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Kalisvar

@kalisvar.bsky.social

52 followers 28 following 17 posts

Infection Control and Infectious Diseases doc. Interested in all things medicine and travel.

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Reposted by Kalisvar

WHO @who.int · Jun 4

New guideline on the clinical management and infection prevention and control of #mpox.

This guidance is designed to support:
✅ Patients with mpox — whether at home, in the community, or in healthcare facilities
✅ The health workers and caregivers supporting them

🔗 bit.ly/43YOzjf

Picture of Tresor, a health worker, checks on two-year-old Ibrahim, who is being treated for mpox, at the Nyiragongo General Referral Hospital, north of Goma in the Democratic Republic of the Congo (DRC) on 14 August 2024.

Reposted by Kalisvar

Alex Sundermann, DrPH @sundermannaj.bsky.social · May 28

New CID study out from Art Baker & team: 12,855 NTM episodes across 10 hospitals over 8 years

💥 1 in 4 were hospital-onset!
📉 HO rates ⏬ 38% over time but varied 15x btwn hospitals
▶️ They used a clean, simple definition for HO NTM (day 3+)

NTM = underestimated #IDSky

🔗 doi.org/10.1093/cid/...

Epidemiology of Healthcare Facility-Associated Nontuberculous Mycobacteria From 2012 Through 2020 in a 10-Hospital Network in the United States

Incidence rates of hospital-onset nontuberculous mycobacteria (NTM) episodes decreased from 2014 through 2020 within a hospital network, but rates varied s

Reposted by Kalisvar

Sean Ong @seanong.bsky.social · May 20

Honoured to be invited to write this commentary with @steventong.bsky.social, on an excellent target trial emulation study which showed that antibiotic use was not associated with improved outcomes in non-severe COVID-19.

jamanetwork.com/journals/jam...

#IDSky

Target Trial Emulation for Antibiotic Use in Acute COVID-19

This study by Pulia and colleagues1 reports results from a large population-based cohort using target trial emulation to examine the associations of antibiotic treatment with clinical outcomes in pati...

jamanetwork.com

Kalisvar @kalisvar.bsky.social · May 18

9/
💡Key takeaway: Patient safety demands a zone-based, proactive, multidisciplinary approach to managing both water and wastewater in hospitals.
Redefining “water safety” may be one of the most important moves in the AMR era.

🧵/end

Kalisvar @kalisvar.bsky.social · May 18

8/
📊 Whether it’s clinical handwash stations, shower design, or cleaning workflows, each part of the system needs integrated thinking.
“Clinically integrated water/wastewater safety” is the new north star—tying engineering, IPC & clinical workflows together.

Kalisvar @kalisvar.bsky.social · May 18

7/
📉 The authors warn against a reactive mindset. Retrofitting drains after AMR outbreaks is costly—and sometimes impossible.
New builds must proactively bake in safety. Hospitals designed today will serve during peak AMR eras. We can’t afford to get it wrong.

Kalisvar @kalisvar.bsky.social · May 18

6/
🛠️ The paper suggests renaming Water Safety Groups to Water/Wastewater Safety Groups (you get the idea) —broadening scope to include wastewater hazards, which are often invisible but just as risky.

Kalisvar @kalisvar.bsky.social · May 18

5/
🚿 Some hospitals have responded with “water-free” or “water-lite” ICUs—removing sinks, switching to wipes, etc.
These aren’t fringe moves—they’re targeted interventions to stop recurring outbreaks when other measures fail. (Personal note: Implementation not so easy!)

Kalisvar @kalisvar.bsky.social · May 18

4/
🔄 Zone B—the periphery—is often neglected, yet staff interact with it constantly. One ICU study showed only 4% of sink use was for handwashing 🤯
Design flaws here can spread AMR via showers, pantries, even jug-filling.

Kalisvar @kalisvar.bsky.social · May 18

3/
🧠 The term “water safety” masks critical risk zones. The authors redefine hospital plumbing into 3 zones:

A) Main water system
B) Periphery (e.g. sinks, traps, final 2m of pipe)
C) Main wastewater system

Each zone needs separate oversight & expertise.
#BuiltEnvironment

Kalisvar @kalisvar.bsky.social · May 18

2/
The authors argue that our traditional idea of “water safety” is outdated—especially in the age of antimicrobial resistance.
They propose a new, more precise framework that accounts for risks from both water and wastewater systems. 🚽🧫
The following are the key points (that I liked) 🧵👇

Kalisvar @kalisvar.bsky.social · May 18

🧵1/
We need more research and reviews around “water safety” in healthcare facilities. This new paper in @thejhi.bsky.social by Weinbren et al. (2025) provides a fresh perspective—challenging the idea that it's just about legionella and outlet water quality. 🏥💧
#HospEpi #AMR

Reposted by Kalisvar

Alex Sundermann, DrPH @sundermannaj.bsky.social · May 12

🧼 Not all endoscope brushes are created equal

A new study in @thejhi.bsky.social compared different brush types ▶️ metal shafts + DuPont fibre bristles removed organic matter >>> than plastic or microfiber brushes

More passes = cleaner scopes

📄: www.journalofhospitalinfection.com/article/S019...

Reposted by Kalisvar

Eli Perencevich @eliowa.bsky.social · May 4

The 2016 Severe Floods and Incidence of Hemorrhagic Fever With Renal Syndrome in the Yangtze River Basin jamanetwork.com/journals/jam... #openaccess #idsky

Hemorrhagic Fever With Renal Syndrome After Flooding in the Yangtze River Basin

This cross-sectional study examines the association between severe floods and long-term incidence of hemorrhagic fever with renal syndrome in the Yangtze River basin and explores the modifying role of...

jamanetwork.com

Reposted by Kalisvar

Eli Perencevich @eliowa.bsky.social · Apr 24

New: Dwell Time and Risk of Bloodstream Infection With Peripheral Intravenous Catheters #idsky #openaccess jamanetwork.com/journals/jam...

Dwell Time and Risk of Bloodstream Infection With Peripheral Intravenous Catheters

This cohort study analyzes the association of dwell time with the risk of bloodstream infections during peripheral intravenous catheter maintenance therapy.

jamanetwork.com

Kalisvar @kalisvar.bsky.social · Apr 16

8/ Bottom line?
This Singapore study offers a real-world, real-cost case for smart PPE deescalation.
🛡️ Safety preserved
💵 Costs down
🌱 Carbon cut
It’s time to reimagine IPC and assess how we protect health workers — and the planet.

Kalisvar @kalisvar.bsky.social · Apr 16

6/ The accompanying editorial calls this a “larger imperative.” jamanetwork.com/journals/jam...
We’re not just talking COVID-19 here — it’s a pivot toward sustainable, evidence-aligned PPE use across all of healthcare.
The gowns we use (and toss) daily? They have a carbon footprint too.

Optimizing Personal Protective Equipment for a Sustainable Future

The important study by Sutjipto et al1 shows that deescalating personal protective equipment (PPE) requirements for COVID-19 can reduce cost and carbon impacts without compromising safety. This 24-mon...

jamanetwork.com

Kalisvar @kalisvar.bsky.social · Apr 16

5/But it wasn’t just about safety.
Check out the sustainability win:
💥 440,532 disposable gowns saved
♻️ 66,080 kg plastic waste avoided
🌍 398,681 kg CO₂ emissions prevented
💸 ~SGD 454k (USD ~$334k) saved

Kalisvar @kalisvar.bsky.social · Apr 16

4/💡Result: No increase in infections.
COVID-19 incidence among staff tracked with community trends.
➕ Median staff-to-community infection ratio actually dropped from 2.6 to 1.5 after PPE deescalation.
Safety? ✔️

Kalisvar @kalisvar.bsky.social · Apr 16

3/📊 The study looked at 12 months before & after the policy change at a major hospital campus.
⚕️ >10,000 healthcare staff
🗓️ 24 months of data
Key question: Did COVID-19 cases among staff rise post-change?

Kalisvar @kalisvar.bsky.social · Apr 16

2/📍Context:
In Sept 2022, Singapore deescalated PPE guidance for routine COVID-19 care:
From → Gowns, gloves, eye protection & N95
To → Just N95s.
Controversial? Maybe.
But what happened next is worth examining.

Kalisvar @kalisvar.bsky.social · Apr 16

1/
🧵 New study out of Singapore's National Centre for Infectious Diseases:
Can less PPE still keep healthcare workers safe from COVID-19 — while saving the planet? Turns out, yes. Let's unpack!
#SkyThread #InfectionControl #PPE #HealthcareSustainability jamanetwork.com/journals/jam...

Plastic Waste and COVID-19 Among Hospital Staff After Deescalation in PPE Use

This quality improvement study evaluates whether personal protective equipment (PPE) deescalation guidelines in Singapore was associated with staff COVID-19 incidence as well as the environmental sust...

jamanetwork.com

Reposted by Kalisvar

Sean Ong @seanong.bsky.social · Apr 13

Looking forward to another packed day at #ESCMIDGlobal. Come say hi at 12:00 at Poster 0737 (Sector A/6/5) where I will be presenting our experience with the vanguard phase of the BALANCE+ Platform, our new platform trial for Gram-negative BSI. Open to new collaborators and sites to join!

Flowchart for the BALANCE+ platform trial, with domains including de-escalation vs no de-escalation, oral beta-lactams vs non-beta-lactams, routine follow-up blood cultures, line retention vs removal, and ceftriaxone vs carbapenems for AmpC.

Reposted by Kalisvar

Journal of Hospital Infection @thejhi.bsky.social · Apr 12

Thanks to @kalisvar.bsky.social for his comprehensive overview of everything new in environmental cleaning, surface transmission dynamics, and mopping up MDROs #AntimicrobialResistance

Reposted by Kalisvar

ESCMID @escmid.bsky.social · Apr 12

The #ESCMIDGlobal 2025 "Year in Infection Control" symposium starts soon in Hall 1! Chairs Nico Tom Mutters and Ermira Tartari, alongside speakers Andrew James Stewardson and @kalisvar.bsky.social , will review the top papers from the past year, ongoing controversies, and take-home messages.