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.

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/

In this episode, Brett, Martin and Phil mull over the newly published WHO discussion document on respiratory particles and Martin catches up with Prof Cath Noakes from the School of Engineering in Leeds, UK to get her take on it.

You can download the document we are discussing here

https://www.who.int/publications/m/item/global-technical-consultation-report-on-proposed-terminology-for-pathogens-that-transmit-through-the-air

In this podcast, Brett and Martin reflect on the "Infection Control Papers of the Year" presented at ECCMID (AKA ESCMID Global) 2024.

Here are a selection of some of the papers mentioned:

• Decolonization in Nursing Homes to Prevent Infection and Hospitalization https://pubmed.ncbi.nlm.nih.gov/37815935/

• Reducing Hospitalizations and Multidrug-Resistant Organisms vi a Regional Decolonization in Hospitals and Nursing Homes https://pubmed.ncbi.nlm.nih.gov/38557703/

• Prevention of non-ventilator-associated hospital-acquired pneumonia in Switzerland: a type 2 hybrid effectiveness-implementation trial https://pubmed.ncbi.nlm.nih.gov/36893785/

• Skin Antisepsis before Surgical Fixation of Extremity Fractures https://www.nejm.org/doi/full/10.1056/NEJMoa2307679

• Trial of Vancomycin and Cefazolin as Surgical Prophylaxis in Arthroplasty https://www.nejm.org/doi/full/10.1056/NEJMoa2301401

• Investigation of individual nurses' relative hand hygiene performance using an anonymous automated electronic hand hygiene monitoring system and a nursing assignment schedule https://www.ajicjournal.org/article/S0196-6553(22)00468-0/abstract

• Environmental cleaning to prevent hospital-acquired infections on non-intensive care units: a pragmatic, single-centre, cluster randomized controlled, crossover trial comparing soap-based, disinfection and probiotic cleaning https://pubmed.ncbi.nlm.nih.gov/37089619/

In our first episode from ECCMID Global 2024, Martin and Brett reflect on the session on design of the healthcare environment sessions from Profs Hilary Humphries and Cath Noakes and a flash poster session featuring VRE Reservoirs in the environment and a tremendous piece of  Burkolderia sleuthing from the UKHSA

In this podcast, we chat with Dr Brian Forde about HAIviz. HAIviz an interactive dashboard for visualising and integrating healthcare-associated genomic epidemiological data. HAIviz displays and links the outbreak timeline, building map, phylogenetic tree, patient bed movements, and transmission network on a single interactive dashboard.

You can view and use the tool for free at Permana, B., Harris, P. N., Roberts, L. W., Cuddihy, T., Paterson, D. L., Beatson, S. A., & Forde, B. M. (2024). HAIviz: an interactive dashboard for visualising and integrating healthcare-associated genomic epidemiological data. Microbial Genomics, 10(2), 001200.

In this episode, Martin Kiernan talks to Mitch Clarke, Clinical Lead and Deputy Director of Infection Prevention and Control at Nottingham University Hospitals in the UK. We discuss an outbreak with a unique NDM CPE infection and look at where the investigations went, including a new reservoir that is a potential source - the floor scrubber.

Papers underpinning this work are here:

1. Benbow A, Clarke M, Yates C, Montgomery R, Staniforth K, Boswell T, et al. Hospital-wide healthcare-associated carbapenemase-producing Enterobacterales outbreak: risks of electric floor scrubbers in catering facilities and kitchens. J Hosp Infect. 2024;146:59-65. https://www.ncbi.nlm.nih.gov/pubmed/38341149 2. Prescott K, Billam H, Yates C, Clarke M, Montgomery R, Staniforth K, et al. Outbreak of New Delhi Metallo-Beta-lactamase Carbapenemase Producing Enterobacterales on a bone marrow transplant unit: Role of the environment. Infect Prev Pract. 2021;3:100125. https://www.ncbi.nlm.nih.gov/pubmed/34368742

In this episode, Martin Talks to Dr Mark Wilcox OBE, Professor of Microbiology at the University of Leeds, Head of Microbiology Research & Development at Leeds University Hospitals NHS Trust and National Clinical Director for Infection Prevention and Control at NHS England. We mull over the possible reasons for the increase in hospital-onset, hospital attributed cases in England, including ribotypes and antibiotic use. Given that the NHS is under great stress, we discuss the damage potential from a ribotype 955 which shares some genetic characteristics with the 027 ribotype that caused so many problems in the UK and worldwide in the early 2000s. One thing that we agree on is that reductions targets (with teeth) have been very successful in the past and should we venture in that direction again?

Information on data collection, hospital and national typing reports for England can be found here: https://www.gov.uk/government/collections/clostridium-difficile-guidance-data-and-analysis#epidemiology

In this episode, after an interesting discovery when searching Youtube, Brett and Martin mull over whether toilet plume is a risk factor for hospital-acquired pneumonia and C. difficile infections. The papers we discuss are listed below.

• Goforth MP, Boone SA, Clark J, Valenzuela PB, McKinney J, Ijaz MK, et al. Impacts of lid closure during toilet flushing and of toilet bowl cleaning on viral contamination of surfaces in United States restrooms. Am J Infect Control 2023. https://doi.org/10.1016/j.ajic.2023.11.020
• Best EL, Sandoe JA, Wilcox MH. Potential for aerosolization of Clostridium difficile after flushing toilets: the role of toilet lids in reducing environmental contamination risk. J Hosp Infect 2012;80(1):1-5. https://doi.org/10.1016/j.jhin.2011.08.010
• Lai ACK, Tan TF, Li WS, Ip DKM. Emission strength of airborne pathogens during toilet flushing. Indoor Air 2018;28(1):73-9. https://doi.org/10.1111/ina.12406

We chat with Dr Deirdre Fitzgerald-Hughes and Aoife Kearney about a national survey undertaken in Ireland. In the survey, they explored CPE knowledge and practices of healthcare workers, including infection prevention and control staff.

There were some interesting findings that may be useful in informing IPC education and training, including convincing people that they need to know more.

The paper we discuss is:

• Kearney, A., Humphreys, H., & Fitzgerald-Hughes, D. (2023). Infection prevention and control policy implementation for CPE: A cross-sectional national survey of healthcare workers reveals knowledge gaps and sub-optimal practices. Journal of Hospital Infection. https://doi.org/10.1016/j.jhin.2023.12.007

In this episode, Martin Kiernan and Phil Russo talk to Professor Michael Borg of the Faculty of Medicine & Surgery in the Medical School at the University of Malta and Head of Department (Infection Control) at Mater Dei Hospital in Malta. We discuss a recent paper desctibing the stages that brought about a 90% reduction in MRSA bloodstream infections over a ten-year period.

The main paper we discuss: Borg MA, Suda D, Tartari E, Farrugia C, Xuereb D, Borg Inguanez M. Preventing healthcare-associated MRSA bacteremia: getting to the root of the problem. Antimicrob Steward Healthc Epidemiol 2023;3(1):e248. https://doi.org/10.1017/ash.2023.518

Other papers by Michael include:

• Borg MA, Suda D, Scicluna E, Brincat A, Zarb P. Universal admission screening: a potential game-changer in hospitals with high prevalence of MRSA. J Hosp Infect 2021;113:77-84. https://doi.org/10.1016/j.jhin.2021.03.024
• Borg MA, Brincat A. Addressing the controversy of 100% hand hygiene compliance: can alcohol rub consumption data serve as a useful proxy validator? J Hosp Infect 2018;100(2):218-9. https://doi.org/10.1016/j.jhin.2018.04.024
• Borg MA, Waisfisz B, Frank U. Quantitative assessment of organizational culture within hospitals and its relevance to infection prevention and control strategies. J Hosp Infect 2015;90(1):75-7. https://doi.org/10.1016/j.jhin.2014.12.015
• Borg MA. Lowbury Lecture 2013. Cultural determinants of infection control behaviour: understanding drivers and implementing effective change. J Hosp Infect 2014;86(3):161-8. https://doi.org/10.1016/j.jhin.2013.12.006
• De Bono S, Heling G, Borg MA. Organizational culture and its implications for infection prevention and control in healthcare institutions. J Hosp Infect 2014;86(1):1-6. https://doi.org/10.1016/j.jhin.2013.10.007
• Borg MA, Hulscher M, Scicluna EA, Richards J, Azanowsky JM, Xuereb D, et al. Prevention of meticillin-resistant Staphylococcus aureus bloodstream infections in European hospitals: moving beyond policies. J Hosp Infect 2014;87(4):203-11. https://doi.org/10.1016/j.jhin.2014.05.00

In this week's episode, Martin talks to Dr Tina Joshi, Associate Professor of Molecular Microbiology in Peninsula Dental School at the University of Plymouth, UK. We discuss her longstanding interest in Clostridioides difficile and her many publications, one of which on the effectiveness of hypochlorite (or lack of it) on spores has been widely covered in the media. We chat about spore attachment to surfaces, the effect of disinfectants and the differences between strains. Some of Tina's papers are listed here.

• Joshi LT, Phillips DS, Williams CF, Alyousef A, Baillie L. Contribution of spores to the ability of Clostridium difficile to adhere to surfaces. Appl Environ Microbiol 2012;78(21):7671-9. https://doi.org/10.1128/AEM.01862-12
• Joshi LT, Welsch A, Hawkins J, Baillie L. The effect of hospital biocide sodium dichloroisocyanurate on the viability and properties of Clostridium difficile spores. Lett Appl Microbiol 2017;65(3):199-205. https://doi.org/10.1111/lam.12768
• Dyer C, Hutt LP, Burky R, Joshi LT. Biocide Resistance and Transmission of Clostridium difficile Spores Spiked onto Clinical Surfaces from an American Health Care Facility. Appl Environ Microbiol 2019;85(17). https://doi.org/10.1128/AEM.01090-19
• Waterfield S, Ahmed H, Jones IA, Burky R, Joshi LT. Isolation of Clostridioides difficile PCR Ribotype 027 from single-use hospital gown ties. J Med Microbiol 2022;71(6). https://doi.org/10.1099/jmm.0.001550
• Ahmed H, Joshi LT. Clostridioides difficile spores tolerate disinfection with sodium hypochlorite disinfectant and remain viable within surgical scrubs and gown fabrics. Microbiology (Reading) 2023;169(11). https://doi.org/10.1099/mic.0.001418
• Malyshev D, Jones IA, McKracken M, Oberg R, Harper GM, Joshi LT, et al. Hypervirulent R20291 Clostridioides difficile spores show disinfection resilience to sodium hypochlorite despite structural changes. BMC Microbiol 2023;23(1):59. https://doi.org/10.1186/s12866-023-02787-z.

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 

In our usual Christmas episode, Brett, Phil and Martin choose our papers and podcasts of 2023. Also this time, Martin set the three of us a challenge: to find an interesting IPC-related paper from the years of our birth (more challenging for some than others..). Martin also reveals the No 1 single in our respective countries on the day of our birth. For Martin, a near miss. For Phil, a very apt song and for Brett... well, his karaoke debut cannot be far off.. Happy holidays everyone!

Martin's 1955 paper: Lowbury, E. J. (1955). "Cross-infection of wounds with antibiotic-resistant organisms." Br Med J 1(4920): 985-990. https://doi.org/10.1136/bmj.1.4920.985

Phil's 1964 paper: Murray, D. G. (1964). "Wound Infections after Surgery for Fractured Hip. A Follow-up Study." JAMA 190: 505-508. https://doi.org/10.1001/jama.1964.03070190025005

Brett's 1979 paper: Ehrenkranz, N. J. and S. J. Pfaff (1979). "Growth of hospital infection control programme and the infection control nurse." J R Soc Med 72(12): 888. https://doi.org/10.1177/014107687907201204

Our top papers

Martin's favourite paper: Wolfensberger, A., L. Clack, S. von Felten, M. Faes Hesse, D. Saleschus, M. T. Meier, K. Kusejko, R. Kouyos, L. Held and H. Sax (2023). "Prevention of non-ventilator-associated hospital-acquired pneumonia in Switzerland: a type 2 hybrid effectiveness-implementation trial." Lancet Infect Dis 23(7): 836-846. https://doi.org/10.1016/S1473-3099(22)00812-X

Phil's favourite paper: Peel, T. N., S. Astbury, A. C. Cheng, D. L. Paterson, K. L. Buising, T. Spelman, A. Tran-Duy, S. Adie, G. Boyce, C. McDougall, R. Molnar, J. Mulford, P. Rehfisch, M. Solomon, R. Crawford, T. Harris-Brown, J. Roney, J. Wisniewski, R. de Steiger and A. T. Group (2023). "Trial of Vancomycin and Cefazolin as Surgical Prophylaxis in Arthroplasty." N Engl J Med 389(16): 1488-1498. https://doi.org/10.1056/NEJMoa2301401

Brett's favourite paper: Seidelman, J. L., C. R. Mantyh and D. J. Anderson (2023). "Surgical Site Infection Prevention: A Review." JAMA 329(3): 244-252. https://doi.org/10.1001/jama.2022.24075

In this week's episode Phil and Brett mull over their wishlists for what they would want in a perfect IPC world. They turn out to be a pretty undemanding pair.. not. However they both see a future in which their wishes could become true. Unsurprisingly AI and automated surveillance loom large in their thoughts.

In this episode, Brett and Martin discuss a paper they were recently involved with - a systematic review and meta-analysis on prior room occupancy and the risk to the next person. This paper has been recently published in Infection, Disease and Health.

Findings provide some evidence to help inform a risk management approach when determining patient room allocation. The risk of pathogen acquisition appears to remain high, supporting the need for continued investment in this area.

Here is a link to the paper.

In our discussion, we also mentioned a paper about nurses views on the environment and risk:

In this week's episode, Martin talks to Dr Jon Otter, epidemiologist, scientst, blogger and Joint Director of Infection Prevention and Control at Guy's and St Thomas' NHS Foundation Trust in the UK. We discuss a session at the recent ICPIC conference on the problems posed by plasmids in terms of outbreak detection, increasing antimicrobial resistance and environmental reservoirs. You can read more about Jon's thoughts in his excellent blog post at https://reflectionsipc.com/2023/09/14/cpe-and-plasmid-transfer-in-hospitals-what-can-we-do-a-rapid-reflection-from-icpic-2023/#more-5141

A paper we discuss from Kalisvar Marimuthu and colleagies can be found here https://www.nature.com/articles/s41467-022-30637-5

You can listen to Kalis discussing it on a previous podcast in our genomics collection here:

https://infectioncontrolmatters.com/topics/methodology/

In this episode, Brett talks to Martin about a recent paper on the potential pitfalls of ice machines and following manufactures' instructions.

The paper we discuss is called "How clean is your ice machine?"

This paper was published in the journal of hospital infection: https://www.sciencedirect.com/science/article/abs/pii/S0195670123002700

In this episode, Martin talks to Dr Jinny Moore from the National Health Security Agency in England about detecting pathogens in the ICU environment. They discuss a recent paper where whole-genome sequencing (WGS) on presumptive S. capitis NRCS-A isolates was collected from infants admitted to nationwide NICU and from environmental sampling in two distinct NICUs. The discussion includes details on the approach to sampling (neonates and environment).

Papers discussed:

Detection, survival, and persistence of Staphylococcus capitis NRCS-A in neonatal units in England https://www.journalofhospitalinfection.com/article/S0195-6701(23)00234-7/fulltext

Other papers of interest:

Laurent F, Butin M. Staphylococcus capitis and NRCS-A clone: the story of an unrecognized pathogen in neonatal intensive care units. Clin Microbiol Infect. 2019;25:1081-5. https://www.ncbi.nlm.nih.gov/pubmed/30928561

Butin M, Martins-Simoes P, Rasigade JP, Picaud JC, Laurent F. Worldwide Endemicity of a Multidrug-Resistant Staphylococcus capitis Clone Involved in Neonatal Sepsis. Emerg Infect Dis. 2017;23:538-9.https://www.ncbi.nlm.nih.gov/pubmed/28221122 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5382751/pdf/16-0833.pdf

Butin M, Martins-Simoes P, Pichon B, Leyssene D, Bordes-Couecou S, Meugnier H, et al. Emergence and dissemination of a linezolid-resistant Staphylococcus capitis clone in Europe. J Antimicrob Chemother. 2017;72:1014-20. https://www.ncbi.nlm.nih.gov/pubmed/27999045 Van Der Zwet WC, Debets-Ossenkopp YJ, Reinders E, Kapi M, Savelkoul PH, Van Elburg RM, et al. Nosocomial spread of a Staphylococcus capitis strain with heteroresistance to vancomycin in a neonatal intensive care unit. J Clin Microbiol. 2002;40:2520-5. https://www.ncbi.nlm.nih.gov/pubmed/12089273 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC120592/pdf/1550.pdf

This week, Martin talks to Dr Jennifer Meddings, Associate Professor at University of Michigan Health and Internist at Ann Arbor about a recently published survey looking at what interventions are commonly used to prevent device-associated infections. We discuss the findings and focus in on prevention of urinary catheter-associated infections and new devices that may have an impact.

The paper can be found here:

Saint, S., M. T. Greene, S. L. Krein, K. E. Fowler, K. A. Linder, D. Ratz & J. Meddings (2023) What US hospitals are doing to prevent common device-associated infections during the coronavirus disease 2019 (COVID-19) pandemic: Results from a national survey in the United States. Infect Control Hosp Epidemiol, 10.1017/ice.2023.65, 1-7. https://www.ncbi.nlm.nih.gov/pubmed/37259703

Other areas and papers that we discuss are here:

New tools that have been developed and piloted in a large surgical collaborative in Michigan, in our project called SUCCESS:  Surgical Urinary Catheter Care Enhancement Safety Study, which has focused on improving urinary catheter safety even beyond CAUTI prevention, including focus on reducing unnecessary use for several common elective procedures, standardizing diagnosis and management of urinary retention, and practices to reduce traumatic injury from catheters and improve success on first catheterization attempt:   https://msqc.org/success/.

Kuriyama, A., K. E. Fowler, J. Meddings, H. Irie, D. Kawakami, H. Iwasaki, M. Sakuraya, K. Katayama, Y. Tokuda & S. Saint (2019) Reducing unnecessary urethral catheter use in Japanese intensive care units: A multicenter interventional study. Infect Control Hosp Epidemiol, 40, 1272-1274. https://www.ncbi.nlm.nih.gov/pubmed/31558172

Patel, P. K., A. Gupta, V. M. Vaughn, J. D. Mann, J. M. Ameling & J. Meddings (2018) Review of Strategies to Reduce Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) in Adult ICUs. J Hosp Med, 13, 105-116. https://www.ncbi.nlm.nih.gov/pubmed/29154382

Patel, P. K., A. Gupta, V. M. Vaughn, J. D. Mann, J. M. Ameling & J. Meddings (2018) Review of Strategies to Reduce Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) in Adult ICUs. J Hosp Med, 13, 105-116. https://www.ncbi.nlm.nih.gov/pubmed/29154382

Meddings, J., S. Saint, S. L. Krein, E. Gaies, H. Reichert, A. Hickner, S. McNamara, J. D. Mann & L. Mody (2017) Systematic Review of Interventions to Reduce Urinary Tract Infection in Nursing Home Residents. J Hosp Med, 12, 356-368. https://www.ncbi.nlm.nih.gov/pubmed/28459908

In this episode, Martin Kiernan talks to Dr Giorgia Gon, Assistant Professor of Epidemiology, London School of Hygiene and Tropical Medicine about a briefing paper that  identifies research priorities for healthcare cleaning in resource-limited settings. We discuss the process of determining the priorities, the groups involved and the final areas that should be targeted with research funding, including cost-effectiveness, the use of biocides or detergents and minimum requirements.

You can find a copy of the CLEAN Briefing here

Other papers of interest:

1. Cross S, Gon G, Morrison E, Afsana K, Ali SM, Manjang T, et al. An invisible workforce: the neglected role of cleaners in patient safety on maternity units. Glob Health Action. 2019;12:1480085. https://www.ncbi.nlm.nih.gov/pubmed/31154993

2. Gon G, Kabanywanyi AM, Blinkhoff P, Cousens S, Dancer SJ, Graham WJ, et al. The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals. Antimicrob Resist Infect Control. 2021;10:8. https://www.ncbi.nlm.nih.gov/pubmed/33413647

3. Storr J, Kilpatrick C, Lee K. Time for a renewed focus on the role of cleaners in achieving safe health care in low- and middle-income countries. Antimicrob Resist Infect Control. 2021;10:59. https://www.ncbi.nlm.nih.gov/pubmed/33762000

In this episode, Martin talks to Giovanni-Battista Fucini about a recent paper from Germany that examined infection rates in critical care in which it was reported that hospitals without sinks in patient rooms have lower infection rates. Newer hospitals in Germany tend not to have sinks in the patient rooms in ICU.

The paper we discuss is here:

Giovanni-Battista, F., C. Geffers, F. Schwab, M. Behnke, W. Sunder, J. Moellmann & P. Gastmeier (2023) Sinks in patient rooms in the ICU are associated with higher rates of hospital-acquired infections. A retrospective analysis of 552 ICUs. J Hosp Infect, 10.1016/j.jhin.2023.05.018. https://doi.org/10.1016/j.jhin.2023.05.018

Other papers of interest are:

• Kotay, S. M., H. I. Parikh, K. Barry, H. S. Gweon, W. Guilford, J. Carroll & A. J. Mathers (2020) Nutrients influence the dynamics of Klebsiella pneumoniae carbapenemase producing enterobacterales in transplanted hospital sinks. Water Res, 176, 115707. https://www.ncbi.nlm.nih.gov/pubmed/32224328
• Constantinides, B., K. K. Chau, T. P. Quan, G. Rodger, M. I. Andersson, K. Jeffery, S. Lipworth, H. S. Gweon, A. Peniket, G. Pike, J. Millo, M. Byukusenge, M. Holdaway, C. Gibbons, A. J. Mathers, D. W. Crook, T. E. A. Peto, A. S. Walker & N. Stoesser (2020) Genomic surveillance of Escherichia coli and Klebsiella spp. in hospital sink drains and patients. Microb Genom, 6. https://www.ncbi.nlm.nih.gov/pubmed/32553019
• Mathers, A. J., K. Vegesana, I. German Mesner, K. E. Barry, A. Pannone, J. Baumann, D. W. Crook, N. Stoesser, S. Kotay, J. Carroll & C. D. Sifri (2018) Intensive Care Unit Wastewater Interventions to Prevent Transmission of Multispecies Klebsiella pneumoniae Carbapenemase-Producing Organisms. Clin Infect Dis, 67, 171-178. https://www.ncbi.nlm.nih.gov/pubmed/29409044
• Grabowski, M., J. M. Lobo, B. Gunnell, K. Enfield, R. Carpenter, L. Barnes & A. J. Mathers (2018) Characterizations of handwashing sink activities in a single hospital medical intensive care unit. J Hosp Infect, 100, e115-e122. https://www.ncbi.nlm.nih.gov/pubmed/29738784
• Kotay, S., W. Chai, W. Guilford, K. Barry & A. J. Mathers (2017) Spread from the Sink to the Patient: In Situ Study Using Green Fluorescent Protein (GFP)-Expressing Escherichia coli To Model Bacterial Dispersion from Hand-Washing Sink-Trap Reservoirs. Appl Environ Microbiol, 83. https://www.ncbi.nlm.nih.gov/pubmed/28235877
• Garvey, M. I., N. Williams, A. Gardiner, C. Ruston, M. A. C. Wilkinson, M. Kiernan, J. T. Walker & E. Holden (2023) The sink splash zone. J Hosp Infect, 135, 154-156. https://www.ncbi.nlm.nih.gov/pubmed/36870392

Martin chats to Phil in Melbourne following a recent presentation. Yes, two old farts reminiscing about the days of wearing out the boot leather collecting surveillance data talk with envy about the potential of HAI surveillance in the era of the electronic medical record, automation and artificial intelligence.

Phil refers to data in these two publications:

• Designing Surveillance of Healthcare-Associated Infections in the Era of Automation and Reporting Mandates
• The prevalence of healthcare associated infections among adult inpatients at nineteen large Australian acute-care public hospitals: a point prevalence survey

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

We discuss One Health in this episode with Professor Tom Riley, using C.difficile as the example of explaining why the concept of One Health is so important.

Tom is a Fellow of the Royal College of Pathologists, the Australian Society for Microbiology, the American Academy of Microbiology, the Society for Healthcare Epidemiology of America and the Faculty of Science of the Royal College of Pathologists of Australasia, and has published over 400 book chapters and refereed publications.

This week, Martin talks to Jincy Jerry, Assistant Director of Nursing in Infection Prevention and Control at the Mater Misericordiae University Hospital, Dublin, Ireland. Jincy is a pioneer in the use of Robotic Process Automation in clinical settings within Irish Healthcare. Robotic process automation (RPA) is a software technology that makes it easy to build, deploy, and manage software robots that emulate humans actions interacting with digital systems and software. In 2021, the project received Prix Hubert Tuor Innovation Academy Award at the 6th International Conference on Prevention and Infection Control (ICPIC), in Geneva.

We discuss the potential and actual benefits, including the freeing up of hours of IP time as well as the use of AI (Artificial Intelligence) in the infection prevention world.

A review paper on this topic can be found here:

Piaggio, D., M. Zarro, S. Pagliara, M. Andellini, A. Almuhini, A. Maccaro & L. Pecchia (2023) The use of smart environments and robots for infection prevention control: A systematic literature review. Am J Infect Control, 10.1016/j.ajic.2023.03.005. https://www.ncbi.nlm.nih.gov/pubmed/36924997

In this podcast, we talk about the CLEEN and I-CLEEN studies. These are a RCT and quasi-experimental genomics study aiming to determine the effect of additional cleaning of shared medical equipment of the frequency of healthcare associated infections.  We also make phone call mid podcast...

A shout out to all the team involved in this project, including being wonderfully coordinated by Dr Kate Browne and with great support from Georgia Matterson.  Full details on the website below.

Link to study website: https://cleenstudy.com/

Link to study protocol: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-023-07144-z

This project is funded by a National Health and Medical Research Council Emerging Leadership Investigator grant (Prof Brett Mitchell, (GNT2008392)).

In this episode, Martin Kiernan talks to Sinèad Horgan, Director of Nursing South/South West Hospital Group, and School of Nursing and Midwifery, College of Medicine and Health, University College Cork in Ireland. We discuss a journey towards surgical site sueveillance and quality improvement and her recent papers on this topic. We discuss knowledge, attitudes, gaining engagement, buy-in and the importance of patient involvement in SSI prevention.

Papers discussed include:

1. Horgan S, et al. Healthcare professionals' knowledge and attitudes of surgical site infection and surveillance: A narrative systematic review. Nurse Educ Pract. 2023;69:103637.  HTTPS://doi:10.1016/j.nepr.2023.103637
2. Horgan S, et al. Impact of a quality improvement intervention on the incidence of surgical site infection in patients undergoing colorectal surgery: Pre-test-post-test design. J Clin Nurs. 2023.  HTTPS://doi:10.1111/jocn.16690
3. Troughton R, et al. Understanding determinants of infection control practices in surgery: the role of shared ownership and team hierarchy. Antimicrob Resist Infect Control. 2019;8:116.  https://doi:10.1186/s13756-019-0565-8

In this episode, we discuss a paper in the Lancet Infectious Disease about preventing non-ventilator associate pneumonia including the determinants of implementation success. Brett and Martin chat with Dr Aline Wolfensberger and Professor Hugo Sax, authors of this paper about this important work.

Link to paper: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00812-X/fulltext

Dr Aline Wolfensberger is a medical doctor, certified in Internal Medicine and in Infectious Diseases and Hospital Epidemiology. She works at the Department of Infectious Diseases and Hospital Epidemiology of the University Hospital Zurich with Professor Hugo Sax. Prof Hugo Sax is a Swiss ID physician who worked for the last 20 years as a leader in infection prevention and control.

Brett Mitchell talks to Dr Sarah Browning and Professor Josh Davis about a recent paper in Infection, Disease and Health - "Have gloves and gowns had their day?" The evidence for gloves and gowns is discussed, as well as results from a recent survey into their use in Australia and New Zealand.

Sarah is an infectious disease physician and Director of Infection Prevention and Control at the Hunter New England (HNE) Health District in NSW, Australia. Josh is infectious disease physician and a clinical trialist, also based at HNE and the Hunter Medical Research Institute.

A link to the article: https://www.idhjournal.com.au/article/S2468-0451(23)00030-5/fulltext

In this episode Phil talks to A/Prof Noleen Bennett* about the state of surveillance and antimicrobial stewardship and what her research has discovered in this area. Noleen also tells about an exciting project she is leading called NISPAC, a streamlined infection and antimicrobial use surveillance system for Australian Residential Aged Care Facilities.

*Associate Professor Noleen Bennett. Infection Control Consultant, Victorian Healthcare Associated Infection Surveillance Coordinating Centre and the National Centre for Antimicrobial Stewardship.

Further information:

1. NISPAC
2. VICNISS 
3. An evaluation of influenza, pneumococcal and herpes zoster vaccination coverage in Australian aged care residents, 2018 to 2022
4. Infection prevention quality indicators in aged care: ready for a national approach
5. Skin and soft tissue infections and current antimicrobial prescribing practices in Australian aged care residents

In this episode recorded at the 2023 SHEA Spring Meeting in Seattle, Martin talks to Associate Professor Alex Sundermann about his work on sequencing all isolates from local healthcare settings and the discoveries that this enables. Healthcare infections due to previous admissions, endoscopes, even pseudo-outbreaks are all laid bare by this approach. Some recent papers from the group are listed below:

1. Sundermann AJ, et al. Two artificial tears outbreak-associated cases of XDR Pseudomonas aeruginosa detected through whole genome sequencing-based surveillance. medRxiv. 2023.

https://doi:10.1101/2023.04.11.23288417 2. Sundermann AJ, et al. Sensitivity of National Healthcare Safety Network definitions to capture healthcare-associated transmission identified by whole-genome sequencing surveillance. Infect Control Hosp Epidemiol. 2023:1-3. https://doi:10.1017/ice.2023.52 3. Branch-Elliman W, et al. The future of automated infection detection: Innovation to transform practice (Part III/III). Antimicrob Steward Healthc Epidemiol. 2023;3(1):e26. https://doi:10.1017/ash.2022.333 4. Sundermann AJ, et al. Whole-genome sequencing surveillance and machine learning for healthcare outbreak detection and investigation: A systematic review and summary. Antimicrob Steward Healthc Epidemiol. 2022;2(1):e91. https://doi:10.1017/ash.2021.241 5. Sundermann AJ, et al. Whole-Genome Sequencing Surveillance and Machine Learning of the Electronic Health Record for Enhanced Healthcare Outbreak Detection. Clin Infect Dis. 2022;75(3):476-482. https://doi:10.1093/cid/ciab946 6. Sundermann AJ, et al. Outbreak of Pseudomonas aeruginosa Infections from a Contaminated Gastroscope Detected by Whole Genome Sequencing Surveillance. Clin Infect Dis. 2021;73(3):e638-e642. https://doi:10.1093/cid/ciaa1887 7. Kumar P, et al. Method for Economic Evaluation of Bacterial Whole Genome Sequencing Surveillance Compared to Standard of Care in Detecting Hospital Outbreaks. Clin Infect Dis. 2021;73(1):e9-e18. https://doi:10.1093/cid/ciaa512 8. Sundermann AJ, et al. Automated data mining of the electronic health record for investigation of healthcare-associated outbreaks. Infect Control Hosp Epidemiol. 2019:1-6. https://doi:10.1017/ice.2018.343

In this second discussion of an abstract presented at the SHEA Spring meeting 2023 in Seattle, Martin talks to MPH candidate Olivia Hess about her work on staff opinions of automated hand hygiene monitoring. Olivia works as a member of Dr Gonzalo Bearman's group at VCU Health (Virginia Commonwealth University) in Richmond, Virginia. We discuss staff attitudes to the technology and it's utility, which are almost universally negative.

Some recent papers on automated hand hygiene monitoring:

1. M. A. Tremblay, et al. 2022 Investigation of Individual Nurses' Relative Hand Hygiene Performance Using an Anonymous Automated Electronic Hand Hygiene Monitoring System and a Nursing Assignment Schedule Am J Infect Control https://10.1016/j.ajic.2022.05.026
2. V. Mouajou, et al. 2022 Hand hygiene compliance in the prevention of hospital-acquired infections: a systematic review J Hosp Infect 119 33-48 https://10.1016/j.jhin.2021.09.016
3. K. J. McKay, et al. 2022 Healthcare workers' experiences of video-based monitoring of hand hygiene behaviours: a qualitative study Am J Infect Control https://10.1016/j.ajic.2022.03.010
4. D. J. Durant, et al. 2020 Adoption of electronic hand hygiene monitoring systems in New York state hospitals and the associated impact on hospital-acquired C. difficile infection rates Am J Infect Control 48 7 733-739 https://10.1016/j.ajic.2020.04.005

And thanks to Marco Bo Hansen for reminding us of this recent paper

A. R. Knudsen, et al. 2023 Individual hand hygiene improvements and effects on healthcare-associated infections: A long-term follow-up study using an electronic hand hygiene monitoring system J Hosp Infect In Press https://10.1016/j.jhin.2023.02.017

In this episode recorded at the 2023 SHEA Spring Meeting in Seattle, Martin talks to abstract presenter Dr Lamia Alam about the work of a Johns' Hopkins group on a systematic review of human factors relating to cleaning in the Operating Room. We discuss the abstract presented at the meeting and also previous work in human factors and environmental service workers from this group that are particular favourites of Martin's (detailed below).

Relevant papers:

1. A. Xie, et al. 2018 Improving Daily Patient Room Cleaning: An Observational Study Using a Human Factors and Systems Engineering Approach IISE Transactions on Occupational Ergonomics and Human Factors 6 3-4 178-191 https://10.1080/24725838.2018.1487348

2. C. Rock, et al. 2016 Using a Human Factors Engineering Approach to Improve Patient Room Cleaning and Disinfection Infect Control Hosp Epidemiol 37 12 1502-1506 https://10.1017/ice.2016.219

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).

This is the 100th episode of Infection Control Matters and includes a special announcement. A big thanks to our 110+ guests so far. In this podcast, Martin, Brett and Phil talk about what we've not covered, some stats and what is to come next.

Check out out new website: https://infectioncontrolmatters.com/

In this episode, Martin Kiernan talks to Dr Valeria Fabre, Associate Professor of Medicine at Johns Hopkins University School of Medicine and  Associate Medical Director of the Antimicrobial Stewardship Program and an Associate Hospital Epidemiologist at the Johns Hopkins Hospital. We discuss the recent SHEA position paper on practical aspects of diagnostic stewardship and the use of the diagnostic pathway (ie, ordering, collecting, processing, reporting, and interpreting results of a diagnostic test).

Paper discussed:

Fabre V, et al. Principles of diagnostic stewardship: A practical guide from the Society for Healthcare Epidemiology of America Diagnostic Stewardship Task Force. Infect Control Hosp Epidemiol. 2023;44(2):178-185.  https://doi:10.1017/ice.2023.5

Other recent papers on this subject:

1. Warren BG, et al. Evaluation of hospital blood culture utilization rates to identify opportunities for diagnostic stewardship. Infect Control Hosp Epidemiol. 2023;44(2):200-205. https://doi:10.1017/ice.2022.191
2. Shallal AB, et al. Role of diagnostic stewardship in reducing healthcare-facility-onset Clostridioides difficile infections. Antimicrob Steward Healthc Epidemiol. 2023;3(1):e53. https://doi:10.1017/ash.2022.305
3. Morgan DJ, et al. Diagnostic Stewardship to Prevent Diagnostic Error. JAMA. 2023. https://doi:10.1001/jama.2023.1678
4. Chiotos K, et al. Mixed-methods process evaluation of a respiratory-culture diagnostic stewardship intervention. Infect Control Hosp Epidemiol. 2023;44(2):191-199. https://doi:10.1017/ice.2022.299
5. Advani SD, et al. Optimizing reflex urine cultures: Using a population-specific approach to diagnostic stewardship. Infect Control Hosp Epidemiol. 2023;44(2):206-209. https://doi:10.1017/ice.2022.315

In this episode Brett and Martin talk to Mairéad Skally and Prof Fidelma Fitzpatrick about their efforts to minimise Clostridioides difficile infections in the Beaumont Hospital in Dublin, Ireland. Mairéad is a Surveillance Scientist and Fidelma is a Consultant Microbiologist and also Head of Department of Clinical Microbiology at the Royal College of Surgeons (Ireland). We discuss 10 years of surveillance in the Beaumont and analysis of a rich pool of data that has helped them achieve a status quo.

The paper we discuss is here:

Skally M, Bennett K, Burns K, Brennan R, Finn C, O’Connell K, et al. A decade of Clostridioides difficile infection: A constant challenge to maintain the status quo. Journal of Hospital Infection. 2023 in press https://doi:10.1016/j.jhin.2023.02.008

In this week's episode, Martin talks to Professor Jean-Yves Maillard from the Cardiff School of Pharmacy in Wales. We discuss detention, removal and prevention of biofilms in wet and dry environments. A range of papers on this topic from his group are listed below.

1. D. I. Centeleghe, et al. 2023 Klebsiella pneumoniae survives on surfaces as a dry biofilm Am J Infect Control https://doi:10.1016/j.ajic.2023.02.009
2. T. J. Tewes, et al. 2022 Raman Microscopic Analysis of Dry-Surface Biofilms on Clinically Relevant Materials Microorganisms 10 7 https://doi:10.3390/microorganisms10071369
3. K. Ledwoch, et al. 2022 Dry surface biofilms: what you need to know Br J Hosp Med (Lond) 83 8 1-3 https://doi:10.12968/hmed.2022.0274
4. K. Ledwoch, et al. 2021 Is a reduction in viability enough to determine biofilm susceptibility to a biocide? Infection Control & Hospital Epidemiology 42 12 1486-1492 https://doi:10.1017/ice.2021.42
5. K. Ledwoch, et al. 2020 It's a trap! The development of a versatile drain biofilm model and its susceptibility to disinfection J Hosp Infect 106 4 757-764 https://doi:10.1016/j.jhin.2020.08.010  

In this week's episode, Brett and Martin talk to Dr Mark Garvey, Consultant Clinical Scientist at University Hospitals Birmingham in the UK. We discuss a new paper from the UHB team which looks at the practical aspects of contamination within the splash radius of a clinical hand hygiene sink in a critical care area. The range of high risk equipment within the zone is quite interesting! Papers mentioned are as below.

1. Garvey MI, Williams N, Gardiner A, Ruston C, Wilkinson M, Kiernan M, et al. The sink splash zone. J Hosp Infect. https://doi:10.1016/j.jhin.2023.01.020   PubMed PMID: 36870392. 2. Garvey MI, Wilkinson MAC, Holden KL, Martin T, Parkes J, Holden E. Tap out: reducing waterborne Pseudomonas aeruginosa transmission in an intensive care unit. J Hosp Infect. 2019;102(1):75-81. https://doi:10.1016/j.jhin.2018.07.039

3. Garvey MI, Bradley CW, Holden E. Waterborne Pseudomonas aeruginosa transmission in a hematology unit? Am J Infect Control. 2018;46(4):383-6. Epub 20171128. https://doi:10.1016/j.ajic.2017.10.013

4. Garvey MI, Bradley CW, Wilkinson MAC, Bradley C, Holden E. Engineering waterborne Pseudomonas aeruginosa out of a critical care unit. Int J Hyg Environ Health. 2017;220(6):1014-9. https://doi:10.1016/j.ijheh.2017.05.011

We talk about the knowledge attitudes and practice of nurses regarding oral hygiene of dependent inpatients in this podcast with Dr Isabel Oliveira. Understanding these is an important element of improving oral care and potentially reducing hospital acquired pneumonia (HAP) more broadly.  Isbael is a rehabilitation nurse with a particular focus and interest in dysphagia and oral care, including the prevention of HAP. She works at the  Centre for Health Studies and Research of the University of Coimbra (CEISUC) in Portugal. 

The paper referred to in this podcast is "Knowledge, attitudes and practices of nurses regarding oral hygiene of dependent inpatients".

Link: https://pubmed.ncbi.nlm.nih.gov/35680116/

In this episode, Brett talks to Associate Professor Matthew Davis about his clinical experience and recent systematic review, exploring the topic of whether indwelling vs intermittent catheterisation increases the risk of UTI. Matt is an Associate Professor of Physical Medicine & Rehabilitation at McGovern Medical School in Houston and has a strong clinician background in caring for people with Spinal Cord Injury.

Here are the papers we refer to in the podcast:

DAVIS, M., JETHANI, L., ROBBINS, E. & KANER, M. 2023. Is It Really the Foley? A Systematic Review of Bladder Management and Infection Risk. Top Spinal Cord Inj Rehabil, 29, 94-107.

https://meridian.allenpress.com/tscir/article-abstract/29/1/94/490861/Is-It-Really-the-Foley-A-Systematic-Review-of?redirectedFrom=fulltext

DAVIS, M. 2019. When guidelines conflict: patient safety, quality of life, and CAUTI reduction in patients with spinal cord injury. Spinal Cord Ser Cases, 5, 56.

https://pubmed.ncbi.nlm.nih.gov/31632714/

In this first episode of 2023, Martin talks to Melissa Rochon and Prof Judith Tanner about their recent paper in the Journal of Hospital Infection that reports on the use of patient-generated images in SSI surveillance.

Papers discussed:

1. Rochon M, et al. Image-based digital post-discharge surveillance in England: measuring patient enrolment, engagement, clinician response times, surgical site infection, and carbon footprint. J Hosp Infect. 2023;133:15-22.  https://doi:10.1016/j.jhin.2023.01.001

2. Tyrer J. Digital photo at discharge: a way of monitoring surgical wounds. Nursing Times. 2022;119(9). https://www.nursingtimes.net/clinical-archive/tissue-viability/digital-photo-at-discharge-a-way-of-monitoring-surgical-wounds-08-08-2022/

In the final podcast of the year, we reflect on some lighthearted moments from 2022 and share our thoughts on a few favourite papers, reflections and podcasts. Being the Christmas special, it isn't too serious.. See you in 2023!

Brett's highlighted papers:

1. Peters A, et al. Impact of environmental hygiene interventions on healthcare-associated infections and patient colonization: a systematic review. Antimicrob Resist Infect Control. 2022;11(1):38.  https://doi:10.1186/s13756-022-01075-1

2. Dancer SJ, et al. One size does NOT fit all: why infection prevention is difficult to randomise or control. Journal of Hospital Infection. 2022.  https://doi:10.1016/j.jhin.2022.02.008

3. Mac Giolla Eain M, et al. Aerosol release, distribution, and prevention during aerosol therapy: a simulated model for infection control. Drug Deliv. 2022;29(1):10-17.  https://doi:10.1080/10717544.2021.2015482

Phil's papers:

1. Grae N, et al. Prevalence of healthcare-associated infections in public hospitals in New Zealand, 2021. J Hosp Infect. 2022;131:164-172.  https://doi:10.1016/j.jhin.2022.10.002

2. Bolten A, et al. The carbon footprint of the operating room related to infection prevention measures: a scoping review. J Hosp Infect. 2022.  https://doi:10.1016/j.jhin.2022.07.011

Martin's papers:

1. Kato H, et al. Expansion of droplets during speaking and singing in Japanese. PLoS One. 2022;17(8):e0272122.  https://doi:10.1371/journal.pone.0272122

2. Juskevicius LF, et al. Lessons learned from a failed implementation: Effective communication with patients in transmission-based precautions. Am J Infect Control. 2022.  https://doi:10.1016/j.ajic.2022.09.029

3. Cawcutt KA, et al. #SoMe the Money! Value, Strategy, and Implementation of Social Media Engagement for Infectious Diseases Trainees, Clinicians, and Divisions. Clin Infect Dis. 2022;74(Suppl_3):S229-S236.  https://doi:10.1093/cid/ciac063

Link to the whole Clinical Infectious Diseases social media supplement: https://academic.oup.com/cid/issue/74/Supplement_3

Link to the Norovirus song: https://youtu.be/ci7migUwURc

Hotel Quarantina (Full version) https://mcdn.podbean.com/mf/download/jh65s2/hotel_quarantina.mp3

In this week's episode, Brett and Martin talk to Dr Emma Burnett, Head of Campus, Fatima College of Health Sciences, Ajman, UAE. We discuss a recent collaborative that has resulted in two papers that examine the development of a conceptual framework that underpins the formation of an optimal infection prevention service. The papers that we discuss are listed below.

1. Robinson J, et al. Designing an optimal infection prevention service: Part 2. Journal of Infection Prevention. 2022.  https://doi:10.1177/17571774221127573 2. Burnett E, et al. Designing an optimal infection prevention service: Part 1. Journal of Infection Prevention. 2022.  https://doi:10.1177/17571774221127695

3. Curran ET, et al. A comparison of the nationally important infection prevention and control documents in NHS England and NHS Scotland. J Infect Prev. 2021;22(2):75-82.  https://doi:10.1177/1757177420971849

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

In this week's episode Martin talks to Brett and Professor Maria Northcote about a recent paper on the expeciences of healthcare-associated infection on the lives of patients. The importance of communication is one of the avenues that we go down.

1. Mitchell BG, et al. Patients' perspectives of healthcare-associated infection: 'you don't know what impacts it will have on your life'. J Hosp Infect. 2022;126:93-102.  doi:10.1016/j.jhin.2022.04.014 https://www.journalofhospitalinfection.com/article/S0195-6701(22)00128-1/fulltext

In this week's episode, Brett, Phil and Martin have a catch-up at the ACIPC conference in Sydney following Brett's session in which the audience were invited to select their priorities for action over the next year. Would the HCAIS that present the biggest burden (HAP and CAUTI) figure highly?

In this special episode for World Antimicrobial Awareness Week, Martin talks to UKHSA subject experts about the ESPAUR Report (English Surveillance Programme for Antimicrobial Utilisation and Resistance) released earlier today. You can find out more on the report at the ESPAUR webinar on 23rd November and can register here to attend: https://www.eventbrite.co.uk/e/espaur-report-2021-to-2022-webinar-tickets-439575370767 

The UK Health Security Agency (UKHSA) is responsible for protecting every member of every community from the impact of infectious diseases, chemical, biological, radiological and nuclear incidents and other health threats. UKHSA provides intellectual, scientific and operational leadership at national and local level, as well as on the global stage, to make the nation's health secure. 

UKHSA leads the English surveillance programme for antimicrobial utilisation and resistance. ESPAUR publish a report annually which includes national data on antimicrobial prescribing and resistance, antimicrobial stewardship implementation, and awareness activities. It is published here during World Antimicrobial Awareness Week.  

https://www.gov.uk/government/publications/english-surveillance-programme-antimicrobial-utilisation-and-resistance-espaur-report 

The national WAAW toolkit which includes a range of resources colleagues can use is available here https://www.gov.uk/government/publications/european-antibiotic-awareness-day-resources-toolkit-for-healthcare-professionals-in-england 

In this episode, recorded live on stage in front of an audience at the Australasian College for Infection Prevention and Control (ACIPC) Conference being held in Sydney. Brett, Phil and Martin talk to Sally HAvers and Belinda Henderson about the challenges facing IPC workers in aged care in Australia and future priorities for IPC going forward in acute care.