environmental hygiene

Towards standardisation of hospital wastewater sampling

Guest Blogger Water , , , , , , , ,

Another guest post from Dr Phil Norville (bio below)…

Very few weeks go by without me reading a paper discussing a multidrug-resistant outbreak that is linked to contaminated water or wastewater systems. The most recent was an outbreak of Achromobacter species in 22 patients which was linked to water in contaminated tubes of a medical pressurizer (used for urology surgery). It was one the reasons Jon and I wrote a letter to the Journal of Hospital Infection calling for a move towards the standardisation of wastewater sampling.

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Candida auris and surface survival

Jon Otter (@jonotter) Candida , ,

Candida auris is an emerging threat to healthcare facilities worldwide. Recent, worrying, data from the US suggests that prevalence is increasing rapidly. So, we need to make sure we have every prevention base covered to reduce the chances of cross-transmission. C. auris seems to be quite an environmental organism – and a recent JHI study confirms this, showing extended survival on surfaces and tolerance to low concentrations of some biocides.

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The ‘thorny 5th Moment for Hand Hygiene’: hands and surfaces collide

Jon Otter (@jonotter) Transmission , ,

We talk often about the 5 Moments for Hand Hygiene but frequently neglect the 5th moment (after contact with a patient’s environment). So much so, that you might even describe this as the “Cinderella moment for hand hygiene”! Could it be that the Cinderella moment is actually the most important in the transmission of pathogens that cause HCAI? Maybe sometimes. But that’s missing the point. If we don’t focus our attention on all moments for hand hygiene, we won’t be as effective as we could be in preventing cross-transmission.

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Are we now over-emphasizing the role of handwashing in preventing spread of infection?

Guest Blogger Hand hygiene , ,

A guest post by Professor Sally Bloomfield explores whether we are over-emphasizing the role of hand washing in preventing the spread of infection…

If you ask whether I think hand hygiene is the single most important intervention for preventing spread of infection, I would answer yes. But I also think the COVID pandemic requires us to re-evaluate how we look at infection prevention (or hygiene) to make it relevant to the issues we now face, which are as much about “airborne “ transmission routes as hands and contact surfaces.

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How dirty is your QWERTY?

Jon Otter (@jonotter) environmental contamination , , , , , ,

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. 

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12 months of COVID – what have we learned? Part 1 (ventilation and the environment)

Jon Otter (@jonotter) COVID-19 , , , , ,

I was part of the panel for the latest HIS webinar earlier this week. And here it is:

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Using “health outcomes” as the basis for developing effective and sustainable hygiene interventions – is 2019 the time for a rethink?

Guest Blogger Disinfection , , , , , ,

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.

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Reflections from Infection Prevention 2015 Part III: Thinking outside the box

Jon Otter (@jonotter) Conferences , , , , , , ,

think outside the box

For the third and final installment of my blog-report from Infection Prevention 2015, I thought I’d cover some of the more innovative approaches in and around the IPC sphere:

Part I: Beating the bugs

Part II: Improving the systems

Part III: Thinking outside the box

New technology to improve hand and environmental hygiene

I for one am pretty sick of seeing unrealistically high levels of hand hygiene compliance being reported from peer-to-peer manual auditing approaches. One way to get more realistic compliance data is through automated approaches to hand hygiene compliance, reviewed here by Drs Dawson (Warwick) and Mackrill (Imperial College London), who also presented their findings at the conference, and by another group here. Drs Dawson and Mackrill considered issues around product usage, self-reporting, direct observation, perceptions of technology (often viewed, unhelpfully, as a ‘silver bullet’), and staff perceptions of need and benefit. They divided the technology into those that monitored product usage, surveillance systems that monitored individual performance, and systems that monitored both product usage and individual performance. Although automated surveillance systems will always be imperfect and involve a degree of inference, would you rather monitor the 5 moments sporadically / badly or have robust measurements of a smaller number of moments? Automated surveillance methods will not replace manual audits – at least for now – but it’s time to take a long hard look at what is available.

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