Infection Control Matters

In this 2-segment episode, Brett, Phil and Martin firstly mull over a nurse-led, bottom up (pun intended) quality improvement project that aimed to reduce CAUTI in a neonatal ICU in Georgia, USA. Having discussed how great it is to see this type of work written up, Martin then spoke to Katie Cabral the lead author for more insights and to find out if the innovation has been sustained.   Cabral K, Anderson V, Allen I, Hoskins D, Byers K, Gettis M. Entering a No Diaper Zone: Rethinking Prevention of Catheter-Associated Urinary Tract Infection. Critical care nurse 2025;45(4):21-8. https://doi.org/10.4037/ccn2025843 

In this episode, Brett, Phil and Martin discuss a recent paper from Freya Bull and colleagues, who undertook a modelling exercise to determine what factors determine the colonisation process for long and short-term urinary catheters. It turns out that different factors are in play here and that strategies for CAUTI prevention miht be different for each. You can read the paper here: Bull F, Tavaddod S, Bommer N, Perry M, Brackley CA, Allen RJ. Different factors control long-term versus short-term outcomes for bacterial colonisation of a urinary catheter. Nat Commun 2025;16(1):3940. https://doi.org/10.1038/s41467-025-59161-y.  Brett's group's previous work on short-term catheters is here: Fasugba O, Cheng AC, Gregory V, Graves N, Koerner J, Collignon P, et al. Chlorhexidine for meatal cleaning in reducing catheter-associated urinary tract infections: a multicentre stepped-wedge randomised controlled trial. Lancet Infect Dis 2019;19(6):611-9. https://doi.org/10.1016/S1473-3099(18)30736-9. 

In this episode, Martin Kiernan talks to Drs Priya Nori and Gonzalo Bearman. Priya is an Associate Professor of Medicine (Infectious Diseases) and Orthopedic Surgery at the Albert Einstein College of Medicine, USA. Gonzalo is Chair of the Division of Infectious Diseases and Professor of Internal Medicine and Associate Chief Quality and Safety Officer for Research at the Virginia Commonwealth University Health System, USA. We chat about a recent book entitled "Courageous Leadership in Infectious Diseases and Public Health During Challenging Times" that they edited, in which they conducted in-depth interviews with luminaries whose careers span multiple aspects of infectious diseases and public health. We discuss the themes, lessons and nuggets gleaned from long and successful careers in Public Health, Infectious Diseases and Infection Prevention. A short section of the book as a preview is available here: https://www.cambridgescholars.com/resources/pdfs/978-1-0364-4766-3-sample.pdf  The book is published by Cambridge Scholars Publishing, Newcastle, UK ISBN: 1-0364-4766-9 and ISBN13: 978-1-0364-4766-3

In this episode, Martin Kiernan talks to Dr Gabriel Birgand, Clinical Co-ordinator of EUCIC (European Committee on Infection Control) which is part of ESCMID Global (European Society for Clinical Microbilogy and Infectious Dieseases). Gabriel is the lead of the Regional Center for Infection Prevention and Control (Pays de la Loire region), Nantes University Hospital and also Head of the National Center for Surveillance and Prevention of AMR (antimicrobial resistance) and HAI (healthcare associated infections) in primary care and nursing homes. EUCIC has recently published a set of slides that have reviewed recent papers relevant to SSI prevention and we had the opportunity to discuss these papers. The link to the slides is below. You can find our more about the activities of EUCIC here: https://www.escmid.org/science-research/eucic/eucic-educational-activities/ To download the freely available slides, follow this link: https://www.escmid.org/fileadmin/escmid/media/pdf/eucic/Review_EUCIC_02_07_2025.pptx 

In this episode, Brett, Phil and Martin discuss a recent paper from the UK Health Security Agency (UKHSA) that examined the timeliness of data points that could be used for a centrally implemented, automated HCAI surveillance system in England, as a potential alternative to the 24 current locally-implemented system. The aim was to examine the potential for a national, automated surveillance system that could reduce the burden of the existing labour-intensive process for mandatory surveillance in England although the results were felt to be generalisable. Link to the paper we discuss: Quan TP, Eyre DW, Shadwell S, West D, Hopkins S, Chudasama D, et al. Timeliness of a potential automated system for national surveillance of healthcare-associated infections in England. J Hosp Infect 2025. https://doi.org/10.1016/j.jhin.2025.04.008. 

In this episode Martin talks to Dr Andy Borman, (Acting Head and Consultant Clinical Scientist, UKHSA National UK Mycology Reference Lab. also Hon Professor of Medical Mycology, MRC CMM, University of Exeter), Dr Colin Brown (Deputy Director of Emerging and Epidemic Infections at UK Health Security Agency; Honorary Consultant in Infectious Diseases & Medical Microbiology at Royal Free London NHS Foundation Trust) and Dr Mariyam Mirfenderesky (Consultant in Medical Microbiology and Infectious Diseases North Middlesex and RF (AMS Lead) and UKHSA on HCAI). The UK Health Security Agency (UKHSA) is the national organisation in the United Kingdom responsible for protecting public health by preventing, detecting, and responding to infectious diseases and other health threats. We chat about how Candidozyma auris (formerly known as Candida auris) is identified in the lab, why it matters clinically, and what it means for infection prevention and control teams. From early lab detection to real-world frontline challenges, we discuss the key issues around this emerging pathogen — and what we need to do next. UK C. auris guidance can be found here: https://www.gov.uk/government/publications/candida-auris-laboratory-investigation-management-and-infection-prevention-and-control

In this episode of Infection Control Matters, we explore the potential of AI tools to support education and professional dialogue in infection prevention and control. We used NotebookLM, an experimental tool from Google designed to help users interact with their documents in new ways—summarising, clarifying, and even generating structured discussions based on uploaded content. Using research and guidance documents, we demonstrate how NotebookLM can be used to create a voice-generated conversation on key themes in IPC. The paper that we uploaded was the recently published cost-effectiveness research that relates to the CLEEN study that we have previously highlihghted. A link to the open access paper can be found below. The main part of this podcast was a dialogue created by NotebookLM following the upload of the paper. None of the voices are human (apart from Martin at the beginning and Brett at the end). This episode offers a glimpse into how AI might be used to support reflection, training, and knowledge sharing across the healthcare community... but with caveats!   The paper we discuss can be found here: Brain D, Sivapragasam N, Browne K, White NM, Russo PL, Cheng AC, et al. Economic Evaluation of Enhanced Cleaning and Disinfection of Shared Medical Equipment. JAMA Netw Open 2025;8(4):e258565. https://doi.org/10.1001/jamanetworkopen.2025.8565 NotebookLM: https://notebooklm.google/  

In this episode of Infection Control Matters, Martin Kiernan speaks with Dr. Nicole Stoesser about a large-scale, multi-centre study exploring the role of hospital sink infrastructure in antimicrobial resistance and pathogen dissemination. Representing the collaborative NITCAR-led "Sinkbug Consortium" we discuss surprising findings from 29 UK hospitals—including widespread antibiotic residues in sink traps—and reflect on the implications for sink design, waste disposal practices, and infection prevention strategies The paper we discuss is here: Rodger G, Chau K, Aranega Bou P, Moore G, Roohi A, The SinkBug Consortium, et al. Survey of healthcare-associated sink infrastructure, and sink trap antibiotic residues and biochemistry, in 29 UK hospitals. J Hosp Infect 2025. https://doi.org/10.1016/j.jhin.2025.02.002. Information on Nitcar: https://nitcollaborative.org.uk/wp/ Other papers of interest: Aranega-Bou P, George RP, Verlander NQ, Paton S, Bennett A, Moore G, et al. Carbapenem-resistant Enterobacteriaceae dispersal from sinks is linked to drain position and drainage rates in a laboratory model system. J Hosp Infect 2019;102(1):63-9. https://doi.org/10.1016/j.jhin.2018.12.007 Grabowski M, Lobo JM, Gunnell B, Enfield K, Carpenter R, Barnes L, et al. Characterizations of handwashing sink activities in a single hospital medical intensive care unit. J Hosp Infect 2018;100(3):e115-e22. https://doi.org/10.1016/j.jhin.2018.04.025

In this episode, Brett and Martin chat with Dr. Jessica Schults and Dr. Sally Havers about a recent study published in the American Journal of Infection Control. The study used a modified Delphi process to identify key healthcare infection surveillance priorities in Queensland. Through a two-round methodology, infection prevention experts identified 13 key infection measures for a standardized minimum dataset. This dataset aims to improve statewide HAI surveillance, enhance data consistency, and support targeted infection prevention efforts. The findings offer a model that could inform broader national and international surveillance strategies. The in-press paper is currently available here Schults JA, Havers S, Henderson B, Healy S, Runnegar N, Hurst T, et al. Expert consensus and recommendations for Healthcare-Associated Infection surveillance in Queensland, Australia: A modified Delphi study. Am J Infect Control 2025. https://doi.org/10.1016/j.ajic.2025.02.012.

In this episode, Phil and Martin talk to Dr Aline Wolfensberger, Senior Attending Physician, Department of Infectious Diseases and Hospital Epidemiology at University Hospital Zurich and a Senior Researcher at the Institute for Implementation Science in Health Care at the Univetsity of Zurich. We discuss a recent paper that has analysed a range of algorithms for detecting non-ventilator associated pneumonia (nvHAP) that have the potential for significantly reducing the surveillance burden. This work also demonstrated the value of an annual local hospital-wide point prevalence survey that provides data on which areas to target. Relevant reading: [1] Mueller A, Pfister M, Faes Hesse M, Zingg W, Wolfensberger A, Swissnoso G. Development and validation of selection algorithms for a non-ventilator hospital-acquired pneumonia semi-automated surveillance system. Clin Microbiol Infect 2024. https://doi.org/10.1016/j.cmi.2024.11.032 [2] Wolfensberger A, Scherrer AU, Sax H. Automated surveillance of non-ventilator-associated hospital-acquired pneumonia (nvHAP): a systematic literature review. Antimicrob Resist Infect Control 2024;13(1):30. https://doi.org/10.1186/s13756-024-01375-8 [3] Wolfensberger A, Jakob W, Faes Hesse M, Kuster SP, Meier AH, Schreiber PW, et al. Development and validation of a semi-automated surveillance system-lowering the fruit for non-ventilator-associated hospital-acquired pneumonia (nvHAP) prevention. Clin Microbiol Infect 2019;25(11):1428 e7- e13. https://doi.org/10.1016/j.cmi.2019.03.019

In this episode, Phil Russo talks to Brett Mitchell and Kate Browne about a study that did not make it over the line. Following a systematic review in 2021 that examined the issue of UTIs in those who self catheterise, a study to examine whether previous work demonstrating a reduction in CAUTI in indwelling catheters through the use of Chlorhexidine for meatal cleansing would be effective was designed. The team discuss the complexities of getting what was essentially a community-based study over the line and why ultimately it did not progress, much to the sadness of the team. previous relevant work is listed below. Mitchell BG, Prael G, Curryer C, Russo PL, Fasugba O, Lowthian J, et al. The frequency of urinary tract infections and the value of antiseptics in community-dwelling people who undertake intermittent urinary catheterization: A systematic review. Am J Infect Control 2021;49(8):1058-65. https://doi.org/10.1016/j.ajic.2021.01.009. Fasugba O, Cheng AC, Gregory V, Graves N, Koerner J, Collignon P, et al. Chlorhexidine for meatal cleaning in reducing catheter-associated urinary tract infections: a multicentre stepped-wedge randomised controlled trial. Lancet Infect Dis 2019;19(6):611-9. https://doi.org/10.1016/S1473-3099(18)30736-9.  

In this episode recorded at the 2024 Australasian College of Infection Prevention and Control (ACIPC) Conference in Melbourne, Brett and Phil talk to Dr Sarah Browning (ID Physician at Hunter New England) and two Junior Medical Officers (JMOs) Sam and Lochlan who worked on IPC-related projects whilst on placement.

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, Brett reviews a few posters from the Hong Kong Infection Control Nurses Association conference.  Topics include fit testing, bloodstream infection surveillance and environmental cleaning.  The poster discussed in the podcast can be viewed and downloaded here.     

In this episode recorded in an Irish Bar in Nelson (NZ), Brett and Martin dive headfirst into the swirling world of toilet aerosols, airborne pathogens, and potential mitigations. We begin with a older study by Scott, Bloomfield, and Barlow examining the effectiveness of disinfection in real-world settings and how this depends heavily on practical application and behavioural compliance. Then we move to move to a recent contribution by Higham and colleagues, who shift the focus from surface disinfection to airborne exposure. Their paper presents a quantitative microbial risk assessment framework that models aerosolised viral particles generated by toilet flushing that demonstrates the importance of ventilation. Finally we discuss the work of Boone and colleagues, who evaluate a practical intervention—an air sanitizer spray—and its impact on reducing airborne virus concentrations following flushing events. Papers that we discuss: Scott E, Bloomfield SF, Barlow CG. Evaluation of disinfectants in the domestic environment under 'in use' conditions. J Hyg (Lond) 1984;92(2):193-203. https://doi.org/10.1017/s0022172400064214 Higham CA, López-García M, Noakes CJ, Tidswell E, Fletcher L. A Quantitative Microbial Risk Assessment (QMRA) framework for exposure from toilet flushing using experimental aerosol concentration measurements. Indoor Environments 2025;2(1). https://doi.org/10.1016/j.indenv.2024.100069  Boone SA, Betts-Childress ND, Ijaz MK, McKinney J, Gerba CP. The impact of an air sanitizer spray on the risk of virus transmission by aerosols generated by toilet flushing. Am J Infect Control 2025. https://doi.org/10.1016/j.ajic.2025.04.008 

In this episode, we discuss the purpose of infection control matters and why we started the podcast. Recorded 1500 days after we started the podcast, Brett, Phil and Martin reflect on the podcast to date. For new listeners, is also a chance to learn more about our approach to the podcast and how to make the most of our website.

In this episode of ICMs we talk to the authors of a world first multi-centre double blind cross-over randomised control trial, which explored the effect of in-room air purification on acute respiratory tract infections.  The rationale and pragmatics of undertaking such a trial are explored, as well as interpretation of the findings.   The lead researcher, Bismi Thottiyil Sultanmuhammed Abdul, a PhD student at the University of Newcastle is joined by some of her supervisors Professors Jenny Sim and Brett Mitchell to explain this study.   The paper can be accessed here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2825943?resultClick=1   Reference: Khadar, B. T. S. A., Sim, J., McDonald, V. M., McDonagh, J., Clapham, M., & Mitchell, B. G. (2024). Air Purifiers and Acute Respiratory Infections in Residential Aged Care: A Randomized Clinical Trial. JAMA Network Open, 7(11), e2443769-e2443769.      

In this episode, Martin talks to Cansu Cimen, a researcher at University Hospitals Groningen in the Netherlands, about a recent paper that documents an outbreak and in particular the critical role of next-generation sequencing (NGS) in tracking and controlling the transmission of MDROs via contaminated duodenoscopes. Focusing on an outbreak linked to ESBL-producing Citrobacter freundii and Klebsiella pneumoniae after endoscopic retrograde cholangiopancreatography (ERCP), standard culture methods failed to detect contamination. After many negative cultures using established methods, destructive dismantling of the implicated scope revealed contamination on hard-to-clean components, highlighting NGS as an effective tool for identifying pathogen transmission pathways. Cimen C, Bathoorn E, Loeve AJ, Fliss M, Berends MS, Nagengast WB, et al. Uncovering the spread of drug-resistant bacteria through next-generation sequencing based surveillance: transmission of extended-spectrum beta-lactamase-producing Enterobacterales by a contaminated duodenoscope. Antimicrob Resist Infect Control 2024;13(1):31. https://doi.org/10.1186/s13756-024-01386-5. Download the paper here

In our second live session at a major conference, this episode of Infection Control Matters was recorded live at a plenary session to close day 1 of the Infection Prevention Society conference (Birmingham, UK). Our guest panelists include Dr Berit Muller-Pebody an Epidemiologist from the UK Health Security Agency, Prof Jennie Wilson from the University of West London and Dr Jacqui Prieto from The University of Southampton. The panel also fielded many questions from delegates from the floor. Topics covered include the role of mandatory surveillance, de-implementation, community based IPC, point prevalence studies, the UK PPS,  fundamentals of care, urinary tract infection, pneumonia and the direction of IPC.      

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.   Publications Browne, K., White, N. M., Russo, P. L., Cheng, A. C., Stewardson, A. J., Matterson, G., ... & Mitchell, B. G. (2024). Investigating the effect of enhanced cleaning and disinfection of shared medical equipment on health-care-associated infections in Australia (CLEEN): a stepped-wedge, cluster randomised, controlled trial. The Lancet Infectious Diseases.   Matterson, G., Browne, K., Tehan, P., Russo, P. L., Kiernan, M., & Mitchell, B. G. (2024). Cleaning time and motion: an observational study on the time required to effectively clean shared medical equipment in hospitals. Journal of Hospital Infection.