Infection Control Matters

We are a group of professionals who work in the field of infectious disease and infection prevention and control. In this podcast series, we discuss new research and issues on the topic of infection prevention and control. We will pick new papers of interest and will discuss them, often with an author of the paper who can give us some insights into the research that go beyond the written paper. Authors will include nurses, doctors, academics, clinicians, administrators and leaders. We should stress that all of our comments relate to our own opinions and that they do not necessarily reflect those institutions and employers that we relate to. We welcome comment, suggestions and ideas. Please consider subscribing for updates and to find collections of topic specific podcasts at www.infectioncontrolmatters.com

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Episodes

Wednesday Mar 20, 2024

In this episode, Martin Kiernan talks to Mitch Clarke, Clinical Lead and Deputy Director of Infection Prevention and Control at Nottingham University Hospitals in the UK. We discuss an outbreak with a unique NDM CPE infection and look at where the investigations went, including a new reservoir that is a potential source - the floor scrubber.
Papers underpinning this work are here:
1. Benbow A, Clarke M, Yates C, Montgomery R, Staniforth K, Boswell T, et al. Hospital-wide healthcare-associated carbapenemase-producing Enterobacterales outbreak: risks of electric floor scrubbers in catering facilities and kitchens. J Hosp Infect. 2024;146:59-65. https://www.ncbi.nlm.nih.gov/pubmed/38341149 2. Prescott K, Billam H, Yates C, Clarke M, Montgomery R, Staniforth K, et al. Outbreak of New Delhi Metallo-Beta-lactamase Carbapenemase Producing Enterobacterales on a bone marrow transplant unit: Role of the environment. Infect Prev Pract. 2021;3:100125. https://www.ncbi.nlm.nih.gov/pubmed/34368742

Thursday Mar 07, 2024

In this episode, Martin Talks to Dr Mark Wilcox OBE, Professor of Microbiology at the University of Leeds, Head of Microbiology Research & Development at Leeds University Hospitals NHS Trust and National Clinical Director for Infection Prevention and Control at NHS England. We mull over the possible reasons for the increase in hospital-onset, hospital attributed cases in England, including ribotypes and antibiotic use. Given that the NHS is under great stress, we discuss the damage potential from a ribotype 955 which shares some genetic characteristics with the 027 ribotype that caused so many problems in the UK and worldwide in the early 2000s. One thing that we agree on is that reductions targets (with teeth) have been very successful in the past and should we venture in that direction again?
Information on data collection, hospital and national typing reports for England can be found here: https://www.gov.uk/government/collections/clostridium-difficile-guidance-data-and-analysis#epidemiology

Wednesday Feb 21, 2024

In this episode, after an interesting discovery when searching Youtube, Brett and Martin mull over whether toilet plume is a risk factor for hospital-acquired pneumonia and C. difficile infections. The papers we discuss are listed below.
Goforth MP, Boone SA, Clark J, Valenzuela PB, McKinney J, Ijaz MK, et al. Impacts of lid closure during toilet flushing and of toilet bowl cleaning on viral contamination of surfaces in United States restrooms. Am J Infect Control 2023. https://doi.org/10.1016/j.ajic.2023.11.020
Best EL, Sandoe JA, Wilcox MH. Potential for aerosolization of Clostridium difficile after flushing toilets: the role of toilet lids in reducing environmental contamination risk. J Hosp Infect 2012;80(1):1-5. https://doi.org/10.1016/j.jhin.2011.08.010
Lai ACK, Tan TF, Li WS, Ip DKM. Emission strength of airborne pathogens during toilet flushing. Indoor Air 2018;28(1):73-9. https://doi.org/10.1111/ina.12406

Wednesday Feb 07, 2024

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:
Kearney, A., Humphreys, H., & Fitzgerald-Hughes, D. (2023). Infection prevention and control policy implementation for CPE: A cross-sectional national survey of healthcare workers reveals knowledge gaps and sub-optimal practices. Journal of Hospital Infection. https://doi.org/10.1016/j.jhin.2023.12.007
 

Wednesday Jan 24, 2024

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
Borg MA, Brincat A. Addressing the controversy of 100% hand hygiene compliance: can alcohol rub consumption data serve as a useful proxy validator? J Hosp Infect 2018;100(2):218-9. https://doi.org/10.1016/j.jhin.2018.04.024
Borg MA, Waisfisz B, Frank U. Quantitative assessment of organizational culture within hospitals and its relevance to infection prevention and control strategies. J Hosp Infect 2015;90(1):75-7. https://doi.org/10.1016/j.jhin.2014.12.015
Borg MA. Lowbury Lecture 2013. Cultural determinants of infection control behaviour: understanding drivers and implementing effective change. J Hosp Infect 2014;86(3):161-8. https://doi.org/10.1016/j.jhin.2013.12.006
De Bono S, Heling G, Borg MA. Organizational culture and its implications for infection prevention and control in healthcare institutions. J Hosp Infect 2014;86(1):1-6. https://doi.org/10.1016/j.jhin.2013.10.007
Borg MA, Hulscher M, Scicluna EA, Richards J, Azanowsky JM, Xuereb D, et al. Prevention of meticillin-resistant Staphylococcus aureus bloodstream infections in European hospitals: moving beyond policies. J Hosp Infect 2014;87(4):203-11. https://doi.org/10.1016/j.jhin.2014.05.00

Wednesday Jan 10, 2024

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
Joshi LT, Welsch A, Hawkins J, Baillie L. The effect of hospital biocide sodium dichloroisocyanurate on the viability and properties of Clostridium difficile spores. Lett Appl Microbiol 2017;65(3):199-205. https://doi.org/10.1111/lam.12768
Dyer C, Hutt LP, Burky R, Joshi LT. Biocide Resistance and Transmission of Clostridium difficile Spores Spiked onto Clinical Surfaces from an American Health Care Facility. Appl Environ Microbiol 2019;85(17). https://doi.org/10.1128/AEM.01090-19
Waterfield S, Ahmed H, Jones IA, Burky R, Joshi LT. Isolation of Clostridioides difficile PCR Ribotype 027 from single-use hospital gown ties. J Med Microbiol 2022;71(6). https://doi.org/10.1099/jmm.0.001550
Ahmed H, Joshi LT. Clostridioides difficile spores tolerate disinfection with sodium hypochlorite disinfectant and remain viable within surgical scrubs and gown fabrics. Microbiology (Reading) 2023;169(11). https://doi.org/10.1099/mic.0.001418
Malyshev D, Jones IA, McKracken M, Oberg R, Harper GM, Joshi LT, et al. Hypervirulent R20291 Clostridioides difficile spores show disinfection resilience to sodium hypochlorite despite structural changes. BMC Microbiol 2023;23(1):59. https://doi.org/10.1186/s12866-023-02787-z.

Thursday Dec 21, 2023

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

Wednesday Dec 13, 2023

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.

Wednesday Nov 29, 2023

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:
Mitchell, B. G., Russo, P. L., Kiernan, M., & Curryer, C. (2021). Nurses' and midwives’ cleaning knowledge, attitudes and practices: An Australian study. Infection, disease & health, 26(1), 55-62. Link here: Nurses' and midwives’ cleaning knowledge, attitudes and practices: An Australian study
 

Wednesday Nov 15, 2023

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/

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About us and contact

Feel free to contact us with suggestions on topics and or speakers. Use Twitter to contact any one or all of us:

Brett Mitchell @1healthau (Twitter link)

Martin Keirnan @emrsa15 (Twitter link)

Deb Friedman @friedmanndeb 

Phil Russo: @PLR_aus (Twitter link)

 

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Martin Kiernan: Martin is a highly experienced nurse who has worked in the field of infection prevention and control since 1990 in the acute hospital community and, more recently, in academic and industry settings with GAMA Healthcare. Martin's reputation as a research collaborator is recognised both nationally and internationally.  Martin’s involvement in professional organisations such as the Infection Prevention Society and the Healthcare Infection Society has enhanced his reputation as a key opinion leader, teacher, leader, and researcher. As a result, he has been invited to act in leadership and mentoring roles to support his colleagues throughout the world in terms of infection prevention.

 

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Professor Brett Mitchell:  Brett is a Professor of Nursing with over 150 peer reviewed journal and oral conference presentations, authored several books, and has been an invited speaker at numerous infection prevention and control conferences in Australia and internationally. He is a Fellow of the Australasian College for Infection Prevention and Control and the Australian College of Nursing. Professor Mitchell is also Editor-in-Chief of Infection, Disease and Health. Professor Mitchell has experience leading nursing teams, research teams and infection prevention and control teams in both Australia and the United Kingdom. Further details: https://www.newcastle.edu.au/profile/brett-mitchell 

 

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Associate Professor Philip Russo:  Phil is Director of Research, Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia and Director of Nursing Research, Cabrini Health. A/Prof. Russo is the Past President of the Australasian College for Infection Prevention and Control. He has worked in both state and national positions, notably leading the establishment of the VICNISS Surveillance Program in Victoria followed by overseeing the successful implementation of the National Hand Hygiene Initiative sponsored by the Australian Commission for Safety and Quality in Health Care. Recently he has been an advisor at both a State and National level in the pandemic response. Further details:  https://research.monash.edu/en/persons/philip-russo

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