate, discussion (and occasional vitriol) about transmission routes for respiratory pathogens, especially SARS-CoV-2. One of the sticking points has been different perspectives on the terminology used. I was privileged to join a working group convened by WHO to propose some new terminology to underpin this discussion. The proposed new terminology has been published recently, and I’d thought I’d share some reflections! Whilst I don’t think this will turn our IPC practice upside down, it is a step towards a more informed approach to preventing the spread of respiratory pathogens.
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Reflections on Infection Prevention and Control 