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.
The risk of interspecies transmission of carbapenemase genes is a real concern. We can barely get our heads around many different types of carbapenemase in a whole host of Gram-negative bacteria (compare the relative simplicity of methicillin resistance in S. aureus: a single gene, in a single species). Throw in interspecies horizontal transmission of carbapenemases and things get really tricky! Do we implement different control strategies to try to interrupt the transmission of carbapenemases (in contrast to the organisms themselves)? Could you have a multispecies outbreak of a carbapenemase on your hands and not even realise it?
A very enjoyable few days in Edinburgh this week for the Federation of Infection Societies / Healthcare Infections Society (FIS/HIS) meeting. Some reflections follow…
It’s the most Chunderful time of the year (or maybe not). The Norovirus ‘season’ will still be on us and a few points are well worth reflecting on. A recent systematic review of Norovirus risk in high and middle-income countries asserts that there may be as many as 12.5 million infections annually these countries alone, with possibly as many as 2.2 million outpatient visits related to the illness. Personally I have always liked having a bit of norovirus around. Keeps the staff on their toes and gives a good indicator of how IPC is really being performed rather than another set of 99% compliant hand hygiene audits.
Reported by Andreas Widmer in Basel and now published by Hugo Sax and colleagues (CID April 15th, 2015), the amazing story of open-cheat heart surgery, Mycobacterium chimaera infections (years after the operation!), and contaminated heater-coolers in your operating room.
While the Swiss were first, we know by now that this problem is unfortunately not limited to the Alp region, but furthermore present e.g. in the Netherlands. If your hospital has a program for open-chest heart surgery, now is the time to check your heater-coolers, to avoid further airborne transmission of M. chimaera from contaminated heater-cooler units.
The August edition of the Journal of Hosptial Infection Journal Roundup is now available, featuring:
- A whopping five-fold increase in the detection of CRE in 25 US community hospitals.
- MALDI-TOF as a new frontier for rapid detection of carbapenemase activity.
- More on fist bumping instead of hand shaking. (Would you like a fist bump greeting from your doctor? No thanks!)
- Triclosan-impregnated stitches would be cost-effective if they were only a little bit effective, but turns out they’re not effective at all.
- The new ‘crAssphage bacteriophage’, C. difficile biofilms, and increasing rates of antibiotic resistance – all in the human gut microbiome.
- Some hope for Ebola drug and vaccine targets.
- How to reduce the number of sickies that children take from school (through effective school-based immunization programmes).
- Thoughtful analysis on S. aureus outbreaks of old with lessons for now.
- Reviews of CRE mortality, global antibiotic use, microbial hitchhikers, overdiagnosis & overtreatment, useless reporting of science in the mainstream media, and whether biocide use drives biocide resistance.
I’ve written three editions of the Journal of Hosptial Infection Roundup now (June, July and August), so there’s a few examples to review. You can read about my methods for producing the Roundup in the blog accompanying the June edition. I thought that now would be a good time to get some feedback, specifically:
- Is the title right? A few people have expected it to be an overview of articles in the Journal of Hospital Infection only.
- Is the length about right? (Do you fall asleep reading it or find yourself begging for more?)
- Is the depth right? Or would you like to read more about less articles, or less about more articles?
Any feedback that you have would be most appreciated. Please either submit a comment below or email me.
Photo credit: ‘Fist bump’.