It's been a month or two since the 2018 Infection Prevention Society Conference in Glasgow, Scotland. So, we thought it would be a good time to look back and remind ourselves of some of the highlights from our point of view. You can access all of the IPS abstracts here.
- Andreas Voss gave a fabulous lecture on a water free ICU. Whilst this concept is very challenging, and feels pretty uncomfortable, the logic is clear. The risk of bacterial contamination from water, especially related to Pseudomonas, is commonplace and difficult to control. By using alcohol gels for hand hygiene most of the time, and hand wipes when hand washing with soap and water would usually be performed (e.g. when hands are visibly soiled), and sterile water for other patient care activities, tap water can be removed from the clinical environment. Evidence from a couple of studies shows that this intervention reduces the rate of antibiotic resistant Gram-negative bacteria in the critical care setting.
- Related to this, research by the University of West London (including our very own Clinical Director, Martin Kiernan) found that hand hygiene performed using antimicrobial hand wipes is just as effective as hand washing using soap and water (abstract #123).
- More work from the University of West London investigated the frequency of patient hand hygiene (abstract #130). In observational evaluations of patient opportunities for hand hygiene, patients had access to hand hygiene facilities in only 31% of 303 opportunities. Antimicrobial hand wipes would help to at least provide patients with the facilities to perform hand hygiene.
- Work from Cardiff University shows that biofilms are incredibly common in healthcare settings, with 95% of 60 items collected from three hospitals in the UK harbouring dry surface biofilm (abstract #96).
- Research from Guy's and St. Thomas' in London reports on the introduction of Clinell's Violet UV-C room decontamination system into an acute admissions ward (abstract #77). In this setting, turnaround time is paramount and there usually isn't time for hydrogen peroxide vapour room decontamination. UV-C was deployed a staggering 3980 times over the course of a year (more than 10 times per day), with turnaround time for UV-C at 1 hour (including room cleaning we presume) compared with 3 hours for hydrogen peroxide vapour. This reinforces that UV-C has an important role to play in automated room decontamination, mainly when C. difficile spores are not the target organism.
- And finally... we launched Rediroom! This is designed to provide instant patient isolation in hospitals. We were delighted that Rediroom won the vote as the best product in the 'Pitch in 5' section of the inaugural IPS Show!
Thanks to the conference organisers for another stellar conference!
The 2018 English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) report has just been released by Public Health England (PHE) and, as with most reports the results show a mixed picture. The good news is that total antibiotic consumption has fallen by 6% over the past four years and is [now] at the lowest level since 2011. The majority of antibiotics continue to be prescribed in primary care (72%), with hospital inpatients making up 12% of the total. Further progress is possible, as PHE estimate that 20% of antibiotics are being prescribed inappropriately, with the vast majority of this being in primary care.
These encouraging figures however are tempered by the not-so-good news that gram-negative bacteria with a detected carbapenemase have increased year-on-year to around 3,000 cases in 2017. The figures show that there has been a 35% increase from 2013 to 2017 in the detection of carbapenemase-producing bacteria. This increasing burden of infections that are extremely difficult to treat means that prevention of infections becomes even more critical. Prevention is coming to the fore, with the report stating that "It is clear that more work needs to be done to both prevent serious infections and reduce the pressure of antibiotic use for the selection of antibiotic-resistant bacteria". It is pleasing to see that the number one future action for ESPAUR will be to emphasise the importance of infection prevention and control with the objective of reducing the numbers of antibiotic-resistant infections. In the coming years as resistance continues to increase, prevention of infections will not only help reduce morbidity and mortality, it will mean that resistant organisms are not selected out by widespread use of the decreasing list of effective antibiotics that we still have.