Persistence and transmission of Candida auris on and from gloves

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Interesting results from Jabeen et al. that many of us might have missed, as they are published in a mycology journal and not in an infection control journal.  Persistence of Candida spp. on latex and nitrile gloves was highest for C. auris and C. parapsilosis.  Interestingly, persistence on nitril gloves was generally less than on latex gloves. Transmission of Candida spp. from gloves (latex, nitril not tested)  to urinary catheter surface was most effective for C. auris and C. albicans.

To be frank, the chosen methods and set-up of the experiments leave quite some room for improvement, but the basic idea of the experiment and the message it conveys are – while not new – of importance: Glove use can be an important factor in the spread of all microorganisms, and in this case, especially C. auris.

Previously it has been shown that glove-use may negatively effect hand hygiene behavior. After years of focusing our attention on hand hygiene compliance and hand-rub technique, this publication is an important reminder, to not forget about adequate glove-use.

Jabeen K, Mal PB, Tharwani A,Hashmi M, Farooqi J. Persistence of Candida auris on latex and nitrile gloves with transmission to sterile urinary catheters.  Medical Mycology, 2019, 0, 1–5 doi: 10.1093/mmy/myz033 Advance Access Publication Date: 0 2019
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Working while sick

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Compared with the general population, healthcare workers (HCWs) have an increased risk of being exposed to respiratory pathogens including flu, causing a potential threat for their own health and their patients’ safety.  At present, the problem of HCW vaccination seems to get the main attention when dealing with influenza prevention, whereas the problem of HCWswho work while feeling sick, seems to be far less addressed.  That is, until recently when Chow et al. studied hospital-acquired respiratory viral infections, sick leave policy, and a need for culture change.

The ISAC Infection Control Study group had already piloted a survey on the topic and wishes to poll your thoughts with the present survey.

While there is nothing to earn, except of the good feeling of having helped someone, we kindly ask you to take the questionnaire (takes 4-5 minutes) and send it to others, including friends or family not in healthcare, as we are especially interested in possible differences.

Link for the survey: https://www.surveymonkey.com/r/ISAC_Influenza

Thanks for helping and of course results will be back on this blog.

Shortages

 

Schermafbeelding 2018-03-29 om 01.01.30Shortages?! Slowly, I get used to it.  Basic antibiotics such as penicillins, CHX-wipes, or now, mupirocin. From what I hear we have to expect severe shortages (= no product) for the next few months. As the use of mupirocin for nasal decolonization of S. aureus (in combination with CHX skin wash) has become part of the pre-operative care for certain indications, the obvious question is: WHAT SHOULD I USE INSTEAD?

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The antibiotic course has had its day?

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In a recent BMJ article, Llewelyn et al. argue that the old dogma of completing a prescribed course of antibiotics to prevent antibiotic-resistance is a myth, not based on evidence.  Actually the opposite, namely taking antibiotics for longer than necessary, increases the risk of resistance.

While I love breaking down old dogmas  (we actually had a poll on this topic some time back), many of today’s papers in the Netherlands (and I am pretty sure elsewhere, too) misinterpret the study, by slaughtering the message to patients to “always complete the full prescription”.  One of the Netherlands most influential newspapers the Volkskrant, already wrote: “Finishing antibiotic course? Nonsense.”

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Contact Precautions for Endemic MRSA and VRE

dilemmaby Andreas Voss and Eli Perencevich,

intentionally posted on “Reflections” and “Controversies” at the same time as a reaction to the JAMA Viewpoint by Morgan, Wenzel & Bearman

 

During the recent ICPIC 2017 and a pre-meeting think tank, the sense and non-sense of RCTs looking at various infection control measures was a major point of discussion during many sessions. Data from well-designed quasi-experimental studies, epidemiological evidence, and logic seems to vanish, whenever a new RCT is published, even if the results are not applicable to situations that are non-endemic, have higher or lower compliance with the preventive measures in question, or whether the intended measures were actually applied within the intended patient group.  Some studies seem to assume that the transmission during the first days of admission are of no consequence. Others assume that given endemicity and a high patient load, the intended measures such as single-room isolation can’t be applied, even if a patient was randomized to receive those measures.

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WHO IPC Core Components

While I had seen the WHO IPC Core Components, I have totally missed the great video they made.  Thus, with no further comment, here the link to this well-made video.

Just in case that the link via the picture doesn’t work, copy and paste the following link into your browser: https://www.youtube.com/watch?v=LZapz2L6J1Q&feature=youtu.be

C. auris questionnaire – the outcome

Overall 61 colleagues from 17 countries answered the questionnaire.  A large proportion (26 of 61) of the answers came from the UK, which might have to do with the fact that the first European outbreak was described in England.

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Of the respondents 32.8% said that their institution released a warning about C. auris.  Analyzing the data separately for the UK and the other participating countries, it became clear that the first European outbreak had impact on the preparedness. In the UK 42.3% of the institutions were warned about the unique capacities of C. auris, versus 25.7 in all other countries.  Regarding the existence of a written guideline dealing with C. auris, the differences were far less pronounced, namely 26.9% versus 20.0%, respectively.

53.9% of the UK responders believe that their lab can correctly diagnose C. auris, versus 31.4% in the other countries.  In addition, the proportion of responders, who didn’t know if their lab was prepared, was higher outside the UK (45.7% versus 26.9%, respectively).

Despite the emerging spread of  C. auris clusters this questionnaire is an indication that most institutions are not adequately prepared.  Obviously the sample is really small, but the outcome was predictable.  With an increasing body of literature, including papers on diagnostic methods and infection control measures, we should hope that the situation should change very soon.  Thus, don’t lean back, start writing.