Day 1 - Tuesday 23 June
Advancing surveillance of HCAIs: Focus on Pneumonia
Michael Klompas
Top 10 IPC publications of the year - A curated review of most influential studies & the impact on frontline IPC practice
Gemma Winzor and Martyn Wilkinson
Sponsored symposium | Impact of geometry, angle and line-of-sight on UV‑C disinfection efficacy
Ellie Wishart, Senior Medical Affairs Manager for EMEA, Nanosonics, UK
Background: Ultraviolet-C (UV‑C) irradiation is widely used for surface disinfection due to its ability to inactivate microorganisms through DNA damage. However, its effectiveness depends on key physical principles, including direct line-of-sight exposure, surface geometry, and microorganism susceptibility. Shadowing and complex surface features may limit UV‑C performance in practical applications.
Methods: A controlled experimental approach was used to evaluate how surface topography and angle of exposure influence UV‑C disinfection efficacy. Test surfaces with varying geometric complexity were exposed to a defined UV‑C dose at multiple angles relative to the light source to simulate direct and indirect irradiation. A panel of microorganisms representing a range of UV‑C resistance profiles was assessed. Microbial reduction was quantified using standard log₁₀ reduction metrics, and statistical analysis was applied to determine the relative contribution of key factors.
Results: UV‑C efficacy was highest under direct exposure and on simple, flat surfaces, achieving substantial microbial reductions. In contrast, increasing surface complexity and steeper angles relative to the UV‑C source significantly reduced disinfection efficacy. Microbial susceptibility also influenced outcomes, with more resistant organisms consistently demonstrating lower reductions. Quantitative analysis showed that angle of exposure and surface geometry, each contributed significantly to overall variability in UV‑C performance.
Conclusions: UV‑C disinfection is governed by fundamental physical constraints, particularly line-of-sight exposure. Efficacy is highly dependent on surface geometry, angle, and orientation, with reduced microbial inactivation in shadowed or complex areas, even at equivalent doses. These findings reinforce that dose alone is insufficient, and that geometry, angle, and microbial resistance must be considered in UV-C based system evaluation and use.
Ongoing and upcoming clinical trials in IPC - Global IPC trends and lessons from WHO guidelines
Walter Zingg
Ethics and AMR Control: The Hidden Dimension of Infection Prevention
Prof Evelina Tacconelli, Professor of Infectious Diseases, University of Verona, Italy
Although AMR is widely recognized as a clinical and public health emergency, its ethical dimensions remain insufficiently addressed within most national and international AMR action plans. Ethical discussions are often limited to individual patient autonomy or restrictive IPC measures, while the broader ethical foundations underlying AMR control strategies remain largely unexplored. This presentation argues that ethics represents an invisible yet central component of AMR prevention and control. Decisions regarding antimicrobial, diagnostic, and IPC stewardship are not merely technical interventions but they inherently involve value-based judgments concerning transparency, equity, responsibility, and the distribution of benefits and harms across individuals, healthcare settings, and society. The presentation explores how the three stewardship components should not be considered independent domains but rather interconnected ethical pillars of a single AMR-control ecosystem. Failure in one area may generate unintended consequences in the others, raising important questions regarding accountability and fairness. Drawing on emerging literature in AMR ethics, stewardship science, and public health ethics, this session will propose a framework for integrating ethical reasoning into the design, implementation, and evaluation of interventions to reduce the AMR burden. Recognizing and explicitly addressing these ethical dimensions is essential to ensure that AMR policies are not only effective and sustainable but also socially legitimate and ethically robust
National and regional insights in IPC
Colin Brown, Eimear Brannigan, Paul McGurnaghan & Shona Cairns
Sponsored symposium | Clinical trial of Primel Active Hand Shield with residual activity compared with an alcohol-based hand sanitiser to measure the effectiveness on hand contamination and microbial transmission
Mark Wilcox
Sampling of healthcare workers' (HCWs) hands was conducted before application, immediate and twice following a pre-defined residual period to determine both the immediate and residual activity. Microbial transmission from hands was also determined by HCWs touching a sterile surface.
On immediate application, antimicrobial activity was similar for both PAHS (97.7% (confidence interval (CI) of 96.5–98.5%) and ABHS (96.8% (CI of 94.9–98.0%)). After the 1-h morning residual period, PAHS retained much of the immediate activity (91.4% (CI of 87.2–94.2%]) whilst ABHS declined after 15 min (77.9%(CI of 64.6–86.2%). Similar trends were observed after afternoon applications (PAHS, 92.1% (CI of 87.8–94.8%) vs ABHS, 68.4% (CI of 47.0–81.1%). Overall, antimicrobial activity on the hands of HCWs utilising PAHS was significantly higher (91%, P<0.03) compared with ABHS, despite fewer applications of PAHS vs ABHS (average 2 vs 5, P<0.01).
These findings show that use of PAHS can reduce microbial contamination on hands despite fewer applications and is less likely to lead to microbial transfer. This addresses the key limitations of ABHS and suggests that use of PAHS has the potential to prevent HCAIs that persist despite current ABHS-based practise.
CLABSI surveillance: Present and Future
Niccolo Buetti
Central line-associated bloodstream infections (CLABSI) remain among the most important healthcare-associated infections, contributing substantially to patient morbidity, mortality, prolonged hospitalization, and healthcare costs worldwide. Effective surveillance is a cornerstone of CLABSI prevention programmes, enabling benchmarking, identification of outbreaks, and evaluation of preventive interventions. This presentation will provide an overview of the future of CLABSI surveillance, beginning with the historical development and current principles of traditional manual surveillance systems based on standardized definitions and infection prevention teams.
The talk will then explore the strengths and limitations of conventional surveillance approaches, including their high workload, inter-observer variability, and challenges in scalability. Particular attention will be given to the emergence of automated surveillance systems integrating microbiology, electronic medical records, and catheter-related data. The Swiss experience with automated CLABSI surveillance will be presented as an example of national implementation efforts aimed at improving efficiency, standardization, and sustainability of surveillance activities across hospitals.
Finally, the presentation will discuss emerging perspectives in the field, focusing on artificial intelligence (AI) and machine learning approaches. Recent developments suggest that AI may enhance case detection, support real-time surveillance, improve data validation, and potentially predict patients at high risk of CLABSI before infection occurs.
Using sequencing data in IPC and AMR surveillance
Esther van Kleef
Wastewater surveillance for developing pathogen forecasting systems
Matt Holden
Wastewater surveillance (WS) has emerged as a versatile population-level tool for monitoring infectious disease trends, providing early warning signals that complement traditional clinical and microbiological surveillance. Its application in poliovirus detection is well established, but the field expanded rapidly during the COVID-19 pandemic, when wastewater-based epidemiology (WBE) demonstrated its value in tracking community SARS-CoV-2 alongside clinical case reporting. This success has accelerated its application across a wider range of pathogens and population health indicators, including antimicrobial resistance (AMR) genes, enteric pathogens, and respiratory viruses relevant to healthcare settings.
WS data are increasingly being integrated into national surveillance systems to support public health planning and outbreak response. In Scotland, established programmes for poliovirus and SARS-CoV-2 are now being expanded, with Public Health Scotland leading efforts to broaden pathogen coverage and strengthen WS as a source of actionable intelligence.
This talk will reflect on the Scottish experience, highlighting key lessons, including the operational realities and limitations of implementation, to inform the design of WS systems that deliver timely and actionable insights. A central focus will be the potential for WS data to underpin pathogen forecasting systems, providing indicators of community burden that can inform hospital preparedness, infection prevention and control (IPC), and AMR surveillance. We will consider the technical and governance challenges involved and explore how WS can function as a complementary pillar alongside genomic and clinical surveillance, supporting integrated, forward-looking health protection and practical IPC decision-making.
Day 2 - Wednesday 24 June
Keynote Presentation | Climate Change: Emerging Pathogens and the Human Parasite
Hugh Montgomery
The greenhouse gases which humanity has released already trap the energy equivalent of 14.8 Hiroshima Bombs every single second. This drives infectious disease in myriad ways: warming waters support Vibrio species and create poisonous algal blooms; changes in temperature and rainfall increase the range, breeding and feeding patterns of vectors, and pathogen replication; tick-borne diseases become more prevalent; animal and plant diseases become more common, collapsing food availability. But such changes, with ecosystem destruction collapse and human ingress, drive spillover events. Such impacts are accelerating fast... but are of minor importance when compared to those deriving from socioeconomic changes. Our lives are under immediate threat.
PPE: Use, Misuse and Harms
Mahmood Bhutta
Our use of personal protective equipment (PPE) in healthcare has reached epidemic proportions, with excessive use driven by misconceptions and behaviors. I will discuss how excessive PPE use harms our planet and global labour rights, and how we might try to change things.
Environmentally sustainable healthcare: The role of infection specialists
Sarah Walpole
How can we mitigate infection risks to patients and those working in and visiting health and social care settings while also mitigating health risks associated with environmental degradation? This talk will explore examples of interventions that IPC professionals have used to bring Win-Win-Win outcomes – for patients, profit/costs, and planet.
IPC practitioners have a privileged position working across health and social care and influencing policy and practice. Every stage of the cycle of health products -production, transportation, use and disposal – contributes to greenhouse gas emissions advancing climate change and associated infectious disease risks. Other environmental impacts include plastic pollution, depletion of natural resources, and reduction of biodiversity.
This talk will present the Infection Societies’ Sustainability Forum (ISSF) and its purpose and practice. It will share the most recent statement developed to guide effective use of PPE, as well as projects currently underway. We’ll examine the progress that infection societies and other health professionals have already made. We’ll explore next steps in bringing IPC expertise to the table as we mitigate and adapt to environmental changes and their health impacts.
Sponsored Symposium | Reducing Blood Culture Contamination: The role of blood culture diversion devices
Phil Norville
Blood culture contamination (BCC) remains a significant challenge for healthcare and infection prevention and control (IPC), with implications for surveillance accuracy, antimicrobial stewardship, patient safety, and sustainability. Contaminated blood cultures can result in unnecessary antimicrobial exposure, prolonged hospital stay, and avoidable environmental and financial costs.
This symposium will be anchored around a recent narrative review published in the Journal of Hospital Infection which synthesised evidence from 25 primary studies evaluating blood culture diversion (BCD), including open diversion techniques and blood culture diversion devices (BCDDs). Several authors from the publication will discuss the key review findings demonstrating that BCDDs consistently reduce BCC and achieve greater reductions in BCC than open diversion alone. The discussion will also highlight evidence regarding impacts on antimicrobial use and length of stay, which are heterogeneous and highly context dependent. Evidence from cost-effectiveness evaluations demonstrated that BCDDs are a cost-saving initiative.
Drawing on the perspectives of the co-authors, the discussion will address practical barriers and facilitators for implementation, including variability in BCC definitions, absence of national surveillance frameworks, device utilisation, human factors, and device selection. The panel will also highlight key evidence gaps and research priorities and discuss how infection and microbiology teams can translate the current evidence base into meaningful, locally relevant improvements in high-risk clinical environments.
Learning outcome
To share and discuss an appraisal of the evidence for blood culture diversion, understand its implications for surveillance, antimicrobial stewardship and sustainability, and identify practical considerations for effective implementation in clinical settings.
Sponsored Symposium | Comparative Performance of Automated Rapid Antimicrobial Susceptibility Testing Systems and Impact on Antimicrobial Stewardship and Healthcare Costs for Gram-Negative Bloodstream Infections
Joanna Miller
Background: At Gateshead Microbiology (England), standard blood culture processing requires 18–24 hours for antimicrobial susceptibility testing (AST) results and a further 18–24 hours to confirm resistance mechanisms. Rapid AST (RAST), performed directly from blood cultures (BC), can deliver minimum inhibitory concentration results within 6 hours, potentially enabling earlier targeted antimicrobial therapy and improving BC clinical pathways in UK hospitals.
Method: Two commercially available RAST systems, Q-Linea ASTar and VITEK® Reveal™, were evaluated against the standard of care (SOC) using categorical agreement (CA) and discrepancy analysis. A total of 113 samples (54 study, 59 control) were included in a clinical impact study using the Reveal™ system. Additionally, consultant microbiologists completed a qualitative questionnaire assessing the potential clinical and economic benefits of earlier results.
Results: Both systems demonstrated high performance, with CA values of 96.1% (ASTar) and 96.5% (Reveal™). The Reveal™ produced results in an average of 5.3 hours, with resistant organisms detected in as little as 3 hours, compared with 21.6 hours for SOC. Earlier availability of results could have improved antimicrobial therapy in 58% of patients and avoided 6% of hospital admissions. Extrapolated data suggested a reduction in length of stay by 441 days and estimated cost savings of £135,958 on admission avoidance if implemented.
Conclusion: Automated RAST systems provide results comparable to SOC while significantly reducing turnaround time. Their use enables same-shift reporting, supports earlier targeted antimicrobial therapy, and improves antimicrobial stewardship and patient care in gram-negative bacteraemia.
How do AMR and AMS differ in the community?
Catrin Moore
Antimicrobial resistance (AMR) represents not only a health challenge but also a substantial economic and societal threat, affecting livelihoods, productivity, and healthcare costs. Between 1.14-4.71 million people were estimated to have died due to antimicrobial resistance (AMR) in 2021, with children under five and older adults being most at risk, modelling projections show a worsening picture. All of this modelling relies on data collected in hospitals globally, very little data derives from the community. Our mixed method study in Uganda has begun to examine the burden of AMR in socioeconomically differing communities in an urban centre in Kampala to understand the use of antibiotics, the burden of resistance and the patient’s pathway for uncomplicated urinary tract infections and whether the data in the community differs from that submitted to the WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) Initiative.
I will present some of our preliminary findings for the Comparing Antibiotic Susceptibility and resisTance in the community to WHO-GLASS submitted national hospital surveillance data: samples and determinants of care seeking among patients with Urinary Tract Infections (CAST-UTI) study.
Building an antimicrobial stewardship strategy: lessons learned along the way
Emma McGuire
AMS programmes are expected to address complex and competing priorities including AMR, patient safety, workforce pressures, and digital transformation. However, there is relatively little practical guidance on how to develop an AMS strategy that is ambitious yet deliverable in today's NHS.
This session will describe the development of a new antimicrobial stewardship strategy at a large UK tertiary centre. The talk will focus on the practical process of strategy development, including lessons learned, challenges encountered, and the importance of collaborative working. The session will explore how stakeholder engagement shaped the strategy, how priorities were identified, and practical aspects of strategy development including governance structures and defining meaningful metrics.
Attendees will leave with practical reflections on developing an AMS strategy within a complex healthcare organisation, with particular focus on collaboration and balancing ambition with operational reality.
Novel Antimicrobial Stewardship Models
Prof Evelina Tacconelli
Antimicrobial stewardship (AMS) has become a cornerstone of global efforts to address AMR. Despite widespread endorsement, important questions remain regarding the definition, scope, implementation, and evaluation of stewardship interventions. Variability in healthcare systems, epidemiology, resources, and patient populations continues to challenge the development of effective and scalable stewardship models. This presentation critically examines whether current definition of AMS is sufficiently robust to support implementation science and sustainable healthcare transformation. It also explores whether existing stewardship outcomes and performance measures adequately capture the complexity of modern antimicrobial decision-making and whether currently used metrics reflect meaningful patients’ outcomes. Building on examples from diverse epidemiological settings, the presentation summarises successful stewardship models and discusses the contextual factors associated with their effectiveness. Finally, it explores key research priorities needed to advance the next generation of stewardship programmes, including the development of standardized outcome measures, evaluation of implementation strategies, incorporation of patient-centred outcomes, and creation of adaptive stewardship frameworks capable of responding to evolving epidemiological and healthcare challenges. By moving beyond traditional intervention-focused approaches, novel stewardship models may offer a pathway towards more effective, measurable, and sustainable AMR control.
AMR in intensive care
Luke Moore
AMR in Conflict Settings: the Hidden Threat
Aula Abbara
The nature of modern conflict has evolved, characterized by a rise in protracted intrastate hostilities and the deliberate destruction of civilian infrastructure and healthcare systems. These conflicts function as systemic stressors that not only escalate the burden of infection—particularly regarding trauma-related complications—but also serve as catalysts for the emergence and dissemination of antimicrobial resistance (AMR). Simultaneously, the collapse of institutional governance and the disruption of essential services severely undermine the capacity of health systems to detect, manage, and contain resistant pathogens. This presentation will explore: (i) the complex intersection between conflict dynamics and AMR evolution; (ii) the current epidemiological burden of AMR within conflict-affected settings; and (iii) strategies to strengthen health system resilience and improve antimicrobial stewardship in affected settings.