The ethics of MDRO screening

I heard an interesting talk by Dr Michael Miller last week on the ethics of screening for MDROs. Whilst we need to think carefully about the ethics of all medical procedures (great and small), I think the benefits to the individual and the population generally outweigh downsides for MDRO screening programmes.

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CPE screening Q&A: the who, when, and how

I gave a talk yesterday as part of a PHE London event on the whys and wherefores of screening for MDROs – my talk was focussed on CPE, and you can download my slides here: “CPE: seek and ye shall find”. I thought a quick Q&A would be the best way to summarise the content.

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Staff screening for MDROs: closing Pandora’s Box

A brave study from the Palmore/Frank group at NIH has opened the Pandora’s Box that is screening staff for MDROs, and, I’m delighted to say, firmly closed it with their findings! Only 3% of staff carried ESBLs, one carried a CPE, and none carried VRE, and this despite extensive contact with MDRO patients for many of the staff sampled!

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Everybody needs good neighbours (for sharing CPE)

BMC Medicine have recently published a study from researchers in Oxford, PHE, and Manchester illuminating the importance of referral networks in the transmission of CPE. The bottom line is that regional referral networks seem to be the most important driver of CPE spread, such that a small CPE problem close to home is more of a threat than a larger CPE problem in a distant referral network!

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What do you do to prevent VRE transmission?

What do you do to prevent VRE transmission?

…you are not alone, if the answer to this question is ‘nothing special’, based on survey published in ARIC! Dale Fisher’s team in Singapore put together a simple survey, asking the global IPC community what measures they have in place to prevent the transmission of VRE. There was a huge degree of variability, ranging from ‘nothing special’ to ‘the kitchen sink’!

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Using the Toolkit to build a CPE policy

toolkit

I led a workshop at IPS today with my colleague Tracey Galletly on using PHE’s Toolkit to build a CPE policy. We based the session around a series of multiple choice questions that the audience voted on. I thought I’d share the results and key points raised! Continue reading

CPE carriage: a rare event in London?

My old CIDR team have just published a study in JAC reporting a very low rate of carriage of CPE in patient admitted to a hospital in central London (just 5 (0.1%) of 4006 patients). This was a lot lower than we expected! Despite the very low rate of carriage, overseas hospitalisation was a significant risk factor for CPE carriage, and supports that we should be screening patients with recent overseas hospitalisation for CPE carriage.

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