Infection Control and Hospital Epidemiology最新文献

{"title":"Recommendations made and accepted by a telehealth-enabled Antimicrobial Stewardship program implemented at rural veterans affairs medical centers.","authors":"Taissa A Bej, Amelia L Milner, Alexandria Nguyen, Amanda Vivo, Geneva Wilson, Sara Abdelrahim, Brigid M Wilson, Corinne Kowal, Sunah Song, Keri L Rodriguez, Nicole Beyer, Zachary Michaels, Carla Amundson, Kristina L Bajema, Jason P Burnham, Christopher J Crnich, Dimitri M Drekonja, Lauren Epstein, Tola Ewers, Daniel J Livorsi, Muthu Narayan, Joshua D Nordman, Federico Perez, Christopher D Pfeiffer, Rabeeya Sabzwari, Ahmed M Salti, Danielle Tate, Tammy Walkner, Andrew S Webster, Charlesnika T Evans, Robin L P Jump","doi":"10.1017/ice.2026.10443","DOIUrl":"https://doi.org/10.1017/ice.2026.10443","url":null,"abstract":"<p><strong>Background: </strong>To support Antimicrobial Stewardship programs (ASPs) as well as the clinical care of patients with infections, we disseminated and implemented a Videoconference Antimicrobial Stewardship Team (VAST) to connect multidisciplinary teams from rural Veterans Affairs (VA) medical centers with geographically distant ID experts. Here, we describe the clinical syndromes discussed and the response to recommendations made during VAST sessions.</p><p><strong>Methods: </strong>Between September 2021 to February 2024, eight ID consultants established VASTs with ten rural VAMCs, holding regularly scheduled videoconference sessions to discuss clinical cases and provide recommendations. Data were collected on patient demographics, clinical syndromes, and recommendations. Acceptance of recommendations within one week of each session was assessed via chart review. Six months after the intervention began, we conducted semi-structured interviews to assess participants' perceptions of VASTs.</p><p><strong>Results: </strong>VASTs reviewed 626 cases involving 527 unique patients. Among 763 clinical syndromes discussed, the most common were infections of the respiratory (29%) or urinary tract (21%). Overall, VASTs made 973 recommendations, of which 71% were accepted. Of 570 recommendations related to antibiotics, 459 (80%) were accepted. Among 403 other recommendations, 235 (58%) were accepted. Interviews with participants indicated the importance of building trust and strong interpersonal relationships.</p><p><strong>Conclusions: </strong>VASTs effectively supported Antimicrobial Stewardship in rural VA medical centers (VAMCs) without local ID expertise. High acceptance rates, particularly for antibiotic-related recommendations, suggest that telehealth-enabled provider-to-provider models enhance stewardship efforts.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Staffing and workflow of an interactive telehealth Antimicrobial Stewardship program with the Veterans Health Administration.","authors":"Amanda Vivo, Geneva M Wilson, Dustin D French, Taissa A Bej, Brigid Wilson, Corinne Kowal, Amelia Milner, Carla Amundson, Kristina Bajema, Jason P Burnham, Christopher Crnich, Lauren Epstein, Daniel J Livorsi, Muthu Narayan, Christopher Pfeiffer, Rabeeya Sabzwari, Ahmed Salti, Danielle Tate, Tammy Walkner, Andrew Webster, Robin Jump, Charlesnika Evans","doi":"10.1017/ice.2026.10452","DOIUrl":"https://doi.org/10.1017/ice.2026.10452","url":null,"abstract":"<p><strong>Objective: </strong>Describe the workload associated with using telehealth to support Antimicrobial Stewardship efforts at Veterans Affairs Medical Centers (VAMCs) without local infectious diseases (ID) expertise.</p><p><strong>Design: </strong>A mixed-methods process assessment to evaluate workload and workflow associated with Videoconference Antimicrobial Stewardship Teams (VASTs).</p><p><strong>Setting and participants: </strong>Rural VAMC champions paired with ID consultants at geographically distant VAMCs to form VASTs.</p><p><strong>Methods: </strong>Total workload estimates were based on time that champions and ID consultants allocated to VAST activities. Clinical Procedural Terminology (CPT) codes were used to estimate the workloads for clinical encounters. Role-based process maps were developed to understand variation in implementation by VAMC.</p><p><strong>Results: </strong>The average workload that champions and ID consultants allocated to VAST activities was 6.7% (range 1.0%-20.0%) and 8.4% (range 2.0%-12.5%) full-time equivalents (FTEs), respectively. Clinical encounters completed by ID consultants contributed an average of 1.4% (range < 0.01%-2.5%) FTEs to the workload. The average proportion of FTEs required to sustain VASTs was 13.0% (range 3.0%-31.6%). Process maps showed four phases common to each VAST's workflow: case identification, meeting preparation, team meeting, and documentation. The tasks associated with each phase varied between VASTs. Champions carried out most tasks related to case finding and meeting preparation; the ID consultants completed most documentation tasks.</p><p><strong>Conclusions: </strong>The distribution of tasks within and among the VASTs indicated opportunities to improve workflow efficiency. Investing <12.5% of the FTE allocated to VA Antimicrobial Stewardship programs to support the time of an ID consultant from another VAMC can help rural VAMCs achieve staffing sustainability.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":2.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do infection prevention and control messages reach the bedside? A national evaluation of communication and training practices.","authors":"Esma Eryilmaz Eren, Ayse Yolcu, Can Huseyin Hekimoglu, Dilek Altun, Esen Batır, Safiye Taşgın, Dilek Dulger, Emine Alp Meşe","doi":"10.1017/ice.2026.10453","DOIUrl":"https://doi.org/10.1017/ice.2026.10453","url":null,"abstract":"<p><strong>Objective: </strong>The implementation of the World Health Organization's multimodal strategy is crucial for strengthening infection prevention and control (IPC) programs. This study aimed to evaluate and compare the perceptions of infection prevention and control professionals (IPCPs) and healthcare workers (HCWs) regarding the effectiveness of the multimodal strategy.</p><p><strong>Methods: </strong>In this study, an online survey was designed that included five MM components: system change, education and training, monitoring and feedback, reminders and communication, and cultural change. The survey was completed by IPCPs and HCWs within the institutions.</p><p><strong>Results: </strong>A total of 102 IPCPs and 166 HCWs from 96 institutions participated in the survey. The mean career duration was 19.8 ± 9.5 years. An Infection Control Committee (ICC) was present in 98% of participants' institutions, and 88% held meetings every three months. Only 10 (10.4%) institutions met the ratio of 1IPC nurse per 150 beds. Effective communication techniques training was provided annually to 55.9% of IPCPs and 59.6% of HCWs.Eighty-one (79.4%) IPCPs reported using effective communication when explaining the five indications of hand hygiene, but only 77 (46.4%) HCWs agreed (P < .001). Ninety-one (89.2%) IPCPs confirmed that effective communication techniques were used in bundle training. But, only 25 (15.0%) HCWs agreed, while 112 (67.5%) HCWs reported being undecided (P < .001). Sixty-one (64.7%) IPCPs and 130 (78.3%) HCWs believed that their institutions effectively motivated HCWs towards IPC measures compliance. However, 44 (43.1%) IPCPs and 29 (17.5%) HCWs were undecided (P = .002).</p><p><strong>Conclusion: </strong>The survey reveals significant inconsistencies among IPCPs and HCWs regarding communication effectiveness, and perceptions of compliance with infection-control measures. These findings highlight the need for more inclusive and transparent communication strategies, regular interdisciplinary training, and stronger organizational support to improve IPC practices.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving urine testing stewardship with a technology-leveraged urine testing guideline.","authors":"Christian J Ostrowski, Mandy C Swann, Jacob R Gillen, Anthony Baffoe-Bonnie","doi":"10.1017/ice.2026.10430","DOIUrl":"https://doi.org/10.1017/ice.2026.10430","url":null,"abstract":"<p><strong>Background: </strong>Unnecessary urine cultures contribute to inappropriate antibiotic use, antimicrobial resistance, and <i>Clostridioides difficile</i> infection, particularly when asymptomatic bacteriuria (ASB) is misclassified as infection. We evaluated the diagnostic stewardship impact of an algorithm-based best practice alert (BPA) embedded in the electronic medical record (EMR) to guide urine testing in hospitalized adults.</p><p><strong>Methods: </strong>This prospective quality improvement study was conducted at a 740-bed tertiary care hospital. The BPA triggered when urinalysis with reflex to culture (UACC) was ordered for patients admitted ≥48 hours, guiding clinicians through an algorithm-based ordering workflow. Monthly rates of UACC and pan-culturing were compared between a 12-month pre-intervention period and a 12-month post-intervention period using interrupted time series (ITS) and Mood's median two-sample test. Gram-negative rod (GNR) bacteremia rates were monitored for safety.</p><p><strong>Results: </strong>Urine testing decreased from 6.45 to 4.41 tests per 1,000 patient-days (31.6% reduction; <i>P</i> < .01), and pan-culturing decreased from 3.47 to 2.70 per 1,000 patient-days (22.2% reduction; <i>P</i> < .01). ITS showed declining trends both before and after implementation, without significant immediate changes in level or slope following the intervention. CAUTI rates remained stable (0.91 vs 0.82 per 1,000 catheter-days; <i>P</i> = .68), as did rates of gram-negative rod bacteremia (0.47 vs 0.70 per 1,000 patient-days; <i>P</i> = .22). Algorithm adherence averaged 63.9% and increased over time (<i>P</i> < .01). CAUTI cases classified as potential asymptomatic bacteriuria declined from 31.8% to 25.0% (<i>P</i> = .68).</p><p><strong>Conclusions: </strong>An EMR-integrated, algorithm-based BPA coincided with sustained lower urine testing and pan-culturing rates without adverse safety signals within the context of existing downward trends. Ongoing monitoring is needed to sustain adoption and appropriate use.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":2.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial decision-making under uncertainty in the high-stakes intensive care unit scenario: a critical interpretative synthesis.","authors":"Bruno Adler Maccagnan Pinheiro Besen, Larissa Bianchini, Bruno M Tomazini, Rachel Riera, Isabela Porto de Toledo, Verônica Colpani","doi":"10.1017/ice.2026.10459","DOIUrl":"https://doi.org/10.1017/ice.2026.10459","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial Stewardship in the intensive care unit setting is a difficult task due to diagnostic uncertainty and perceived high-risk of poor outcomes in case of delayed or inappropriate treatment. Although novel diagnostics and other strategies have been proposed to improve antimicrobial use, their clinical effectiveness in real-world settings has been suboptimal.</p><p><strong>Methods: </strong>We designed a critical interpretative synthesis of the literature, which allows the combination of quantitative and qualitative studies to revise and critique concepts used in Antimicrobial Stewardship efforts in the ICU setting. We searched the literature in duplicate with a sensitive strategy to identify main concepts, and we developed a main theme and conceptual framework after identifying the main concepts and strategies.</p><p><strong>Results: </strong>After screening 41,192 titles and abstracts and reviewing 1,335 full-text manuscripts, we selected 29 main manuscripts for this synthesis. We identified that classical concepts, such as the use of broad-spectrum antibiotics followed by de-escalation and the use of biomarkers of infection and novel diagnostics, although with face validity and supported by efficacy studies, carry a high risk of being ineffective in real-world settings. We argue that this discrepancy is due to cognitive biases in antimicrobial decision-making in the ICU setting, including risk-aversion behavior, diagnostic momentum, premature closure, therapeutic momentum, hyperbolic discounting, commission bias, and anchoring bias, among others, which drive intensivists towards overdiagnosis and overtreatment of infection.</p><p><strong>Conclusions: </strong>Incorporation of the cognitive theory of decision-making in future stewardship efforts is necessary in the ICU setting along with traditional stewardship interventions.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of admission screening on <i>Clostridioides difficile</i> infection rates in a hematology-oncology and hematopoietic cell transplant unit.","authors":"Christine W Lucky, Lahari Thotapalli, Laura K Rusie, Yoona Rhee, Michael E Schoeny, Nicole A Kraut, Alexandra Seguin, Brian D Stein, Raul I Rodriguez, Mary K Hayden, Michael Y Lin","doi":"10.1017/ice.2026.10442","DOIUrl":"https://doi.org/10.1017/ice.2026.10442","url":null,"abstract":"<p><p>We evaluated <i>Clostridioides difficile</i> admission screening in a cancer unit. Admission screening was associated with a non-significant decrease in hospital-onset <i>C. difficile</i> infection (CDI) incidence and a significant decrease in community-onset CDI incidence, which may reflect, in part, the artifactual impact of screening on subsequent provider testing behavior.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of an artificial intelligence model for evaluation of unnecessary central lines, Northern California 2025.","authors":"Jenna M Wick, Apoorva Bhaskara, Wajeeha Tariq, Sean Lau, Mindy M Sampson, Jorge L Salinas","doi":"10.1017/ice.2026.10462","DOIUrl":"https://doi.org/10.1017/ice.2026.10462","url":null,"abstract":"<p><p>We used a large language model integrated in the electronic health record to evaluate unnecessary central lines. It had a 16% sensitivity and 99% specificity for detecting unnecessary lines. Although it missed many unnecessary lines, the high specificity suggests potential as a tool where human review is not feasible.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring the efficacy of standard and novel disinfection methods on inpatient clinician-assigned phone: a 2-phase randomized experimental study.","authors":"Bobby G Warren, Emily J Burke, Keyera M Wynn, Aaron Barrett, Amanda M Graves, Guerbine Fils-Aime, Deverick J Anderson, Becky A Smith","doi":"10.1017/ice.2026.10460","DOIUrl":"https://doi.org/10.1017/ice.2026.10460","url":null,"abstract":"<p><p>We conducted a two-phase randomized controlled trial evaluating routine versus automated hydrogen peroxide-peracetic acid disinfection of inpatient clinician-assigned phones. Both strategies significantly reduced microbial bioburden and clinically important pathogens. High baseline contamination under routine practice suggests adherence, rather than intrinsic efficacy, is the primary determinant of device cleanliness.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial disparities in healthcare-associated infections: a systematic review and meta-analysis.","authors":"Reinaldo Perez, Sonali D Advani, Rebecca North, Alison G C Smith, Ibukunoluwa C Kalu, Steph Hendren, Sarah Peskoe, Carl Pieper, Helen Zhang, Melissa Campbell, Sophie Nick, Michael Yarrington, Erin Gettler, Jay Krishnan, Nwora Lance Okeke, Janine Young, Deverick J Anderson","doi":"10.1017/ice.2026.10461","DOIUrl":"https://doi.org/10.1017/ice.2026.10461","url":null,"abstract":"<p><strong>Objective: </strong>Racial and ethnic disparities in healthcare-associated infections (HAIs) could have significant implications for hospital-based incentive programs. We sought to quantify racial and ethnic disparities in HAIs across inpatients in the United States.</p><p><strong>Design: </strong>Systematic Review and Meta-Analysis.</p><p><strong>Methods: </strong>Medline, Embase, and Scopus were searched 2008-2022 for English language studies describing reportable HAIs among inpatients and references to race or ethnicity. Studies were excluded if they used an aggregate outcome of \"infection,\" described a non-acute care setting, or measured a respiratory virus. Meta-analysis was performed using random-effects model on pooled continuous outcomes with 3 or more studies.</p><p><strong>Results: </strong>39 studies met criteria for inclusion; 23 evaluated surgical site infections (SSI), 6 evaluated hospital-onset <i>Clostridioides difficile</i> infection (HO-CDI), 5 evaluated central line-associated bloodstream infections (CLABSI), and 8 examined other HAIs. There was a high degree of heterogeneity across studies. Meta-analysis was performed for 10 distinct HAI/risk factor combinations. Race and ethnicity were not associated with SSIs (Black vs White OR 1.19, 95% CI 0.95-1.48; Hispanic vs White OR 1.01, 95% CI 0.78-1.31). Hispanic patients had lower risk of HO-CDI relative to White patients (OR 0.80, 95% CI 0.64-0.98). Black (OR 1.36, 95% CI 1.07-1.70) or Hispanic (OR 1.16, 95% CI 1.073-1.249) patients had increased risk of CLABSI compared with White patients.</p><p><strong>Conclusions: </strong>Racial and ethnic disparities were observed in rates of HAIs, specifically for CLABSI and HO-CDI. However, conclusions are limited by the substantial heterogeneity present. Further research characterizing social determinants of health driving these disparities is needed.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-15"},"PeriodicalIF":2.9,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A decade of change: evolving epidemiology of invasive pulmonary mold infections in hematologic malignancy patients from a longitudinal infection control surveillance program.","authors":"Guy Handley, Jane Powell, Dimitrios P Kontoyiannis, Adina Feldman, Micah Bhatti, Roy F Chemaly, Amy Spallone","doi":"10.1017/ice.2026.10456","DOIUrl":"https://doi.org/10.1017/ice.2026.10456","url":null,"abstract":"<p><p>Epidemiologic trends in pulmonary mold infections were assessed. Of 227 infections, 24 were considered late-onset (>14 days) and Aspergillus less common (58.3% vs 78.3%; P = .030). For late-onset cases, Aspergillus was dramatically less frequent from 2020-2025 compared to 2014-2019 (11.1% vs 86.7%, P < .001), while Fusarium spp. increased (44.4% vs 0%, P = .012).</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}