Getting to grips with healthcare-associated Gram-negative bloodstream infection

I did a Webber Teleclass today on GNBSI. I covered some background and epi, drivers of GNBSI, and how we can take positive steps to tackle GNBSI. Here’s my slides, with a summary below.

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It (the flu) came from the desert

We tend to find that the flu season in Australia is an early predictor for the severity of the coming flu season in the Europe. And the early indications are the flu in Aus this year is bad – unprecedentedly bad. So, let’s get our flu vaccination campaign planning hats on!

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Who’s looking for CPE in English hospitals?

A team of authors surveyed NHS acute hospitals in England to determine the approach to CPE detection, including laboratory methods. The findings provide an opportunity to compare the approach to CPE detection and prevalence nationally, identifying higher CPE prevalence in the North-West, North-East and the South-East (the region that includes London) of England. The findings also suggest that more screening for CPE would detect more carriers – and perhaps help to prevent a silent epidemic of CPE in some regions.

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Planning to halve GNBSI: getting to grips with healthcare-associated E. coli BSI sources

Today, the Journal of Hospital Infection have published an article from our research group about E. coli BSI sources. The key message is that the sources of E. coli BSIs at a large teaching hospital differ considerably from the national average, with a large proportion related to febrile neutropaenia (18%) and diverse gastrointestinal sources (15%). This calls into question the ‘preventable’ proportion of these cases – and adds something to the discussion as to whether the national ambition to halve GNBSI by 2021 is feasible.

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Making terminal disinfection BETR part II: another perspective

Marc recently posted about the second clinical outcome findings from the BETR-D study, recently published in the Lancet Infectious Diseases. Marc contended that the team may have been ‘blinded by the [UV] light’ in reaching the conclusion that enhanced terminal room disinfection led to a hospital wide reduction in acquisition of key pathogens. Here, in the spirit of healthy academic debate, I offer another perspective.

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Are our attempts to contain CPE going down the drain?

I posted recently on the potential risk of CPE contamination of sinks, drains, and hospital wastewater. The question in my mind then was whether contamination is a smoking gun or innocent bystander regarding CPE transmission? What we really need is an intervention to show that better management of sinks and drains results in reduce CPE transmission. And now, we have one! The findings suggest that attempts to control CPE will go down the drain if we don’t intervene to improvement the management of sinks and drains.

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