Global Handwashing Day

Only 13 or so hours (depending on your time zone) to the third annual Global Handwashing Day,which occurs October 15, 2010. This should not be confused with World Hand Hygiene Day, which occurred May 5, 2010 or even World MRSA Day or for those of you really in the know, "MDR-Acinetobacter Day," which occurred on Oct.4.2010.  All kidding aside, tomorrow is an important day to recognize the lack of access to basic soap and water that many children in the developing world need to prevent illness and death.  This day is for the children.

The graph below, from a 2005 Lancet paper by Luby et al., highlights why tomorrow is so important.  In Karachi Pakistan's squatter settlements, investigators randomized 300 households to plain soap/water, 300 to antibacterial soap and 306 to usual practice.  Both groups randomized to soap (antibacterial soap didn't matter) had 50% less pneumonia, 53% less diarrhea and 34% less impetigo compared to the control group. This day tomorrow is about making sure each child is on the green (or red) line and not suffering on the blue line.

Luby et al, Lancet 2005 doi link

Everybody loves a good argument

A Journal of Clinical Microbiology editor just sent me the download statistics for their new "point-counterpoint" feature. The format is extremely popular, and I was happy to learn how many people have downloaded the MRSA screening piece that Lance Peterson and I published in March. For ASM journals, there is free access once an article has been in publication for more than six months.....so feel free to download it, in pdf or html format.

Bacteria can walk?---Whoa, Nellie!---Bacteria can walk!

Image Credit: Gerard Wong, UCLA

Well, I knew there had to be an explanation.  It couldn't be that bacteria spread from patient to patient because hand hygiene compliance is only 60%.  No, it can't be our fault.  Now, there is finally data for surgeons to use when they say they're too busy to wash their hands.  They can just say that the bacteria will just walk to the next patient room anyway, so why bother.  Well, maybe not exactly...

There is a new study out in Science from scientists at UCLA, Houston, Illinois and Notre Dame that identified a new surface motility mechanism in Pseudomonas aeruginosa whereby they were able to stand upright and "walk" in a verticle orientation. This was thought to allow for surface exploration, improve surface detachment and perhaps enhance biofilm formation.

So maybe washing our hands makes them too slippery for bacteria to walk on and they just trip?  OK, I just made that up. Anyway, it probably remains a good idea to perform proper hand hygiene.

Gibiansky et al. Science 8 October 2010

h/t: ars technica, Nobel Intent post

How important is the physical exam?

Most of us do parts of it each time we care for a patient. Aspects of the physical exam are included in several of our nosocomial infection definitions. Yet how good are we at performing physical exams anymore? How reproducible and reliable are physical findings (within and between observers)? How sensitive and specific for diagnosing illness, including infection?

I'll admit I've sometimes thought (usually when frustrated over low hand hygiene adherence) that patients would be safer if healthcare workers didn't touch them at all.

If this topic interests you, today's NY Times has an article on Dr. Abraham Verghese, who is passionate about "taking back" the lost art of the physical exam.

SHEA's white paper on elimination of healthcare associated infections

Eli asked me to take on the daunting task of posting on SHEA's new white paper, Moving toward Elimination of Healthcare-Associated Infections: A Call to Action. So I read it. Well, at least part of it. I didn't think I could do it justice, so I asked two of the country's leading experts to make a video for our readers. This video will tell you everything you need to know. Click here to view it.

Happy Weekend: Didier Pittet on Yesterday and Tomorrow's Heroes

Do you have any time left?  Yesterday I posted Günter Kampf's talk on hand hygiene from Medline's third annual conference called Prevention Above All.  Today we have Didier Pittet speaking on Preventing Healthcare-Associated Infections: Pioneers of Yesterday - Heroes of Tomorrow.  Lot's of history: Florence Nightingale and Ignaz Semmelweis. Enjoy

Happy Weekend: Günter Kampf on Hand Hygiene

It's the weekend, so you have some time, right? Medline recently held their third annual conference called Prevention Above All, August 16-17, 2010. Günter Kampf, MD speaks on Hand Hygiene Strategies: Challenging the Status Quo, which may be of interest to you. The list of speakers is impressive, including Atul Gawande.  Tomorrow, I will post Didier Pittet's talk.  This is part 1 of 6, just click on the next section when the part finishes to hear the whole talk. Enjoy.