Infection Control Matters

Martin Kiernan managaed to grab a few minutes with Dr Michael Klompas, ID Physicial at Brigham and Women's Hospital, Boston and Associate Professor at Harvard Medical School, at the SHEA Spring meeting. We discuss the use of N95 masks and whether in a time of Omicron increased prevalence they should be used in all healthcare settins and not just for suspected or confirmed cases of COVID. Some of Dr Klompas' recent papers are here:

1. Klompas M, et al. Universal Use of N95 Respirators in Healthcare Settings When Community Coronavirus Disease 2019 Rates Are High. Clin Infect Dis. 2022;74(3):529-531.  doi:10.1093/cid/ciab539

2. Klompas M, et al. Preventing SARS-CoV-2 Transmission in Health Care Settings in the Context of the Omicron Variant. JAMA. 2022;327(7):619-620.  https://jamanetwork.com/journals/jama/article-abstract/2788503

3. Klompas M, et al. COVID-19's Challenges to Infection Control Dogma Regarding Respiratory Virus Transmission. Clin Infect Dis. 2022.  https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciac204/6546689

4. Baker MA, et al. Rapid control of hospital-based SARS-CoV-2 Omicron clusters through daily testing and universal use of N95 respirators. Clin Infect Dis. 2022.  https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciac113/6523822

5. Klompas M, et al. Current Insights Into Respiratory Virus Transmission and Potential Implications for Infection Control Programs : A Narrative Review. Ann Intern Med. https://pubmed.ncbi.nlm.nih.gov/34748374/

In this week's episode, Martin Kiernan talks to Dr Judith Tanner, Professor of Adult Nursing at the University of Nottingham, UK about a paper in which a mixed methods approach to examining potential and actual barriers to implementation of patient warming were examined. Papers discussed during the session include:

1. Tanner J, et al. Using a comprehensive audit to identify local context prior to care bundle design and implementation for inadvertent perioperative hypothermia in colorectal surgery. BMJ Open Qual. 2021;10(1).   doi:10.1136/bmjoq-2020-001132  https://bmjopenquality.bmj.com/content/10/1/e001132

In this episode, Phil Russo flies solo and discusses strategies for prevention of SSI with Professor Charles Edmiston, Emeritus Professor at the Medical College of Wisconsin in Milwaukee. Chuck has a longstanding interest in SSI prevention and a few of his papers are listed below. As ever, 'compliance' with interventions is a key issue.

1. Parvizi, J., S. Barnes, N. Shohat & C. E. Edmiston, Jr. (2017) Environment of care: Is it time to reassess microbial contamination of the operating room air as a risk factor for surgical site infection in total joint arthroplasty? Am J Infect Control, 45, 1267-1272. https://www.ncbi.nlm.nih.gov/pubmed/28818359

In this episode Brett Mitchell talks to Associate Professor Holly Seale about the role of social scientists, vaccine hesitancy, booster vaccines and the potential implications for the next influenza season. Holly is an infectious disease social scientist at the School of Population Health at the University of New South Wales in Australia. She has over 15 years of experience in undertaking social science research focused on improving confidence and engagement of different at-risk groups with immunisation and other prevention strategies.

In this week's episode, Martin Kiernan talks to Alexandra Peters, who works in Prof. Didier Pittet's group at the University Hospitals of Geneva and with a WHO Collaborating Centre. We discuss a new systematic review that demonstrates that there is significant evidence that environmental decontamination reduces healthcare-associated infections and colonisations and also progress on a new Healthcare Environmentsl Hygiene (HEH) self-assessment tool, the results of which will shortly be published.

Papers that we discuss are:

Peters, A., Schmid, M.N., Parneix, P. et al. Impact of environmental hygiene interventions on healthcare-associated infections and patient colonization: a systematic review. Antimicrob Resist Infect Control 11, 38 (2022). https://doi.org/10.1186 - https://link.springer.com/article/10.1186/s13756-022-01075-1#article-info

Accepted paper, shortly to appear in the AJIC website:

Peters, A., Schmid, M., deKraker, M. et al. Results of an international pilot survey on healthcare environmental hygiene at the facility level. American Journal of Infection Control (2022)

Also mentioned:

Brett G Mitchell, Lisa Hall, Nicole White, Adrian G Barnett, Kate Halton, David L Paterson, Thomas V Riley, Anne Gardner, Katie Page, Alison Farrington, Christian A Gericke, Nicholas Graves, An environmental cleaning bundle and health-care-associated infections in hospitals (REACH): a multicentre, randomised trial, The Lancet Infectious Diseases,

Deverick J Anderson, Rebekah W Moehring, David J Weber, Sarah S Lewis, Luke F Chen, J Conrad Schwab, Paul Becherer, Michael Blocker, Patricia F Triplett, Lauren P Knelson, Yuliya Lokhnygina, William A Rutala, Daniel J Sexton, Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile: a secondary analysis of a multicentre cluster randomised controlled trial with crossover design (BETR Disinfection), The Lancet Infectious Diseases, Volume 18, Issue 8, 2018, Pages 845-853, https://doi.org/10.1016/S1473-3099(18)30278-0 https://www.sciencedirect.com/science/article/pii/S1473309918302780

In this week's episode, Brett Mitchell and Martin Kiernan use a recent paper published in Infection Control and Hospital Epidemiology to start a discussion about an relationship between IPC Team staffiing levels and levels of healthcare-associated infections. How are staffing levels set and is it just a number or is there more to it? The papers that we discuss are listed below.

1. Clifford RJ, Newhart D, Laguio-Vila MR, Gutowski JL, Bronstein MZ, Lesho EP. Infection preventionist staffing levels and rates of 10 types of healthcare-associated infections: A 9-year ambidirectional observation. Infect Control Hosp Epidemiol. 2022:1-6. doi:10.1017/ice.2021.507

2. Mitchell BG, Hall L, MacBeth D, Gardner A, Halton K. Hospital infection control units: staffing, costs, and priorities. Am J Infect Control. 2015;43:612-6. doi:10.1016/j.ajic.2015.02.016

3. Dickstein Y, Nir-Paz R, Pulcini C, Cookson B, Beovic B, Tacconelli E, et al. Staffing for infectious diseases, clinical microbiology and infection control in hospitals in 2015: results of an ESCMID member survey. Clin Microbiol Infect. 2016;22:812 e9- e17. doi:10.1016/j.cmi.2016.06.014

In this episode, Martin Kiernan talks to Professor Gonzalo Bearman, Chair, Division of Infectious Diseases and Hospital Epidemiologist/Medical Director of VCU Healthcare and the Richard P. Wenzel Professor of Internal Medicine at the Virginia Commonwealth University Health System (full CV here) 

Following on from the increase in virtual working due to the pandemic, we discuss the potential for providing healthcare facilities in low and middle income countries with virtual support and consulting. The papers that we discuss are listed here.

1. Jones, T., Marimuthu, K., Bearman, G. Virtual Infection Prevention and Control in Low- and Middle-Income Countries, International Journal of Infectious Diseases,

2. Anderson, D., Miller, B., Chen, L., Adcock, L., Cook, E., Cromer, A., . . . Sexton, D. (2011). The Network Approach for Prevention of Healthcare-Associated Infections: Long-Term Effect of Participation in the Duke Infection Control Outreach Network. Infection Control & Hospital Epidemiology, 32(4), 315-322. https://doi.org/10.1086/658940

3.Pryor, R., Vokes, R., Anderson, D., & Bearman, G. (2021). Virtual infection prevention—The next frontier. Infection Control & Hospital Epidemiology, 42(11), 1374-1375. https://doi.org/10.1017/ice.2020.1404

In this episode, Brett Mitchell and Martin Kiernan discuss methods of drying hands after hand hygiene has been performed, with a focus on hand dryers versus paper towel. Personal details about Martin's habits are disclosed as we mull this over and present some papers.

Papers presented include:

1. Suen, L. K., Lung, V. Y., Boost, M. V., Au-Yeung, C. H., & Siu, G. K. (2019). Microbiological evaluation of different hand drying methods for removing bacteria from washed hands. Scientific reports, 9(1), 1-7.  https://www.nature.com/articles/s41598-019-50239-4

2. Reynolds, K. A., Sexton, J. D., Norman, A., & McClelland, D. J. (2021). Comparison of electric hand dryers and paper towels for hand hygiene: a critical review of the literature. Journal of applied microbiology, 130(1), 25-39.  https://pubmed.ncbi.nlm.nih.gov/32794646/

The WHO Global Outreach Alert and Response Network (GOARN) is the topic for this podcast. We talk with Dr Peta-Anne Zimmerman about the network, what is does and how to get involved.

Dr Peta-Anne Zimmerman is Senior Lecturer and Program Advisor for the Griffith University and is Board Director of the Australasian College for Infection Prevention and Control. She is also a Senior Faculty and Focal Point for the Global Outbreak Alert and Response Network of the World Health Organization.

The weblink to GOARN for more information is https://extranet.who.int/goarn/

In this episode we return to another ICM favourite topic, healthcare-associated pneumonia that is not device-associated. Martin Kiernan talks to Dr Mark Garvey, Director of Infection Prevention and Helen Woodall, Senior Dental Nurse, both of University Hospitals Birmingham NHS Trust about the 'Mouth Care Matters' initiative. Education of registered nurses and healthcare assistants was a key part of the strategy, which ultimately resulted in a significant reduction in infections.

Note that in England a 'Trust' is an NHS healthcare provider organisation which may be made up of more than one hospital or unit.

The paper outlining the initiative and results can be found here https://www.journalofinfection.com/article/S0163-4453(21)00275-9/fulltext