The lowbury lecture 2016: can intersectional innovations reduce hospital infection?

Saint, S. The Journal of Hospital Infection. Published online: November 28, 2016

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Preventing healthcare-associated infection remains an international priority given the clinical and economic consequences of this largely preventable patient safety harm. While important strides have been made in preventing hospital infections over the past several decades, thorny issues remain, including how to consistently improve hand hygiene rates and further reduce device-related complications such as catheter-associated urinary tract infection.

Rather than relying solely on directional innovations – incremental changes that continue to serve as the bedrock of scientific advancement – perhaps we should also search for “intersectional innovations,” which represent breakthrough discoveries that emanate from the intersection of often widely divergent disciplines. Several intersectional innovations that have the potential to greatly impact infection prevention efforts include human factors engineering, sociology, and engaging the senses. Indeed, Professor Edward Joseph Lister Lowbury, the namesake of this lecture, exemplified intersectional thinking in his own life having been both an accomplished bacteriologist and poet. By incorporating approaches outside of traditional biomedical science we will hopefully provide patients with the safe care they expect and deserve.

Read the full article here

New Method for Predicting Congenital CMV Infection During the Prenatal Period

Tanimura, K. et al. (2016) Clinical Infectious Diseases. DOI:10.1093/cid/ciw707

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Image source: Pete Jeffs – Wellcome Images // CC BY-NC-ND 4.0

Image shows illustration of a human cytomegalovirus (HCMV) virus particle

Background: The aim of this prospective study was to determine maternal clinical, laboratory, and ultrasound findings that effectively predict the occurrence of congenital cytomegalovirus (CMV) infection in high-risk pregnant women.

Conclusions: This is the first prospective cohort study to suggest that the presence of CMV-DNA in the maternal uterine cervical secretion and ultrasound fetal abnormalities was predictive of the occurrence of congenital CMV infection in high-risk pregnant women.

Read the full abstract here

Post-prescription antibiotic review based on computerized tools

Bouchand, F. et al. The Journal of Hospital Infection. Published online: November 25 2016

 

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Background: Controlling antibiotic use in healthcare establishments limits their consumption and the emergence of bacterial resistance.

Aim: We evaluated the efficiency of an innovative antibiotic-stewardship strategy implemented over 3 years in a university hospital.

 

Conclusion: This computerized, shared-access, antibiotic-stewardship strategy seems to be time-saving and effectively limited misuse of broad-spectrum antibiotics.

Read the full abstract here

Chlorhexidine bathing and health care-associated infections among adult intensive care patients

Frost, S.A. et al. Critical Care. Published online: 23 November 2016

 

L0075034 An intensive care unit in a hospital.

Image source: Robert Priseman – Wellcome Images // CC BY-NC-ND 4.0

Background: Health care-associated infections (HAI) have been shown to increase length of stay, the cost of care, and rates of hospital deaths . Importantly, infections acquired during a hospital stay have been shown to be preventable. In particular, due to more invasive procedures, mechanical ventilation, and critical illness, patients cared for in the intensive care unit (ICU) are at greater risk of HAI and associated poor outcomes.

Conclusion: This meta-analysis of the effectiveness of CHG bathing to reduce infections among adults in the ICU has found evidence for the benefit of daily bathing with CHG to reduce CLABSI and MRSA infections. However, the effectiveness may be dependent on the underlying baseline risk of these events among the given ICU population. Therefore, CHG bathing appears to be of the most clinical benefit when infection rates are high for a given ICU population.

Read the full abstract and article here

Antibiotic prescribing and resistance

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Public Health England has published English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) report 2016.

The ESPAUR report includes national data on antibiotic prescribing and resistance, and hospital antimicrobial stewardship implementation. It forms a standard against which antimicrobial use and antimicrobial resistance can be compared in successive years and a resource for commissioning and implementing antimicrobial stewardship policies in England.

Additional link: PHE press release

Respiratory tract infections: infection control in healthcare settings

Guidance on transmission routes and precautions in healthcare settings | PHE

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Image source: David S. Goodsell, RCSB Protein Data Bank – Wellcome Images // CC BY-NC-ND 4.0 

Image shows molecular model from X-ray diffraction data of a rhinovirus particle.

Avoiding transmission of acute respiratory infections in healthcare settings can prevent considerable mortality, morbidity and healthcare costs. Patients in healthcare settings, which include acute hospitals, outpatient clinics, A&E departments, specialised units and primary care, are often vulnerable because of age or chronic disease, and may suffer more severe disease or complications from acute respiratory infections.

This document summarises recommendations for the prevention and control of  acute respiratory infections in healthcare settings for clinical and public health colleagues. Preventing infection in healthcare settings requires the consistent application of infection control measures by healthcare workers and the involvement of the local infection control team. It also requires efforts to: maximise coverage of seasonal influenza vaccine among vulnerable groups and healthcare workers, and limit the spread of infection by visitors or infected staff, as well as general education and awareness-raising.

Read the full guidance here