Infection Control and Hospital Epidemiology最新文献

{"title":"Evaluating potential modifications to the Centers for Disease Control and Prevention's Adult Sepsis Event definition: impact on sepsis incidence, outcomes, and clinical validity.","authors":"Lucia Millham, Simran Gupta, Michael Klompas, Christina A Chan, Raymund B Dantes, Chanu Rhee","doi":"10.1017/ice.2025.10218","DOIUrl":"https://doi.org/10.1017/ice.2025.10218","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate potential modifications to the Centers for Disease Control and Prevention (CDC)'s Adult Sepsis Event (ASE) definition aimed at mitigating variable blood culturing practices, better-capturing cases where timely care may have prevented deterioration, and improving clinical credibility.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>5 US hospitals.</p><p><strong>Patients: </strong>Hospitalized adults, 2015-2022.</p><p><strong>Methods: </strong>We assessed the impact of potential ASE modifications on community-onset sepsis incidence and mortality and reviewed 280 charts to assess positive predictive value (PPV) for clinical sepsis.</p><p><strong>Results: </strong>Among 1,101,252 hospitalized adults, 51,712 (4.7%) met community-onset ASE criteria (16.1% mortality). Expanding infection criteria to include present-on-admission infection codes when blood cultures were not drawn, non-blood clinical cultures, and discharge alive on antibiotic day three increased incidence by 15.0%, 12.2%, and 4.9%, respectively; all led to mild decreases in mortality rates. Expanding organ dysfunction criteria to include hypotension increased ASE incidence by 32.3% and decreased mortality by 18.5%. Broadening respiratory failure criteria to include noninvasive ventilation and high-flow oxygen had minimal impact. On chart review, original ASE criteria had 80% PPV for clinical sepsis. PPV was similar when identifying infection using present-on-admission infection codes instead of blood cultures and when including patients discharged alive on antibiotic day three. PPV decreased to 50% when using non-blood clinical cultures to identify infection, 17% when using single hypotension values alone to indicate organ dysfunction, and 30% when all ASE components occurred exactly 2 days vs within +/-1 day from the blood culture day.</p><p><strong>Conclusions: </strong>Our findings inform modifications to ASE to optimize its utility for national epidemiologic monitoring and quality measurement.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760027","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":"Extracting antibiotic susceptibility from free-text microbiology reports using natural language processing.","authors":"Andrew Chou, Ronald George Hauser, Lori A Bastian, Cynthia A Brandt, Barbara W Trautner","doi":"10.1017/ice.2025.10210","DOIUrl":"https://doi.org/10.1017/ice.2025.10210","url":null,"abstract":"<p><p>There is a clinical need to appropriately apply large language model (LLM)-based systems for use in infectious diseases. We sought to use LLM and machine learning for extracting antibiotic susceptibility from clinical microbiology free-text reports, allowing use for outbreak detection, increasing information gathering efficiency, and public health reporting.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753270","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 asymptomatic <i>Clostridioides difficile</i> carriage screening on antibiotic stewardship among hospitalized patients.","authors":"Mayan Gilboa, Eyal Meltzer, Noam Barda, Yovel Peretz, Itzchak Levi, Ido Cohen, Galia Rahav, Nati Keller, Dafna Yahav, Gili Regev-Yochay","doi":"10.1017/ice.2025.10213","DOIUrl":"https://doi.org/10.1017/ice.2025.10213","url":null,"abstract":"<p><p>This study evaluated how informing clinicians about <i>Clostridioides difficile</i> (CD) carriage affected antibiotic stewardship. A quasi-experimental pre/post design assessed antibiotic use in carriers versus non-carriers. Clinician awareness was associated with reduced antibiotic use, particularly quinolones, among carriers. Findings suggest screening and targeted education enhance stewardship and reduce high-risk antibiotic use.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":2.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753271","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":"Hospital onset bacteremia and fungemia should be a pay-for performance measure: a pro/con debate.","authors":"Gregory M Schrank, Theresa Madaline","doi":"10.1017/ice.2025.10216","DOIUrl":"https://doi.org/10.1017/ice.2025.10216","url":null,"abstract":"<p><p>Healthcare-associated infections (HAIs) result in substantial patient harm and avoidable costs. Pay-for-performance programs (PFP) through the Centers for Medicare and Medicaid Services (CMS) have resulted in reductions of HAIs like central line-associated bloodstream infections (CLABSI) and methicillin-resistant <i>Staphylococcus aureus</i> bacteremia, through robust infection prevention programs and practices. Hospital Onset Bacteremia and Fungemia (HOB) is proposed as an alternative quality measure for public reporting and PFP, and was endorsed by the National Quality Forum in 2022. This broad measure is designed as an electronic quality measure that avoids manual abstraction and excludes risk adjustment. HOB would substantially expand the scope of focus of existing bloodstream infection measurement, and is currently being considered for voluntary reporting in 2025. In this article, we provide arguments for and against adopting HOB as a PFP measure linked to CMS payments.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649378","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":"Is it useful to culture the intravascular catheter tip for management of central line-associated bloodstream infections?","authors":"Yu-Mi Lee, Geonui Kim, Dong Youn Kim, Ki-Ho Park, Young Jin Kim, Mi Suk Lee","doi":"10.1017/ice.2025.10215","DOIUrl":"https://doi.org/10.1017/ice.2025.10215","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":3.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636971","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":"Evaluation of swabbing methods for culture and non-culture-based recovery of multidrug-resistant organisms from environmental surfaces.","authors":"Ahmed Babiker, Julia Van Riel, Sarah Lohsen, Alex Page, Amanda Strudwick, Eli Wilber, Michael Woodworth, Sarah Satola","doi":"10.1017/ice.2025.10214","DOIUrl":"https://doi.org/10.1017/ice.2025.10214","url":null,"abstract":"<p><strong>Objectives: </strong>Sponge-Sticks (SS) and ESwabs are frequently utilized for detection of multidrug-resistant organisms (MDROs) in the environment. Head-to-head comparisons of SS and ESwabs across recovery endpoints are limited.</p><p><strong>Design: </strong>We compared MDRO culture and non-culture-based recovery from (1) ESwabs, (2) cellulose-containing SS (CS), and (3) polyurethane-containing SS (PCS).</p><p><strong>Methods: </strong>Known quantities of each MDRO were pipetted on a stainless-steel surface and swabbed by each method. Samples were processed, cultured, and underwent colony counting. DNA was extracted from sample eluates, quantified, and underwent metagenomic next-generation sequencing (mNGS). MDROs underwent whole genome sequencing (WGS). MDRO recovery from paired patient perirectal and PCS-collected environmental samples from clinical studies was determined.</p><p><strong>Setting: </strong>Laboratory experiment, tertiary medical center, and long-term acute care facility.</p><p><strong>Results: </strong>Culture-based recovery varied across MDRO taxa, it was highest for vancomycin-resistant <i>Enterococcus</i> and lowest for carbapenem-resistant <i>Pseudomonas aeruginosa</i> (CRPA). Culture-based recovery was significantly higher for SS compared to ESwabs except for CRPA, where all methods performed poorly. Nucleic acid recovery varied across methods and MDRO taxa. Integrated WGS and mNGS analysis resulted in successful detection of antimicrobial resistance genes, construction of high-quality metagenome-assembled genomes, and detection of MDRO genomes in environmental metagenomes across methods. In paired patient and environmental samples, multidrug-resistant <i>Pseudomonas aeruginosa (</i>MDRP) environmental recovery was notably poor (0/123), despite detection of MDRP in patient samples (20/123).</p><p><strong>Conclusions: </strong>Our findings support the use of SS for the recovery of MDROs. Pitfalls of each method should be noted. Method selection should be driven by MDRO target and desired endpoint.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":3.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626237","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":"N95^® filtering facepiece respirator contamination with SARS-CoV-2 following reuse and extended use.","authors":"James S Ford, Ralph C Wang, Benjamin Stephenson, Nida F Degesys, Jahan Fahimi, Edward M Fisher, Delbert Harnish, Courtney M C Jones, Susan Peterson, Efrat Rosenthal, Richard Rothmann, Manish N Shah, Vaishal Tolia, Anna Q Yaffee, Katherine N Yoon, Maria C Raven","doi":"10.1017/ice.2025.92","DOIUrl":"https://doi.org/10.1017/ice.2025.92","url":null,"abstract":"<p><strong>Objective: </strong>During the COVID-19 pandemic, the United States Centers for Disease Control and Prevention provided strategies, such as extended use and reuse, to preserve N95 filtering facepiece respirators (FFR). We aimed to assess the prevalence of N95 FFR contamination with SARS-CoV-2 among healthcare personnel (HCP) in the Emergency Department (ED).</p><p><strong>Design: </strong>Real-world, prospective, multicenter cohort study. N95 FFR contamination (primary outcome) was measured by real-time quantitative polymerase chain reaction. Multiple logistic regression was used to assess factors associated with contamination.</p><p><strong>Setting: </strong>Six academic medical centers.</p><p><strong>Participants: </strong>ED HCP who practiced N95 FFR reuse and extended use during the COVID-19 pandemic between April 2021 and July 2022.</p><p><strong>Primary exposure: </strong>Total number of COVID-19-positive patients treated.</p><p><strong>Results: </strong>Two-hundred forty-five N95 FFRs were tested. Forty-four N95 FFRs (18.0%, 95% CI 13.4, 23.3) were contaminated with SARS-CoV-2 RNA. The number of patients seen with COVID-19 was associated with N95 FFR contamination (adjusted odds ratio, 2.3 [95% CI 1.5, 3.6]). Wearing either surgical masks or face shields over FFRs was not associated with FFR contamination, and FFR contamination prevalence was high when using these adjuncts [face shields: 25% (16/64), surgical masks: 22% (23/107)].</p><p><strong>Conclusions: </strong>Exposure to patients with known COVID-19 was independently associated with N95 FFR contamination. Face shields and overlying surgical masks were not associated with N95 FFR contamination. N95 FFR reuse and extended use should be avoided due to the increased risk of contact exposure from contaminated FFRs.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626238","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":"Epidemiologic validation of the National Healthcare Safety Network's updated <i>Clostridioides difficile</i> test method definition.","authors":"Nicholas A Turner, Barry Shelton, Becky A Smith, Linda Crane, Polly Padgette, Linda Roach, Brittain Wood, Diana Alame, Deverick J Anderson","doi":"10.1017/ice.2025.10222","DOIUrl":"10.1017/ice.2025.10222","url":null,"abstract":"<p><p>This longitudinal survey examined the effect of the National Healthcare Safety Network's (NHSN) recently updated <i>Clostridioides difficile</i> test method definition on reporting of hospital-onset <i>C. difficile</i>. Among six hospitals with ≥ 5 years of data available, the updated NHSN definition was associated with improved concordance between predicted versus reported cases.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":2.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Did universal masking during the COVID-19 pandemic reduce MRSA and MSSA acquisition in the NICU?","authors":"Meaghan Neary, Kathleen Quan, Thomas Tjoa, Cassiana E Bittencourt, Susan S Huang, Cherry Uy","doi":"10.1017/ice.2025.10209","DOIUrl":"https://doi.org/10.1017/ice.2025.10209","url":null,"abstract":"<p><strong>Objectives: </strong>To assess whether universal masking during the COVID-19 pandemic reduced neonatal acquisition of <i>S. aureus</i>.</p><p><strong>Study design: </strong>We performed a retrospective cohort study of neonates admitted to a level three regional NICU for three years before and after implementation of universal masking for the COVID-19 pandemic. Multivariable proportional hazards regression models evaluated the effect of masking on time-to-acquisition of methicillin-resistant and methicillin-sensitive <i>S. aureus</i> (MRSA and MSSA) while adjusting for fixed and time-varying neonatal characteristics.</p><p><strong>Results: </strong>We analyzed 2,728 neonates, 1,446 pre-pandemic and 1,282 post-pandemic; 84.9% were inborn, with mean gestational age of 34 weeks and 6 days (SD = 4.2) and mean birthweight of 2,500 grams (SD = 975). The mean number of screening cultures per neonate was 3.07 (SD = 3.31). When adjusting for covariates, universal masking was associated with decreased acquisition of MRSA (hazard ratio =0.43 (95% CI: 0.19-0.99), <i>p</i> = 0.04) but not MSSA (HR = 1.27 (95% CI: 00.87-1.85), <i>p</i> = 0.21). Among covariates, airway devices and maternal <i>S. aureus</i> status were associated with <i>S. aureus</i> acquisition.</p><p><strong>Conclusions: </strong>Universal masking decreased the rate of NICU MRSA acquisition by 60% while MSSA acquisition was unchanged. Masking may reduce MRSA spread via colonized healthcare personnel while MSSA may be more likely to be acquired from parental skin-to-skin contact and was thus unaffected by masking.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608260","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":"Modeling the impact of health care worker masking to reduce nosocomial SARS-CoV-2 transmission under varying adherence, prevalence, and transmission settings.","authors":"Timothy D Whiteley, James Stimson, Colin S Brown, Julie V Robotham, Stephanie Evans","doi":"10.1017/ice.2025.78","DOIUrl":"https://doi.org/10.1017/ice.2025.78","url":null,"abstract":"<p><strong>Objectives: </strong>To understand the scenarios where health care worker (HCW) masking is most impactful for preventing nosocomial transmission.</p><p><strong>Methods: </strong>A mathematical agent-based model of nosocomial spread with masking interventions. Masking adherence, community prevalence, disease transmissibility, masking effectiveness, and proportion of breakroom (unmasked) interactions were varied. The main outcome measure is the total number of nosocomial infections in patients and HCW populations over a simulated three-month period.</p><p><strong>Results: </strong>HCW masking around patients and universal HCW masking reduces median patient nosocomial infections by 15% and 18%, respectively. HCW-HCW interactions are the dominant source of HCW infections and universal HCW masking reduces HCW nosocomial infections by 55%. Increasing adherence shows a roughly linear reduction in infections. Even in scenarios where a high proportion of interactions are unmasked \"breakroom\" interactions, masking is still an effective tool assuming adherence is high outside of these areas. The optimal scenarios where masking is most impactful are those where community prevalence is at a medium level (around 2%) and transmissibility is high.</p><p><strong>Conclusions: </strong>Masking by HCWs is an effective way to reduce nosocomial transmission at all levels of mask effectiveness and adherence. Increases in adherence to a masking policy can provide a small but important impact. Universal HCW masking policies are most impactful should policymakers wish to target HCW infections. The more transmissible a variant in circulation is, the more impactful HCW masking is for reducing infections. Policymakers should consider implementing masking at the point when community prevalence is optimum for maximum impact.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505609","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}