I was interested to read a randomised controlled trial of pulsed xenon UV (PX-UV) for room disinfection in Clinical Infectious Diseases. In this study, PX-UV was not associated with a reduction in HCAI. Some may be quick to say that this provides evidence that “automated room disinfection systems don’t work”, but there are important differences in the technologies involved as well as the usual strengths and limitations of the study methodology that could explain this outcome.
Continue readingWhat is the difference between hospital hygiene and hospital cleanliness?
This guest post is by Prof Sally Bloomfield, Chairman, International Scientific Forum on Home Hygiene (IFH)…
At Infection Prevention 2024 in September, I gave a presentation on this issue which I found challenging and thought-provoking to write. I started from the point that environmental hygiene and cleanliness in healthcare settings has 2 fundamentally different functions:
| “Hygiene” through practices that reduce risk of exposure of patients, healthcare personnel and visitors to pathogenic microbes | “Visual cleanliness” is vital to sustaining patient, visitor and staff perception that high quality care is being delivered |
| Physical removal and/or disinfection to reduce microbial contamination on environmental surfaces (and air) to an acceptable (safe) level | Physical removal of dust, soil, etc by mechanical action with or without detergent, until visibly clean |
Want to reduce HCAI? Then employ a few more staff in your infection prevention department!
A useful US study has explored the ratio between infection prevention staffing levels, facility size, and HCAI-related outcomes. The reassuring news is that there was some correlation between IPC staffing levels in HCAI-related outcomes, suggesting that we are doing something right as a profession!
Continue readingPeripheral vascular access: we can do better!
We know all about reducing risks from central venous catheters (CVCs). Matching Michigan. High Impact Interventions. And reductions in CVC-associated BSIs. But we don’t spend enough time or effort in addressing risks associated with peripheral venous catheters. Infection Prevention in Practice recently published an expert opinion piece about achieving best practice in the use of PVCs.
Continue readingWhole genome sequencing to support IPC has been ‘the future’ for too long
There has been a lot of excitement about the prospects of whole genome sequencing (WGS) to support infection prevention and control in a really meaningful way over the past decade or two. But to me this potential seems largely unfulfilled. WGS remains largely the domain of reference and research laboratories, and has not transitioned effectively to support IPC daily decision making. A recent review highlights the potential of WGS to support IPC, and identifies some of the barriers to be overcome if WGS really is to be a big part of our future in IPC.
Continue readingBiofilms…the gift that keeps on giving!
Last week I spent some time at the Infection Prevention Society (IPS) annual conference in Birmingham which provided a fantastic selection of talks and discussions on current and emerging IPC challenges. One topic which came up time and time again was biofilms…. for example, whether the presence of biofilms provide Candida auris with the ability to persist in the clinical environment for prolonged periods, through to the role of biofilms in reduced susceptibility to disinfectants and antibiotics. It made me revisit an excellent recent review published in Antimicrobial Resistance and Infection Control, which is the topic of today’s blog and tomorrow’s IPC Journal Club (register here).
Continue readingMaking peripheral vascular access a central focus
I did a talk at the Infection Prevention 2024 conference in Birmingham earlier in the week on ‘making peripheral vascular access a central focus’. Understandably for many reasons, much of our vascular access infection prevention effort is focussed on central lines. But this means we probably don’t spend enough time considering infection (and other complication) risks from peripheral vascular access and what we can do to prevent these.
Continue readingAvian influenza: it’s in the (waste)water
There is a sense of steadily building concern around avian influenza, remembering that an avian influenza outbreak would knock spots off COVID-19 (especially the modern variants) in terms of bad clinical outcomes. A letter in the NEJM relates wastewater surveillance in the state of Texas that has identified H5N1 avian influenza in all 10 cities in the surveillance programme since March 2024. This suggests that avian influenza is out there, and flying under the radar in animal populations. So, now would be a good time to dust down your pandemic influenza preparedness documents…
Continue readingImproving cleaning and disinfection of shared medical equipment: it’s time to ‘CLEEN between’
A fantastic new study from Brett Mitchell’s prolific group in Australia has recently been published in Lancet Infectious Diseases and the results are pretty spectacular. A fairly low cost intervention of an extra 3 hours of cleaning and disinfecting shared medical equipment each day resulted in a whopping 35% reduction in HCAI in a randomised controlled trial. I’m delighted to say that Prof Brett Mitchell will be introducing an IPC Journal Club on this study next Wednesday (register here).
Continue readingMpox: situation overview and IPC implications
I gave an mpox webinar yesterday, to focus on the new threat from the Clade Ib outbreak of mpox currently going on in the Democratic Republic of Congo (DRC), which has prompted the WHO to declare a public health emergency of international concern.
Continue reading
Reflections on Infection Prevention and Control 