Between October 2024 and January 2025, the UK identified eight cases of Clade Ib Monkeypox virus (MPXV), with seven patients admitted to high consequence infectious disease (HCID) centres. A comprehensive environmental sampling study was conducted to assess the extent of MPXV contamination in isolation rooms and anterooms, focusing on both air and surface samples.
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Candidozyma auris: an emerging threat
I’ve written this post in preparation for tomorrow’s Journal Club, which will be based on this NEJM review of Candidozyma auris (formerly Candida auris). You can register for Journal Club here (or watch the recording afterwards here).
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 readingImproving environmental hygiene reduces HCAI: but which monitoring method is most effective?
A superb cluster randomised trial has just been published in Clinical Infectious Diseases testing whether improved environmental hygiene via objective monitoring and feedback reduces HCAI. The study also tests whether ATP or UV fluorescent marker monitoring is more effective. The findings reinforce that improving environmental hygiene reduces HCAI, and (I think surprisingly) suggest that ATP is more effective than UV monitoring.
Continue readingHow dirty is your QWERTY?
I was recently involved in a study to examine the microbial profile of computer keyboards in a multi-centre study in the UK. The findings have just been published in the Journal of Hospital Infection.
Continue readingThe role contaminated surfaces in COVID-19 transmission: a HIS audience-led webinar
The next instalment of the HIS audience-led webinar series is on the role of contaminated surfaces in COVID-19 transmission. I was delighted to be part of the panel for this one:
- Dr Lena Ciric – Associate Professor in Environmental Engineering, University College London
- Dr Stephanie Dancer – Consultant Microbiologist, NHS Lanarkshire and Professor of Microbiology, Edinburgh Napier University, Scotland
- Dr Manjula Meda – Consultant Clinical Microbiologist and Infection Control Doctor, Frimley Park Hospital
- Dr Jon Otter – Infection prevention and control Epidemiologist, Imperial College London
- Chair: Dr Surabhi Taori, Consultant microbiologist and infection control doctor, Kings College Hospital NHS Foundation Trust
Here’s the recording:
Developing antimicrobial “smart surfaces” to tackle HCAI and AMR
I participated in a launch event by the Institute of Molecular Science and Engineering (IMSE) at Imperial College London yesterday for a new white paper on developing “smart surfaces” to tackle HCAI and AMR.
How far can environmental hygiene REACH in reducing HCAI?
Brett Mitchell and colleagues have just published the exciting findings of the Researching Effective Approaches to Cleaning in Hospitals (REACH) study in the Lancet Infectious Diseases, along with my editorial. This large 11-centre randomised intervention study found that a low-cost enhancement to environmental hygiene managed to significantly reduce VRE infections, but did not reduce S. aureus bacteraemia or C. difficile infections.
Using “health outcomes” as the basis for developing effective and sustainable hygiene interventions – is 2019 the time for a rethink?
This is a guest post by Prof Sally Bloomfield…
For many years, “5 log reduction” (LR) has been the gold standard for disinfectant efficacy despite absence of dose:response data linking it to clinical outcomes. The family of EN tests now used to support claims for disinfectant products has its origins in the European Suspension Test (5LR, 5 mins, 5 test organisms) where 5 LR was probably chosen because it is the limit of sensitivity in an assay where, traditionally, the initial bioburden is 108 colony forming units. For soap, detergent or dry wiping procedures, until recently their effectiveness has been assumed – possibly on the basis that they produce visible cleanliness? It is only recently that we have had access to efficacy data based on lab models. A trial of EN 1699 handwashing test showed a mean 2.76 LR when hands contaminated with E .coli are washed with soap.
Keeping hospitals clean and safe without breaking the bank
A paper has just been published in ARIC as the first academic output of the Healthcare Cleaning Forum. I blogged earlier this year to relate the inaugural Healthcare Cleaning forum, and this paper expands on the key themes: establishing environmental hygiene as a patient safety initiative, providing an overview of the importance of environmental hygiene in healthcare, exploring the human factors driving the standards of environmental hygiene along with the need for effective education, the possibilities and challenges of automation, and the cost and value of environmental hygiene.
One of the key aims of the forum is to be a champion for environmental hygiene professionals. There’s a famous story of when president JFK visited NASA and asked a janitor who was mopping the floor what they were doing. The answer was simple and profound: “I’m helping to put a man on the moon.” If you asked somebody working in environmental hygiene in your hospital what they were doing, would the response be: “I’m helping to maximise patient safety and prevent healthcare-associated infection.” Probably not. We need to champion the cause of environmental hygiene professionals, who lack professional status, are often not paid enough, and often have limited options for career progression.
Is environmental a treasured investment priority in hospitals?
Related to this is our perception of the cost and value of environmental hygiene in hospitals. Is our level of investment appropriate given the risks associated with inadequate environmental hygiene in hospitals? Would we really find highly valued cleaning and disinfection materials in the metaphorical safe of a hospital manager (see the cartoon above)? Probably not! We need work towards better evidence to understand the value of environmental hygiene in hospitals in the context of other investment priorities.
Reflections on Infection Prevention and Control 