Infection Control Matters

Do you have enough staff in your IP Team? Calculating the staffing requirement for your program

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:
Bartles R, Dickson A, Babade O. A systematic approach to quantifying infection prevention staffing and coverage needs. Am J Infect Control 2018;46(5):487-91. https://doi.org/10.1016/j.ajic.2017.11.006.
Knighton SC, Engle J, Berkson J, Bartles R. A narrative review of how infection preventionist (IP) staffing and outcome metrics are assessed by health care organizations and factors to consider. Am J Infect Control 2024;52(1):91-106. https://doi.org/10.1016/j.ajic.2023.06.017.
Bartles R, Reese S, Gumbar A. Closing the gap on infection prevention staffing recommendations: Results from the beta version of the APIC staffing calculator. Am J Infect Control 2024. https://doi.org/10.1016/j.ajic.2024.09.004.

Could you have an ERCP-related outbreak? Sequencing to the rescue but you'll have to trash the scope!

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

Reducing glove use in the ambulance service

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

Can sensors and AI improve cleaning and patient safety?

In this episode, recorded at the 2024 Infection Prevention Society Conference in Birmingham (UK) Brett and Martin talk to Conor McGinn, Assistant Professor in the Department of Mechanical and Manufacturing Engineering at Trinity College Dublin and CEO of Akara AI, a robotics company spin-off from Trinity. We talk about a presentation that Conor gave, demonstrating how infrared sensors analysed by AI can provode feedback on techniques in the operating room and how they could improve cleaning standards in hospitals.
A link to the video we discussed is here https://youtu.be/CPCFuXyQarY?si=xh1RjXAaKeKY708a
and you can also see Conor's talk here https://youtu.be/3SCEkbwKhM4?si=uztJcnVIAe-vq5U8

Prevalence, fundamental care, UTI recorded live at the Infection Prevention Society Conference 2024

In our second live session at a major conference, this episode of Infection Control Matters was recorded live at a plenary session to close day 1 of the Infection Prevention Society conference (Birmingham, UK). Our guest panelists include Dr Berit Muller-Pebody an Epidemiologist from the UK Health Security Agency, Prof Jennie Wilson from the University of West London and Dr Jacqui Prieto from The University of Southampton. The panel also fielded many questions from delegates from the floor.
Topics covered include the role of mandatory surveillance, de-implementation, community based IPC, point prevalence studies, the UK PPS,  fundamentals of care, urinary tract infection, pneumonia and the direction of IPC.
 
 
 

Is IPC the friend of sustainability?

Dr Gemma L Saravanos (she/her) is an infectious diseases epidemiologist and a Registered Nurse leading public health research, and education of pre-registration nursing students. She is based at the Susan Wakil School of Nursing and Midwifery, University of Sydney and works across the Camperdown (Patyegarang) and Westmead (Baludarri) campuses in Sydney.
 
In this episode, Phil chats to Gemma about an open access publication she led discussing IPC programs contribution to environmental harm, and argues the case that increased investment in IPC is crucial for sustainable health and environmental systems.
 
Saravanos, G.L., Islam, M.S., Huang, Y. et al. Infection prevention and control programme priorities for sustainable health and environmental systems. BMC Global Public Health 2, 6 (2024). https://doi.org/10.1186/s44263-023-00031-4 

The CLEEN study: Background and discussion with the authors

Our guest host, Dr Sally Havers this week talks to some of authors from ClEaning and Enhancd DisinfectioN (CLEEN) study (including some regular voices..). The study was recently published in the Lancet Infectious Disease (link below).
 
The CLEEN study is a world first RCT that explores the impact of cleaning and disinfection of shared medical equipment on HAIs. The study reports significant reductions in HAIs associated with increased cleaning and disinfection of shared equipment.
 
In this chat, the background to the study is discussed, as well as some implementation and practical considerations. We also touch on the time it takes to clean, which is related to another paper from the CLEEN study recently published in the Journal of Hospital Infection.
 
For those attending the 2024 IPS conference in Birmingham in a few weeks, Brett will be presenting the full methodology and main effectiveness results at the conference. Early cost-effectiveness data will also be presented, as well as results from a time and motion study exploring how long it takes to clean equipment.
For those attending the 2024 ACIPC conference in Melbourne in November, there is a concurrent session on the main effectiveness results and a lightning session on how long it takes to clean equipment.
 
Publications
Browne, K., White, N. M., Russo, P. L., Cheng, A. C., Stewardson, A. J., Matterson, G., ... & Mitchell, B. G. (2024). Investigating the effect of enhanced cleaning and disinfection of shared medical equipment on health-care-associated infections in Australia (CLEEN): a stepped-wedge, cluster randomised, controlled trial. The Lancet Infectious Diseases.
 
Matterson, G., Browne, K., Tehan, P., Russo, P. L., Kiernan, M., & Mitchell, B. G. (2024). Cleaning time and motion: an observational study on the time required to effectively clean shared medical equipment in hospitals. Journal of Hospital Infection.
 

Removing contact precautions - what trial do we need?

In this episode, Brett and Martin discuss a recent paper from Sarah Browning and colleagues that describes how an RCT on the ending of aspects of contact precautions (gloves and aprons) for MRSA and VRE could be conducted. The paper can be found here:
https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(24)00243-X/abstract
 
Our other podcasts on contact precautions, gloves and aprons can be found here:
https://infectioncontrolmatters.podbean.com/e/have-gloves-had-their-day/
https://infectioncontrolmatters.podbean.com/e/reflecting-on-a-contact-precautions-talk-at-eccmid-with-dr-gonzalo-bearman/
https://infectioncontrolmatters.podbean.com/e/25-years-of-contact-precautions-but-benefit-or-harm-and-what-is-the-evidence-with-prof-jennie-wilson/
 
 

Using AI in Infection Prevention: Opportunities and Dangers

In this episode, Martin Kiernan catches up with Dr Gonzalo Bearman, Professor of Internal Medicine at Virginia Commonwealth University, Richmond, USA. We talk about the opportunities and dangers of using large language models like ChatGPT in the infecton prevention space. A link to a recent open access paper on this topic is here
Langford BJ, Branch-Elliman W, Nori P, Marra AR, Bearman G. Confronting the Disruption of the Infectious Diseases Workforce by Artificial Intelligence: What This Means for Us and What We Can Do About It. Open Forum Infect Dis. 2024;11:ofae053 https://www.ncbi.nlm.nih.gov/pubmed/38434616
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10906702/pdf/ofae053.pdf 

An award-winning MDT collaborative approach to reducing risks from water in a large organisation

In this episode, Martin Kiernan talks to representatives of the Multi-disciplinary Team at Leeds Teaching Hospitals NHS Trust in the UK, Dr Jessica Martin IPC Matron Adele Dyche and Haematology Matron Katie Sweeting . Building on from previously published work, they describe how efforts from the front line can impact on water safety, including initiatives such as sink removal, education programmes and collaborative working. This work won the 2023 award for Infection Prevention and Control at the annual Nursing Times Awards
The original paper from the group can be found here:
Rice W, Martin J, Hodgkin M, Carter J, Barrasa A, Sweeting K, et al. A protracted outbreak of difficult-to-treat resistant Pseudomonas aeruginosa in a haematology unit: a matched case-control study demonstrating increased risk with use of fluoroquinolone. J Hosp Infect. 2023;132:52-61. https://www.ncbi.nlm.nih.gov/pubmed/36563938