Infection Control Matters

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:

In this episode, Martin Kiernan and Phil Russo talk to Professor Michael Borg of the Faculty of Medicine & Surgery in the Medical School at the University of Malta and Head of Department (Infection Control) at Mater Dei Hospital in Malta. We discuss a recent paper desctibing the stages that brought about a 90% reduction in MRSA bloodstream infections over a ten-year period.

The main paper we discuss: Borg MA, Suda D, Tartari E, Farrugia C, Xuereb D, Borg Inguanez M. Preventing healthcare-associated MRSA bacteremia: getting to the root of the problem. Antimicrob Steward Healthc Epidemiol 2023;3(1):e248. https://doi.org/10.1017/ash.2023.518

Other papers by Michael include:

• Borg MA, Suda D, Scicluna E, Brincat A, Zarb P. Universal admission screening: a potential game-changer in hospitals with high prevalence of MRSA. J Hosp Infect 2021;113:77-84. https://doi.org/10.1016/j.jhin.2021.03.024

In this week's episode, Martin talks to Dr Tina Joshi, Associate Professor of Molecular Microbiology in Peninsula Dental School at the University of Plymouth, UK. We discuss her longstanding interest in Clostridioides difficile and her many publications, one of which on the effectiveness of hypochlorite (or lack of it) on spores has been widely covered in the media. We chat about spore attachment to surfaces, the effect of disinfectants and the differences between strains. Some of Tina's papers are listed here.

• Joshi LT, Phillips DS, Williams CF, Alyousef A, Baillie L. Contribution of spores to the ability of Clostridium difficile to adhere to surfaces. Appl Environ Microbiol 2012;78(21):7671-9. https://doi.org/10.1128/AEM.01862-12
  

In our usual Christmas episode, Brett, Phil and Martin choose our papers and podcasts of 2023. Also this time, Martin set the three of us a challenge: to find an interesting IPC-related paper from the years of our birth (more challenging for some than others..). Martin also reveals the No 1 single in our respective countries on the day of our birth. For Martin, a near miss. For Phil, a very apt song and for Brett... well, his karaoke debut cannot be far off.. Happy holidays everyone!

Martin's 1955 paper: Lowbury, E. J. (1955). "Cross-infection of wounds with antibiotic-resistant organisms." Br Med J 1(4920): 985-990. https://doi.org/10.1136/bmj.1.4920.985

Phil's 1964 paper: Murray, D. G. (1964). "Wound Infections after Surgery for Fractured Hip. A Follow-up Study." JAMA 190: 505-508. https://doi.org/10.1001/jama.1964.03070190025005

Brett's 1979 paper: Ehrenkranz, N. J. and S. J. Pfaff (1979). "Growth of hospital infection control programme and the infection control nurse." J R Soc Med 72(12): 888. https://doi.org/10.1177/014107687907201204

Our top papers

Martin's favourite paper: Wolfensberger, A., L. Clack, S. von Felten, M. Faes Hesse, D. Saleschus, M. T. Meier, K. Kusejko, R. Kouyos, L. Held and H. Sax (2023). "Prevention of non-ventilator-associated hospital-acquired pneumonia in Switzerland: a type 2 hybrid effectiveness-implementation trial." Lancet Infect Dis 23(7): 836-846. https://doi.org/10.1016/S1473-3099(22)00812-X

Phil's favourite paper: Peel, T. N., S. Astbury, A. C. Cheng, D. L. Paterson, K. L. Buising, T. Spelman, A. Tran-Duy, S. Adie, G. Boyce, C. McDougall, R. Molnar, J. Mulford, P. Rehfisch, M. Solomon, R. Crawford, T. Harris-Brown, J. Roney, J. Wisniewski, R. de Steiger and A. T. Group (2023). "Trial of Vancomycin and Cefazolin as Surgical Prophylaxis in Arthroplasty." N Engl J Med 389(16): 1488-1498. https://doi.org/10.1056/NEJMoa2301401

Brett's favourite paper: Seidelman, J. L., C. R. Mantyh and D. J. Anderson (2023). "Surgical Site Infection Prevention: A Review." JAMA 329(3): 244-252. https://doi.org/10.1001/jama.2022.24075

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