Infection Control Matters

In this episode, Phil and Martin talk to Dr Aline Wolfensberger, Senior Attending Physician, Department of Infectious Diseases and Hospital Epidemiology at University Hospital Zurich and a Senior Researcher at the Institute for Implementation Science in Health Care at the Univetsity of Zurich. We discuss a recent paper that has analysed a range of algorithms for detecting non-ventilator associated pneumonia (nvHAP) that have the potential for significantly reducing the surveillance burden. This work also demonstrated the value of an annual local hospital-wide point prevalence survey that provides data on which areas to target.

Relevant reading:

[1] Mueller A, Pfister M, Faes Hesse M, Zingg W, Wolfensberger A, Swissnoso G. Development and validation of selection algorithms for a non-ventilator hospital-acquired pneumonia semi-automated surveillance system. Clin Microbiol Infect 2024. https://doi.org/10.1016/j.cmi.2024.11.032

In this episode Martin Talks to Silvana Gastaldi who is a infection prevention and control health referent at UK-MED (a frontline humanitarian medical NGO). We discuss her revent paper in the Journal of Hospital Infection that reviews the literature on methods of assessing how effective environmental cleaning services and procedures are, including ATP, fluorescent UV marking, visual and microbiological methods and also discuss the potential for AI to assist in the healthcare environmental decontamination arena.

The paper we discuss:

Gastaldi S, Accorgi D, D'Ancona F. Tools and strategies for monitoring hospital environmental hygiene services. J Hosp Infect 2025. https://doi.org/10.1016/j.jhin.2025.01.011

To listen to a previous podcast in which Dr Phil Carling, developer of the UV marking systems talks about it's development and initial use please click here

Podcast website and collections: www.infectioncontrolmatters.com

In this episode, Phil Russo talks to Brett Mitchell and Kate Browne about a study that did not make it over the line. Following a systematic review in 2021 that examined the issue of UTIs in those who self catheterise, a study to examine whether previous work demonstrating a reduction in CAUTI in indwelling catheters through the use of Chlorhexidine for meatal cleansing would be effective was designed. The team discuss the complexities of getting what was essentially a community-based study over the line and why ultimately it did not progress, much to the sadness of the team. previous relevant work is listed below.

Mitchell BG, Prael G, Curryer C, Russo PL, Fasugba O, Lowthian J, et al. The frequency of urinary tract infections and the value of antiseptics in community-dwelling people who undertake intermittent urinary catheterization: A systematic review. Am J Infect Control 2021;49(8):1058-65. https://doi.org/10.1016/j.ajic.2021.01.009.

Fasugba O, Cheng AC, Gregory V, Graves N, Koerner J, Collignon P, et al. Chlorhexidine for meatal cleaning in reducing catheter-associated urinary tract infections: a multicentre stepped-wedge randomised controlled trial. Lancet Infect Dis 2019;19(6):611-9. https://doi.org/10.1016/S1473-3099(18)30736-9.

In this episode Brett and Phil chat about a few of the posters presented at the Australasian College for Infection Prevention and Control 2024 Conference held in Melbourne in November 2024. Poster topics include hand hygiene, surveillance, and a pilot RCT on chlorhexidine impregnated dressings.

You can access poster abstracts below and a pdf of the posters here

Improving Hand Hygiene Practices in the Marshall Islands

Epidemiology of Hospital-acquired Bloodstream Infections at a Quaternary Hospital Service

An antimicrobial dressing for prevention of infection complication related peripheral intravenous catheter: an international randomised controlled trial.

Comparing Healthcare Associated Infection data to Hospital Acquired Complication Infection data collection and finding the documentation differences to improve accuracy

In this episode recorded at the 2024 Australasian College of Infection Prevention and Control (ACIPC) Conference in Melbourne, Brett and Phil talk to Dr Sarah Browning (ID Physician at Hunter New England) and two Junior Medical Officers (JMOs) Sam and Lochlan who worked on IPC-related projects whilst on placement.

In this episode, Brett, Phil and Martin reflect on the year. We chat about favourite podcasts, papers and conferences in our usual informal manner (well probably even more informal than normal). Papers we mention are listed below.

Cimen C, Bathoorn E, Loeve AJ, Fliss M, Berends MS, Nagengast WB, et al. Uncovering the spread of drug-resistant bacteria through next-generation sequencing based surveillance: transmission of extended-spectrum beta-lactamase-producing Enterobacterales by a contaminated duodenoscope. Antimicrob Resist Infect Control 2024;13(1):31. https://doi.org/10.1186/s13756-024-01386-5

Torres-Teran MM, Greentree DH, Varghese MM, Cadnum JL, Pavis RL, Saade EA, et al. Identifying and Remediating Super-splasher Sinks to Reduce Dispersal of Pathogens From Sink Drains. Open Forum Infect Dis 2024;11(7):ofae293. https://doi.org/10.1093/ofid/ofae293

Bush M, Bennett CM, Hutchinson A, Bouchoucha SL. Post implementation quarantine recommendations that support preparedness: A systematic review and quarantine implementation capability framework. Infect Dis Health 2024;29(3):152-71. https://doi.org/10.1016/j.idh.2024.02.004

Dhar S, Jinadatha C, Kilgore PE, Henig O, Divine GW, Todter EN, et al. Lowering the Acquisition of Multidrug-Resistant Organisms (MDROs) With Pulsed-xenon (LAMP) Study: A Cluster-Randomized, Controlled, Double-Blinded, Interventional Crossover Trial. Clin Infect Dis 2024;79(4):1024-30. https://doi.org/10.1093/cid/ciae240

Widmer AF, Atkinson A, Kuster SP, Wolfensberger A, Klimke S, Sommerstein R, et al. Povidone Iodine vs Chlorhexidine Gluconate in Alcohol for Preoperative Skin Antisepsis: A Randomized Clinical Trial. JAMA 2024;332(7):541-9. https://doi.org/10.1001/jama.2024.8531

Leistner R, Kohlmorgen B, Brodzinski A, Schwab F, Lemke E, Zakonsky G, et al. 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. EClinicalMedicine 2023;59:101958. https://doi.org/10.1016/j.eclinm.2023.101958

Denkel LA, Voss A, Caselli E, Dancer SJ, Leistner R, Gastmeier P, et al. Can probiotics trigger a paradigm shift for cleaning healthcare environments? A narrative review. Antimicrob Resist Infect Control 2024;13(1):119. https://doi.org/10.1186/s13756-024-01474-6

In this episode of ICMs we talk to the authors of a world first multi-centre double blind cross-over randomised control trial, which explored the effect of in-room air purification on acute respiratory tract infections.  The rationale and pragmatics of undertaking such a trial are explored, as well as interpretation of the findings.

The lead researcher, Bismi Thottiyil Sultanmuhammed Abdul, a PhD student at the University of Newcastle is joined by some of her supervisors Professors Jenny Sim and Brett Mitchell to explain this study.

The paper can be accessed here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2825943?resultClick=1

Reference:

In this episode, Martin talks to Dr Rebecca Crapanzano-Sigafoos (formerly Bartles) who is Executive Director, Center for Research, Practoce and Innovation at the Association for Professionals in Infection Control and Epidemiology (APIC). We talk about about her work on staffing levels for IPC Teams, beginning with her early work looking at workload and then the recent review and paper on data obtained from the beta version of the APIC Staffing Calculator. It turns out that the vast majority of 390+ participating organisations are understaffed.. What might help however was the finding that hospitals that were better staffed had significantly lower infection rates according to accepted published data. Papers we discuss are found below:

In this episode, Martin talks to Cansu Cimen, a researcher at University Hospitals Groningen in the Netherlands, about a recent paper that documents an outbreak and in particular the critical role of next-generation sequencing (NGS) in tracking and controlling the transmission of MDROs via contaminated duodenoscopes.

Focusing on an outbreak linked to ESBL-producing Citrobacter freundii and Klebsiella pneumoniae after endoscopic retrograde cholangiopancreatography (ERCP), standard culture methods failed to detect contamination. After many negative cultures using established methods, destructive dismantling of the implicated scope revealed contamination on hard-to-clean components, highlighting NGS as an effective tool for identifying pathogen transmission pathways.

Cimen C, Bathoorn E, Loeve AJ, Fliss M, Berends MS, Nagengast WB, et al. Uncovering the spread of drug-resistant bacteria through next-generation sequencing based surveillance: transmission of extended-spectrum beta-lactamase-producing Enterobacterales by a contaminated duodenoscope. Antimicrob Resist Infect Control 2024;13(1):31. https://doi.org/10.1186/s13756-024-01386-5.

Download the paper here

In this episode recorded live at the IPS Conference in Birmingham UK in September 2024, Martin talks to Claire Fitzsimons, Senior Infection Prevention and Control Practitioner at the Northern Ireland Ambulance Service Health and Social Care Trust. We discuss a poster that she presented at the conference that looked as ways of reducing glove use in the ambulance service through a range of improvement methodologies.

A copy of the poster can be found here