Infection Control Matters

It was day 3 at ESCMID Global 2024 and Phil, Brett and Martin mull over the day. Amongst the items we discuss are:
What does endogenous really mean?
AI in the IPC space - friend or foe?
Fungal outbreaks - epidemiological challenges and tracing the source
Automated bloodstream infection surveillance
The Euro PPS survey results - data in action (or inaction)
Subsequent to the podcast recording the ECDC PPS results have been published and can be found here:
https://www.ecdc.europa.eu/sites/default/files/documents/healthcare-associated--infections-antimicrobial-use-point-prevalence-survey-2016-2017.pdf

In this episode, Phil, Brett and Martin dicuss more sessions from ESCMID Global (Barcelona, 2024). We talk about sessions on cleaning the occupied bed space, SSI prevention and the difficulty of designing and executing good studies in IPC. We were particularly interested in papers from Italy on the use of probiotics in IPC and some papers from Prof Cassini's group are highlighted below.
Calabro GE, Caselli E, Rognoni C, Laurenti P, Moscato U, ML DIP, et al. [Health Technology Assessment of the introduction of the Probiotic Cleaning Hygiene System (PCHS) in the Italian healthcare setting: update]. J Prev Med Hyg. 2023;64:E1-E35. https://www.ncbi.nlm.nih.gov/pubmed/37881619
D'Accolti M, Soffritti I, Bini F, Mazziga E, Cason C, Comar M, et al. Shaping the subway microbiome through probiotic-based sanitation during the COVID-19 emergency: a pre-post case-control study. Microbiome. 2023;11:64. https://www.ncbi.nlm.nih.gov/pubmed/36991513
D'Accolti M, Soffritti I, Bini F, Mazziga E, Mazzacane S, Caselli E. Pathogen Control in the Built Environment: A Probiotic-Based System as a Remedy for the Spread of Antibiotic Resistance. Microorganisms. 2022;10. https://www.ncbi.nlm.nih.gov/pubmed/35208679
Caselli E, Purificato I. Could we fight healthcare-associated infections and antimicrobial resistance with probiotic-based sanitation? Commentary. Ann Ist Super Sanita. 2020;56:263-6. https://www.ncbi.nlm.nih.gov/pubmed/32959791|
Caselli E, D'Accolti M, Vandini A, Lanzoni L, Camerada MT, Coccagna M, et al. Impact of a Probiotic-Based Cleaning Intervention on the Microbiota Ecosystem of the Hospital Surfaces: Focus on the Resistome Remodulation. PLoS One. 2016;11:e0148857. https://www.ncbi.nlm.nih.gov/pubmed/26886448

In this episode, Brett, Martin and Phil mull over the newly published WHO discussion document on respiratory particles and Martin catches up with Prof Cath Noakes from the School of Engineering in Leeds, UK to get her take on it.
 
You can download the document we are discussing here
https://www.who.int/publications/m/item/global-technical-consultation-report-on-proposed-terminology-for-pathogens-that-transmit-through-the-air

In this podcast, Brett and Martin reflect on the "Infection Control Papers of the Year" presented at ECCMID (AKA ESCMID Global) 2024.
Here are a selection of some of the papers mentioned:
Decolonization in Nursing Homes to Prevent Infection and Hospitalization https://pubmed.ncbi.nlm.nih.gov/37815935/
Reducing Hospitalizations and Multidrug-Resistant Organisms vi a Regional Decolonization in Hospitals and Nursing Homes https://pubmed.ncbi.nlm.nih.gov/38557703/
Prevention of non-ventilator-associated hospital-acquired pneumonia in Switzerland: a type 2 hybrid effectiveness-implementation trial https://pubmed.ncbi.nlm.nih.gov/36893785/
Skin Antisepsis before Surgical Fixation of Extremity Fractures https://www.nejm.org/doi/full/10.1056/NEJMoa2307679
Trial of Vancomycin and Cefazolin as Surgical Prophylaxis in Arthroplasty https://www.nejm.org/doi/full/10.1056/NEJMoa2301401
Investigation of individual nurses' relative hand hygiene performance using an anonymous automated electronic hand hygiene monitoring system and a nursing assignment schedule https://www.ajicjournal.org/article/S0196-6553(22)00468-0/abstract
Environmental cleaning to prevent hospital-acquired infections on non-intensive care units: a pragmatic, single-centre, cluster randomized controlled, crossover trial comparing soap-based, disinfection and probiotic cleaning https://pubmed.ncbi.nlm.nih.gov/37089619/

In our first episode from ECCMID Global 2024, Martin and Brett reflect on the session on design of the healthcare environment sessions from Profs Hilary Humphries and Cath Noakes and a flash poster session featuring VRE Reservoirs in the environment and a tremendous piece of  Burkolderia sleuthing from the UKHSA

In this podcast, we chat with Dr Brian Forde about HAIviz. HAIviz an interactive dashboard for visualising and integrating healthcare-associated genomic epidemiological data. HAIviz displays and links the outbreak timeline, building map, phylogenetic tree, patient bed movements, and transmission network on a single interactive dashboard.
You can view and use the tool for free at https://haiviz.fordelab.com 
Papers referred to in the podcast:
Permana, B., Harris, P. N., Roberts, L. W., Cuddihy, T., Paterson, D. L., Beatson, S. A., & Forde, B. M. (2024). HAIviz: an interactive dashboard for visualising and integrating healthcare-associated genomic epidemiological data. Microbial Genomics, 10(2), 001200.
 
 

In this episode, Martin Kiernan talks to Mitch Clarke, Clinical Lead and Deputy Director of Infection Prevention and Control at Nottingham University Hospitals in the UK. We discuss an outbreak with a unique NDM CPE infection and look at where the investigations went, including a new reservoir that is a potential source - the floor scrubber.
Papers underpinning this work are here:
1. Benbow A, Clarke M, Yates C, Montgomery R, Staniforth K, Boswell T, et al. Hospital-wide healthcare-associated carbapenemase-producing Enterobacterales outbreak: risks of electric floor scrubbers in catering facilities and kitchens. J Hosp Infect. 2024;146:59-65. https://www.ncbi.nlm.nih.gov/pubmed/38341149 2. Prescott K, Billam H, Yates C, Clarke M, Montgomery R, Staniforth K, et al. Outbreak of New Delhi Metallo-Beta-lactamase Carbapenemase Producing Enterobacterales on a bone marrow transplant unit: Role of the environment. Infect Prev Pract. 2021;3:100125. https://www.ncbi.nlm.nih.gov/pubmed/34368742

In this episode, Martin Talks to Dr Mark Wilcox OBE, Professor of Microbiology at the University of Leeds, Head of Microbiology Research & Development at Leeds University Hospitals NHS Trust and National Clinical Director for Infection Prevention and Control at NHS England. We mull over the possible reasons for the increase in hospital-onset, hospital attributed cases in England, including ribotypes and antibiotic use. Given that the NHS is under great stress, we discuss the damage potential from a ribotype 955 which shares some genetic characteristics with the 027 ribotype that caused so many problems in the UK and worldwide in the early 2000s. One thing that we agree on is that reductions targets (with teeth) have been very successful in the past and should we venture in that direction again?
Information on data collection, hospital and national typing reports for England can be found here: https://www.gov.uk/government/collections/clostridium-difficile-guidance-data-and-analysis#epidemiology

In this episode, after an interesting discovery when searching Youtube, Brett and Martin mull over whether toilet plume is a risk factor for hospital-acquired pneumonia and C. difficile infections. The papers we discuss are listed below.
Goforth MP, Boone SA, Clark J, Valenzuela PB, McKinney J, Ijaz MK, et al. Impacts of lid closure during toilet flushing and of toilet bowl cleaning on viral contamination of surfaces in United States restrooms. Am J Infect Control 2023. https://doi.org/10.1016/j.ajic.2023.11.020
Best EL, Sandoe JA, Wilcox MH. Potential for aerosolization of Clostridium difficile after flushing toilets: the role of toilet lids in reducing environmental contamination risk. J Hosp Infect 2012;80(1):1-5. https://doi.org/10.1016/j.jhin.2011.08.010
Lai ACK, Tan TF, Li WS, Ip DKM. Emission strength of airborne pathogens during toilet flushing. Indoor Air 2018;28(1):73-9. https://doi.org/10.1111/ina.12406

We chat with Dr Deirdre Fitzgerald-Hughes and Aoife Kearney about a national survey undertaken in Ireland. In the survey, they explored CPE knowledge and practices of healthcare workers, including infection prevention and control staff.
There were some interesting findings that may be useful in informing IPC education and training, including convincing people that they need to know more.
The paper we discuss is:
Kearney, A., Humphreys, H., & Fitzgerald-Hughes, D. (2023). Infection prevention and control policy implementation for CPE: A cross-sectional national survey of healthcare workers reveals knowledge gaps and sub-optimal practices. Journal of Hospital Infection. https://doi.org/10.1016/j.jhin.2023.12.007