In this week's episode Phil and Brett mull over their wishlists for what they would want in a perfect IPC world. They turn out to be a pretty undemanding pair.. not. However they both see a future in which their wishes could become true. Unsurprisingly AI and automated surveillance loom large in their thoughts.

In this episode, Brett and Martin discuss a paper they were recently involved with - a systematic review and meta-analysis on prior room occupancy and the risk to the next person. This paper has been recently published in Infection, Disease and Health.

Findings provide some evidence to help inform a risk management approach when determining patient room allocation. The risk of pathogen acquisition appears to remain high, supporting the need for continued investment in this area.

Here is a link to the paper.

In our discussion, we also mentioned a paper about nurses views on the environment and risk:

In this week's episode, Martin talks to Dr Jon Otter, epidemiologist, scientst, blogger and Joint Director of Infection Prevention and Control at Guy's and St Thomas' NHS Foundation Trust in the UK. We discuss a session at the recent ICPIC conference on the problems posed by plasmids in terms of outbreak detection, increasing antimicrobial resistance and environmental reservoirs. You can read more about Jon's thoughts in his excellent blog post at https://reflectionsipc.com/2023/09/14/cpe-and-plasmid-transfer-in-hospitals-what-can-we-do-a-rapid-reflection-from-icpic-2023/#more-5141

A paper we discuss from Kalisvar Marimuthu and colleagies can be found here https://www.nature.com/articles/s41467-022-30637-5

You can listen to Kalis discussing it on a previous podcast in our genomics collection here:

https://infectioncontrolmatters.com/topics/methodology/

In this episode, Brett talks to Martin about a recent paper on the potential pitfalls of ice machines and following manufactures' instructions.

The paper we discuss is called "How clean is your ice machine?"

This paper was published in the journal of hospital infection: https://www.sciencedirect.com/science/article/abs/pii/S0195670123002700

In this episode, Martin talks to Dr Jinny Moore from the National Health Security Agency in England about detecting pathogens in the ICU environment. They discuss a recent paper where whole-genome sequencing (WGS) on presumptive S. capitis NRCS-A isolates was collected from infants admitted to nationwide NICU and from environmental sampling in two distinct NICUs. The discussion includes details on the approach to sampling (neonates and environment).

Papers discussed:

Detection, survival, and persistence of Staphylococcus capitis NRCS-A in neonatal units in England https://www.journalofhospitalinfection.com/article/S0195-6701(23)00234-7/fulltext

Other papers of interest:

Laurent F, Butin M. Staphylococcus capitis and NRCS-A clone: the story of an unrecognized pathogen in neonatal intensive care units. Clin Microbiol Infect. 2019;25:1081-5. https://www.ncbi.nlm.nih.gov/pubmed/30928561

Butin M, Martins-Simoes P, Rasigade JP, Picaud JC, Laurent F. Worldwide Endemicity of a Multidrug-Resistant Staphylococcus capitis Clone Involved in Neonatal Sepsis. Emerg Infect Dis. 2017;23:538-9.https://www.ncbi.nlm.nih.gov/pubmed/28221122

Butin M, Martins-Simoes P, Pichon B, Leyssene D, Bordes-Couecou S, Meugnier H, et al. Emergence and dissemination of a linezolid-resistant Staphylococcus capitis clone in Europe. J Antimicrob Chemother. 2017;72:1014-20. https://www.ncbi.nlm.nih.gov/pubmed/27999045

This week, Martin talks to Dr Jennifer Meddings, Associate Professor at University of Michigan Health and Internist at Ann Arbor about a recently published survey looking at what interventions are commonly used to prevent device-associated infections. We discuss the findings and focus in on prevention of urinary catheter-associated infections and new devices that may have an impact.

The paper can be found here:

Saint, S., M. T. Greene, S. L. Krein, K. E. Fowler, K. A. Linder, D. Ratz & J. Meddings (2023) What US hospitals are doing to prevent common device-associated infections during the coronavirus disease 2019 (COVID-19) pandemic: Results from a national survey in the United States. Infect Control Hosp Epidemiol, 10.1017/ice.2023.65, 1-7. https://www.ncbi.nlm.nih.gov/pubmed/37259703

Other areas and papers that we discuss are here:

New tools that have been developed and piloted in a large surgical collaborative in Michigan, in our project called SUCCESS:  Surgical Urinary Catheter Care Enhancement Safety Study, which has focused on improving urinary catheter safety even beyond CAUTI prevention, including focus on reducing unnecessary use for several common elective procedures, standardizing diagnosis and management of urinary retention, and practices to reduce traumatic injury from catheters and improve success on first catheterization attempt:   https://msqc.org/success/.

Kuriyama, A., K. E. Fowler, J. Meddings, H. Irie, D. Kawakami, H. Iwasaki, M. Sakuraya, K. Katayama, Y. Tokuda & S. Saint (2019) Reducing unnecessary urethral catheter use in Japanese intensive care units: A multicenter interventional study. Infect Control Hosp Epidemiol, 40, 1272-1274. https://www.ncbi.nlm.nih.gov/pubmed/31558172

Patel, P. K., A. Gupta, V. M. Vaughn, J. D. Mann, J. M. Ameling & J. Meddings (2018) Review of Strategies to Reduce Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) in Adult ICUs. J Hosp Med, 13, 105-116. https://www.ncbi.nlm.nih.gov/pubmed/29154382

Patel, P. K., A. Gupta, V. M. Vaughn, J. D. Mann, J. M. Ameling & J. Meddings (2018) Review of Strategies to Reduce Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) in Adult ICUs. J Hosp Med, 13, 105-116. https://www.ncbi.nlm.nih.gov/pubmed/29154382

Meddings, J., S. Saint, S. L. Krein, E. Gaies, H. Reichert, A. Hickner, S. McNamara, J. D. Mann & L. Mody (2017) Systematic Review of Interventions to Reduce Urinary Tract Infection in Nursing Home Residents. J Hosp Med, 12, 356-368. https://www.ncbi.nlm.nih.gov/pubmed/28459908

In this episode, Martin Kiernan talks to Dr Giorgia Gon, Assistant Professor of Epidemiology, London School of Hygiene and Tropical Medicine about a briefing paper that  identifies research priorities for healthcare cleaning in resource-limited settings. We discuss the process of determining the priorities, the groups involved and the final areas that should be targeted with research funding, including cost-effectiveness, the use of biocides or detergents and minimum requirements.

You can find a copy of the CLEAN Briefing here

Other papers of interest:

1. Cross S, Gon G, Morrison E, Afsana K, Ali SM, Manjang T, et al. An invisible workforce: the neglected role of cleaners in patient safety on maternity units. Glob Health Action. 2019;12:1480085. https://www.ncbi.nlm.nih.gov/pubmed/31154993

2. Gon G, Kabanywanyi AM, Blinkhoff P, Cousens S, Dancer SJ, Graham WJ, et al. The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals. Antimicrob Resist Infect Control. 2021;10:8. https://www.ncbi.nlm.nih.gov/pubmed/33413647

3. Storr J, Kilpatrick C, Lee K. Time for a renewed focus on the role of cleaners in achieving safe health care in low- and middle-income countries. Antimicrob Resist Infect Control. 2021;10:59. https://www.ncbi.nlm.nih.gov/pubmed/33762000

In this episode, Martin talks to Giovanni-Battista Fucini about a recent paper from Germany that examined infection rates in critical care in which it was reported that hospitals without sinks in patient rooms have lower infection rates. Newer hospitals in Germany tend not to have sinks in the patient rooms in ICU.

The paper we discuss is here:

Giovanni-Battista, F., C. Geffers, F. Schwab, M. Behnke, W. Sunder, J. Moellmann & P. Gastmeier (2023) Sinks in patient rooms in the ICU are associated with higher rates of hospital-acquired infections. A retrospective analysis of 552 ICUs. J Hosp Infect, 10.1016/j.jhin.2023.05.018. https://doi.org/10.1016/j.jhin.2023.05.018

Other papers of interest are:

• Kotay, S. M., H. I. Parikh, K. Barry, H. S. Gweon, W. Guilford, J. Carroll & A. J. Mathers (2020) Nutrients influence the dynamics of Klebsiella pneumoniae carbapenemase producing enterobacterales in transplanted hospital sinks. Water Res, 176, 115707. https://www.ncbi.nlm.nih.gov/pubmed/32224328

Martin chats to Phil in Melbourne following a recent presentation. Yes, two old farts reminiscing about the days of wearing out the boot leather collecting surveillance data talk with envy about the potential of HAI surveillance in the era of the electronic medical record, automation and artificial intelligence.

Phil refers to data in these two publications:

• Designing Surveillance of Healthcare-Associated Infections in the Era of Automation and Reporting Mandates

We discuss One Health in this episode with Professor Tom Riley, using C.difficile as the example of explaining why the concept of One Health is so important.

Tom is a Fellow of the Royal College of Pathologists, the Australian Society for Microbiology, the American Academy of Microbiology, the Society for Healthcare Epidemiology of America and the Faculty of Science of the Royal College of Pathologists of Australasia, and has published over 400 book chapters and refereed publications.