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Decontamination


that require cleaning and disinfection. The information can be presented in a dashboard for each room. “In the future the aim is to use Virtual Reality


to visualise which surfaces have been touched, enabling staff to focus cleaning on those areas. Even better, if you had a robot in the room, it could clean the surfaces immediately after they have been touched,” Joost commented. “You may think this is science fiction, but I do not think so,” he concluded. Healthcare professionals in LMICs now use smart phones everyday and Joost predicted that some of these technology applications may be adopted in these countries even earlier than in high income countries. However, climate change and increasing urbanisation in LMICs will present significant challenges going forward, so there will be a need to address the risk of emerging pathogens, zoonosis, increasing demand for fresh water supplies, challenges around waste management, and pressure on resources, he warned.


Joost’s presentation provided a valuable insight into the key challenges and solutions adopted in LMICs, while providing an opportunity to reflect on effective IP&C strategies that can benefit all settings. He invited delegates to think further around the difficult issue of sustainability, as well as the technologies that could drive improvement in the future, across LMICs and high-income countries. “Ultimately, it is all about knowledge transfer,” CSJ


he concluded


References 1 Stewardson AJ, et al, Effect of carbapenem resistance on outcomes of bloodstream infection caused by Enterobacteriaceae in low-income and middle-income countries (PANORAMA): a multinational prospective cohort study. Lancet Infect Dis. 2019 Jun;19(6):601-610. doi: 10.1016/S1473- 3099(18)30792-8. Epub 2019 Apr 29. PMID: 31047852.


2 WHO. Minimum requirements for infection prevention and control programmes. https://www.who.int/publications-detail- redirect/9789241516945 (2019).


3 WHO. Guidelines on core components of infection prevention and control programmes at the national and acute healthcare facility level. (2016).


4 Chng, K.R., Li, C., Bertrand, D. et al. Cartography of opportunistic pathogens and antibiotic resistance genes in a tertiary hospital environment.Nat Med26, 941–951 (2020). https://doi.org/10.1038/s41591-020-0894-4


5 Haak, B. W., & Wiersinga, W. J. (2020). Uncovering hidden antimicrobial


resistance patterns within the hospital microbiome. Nature Medicine, 26(6), 826- 828. https://doi.org/10.1038/s41591-020-0919-z


6 Yee D, Osuka H, Weiss J, et al. Identifying the priority infection prevention and control gaps contributing to neonatal healthcare-associated infections in low- and middle-income countries: results from a modified Delphi process. Journal of Global Health Reports. 2021;5:e2021018. doi:10.29392/001c.21367


7 van Ingen J, et al. Global outbreak of severe Mycobacterium chimaera disease after cardiac surgery: a molecular epidemiological study. Lancet Infect Dis. 2017 Oct;17(10):1033-1041. doi: 10.1016/S1473-3099(17)30324-9. Epub 2017 Jul 12. PMID: 28711585.


8 Nurjadi D, et al, Genomic Investigation and successful containment of an intermittent common source outbreak of OXA-48- producing Enterobacter cloacae related to hospital shower srains. Microbiol Spectr. 2021 Dec 22;9(3):e0138021. doi: 10.1128/ Spectrum.01380-21. Epub 2021 Nov 24. PMID: 34817232; PMCID: PMC8612159


9 Hopman J, Tostmann A, Wertheim H, Bos M, Kolwijck E, Akkermans R, Sturm P, Voss A, Pickkers P, Vd Hoeven H. Reduced rate of intensive care unit acquired Gram-negative bacilli after removal of sinks and introduction of ‘water-free’ patient care. Antimicrob Resist Infect Control. 2017 Jun 10;6:59. doi: 10.1186/ s13756-017-0213-0. PMID: 28616203; PMCID: PMC5466749


10 Grabowski M, Lobo JM, Gunnell B, Enfield K, Carpenter R, Barnes L, Mathers AJ. Characterizations of handwashing sink activities in a single hospital medical intensive care unit. J Hosp Infect. 2018 Nov;100(3):e115-e122. doi: 10.1016/j. jhin.2018.04.025. Epub 2018 May 5. PMID: 29738784.


11 Kramer A, Schwebke I, Kampf G. How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infect Dis. 2006 Aug 16;6:130. doi: 10.1186/1471-2334-6-130. PMID: 16914034; PMCID: PMC1564025.


12 Mary K. Hayden, Marc J. M. Bonten, Donald W. Blom, Elizabeth A. Lyle, David A. M. C. van de Vijver, Robert A. Weinstein, Reduction in acquisition of vancomycin-resistant Enterococcus after enforcement of routine environmental cleaning measures, Clinical Infectious Diseases, Volume 42, Issue 11, 1 June 2006, Pages 1552–1560, https://doi. org/10.1086/503845


13 Anderson RE, Young V, Stewart M, Robertson C, Dancer SJ. Cleanliness audit of clinical surfaces and equipment: who cleans what? J Hosp Infect. 2011 Jul;78(3):178-81. doi: 10.1016/j.jhin.2011.01.030. Epub 2011 Apr 16.


PMID: 21497943


14 Kapoor A, Vora A, Nataraj G, Mishra S, Kerkar P, Manjunath CN. Guidance on reuse of cardio- vascular catheters and devices in India: A consensus document. Indian Heart J. 2017 May- Jun;69(3):357-363. doi: 10.1016/j.ihj.2017.04.003. Epub 2017 Apr 13. PMID: 28648434; PMCID: PMC5485387.


15 Moszczynski A. Is once always enough? Revisiting the single use item. J Med Ethics. 2009 Feb;35(2):87-90. doi: 10.1136/ jme.2008.025643. PMID: 19181878.


16 Ali S, Moore G, Wilson AP. Effect of surface coating and finish upon the cleanability of bed rails and the spread of Staphylococcus aureus. J Hosp Infect. 2012 Mar;80(3):192-8. doi: 10.1016/j.jhin.2011.12.005. Epub 2012 Jan 20. PMID: 22264495.


17 Hopman J, Nillesen M, de Both E, Witte J, Teerenstra S, Hulscher M, Voss A. Mechanical vs. manual cleaning of hospital beds: a prospective intervention study. J Hosp Infect. 2015 Jun;90(2):142-6. doi: 10.1016/j. jhin.2014.12.023. Epub 2015 Mar 4. PMID: 25804978.


18 Hopman J, Hakizimana B, Meintjes WA, Nillessen M, de Both E, Voss A, Mehtar S. Manual cleaning of hospital mattresses: an observational study comparing high- and low-resource settings. J Hosp Infect. 2016 Jan;92(1):14-8. doi: 10.1016/j. jhin.2015.09.017. Epub 2015 Oct 19. PMID: 26607236.


About the CSC


The CSC was formed in 1960 as a result of the enthusiasm of a small group interested in sterilisation processes and the provision of sterile supplies in hospitals, brought together by Professor Michael Damady. As topics discussed at meetings, and indeed the character of the meetings themselves, have changed over the years, the central themes have been maintained: applied and basic research topics; the general interchange of information; and the generation of CSC guidance documents, using multidisciplinary members. Several successful national groups have emerged from the Club’s membership, including the Institute for Decontamination Sciences (IDSc and formally the ISSM), the Infection Prevention Society (IPS, formally ICNA) and the Healthcare Infection Society (formally Hospital Infection Society). For further details, visit: https://


centralsterilisingclub.org/ For membership please contact: membership@centralsterilisingclub.org


August 2023 I www.clinicalservicesjournal.com 37


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