A Swiss study has found that the mean cost of a contact precautions day is £130. This is useful in helping us to understand the financial impact of infection prevention and HCAI.
The PHE Toolkit recommends pre-emptive isolation for patients who meet one of the risk-factor triggers for CPE screening. Furthermore, the pre-emptive isolation recommended in the Toolkit should be continued until three negative screens are obtained, each separated by 48 hours. In what is best described as a data-based thought experiment, colleagues from Imperial tested the impact of various CPE screening strategies on the burden of contact precautions generated.
They say that things come in threes, so following hot on the heels of blogs about MRSA and other MDROs in nursing homes, I was struck by a recent outbreak report of CRE associated with nursing homes the Netherlands.
Following the admission of a patient from a Greek ICU, a nosocomial transmission of CRE (ST258 KPC K. pneumoniae) occurred. By the way, this occurred despite the hospital recognising the risk of CRE at the time of admission from the Greek ICU, perform an admission screening and implementing pre-emptive contact precautions. Then the index patient was transferred to a nursing home, where subsequent transmission occurred to four other patients.
The latest edition of Journal Roundup is now available on the Journal of Hospital Infection website, freely accessible here.
- Ebola science continues to make waves in the big journals. One of the most interesting aspects of the new developments prompted by the Ebola outbreak in West Africa is real advances in vaccine development for Ebola and related viruses.
- We still use a lot more antibiotics than we need to. Why should 50% of inpatients in US hospitals be on antibiotics but only 35% in European hospitals? Is it really that different on either side of the Atlantic?
- Selective digestive decontamination (SDD) results in more pronounced increases in antibiotic resistant bacteria.
- One of the key arguments against contact precautions is an increase in the rate of adverse events due to lower observation. However, a study found that abandoning contact precautions for MRSA and VRE didn’t affect the rate of adverse events. Could it be that the increase in adverse events blamed on contact precautions is explained by underlying risk factors?
- Reference to an outbreak of NDM-producing CRE, prompting calls for sterilization of duodenoscopes (made especially topical by the recent duodenoscope-associated outbreak of CRE in LA).
- Seeding hospital surfaces with Bacillus spores to prevent contamination with multidrug-resistant organisms. That just can’t be a good idea!
- Some brief updates from ID Week in Philadelphia and HIS in Lyon.
Journal Roundup is changing! As a result of feedback received from six months of Journal Roundup, I’ve decided to change the format to write a little more detail on fewer articles. This gives me a good opportunity to accept submissions from others to include in the Roundup. So, Journal Roundup is seeking submissions! If you read an article that you think should be included in the Journal Roundup, please submit a short critique (100 to 300 words) of the article as a comment below to be considered for inclusion in a future edition of the Roundup. I won’t publish the comment on this blog, but your contribution will be acknowledged, of course!
Let’s get those submissions rolling in!
Image: Bacterial spores.