“Why Dutch hospitals are so good at beating superbugs”

It is with great pleasure that I ask your attention for this article that appeared in the Economist. Yes, we still have low resistance rates in our hospitals and if you’re interested in how that happened, read it. The prosaic composition contains two parts; a very realistic thriller-like opening, followed by a second part with a rather unrealistic explanation. Both parts are separated by a short sentence of absolute nonsense. Time for a review. Continue reading

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Hand hygiene and the courage to challenge: a personal reflection

Allow me to set the scene: I was visiting an elderly relative in an NHS hospital recently (they would deny being elderly – but I’m afraid it is now true). I witnessed a healthcare worker moving efficiently from bed to bed examining each patient (including direct patient contact) to take observations without any hand hygiene between patients and without decontamination of the reusable blood-pressure cuff. I explained to my relative the need to challenge this behaviour. My relative asked – almost pleaded with me – not to intervene saying “you’ll clear off and they’ll be left caring for me overnight”. So, did I have the courage to defy my relative and challenge this behaviour?

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Are alcohol gels doomed by resistant bacteria?

A high profile article was published earlier this year in Science Translational Medicine, suggesting that Enterococcus faecium can exhibit clinically relevant levels of tolerance to alcohol-based hand hygiene products. The article has generated a huge amount of press coverage and discussion amongst experts. So, I thought it was about time I gave the article a once over. My initial thought was this would be unhelpful extrapolation of low-level tolerance to alcohol gel that wouldn’t be meaningful in a clinical setting. But having read the paper, there’s genuine concern here. Overall though, if true resistance to alcohol gel was going to be a problem, I’m pretty sure it would have reared its ugly head already.

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The Trojan Horse

Trojan_horse_ÇanakkaleI’ve been mulling over the issue of sinks in clinical areas a lot recently and a paper published today in the Journal of Hospital Infection has really crystallised my thoughts. Sinks are everywhere; often extra ones are installed in the quest for high hand hygiene compliance however are we really thinking about the risks that these may cause apart from the traditional ones posed by Pseudomonas and Legionella? Do we even really reflect upon what they are used for? Continue reading

The ‘Cinderella’ Moment for Hand Hygiene

It probably has not escaped your attention that it’s World Hand Hygiene Day tomorrow, on the 5th of May. This year, it’s a double-header focussing on hand hygiene and sepsis, under the theme: “Sepsis – it’s in your hands.” But, which is the ‘Cinderella’ Moment for Hand Hygiene? Moment 5, of course: following contact with the patient environment.

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Hand hygiene compliance: we’re kidding ourselves

I’d like to direct your attention to a flurry of fairly recent correspondence in the Journal of Hospital Infection around whether the high levels of hand hygiene compliance commonly reported in England are realistic and useful.1-5

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