A 'Tuba Drain' incorporated in sink drains reduces counts of antibiotic-resistant bacterial species at the plughole: a blinded, randomized trial in 36 sinks in a hospital outpatient department with a low prevalence of sink colonization by antibiotic-resistant species.

Background: Multi-resistant Gram-negative bacteria (GNB) survive in hospital drains in traps that contain water and may ascend into the sink because of splashes, or biofilm growth.

Aim: To investigate whether the 'Tuba Drain' (TD) a long, bent, continually descending copper tube between the sink outlet and the trap prevents the ascent of bacteria.

Methods: After initial laboratory tests confirmed that the TD prevented bacteria in the U-bend from splashing upwards into the sink outlet, TDs were assessed in a randomized, blinded trial in a hospital outpatient department built in 2019.

The Citizen Phage Library: Rapid Isolation of Phages for the Treatment of Antibiotic Resistant Infections in the UK.

Antimicrobial resistance poses one of the greatest threats to global health and there is an urgent need for new therapeutic options. Phages are viruses that infect and kill bacteria and phage therapy could provide a valuable tool for the treatment of multidrug-resistant infections. In this study, water samples collected by citizen scientists as part of the Citizen Phage Library (CPL) project, and wastewater samples from the Environment Agency yielded phages with activity against clinical strains BPRG1484 and BPRG1482.

Phage Therapy of Mycobacterium Infections: Compassionate Use of Phages in 20 Patients With Drug-Resistant Mycobacterial Disease.

Background: Nontuberculous Mycobacterium infections, particularly Mycobacterium abscessus, are increasingly common among patients with cystic fibrosis and chronic bronchiectatic lung diseases. Treatment is challenging due to intrinsic antibiotic resistance. Bacteriophage therapy represents a potentially novel approach.

Paediatric endophthalmitis: a UK retrospective study.

Introduction: Paediatric endophthalmitis is a severe but rare complication of intraocular surgery, penetrating trauma and far less commonly extra-ocular surgery or endogenous origin. We set out to establish the incidence and risk factors of exogenous endophthalmitis in children, and to develop an evidence-based protocol that can be used for treatment of suspected exogenous endophthalmitis in children.

Methods: Microbiology reports and operation numbers were obtained from two large tertiary referral hospitals sharing 24-h paediatric ophthalmology cover for the period January 2009-December 2016.

Engineered bacteriophages for treatment of a patient with a disseminated drug-resistant Mycobacterium abscessus.

A 15-year-old patient with cystic fibrosis with a disseminated Mycobacterium abscessus infection was treated with a three-phage cocktail following bilateral lung transplantation. Effective lytic phage derivatives that efficiently kill the infectious M. abscessus strain were developed by genome engineering and forward genetics.

Outcomes for a large metaphyseal volume hemiarthroplasty in complex fractures of the proximal humerus.

Background: A large metaphyseal volume shoulder hemiarthroplasty has been in use within our department since 2008; however, no clinical outcome data are available for this prosthesis apart from the designer surgeon series.

Materials And Methods: During a 5-year period, data were collected for 40 patients (30 women, 10 men) treated consecutively with the Zimmer Anatomical Shoulder Fracture hemiarthroplasty system (Zimmer, Warsaw, IN, USA).

Results: The final analysis included 26 patients.

Carbapenemase-bearing Klebsiella spp. in sink drains: investigation into the potential advantage of copper pipes.

Sink drains have long been known to harbour pathogenic bacteria and efforts such as heated sink traps have been made to control them. Sink outlet pipes have been implicated in outbreaks of infection by multi-resistant Klebsiella pneumoniae. To investigate whether a change to copper pipes might prevent cross-infection, sections of standard sink outlet pipe were left in containers of water to which multi-resistant human strains of K.

Use of bacteriophages in the treatment of Pseudomonas aeruginosa infections.

Phage therapy for Pseudomonas aeruginosa infections has been used for more than 50 years. Controlled investigation into its use dates from the early 1990s when positive laboratory studies of local and systemic infection were followed by clinical studies: symptomatic improvement and phage multiplication were seen in a pet dog with otitis and a human with an infected burn. Antibiotic resistance has renewed interest in this approach.

Reduction of blood stream infections in children following a change to chlorhexidine disinfection of parenteral nutrition catheter connectors.

Background & Aims: Catheter-related-blood-stream-infection (CRBSI) might be prevented by optimal catheter connector antisepsis in children with intestinal failure on parenteral nutrition (PN). We changed the disinfectant used from isopropanol 70% to chlorhexidine 2% in 70% isopropanol, which leaves a residue of chlorhexidine on the connector.

Methods: We conducted this before/after study in children treated with PN for >28 days.

Central venous catheter-associated bloodstream infections in a pediatric intensive care unit: effect of the location of catheter insertion.

Objective: To compare the rate of central venous catheter-associated bloodstream infections between pediatric intensive care unit admissions where central venous catheters were inserted within the same hospital (internal central venous catheters) and those where central venous catheters were inserted before transfer from other hospitals (external central venous catheters).

Design: Retrospective analysis of prospectively collected data.

Setting: A tertiary care pediatric intensive care unit in London, UK.

Topical treatment of Pseudomonas aeruginosa otitis of dogs with a bacteriophage mixture: a before/after clinical trial.

In an evaluation of a bacteriophage treatment for infection, ten dogs were included with chronic Pseudomonas aeruginosa otitis. Each received, directly into the auditory canal of one ear, a single dose of a topical preparation containing approximately 1 × 10(5) plaque forming units (PFU) of each of 6 bacteriophage strains, active against P. aeruginosa.

A fall in bloodstream infections followed a change to 2% chlorhexidine in 70% isopropanol for catheter connection antisepsis: a pediatric single center before/after study on a hemopoietic stem cell transplant ward.

Background: Some catheter-related bloodstream infections originate from catheter connectors; therefore, improved antisepsis of these might be expected to reduce the incidence of such infections.

Methods: In this observational before/after study at a pediatric tertiary referral hospital, inpatients up to 16 years old undergoing hemopoietic stem cell transplants were studied. Catheter connection antisepsis was changed from 70% isopropanol alone to 2% chlorhexidine in 70% isopropanol.

Bacterial counts from hospital doctors' ties are higher than those from shirts.

Doctor ties are often contaminated with bacteria, and it has been suggested that they should not be worn. We have compared bacterial counts from the ties and shirt pockets of 50 doctors. Counts were higher (P = .

Alginate lyase enhances antibiotic killing of mucoid Pseudomonas aeruginosa in biofilms.

Once mucoid (alginate-producing) strains of Pseudomonas aeruginosa have become established in the respiratory tracts of cystic fibrosis patients they can rarely be eliminated by antibiotic treatment alone; we have investigated, in an in vitro biofilm system, the putative role of co-administration of alginate lyase with antibiotic. Biofilms were maintained in continuous flow culture in a medium resembling sputum from CF patients. Antibiotics and/or alginate lyase were added to some of the cultures.

Experimental bacteriophage protection against Staphylococcus aureus abscesses in a rabbit model.

In a rabbit model of wound infection caused by Staphylococcus aureus, 2 x 10(9) PFU of staphylococcal phage prevented abscess formation in rabbits when it was injected simultaneously with S. aureus (8 x 10(7) CFU) into the same subcutaneous site. Phage multiplied in the tissues.