WAAW 2022: A focus on prevention (IPC and vaccination)

Was delighted to introduce our series of events planned to coincide with World Antibiotic Awareness Week 2022 earlier today. I gave a short talk on why preventing infection via IPC measures and vaccination needs to be a cornerstone of our strategy to turn the time on antimicrobial resistance (slides here).

I also shot a short video to get us thinking about how the language we use will influence the degree to which we connect with the various stakeholders that need to collaborate to address antimicrobial resistance:

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The anatomy of a good blog

ICHE recently published an unusual article (which other article has ‘the world wide web’ as their setting) on blogging in ID and clinical micro. The article reviewed around 100 blogs and rated them using a multifaceted tool. The article has some useful qualitative feedback from bloggers and readers, and identifies some gaps in the blogosphere (especially around antimicrobial stewardship). Rachael Troughton, one of the study authors, recently published a post on the article – and here’s my take on it.

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Take care. Not antibiotics.

Mindful of our need to up our game in terms of communication to non-experts around AMR-related issues, I have been scouting around for a good video to portray the basic of AMR, and came across this by Health Education England. It’s not the best animation that I have seen, but I quite like it – and the strap line at the end is interesting (“Take care. Not antibiotics”). I’d be interested in your views on this video, and please feel free to flag any other good ones out there.

Blog-ception: An article on a blog about an article about blogs

Racheal Troughton (bio below) reports on a fascinating study…As readers of this post are no doubt aware, the community of researchers and clinicians working in infectious diseases are increasingly using social media as a resource, and a platform for scientific discourse. But there is little discussion on precisely how it is being used. Back in 2015, we began a study to analyse the content and culture surrounding blogs in the field of infectious diseases – the “blogosphere”. Continue reading

Special issue on MDR-GNR

The Journal of Hospital Infection have published a welcome special issue on multidrug-resistant Gram-negative bacteria. The collection includes some updates on epidemiology, staff carriage (again!), clinical microbiology, and patient perspectives on CPE, and is well worth a read.

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Spread the word, not the MDROs!

xdro registry

Guest blogger, Rita Bos (bio below) writes:

This month, while randomly searching Pubmed with the subject MDRO (I know, a rather bizarre hobby), I came across a French study on MDRO information in patient transfer letters. In this paper, which was published in the French journal “Médecine et maladies infectieuses” Lefebvre et al (of the Infection Control Unit of the Dijon University Hospital, Dijon, France) investigated the proportion of transfer letters that contained information of infection or colonization with MDR bacteria.

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I have thought a lot (probably too much) about the best way to describe the issue of carbapenem resistance in Enterobacteriaceae. I decided ages ago that CRE (a la the CDC) is the way to go as a generic term to describe the problem. But the more I think about it, the more I am coming around to the idea that CPE (a la PHE) is better. And here’s why:

  • The real issue from a clinical and infection control viewpoint is CPE. Enterobacteriaceae that are resistant to carbapenems by means other than an acquired carbapenemase (i.e. CRE that are not carbapenemase producers) are important, but they don’t seem to have the same capacity to spread as carbapenemase producers.
  • It’s a really confusing situation in terms of terminology. From the “end user” staff member on the front line and patient, all that really counts is whether it is a CPE or not. It’s really rather confusing to tell a patient that the have a “CRE that is also a carbapenemase producer” – easier just to say “you have a CPE”. (I accept that you will also need to tell a patient if they have a CRE that is not a carbapenemase producer – but I think this way around is easier.)
  • CPE is already en vogue in the UK (mainly due to the PHE Toolkit) so using any other term risks confusion at the time of patient transfer. (Clearly, this point is reversed if you are working in the US!)

I still think that “CRO/CPO” is not the way to go, given the gulf in epidemiology between the Enterobacteriaceae and the non-fermenters (although, sometimes, begrudgingly, you have to go there). What I mean by this is that you will sometimes detect a carbapenemase gene from a PCR but don’t yet know whether it is from a non-fermenter or Enterobacteriaceae species. In this circumstance, this has to go down as a ‘CPO’.

So, there you have it, a personal U-turn. CRE -> CPE. But I wonder whether CDC and PHE and the international community will ever agree a common term…

Twitter for healthcare professionals: useful or a waste of time?


An unusual review has just been published by Clinical Infectious Diseases by Debra Goff, Ravina Kullar and Jason Newland entitled Review of Twitter for Infectious Diseases Clinicians: Useful or a Waste of Time?”. As a keen reader of the journal, and a keen Twitter user, I found the article to be a fascinating read.

The authors make a strong argument that Twitter is a better fit with our “always on” culture than traditional forms of communication: and cite the fact that ‘UpToDate’ has pretty much replaced textbooks. However, I was interested to read that around 1.5% of all Twitter users are healthcare professionals (75,000 / 5,000,000). Does this mean that healthcare professionals are underrepresented on Twitter, since around 6% of the UK workforce work in the healthcare sector (1.4 m / 23 m)?

One interesting section addresses the accuracy of data on Twitter, which you’d expect to be somewhat flaky. However, an interesting analysis of tweets related to the H1H1 swine flu outbreak identified a surprising degree of accuracy. For example, 90% of the tweets contained a reference to source information where considered necessary, and <5% of tweets were classified as misinformation / speculation.

The article serves as a “how-to” guide, with a basic overview of what Twitter is and how it works. There’s also a useful list of people and organizations to follow to get you started (including ‘lil old me, I’m delighted to say)! The table of ‘Twitter Terminology’ is especially useful: this would have been a much-used resource for me if available when I started out on Twitter and didn’t know my retweet from my favorite!

From a personal viewpoint, I was pretty resistant to the idea of Twitter. How did I feel about putting myself ‘out there’ is such a public space? I have to admit though, my experience of Twitter for professional use has been unanimously positive:

  • It’s a very personalized newsfeed – I pick up on a lot of useful new data.
  • I’ve not had any ‘trolling’ whatsoever. Yes, some challenging, frank discussions. But nothing nasty.
  • I try hard to fit Twitter into my schedule and not let it take over my life. My general rule is that what goes out on Twitter is what I do anyway – so it’s pretty much time-neutral. In reality, it’s not quite time-neutral, but it’s pretty close.
  • It goes hand in hand with this blog. Sometimes 140 characters just won’t do – and that’s where this blog comes in!
  • I’ve made some really useful new contacts (not least Debbie Goff and Jason Newland, two of the review’s authors).
  • Live-tweeting conferences is a lot of fun; it has added a lot of value to my conference experience, and has served as notes for more comprehensive reports. (My conference experience has been enhanced further by Symplur Healthcare Hashtags analytics, which is also mentioned in the review.)

So, ‘Twitter for healthcare professionals: useful or a waste of time?’ It’s unrealistic to expect Twitter use to be completely time-neutral, but I do think that you can get close to that and add a new dimension to your worklife.

Image: Charis Tsevis.