Infection Control and Hospital Epidemiology最新文献

{"title":"Incorporating microbial cell-free DNA testing into healthcare-associated invasive fungal infection surveillance: benefits and challenges.","authors":"Daniel Z Uslan, Ishminder Kaur, Omai B Garner, Shangxin Yang","doi":"10.1017/ice.2025.48","DOIUrl":"https://doi.org/10.1017/ice.2025.48","url":null,"abstract":"<p><p>Surveillance by clinical epidemiology teams for invasive fungal infections (IFIs) in healthcare settings can be challenging due to several factors including low sensitivity of noninvasive conventional microbiologic diagnostics, nonspecific clinical presentation, and complex patient populations. Recently, availability of microbial cell-free DNA testing (cfDNA) via the Karius Test has shown promise for increased diagnostic sensitivity of IFIs. However, how to best incorporate cfDNA results into IFI surveillance remains a vexing challenge. Herein, we provide perspectives on the benefits and challenges of use of cfDNA for IFI surveillance.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":3.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780051","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":"Prevalence and predictors of multidrug resistant organism infections in critically ill patients with opioid use disorder: a multicenter retrospective cohort study.","authors":"Zeeshan M Rizwan, Haris Akhtar, Julie L Cunningham, Kristin C Cole, John C O'Horo, Ognjen Gajic, Ryan W Stevens","doi":"10.1017/ice.2025.64","DOIUrl":"https://doi.org/10.1017/ice.2025.64","url":null,"abstract":"<p><strong>Objective: </strong>Patients with Opioid Use Disorder (OUD) are prone to Multidrug-Resistant Organism (MDRO) colonization and infections, thus at risk for worse outcomes during critical illness. Understanding the prevalence and predictors of MDRO infections is essential to optimize interventions and treatments.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>The study evaluated the prevalence of MDRO isolation among adults with OUD admitted to an intensive care unit (ICU) between January 1, 2018, and July 31, 2023. It included adults admitted to an ICU with bacterial infections and positive cultures obtained within 48 hours of admission. Demographics, clinical traits, and MDRO isolation rates were analyzed using descriptive statistics, univariate methods, and Least Absolute Shrinkage and Selection Operator (LASSO) regression.</p><p><strong>Results: </strong>MDRO isolation occurred in 178 of 790 patients (22.5%), with methicillin-resistant <i>Staphylococcus aureus</i> as the most frequently isolated organism. LASSO regression identified housing insecurity (OR: 1.79, 95% CI 1.09-2.93, <i>P</i> = .022), no receipt of medications for OUD treatment (OR: 1.56, 95% CI 1.06-2.29, <i>P</i> = .023), positive hepatitis C virus (HCV) status (OR: 2.19, 95% CI 1.19-4.03, <i>P</i> = .012), and intravenous antibiotic use in the prior 90 days (OR: 1.04 per 24 h, 95% CI 1.01-1.07, <i>P</i> = .007) as significant predictors of MDRO isolation.</p><p><strong>Conclusions: </strong>The study highlights a high prevalence of MDRO isolation in critically ill OUD patients admitted for infection-related issues with positive cultures obtained within 48 hours of admission, influenced by factors like housing insecurity, no receipt of medications for OUD treatment, HCV status, and prior antibiotic use.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780052","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":"Ceiling-mounted far-UVC fixtures reduce the surface bioburden in occupied clinical areas.","authors":"Emilie Hage Mogensen, Jacob Thyrsted Jensen, Søren Helbo Skaarup, Andreas Fløe Hvass, Cecilie Lynggaard Jeppesen, Maja Holst Rasmussen, Birgit Thorup Røge, Sara Moeslund Joensen, Stine Yde Nielsen, Elisabeth Bendstrup, Pernille Hauschildt, Anne Friesgaard Christensen, Christian Kanstrup Holm","doi":"10.1017/ice.2025.62","DOIUrl":"https://doi.org/10.1017/ice.2025.62","url":null,"abstract":"<p><p>Contaminated surfaces in clinics pose a pathogen transmission risk. Far ultraviolet-C light (UVC), with a favorable safety profile for human exposure, has the potential for continuous pathogen inactivation in occupied clinical areas. This study demonstrated real-world bioburden reduction on surfaces, despite frequent contamination from routine use by staff and patients in clinics.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":3.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771713","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":"Infection prevention and control practices among pediatric family caregivers during respiratory viral season and an enteric outbreak.","authors":"Aparna Darbha, Meghan Engbretson, Nisha Thampi","doi":"10.1017/ice.2025.53","DOIUrl":"https://doi.org/10.1017/ice.2025.53","url":null,"abstract":"<p><p>We audited family caregivers' hand hygiene (HH) and masking practices at a pediatric tertiary care center during a period of increased community viral circulation and an enteric outbreak. Observed HH rates were below 5%, whereas masking was above 90%. Awareness of practices can inform strategies in caregiver infection prevention education.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":3.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772064","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":"Nosocomial or community-acquired? A comparison of healthcare-associated infection definitions and maximum incubation periods of common respiratory viral infections at a large academic hospital.","authors":"Dalton R Butcher, Lauren DiBiase, Emily Sickbert-Bennett","doi":"10.1017/ice.2025.43","DOIUrl":"https://doi.org/10.1017/ice.2025.43","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-2"},"PeriodicalIF":3.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772066","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":"Restoring the 2-set blood culture practice after the resolution of supply shortage.","authors":"Shogo Hanai, Chiyo Shintani, Yuki Higashimoto, Yuki Uehara, Yohei Doi, Hitoshi Honda","doi":"10.1017/ice.2025.60","DOIUrl":"https://doi.org/10.1017/ice.2025.60","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":3.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772160","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":"Comparison of Medicare claims-based <i>Clostridioides difficile</i> infection epidemiologic case classification algorithms to medical record review by the Emerging Infections Program using a linked cohort, 2016-2021.","authors":"Dustin W Currie, Chantal Lewis, Joseph D Lutgring, Sophia V Kazakova, James Baggs, Lauren Korhonen, Maria Correa, Dana Goodenough, Danyel M Olson, Jill Szydlowski, Ghinwa Dumyati, Scott K Fridkin, Christopher Wilson, Alice Y Guh, Sujan C Reddy, Kelly M Hatfield","doi":"10.1017/ice.2024.204","DOIUrl":"https://doi.org/10.1017/ice.2024.204","url":null,"abstract":"<p><strong>Background: </strong>Medicare claims are frequently used to study <i>Clostridioides difficile</i> infection (CDI) epidemiology. However, they lack specimen collection and diagnosis dates to assign location of onset. Algorithms to classify CDI onset location using claims data have been published, but the degree of misclassification is unknown.</p><p><strong>Methods: </strong>We linked patients with laboratory-confirmed CDI reported to four Emerging Infections Program (EIP) sites from 2016-2021 to Medicare beneficiaries with fee-for-service Part A/B coverage. We calculated sensitivity of ICD-10-CM codes in claims within ±28 days of EIP specimen collection. CDI was categorized as hospital, long-term care facility, or community-onset using three different Medicare claims-based algorithms based on claim type, ICD-10-CM code position, duration of hospitalization, and ICD-10-CM diagnosis code presence-on-admission indicators. We assessed concordance of EIP case classifications, based on chart review and specimen collection date, with claims case classifications using Cohen's kappa statistic.</p><p><strong>Results: </strong>Of 12,671 CDI cases eligible for linkage, 9,032 (71%) were linked to a single, unique Medicare beneficiary. Compared to EIP, sensitivity of CDI ICD-10-CM codes was 81%; codes were more likely to be present for hospitalized patients (93.0%) than those who were not (56.2%). Concordance between EIP and Medicare claims algorithms ranged from 68% to 75%, depending on the algorithm used (κ = 0.56-0.66).</p><p><strong>Conclusion: </strong>ICD-10-CM codes in Medicare claims data had high sensitivity compared to laboratory-confirmed CDI reported to EIP. Claims-based epidemiologic classification algorithms had moderate concordance with EIP classification of onset location. Misclassification of CDI onset location using Medicare algorithms may bias findings of claims-based CDI studies.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-9"},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709786","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":"Exploring social vulnerability in National Health Safety Network surgical site infections.","authors":"Michael Dewitt, Caroline Reinke, Michael Inman, Werner Bischoff, Shelley Kester, Anupama Neelakanta, Mindy Sampson, Catherine Passaretti","doi":"10.1017/ice.2025.52","DOIUrl":"https://doi.org/10.1017/ice.2025.52","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between social vulnerability index (SVI) and surgical site infections (SSIs) using National Healthcare Safety Network (NHSN) criteria.</p><p><strong>Design: </strong>Retrospective cohort study between August 1, 2022, and August 31, 2023.</p><p><strong>Setting: </strong>In total, 20 acute care hospitals in the Southeast United States.</p><p><strong>Patients: </strong>Totally, 23,768 total hip arthroplasty, total knee arthroplasty, abdominal hysterectomy, colon, and spinal fusion surgeries in 22,239 patients were included. Procedures with infection present at the time of surgery or incomplete geographic tracking data were excluded.</p><p><strong>Methods: </strong>Patient addresses as noted in the electronic health record were geocoded to determine census tract of residence and determine SVI. Demographic and clinical data were linked with SVI scores. SSIs were identified according to NHSN criteria. SVI was categorized into quartiles, and logistic regression was used to evaluate the association between SVI quartile (overall and for each SVI theme) and SSI risk. Subgroup analyses by procedure type and race were performed. Multivariable models of the association between overall SVI and SSI were adjusted for demographic and clinical factors.</p><p><strong>Results: </strong>Patients in the top SVI quartiles had significantly higher odds of developing SSIs after adjusting for other clinical and demographic factors. Increased risk was found for socioeconomic status and household characteristics themes, but not for the racial/ethnic minority theme. Association between SVI and SSI risk varied by type of surgery.</p><p><strong>Conclusions: </strong>Living in an area with a higher SVI is associated with increased SSI risk. Targeted interventions are needed to mitigate these disparities and improve outcomes.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709794","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":"Weekend effect on blood culture contamination: an observational study at a university hospital in Japan.","authors":"Kazuhiko Nakaharai, Yoichi Shinozaki, Taku Tamura, Yasushi Nakazawa, Masaki Yoshida","doi":"10.1017/ice.2025.44","DOIUrl":"https://doi.org/10.1017/ice.2025.44","url":null,"abstract":"<p><strong>Background: </strong>An association between weekend/off-hour care and unfavorable clinical outcomes has been observed, commonly called the \"weekend effect.\" In the present study, we examined whether there was a weekend effect associated with blood culture (BC) contamination, which can lead to inappropriate medical resource consumption.</p><p><strong>Methods: </strong>We conducted a single-center retrospective observational study using data from BC tests performed on adult patients. The primary outcome was the incidence of BC contamination, which was compared between weekend and weekday sampling groups. In a multivariable logistic analysis, we evaluated the association between weekend sampling and the incidence of BC contamination.</p><p><strong>Results: </strong>The analysis included 7,597 weekend and 50,655 weekday BC sets from 1 January 2013 to 31 December 2019. The proportion of BC contamination during the study period was 1.15% (87/7,597) and 0.80% (405/50,655) in the weekend and weekday groups, respectively. In the logistic regression analysis adjusted for blood sampling settings, weekend sampling was significantly associated with increased BC contamination (odds ratio, 1.36; 95% confidence interval, 1.06-1.71).</p><p><strong>Conclusions: </strong>This study highlighted a significant association between weekend blood sampling for BC and an increased incidence of contamination. To provide better-quality care, further studies evaluating the differences in staffing and blood collection processes on weekends and weekdays are warranted.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709795","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":"Development and validation of two novel antibiotic use metrics suitable for facilities and practitioners in post-acute and long-term care settings.","authors":"Sunah Song, Brigid Wilson, Taissa A Bej, Corinne Kowal, Federico Perez, David A Nace, Taylor Boyer, Katie J Suda, Charlesnika T Evans, Aoife Fleming, Robin L P Jump","doi":"10.1017/ice.2025.42","DOIUrl":"https://doi.org/10.1017/ice.2025.42","url":null,"abstract":"<p><strong>Objective: </strong>Many post-acute and long-term care settings (PALTCs) struggle to measure antibiotic use via the standard metric, days of therapy (DOT) per 1000 days of care (DOC). Our objective was to develop antibiotic use metrics more tailored to PALTCs.</p><p><strong>Design: </strong>Retrospective cohort study with a validation cohort.</p><p><strong>Setting: </strong>PALTC settings within the same network.</p><p><strong>Methods: </strong>We obtained census data and pharmacy dispensing data for 13 community PALTCs (January 2020-December 2023). We calculated antibiotic DOT/1000 DOC, DOT per unique residents, and antibiotic starts per unique residents, at monthly intervals for community PALTCs. The validation cohort was 135 Veterans Affairs Community Living Centers (VA CLCs). For community PALTCs only, we determined the DOT and antibiotics starts per unique residents cared for by individual prescribers.</p><p><strong>Results: </strong>For community PALTCs, the correlation between facility-level antibiotic DOT/1000 DOC and antibiotic DOT/unique residents and antibiotic courses/unique residents was 0.97 (<i>P</i> < 0.0001) and 0.84 (<i>P</i> < 0.0001), respectively. For VA CLCs, those values were 0.96 (<i>P</i> < 0.0001) and 0.85 (<i>P</i> < 0.0001), respectively. At community PALTCs, both novel metrics permitted assessment and comparison of antibiotic prescribing among practitioners.</p><p><strong>Conclusion: </strong>At the facility level, the novel metric antibiotic DOT/unique residents demonstrated strong correlation with the standard metric. In addition to supporting tracking and reporting of antibiotic use among PALTCs, antibiotic DOT/unique residents permits visualization of the antibiotic prescribing rates among individual practitioners, and thus peer comparison, which in turn can lead to actionable feedback that helps improve antibiotic use in the care of PALTC residents.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709792","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}