Top 10 IPC papers of the past year: priority pathogens and AI

Top 10 IPC papers of the past year: priority pathogens and AI

Last week at the annual Infection Prevention Society Conference Jon and I went through out top 10 IPC papers of the past year covering the topics priority pathogens and AI. Next week we will be running through the papers again in an IPC Partners journal club which you can register for here. It was a difficult task but here are my top 5 covering whole genome sequencing (WGS) water-safe care, Candidozyma auris and dry surface biofilm (DSB).

1. Whole-genome sequencing moves from research to reality

Personally, I think WGS has huge potential for IPC in terms of outbreak detection and even prediction, however one of the main challenges is how do we translate genomic data into actionable intelligence for frontline teams? The paper by Price et al along with colleagues from The Genomics to Optimise Infection Prevention (GENOTIPE)  provide a UK-focused roadmap for implementing pathogen WGS within routine IPC practice.

The roadmap identifies several priorities, including rapid turnaround times, integration of genomic, clinical and epidemiological data, standardised reporting, and coordination between local, regional and national systems. Generating genomic data is relatively straightforward; turning that information into timely IPC decisions is considerably more challenging.

For IPC professionals, this paper is a reminder that technological innovation alone is rarely enough. Success depends on governance, workforce capability, interoperability and demonstrating real-world value. These lessons extend well beyond genomics and are relevant to many emerging healthcare technologies.

2. Can routine genomic surveillance be delivered at scale?

Following the roadmap set out by the GENOTIPE team my next paper was to see if this work was implementable at scale and to examine the costs associated with implementation. Waggle and colleagues present a practical model for implementing large-scale genomic surveillance in a hospital setting. Over a three-year period, the programme sequenced more than 7,800 bacterial isolates, increased throughput and reduced sequencing costs from less than $100 to less than $70 per sample. While the reported per-sample costs are approaching levels that may be acceptable for routine use, the authors note that these estimates exclude major equipment purchases and infrastructure costs.

What makes this work particularly interesting is its focus on implementation rather than proof of concept. The authors demonstrate that sequencing can become part of routine surveillance workflows rather than being reserved for high-profile outbreaks.

However, the paper also highlights a recurring challenge in IPC innovation. Producing data is only valuable if that information reaches decision-makers quickly enough to influence action. A ten-day turnaround may be sufficient for surveillance and outbreak investigation, but timeliness remains critical if genomic intelligence is to become embedded within routine IPC practice

3. Understanding the epidemiology of Candidozyma auris

Few pathogens have captured the attention of IPC teams in recent years as much as Candidozyma auris. Its ability to persist in healthcare environments, colonise patients and demonstrate multidrug resistance makes it a unique challenge.

Okeke et al provide valuable epidemiological insights from an acute hospital outbreak investigation in London. Among the key findings were strong associations between colonisation and prior antibacterial exposure, as well as exposure to Doppler probes. Longer hospital exposure before testing was also associated with increased risk.

Whilst the study was conducted during an outbreak and may not be representative of all settings, the implications are important. The findings reinforce the need for robust environmental decontamination, particularly for shared medical equipment, alongside effective screening strategies. For IPC practitioners, it is another reminder that transmission pathways are often multifactorial, requiring a combination of surveillance, environmental controls and device management.

4. Water-safe care and the built environment remain critical

One of my own talks at IP2026 focused on biofilms and novel decontamination methods, highlighting how hospital water systems continue to emerge as important reservoirs for healthcare-associated pathogens. Meda et al describe a large outbreak involving carbapenemase-producing Enterobacterales (CPE), where wastewater was identified as the key reservoir.

The outbreak response combined universal patient screening with water-safe interventions, resulting in a sustained reduction in transmission. Although the individual effect of each intervention could not be separated, the study provides further evidence supporting water-safe approaches to healthcare design and operation.

As healthcare systems continue to invest in estate modernisation and new hospital developments, IPC involvement in the design and management of the built environment remains essential. Water safety is no longer simply an estates issue; it is increasingly recognised as a core component of infection prevention.

5. Dry surface biofilm: an underappreciated risk?

DSB has fascinated me for years and I have been lucky to collaborate with the team at Cardiff University on various studies, including one on Klebsiella , but questions remain about its potential role in pathogen transmission. Chowdhury et al explored whether Staphylococcus aureus biofilm could transfer through and via hospital bed sheets. Their findings suggest that it can.

The study demonstrated that transfer increased when fabrics were wetted and that lower thread-count sheets facilitated greater bacterial transfer. The authors also identified substantial bacterial contamination on clinical mattress and pillow covers.

Whilst largely laboratory-based, the paper raises important questions about how environmental reservoirs contribute to pathogen transmission. For IPC teams, the findings reinforce the importance of effective cleaning, decontamination and laundering processes, whilst highlighting that the patient environment remains an area where further research is needed.

Final thoughts

Taken together, these papers highlight two dominant themes shaping the future of IPC. The first is the growing role of advanced technologies such as genomics and AI-enabled surveillance. The second is a continued recognition that traditional IPC principles, including environmental hygiene, water safety and equipment decontamination, remain fundamental to controlling transmission.

Innovation will undoubtedly play a major role in the next decade of infection prevention. However, these papers remind us that successful implementation depends not only on new technologies, but also on understanding epidemiology, improving systems and maintaining focus on the basics that continue to protect patients every day