No jab, no play; no jab, no pay

It may be the annual “cucumber time” or Trump-fatigue, but childhood vaccination is dominating Dutch news. The problem: the proportion of children being immunized against, for instance measles, is (slowly) declining and approaches the level that offers herd protection. That is a risk for children in the time window between passive protection by mothers’ IgG and active immunisation (at 14 months) and for persons that cannot be immunized for medical reasons. We were familiar with parents refusing immunization of their kids for religious reasons (because someone forgot to mention vaccination in the bible), but now non-religious and well-educated parents do the same. These “philosophic refusals” mostly decide to do so on information derived from internet. How can epidemiology help us to curb this problem? Continue reading

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It’s time for a mini-revolution in scientific publishing: a truly universal manuscript format

There’s a problem with academic publishing. This could be (but isn’t) a post about the lottery of peer review, the scandalous mountain of largely unpaid reviewing and editorial work that journals benefit from, the urgent need to adopt open access, or the interesting dynamics introduced by pre-print servers. Instead, this post is about a big problem with an easy solution: hours and hours of expert scientific time (and with that, grant money) currently being wasted reformatting manuscript for the initial submission to various journals. The solution: create and implement a truly universal manuscript format for the initial submission.

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Evaluating the value of multidisciplinary reviews to get to the root causes of C. difficile infection

An interesting paper has been published evaluating the cost and value of multidisciplinary team (MDT) meetings to investigate C. difficile cases. The study counts the cost of C. difficile MDTs (somewhere between £25k and £50k over two years), and concludes that they had limited value in delivering additional learning or quality improvement. But I beg to differ…!

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Planning to halve GNBSI: getting to grips with healthcare-associated E. coli BSI sources

Today, the Journal of Hospital Infection have published an article from our research group about E. coli BSI sources. The key message is that the sources of E. coli BSIs at a large teaching hospital differ considerably from the national average, with a large proportion related to febrile neutropaenia (18%) and diverse gastrointestinal sources (15%). This calls into question the ‘preventable’ proportion of these cases – and adds something to the discussion as to whether the national ambition to halve GNBSI by 2021 is feasible.

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Beware Biofilms!

Have you ever wondered how on earth vegetative bacteria can survive on dry surfaces for years? Or why when you have an outbreak and you swab the environment you don’t find the outbreak strain even though you’re pretty sure it’s there? Or why a disinfectant that gets a 4-log reduction in the lab can’t eliminate a couple of hundred cfu of bacteria from a dry surface? Dry surface biofilms could be the answer to all these questions! I was involved in a multicentre survey of dry biofilms from across the UK, and we identified dry surface biofilms on 95% of the 61 samples there were tested. Worryingly, viable MRSA was identified on 58% of the surfaces! We need to think carefully about how much of a risk dry surface biofilms present, and whether we need to do more to tackle them.

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Novel strategies in science communication: Fiction or future?

Guest blogger, Tjitske van Engelen (details below) writes…

It is Friday night eight ‘o clock. Everybody tunes in via online podcasts, live feed webpages or plain old television. And there he is; the man of the hour. Respected by fellow man for his charismatic behavior and loved by women for his enchanting smiles. The well-known jingle introduces the vibrant young show host whilst he enters the stage. Tonight will be a night to remember. It is one of these shows that everybody will talk about during the Monday morning coffee break. No way you are not watching. It is the quarter-finals: ‘thrombosis in neonates’ versus ‘fluid resuscitation in the critically ill’. A Norwegian versus a South-African researcher. The jury consists of one hundred participants with no prior knowledge of the fields of research. The contestants are scored as usual based on the three pillars of the show. First, did I learn something new? Secondly, can I repeat what I have learned? And thirdly, does it make me want to learn more? In the beginning, many contestants made a rookie mistake: too much information squeezed in the set three-minute-pitch. It was rather funny, to hear them stumble over their difficult words. Who has ever heard of macrophages before? Well, only two of the jury members, as it turned out. However, after last week’s show (‘antibiotic resistance’ versus ‘genetics and infection’) the number of Google hits for meticillin-resistant Staphylococcus aureus were sky high, adding to the third pillar of the show. Apparently people wanted to learn more after the engaging talk of the young scientist who explained her strategies to reduce the use of antibiotics. She has won an additional 30 seconds of pitch time for her semi-finals, kindly donated by Google. Fiction or future?

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Evaluating the economic value of the CDC CRE Toolkit

Continuing the theme of CPE (or CRE if you prefer) Toolkit evaluation, a US research group has performed a modelling study to evaluate the economic impact of the US CDC CRE Toolkit. Curiously, whilst all approaches generated cost savings eventually, hospitals acting independently rather than as a co-ordinated region resulted in faster but ultimately smaller cost savings.

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