13

Welcome to the Infection Control online newsfeed. Here you’ll find all the latest research, news stories, policy updates and guidelines. View our other newsfeeds for more subject-specific news.

Advertisements

New flu vaccine available this winter for those aged 65 and over

A more effective flu vaccine is available this winter for those aged 65 and over, which could prevent deaths and reduce the burden on the NHS | Public Health England

paper-3418561_1920

Public Health England (PHE) has announced that a more effective flu vaccine will be available this winter for those aged 65 and over. The broader flu vaccination, for eligible adults under 65, will also be improved and the nasal spray vaccine to primary school children will be extended to those in year 5.

PHE’s annual flu marketing campaign will launch on 8 October. NHS England has also announced the extension of NHS seasonal influenza vaccination to social care workers and staff in the voluntary managed hospice sector.

People who are eligible for the flu vaccine this year include:

  • adults aged 65 and over
  • adults aged 18 to 64 with a long term health condition
  • children aged 2 to 3 at their GP practice
  • school children in years reception, 1, 2, 3, 4 and 5
  • pregnant women
  • health and social care workers
  • carers
  • morbidly obese people

Full detail here

Jet-air dryers should not be used in hospital toilets

University of Leeds | September 2018 | Jet-air dryers should not be used in hospital toilets

A new study from researchers at Leeds University and Leeds Teaching Hospital Trust investigated whether the way people dried their hands (using paper towels or jet-air dryers) has an impact on the spread of bacteria. 

hand-dryers-100786_1920.jpg

The academics argue that official guidance about how to prevent bacterial contamination in hospital buildings needs to be strengthened. Currently, the official Department of Health guidance states that air dryers can be placed in toilets in the public areas of a hospital but not in clinical areas: but this due to the noise they create rather than due to any potential  risks they pose for cross contamination (via University of Leeds).

Over 12 weeks at three hospitals in the UK, Italy and France levels of bacterial contamination from two toilets at each hospital were measured, allowing comparisons to be made when either paper towels or jet-air dryers were in use. Samples were taken from the floors, air and surfaces in each of the toilets.

The researchers found that across the three hospitals, bacterial counts were significantly higher in the toilets on the days that jet-air dryers were in use.

Professor Wilcox, Professor of Medical Microbiology at the University of Leeds supervised the study. He said:

“We found multiple examples of greater bacterial contamination on surfaces, including by faecal and antibiotic-resistant bacteria, when jet-air dryers rather than paper towels were in use. Choice of hand drying method affects how likely microbes can spread, and so possibly the risk of infection.” (Source: University of Leeds)

The study has been published in The Journal of Hospital Infection. 

Summary

Background

Hand hygiene is a fundamental component of infection prevention, but few studies have examined whether hand-drying method affects the risk of dissemination of potential pathogens.

Aim

To perform a multi-centre, internal-crossover study comparing bacterial contamination levels in washrooms with hand-drying by either paper towels (PT) or jet air dryer (JAD; Dyson).

Methods

A total of 120 sampling sessions occurred over 12 weeks in each of three hospitals (UK, France, Italy). Bacteria were cultured from air, multiple surfaces, and dust. Washroom footfall (patients/visitors/staff) was monitored externally.

Findings

Footfall was nine times higher in UK washrooms. Bacterial contamination was lower in PT versus JAD washrooms; contamination was similar in France and the UK, but markedly lower in Italian washrooms. Total bacterial recovery was significantly greater from JAD versus PT dispenser surfaces at all sites (median: 100–300 vs 0–10 cfu; all P < 0.0001). In the UK and France, significantly more bacteria were recovered from JAD washroom floors. UK meticillin-susceptible Staphylococcus aureus recovery was three times more frequent and six-fold higher for JAD vs PT surfaces. UK meticillin-resistant S. aureus recovery was three times more frequent from JAD versus PT surfaces or floors. Significantly more enterococci and extended-spectrum β-lactamase (ESBL)-producing bacteria were recovered from UK JAD versus PT washroom floors. In France, ESBL-producing bacteria were recovered from dust twice as often during JAD versus PT use.

Conclusion

Multiple examples of significant differences in surface bacterial contamination, including by faecal and antibiotic-resistant bacteria, were observed, with higher levels in JAD versus PT washrooms. Hand-drying method affects the risk of (airborne) dissemination of bacteria in real-world settings.

 

The full article can be downloaded from the Journal of Hospital Infection  

Contact among healthcare workers in the hospital setting: developing the evidence base for innovative approaches to infection control

English, K.M. | 2018| BMC Infectious Diseases |Contact among healthcare workers in the hospital setting: developing the evidence base for innovative approaches to infection control.

 

A recent article from the BMC Infectious Diseases looks at healthcare-associated infections (HAI) in  care hospitals in Canada.

Abstract

Background:

Nosocomial, or healthcare-associated infections (HAI), exact a high medical and financial toll on patients, healthcare workers, caretakers, and the health system. Interpersonal contact patterns play a large role in infectious disease spread, but little is known about the relationship between health care workers’ (HCW) movements and contact patterns within a heath care facility and HAI. Quantitatively capturing these patterns will aid in understanding the dynamics of HAI and may lead to more targeted and effective control strategies in the hospital setting.

Methods:

Staff at 3 urban university-based tertiary care hospitals in Canada completed a detailed questionnaire on demographics, interpersonal contacts, in-hospital movement, and infection prevention and control practices. Staff were divided into categories of administrative/support, nurses, physicians, and “Other HCWs” – a fourth distinct category, which excludes physicians and nurses. Using quantitative network modeling tools, we constructed the resulting HCW “co-location network” to illustrate contacts among different occupations and with locations in hospital settings.

Results:

Among 3048 respondents (response rate 38%) an average of 3.79, 3.69 and 3.88 floors were visited by each HCW each week in the 3 hospitals, with a standard deviation of 2.63, 1.74 and 2.08, respectively. Physicians reported the highest rate of direct patient contacts (more than 20 patients/day) but the lowest rate of contacts with other HCWs; nurses had the most extended (over  20 min) periods of direct patient contact. “Other HCWs” had the most direct daily contact with all other HCWs. Physicians also reported significantly more locations visited per week than nurses, other HCW, or administrators; nurses visited the fewest. Public spaces such as the cafeteria had the most staff visits per week, but the least mean hours spent per visit. Inpatient settings had significantly more HCW interactions per week than outpatient settings.

Conclusions:

HCW contact patterns and spatial movement demonstrate significant heterogeneity by occupation. Control strategies that address this diversity among health care workers may be more effective than “one-strategy-fits-all” HAI prevention and control programs

The full article is available to read in full from BMC

NICE aims to improve flu vaccination uptake

The National Institute for Health and Care Excellence (NICE) and Public Health England have published new guidance on how to increase uptake of NHS flu vaccinations by identifying and encouraging those who are eligible.

 It describes ways to increase awareness and how to use all opportunities in primary and secondary care to identify people who should be encouraged to have the vaccination.

Recommendations

This guideline includes recommendations on:

Full guideline: Flu vaccination: increasing uptake

Infection control protocols: Is it time to clean up our act?

Makiela, S. , Weber, A., Maguire, B.J ., Taylor-Robinson, A.W. |2018|Infection control protocols: Is it time to clean up our act?| Australian Journal of Paraemdicine | Vol. 3 |3, 5|Accessed here: ajp.paramedics.org

New commentary published in the Australian Journal of Paraemdicine considers the infection protocols for emergency care, notes that Australia currently has no national protocol, (there are guidelines at state and territory level)  and praises the infection control measures in the United Kingdom.

clean-571679_1920.jpg

Abstract
While paramedics in Australia respond to many call-outs daily, little is known of the risks of infectious disease transmission that may arise from contamination of vehicles, equipment, personnel and/or patients. We examine what is currently known of the current risks in Australia posed by contamination of emergency service vehicles by antimicrobial-resistant microorganisms.

The commentary can be read here 

Hospital superbugs developing ‘tolerance to alcohol disinfectants’

Nursing Times | August 2018 | Hospital superbugs developing ‘tolerance to alcohol disinfectants’

An Australian study has found that multidrug-resistant bacterial species that can cause infections in hospitals are becoming increasingly tolerant to the alcohols used in handwash disinfectants. adult-alcohol-clean-257279.jpg

Australian researchers analysed bacterial samples from two different hospitals over a nineteen-year period between 1997 and 2015. They discovered that drug-resistant E. faecium infections had increased, in spite of  using  alcohol based disenfectants. This led  the research team to investigate if E. faecium could be developing resistance to the alcohols used in hand rubs (Source: Nursing Times). 

Rotherham NHS staff can request this article here 

 

Antimicrobial Resistance and Immunisation

Houses of Parliament | July 2018 |Antimicrobial Resistance and Immunisation

A new POSTnote, based on literature reviews and interviews with range of stakeholders, and externally peer reviewed, has been released from the House of Commons Library. This POSTnote considers the rise of antimicrobial resistance and immunisation. 

AMR
Image source: researchbriefings.parliament.uk

Key points from the POSTNOTE:

  • Antimicrobial resistance (AMR) has reached a point where some infections may become untreatable.
  • Immunisation is one strategy to tackle AMR, by decreasing rates of infection and thereby antibiotic use and preventing the development of resistant infections.
  • The World Health Organization has developed a list of pathogens where AMR is of most concern and new antibiotics are needed; there is no equivalent for vaccines.
  • Quantifying the impact of immunisation on AMR and incorporating this into calculating the cost-effectiveness of vaccines is still an area of ongoing research.
  • Using immunisation to tackle AMR depends on wider use and increased uptake of existing vaccines, and increasing the development of new ones (Source: House of Commons Library).

The briefing Antimicrobial Resistance and Immunisation is available from the House of Commons Library