More of a bad thing: ESBL-E

May 26, 2015May 26, 2015 Andreas Voss (@AVIPNL) Antibiotic resistance antibiotic resistance, culture methods, ESBL

In a short, but important Dutch study, the added value of selective pre-enrichment for the detection of ESBL-producing enterobacteriacea (ESBL-E) was evaluated. The authors used their yearly prevalence study to shed more light onto the question if pre-enrichment (using a broth) might be equally improving the performance of ESBL-E detection, as it does with MRSA. While the literature on the topic might be controversial, this straightforward, well-performed study showed that direct culture failed to identify 25.9% (7/27) ESBL-E rectal carriers, which corresponds to 1.2% (7/562) of the screened population. While the overall rate of ESBL-E rectal carriage is not very high (4.8%) this study still demonstrates the importance of improving our methods to detect multi-drug resistant pathogens.

Continue reading →

Maple syrup to fight antimicrobial resistance

May 21, 2015May 20, 2015 Andreas Voss (@AVIPNL) Antibiotic resistance #maple syrup, antimicrobial resistance

I always knew it. Pancakes with maple syrup are so good, they must be “healthy”.

Canadian researchers took a different look at North American maple tree syrup. They published that the phenolic compounds contained in the syrup potentiates antimicrobial susceptibility by increasing outer-membrane permeability and effectively inhibit efflux pump activity, in addition to reducing biofilm formation.

After all the research into the antimicrobial activity of foods & spices (e.g. garlic), I am happy to see a less smelly product being promoted. In addition, this may explain why antimicrobial resistance is low in the Netherlands, a country with a proud tradition of pancake restaurants everywhere.

Seriously, antimicrobial activities have been reported from many extracts of “food & spices”, but none really made it into clinical practice. So far the mushrooms seem to be winning. Go Penicillium.

Photo: wikipedia

Probiotics for environmental cleaning – can’t B. cereus

May 16, 2015May 16, 2015 Andreas Voss (@AVIPNL) Disinfection bacillus, cleaning, disinfection, probiotics

Schermafbeelding 2015-05-16 om 23.53.46

Vandini et al. (1) evaluate the effect of a microbial cleaner, containing spores of food grade Bacillus subtilis, Bacillus pumilus and Bacillus megaterium in two Italian and one Belgium hospital.

According to the abstract 20,000 microbiological samples were taken from surfaces, during the 24-week investigation, which would equal approximately 120 samples per day!

While nothing about blinding or block-randomization (or any possible approach that would eliminate bias) was mentioned, it is stated that the cleaning staff was not aware which cleaning product they used. Seen the fact that chlorine based-cleaners were the standard products in the two Italian hospitals, this seems hard to believe. The study period started at different times in the hospitals (but not by design) and in opposite to the abstract for different periods of time, namely 6, 24, and 66 weeks, respectively.

Continue reading →

Attendance Grants Available

May 13, 2015May 13, 2015 Andreas Voss (@AVIPNL) Conferences #ESCMID/SHEA course, #hospitalepidemiology

ESCMID/SHEA
Training Course in Hospital Epidemiology
Goes Down Under

Cairns, Australia

20 July 2015 – 24 July 2015

This is the 2nd Australian edition of the (former) ESCMID-SHEA course. This course will be based on 3 cases that are handled by 6 groups of 10 students.

Each group has a dedicated faculty member to guide them, while 3 additional faculty members will be available for more general guidance (including handling of datasets and statistical/epidemiological issues). The cases run throughout the week and the theory will be given, based on the problems encountered in the cases.

Attendance Grants:

ESCMID provides a number of attendance grants for ESCMID “young scientist members”. The grant covers the registration fee, but not travel or accommodation costs. Please apply here before 1 June 2015. Applicants will be informed about their acceptance by 8 June 2015.

Continue reading →

ICPIC 2015

May 10, 2015May 10, 2015 Andreas Voss (@AVIPNL) Meetings #ICPIC2015

Join us in Geneva from 16 to 19 June 2015!

The ICPIC programme has now been finalized and is available via the ICPIC website.

Click here to discover the detailed programme .

The committee has invited key opinion leaders in the field, who will address a full range of topics in prevention and infection control. Do not miss this opportunity to meet and network with top experts in your field!

Highlights of the programme

Ebola hands-on workshop on Tuesday 16 June 2015
Innovation Academy on Wednesday 17 and Friday 19 June
Implementation Academy on Wednesday 17 June
PIC Talks on Wednesday 17 June
Keynote lecture on CLABSI – view from the past to the future
Meet the Expert interactive sessions in a wide range of topics

Continue reading →

Excluding Funguria from CAUTI or “How to effortlessly reduce HAI-rates”

May 9, 2015May 12, 2015 Andreas Voss (@AVIPNL) CAUTI #candida, #CAUTI, #funguria, #HAI rates

According to Dicks et al. (ICHE 2015;36:467-9) the presence of fungi in urine rarely represents true infection. The authors state, that excluding yeast from catheter-associated UTI surveillance definition reduced CAUTI-rates by 25% in community hospitals and at tertiary-care medical center.

While I agree, that in many instances candiduria represents colonization or contamination of the specimen and not invasive candidiasis, and that not all cases of candiduria need treatment, they all warrant a clinical evaluation. In my Iowa years (1992/93) Dick Wenzel, Mike Pfaller and other established the importance of yeast in HAI’s, Pittet and others developed indices to better detect patients with candidemia, and my own research showed that candida in urine was one of the most important warning signs in patients suspected for candidemia. Once excluded from surveillance definitions, will our colleagues still see the importance of this occurrence? True, fungi in urine not always represents true infection, but frequently are a warning sign. I am not sure about the need to change CAUTI definitions, or why one would stop at fungi for exclusion, but in general believe that we should leave our definitions as stable as possible.

Mycobacterium chimaera & Open-Chest Heart Surgery

May 5, 2015May 6, 2015 Andreas Voss (@AVIPNL) Environment, outbreaks environmental contamination, M. chimaera, outbreak

Outbreak of Mycobacterium chimaera Infection After Open-Chest Heart Surgery

Reported by Andreas Widmer in Basel and now published by Hugo Sax and colleagues (CID April 15^th, 2015), the amazing story of open-cheat heart surgery, Mycobacterium chimaera infections (years after the operation!), and contaminated heater-coolers in your operating room.

While the Swiss were first, we know by now that this problem is unfortunately not limited to the Alp region, but furthermore present e.g. in the Netherlands. If your hospital has a program for open-chest heart surgery, now is the time to check your heater-coolers, to avoid further airborne transmission of M. chimaera from contaminated heater-cooler units.

5th May Hand Hygiene Day

May 2, 2015May 5, 2015 Andreas Voss (@AVIPNL) Hand hygiene hand hygiene

Dear friends and colleagues, The Hand Hygiene day on the 5^th of May is approaching. However, this year is different. 2015 is the 10^th anniversary of the WHO Clean Care is Safe Care program and we would like you to help us commemorate this day. We are simply asking you to participate to the #safeHANDS campaign by taking your photo using WHO #safeHANDS board and posting it on the website (see below) or on the social media Twitter or Instagram to remind the world that hand hygiene saves lives. It is as simple as that. You can also organize a Hand Sanitizing Relay and even beat a GUINNESS WORLD RECORD. Here are links providing you all information: 1) WHO campaign webpage: http://www.who.int/gpsc/5may/EN_PSP_GPSC1_5May_2015/en/ 2) Where to post your pictures: http://www.CleanHandsSaveLives.org/safehands/ 3) The safeHANDS campaign promotion clip: http://tinyurl.com/safeHANDSclip 4) The Hand Sanitizing Relay – possible Guinness World Record explanatory clip: http://tinyurl.com/HHRelay

WHO Antimicrobial Resistance Analysis

May 1, 2015May 5, 2015 Andreas Voss (@AVIPNL) Antibiotic resistance antimicrobial resistance, WHO

Over a 2-year period, from 2013 to 2014, WHO undertook an initial “country situation analysis” in order to determine the extent to which effective practices and structures to address antimicrobial resistance have been put in place and where gaps remain.

A survey was conducted in countries in all six WHO regions and focused on the building blocks that are considered prerequisites to combat antimicrobial resistance: a comprehensive national plan, laboratory capacity to undertake surveillance for resistant microorganisms, access to safe, effective antimicrobial medicines, control of the misuse of these medicines, awareness and understanding among the general public and effective infection prevention and control programmes.

Link to document: http://www.who.int/drugresistance/documents/situationanalysis/en/