Now that 2018 is behind us, I thought I’d share with you, dear readers, the hottest reflections from 2018.
How to predict ESBL (part 5)
A brief update on the ESBL predict study, after the last update from 6 months ago. Tim Deelen from our group is still running the show and we are still seeking hospitals for participation. It’s for free, it’s easy, relevant and fun! We passed the 5,500 episodes and we learn a lot, including how countries deal with the ethical aspects of this study. Continue reading
The antibiotic resistance crisis resolved by bacteriophages (part 3)
Last October Dutch people were “informed” about the potential of bacteriophages. In short, “bacteriophages work where antibiotics fail because of resistance in critically ill patients, something that is already known for 100 years, and that is neglected by modern medicine”. Some questions were raised, see here and here, but curretly Dutch physicians receive many/daily requests from patients on phage therapy and the most desperate patients pay thousands of euros to seek help abroad, without reimbursement from health insurance. Last week, we had invited the most experienced clinical experts and scientists acting at the cutting edge of preclinical bacteriophage research. Here is my impression of the clinical part. Continue reading
Top 10 reflections from 2017
As we come towards the end of 2017, we’d like to take the opportunity to thank you all for reading Reflections: we hope you have enjoyed reading it as much as we have enjoyed writing it!
How to predict ESBL BSI (part 2)
A month ago (April 11) I blogged on the difficulties in predicting the presence of ESBL-producing bacteria as a cause of infection at the time antibiotics must be started. Wouter Rottier (PhD student) developed 2 prediction rules (for community-onset and hospital-onset infection), that seem to do better than current guideline recommendations (especially for reducing unnecessary carbapenem use). Another PhD student (Tim Deelen) now wants to validate these rules, globally. The “crowd-funding study approach” worked and sites across the world joined us…. Continue reading
Christmas 2014 Update
Now that you have digested your Christmas turkey, I thought that it would be a good time to send out an update. These articles have been posted since the last update:
- Who’s harbouring CRE? (Published 22nd December 2014)
- ECDC data shows progressive, depressing increase in antibiotic resistance in Europe (Published 16th December 2014)
- Is deliberately seeding hospital rooms with Bacillus spores a good idea? No, I don’t think so either! (Published 8th December 2014)
- Filling the gaps in the guidelines to control resistant Gram-negative bacteria (Published 2nd December 2014)
- Journal Roundup November 2014: Journal Roundup: Ebola (again), The rise (and rise) and fall of MRDOs & Infection Prevention 2014 (Published 28th November 2014)
- The inanimate environment doesn’t contribute to pathogen transmission in the operating room…OR does it? (Published 27th November 2014)
- Being bitten by antibiotic resistant CRAB hurts! (Acinetobacter that is.) (Published 25th November 2014)
- Reflections from HIS 2014, Part III: Education, communication, and antibiotic resistance (Published 21st November 2014)
- Reflections from HIS 2014, Part II: Dealing with the contaminated environment (Published 20th November 2014)
- Reflections from HIS 2014, Part I: Updates on C. difficile, norovirus and other HCAI pathogens (Published 19th November 2014)
- What’s trending in the infection prevention and control literature? (Published 16th November 2014)
- HIS Poster Round: Dealing with contaminated hands, surfaces, water and medical devices (Published 15th November 2014)
- Carbapenem-resistant Enterobacteriaceae (CRE): so what should an infection prevention and control team do now? (Published 11th November 2014)
- A postcard from Portugal: “Some days we don’t have any needles on the ICU” (Published 5th November 2014)
- Ebola: infection prevention and control considerations (Published 30th October 2014)
- ID Week 2014 as seen by an Infection Preventionist (Published 28th October 2014)
- Selective Digestive Decontamination (SDD) is dead; long live faecal microbiota transplantation (FMT) (Published 27th October 2014)
I’m in a rather reflective mood, so time to remind you of some of the key themes from 2014: Ebola, MERS-CoV, universal vs. targeted interventions, faecal microbiota transplantation (FMT), whole genome sequencing (WGS), carbapenem-resistant Enterobacteriaceae (CRE), and some interesting developments in environmental science. And what will we be still talking about come Christmas 2015? Let’s hope it won’t be Ebola, and I think that WGS will be a lab technique akin to a Vitek machine rather than subject matter for NEJM. But I think we still have ground to cover on whether to go for universal or targeted interventions, FMT, and improving our study designs in infection prevention and control. I can also foresee important studies on the comparative and cost-effectiveness of the various tools at our disposal.
And finally, before I sign off for 2014, a classic BMJ study on why Rudolf’s nose is red (it’s to do with the richly vascularised nasal microcirculation of the reindeer nose, apparently).
Image: Christmas #27.
Autumn 2014 Update
It’s been another busy quarter on the Micro Blog, with posts on Ebola, coverage of Infection Prevention 2014, and updates on multidrug-resistant Gram-negative rods (especially CRE):
- Journal Roundup September 2014: Ebola, Environmental science, and MDR-GNR (Published 15th October 2014)
- Infection Prevention 2014: Some highlights (Published 6th October 2014)
- Universal vs. targeted interventions in infection prevention and control: the case for a targeted strategy (Published 30th September 2014)
- How to assess scientific posters: a practical guide (Published 29th September 2014)
- Tending the human microbiome (Published 25th September 2014)
- Not all resistant Gram-negative bacteria are created equal: Enterobacteriaceae vs. non-fermenters (Published 17th September 2014)
- Acinetobacter contamination: is anywhere safe? (Published 9th September 2014)
- Ebola: PPE and paranoia (Published 3rd September 2014)
- Journal Roundup August 2014: seeking your input (Published 27th August 2014)
- CRE and friends: Q&A (Published 20th August 2014)
- Are contaminated hands more important than contaminated surfaces? (Published 18th August 2014)
- Isolation: the enemy of CRE (Published 13th August 2014)
- My close shave with viral haemorrhagic fever (VHF) (Published 5th August 2014)
- Preventing HCAI: go long or go wide? (Published 29th July 2014)
- How to write a conference abstract…and beyond! (Published 25th July 2014)
- Journal Roundup July 2014 (Published 22nd July 2014)
- Should every body have a silver lining (inside and out)? (Published 15th July 2014)
As ever, if you have any questions, fire away. We love the interaction!
Image credit: ‘Autumn in New York’.
Summer 2014 Update
It’s been another busy quarter on the blog, with some updates from ECCMID and APIC, the inaugural ‘Journal Roundup’ plus a few key studies.
- ESCMID MDR-GNR guidelines (Published 2nd July 2014)
- Inaugural ‘Journal Roundup’ (June 2014) (Published 26th June 2014)
- What works to control antibiotic-resistant bacteria in the ICU? A two-for-the-price-of-one study (Published 17th June 2014)
- Highlights from APIC 2014 (Published 9th June 2014)
- Which transmission route is most important for influenza? (Published 4th June 2014)
- MERS-CoV: a survival guide for you and your patients (Published 28th May 2014)
- Perspectives from ECCMID 2014: the box set (Published 21st May 2014)
- Perspective from ECCMID Part IV: We need to stop polluting our planet with antibiotics (Published 20th May 2014)
- Perspective from ECCMID Part III: CDI synthetic “repoopulation” (bacteriotherapy) closer than you think & “CA-CDI” still pie in the sky (Published 19th May 2014)
- Perspective from ECCMID 2014 Part II: What to do about MDR-GNR? (Published 16th may 2014)
- Perspective from ECCMID 2014 Part I: a voice against ‘selective’ digestive decontamination (SDD) (Published 15th May 2014)
- What does lab diagnosis of MDR-GNR have to do with SURFing? (Published 9th May 2014)
- Chronic wound? No problem – a splash of oxygen peroxide should do the trick (Published 7th May 2014)
- How much Clostridium difficile infection is hospital-acquired? Part II (published 29th April 2014)
- APIC New England 2014 Conference Report: ‘The how, when, & where of C. diff – can you “C” the difference?’ (Published 25th April 2014)
- IFIC 2013 Conference Report (Published 17th April 2014)
Please keep your responses coming – and let me know if you’d like to contribute a guest blog!
Photo: ‘Summer’ by Matteo Angelino.
2014 Spring Update
It’s been a busy quarter on the blog; please see below for the blog posts since the Christmas update (which now seems like a long time ago!).
The SHEA and HIS/IPS spring conferences provided much food for thought. Also, I was delighted to host a guest blog from Prof Sally Bloomfield on What do we mean by ‘cleaning’ and ‘disinfection’?, which prompted some fascinating discussion. If you’re interested in contributing a guest blog, these are always welcome, so please let me know.
Thanks as ever for the comments – please do keep them coming.
- HIS / IPS Spring Meeting: What’s that coming over the hill? It’s a MDR-GNR monster! (Published 9th April 2014)
- Dissecting the epidemiology of resistant Enterobacteriaceae and non-fermenters (Published 8th April 2014)
- SHEA 2014 Spring Conference: Out with contact precautions. In with faecal transplantation (Published 6th April 2014)
- Considering the burden of enhanced CRE screening (Published 1st April 2014)
- Busy hospitals, contaminated surfaces and the acquisition of Acinetobacter baumannii (Published 24th March 2014)
- CRE can survive on dry surfaces for longer than you may expect (Published 18th March 2014)
- ICHE special edition on CRE and MDROs (Published 11th March 2014)
- A postcard from São Paulo, Brazil: thank goodness for the NHS (Published 24th February 2014)
- What can outbreaks of Salmonella from the 1950s tell us about CRE? (Published 18th February 2014)
- An overview of the options for antimicrobial surfaces in hospitals (Published 12th February 2014)
- What do we mean by ‘cleaning’ and ‘disinfection’? (Published 5th February 2014)
- How much patient-to-patient spread of S. aureus occurs? Apparently, not much (Published 28th January 2014)
- The Hospital Microbiome Project (Published 17th January 2014)
- Meeting up with ‘old friends’ keeps you healthy – especially when they’re worms (Published 2nd January 2014)
Photo credit: ‘Easter Bunny’ by Jimmy Hilario.
A Belated Christmas Stocking
If your Christmas Stocking disappointed, perhaps we can help. There were loads of fascinating articles published during 2013 that I had on my list to cover on the blog, but just ran out of time. So, rather than letting them fall into the ether, I thought I’d point you in their general direction!
New and novel aspects of environmental contamination:
- Enterococcus spp on fomites and hands indicate increased risk of respiratory illness in child care centers
- Aerosolization of Acinetobacter baumannii in a trauma ICU
- Compatibility of hydrogen peroxide vapor room decontamination with physiological monitors
- Computer keyboard covers impregnated with a novel antimicrobial polymer significantly reduce microbial contamination
- Transfer of Clostridium difficile spores by nonsporicidal wipes and improperly used hypochlorite wipes: practice + product = perfection
- Lifting the lid on toilet plume aerosol: a literature review with suggestions for future research
- The effectiveness of a single-stage versus traditional three-staged protocol of hospital disinfection at eradicating vancomycin-resistant Enterococci from frequently touched surfaces
- Intrinsic bacterial burden associated with intensive care unit hospital beds: effects of disinfection on population recovery and mitigation of potential infection risk
- Predictors of stethoscope disinfection among pediatric health care providers
- The effect of terminal cleaning on environmental contamination rates of multidrug-resistant Acinetobacter baumannii
- Are gym surfaces reservoirs for Staphylococcus aureus? A point prevalence survey
- Efficacy of different cleaning and disinfection methods against Clostridium difficile spores: importance of physical removal versus sporicidal inactivation
- Variability of Adenosine Triphosphate–Based Bioluminescence Assay Readings among Drug-Resistant Pathogens
- Microbial Assessment of High-, Medium-, and Low-Touch Hospital Room Surfaces
- Microbial contents of vacuum cleaner bag dust and emitted bioaerosols and their implications for human exposure indoors
- Women doctors’ purses as an unrecognized fomite
Which interventions work to control hospital transmission?
- Global implementation of WHO’s multimodal strategy for improvement of hand hygiene: a quasi-experimental study
- Is hand hygiene before putting on nonsterile gloves in the intensive care unit a waste of health care worker time?–a randomized controlled trial
- Interventions to reduce colonisation and transmission of antimicrobial-resistant bacteria in intensive care units: an interrupted time series study and cluster randomised trial
- Reducing the spread of Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus on a burns unit through the intervention of an infection control bundle
- The importance of long-term acute care hospitals in the regional epidemiology of Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae.
- Oral DAV131, a charcoal-based adsorbent, inhibits intestinal colonization by β-lactam-resistant Klebsiella pneumoniae in cefotaxime-treated mice
- Duration of carriage of carbapenem-resistant Enterobacteriaceae following hospital discharge.
- Infection prevention considerations related to New Delhi metallo-β-lactamase Enterobacteriaceae: a case report
- Differences in outcome according to Clostridium difficile testing method: a prospective multicentre diagnostic validation study of C difficile infection
- Potential for transmission of spores by patients awaiting laboratory testing to confirm suspected Clostridium difficile infection
- Anti-depressant link to Clostridium difficile infection
- Low prevalence of meticillin-resistant Staphylococcus aureus carriage at hospital admission: implications for risk-factor-based vs universal screening
- Selection for qacA carriage in CC22, but not CC30, methicillin-resistant Staphylococcus aureus bloodstream infection isolates during a successful institutional infection control programme
- Do patients feel comfortable asking healthcare workers to wash their hands?
Photo credit: Bo Insogna.