Previous infection control questions in the SAQs have consisted of the following:
Question 7 from the first paper of 2011 puts the candidate in the position of an ICU director, confronted with the reality that their unit is a disgusting toilet full of MRSA. The candidate is then invited to produce a program which will reduce the incidence of MRO transmission. The question was done poorly (only 25% of the candidates passed) presumably because this topic is boring, and nobody wanted to study it.
In order to counteract this phenomenon, the trainees need a brief point-form set of evidence-based guidelines which they can memorise and dutifully regurgitate during the viva. Given the non-trivial value of infection control policies, the retention of this material can only have a positive effect in the long term, as it seeps back out of the unconscious and into daily practice.
Such brief point-form summaries are nowhere to be found. For instance, Oh's Manual contains a whole chapter on nosocomial infections (Ch.70 by Hatcher and Dhillon), but the section on infection control spans only two or three paragraphs. Clearly, a better resource is needed for the time-poor trainee.
If one were to limit oneself to reading only one paper on this topic, the SHEA guidelines statement from 2003 should be that paper. The brief point-form summary offered below has been cobbled together from the SHEA guidelines. For general infection control information, Eggimann and Pittet's 2003 article is satisfactory. If one wanted a brief overview instead of detailed data, one could do worse than this brief book chapter by Dhillon Shah and Rimawi. If, however, one were insane, one could peruse the CDC guidelines database, or the 54-page NSW Health Infection Control Policy Directive for a more local flavour.
This specific issue became the subject of Question 11 from the first paper of 2011.
According to a 2011 review, antimicrobial stewardship interventions beyond 6 months were associated with reductions in antimicrobial resistance rates, which suggests that the above strategies can be rapidly effective.
According to the college answer for Question 12 from the first paper of 2016, these should take the form of Unit Policies and "MUST be instituted, championed and audited". The words "championed and audited" sound a lot like a memorably spoutable key phrase, and may be associated with increased marks. Another such key phrase to trigger a mark-gasm is probably "bundles of care", such as an Education Bundle, Prevention Bundle and Management Bundle. The college seem to love bundles.
Data collection and audit
Chapter 70 (pp. 724) Nosocomial infections by James Hatcher and Rishi H-P Dhillon
Widmer, A. F. "Infection control and prevention strategies in the ICU." Intensive care medicine 20.4 (1994): S7-S11.
Eggimann, Philippe, and Didier Pittet. "Infection control in the ICU." Chest Journal 120.6 (2001): 2059-2093.
Lucet, Jean-Christophe, et al. "Successful long-term program for controlling methicillin-resistant Staphylococcus aureus in intensive care units." Intensive care medicine 31.8 (2005): 1051-1057.
Dhillon, Shah, Rimawi: "Chapter 12: ICU Infection Control and Preventive Measures", page 54 in: "Bedside Critical Care Guide." by Rimawi, Ramzy H.(2013). OMICS Group eBooks
Muto, Carlene A., et al. "SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and enterococcus." Infection Control 24.05 (2003): 362-386.
Gniadkowski, M. "Evolution and epidemiology of extended‐spectrum β-lactamases (ESBLs) and ESBL‐producing microorganisms." Clinical microbiology and infection 7.11 (2001): 597-608.
Huskins, W. Charles, et al. "Intervention to reduce transmission of resistant bacteria in intensive care." New England Journal of Medicine 364.15 (2011): 1407-1418.
Kollef, Marin H., and Victoria J. Fraser. "Antibiotic resistance in the intensive care unit." Annals of internal medicine 134.4 (2001): 298-314.
Kaki, Reham, et al. "Impact of antimicrobial stewardship in critical care: a systematic review." Journal of antimicrobial chemotherapy 66.6 (2011): 1223-1230.