Crohn’s Disease: Bacteria never sleep, so look busy
CWDM are bacteria with absent or rudimentary cell structures. They exist as part of the life cycle of Mycobacterium species. Dormant CWDM are characterised by low metabolic activity and replication. and increased resistance to host/environmental stresses, including antibiotic action. Crohn’s disease is sometimes associated with the human carriage of CWDM, particularly members of the Mycobacterium avium Complex (MAC).
Reactivation of tuberculosis is also attributed to escape from dormancy.
Previous work by us suggested that carriage of dormant CWDM was ubiquitous in both IBD patients and healthy controls. This raised the possibility that variant forms of CWDM may be present in IBD patients. Here we report the findings of three studies on patients diagnosed with IBD and on healthy human controls.
Using already existing methods in combination with newly developed media we were able to demonstrate the carriage of CWDM in samples from healthy controls and IBD patients. We were also able to demonstrate and provisionally characterise variant CWDM forms present in human blood and deep ileal tissue of IBD patients but not in controls. These variant forms produced metabolites capable of causing inflammation.
The detection of variant forms of CWDM present in IBD patients may be a reliable biomarker, and several confirmatory studies have followed our preliminary observations.
To confirm pathogenicity and identity of these isolates, we are continuing with molecular testing, including next generation sequencing (NGS) on extracted DNA. Pathogenicity studies will be necessary. Demonstration of a newly described CWDM, if confirmed, may require infection control risk assessments.
John is a 68 year old free-lance medical laboratory scientist, and worked in medical microbiology for public and private providers for 43 years. He also helped to set up and run an environmental testing laboratory in my “spare time”. He currently operates a private research laboratory, Otakaro Pathways Ltd.
John is particularly interested in antimicrobial resistance, and emerging bacterial infectious diseases. Most of his work involves an understanding of the underlying relationships between microorganisms, plants, and animals.
He believes that a solution can only be found if the life cycle of the problem organism is completely understood. The rest will then follow.
His experience in bacteriology and my international research relationships with other medical laboratory scientists have been invaluable in the investigation of emerging pathogenic organisms.
As in most businesses, his work is directed towards financially and sustainable solutions to complex problems.
John is presently involved in research in four areas:
- The relationship between autoimmune diseases and Mycobacterium species.
- Bioremediation, particularly in relation to the use of naturally occurring microorganisms.
- Biodiscovery of new antibiotic compounds.
New Zealand CPE guidelines – 1 year on
In this talk Josh will provide an update on the national response to CPE and how the CPE IPC guidelines have contributed. He will also seek to identify strengths and weaknesses of the national response and ongoing practical measures for local IPC teams and other stakeholders to focus on.
Josh Freeman is the Clinical Director of Microbiology at Canterbury DHB and was previously the Clinical Lead of the Hand Hygiene New Zealand Programme. He has a longstanding interest in infection prevention and in particular the transmission of resistant gram negative organisms. Currently he’s working on initiatives to improve implementation of NZ’s national response to the evolving epidemic of carbapenemase-producing Enterobacteriaceae (CPE).
Prof. Mary-Louise McLaws
What hand hygiene would be like if kids ran hospitals
Hand hygiene is the first infection prevention and control activity we learn in childhood during toilet training. We are asked to learn a new approach at nursing and medical school. Yet, better handwashing after patient contact and in-depth discussions with mothers and children support the view that our childhood training influences our ward based compliance. Compliance with the introduction of the World Health Organization My Five Moments for Hand Hygiene identify Moments 3, 4 and 5, after different contacts, is universally better complied than before contact, Moment 1. I will discuss behavioural theories we can use to overcome our entrenched childhood behaviours.
CLABSI – Why targeting a zero benchmark is flawed
The Pronovost aseptic insertion program was attributed to successfully reducing in CLABSIs to a median of zero CLABSI per 1000 line days in USA. All Intensive Care Units in New South Wales public hospitals introduced the Pronovost program and reduced CLABSIs by 60% and if we reached zero why is this threshold setting us up for failure?
Mary-Louise is Professor of Epidemiology, Healthcare Associated Infection and Infectious Diseases Control at The University of New South Wales (UNSW) Australia, the Water-Health Leader for the UNSW Global Water Institute and Deputy President of the UNSW Academic Board. Her clinical epidemiology research is focused in patient safety improvement programs.
Mary-Louise has focused her research program on surveillance and hand hygiene. She performed the first Australian prevalence survey healthcare associated infections in the mid-1980s and went on to develop the first standardised semi-automated surveillance system for healthcare associated infections on behalf of the NSW Ministry of Health. In the mid-2000s she was the WHO Advisor to China and Malaysia for the development of their national HAI surveillance systems. She was a contributor to the WHO Guidelines for Hand Hygiene and an advisor to the WHO First Global Patient Safety Challenge: Clean Care is Safer Care project. Mary-Louise holds membership to the World Health Organization (WHO) Technical Steering Committee for the Infection Prevention and Control Global Unit.
As honorary epidemiologist to NSW Clinical Excellence Commission she collaborated on the first Australian hand hygiene intervention Clean Care Saves Live that preceded the national program while supervising early Australian behavioural aspects of hand hygiene intervention. She also collaborated on the NSW Clinical Excellence Commission CLABSI intervention that aimed at reducing central line associated infections in 32 intensive care units by introducing an aseptic insertion approach. This was adopted by ANZICS and rolled out nationally. She also collaborated on the Sepsis Kills intervention that aimed at early detection and treatment of sepsis in 32 emergency departments. This intervention saved over 200 lives and was awarded the Global Sepsis Alliance in the Government Category and in 2017 the Medical Journal of Australia/MDA awarded the publication Best Research Paper.
Post-SARS she collaborated with the Health Bureau to review the response to the outbreak in Beijing. In preparation of pandemic influenza the Chief Medical Officer appointed Mary-Louise to review the Australian Infection Prevention Guidelines for Healthcare Workers for evidence-based recommendations. Her capacity building in patient safety in low-medium resource settings includes ICU projects in Turkey, haemodialysis in Vietnam, hand hygiene for crowded healthcare settings in Vietnam, needlestick injury surveillance in Taiwan, water-related health in Vanuatu and Mali and understanding antibiotic prescribing practices and use of antibiotic in the community and food animals in Cambodia.
Her most recent projects have contested the reliability and validity of the human auditing used in the Australian national hand hygiene program against automation and clinicians’ behaviour around compliance.
Dr Phil Schroeder and Kelly Robertson
Canterbury Primary Response Group (CPRG)
Managing Infectious Outbreaks – the Canterbury Collaborative Approach
The Canterbury Primary Response Group (CPRG) was formed in 2005 following the threats of SARS and avian influenza worldwide. The possible impact of these virus’ alerted health care professionals that a community-wide approach was needed to manage and coordinate a response to any outbreak or potential outbreak.
Therefore CPRG took the responsibility to coordinate and manage the regional, out of hospital, planning and response coordination to annual influenza threats and the possible escalation to pandemic outbreaks.
This presentation will outline the bringing together of not only a wide range of health providers but also key community agencies to plan strategies and responses to infectious outbreaks. It will focus on what the group has learned during this journey and its future planning for seasonal influenza, and other possible infectious outbreaks.
Dr Phil Schroeder is a general practitioner with over 25 years’ experience as a rural GP initiating general practice services in the township of Rolleston, 20 kilometres South of Christchurch.
He became involved with CPRG, in 2005, when the district turned its attention to the H5N1 Avian Influenza threat. This was exercised in full when H1N1 “Swine Flu” arrived in New Zealand in late April 2009 and Dr Schroeder headed the Primary Health Response in Canterbury where there was widespread use of flu centres to both treat and protect the Canterbury population.
Since then Phil has continued to provide clinical leadership for primary and community care in responding to both natural disasters and infectious outbreaks that the region have experienced.
Kelly Robertson is a Registered Nurse, with 40 years+ experience working in both the secondary and primary health care sectors. She is currently the Nursing Advisor for the Canterbury Primary Response Group (CPRG), and has been involved with CPRG since its inception in 2005.
Kelly was part of the planning and leadership team during the H1N1 (pdm09) outbreak and also lead the nursing team at the Central Flu Center during this time. She has continued to provide nursing leadership for the group, especially during the subsequent seismic events of 2010-2011 and 2016.
Building resilience through change
This presentation explores the place of stress in modern living, the causes of it, and our default responses to it. It focuses on understanding our responses to stressful events and the coping strategies we employ. Also covered are the importance of de-escalation and self-care to prevent burn-out and build personal resilience.
The presentation will allow delegates to:
- Recognise and identify their own personal stressors
- Use the Stress Escalator Tool to help visualise the elevating nature of stress
- Identify the signs and symptoms of someone experiencing elevated and critical stress
- Understand the need to be continually de-escalating
- Incorporate practical strategies into everyday life to reduce stress and improve well-being
This presentation is interactive and shares practical ways to take ownership, be accountable and take responsibility for one’s own well-being and resilience.
Lisa Stirling works as a Staff Support Professional for Workplace Support. Through this role Lisa provides support and assistance to individuals to improve their well-being within their work environment. Support could include anything from anxiety and depression to family and relationship challenges, mental well-being and stress management.
Lisa is a sought-after workshop facilitator and adult educator who has led well-being and employment education workshops for various organisations including Canterbury District Health Board, Ministry of Social Development and Inland Revenue Department.
Lisa’s workshops are engaging, informative, practical and relevant. She is personable and authentic and draws on her rich life experience. Lisa is relatable and down to earth, has a great sense of humour and the ability to relay complex concepts into everyday language that people can grasp and implement into their daily lives.
Illness and recovery – Living to tell the tale
After a weekend away hunting, and thinking I was reasonably fit and healthy, nothing could have prepared him for what would unfold in the weeks and months ahead. From the initial doctor’s visit, to the mother’s lifesaving instincts, the baffled experts and the prompt medivac.
In an induced coma on life support, he couldn’t respond to any questions or give any information that might help the medical team. His family who never left his bedside were the ones that had to endure the daily struggle of the updates from the ICU staff, see his body go through some horrific things and literally watch him fade away. He’ll never forget the relief he could see on their faces when he was finally able to talk to them again after so many potential complications.
However, as we would learn, the road to recovery is a long and arduous one.
Chris is a 36 years old and self-employed engineer based near Ashburton, Mid-Canterbury. He was born and raised in Mid-Canterbury, educated at Christchurch Boys High School, and qualified with a NZ Diploma in Mechanical Engineering from CPIT.
He is one of three siblings, an uncle to a niece and two nephews and enjoy making time for friends and family.
As a keen outdoorsman, with a passion for hunting, fishing, and the great outdoors which means he is often found up a mountain, down a river or out on a lake. With an extensive background in agriculture, his business focusses on fabrication, manufacturing, design and consultation for the agricultural and general engineering industries.
Prior to falling ill in 2018, besides back surgeries, he had never been hospitilised for a serious medical condition and would consider myself to be in fairly good health.
He looks forward to sharing with you my experiences of before, during and after his illness, and he hopes what he shares will further your understanding from a patient’s perspective.
Reprocessing in endoscopy
Information to come
Holly is the charge nurse manager of the gastrointestinal investigative unit (endoscopy) in Christchurch Hospital. She trained and qualified as a nurse in the UK and only discovered a passion for gastroenterology nursing on my arrival to NZ in 2003. She has recently gained a Masters in Health Science from the University of Otago and have completed and presented audits looking at the psychological services available for people living with inflammatory bowel disease.
Canterbury District Health Board
Canterbury District Health Boards (Canterbury DHB) primary focus is on providing healthcare to the Canterbury Region. Canterbury DHB is responsible for the health and wellbeing of an estimated 558,830 residents, covering a region of 26,881 square kilometers. Canterbury DHB is divided between six regional local authorities and it is the second largest DHB in terms of population and area.
The Canterbury Health System is internationally recognised as a world leader in integrated health care, putting Canterbury people at the centre of everything we do.
The Canterbury DHB Infection Prevention and Control Service (IP&C) provides expert guidance and support to minimise the occurrence and spread of healthcare related infections. It strategically deploys its resources to provide maximum benefits to patients. This allows this service to ensure that they put the Canterbury population at the centre of everything they do.
The IP&C service has recently undergone a significant review and is at the beginning of an exciting journey of change and innovation.
Endurocide Infection Control – Bio Technics Ltd
Endurocide® Antimicrobial & Sporicidal Curtains – The next generation of patented semi-disposables. Curtain surface is static on a molecular level – traps the pathogens & holds them. Contains active sporicide, bacteriocide & fungicide which gets to work immediately. Effective against c.diff, VRE’s, MRSA, H1N1 Swine Flu etc. Designed specifically to help reduce the risk of spreading infection. Medical trial proves efficacy against spores, bacteria and fungi for up to 2 years. Compatible with all track, lightweight and easy to install.
Southern Cross Hospitals
Southern Cross Hospitals operates New Zealand’s largest network of private surgical hospitals, with a focus on high quality care and patient safety.
This focus naturally leads us to monitor and measure what we do, including reporting our performance. We recently published the outcome of a long-term surveillance and quality improvement project in reducing surgical site infections in the Southern Cross Hospitals network, 2014-2015. We work with others in the health sector to support best practice and improve safety, quality and the experience patients have in hospital.
Robust clinical safety, quality and risk systems are in place to support independent medical specialists and nursing teams in our hospitals. Our national network of wholly-owned and joint venture facilities allows us to offers services including surgery, medicine and rehabilitation support. Our centres include digital operating theatres, robotic surgery, a state-of-the-art interventional cardiology centre, imaging, and a range of consulting and specialist therapy centres.
St Georges Hospital
As one of the largest private hospitals in New Zealand, St George’s Hospital provides a comprehensive range of surgical, medical, maternity and cancer care services. With it’s 11 theatres, cardiac cath lab, 3 surgical wards, ICU, comprehensive cancer care and maternity services St Georges Hospital can provide a wide range of options for both patients and surgeons.
First established in 1928 as an incorporated society and a registered charity, St George’s Hospital has a long history of providing quality healthcare services. The patient population is diverse, and patients travel from around New Zealand to take advantage of the modern equipment, facilities and technology that St George’s Hospital has to offer.
Currently St George’s Hospital is undergoing a significant redevelopment due to damage sustained in the 2011 earthquakes. This work, which is scheduled to be completed in 2020, is a unique opportunity to replace what was lost whilst providing clinicians and staff with world-class facilities that are modern, future-proofed and, most importantly, safe.