With Vancouver and the Lower Mainland plagued with a scourge of rats, new research from UBC suggests there may be grave consequences if the rodents’ risk to human health continues to be underestimated.
The UBC team studied the feces of rats caught at an Abbotsford poultry farm, and discovered that not only was every specimen carrying a strain of avian E.coli, more than a quarter of the vermin carried multi-drug resistant strains of the disease.
The study’s lead author, assistant professor Chelsea Himsworth, had already gathered evidence of human pathogens, including MRSA and C.difficile, in the feces of rats on Vancouver’s Downtown Eastside.
Read the full article on CBC.ca
Do your staff know the four moments for hand hygiene?
This may be easier to remember as “Clean your hands before and after contact with the patient or patient environment.”
Two important points:
1. Although the provincial hand hygiene compliance rate is an impressive 88% after patient/environment contact, the before rate is only 78% – which is below the target rate of 80%. Remind your staff, cleaning their hands BEFORE contact with the patient or patient environment is extremely important!
2. The patient environment counts too! Even if staff only touch the patient’s IV stand, bed rail or blanket… these can be contaminated.
A 2012 study of patients with Clostridium difficile infection* found that the acquisition of spores on gloved hands was as likely after contact with commonly touched environmental surfaces (ie, bed rail, bedside table, telephone, call button) as after contact with commonly examined skin sites (ie, chest, abdomen, arm, hand).
If your staff need a refresher in hand hygiene, the Provincial Hand Hygiene Basics educational module is available on the PHSA Learning Hub; the more advanced BC Infection Control and Hand Hygiene online module also has a section on hand hygiene. You can also download our poster.
*Source: Acquisition of spores on gloved hands after contact with the skin of patients with Clostridium difficile infection and with environmental surfaces in their rooms
Dubert M. Guerrero, MDa, Michelle M. Nerandzic, BSb, Lucy A. Jury, RNc, Sadao Jinno, MDa, Shelley Chang, PhDd, Curtis J. Donskey, MDc
American Journal of Infection Control, Volume 40, Issue 6, August 2012, Pages 556–558
In December 2015, the Association of Medical Microbiology and Infectious Disease Canada (AMMI) published an updated guidance document for the use of antivirals in the management of care facility influenza outbreaks for the 2015-16 season.
Given the potential for low vaccine effectiveness of this season’s influenza vaccine, the AMMI guidance document states that, at the discretion of the local health authority or Medical Health Officer, antiviral prophylaxis may be extended beyond unvaccinated health care providers to also include vaccinated health care providers, in the context of care facility influenza outbreaks. Notably this applies to outbreaks caused by H3N2 viruses.
Excerpt from the document:
“[Current] measures for facility influenza outbreak control that are considered the ongoing standard of care include: seasonal influenza vaccination of staff and residents (preferably pre-season); antiviral prophylaxis of all non-ill residents; early antiviral treatment of symptomatic individuals (workers or residents both vaccinated and unvaccinated); reinforced infection control measures including respiratory etiquette and use of personal protective equipment; and exclusion of ill staff or visitors and new admission deferral. Outbreak control measures also include antiviral chemoprophylaxis for unvaccinated staff; this may be extended to vaccinated staff as an option or at the discretion of the local health authority/Medical Officer of Health during outbreaks, notably those due to H3N2 viruses that may otherwise be poorly controlled by standard measures.”
What does this mean for you?
Currently the provincial guidance on the prophylactic use of antivirals for healthcare providers pertains only to unvaccinated healthcare providers. Therefore, if you have questions about how the new AMMI recommendations may affect your facility, for residential care sites you can contact your local Medical Health Officer or designate, and for acute care sites you can contact your local Infection Control Practitioner.
You can read the AMMI guidance document here; supplementary documents can be found on the AMMI website Guidelines page.
The discovery that the MCR-1 gene — which makes E. coli and some other species of bacteria resistant to colistin — has been in Canada for at least five years has scientists wondering when it first emerged and how to stop its spread.
The existence of the plasmid-mediated colistin resistance, or MCR-1, gene was first reported in November 2015 in the medical journal the Lancet after scientists identified it in E. coli samples taken from farm animals, meat sold in markets and hospital patients in China. MCR-1 is located on a plasmid, a free-floating snippet of DNA that bacteria can easily share, thus spreading the resistance to other organisms.
Since the Lancet paper, at least a dozen other countries have also found the MCR-1 gene. Scientists, looking through databases of bacterial samples, detected the gene everywhere from Denmark and Algeria to Laos.
Among them is Canada, where an investigation was triggered in December by the Public Health Agency of Canada. The Canadian findings have not yet been published, but a case report has been submitted to the Lancet, according to Dr. Michael Mulvey, chief of antimicrobial resistance with the PHAC’s lab in Winnipeg.
The superbug gene was found in three different samples of E. coli, all previously collected for special research projects: one from a 62-year-old patient in Ottawa and two from ground beef sold in Ontario.
“To see it show up was a surprise for me,” Mulvey said. “It supports that there’s global dissemination of this gene already … we’re now going to have to look back even prior to (2010), because maybe it’s been around for even longer.”
Read the full stories on CTV.ca and The Toronto Star