European Antibiotic Awareness Day 2012: getting smart about antibiotics, a public-professional partnership.

November 18th 2012 is the fifth annual European Antibiotic Awareness Day (EAAD), an opportunity to raise public and professional awareness about the importance of prudent antibiotic use, and the threat of antibiotic resistance to public health. The aims of EAAD have been supported and reinforced by antibiotic stewardship campaigns across Europe, aimed at both healthcare professionals, and the public. Within the UK, antimicrobial stewardship is embedded within the Health and Social Care Act 2008, and is taken into account by the Care Quality Commission when making decisions about registration. The Department of Health Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection has recently produced guidance for antimicrobial stewardship in hospitals, 'Start Smart - then Focus', and the Royal College of General Practitioners has agreed antimicrobial stewardship as a clinical priority for 3 years, providing educational and audit materials, and tools to help general practitioners in patient consultations, to manage public demand for antibiotics when not clinically indicated. British Infection Association members need to be familiar with these initiatives and resources, and are encouraged to lead on local initiatives within their own workplaces and communities.

Building new hospitals: a UK infection control perspective.

Infection control input is vital throughout the planning, design and building stages of a new hospital project, and must continue through the commissioning (and decommissioning) process, evaluation and putting the facility into full clinical service. Many hospitals continue to experience problems months or years after occupying the new premises; some of these could have been avoided by infection control involvement earlier in the project. The importance of infection control must be recognized by the chief executive of the hospital trust and project teams overseeing the development. Clinical user groups and contractors must also be made aware of infection control issues. It is vital that good working relationships are built up between the infection control team (ICT) and all these parties. ICTs need the authority to influence the process. This may require their specific recognition by the Private Finance Initiative National Unit, the Department of Health or other relevant authorities. ICTs need training in how to read design plans, how to write effective specifications, and in other areas with which they may be unfamiliar. The importance of documentation and record keeping is paramount. External or independent validation of processes should be available, particularly in commissioning processes. Building design in relation to infection control needs stricter national regulations, allowing ICTs to focus on more local usage issues. Further research is needed to provide evidence regarding the relationship between building design and the prevalence of infection.

A district general hospital's method of post-operative infection surveillance including post-discharge follow-up, developed over a five-year period.

We report on a post-operative infection surveillance system which includes post-discharge follow-up, developed over five years in a district general hospital in the West Midlands, UK. The methods used for following up 667 patients undergoing one of five representative surgical procedures are described. Emergency, elective and day-case procedures are included. A combination of healthcare worker questionnaire, telephone calls and patient questionnaire gave a follow-up rate of 92.7%. The system took infection control staff an average of 40 min per patient (30 min inpatient assessment, 10 min post-discharge). Almost half (48%) of surgical site infections were diagnosed after discharge from hospital. The system worked equally well when conducted as part of the UK Nosocomial Infection National Surveillance Scheme (NINSS), or as in-house projects. It is likely that the system could be used in other areas with similar population characteristics and support from local general practitioners working in the community.