Infection Control Matters

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

Healthcare Cleaning - a visit to Interclean that's an eye-opener

In this episode, Brett and Martin report on a visit to the massive Interclean Expo held biannually in Amsterdam and the Healthcare Hygiene meeting. We report on the staggering range of equipment available and the fact that IPC often has little say in this especially if there are potential risks, referring to a previous podcast https://infectioncontrolmatters.podbean.com/e/investigating-a-unique-cpeoutbreak-a-possible-new-place-to-look/
 
Click here for a video of one hall at Interclean (of 12).
 

A novel approach to employing environmental service workers and an outbreak (or pseudo-outbreak) of SSI

In this episode, Martin has been on the road again and talks to two poster presenters at the IPAC-Canada 2024 conference. In the first part, Martin talks to Margaret Cameron from Peterborough Regional Health Centre, Ontario about the use of the Multiple Mini Interviewing approach to the selection of suitable candidates to become part of the hospital Environmental Service Attendant team. This innovative approach uses scenarios to test a candidate's suitability for this important role.
In the second part, Karrie Yausie from Saskatchewan health Authority talks about a blip in orthopaedic implant SSI rates that was investigated with some interesting aspects.
 
You can download Margaret's poster here and Karrie's here

More posters from ESCMID Global 2024, inc C. diff, UV-C, wastewater surveillance, LA-MRSA

This week we have a second batch of posters that we liked at ESCMID Global and will be talking about:
VRE Surveillance using hospital waste water during an outbreak
Assessing the Hawthorne effect: Implications and solutions
The impact of an early Infectious Disease consultation for CLABSI: a single centre retrospective study
Semi-continuous disinfection of sinks with UVC on a haematologydepartment for infection prevention
Urinary tract microbiome of asymptomatic individuals with spinal cord injury
Nurses known to be colonized with livestock-associated MRSA did not cause transmission to patients
Clostridium difficile contamination of australian retail vegetables and households
Prolonged use of breathing systems used in anesthesia for up to 7 days instead of 24H
A pdf of the posters can be downloaded here

Posters from ESCMID Global 2024 - Part 1

In this episode Brett, Phil and Martin tour the posters at ESCMID Global 2024 and we discuss some of them with the authors. A link to images of the posters can be found below.
Here are the posters we discuss
AMR Surveillance in waste water and clinical isolates from a tertiary hospital: Preliminary results
Deciphering the temporal short-term dynamics of Acinetobacter baumanii: Impact of colonisation pressure in infection in an endemic Indian intensive care unit (Manasa Tantry discussion)
Post-antibiotic risk for recurrent lower respiratory tract infection during prolonged hospitalisation
Transmission of MDRO during physical and occupational therapy appointmants a 3 Veterans Affairs Hospitals
Aircraft lavatory wastewater surveillance for SARS-CoV2 and other coronaviruses by using family-wide RT-PCR, Thailand, October – November 2023
Enhancing feedback and implementation of infection risk scan findings (IRIS) among healthcare workers in nursing homes
Proper glove use: a multicentre before-after regional study (Anne F. Voor and Juliëtte Severin discussion)
Poster link to see the posters we discuss Posters from ESCMID Global - Part 1
More posters to come!

Reflections on Day 3 at ESCMID Global 2024

It was day 3 at ESCMID Global 2024 and Phil, Brett and Martin mull over the day. Amongst the items we discuss are:
What does endogenous really mean?
AI in the IPC space - friend or foe?
Fungal outbreaks - epidemiological challenges and tracing the source
Automated bloodstream infection surveillance
The Euro PPS survey results - data in action (or inaction)
Subsequent to the podcast recording the ECDC PPS results have been published and can be found here:
https://www.ecdc.europa.eu/sites/default/files/documents/healthcare-associated--infections-antimicrobial-use-point-prevalence-survey-2016-2017.pdf