Nine decades of antibiotics: a story with two endings…

I did a talk today in Portugal covering the nine decades since Fleming discovered the effects of Penicillium sp. in 1928. I thought it would be interesting to have two endings to the talk: an upbeat one, and a doomsday one.

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Do single rooms prevent HCAI? This suggest suggests YES for norovirus, but no for C. difficile infection and E. coli BSI

There are pros and cons of increasing the proportion of single rooms. One of the commonly-cited pros is a reduction in HCAI. A recent UK study provides some evidence that C. difficlie infection, and MSSA /  E. coli BSIs are not reduced by a move to a hospital with more single rooms, but that norovirus control is more effective when you have more single rooms.

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Counting the cost of HCAI-related litigation

I heard an eye-opening talk at IPS about the cost of HCAI-related litigation to the NHS. This is something that gets talked about a lot in economic analyses (“these figures do not include the cost of litigation”), but it is difficult to find accurate figures on the scale of the expense. Data from NHS Resolution* suggests that HCAI-related litigation costs the NHS in the region of £60m per annum, which accounts for around 4% of all harm settlements from NHS Resolution each year.

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Do single rooms reduce HCAI?

An interesting review article examines the relationship between three related variables: the proportion of single rooms, the size of the patient room and patient proximity, and the availability of antiseptic hand rub, with various HCAI indicators. The bottom line is that both a move towards a higher proportion of single rooms and larger patient rooms are associated with reduced HCAI, and making hand gels more available improves compliance with their use (unsurprisingly).

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“HCAI”

Airquotes

I read a Controversies blog today, reflecting on a recent editorial suggesting that, because of frequent over-diagnosis, we should use quote marks every time we write “CAUTI” – and even use air quotes every time we say it! But why stop at CAUTI? Should we be talking about “CLABSI”, “CDI”, “SSI” and, well, any “HCAI” really?

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