Antimicrobial resistance (AMR)

Department for Environment, Food & Rural Affairs, Department of Health and Social Care, Public Health England, and Veterinary Medicines Directorate | December 2018 |Antimicrobial resistance (AMR)

The Department for Environment, Food & Rural Affairs, Department of Health and Social Care, Public Health England, and Veterinary Medicines Directorate  have updated  information and resources on the government’s plans to slow the growth of antimicrobial resistance.

Full details here

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

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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. 

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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