Controversies in Hospital Infection Prevention
Wherein we ponder vexing issues in infection prevention and control, inside and outside the hospital.
Controversies in Hospital Infection Prevention's Latest Posts
The conventional wisdom is that bacteria pay a “fitness cost” as they accumulate antibiotic resistances, a phenomenon I discussed in a short post last year. More resistant, but less fit, and (one hopes) less virulent. Thus some of the most problematic multi-drug resistant organisms (MDROs), such as Acinetobacter, cause disease almost exclusively in the most vulnerable patients—those bugs simply aren’t virulent enough to wreak their havoc in the healthy. When an MDRO […]
Martin Kiernan, Infection Prevention Consultant at Southport and Ormskirk NHS Trust in the North-West of England, penned the Catheter's Lament while on the train to the IPS conference this year. It was the last slide of his EM Cottrell Lecture, "The Life and Times of the Urinary Catheter." Graphics courtesy of Clinidirect. Thanks to both for sharing.
It was “match day” today for the internal medicine subspecialties. For some fields, there are far more applicants than training positions. Thus hundreds of would-be gastroenterologists and cardiologists find themselves out in the cold, unable to pursue their chosen profession. Not so for infectious diseases (ID). This year marks a new record for unfilled ID programs (54), with many training programs unable to fill a single training spot in the match. Given current trends, we are […]
There's a great article in The Atlantic on fecal transplants for C. difficile infection (free full text here). What I like about this piece is that it describes the very real barriers to fecal transplantation without any sugar coating. It also highlights the work of Dr. Bruce Hirsch, an infectious disease doctor who crafts capsules with fecal bacteria (or "crapsules" as he calls them) so that patients can be transplanted without an NG tube or colonoscopy. Photo: Salon.com
Chlorhexidine. We love it, we just can't get enough of it, we are up to our neck in it and we cheer for it. Basically it's the greatest. But some of us have been concerned that the widespread use of CHG would lead to resistance, particularly in Acinetobacter.There is a new report in PNAS by investigators in Australia and the UK that looked at gene expression in A. baumannii after chlorhexidine exposure. The most highly up-regulated genes were those encoding the RND efflux system AdeAB. […]
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