Infection Control and Hospital Epidemiology最新文献

{"title":"Diagnostic yield of blood cultures in febrile neutropenia-a real-world observational study from an academic medical center during blood culture bottle shortage.","authors":"Yuanli Lei, Maria Alkozah, Rita Wilson Dib, Bibi Maryam, Brandon Mohler, Emily A Siegrist, Joseph Sassine","doi":"10.1017/ice.2025.10310","DOIUrl":"https://doi.org/10.1017/ice.2025.10310","url":null,"abstract":"<p><p>This single-center retrospective analysis evaluated the yield of blood cultures in patients with febrile neutropenia during a supply shortage. The detection rate of true bacteremia was observed to increase with the number of sets obtained, although this increase was not statistically significant. Findings support limiting repeat cultures within 48 hours.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":2.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258137","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":"Implementation of conditional reflex urine culturing decreases unnecessary antimicrobial use.","authors":"Aoi Yogo, Elie A Saade, Eric M Ransom, Brigid M Wilson, Timothy C Jenkins, Abhishek Deshpande, Curtis J Donskey, Zainab Albar, Lauren H Epstein, Leila S Hojat","doi":"10.1017/ice.2025.10309","DOIUrl":"https://doi.org/10.1017/ice.2025.10309","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of implementation of a conditional reflex urine culturing strategy on urine culture rates, antimicrobial use, and clinical outcomes in hospitalized adults.</p><p><strong>Design: </strong>Pre-post quasi-experimental study.</p><p><strong>Setting: </strong>Emergency departments and inpatient units within a large, integrated healthcare system in Northeast Ohio, comprising 10 medical centers.</p><p><strong>Patients: </strong>Adult patients with a urine culture ordered from June 1, 2018, to May 31, 2023.</p><p><strong>Methods: </strong>A system-wide intervention was implemented on June 1, 2020, requiring urinalysis (UA) with pyuria findings to trigger a urine culture order. We compared urine culture rates, antimicrobial use (measured by days of therapy [DOT] and days of antimicrobial spectrum coverage [DASC]), and clinical outcomes between pre-and post-intervention periods.</p><p><strong>Results: </strong>The intervention resulted in an 85.4% reduction in urine culture rates (0.54 vs 3.71 per 100 patient days). Antimicrobial use decreased, with DOT per 100 patient days dropping by 11.5% and DASC/DOT by 16.1%. No significant differences were observed in <i>Clostridioides difficile</i> infection rate, subsequent bloodstream infections with urinary pathogens, or mortality between pre- and post-intervention groups.</p><p><strong>Conclusions: </strong>A conditional reflex urine culturing strategy implemented as part of a diagnostic stewardship framework reduced urine culture and antimicrobial use without adverse clinical outcomes. This highlights the potential of diagnostic stewardship to optimize antimicrobial use in hospitalized adults.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":2.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258100","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":"Factors associated with healthcare personnel glove or gown contamination with MRSA: a cohort study of VA hospitals in 5 states.","authors":"Lyndsay M O'Hara, Lisa Pineles, Michelle Newman, Mary Bahr-Robertson, Gio J Baracco, Matthew Bidwell Goetz, Kevin S Ikuta, Christopher J Crnich, Suzanne F Bradley, Kathleen A Linder, Michael A Rubin, Karim Khader, Richard E Nelson, J Kristie Johnson, Eli N Perencevich, Martin E Evans, Anthony D Harris","doi":"10.1017/ice.2025.10253","DOIUrl":"https://doi.org/10.1017/ice.2025.10253","url":null,"abstract":"<p><strong>Objective: </strong>To determine the rate of healthcare personnel (HCP) glove or gown contamination with methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) and to estimate which patient care interactions and HCP roles are associated with greater contamination.</p><p><strong>Design: </strong>Multicenter cohort study.</p><p><strong>Setting: </strong>Five Veterans Affairs medical centers in the United States.</p><p><strong>Patients and participants: </strong>Patients with a positive MRSA clinical or surveillance culture within the past 7 days were enrolled. Five HCP in the room were observed for each patient. After completion of tasks and prior to room exit, HCP gloves and gowns were cultured separately.</p><p><strong>Results: </strong>We enrolled 799 patients and obtained 3,832 glove and gown cultures. Contamination of HCP gloves or gown with MRSA occurred 713 of 3,832 (18.6%) of the time, while 589 of 3,832 (15.4%) of interactions resulted in contamination of gloves, and 319 of 3,831 (8.3%) of interactions resulted in contamination of gowns. The gloves and gowns of physical therapists and occupational therapists were most frequently contaminated. Any interactions that involved touching the patient resulted in glove or gown contamination in 622 of 2,901 (21.4%) of observations, while touching only the environment resulted contamination in 91 of 931 (9.8%) of observations. Rates of glove or gown contamination were similar in the intensive care unit (ICU) and non-ICU.</p><p><strong>Conclusions: </strong>Contamination of HCP gloves and gowns with MRSA occurs frequently when caring for Veteran patients particularly when there is direct patient contact. Hospitals may consider optimizing contact precautions by using fewer precautions for low-risk interactions and more precautions for high-risk interactions.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-5"},"PeriodicalIF":2.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238601","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":"Speech intelligibility and hearing acuity assessments of N95/P2 respirator with under-mask elastic band beard cover.","authors":"Irene Ng, Benjamin Kave, Camille Paynter, Charles Bodas, Megan Roberts, Shan Hung, Daryl Lindsay Williams","doi":"10.1017/ice.2025.10297","DOIUrl":"https://doi.org/10.1017/ice.2025.10297","url":null,"abstract":"<p><strong>Objective: </strong>Using the Modified Rhyme Test in accordance with the National Institute for Occupational Safety and Health (NIOSH) protocol, we assessed the communication performance for both speech intelligibility and hearing acuity in bearded healthcare workers (HCWs) wearing a N95/P2 respirator with an under-mask elastic band beard cover.</p><p><strong>Design and setting: </strong>A prospective simulation study conducted at the respiratory fit test center of the Royal Melbourne Hospital.</p><p><strong>Participants: </strong>Bearded HCWs who required respiratory protection and could not shave for medical, cultural, or religious reasons.</p><p><strong>Results: </strong>The overall performance rating score was 91.3% and 99.8% for speech intelligibility and hearing acuity respectively. There was a reduction in the percentage of correct words perceived by a panel of trained listeners when bearded HCWs were speaking while wearing the N95/P2 respirator/elastic band combination compared to the uncovered beard condition (84.5% vs. 92.9%, <i>p</i> = 0.011). However, no significant difference was found in the perception of medical phrases between these two conditions. In the hearing assessment, there were no differences found in hearing correct single words or medical phrases between the two conditions.</p><p><strong>Conclusions: </strong>This study demonstrates that when bearded HCWs wore the N95/P2 respirator/elastic band combination, their speech intelligibility and hearing acuity greatly exceeded the NIOSH standard of 70% in the Modified Rhyme Test. This finding is crucial for ensuring effective communication among bearded HCWs, thereby supporting both respiratory protection and operational efficiency in healthcare settings.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206451","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 silencing automated penicillin cross-reactivity alerts on perioperative antibiotic prescribing and surgical site infection rates.","authors":"Michael J Durkin, Joshua Nordman, Alice Bewley, Andrew Atkinson, Jonas Marschall, Helen Newland, Kimberly G Blumenthal","doi":"10.1017/ice.2025.10311","DOIUrl":"https://doi.org/10.1017/ice.2025.10311","url":null,"abstract":"<p><p>We evaluated the impact of silencing penicillin cross-reactivity alerts on perioperative antibiotic prescribing and surgical site infections (SSIs) in 6 hospitals using an interrupted time series analysis. Silencing the alerts minimally increased cefazolin prescribing among penicillin allergy labeled patients (sensitivity analysis only; <i>P</i> = 0.03) and had no influence on SSIs (<i>P</i> = 0.32).</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185818","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":"Variability of multidrug-resistant organism reporting across Tennessee microbiology laboratories.","authors":"Matthew Lokant, Christopher Wilson, Thomas Talbot, Priscilla Pineda, Erin Hitchingham, Melphine Harriot, Raquel Villegas, Kaleb Wolfe, Milner Staub","doi":"10.1017/ice.2025.10212","DOIUrl":"https://doi.org/10.1017/ice.2025.10212","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185789","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":"Assessing blood culture appropriateness in solid organ transplant recipients: a diagnostic stewardship approach.","authors":"Julie M Steinbrink, Nitin Mehdiratta, Heather Pena, Ian Welsby, Amanda Seidenfeld, Adam DeVore, Matthew Ellis, Lindsay King, John Reynolds, Matthew Hartwig, Jacob Schroder, Debra Sudan, Barbara Alexander, Manuela Carugati, Jessica Seidelman","doi":"10.1017/ice.2025.10312","DOIUrl":"10.1017/ice.2025.10312","url":null,"abstract":"<p><strong>Objective: </strong>Diagnostic stewardship of blood culture utilization is important to mitigate the risks associated with unnecessary culturing. Although blood culture algorithms have been studied previously, there is a lack of data on their application among solid organ transplant (SOT) recipients. This study aims to retrospectively apply a blood culture algorithm (initially developed for a non-immunocompromised population) to adult SOT recipients and assess its performance.</p><p><strong>Methods: </strong>We conducted a manual retrospective review of adult SOT recipients with a blood culture event (BCE) between February 2022 and January 2024 at a single academic medical center. BCEs were categorized as appropriate, inappropriate, or lacking documentation, according to a previously established institutional blood culture algorithm.</p><p><strong>Results: </strong>Of 737 BCEs among adult SOT recipients, 185 (25%) were inappropriate. Within the subset of inappropriate BCEs, 178 (96%) yielded negative cultures, while 7 (4%) were deemed contaminants. No true positives were identified. Inappropriate BCEs were most commonly triggered by isolated fever and/or leukocytosis (136, 74%), and lower urinary tract infection (17, 9%). 17 of 18 BCEs due to donor blood culture positivity at the time of organ transplantation resulted in a negative blood culture in the recipient.</p><p><strong>Discussion: </strong>Once applied retrospectively, our institutional blood culture algorithm did not miss any true positive bloodstream infections among adult SOT recipients. This study provides initial evidence supporting the cautious application of blood culture diagnostic algorithms in adult SOT populations. Further prospective investigations are warranted to validate these findings.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":2.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185655","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":"Economic impact of multiple recurrent <i>Clostridioides difficile</i> infection in a community teaching hospital.","authors":"Joseph Reilly, Gemma Downham, Manish Trivedi","doi":"10.1017/ice.2025.10295","DOIUrl":"https://doi.org/10.1017/ice.2025.10295","url":null,"abstract":"<p><p>A retrospective study evaluating the economic impact on a community teaching hospital of 29 patients with multiple <i>Clostridioides difficile</i> infection admissions in a 4-year period showed an estimated net loss of $2,232,997, posing a substantial economic impact on the hospital.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185780","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 solution for dysfunctional dilution: real-time detection of malfunctioning automated disinfectant dispensers using colorimetric or hydrophobic wipes that indicate disinfectant concentrations.","authors":"Jennifer L Cadnum, Elizabeth C Eckstein, Abhishek Deshpande, Curtis J Donskey","doi":"10.1017/ice.2025.10263","DOIUrl":"https://doi.org/10.1017/ice.2025.10263","url":null,"abstract":"<p><p>Automated dispensers that dilute concentrated disinfectants with water are commonly used but can malfunction. We provide proof-of-principle that incorporating indicators into wipe products could be an effective method to provide environmental services staff with real-time visual indication that disinfectants are present and at correct concentrations with every use.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":2.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130747","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":"Associations between routine oral care and in-hospital mobility with non-ventilator hospital-acquired pneumonia.","authors":"Sheryl A Kluberg, Tom Chen, Rui Wang, Robert Jin, Laura DelloStritto, Dian Baker, Karen Giuliano, Edward J Septimus, Jeffrey S Guy, Russell E Poland, E Jackie Blanchard, Kenneth E Sands, Michael Klompas","doi":"10.1017/ice.2025.10245","DOIUrl":"https://doi.org/10.1017/ice.2025.10245","url":null,"abstract":"<p><strong>Objective: </strong>Non-ventilator hospital-acquired pneumonia (NV-HAP) is common and deadly. Guidelines recommend improving oral care and mobility performance to prevent NV-HAP but data on their impact are limited. We therefore evaluated associations between oral care and mobility performance with NV-HAP and mortality rates in a large hospital network.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>144 acute care hospitals.</p><p><strong>Patients: </strong>Adults hospitalized for ≥4 days between May 2021 and July 2023.</p><p><strong>Methods: </strong>We extracted daily data on oral care performance (yes, no) and patient mobility (bed-bound, upright, walking) and used time-varying Cox proportional hazards models to evaluate associations between oral care and mobility performance with NV-HAP and in-hospital mortality risk, adjusting for patients' demographics, comorbidities, hospital service, daily vital signs, and daily laboratory measures.</p><p><strong>Results: </strong>Among 1,744,811 hospitalizations (9.6 million hospital-days), median patient age was 68 (IQR 55-78) and 50.6% were female. Persistent oral care for ≥3 days was associated with 16% less NV-HAP (hazard ratio (HR) 0.84; 95% CI: 0.82-0.86) and 6% lower mortality (HR 0.94; 95% CI: 0.92-0.96), with stronger effects in the ICU than outside the ICU. Persistent walking for ≥3 days was associated with 18% less NV-HAP (HR 0.82; 95% CI: 0.79-0.85) and 80% lower hospital-mortality (HR 0.20; 95% CI: 0.19-0.21), with stronger effects outside the ICU than in the ICU.</p><p><strong>Conclusions: </strong>In a large hospital network, both oral care and mobility were associated with lower risk of NV-HAP and hospital mortality, with differential effects inside and outside of the ICU. Prospective trials are needed to confirm these potential benefits.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124686","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}