PHE have just launched an interactive database for HCAI and AMR data from England using their ‘Fingertips’ platform. The HCAI data in the module has been available for years, but was buried in pretty dense Excel spreadsheets so tricky to visualise. The Fingertips platform makes data extraction and visualisation so easy even I can do it (example below).
Diluting the efficacy of hydrogen peroxide room decontamination?
A somewhat perplexing new study has just been published in the Journal of Hospital Infection comparing the effectiveness of two hydrogen peroxide based automated room decontamination systems: a low-concentration (5%) hydrogen peroxide system (Deprox) and a high-concentration (30%) hydrogen peroxide system (Bioquell).
The study evaluated the impact of the two systems each run in 10 single rooms containing seeded metal discs placed in five locations, with a 6-log load of MRSA, K. pneumoniae, and C. difficile spores. The MRSA and K. pneumoniae were either low soiling (0.03% BSA) or heavy soiling (10% BSA), and the C. difficile spores was either low soiling (0.03% BSA) or in body fluid. In addition, surface samples were taken from 22 surfaces in each room before and after decon using contact plates. The bottom line is that both systems achieved a >5-log reduction on all of the discs (including those with heavy soiling), and there were no real differences in the levels of surface contamination remaining. All this understandably moved the authors to conclude that ‘The starting concentration and mode of delivery of hydrogen peroxide may not improve the efficacy of decontamination in practice.’
Poultry production and antimicrobial resistance in India
Take a look at these three stories on intensive poultry production and antimicrobial resistance in India published yesterday on the Bloomberg website. In accordance with what the movie industry does, these articles should be accompanied by a warning: “These articles contains scenes that some readers may find disturbing”. As the editor of the articles said in an email to colleagues that forwarded it to me: “I think you’ll agree that these are important stories and deserve attention (and hopefully a response from the appropriate authorities and the community).” Obviously, I do agree.
Survey of social media use by healthcare professionals
I have been asked by ECCMID to do a talk on ‘Selling your colleagues and society: how to use social media.’ While there is some good data on social media use by scientists, I was struggling to find specific data on social media use by healthcare professionals. So I thought I’d generate some (and in doing so, generate the power of social media!). So, I have put together a short, simple survey that I hope you will have time to complete here.
Review on AMR: Report on Infection Prevention and Control, and Surveillance
The Review on AMR published their final instalment today: a report on Infection Prevention and Control, and Surveillance. A report on IPC was not planned at the start of the Review, so the existence of this report illustrates the responsiveness of the Review team. Also, having been peripherally involved in reviewing this report, I am aware that it was written within an extremely short timeframe but it does not show: it is comprehensive and thought-provoking (as it should be) with some useful recommendations.
Adapt to adopt | Didier Pittet | TEDxPlaceDesNations
Just as another way of sharing here the link to Didier’s TEDx PlaceDesNations talk: http://tinyurl.com/AdaptToAdopt or click on the picture.
Reflections from IFIC 2016
I enjoyed my first IFIC experience over the past few days in Vienna, and thought I’d share some reflections.
I found the pro-con debate between Dr Michaal Borg and Prof Gary French on whether we need more evidence to improve infection prevention and control useful. (Clearly, my vote was for Prof French, my PhD supervisor and all-around acadmic mentor.) Prof French gave a good case for an evidence-based medicine approach to IPC, bemoaning poor-quality evidence to support IPC interventions and an over-reliance on ritual and tradition. Although decent IPC study designs are tricky (and tricker than for an antibiotic trials), they are possible, as illustrated by the small number of cluster RCTs we have at our disposal. Dr Borg argued convincingly that, even if cluster RCTs support on intervention, they would likely be performed in high-resource, academic teaching hospitals, which are a different plant to the average hospital so may well not be applicable. Furthermore, clinicans are pretty poor at following guidelines even if they are evidence-based because culture eats policy for breakfast! Michael questioned whether the ‘English MRSA Miracle’ was founded in evidence-based medicine, or a pragmatic multi-faceted intervention. On balance, the room sided with Michael, agreeing that we have enough evidence to make a big different (but all agreed that better quality evidence wouldn’t hurt)!
What are we doing to improve hospital room cleaning and disinfection?
I gave a webinar last week for 3M (you can download my slides here) on “Your hospital room can make you sick: How improved cleaning and disinfection can help”. I asked the audience what they were doing to improve cleaning and disinfection, and thought I would share the findings. I don’t know the exact size of the audience (but it’s usually a couple of hundred mainly US based IPC folks), and the audience were allowed to choose any answers that applied to them for the second two questions.
Why are we not using existing data for healthcare-associated infection surveillance?
This is a guest post by Dr Gabriel Birgand (bio below), a researcher at Imperial College London…
Surveillance is an essential component in any infection control programme. In UK, the surveillance of infections associated with some procedures (e.g. certain orthopaedic procedures) is mandated by Public Health England. This surveillance requires time and represents either a full time job (i.e. dedicated nurses doing the data collection and follow-up of patients undergoing surgery) or additional work (i.e. surveillance of catheter-associated urinary tract infection by infection control nurses). This process is time-consuming, expensive and dependent on the rigour of the person in charge of the surveillance. Despite proven value, the involved nature of the method makes these manual HCAI surveillance systems difficult cumbersome to deliver. Moreover, hospitals often struggle to recruit and retain nursing staff dedicated to surveillance meaning that reporting is frequently incorporated into other posts, which interrupts other clinical duties and may reduce the detail of reporting.
We need to EMBRACE engineers in the fight against HCAI and AMR
I attended the first EMBRACE seminar today at Imperial College London. EMBRACE (Engineering, Medicine, Natural Sciences and Physical Sciences Bridging Research in Antimicrobial resistance: Collaboration and Exchange) is a gap-bridging collaborative aiming to bring together Engineers, Scientists, Doctors, and others to find new ways to address AMR and tackle HCAI. I thought I’d share some of my highlights from the seminar.
Reflections on Infection Prevention and Control 