Episodes
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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
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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 the24 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.
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Missing episodes?
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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.
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In this episode, we explore the crucial disconnect between national infection prevention and control (IPC) guidelines and the local policies implemented in residential aged care (RAC) facilities. Brett and Martin talk to Dr Sanne Peters and Dr Kirsty Buising about their recent paper that reports on their recent analysis using the AACTT (Action, Actor, Context, Target, Time) behavioural framework, which reveals a lack of alignment and specificity in many local IPC documents.
We discuss:
Why well-intentioned policies often fail to drive behaviour
The implications of vague IPC statements in high-risk environments
How local RAC settings can better translate national guidelines into actionable, behaviourally specific practices
The role of co-design, leadership, and implementation science in bridging the gap
The paper we discuss:
Peters S, Lim LL, Francis JJ, Bennett N, Fetherstonhaugh D, Buising K, et al. Analysis of infection prevention and control documentation in residential aged care based on a behaviour specification framework. Infect Dis Health 2025. https://doi.org/10.1016/j.idh.2025.03.002.
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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
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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/
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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
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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.
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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
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In this episode Martin Talks to Silvana Gastaldi who is a infection prevention and control health referent at UK-MED (a frontline humanitarian medical NGO). We discuss her revent paper in the Journal of Hospital Infection that reviews the literature on methods of assessing how effective environmental cleaning services and procedures are, including ATP, fluorescent UV marking, visual and microbiological methods and also discuss the potential for AI to assist in the healthcare environmental decontamination arena.
The paper we discuss:
Gastaldi S, Accorgi D, D'Ancona F. Tools and strategies for monitoring hospital environmental hygiene services. J Hosp Infect 2025. https://doi.org/10.1016/j.jhin.2025.01.011
To listen to a previous podcast in which Dr Phil Carling, developer of the UV marking systems talks about it's development and initial use please click here
Podcast website and collections: www.infectioncontrolmatters.com
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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.
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In this episode Brett and Phil chat about a few of the posters presented at the Australasian College for Infection Prevention and Control 2024 Conference held in Melbourne in November 2024. Poster topics include hand hygiene, surveillance, and a pilot RCT on chlorhexidine impregnated dressings.
You can access poster abstracts below and a pdf of the posters here
Improving Hand Hygiene Practices in the Marshall Islands
Epidemiology of Hospital-acquired Bloodstream Infections at a Quaternary Hospital Service
An antimicrobial dressing for prevention of infection complication related peripheral intravenous catheter: an international randomised controlled trial.
Comparing Healthcare Associated Infection data to Hospital Acquired Complication Infection data collection and finding the documentation differences to improve accuracy
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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.
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In this episode, Brett, Phil and Martin reflect on the year. We chat about favourite podcasts, papers and conferences in our usual informal manner (well probably even more informal than normal). Papers we mention are listed below.
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
Torres-Teran MM, Greentree DH, Varghese MM, Cadnum JL, Pavis RL, Saade EA, et al. Identifying and Remediating Super-splasher Sinks to Reduce Dispersal of Pathogens From Sink Drains. Open Forum Infect Dis 2024;11(7):ofae293. https://doi.org/10.1093/ofid/ofae293
Bush M, Bennett CM, Hutchinson A, Bouchoucha SL. Post implementation quarantine recommendations that support preparedness: A systematic review and quarantine implementation capability framework. Infect Dis Health 2024;29(3):152-71. https://doi.org/10.1016/j.idh.2024.02.004
Dhar S, Jinadatha C, Kilgore PE, Henig O, Divine GW, Todter EN, et al. Lowering the Acquisition of Multidrug-Resistant Organisms (MDROs) With Pulsed-xenon (LAMP) Study: A Cluster-Randomized, Controlled, Double-Blinded, Interventional Crossover Trial. Clin Infect Dis 2024;79(4):1024-30. https://doi.org/10.1093/cid/ciae240
Widmer AF, Atkinson A, Kuster SP, Wolfensberger A, Klimke S, Sommerstein R, et al. Povidone Iodine vs Chlorhexidine Gluconate in Alcohol for Preoperative Skin Antisepsis: A Randomized Clinical Trial. JAMA 2024;332(7):541-9. https://doi.org/10.1001/jama.2024.8531
Leistner R, Kohlmorgen B, Brodzinski A, Schwab F, Lemke E, Zakonsky G, et al. Environmental cleaning to prevent hospital-acquired infections on non-intensive care units: a pragmatic, single-centre, cluster randomized controlled, crossover trial comparing soap-based, disinfection and probiotic cleaning. EClinicalMedicine 2023;59:101958. https://doi.org/10.1016/j.eclinm.2023.101958
Denkel LA, Voss A, Caselli E, Dancer SJ, Leistner R, Gastmeier P, et al. Can probiotics trigger a paradigm shift for cleaning healthcare environments? A narrative review. Antimicrob Resist Infect Control 2024;13(1):119. https://doi.org/10.1186/s13756-024-01474-6
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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 Dr Rebecca Crapanzano-Sigafoos (formerly Bartles) who is Executive Director, Center for Research, Practoce and Innovation at the Association for Professionals in Infection Control and Epidemiology (APIC). We talk about about her work on staffing levels for IPC Teams, beginning with her early work looking at workload and then the recent review and paper on data obtained from the beta version of the APIC Staffing Calculator. It turns out that the vast majority of 390+ participating organisations are understaffed.. What might help however was the finding that hospitals that were better staffed had significantly lower infection rates according to accepted published data. Papers we discuss are found below:
Bartles R, Dickson A, Babade O. A systematic approach to quantifying infection prevention staffing and coverage needs. Am J Infect Control 2018;46(5):487-91. https://doi.org/10.1016/j.ajic.2017.11.006.Knighton SC, Engle J, Berkson J, Bartles R. A narrative review of how infection preventionist (IP) staffing and outcome metrics are assessed by health care organizations and factors to consider. Am J Infect Control 2024;52(1):91-106. https://doi.org/10.1016/j.ajic.2023.06.017.Bartles R, Reese S, Gumbar A. Closing the gap on infection prevention staffing recommendations: Results from the beta version of the APIC staffing calculator. Am J Infect Control 2024. https://doi.org/10.1016/j.ajic.2024.09.004. -
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
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In this episode recorded live at the IPS Conference in Birmingham UK in September 2024, Martin talks to Claire Fitzsimons, Senior Infection Prevention and Control Practitioner at the Northern Ireland Ambulance Service Health and Social Care Trust. We discuss a poster that she presented at the conference that looked as ways of reducing glove use in the ambulance service through a range of improvement methodologies.
A copy of the poster can be found here
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In this episode, recorded at the 2024 Infection Prevention Society Conference in Birmingham (UK) Brett and Martin talk to Conor McGinn, Assistant Professor in the Department of Mechanical and Manufacturing Engineering at Trinity College Dublin and CEO of Akara AI, a robotics company spin-off from Trinity. We talk about a presentation that Conor gave, demonstrating how infrared sensors analysed by AI can provode feedback on techniques in the operating room and how they could improve cleaning standards in hospitals.
A link to the video we discussed is here https://youtu.be/CPCFuXyQarY?si=xh1RjXAaKeKY708a
and you can also see Conor's talk here https://youtu.be/3SCEkbwKhM4?si=uztJcnVIAe-vq5U8
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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.
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