Infection Control Matters

In this podcast, Martin Kiernan talks to Dr Alicia Demirjian about the issue of seemingly increasing reports of Staphylococcus capitis cases in neonates. Alicia is Consultant Epidemiologist at the Evelina Children's hospital in London and leads the antimicrobial resistance and prescribing team at the UK Health Security Agency (UKHSA) - formerly Public Health England. Alicia has been working on this issue for a while now and we discuss the problem (and if there is one), findings to date and possible interventions. Some of the papers that we discuss are here, as is a link to the video on how to clean an incubator, a complex piece of equipment that is often still contaminated after cleaning and disinfection.

Cleaning video:

https://www.youtube.com/watch?v=ELF-0MTFJfE

Papers:

Wirth, T., M. Bergot, et al (2020) Niche specialization and spread of Staphylococcus capitis involved in neonatal sepsis. Nat Microbiol, 5, 735-745. https://www.ncbi.nlm.nih.gov/pubmed/32341568

Thorn, L. M., et al (2020) Risk factors for Staphylococcus capitis pulsotype NRCS-A colonisation among premature neonates in the neonatal intensive care unit of a tertiary-care hospital: a retrospective case-control study. Infect Prev Pract, 2, 100057. https://www.ncbi.nlm.nih.gov/pubmed/34368703

In this episode, Martin Kiernan talks to Prof Heather Loveday, Director of the Richard Wells Research Centre at the University of West London about an lecture recently given at the 2021 IPS Conference. The topic discussed centres on the role that fundamental care has in the prevention of healthcare-associated infections and the impact of 'missed' care.

Papers for futher reading on these topics are listed below.

Journal of Clinical Nursing special issue on fundamental care: https://onlinelibrary.wiley.com/toc/13652702/2018/27/11-12

In this week's episode, Martin Kiernan talks to Dr Jon Otter of Guy's and St Thomas' Hospital NHS Trust in the UK about a couple of Jon's recent blog postings on the popular "Reflections" blog (https://reflectionsipc.com/). We first discuss a paper in the New England Journal of Medicine that reported on a study that examined the use of monoclonal antibodies in preventing infection in unvaccinated household contacts of COVID that can be found here https://www.nejm.org/doi/full/10.1056/NEJMoa2109682.

Then we go on to discuss Jon's recent presentation on future priorities for iPC in healthcare, the slides for which are available here (https://jonotter.files.wordpress.com/2021/10/211014-the-future-of-healthcare-and-ipc.pptx).

In this episode, Prof Brett Mitchell talks to Dr Carl-Johan Frankel from the Department of Infection Control, Lund University, Sweden about his recent paper examining the risk of transmission of Norovirus to roomates. Does norovirus transmit readily to other occupants? The findings may well surprise you! The paper is here: https://www.journalofhospitalinfection.com/article/S0195-6701(21)00313-3/fulltext

Other papers referred to:

Risk of transmission to subsequent room occupants: https://www.journalofhospitalinfection.com/article/S0195-6701(15)00312-6/fulltext

Prolonged environmental survival of small round structured viruses: https://www.journalofhospitalinfection.com/article/S0195-6701(97)90230-9/pdf

In another special edition from the 2021 IPS conference in Liverpool UK, Martin Kiernan talks to Dr Jon Otter, who presented a paper on improving and broadening surgical site infection surveillance. But to whom does it matter and how can IPC Teams achieve engagement with other clinical specialities and managers of healthcare providers?

Shockingly in this episode Jon admits to finding a qualitative study of interest - Tanner J, Padley W, Davey S, Murphy K, Brown B Patients’ experiences of surgical site infection. Journal of Infection Prevention 2012; 13: 164-8.

Another paper discussed is a further study by Prof Judith Tanner, in which bundle adherence is low, however is data feedback getting to the right place?

Tanner J, Kiernan M, Hilliam R et al. Effectiveness of a care bundle to reduce surgical site infections in patients having open colorectal surgery. Ann R Coll Surg Engl 2016; 98: 270-4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5226025/pdf/rcsann.2016.0072.pdf

In this episode from the IPS conference, Prof Brett Mitchell is joined by Dr Evonne Curran who has worked in the field of infection prevention and control for a number of years, was a Nurse Consultant with Health Protection Scotland and is now an independent consultant. Together they discuss the relevance of guidelines to clinical practice and whether the development process is really producing guidance that is useful in the field of nfection prevention. In this podcast these papers are referred to:

Smith GC, Pell JP Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ 2003; 327: 1459-61. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/pdf/32701459.pdf

Yeh RW, Valsdottir LR, Yeh MW et al. Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial. BMJ 2018; 363: k5094. https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/30545967/

Greenhalgh T Will COVID-19 be evidence-based medicine's nemesis? PLoS Med 2020; 17: e1003266. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326185/pdf/pmed.1003266.pdf

In this final episode at ICPIC 2021 (Geneva), Martin Kiernan talks to Professor Andreas Voss  from the Radboud University Medical Centre (Radboudumc) and Canisus-Wilhelmina Ziekenhuis in the Netherlands. Andreas is always a sought after speaker for his engaging style whilst getting to the heart of the matter. To get the most from this podcast, you might need to look at the papers we mention below.

Endoscopes

Benowitz I, Moulton-Meissner HA, Epstein L, Arduino MJ. Gastrointestinal Flexible Endoscopes: Infection Control Risks, Lessons Learned from Outbreaks, and Centers for Disease Control and Prevention Guidance. Gastrointestinal Endoscopy Clinics of North America. 2020;30(4):723-33 https://www.sciencedirect.com/science/article/abs/pii/S1052515720300702?via%3Dihub

Sinks

De Geyter D, Blommaert L, Verbraeken N, Sevenois M, Huyghens L, Martini H, et al. The sink as a potential source of transmission of carbapenemase-producing Enterobacteriaceae in the intensive care unit. Antimicrob Resist Infect Control. 2017;6:24. https://www.ncbi.nlm.nih.gov/pubmed/34111433

Decreased other infections (STD and Norovirus)

Nelson B. The positive effects of covid-19. BMJ. 2020;369:m1785. http://www.bmj.com/content/369/bmj.m1785.abstract

Bruggink LD, Garcia-Clapes A, Tran T, Druce JD, Thorley BR. Decreased incidence of enterovirus and norovirus infections during the COVID-19 pandemic, Victoria, Australia, 2020. Commun Dis Intell (2018). 2021 Jan 29;45. doi: 10.33321/cdi.2021.45.5. PMID: 33573536.

Impact on ocular health

Bahkir, Fayiqa Ahamed; Grandee, Srinivasan Subramanian Impact of the COVID-19 lockdown on digital device-related ocular health, Indian Journal of Ophthalmology: November 2020 - Volume 68 - Issue 11 - p 2378-2383 doi: 10.4103/ijo.IJO_2306_20

Dog-assisted therapy

Edner A, Lindstrom-Nilsson M, Melhus A. Low risk of transmission of pathogenic bacteria between children and the assistance dog during animal-assisted therapy if strict rules are followed. J Hosp Infect. 2021;115:5-9.

https://www.journalofhospitalinfection.com/article/S0195-6701(21)00178-X/fulltext

Lace up masks

Wang X, Lin F, Wang Z, Hu J, Li X, Zhu B, et al. The defects of lace-up surgical masks and related solutions in operating rooms. J Hosp Infect. 2021;115:64-70. https://www.journalofhospitalinfection.com/article/S0195-6701(21)00237-1/fulltext#relatedArticles

Migrane and mask wearing

Bharatendu C, Ong JJY, Goh Y, Tan BYQ, Chan ACY, Tang JZY, et al. Powered Air Purifying Respirator (PAPR) restores the N95 face mask induced cerebral hemodynamic alterations among Healthcare Workers during COVID-19 Outbreak. J Neurol Sci. 2020;417:117078.

https://www.jns-journal.com/action/showPdf?pii=S0022-510X%2820%2930415-9

A nose for pneumonia

Chen, C.-Y., Lin, W.-C. & Yang, H.-Y. Diagnosis of ventilator-associated pneumonia using electronic nose sensor array signals: solutions to improve the application of machine learning in respiratory research. Respir Res 2020;21:45 (2020). https://doi.org/10.1186/s12931-020-1285-6

Social media for epidemiologists

Hammer CC, Boender TS, Thomas DR. Social media for field epidemiologists (#SoMe4epi): How to use Twitter during the #COVID19 pandemic. Int J Infect Dis. 2021.

https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(21)00437-9

Use of Emoji in communication

Lotfinejad, N., Assadi, R., Aelami, M. H. & Pittet, D. Emojis in public health and how they might be used for hand hygiene and infection prevention and control. Antimicrob Resist Infect Control 2020;9:27. https://doi.org/10.1186/s13756-020-0692-2 

On Call IPC Services

Humphreys H. Infection prevention and control advice out-of-hours. J Hosp Infect. 2020;105(4):795-6.

https://www.journalofhospitalinfection.com/article/S0195-6701(20)30262-0/fulltext

Handshake/Fist Bump

Sklansky M, Nadkarni N, Ramirez-Avila L. Banning the handshake from the health care setting. JAMA. 2014;311(24):2477-8.

https://jamanetwork.com/journals/jama/article-abstract/1873637

Mela S, Whitworth DE. The fist bump: a more hygienic alternative to the handshake. Am J Infect Control. 2014;42(8):916-7.

http://www.ncbi.nlm.nih.gov/pubmed/25087144

Elbow or hand

Liu H, Gao L, Sun C. Elbow instead of hand: is it more helpful or harmful? J Public Health (Oxf). 2020.

https://www.ncbi.nlm.nih.gov/pubmed/32529204

In another special edition from ICPIC, Martin talks to An Caluwaerts, IPC Specialist from Kliniek Sint Jan, Brussels. This was a poster presentation that was selected as part of a poster walk and it is a practical piece of work that describes the process of calculating the number of staff (and hours) needed to clean a standard hospital ward. A copy of the poster can be downloaded below.

DETERMINING STAFFING LEVELS FOR ENVIRONMENTAL CLEANING: TIME MEASUREMENTS IN NON-CRITICAL CARE UNITS IN AN ACUTE CARE HOSPITAL IN BRUSSELS

In another episode from the 2021 ICPIC Conference, Martin Kiernan talks to Dr Amy Mathers, who moderated and spoke at a session on whole genome sequencing and also the issue of plasmid-mediated outbreaks. World-reknowned for her work on drains and sinks at the University of Virginia (see http://uvasinklab.org/), here are just a couple of the research outputs.

Intensive Care Unit Wastewater Interventions to Prevent Transmission of Multispecies Klebsiella pneumoniae Carbapenemase–Producing organisms

https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy052/4834952

Spread from the Sink to the Patient: In Situ Study Using Green Fluorescent Protein (GFP)-Expressing Escherichia coli To Model Bacterial Dispersion from Hand-Washing Sink-Trap Reservoirs

http://aem.asm.org/content/early/2017/02/13/AEM.03327-16.abstract

In this episode from the 2021 ICPIC Conference, Martin Kiernan talks to John McConnell, Editor-in-Chief of the Lancet Infectious Diseases about his keynote yesterday about the impact (and vice-versa) of the COVID pandemic on publishing both in peer-reviewed journals and in pre-print forms.

An enormous increase in the number of submissions and diversification in countries submitting are amongst the areas that we discuss. Ultimately, the research and publication process has been critical in the dissemination of the most useful data that have shaped interventions and treatments.