Infection Control Matters

MDRO Plasmid-related outbreaks - is there anything we can do? With Jon Otter

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/

Ice machines - a chilling thought?

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

Detection of pathogens in the neonatal ICU environment with Dr Ginny Moore

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/28221122https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5382751/pdf/16-0833.pdf
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 Van Der Zwet WC, Debets-Ossenkopp YJ, Reinders E, Kapi M, Savelkoul PH, Van Elburg RM, et al. Nosocomial spread of a Staphylococcus capitis strain with heteroresistance to vancomycin in a neonatal intensive care unit. J Clin Microbiol. 2002;40:2520-5. https://www.ncbi.nlm.nih.gov/pubmed/12089273 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC120592/pdf/1550.pdf

Preventing device-associated infections during a COVID-19 pandemic

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

Identifying healthcare cleaning research priorities in resource-limited settings

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

Sinks in ICU Patient Rooms. Lower numbers of sinks equals lower infection rates?

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
Constantinides, B., K. K. Chau, T. P. Quan, G. Rodger, M. I. Andersson, K. Jeffery, S. Lipworth, H. S. Gweon, A. Peniket, G. Pike, J. Millo, M. Byukusenge, M. Holdaway, C. Gibbons, A. J. Mathers, D. W. Crook, T. E. A. Peto, A. S. Walker & N. Stoesser (2020) Genomic surveillance of Escherichia coli and Klebsiella spp. in hospital sink drains and patients. Microb Genom, 6. https://www.ncbi.nlm.nih.gov/pubmed/32553019
Mathers, A. J., K. Vegesana, I. German Mesner, K. E. Barry, A. Pannone, J. Baumann, D. W. Crook, N. Stoesser, S. Kotay, J. Carroll & C. D. Sifri (2018) Intensive Care Unit Wastewater Interventions to Prevent Transmission of Multispecies Klebsiella pneumoniae Carbapenemase-Producing Organisms. Clin Infect Dis, 67, 171-178. https://www.ncbi.nlm.nih.gov/pubmed/29409044
Grabowski, M., J. M. Lobo, B. Gunnell, K. Enfield, R. Carpenter, L. Barnes & A. J. Mathers (2018) Characterizations of handwashing sink activities in a single hospital medical intensive care unit. J Hosp Infect, 100, e115-e122. https://www.ncbi.nlm.nih.gov/pubmed/29738784
Kotay, S., W. Chai, W. Guilford, K. Barry & A. J. Mathers (2017) Spread from the Sink to the Patient: In Situ Study Using Green Fluorescent Protein (GFP)-Expressing Escherichia coli To Model Bacterial Dispersion from Hand-Washing Sink-Trap Reservoirs. Appl Environ Microbiol, 83. https://www.ncbi.nlm.nih.gov/pubmed/28235877
Garvey, M. I., N. Williams, A. Gardiner, C. Ruston, M. A. C. Wilkinson, M. Kiernan, J. T. Walker & E. Holden (2023) The sink splash zone. J Hosp Infect, 135, 154-156. https://www.ncbi.nlm.nih.gov/pubmed/36870392

Future directions for surveillance

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
The prevalence of healthcare associated infections among adult inpatients at nineteen large Australian acute-care public hospitals: a point prevalence survey

C. difficile and One Health with Prof Tom Riley

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.

Saving time and increasing IPC efficiency using Robotic Process Automation

This week, Martin talks to Jincy Jerry, Assistant Director of Nursing in Infection Prevention and Control at the Mater Misericordiae University Hospital, Dublin, Ireland. Jincy is a pioneer in the use of Robotic Process Automation in clinical settings within Irish Healthcare. Robotic process automation (RPA) is a software technology that makes it easy to build, deploy, and manage software robots that emulate humans actions interacting with digital systems and software. In 2021, the project received Prix Hubert Tuor Innovation Academy Award at the 6th International Conference on Prevention and Infection Control (ICPIC), in Geneva.
We discuss the potential and actual benefits, including the freeing up of hours of IP time as well as the use of AI (Artificial Intelligence) in the infection prevention world.
 
A review paper on this topic can be found here:
Piaggio, D., M. Zarro, S. Pagliara, M. Andellini, A. Almuhini, A. Maccaro & L. Pecchia (2023) The use of smart environments and robots for infection prevention control: A systematic literature review. Am J Infect Control, 10.1016/j.ajic.2023.03.005. https://www.ncbi.nlm.nih.gov/pubmed/36924997

A CLEEN study chat and a rude interruption!

In this podcast, we talk about the CLEEN and I-CLEEN studies. These are a RCT and quasi-experimental genomics study aiming to determine the effect of additional cleaning of shared medical equipment of the frequency of healthcare associated infections.  We also make phone call mid podcast...
A shout out to all the team involved in this project, including being wonderfully coordinated by Dr Kate Browne and with great support from Georgia Matterson.  Full details on the website below.
Link to study website: https://cleenstudy.com/
Link to study protocol: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-023-07144-z
This project is funded by a National Health and Medical Research Council Emerging Leadership Investigator grant (Prof Brett Mitchell, (GNT2008392)).