Which research areas have you noticed emerging on the journals as COVID-19 submissions begin to decline?

Nik Mahida: In terms of papers coming in, I haven't seen one massive specific theme emerge but several smaller ones are beginning to become apparent.

I think – looking forward – that water safety remains a big topic. Obviously, Pseudomonas and Legionella feature, but I’d love to see work on new and emerging organisms - Mycobacterium abscessus and Cupriavidus species for example, which have recently been detected in water samples and patient specimens within healthcare environments. Much more research is needed there, and it is on the horizon as a big issue in coming years, as we aim to strike a balance between providing water for the care of patients and recognizing that it can also pose a hazard.  

The other thing I have been thinking about is the longer-term impact of COVID-19. Building design and ventilation remain very topical, as does mask usage – what's the right mask to wear, do you have use an FFP3 or is a surgical mask adequate? The pandemic is still going on in terms of the impact on IPC practice.

Gemma Winzor: Building on the point you raised about water safety, Nik, in the United Kingdom, the NHS is about to embark on a huge project of new-build hospitals – probably the biggest group of projects the NHS has ever known. There will be at least one infection control practitioner inputting into that for each new building.

I’d be interested to receive work which feeds into the thinking around the project: the built environment and what we can do at the early stages of designing and planning, because obviously getting these buildings right will be key to preventing patient harm in the future. You only have one chance to do that.

NM: We could weave lessons learned from the pandemic into that. What’s the learning from the built environment and how it is designed, what sort of research is emerging in that field which might help us future proof ourselves?

GW: We learned a lot of things in this pandemic – about ventilation, and about spacing of patients, spacing of staff, and even spacing in non-clinical areas, waiting rooms, corridors. The buildings as they stand were unprepared for a pandemic of this type. Furthermore, we have seen medico-legal implications of this playing out in the UK.

So for anyone reading this blog who has work on ways to future-proof our buildings, be it capacity, strategies against emerging pathogens or how well these buildings last into the future, let us know!

Have you noticed any change in the outbreaks you receive submissions about?

GW: There are certainly emerging pathogens that we need to be worried about that perhaps a decade ago we weren't even looking for. The patients have changed and the technology we use to detect and analyse pathogens has changed. Pseudomonas aeruginosa, the non-tuberculous mycobacteria, are some of the  big ones.

NM: We’ve also published on water related outbreaks reports caused by Gram negative organisms such as Elizabethkingia species and Serratia marcescens as well as fungi.

GW: Alongside emerging infections, I think the focus of the coming years could be on re-emerging infections – infections which may have completely fallen off our radar because they've been well-controlled by vaccination, or that have not historically affected this country but are beginning to do so. Vaccination programmes have been disrupted have been disrupted by COVID-19, leaving certain populations more vulnerable.  

Additionally, against a backdrop of climate change and increased globalization, we have experienced re-emergence of pathogens such as monkeypox and Corynebacterium diptheriae  in the UK and Europe (particularly amongst asylum seeker and refugee groups) This has IPC implications for all healthcare institutions.

NM: And of course, there is still important work being done in areas which are more familiar to us – control of gram negatives still remains a key topic. A recent ESPAUR report showed a 2.2% rise, so reports on the outbreak and control of gram-negatives would be welcome at IPIP. It’s a problem that is not going to get resolved quickly or easily, and the more we can learn about it the better.

On a slight tangent, I’d finally like to mention that faecal microbiota transplantation is an exciting emerging field. We get great work on that in the JHI from France, Spain and South Korea. We also published a big review of the risks of FMT recently. We haven’t had that many papers, but I’d like to see more submissions in this area.