Evidence-based articles from our physician team on infection prevention, antimicrobial stewardship, healthcare safety, and clinical education.
April 27, 2026
WHO's Exercise Polaris II gathered 26 countries, 600 experts, and a fictional bacterium to stress-test the global outbreak response machinery. What happened next matters for every IPC professional on the planet.
April 22, 2026
Measles outbreak reaches 997 cases in South Carolina, HICPAC disbanding alarms infection prevention experts, CDC EIS Conference marks 75 years — and more critical IPC and epidemiology news from today.
January 8, 2026
Despite decades of campaigns, global hand hygiene compliance in healthcare settings averages only 40–60%. We explore the behavioural science behind non-compliance and evidence-based interventions that create lasting change.
February 12, 2026
Antimicrobial resistance now kills more people annually than HIV and malaria combined. With the pipeline of new antibiotics drying up, infection prevention is more critical than ever as our last line of defence.
March 5, 2026
Three ICUs across two US health systems share the strategies — beyond the standard bundle — that enabled them to maintain zero central line-associated bloodstream infections for over two years.
April 18, 2026
Up to 30% of healthcare workers develop occupational contact dermatitis — a painful, underreported condition that paradoxically increases infection transmission risk. Dr. Fabíola Tiburcio explains prevention and management.
May 27, 2026
The explosion of mandatory online training has created a checkbox culture in many healthcare facilities. We examine what makes IPC e-learning actually change clinical behaviour — and how to design programmes that work.
July 14, 2026
Hospital construction and renovation projects are a leading cause of Aspergillus outbreaks in haematology and transplant units. A comprehensive ICRA process and barrier precautions save lives.
January 8, 2026
Hand hygiene is universally recognised as the single most effective intervention to prevent healthcare-associated infections. Yet despite decades of global campaigns, educational programmes, and policy mandates, compliance rates in healthcare settings worldwide remain stubbornly low — averaging 40–60% across most facilities, with some studies reporting rates below 30% in high-risk units such as ICUs.
The question is no longer what to do — the evidence is clear. The question is why don't healthcare workers do it consistently, and what interventions actually produce lasting change?
Research in health psychology identifies three root causes of hand hygiene non-compliance: (1) Capability gaps — staff don't know when or how to perform hand hygiene correctly; (2) Opportunity barriers — ABHR is not accessible at the point of care, or workflow makes compliance inconvenient; (3) Motivation deficits — staff don't believe their hands are contaminated, don't perceive the risk to their patient, or don't see peers and leaders doing it.
Most hospital interventions address only capability — through training and posters. This explains why compliance improves immediately after training and then rapidly decays. Lasting change requires simultaneously addressing opportunity and motivation.
The WHO Multimodal Hand Hygiene Improvement Strategy — implemented in over 100 countries — identifies five components that must be implemented simultaneously: (1) System change: ensuring ABHR is available at every point of care; (2) Training: educating all staff using WHO materials; (3) Evaluation and feedback: regular audit with unit-level data shared with teams; (4) Reminders in the workplace: cues at point of care; (5) Institutional safety climate: executive leadership visibly engaged.
Facilities that implement all five components achieve compliance rates of 70–80% — significantly above the global average. Those that implement only one or two components see minimal sustained improvement.
Electronic monitoring technology — including AI-powered video monitoring and sensor-based systems — is showing promise as an objective, real-time complement to direct observation, providing granular data that enables targeted feedback at the individual and unit level.
Published by No Infection Consulting & Education · January 8, 2026
February 12, 2026
In 2024, the Lancet published landmark data showing that antimicrobial resistance (AMR) directly caused 1.27 million deaths globally — more than HIV/AIDS and malaria combined. By 2050, AMR is projected to cause 10 million deaths annually unless dramatic action is taken. We are living through the early stages of what infectious disease specialists have called the post-antibiotic era.
For healthcare professionals in 2026, this is not an abstract global health concern — it is a daily clinical reality. Patients with infections caused by carbapenem-resistant Enterobacterales (CRE), pan-resistant Acinetobacter baumannii, or extensively drug-resistant tuberculosis face treatment options that were unthinkable a generation ago: last-resort antibiotics with significant toxicity, combination therapies with uncertain efficacy, or in the most severe cases, no effective treatment at all.
Resistance emerges and spreads through a combination of evolutionary pressure (antibiotic use selects for resistant organisms) and transmission (resistant organisms spread between patients via healthcare workers' hands, contaminated surfaces, and shared equipment). Both drivers must be addressed simultaneously. Antibiotic stewardship programmes reduce selection pressure by ensuring antibiotics are used only when necessary and with the narrowest effective spectrum. Infection prevention programmes interrupt transmission by keeping resistant organisms from spreading once they are present.
IPC practitioners are on the front line of the AMR response. Key responsibilities include: implementing and maintaining contact precautions for MDRO-colonised and infected patients; conducting active surveillance cultures in high-risk units; leading environmental decontamination using appropriate sporicidal agents; coordinating with the ASP team to share resistance data and co-manage outbreak investigations; and educating clinical staff about the connection between their individual prescribing and hand hygiene practices and the facility's resistance profile.
Published by No Infection Consulting & Education · February 12, 2026
March 5, 2026
The CLABSI bundle — maximal sterile barrier precautions, chlorhexidine skin antisepsis, optimal site selection, daily necessity review, and hub disinfection — has been the standard of care for over a decade. Yet across US hospitals, CLABSI rates persist at an average of 0.8 per 1,000 catheter days in adult ICUs. What separates facilities that achieve and sustain zero CLABSI from those that continue to have preventable infections?
We spoke with IPC leads from three ICUs — a medical ICU in Boston, a surgical ICU in Houston, and a cardiothoracic ICU in Miami — that each maintained zero CLABSI for 24 or more consecutive months. Their stories reveal common themes that go beyond protocol compliance.
All three units conduct a formal root cause analysis for every CLABSI event — not to identify who failed, but to identify what system conditions allowed the failure to occur. This approach, grounded in just culture principles, surfaces genuine contributing factors (inadequate supply access, understaffing, knowledge gaps) rather than simply documenting that a protocol was not followed.
All three units have formalised the nurse's role as an observer during central line insertions, with explicit authority — and expectation — to halt the procedure and address technique concerns without fear of retribution. This requires sustained cultural and leadership investment, but dramatically reduces insertion bundle violations.
Public celebration of CLABSI-free milestones — displayed on unit whiteboards, announced at huddles, shared with hospital leadership — reinforces the team's identity as a high-performing unit and creates social motivation to protect the record. This shifts the dynamic from compliance-as-obligation to compliance-as-pride.
Published by No Infection Consulting & Education · March 5, 2026
April 18, 2026
Occupational contact dermatitis (OCD) is one of the most prevalent work-related skin conditions among healthcare workers, affecting an estimated 10–30% of nurses and other clinical staff. Paradoxically, this condition — caused in large part by the very infection prevention measures healthcare workers are required to perform — can itself increase infection transmission risk. Damaged skin loses its integrity as a physical barrier, harbouring more pathogenic organisms and shedding more organisms during patient care.
Healthcare workers with symptomatic dermatitis are also significantly less likely to perform hand hygiene at the required frequency, creating a vicious cycle of reduced compliance and increased infection risk. Understanding and preventing OCD is therefore not merely an occupational health issue — it is an IPC imperative.
Irritant contact dermatitis (ICD) is the most common form, caused by cumulative exposure to water, detergents, and chemical irritants. It typically presents as redness, dryness, cracking, and fissuring of the hands and wrists. Allergic contact dermatitis (ACD) is an immune-mediated reaction to specific allergens — most commonly latex proteins (from latex gloves), preservatives in ABHR products, and fragrances in skincare products. ACD causes more intense inflammation and requires identification and avoidance of the specific allergen.
Effective prevention strategies include: selecting ABHR products with added emollients (most modern products contain these — check the formulation); providing skin moisturiser containing dimethicone or glycerin in all clinical areas and encouraging use after each shift; switching to nitrile latex-free gloves facility-wide to eliminate latex sensitisation; avoiding antibacterial soaps with triclosan or high concentrations of iodine for routine hand hygiene; and providing occupational health assessment for any healthcare worker with persistent symptoms. Early identification and management of OCD prevents progression to chronic disease and supports sustained hand hygiene compliance.
Published by No Infection Consulting & Education · April 18, 2026
May 27, 2026
The rise of mandatory online learning in healthcare has produced a paradox: unprecedented access to IPC education, and unprecedented evidence that much of it doesn't change behaviour. Studies consistently show that knowledge scores improve immediately after completion of e-learning modules — and return to baseline within weeks, with little change in observed clinical practice.
What separates e-learning that creates lasting behavioural change from e-learning that merely satisfies a compliance checkbox? The answer lies in instructional design principles that are frequently ignored in healthcare e-learning development.
Most healthcare e-learning presents information passively: text screens, narrated slides, videos. Learners absorb information briefly and then move on. Without active recall, spaced repetition, or application to real clinical scenarios, this information is not encoded into long-term memory. The click-through behaviour — advancing through slides as quickly as possible to reach the completion screen — is a rational response to poorly designed mandatory training.
Effective IPC e-learning incorporates: (1) Case-based learning — presenting clinical scenarios requiring the learner to make decisions before revealing the correct answer; (2) Active recall — frequent low-stakes questions that require retrieval of previously learned information, exploiting the testing effect; (3) Spaced repetition — reintroducing key concepts at intervals to strengthen long-term retention; (4) Feedback — immediate, explanatory feedback on incorrect answers that addresses misconceptions rather than simply stating the correct answer; (5) Transfer-appropriate practice — scenarios that closely mirror the clinical situations where the behaviour must be applied. At No Infection, all our courses are designed on these principles — our final assessments are not afterthoughts but integral to the learning process.
Published by No Infection Consulting & Education · May 27, 2026
July 14, 2026
Every hospital construction and renovation project represents a potential threat to the most vulnerable patients in the facility. Aspergillus fumigatus and other environmental moulds — ubiquitous in soil, decaying vegetation, and building materials — are mobilised in large quantities when walls are demolished, ceilings disturbed, or air handling systems disrupted. For immunocompromised patients, particularly those undergoing haematopoietic stem cell transplantation or receiving intensive chemotherapy, inhalation of even a small number of Aspergillus conidia can cause invasive pulmonary aspergillosis — a condition with mortality rates of 30–90% in the most immunosuppressed patients.
The Infection Control Risk Assessment (ICRA) is the systematic framework used to evaluate infection risks associated with construction, renovation, and maintenance activities in healthcare facilities, and to implement proportionate control measures before, during, and after the project.
The ICRA involves two matrices: (1) Patient risk group — from low risk (general medicine patients) to highest risk (allogeneic HSCT recipients); (2) Construction activity type — from Type A (minor maintenance without dust) to Type D (major demolition generating significant dust). The intersection of these two matrices determines the required infection control class (Class I through IV) and the specific barrier and monitoring requirements. For the highest-risk combination, requirements include: full dust barriers from floor to ceiling, sealed with tape; negative pressure within the construction zone maintained at all times; HEPA-filtered air supplied to the construction area; patient relocation from adjacent areas if barriers cannot be fully maintained; and daily monitoring of construction zone air pressure differentials.
Published by No Infection Consulting & Education · July 14, 2026
April 22, 2026
NO INFECTION CONSULTING & EDUCATION
Daily Intelligence Report — Infection Prevention & Epidemiology | April 22, 2026
South Carolina reports 997 confirmed measles cases, centered in Spartanburg County. Nationally, the United States has already confirmed over 1,600 cases since the start of 2026, placing the country at risk of losing its measles-elimination status when PAHO reviews it in November. Declining vaccination rates and federal funding cuts are the primary drivers.
The abrupt disbanding of the Healthcare Infection Control Practices Advisory Committee (HICPAC) has silenced decades of infection control expertise, leaving healthcare workers without unified national guidance as deadly threats to patient safety continue to rise. APIC and SHEA have announced the creation of the joint Healthcare Infection Prevention Advisory Group (HIPAG) as an emergency response.
Infection prevention experts describe 2026 as a pivotal moment for the field, shaped by unpredictable changes in US health policy and growing financial pressure on hospitals. Healthcare organizations may implement hiring freezes for IPC practitioners, threatening programmes that are critical to patient safety. The defining question: will leadership view IPC as a liability to cut or a strategic asset essential for resilience?
The CDC's Epidemic Intelligence Service (EIS) Annual Conference is underway this week, bringing together the agency's "disease detectives" to present outbreak investigations, new scientific findings, and forward-thinking public health strategies. The 2026 conference marks the 75th anniversary of the EIS programme — one of the most respected applied epidemiology institutions in the world.
Researchers at the University of Florida warn that Influenza D virus and a canine coronavirus have real potential to trigger outbreaks if surveillance and diagnostics continue to lag. Studies show that up to 97% of cattle workers already carry Influenza D antibodies — suggesting ongoing silent human exposure. A recently isolated strain from China has developed capacity for human-to-human transmission.
A Gavi insight paper identifies six immediate threats to global health in 2026: antimicrobial resistance accelerated by armed conflict, vaccine misinformation, expansion of vector-borne diseases (dengue, yellow fever, chikungunya) driven by climate change, mpox clade I, H5N1 avian influenza, and the defunding of global disease surveillance networks. Rising temperatures are expanding mosquito habitats, increasing the speed of arboviral transmission to humans.
Published by No Infection Consulting & Education · April 22, 2026
April 27, 2026 · 4 min read
WHO's Exercise Polaris II gathered 26 countries, 600 experts, and a fictional bacterium to stress-test the global outbreak response machinery. What happened next matters for every IPC professional on the planet.
Imagine a new bacterium — never seen before — spreading silently across borders. Governments scrambling to coordinate. Hospitals on alert. Information flowing, or failing to flow, between dozens of countries in real time.
That was the scenario the World Health Organization put to the test last week. And for once, the news from the frontlines of global health security is cautiously good.
Exercise Polaris II, which wrapped up on April 23, brought together 26 countries and territories, 600 health emergency experts, and more than 25 international partners over two intensive days. The drill was not a theoretical workshop. It was a live stress-test of the real machinery of global outbreak response — the calls, the decisions, the gaps.
This was the second edition of Exercise Polaris. The first, held in April 2025, simulated a fictional viral outbreak. This year, the threat was bacterial — and the scale was significantly larger, with new regional networks activated for the first time. The evolution is deliberate: each iteration raises the complexity of the scenario, forcing systems to adapt to threats they have never rehearsed before.
"It is not enough to have plans on paper — what matters is how they perform in practice."
— Edenilo Baltazar Barreira Filho, Director of Public Health Emergencies, Ministry of Health, BrazilIt is a lesson the world learned painfully during COVID-19. Countries that had pandemic plans often found those plans crumbling under the weight of real decisions — supply chain failures, political pressure, and communication breakdowns that no tabletop exercise had anticipated. Exercise Polaris II is designed to close that gap before the next crisis forces the lesson again.
Perhaps the most significant aspect of Polaris II is what it represents structurally. This is not a one-off drill. It is part of HorizonX, WHO's forward-looking, multi-year simulation programme, built on a clear premise: collective readiness must be a continuous investment — not a periodic reflex triggered only when alarm bells ring.
Dr. Chikwe Ihekweazu, Executive Director of WHO's Health Emergencies Programme, framed it directly: the exercise reflects the spirit of the Global Health Emergency Corps — a trained, coordinated, and connected workforce ready to respond wherever and whenever it is needed.
For those working on the front lines of infection prevention and control — whether in a hospital, a public health agency, or a consulting role — Exercise Polaris II sends a signal worth taking seriously. The global infrastructure is being built and tested. The question is whether your institution is keeping pace with the same rigor.
Coordination, real-time information sharing, and a workforce that knows its role before the crisis hits — these are not administrative luxuries. They are the difference between containment and catastrophe. Between a cluster and a pandemic.
Source: WHO News Release, April 27, 2026 →
Published by No Infection Consulting & Education · April 27, 2026