At the CSICN we get a lot of questions directed to us. So, we thought we might try addressing some of them in the e-focus newsletter. The first one is a question that we commonly get asked about hand hygiene:

Can hand hygiene dispensers or bottles be "topped-up" or refilled?

Hand hygiene dispensers should never be refilled or topped up.

While it may seem counter-intuitive, certain germs are actually able to live in just about any type of hand hygiene product. Several studies have shown that multi-use products can become contaminated with disease-causing germs over time – this includes liquid soap, antimicrobial soaps, and even alcohol-based hand rubs.

Plain liquid soap is only meant to help get germs off of the skin – there aren’t any products in it that actually kill germs. So, if dispensers are refilled or “topped-up” plain soaps can become contaminated quite easily. While antimicrobial soaps do have products in them that kill germs, there are increasing numbers of germs that are becoming resistant to the antimicrobial products that they contain. This may allow for contamination of these products by germs that are difficult to treat or kill.

Alcohol-based hand rubs contain between 60-90% alcohol. In these concentrations, alcohol is considered an intermediate-level germicide, but it is not sporicidal. Spore-forming bacteria, such as Bacillus species and Clostridium species can survive in alcohol at these concentrations. There have been reports of outbreaks associated with contaminated alcohol products.

These findings highlight the importance of following expert recommendations to not refill or “top-up” hand hygiene product dispensers due to the potential risk of infection.

Email us your question to askcsicn@hhsc.ca.
(Photo credit: http://richardwiseman.wordpress.com/2009/05/)


pH1N1 Update

The Ontario Ministry of Health and Long-Term Care (MOHLTC) has posted several new or updated resources for Health Care Professionals. Please visit the MOHTLC H1N1 Flu Virus Health Care Professionals page to access all of these resources (http://www.health.gov.on.ca/en/ccom/flu/h1n1/pro/).  Or click on the following links to take you directly to a specific resource:
 

• Guidance for Primary Care: How to Organize your Primary Care Practice during the Response to pH1N1 
• Guidance Document for the Prevention and Management of Influenza-Like Illness in Child Care Settings during the Pandemic (H1N1) 2009 
• Guidance on Public Health Measures for the Pandemic H1N1 Influenza Virus in First Nation Communities
• Clinical Guidance for the Management of Clients with Influenza-like Illness in Home Care Settings during the Pandemic (H1N1) 2009
• Guidance for Pharmacists and Pharmacies on Ontario's Antiviral Distribution Strategy for Managing Influenza-Like Illness during Pandemic (H1N1) 2009
• Guidance for the Prevention and Management of Influenza-like Illness in Shelters during the Pandemic (H1N1) 2009

The Public Health Agency of Canada has also released new H1N1 information and recommendations for pregnant and breastfeeding women, which can be found here.


Congratulations to Another CIC Achiever! 

Susan Allard recently wrote and passed her CIC exam. Susan is a member of the Joseph Brant Memorial Hospital Infection Control team. Way to go Sue! We are proud of your accomplishment. (picture: Anne Bialachowski [CSICN Network Coordinator] congratulates Susan Allard on her success)


[Wo]man on the Street

CSICN Consultant Virginia Tirilis was on the streets of Vilnius, Lithuania for the Tenth Congress of the International Federation of Infection Control in October. This is what Virginia had to say:

"Every attendee was provided an electronic document on a CD-ROM.  Its contents include key IFIC publications and educational tools such as the chapters as well as teaching slides of IFIC Basic Concepts of Infection Control as well as the 2009 edition of Information Resources in Infection Control.   This CD will be made available in our library."

Interested in more resources? www.nric.org.uk  is a National Review site of IC information containing literature reviews, abstracts, papers with comments posted from reviewers if the paper is of value. Check it out.

There were ‘excellent’ presentations from all four of the keynote speakers:
 

• Global strategies for antimicrobial resistance prevention and control (Gerald Dziekan; WHO Geneva, Switzerland)
• Fact: did you know that 300mg of antibiotics are used in the US per 1 kg of meat?
• H1N1: lessons learned and moving forward (Jonathan Van-Tam; Health Protection Agency Nottingham, UK)
• Fact: 1558 pandemic; “One third of the people did taste the illness” (aka: attack rate)
• Getting to Zero and Other Possible Dreams (Donald Goldmann; Institute for Health Improvement Cambridge, USA)
• Fact: build WILL, get great IDEAS and EXECUTE to achieve system level results
• Dynamics of MRSA spread in healthcare settings and beyond (Hajo Grundmann; EARSS Bilthoven, The Netherlands)
• Fact:  mathematical models will help predict the spread of MRSA and find crucial control points