Infection Control Matters

In this episode, Martin Kiernan talks with Dr Alexandra Peters, President of Clean Hospitals, ahead of the annual Clean Hospitals Day on 20 October.
They discuss this year’s theme of empowerment—why environmental services staff should be recognised as frontline healthcare workers, and why training, professionalisation and giving them a voice matter for patient safety. Alexandra describes how training, certification and career progression are used to professionalise environmental services in Switzerland, and why giving staff knowledge isn't enough if they aren't also given a voice. The conversation asks a fundamental question: should an environmental services worker have the authority to say that a room isn't yet safe for the next patient—even when operational pressures say otherwise?
Alexandra also explains how you can get involved in Clean Hospitals Day 2026, with free campaign resources available in 22 languages.
Clean Hospitals Website: www.cleanhospitals.com
Direct link to the promotional materials here: https://cleanhospitals.com/promotional-toolkit-2026/ 
Peters A, Mocenic M, Brois P, Rioja E, Mitchell BG, Dancer SJ, et al. Clean hospitals day 2026: empowerment of environmental services staff. Journal of Hospital Infection 2026;176:201–3. https://doi.org/10.1016/j.jhin.2026.09.015. 
Direct link to the paper: https://www.journalofhospitalinfection.com/article/S0195-6701(26)00373-7/pdf 

In this episode, Phil Russo and Brett Mitchell are joined by Dr Shalini Elangovan from Duke-NUS Medical School in Singapore to discuss her global study exploring how IPC professionals make decisions.
Using a discrete choice experiment, Shalini and colleagues examined the trade-offs people make between clinical evidence, cost-effectiveness, implementation time and the additional workload an intervention creates.
What actually makes an IPC professional say “yes” to an intervention? The study found that cost-effectiveness was the most important attribute overall, but also identified striking differences between “evidence seekers” and “efficiency seekers,” particularly between respondents from lower/middle- and high-income countries. This suggests that the setting in which you work may influence what you value when deciding whether an IPC intervention is worth implementing.
Link to the paper is here:Elangovan S, Senanayake S, Venkatachalam I, Ling ML, Graves N, Kularatna S. Preferences for Infection Prevention in Hospital-Acquired Infections. JAMA Netw Open 2026;9(4):e267432. https://doi.org/10.1001/jamanetworkopen.2026.7432. 
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2847770 

In this episode of Infection Control Matters, Martin Kiernan talks to Brett Mitchell about a new review of RCTs in IPC over the past two decades. The review identified 239 trials, with a striking increase in recent years—but the research is concentrated in a relatively small number of areas. We also explore a much bigger issue: what happens to new evidence once it has been published? If guidelines remain unchanged while new RCTs accumulate, are we really translating research into practice?
We discuss what is driving this growth, where the important evidence gaps remain, and whether IPC guidelines are keeping pace with the emerging evidence. Could living guidelines be part of the answer?
Paper we discuss:Mitchell BG, Matterson G, Carroll MR, Donnelly H, Marimuthu K, Tehan PE. Global randomised controlled trials in infection prevention and control: a bibliographic review from the past two decades. J Hosp Infect 2026. https://doi.org/10.1016/j.jhin.2026.03.037. 
Direct download link: https://www.journalofhospitalinfection.com/action/showPdf?pii=S0195-6701%2826%2900129-5 
Another paper that we mention on the effect of delays in implementation:Reagan KA, Chan DM, Vanhoozer G, Pryor RJ, Doll ME, Godbout EJ, et al. Resistors and constipators: Financial impact in an academic medical center, a mathematical model. Infect Control Hosp Epidemiol 2022;43(4):533–5. https://doi.org/10.1017/ice.2021.34. 

In this episode, Brett and Martin discuss a cluster RCT from the Journal of Hospital Infection that took a very different approach. The researchers used social network analysis to identify the people operating room nurses naturally turned to for advice and support. Six of these informal influencers were then trained as peer champions—not as auditors or compliance police, but as positive role models who could encourage better practice through their existing relationships.
 Over 12 months, hand hygiene compliance increased from 41.8% to 79.2% in the intervention group, compared with an increase from 42.6% to 59.3% with standard education. The study also reported improvements in knowledge and team climate.
But there is plenty to debate. Can we really attribute the reported reduction in surgical site infections to the intervention? And could we use the same idea to influence other IPC behaviours—perhaps getting the right people to model cleaning shared equipment, PPE use or other everyday safety behaviours?
 
Link to the paper is here:Ye L, Jia X, Zhengyuan C, Dan Y, Jinjing Z, Nana W. Social network analysis-informed peer champions for hand hygiene in the operating room: a cluster randomised controlled trial. J Hosp Infect 2026;171:113–9. https://doi.org/10.1016/j.jhin.2026.03.003 
The other paper we mention is here:Seto WH, Ching TY, Yuen KY, Chu YB, Seto WL. The enhancement of infection control in-service education by ward opinion leaders. Am J Infect Control 1991;19(2):86–91. https://doi.org/10.1016/0196-6553(91)90044-d. 

In this episode of Infection Control Matters, Brett and Martin talk to Professor Tom Riley about why we need to look well beyond the hospital to understand where Clostridioides difficile comes from.
Tom discusses the growing importance of C. difficile as a community-acquired infection and explains how antimicrobial use in agriculture, animals, animal faeces, food and the environment may all form part of the transmission pathway. We explore some findings from his research, including C. difficile contamination of potatoes and domestic kitchens.
We also discuss the challenges of controlling highly persistent spores in the environment, the potential role of foodborne transmission, and Tom's recent involvement with the Food and Agriculture Organization of the United Nations, where genomic evidence from an onion-associated outbreak provided compelling evidence for foodborne transmission.
From animal antibiotics and manure to potatoes, kitchen sinks and the wider environment, this conversation challenges us to rethink where C. difficile comes from—and where infection prevention needs to look next.
Perhaps the most important message? To understand C. difficile, we need to follow the faeces.
Access the UN FAO report on toxigenic Clostridia in food here: https://openknowledge.fao.org/items/cce3d2ab-e8d7-4ab2-a349-dacba4eda392 

Artificial intelligence has enormous potential in healthcare, but where can it genuinely improve infection prevention without replacing clinical judgement? In this episode, Phil Russo and Martin Kiernan are joined by Professor Judith Tanner (University of Nottingham) and Melissa Rochon (Guy's and St Thomas' NHS Foundation Trust) to discuss a recent paper about the WISDOM study, a randomised feasibility trial evaluating AI-assisted digital surveillance for surgical wounds after hospital discharge.
Following on from a previous podcast in which patients submit wound photographs from home (https://infectioncontrolmatters.podbean.com/e/surgical-site-infection-surveillance-by-patient-generated-images/), this paper describes how AI can prioritise images that need urgent clinical review, and why this approach could transform surgical site infection surveillance while reducing unnecessary hospital visits. The guests discuss developing an AI model from almost 40,000 wound images, ensuring equitable performance across different skin tones, patient acceptance of digital follow-up, workforce redesign, and how remote monitoring could evolve into supported self-care. Rather than replacing clinicians, AI is shown to be a practical tool for helping healthcare teams focus on the patients who need them most.
Rochon M, Tanner J, Cariaga K, Jurkiewicz J, Beckhelling J, Harris R, et al. AI-enabled digital wound monitoring after cardiac surgery: a randomised controlled feasibility, safety, and acceptability trial. J Hosp Infect 2026. https://doi.org/10.1016/j.jhin.2026.04.020. 
https://www.journalofhospitalinfection.com/action/showPdf?pii=S0195-6701%2826%2900159-3 

Candidozyma auris has become one of the greatest environmental challenges facing infection prevention teams. Its ability to survive on surfaces, form resilient biofilms and spread within healthcare settings has raised important questions about whether our current cleaning and disinfection practices are enough.
In this episode, Martin and Brett are joined by Aristotelis Papadimitriou from Athens to discuss his newly published systematic review on environmental decontamination of Candidozyma auris. They explore which disinfectants are the most effective, why biofilms change everything, the importance of fungal clades, and the significant gap between laboratory efficacy studies and the realities of cleaning busy healthcare environments.
Open access paper we discuss:
Papadimitriou A, Drosopoulou LP, Tseroni M, Kontopidou FV, Tsakris A, Vrioni G. Breaking the Chain of Infection: A Systematic Review of Environmental Decontamination of Candidozyma auris (2017-2025). J Fungi (Basel) 2026;12(2). https://doi.org/10.3390/jof12020131 

The tables are turned in this episode. Prof Trisha Peel and Dr Sally Havers guest host this podcast and interview Brett Mitchell, Nicole White and Martin Kiernan about their recent publication in Lancet Infectious Disease.
The publication showcases results from a recent multi-centre RCT demonstrating the benefit of improving oral care in reducing the risk of non-ventilator associated pneumonia (NV-HAP). The authors are probed about why they did the study, key findings, implementation and other aspects not always published in peer reviewed journals.
White NM, Russo PL, Matterson G, Browne K, Cheng AC, Kiernan M, et al. Effectiveness of oral care for the prevention of non-ventilator hospital-acquired pneumonia (HAPPEN): a multicentre, stepped-wedge, cluster-randomised trial in Australia. Lancet Infect Dis 2026. https://doi.org/10.1016/S1473-3099(26)00235-5
Information about the study available here: https://happenstudy.com/

In the second ESCMID Global 2026 poster tour episode, Brett and Martin found three different and thought-provoking posters that highlight the importance of people, partnerships and communication in advancing infection prevention and control.
We begin by talking to Dr Aline Wolfensberger from Zurich about a Swiss project that used human-centred design and co-production to develop practical tools that engage patients and relatives in the prevention of non-ventilator hospital-acquired pneumonia. Through a process of interviews, observations and co-design workshops, the team created innovative, low-cost solutions to promote oral care and mobilisation, demonstrating how patients and families can become active partners in prevention.
https://mcdn.podbean.com/mf/download/ina7czek4ac7q83r/ESCMID_Global_2026_-_Patient_partnership_for_prevention_PPP_-_co-designed_solutions_to_engage_patients_and_relatives_in_non-ventilator_hospital-acquired_pneumonia_preventiona7pol.pdf 
 
We then examined an innovative researcher–journalist residency programme that explored the challenges of communicating science to wider audiences. The project revealed the differing cultures, expectations and pressures faced by researchers and journalists, while identifying opportunities to strengthen collaboration and improve public understanding of infectious diseases and healthcare.
https://mcdn.podbean.com/mf/download/ykf54b6zejskjhwt/ESCMID_Global_2026_-_Promoting_scientific_communication-_insights_from_a_joint_researcher_journalist_residency8nweq.pdf 
 
Finally, we discussed findings from the EU-JAMRAI 2 initiative with the author. This work explored the collaboration needs of infection prevention professionals across Europe. The study highlights the value of mentorship, peer-to-peer learning and international networking in supporting professional development and sharing best practice.
https://mcdn.podbean.com/mf/download/yungzdpc6fatf3zd/ESCMID_Global_2026_-_Assessment_of_peer-to-peer_collaboration_needs_across_IPC_professionals_in_Europe_an_EU-JAMRAI-2_initiative9cro2.pdf 

In the first of two special episodes recorded live from the poster hall at ESCMID Global 2026 in Munich, Brett and Martin swap the lecture theatre for the exhibition floor as they explore some of the most interesting infection prevention and antimicrobial resistance research on display.
In this episode we discuss the following posters. Links to copies of the posters are provided.
The hidden cost of contact precautions – Researchers from Greece quantify the enormous bed capacity burden created by patients requiring isolation or cohorting for multidrug-resistant organisms, showing that although only 4% of admissions required contact precautions, they accounted for over 10% of hospital bed-days.https://mcdn.podbean.com/mf/download/qgadvjnz5btbbhru/ESCMID_Global_2026_-_Bed_resources_needed_for_patients_on_contact_precautions_because_of_MDR_pathogens8p3ta.pdf 
Can Google Maps reviews tell us something about infection prevention? – An innovative analysis from Germany and Spain explores thousands of online hospital reviews, demonstrating that infection prevention issues feature prominently in patient feedback and are often associated with more negative experiences.https://mcdn.podbean.com/mf/download/4fgzatetxdrdiunr/ESCMID_Global_2026_-_Infection_prevention_in_hospitals_in_Germany_and_Spain-_a_Google_Maps_review_analysis6b9ko.pdf 
What lives on shared surfaces in long-term care? – A Dutch environmental microbiology study reveals frequent contamination of high-touch communal surfaces with clinically important Gram-negative organisms, raising important questions about cleaning practices and transmission risks in care facilities.https://mcdn.podbean.com/mf/download/w9vgebabddcywhny/ESCMID_Global_2026_-_Gram-negative_microorganisms_on_high-touch_shared_surfaces_in_Dutch_long-term_care_facilities7clqb.pdf 
Using bacteriophages as environmental disinfectants – Researchers from China describe how a targeted phage cocktail reduced environmental contamination and clinical isolation rates of carbapenem-resistant Acinetobacter baumannii in an intensive care setting, offering a fascinating glimpse into future biological approaches to environmental decontamination.https://mcdn.podbean.com/mf/download/vj92ubxxfw8t9szj/ESCMID_Global_2026_-_Phage_intervention_effectively_reduces_nosocomial_transmission_of_carbapenem-resistant_em_Acinetobacter_baumannii_-em_ays63.pdf 
Is more screening worth it? – A Norwegian modelling study examines the economics of expanded admission screening for antimicrobial resistance, suggesting that broader screening of higher-risk patients can prevent healthcare-associated infections and remain cost-effective in a low-prevalence setting.https://mcdn.podbean.com/mf/download/bfmjj2t797589cfy/ESCMID_Global_2026_-_Cost-effectiveness_of_proposed_screening_guideline_for_resistant_microbes_compared_to_current_screening_guideline_for_patients_upon_admission_to_Norwegian_hospitals8oum8.pdf 
Making guidelines engaging again – An Irish trainee-led "Infection Guideline Club" demonstrates how peer-delivered education can improve engagement with clinical guidelines, build confidence, and create valuable opportunities for discussion and learning.https://mcdn.podbean.com/mf/download/w9zpcbrbrimdken8/ESCMID_Global_2026_-_Successful_development_of_peer_delivered_Infection_Guideline_Club_-_a_six-month_pilot_and_anonymous_participant_survey8ruuu.pdf