Infection Control and Hospital Epidemiology最新文献

{"title":"Getting real <i>clean</i>: a virtual reality training pilot study for cleaning and low-level disinfection of portable medical equipment.","authors":"Esteban A Barreto, Michelle S Jerry, Vianelly García, Chloe V Green, Andrea S Greenfield, Eileen F Searle, Erica S Shenoy","doi":"10.1017/ice.2025.89","DOIUrl":"https://doi.org/10.1017/ice.2025.89","url":null,"abstract":"<p><p>Portable medical equipment (PME) is inconsistently cleaned and disinfected, resulting in contamination that increases the risk of healthcare-associated infections. A virtual reality PME cleaning and disinfection training module was designed and tested at multiple healthcare facilities. Barriers identified during an initial phase led to improvements in the second phase.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":3.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266100","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":"Society for Healthcare Epidemiology of America (SHEA) infectious diseases fellow infection prevention and control and healthcare epidemiology curriculum.","authors":"Elise M Martin, Catherine Cichon, Rebecca Choudhury, Shandra R Day, Yasaman Fatemi, Vera P Luther, Terri Stillwell, Abby Sung","doi":"10.1017/ice.2025.85","DOIUrl":"https://doi.org/10.1017/ice.2025.85","url":null,"abstract":"<p><p>With the rapid expansion of the Infection Prevention Control/Healthcare Epidemiology (IPC/HE) fields over recent decades, the pivotal roles of IPC/HE in hospital regulation, quality improvement, patient safety, and healthcare finances have become increasingly apparent. Consequently, the demand for effective IPC/HE leaders has surged.^1,2 Training in IPC/HE is essential for all infectious diseases (ID) fellows (both adult and pediatric), including those planning a career in hospital epidemiology as well as those planning to focus on general ID, transplant, HIV, etc. ID fellows, however, have historically felt ill-prepared in IPC/HE. Joiner et al's survey highlighted this gap, revealing that only half of respondents felt adequately trained in infection control, despite half of them participating in infection control in their practice.³ IPC/HE fellow education is not currently standardized, and most IPC/HE training is led by individual mentors and healthcare facilities.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208471","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":"Visitation and universal masking impact to healthcare-associated respiratory viral infection rates in a freestanding children's hospital.","authors":"Kellie Rusin, Samuel R Dominguez, Kelly Pearce, Lori Silveira, Ann-Christine Nyquist, Sara R Saporta-Keating","doi":"10.1017/ice.2025.95","DOIUrl":"https://doi.org/10.1017/ice.2025.95","url":null,"abstract":"<p><p>Pediatric healthcare-associated respiratory viral infections (HA-RVI) were evaluated during four intervention periods using different visitation models. Allowing two visitors and requiring universal masking significantly decreased HA-RVI rates (<i>P</i> < .001). There was no significant difference in HA-RVI rates between periods restricting younger siblings versus periods allowing all siblings without seasonal/age restriction.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":3.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208472","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":"Whole-genome sequencing surveillance of vancomycin-resistant <i>Enterococcus faecium</i> (VRE) detects hospital outbreaks and identifies the postanesthesia care unit as a transmission locus.","authors":"Sarah M Schrader, Meghan A Baker, Chanu Rhee, Michael Klompas, Samantha Taffner, Zachary Pearson, Jay Worley, Lynn Bry, Sanjat Kanjilal, Manfred Brigl, Nicole D Pecora","doi":"10.1017/ice.2025.68","DOIUrl":"https://doi.org/10.1017/ice.2025.68","url":null,"abstract":"<p><strong>Objective: </strong>Vancomycin-resistant enterococci (VRE) can cause serious healthcare-associated infections. Patients can become colonized and infected through contact with healthcare workers, hospital surfaces, equipment, and other patients. We evaluated the utility of broadly applied whole-genome sequencing (WGS) surveillance of vancomycin-resistant <i>Enterococcus faecium</i> (VREfm) for detection of hospital-based transmission.</p><p><strong>Design: </strong>Retrospective genomic and epidemiologic analysis of clinical VREfm isolates.</p><p><strong>Setting: </strong>Brigham and Women's Hospital, an 800-bed tertiary care center in Boston, MA, USA.</p><p><strong>Methods: </strong>VREfm was isolated from patient screening and diagnostic specimens. We sequenced the genomes of 156 VREfm isolates, 12 at the request of infection control and 144 as a convenience sample, and used single nucleotide polymorphism (SNP) differences to assess relatedness. For isolate pairs separated by 15 or fewer SNPs by two orthogonal comparison methods, we mapped epidemiologic connections to identify putative transmission clusters.</p><p><strong>Results: </strong>We found evidence for 16 putative transmission clusters comprising between two and four isolates each and involving 41/156 isolates (26.3%). Our analysis discovered 14 clusters that were missed by traditional surveillance methods and additional members of two clusters that were detected by traditional methods. Patients in four transmission clusters were linked only by exposure to the postanesthesia care unit.</p><p><strong>Conclusions: </strong>We show that WGS surveillance for VREfm can support infection control investigations and detect transmission events missed by routine surveillance methods. We identify the postanesthesia care unit as a locus for VREfm transmission, which demonstrates how WGS surveillance could inform targeted interventions to prevent the spread of VREfm.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":3.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208473","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":"Comparative performance of sponge versus flocked swabs for culture-based and metagenomic detection of microbial contamination in the healthcare environment.","authors":"Matthew J Ziegler, Sean Loughrey, Selamawit Bekele, Elizabeth Huang, Pam Tolomeo, Michael Z David, Ebbing Lautenbach, Laurel J Glaser, Brendan J Kelly","doi":"10.1017/ice.2025.87","DOIUrl":"https://doi.org/10.1017/ice.2025.87","url":null,"abstract":"<p><strong>Background: </strong>Identifying optimal methods for sampling surfaces in the healthcare environment is critical for future research requiring the identification of multidrug-resistant organisms (MDROs) on surfaces.</p><p><strong>Methods: </strong>We compared 2 swabbing methods, use of a flocked swab versus a sponge-stick, for recovery of MDROs by both culture and recovery of bacterial DNA via quantitative 16S polymerase chain reaction (PCR). This comparison was conducted by assessing swab performance in a longitudinal survey of MDRO contamination in hospital rooms. Additionally, a laboratory-prepared surface was also used to compare the recovery of each swab type with a matching surface area.</p><p><strong>Results: </strong>Sponge-sticks were superior to flocked swabs for culture-based recovery of MDROs, with a sensitivity of 80% compared to 58%. Similarly, sponge-sticks demonstrated greater recovery of <i>Staphylococcus aureus</i> from laboratory-prepared surfaces, although the performance of flocked swabs improved when premoistened. In contrast, recovery of bacterial DNA via quantitative 16S PCR was greater with flocked swabs by an average of 3 log copies per specimen.</p><p><strong>Conclusions: </strong>The optimal swabbing method of environmental surfaces differs by method of analysis. Sponge-sticks were superior to flocked swabs for culture-based detection of bacteria but inferior for recovery of bacterial DNA.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149917","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":"Risk factors for catheter-related bloodstream infections in a high-risk cancer patient population.","authors":"Andrea Haddad, Rita Wilson Dib, Anne-Marie Chaftari, Ying Jiang, Mohamed Moussa, Hiba Dagher, Ann Philip, Ray Hachem, Issam Raad","doi":"10.1017/ice.2025.45","DOIUrl":"https://doi.org/10.1017/ice.2025.45","url":null,"abstract":"<p><p>To identify risk factors for catheter-related bloodstream infections (CRBSI) in cancer patients, we compared 200 CRBSI cases to 400 controls. Neutropenia, transplants, multiple catheters, blood products, and basilic/cephalic PICCs increased CRBSI risk, while jugular insertion was protective. Catheter site selection can reduce risk. Other targeted strategies are warranted.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":3.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142468","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":"The association between the practice of oral care and the incidence of hospital-acquired pneumonia in intensive care medicine.","authors":"Xiaoqiang Lv, Jun Yang, Li Wang, Li Tong, Fu Ding","doi":"10.1017/ice.2025.91","DOIUrl":"https://doi.org/10.1017/ice.2025.91","url":null,"abstract":"<p><strong>Background: </strong>Hospital-acquired pneumonia (HAP) represents one of the most common nosocomial infections in intensive care units (ICUs), accounting for 25% of all hospital-acquired infections. While oral care is recommended as a preventive measure, the relationship between standardized oral care practices and HAP incidence remains incompletely characterized.</p><p><strong>Objective: </strong>To evaluate the association between oral care practice compliance and HAP incidence in ICU patients, and to identify specific aspects of oral care delivery that influence outcomes.</p><p><strong>Methods: </strong>We conducted a prospective mixed-methods observational cohort study from May 2021 across seven ICUs in a tertiary hospital in China. The study utilized a two-phase approach: (1) systematic assessment of oral care implementation through structured observation of nursing staff (n = 58), and (2) prospective evaluation of HAP outcomes in patients (n = 142). Primary outcomes included oral care compliance metrics and HAP incidence. HAP was defined according to standardized clinical criteria and confirmed by two independent physicians.</p><p><strong>Results: </strong>Among 142 unique patients, 63 (44.37%) received oral care orders. The oral care completion rate was 61.93%, and the qualification rate was 54.13%. In our analysis, HAP (including both ventilator-associated pneumonia [VAP] and non-ventilator hospital-acquired pneumonia [NVHAP]) occurred in 15/63 (23.81%) patients receiving oral care and 22/79 (27.85%) patients without oral care. Multivariate analysis revealed that incomplete oral care (adjusted OR 2.47, [95% CI, 1.15-4.45], <i>P</i> = 0.009), non-qualified care techniques (adjusted OR 3.17, [95% CI, 1.45-6.35], <i>P</i> = 0.002), and inadequate item qualification (adjusted OR 3.33, [95% CI, 1.47-6.55], <i>P</i> = 0.001) were independently associated with increased HAP risk, after adjusting for confounders. Stratified analysis showed similar associations in both VAP and NVHAP subgroups.</p><p><strong>Conclusion: </strong>Our investigation demonstrated that suboptimal oral care practices were associated with increased HAP risk in ICU patients. Implementation of evidence-based standardized protocols and improved adherence strategies may help reduce HAP incidence.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109790","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":"Usage of oral vancomycin for acute <i>Clostridioides difficile</i> infection (CDI) resulting in later acquisitions of vancomycin-resistant enterococci (VRE).","authors":"Evgeny Rogozin, Husam Maree, Majdi Masarwi, Rozan Hasona, Herschel T Horowitz, Ruth Bouganim, Dror Marchaim","doi":"10.1017/ice.2025.81","DOIUrl":"https://doi.org/10.1017/ice.2025.81","url":null,"abstract":"<p><strong>Objective: </strong>Therapeutic guidelines for <i>Clostridioides difficile</i> infections (CDI) were revised a few years ago, promoting the usage of oral vancomycin even for primary mild infections. Vancomycin-resistant enterococci (VRE) is one of the worldwide most significant pathogens. Our study aim was to explore the independent association between oral vancomycin treatment for CDI, and subsequent VRE acquisitions.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Academic 904-bed general hospital (Shamir Medical Center, Israel).</p><p><strong>Patients: </strong>Adult (>18 yr) inpatients with primary CDI and no prior VRE.</p><p><strong>Methods: </strong>Study was conducted for calendar years 2016-2020. Logistic regression was used to model-independent predictors for VRE acquisitions. A propensity score (PS)-matched analysis (logistic regression) of the risk of receiving oral vancomycin was conducted to further eliminate potential confounders.</p><p><strong>Results: </strong>Overall, 606 patients were included (54% females), with a median age of 75 (IQR = 65-85) years. Independent predictors for VRE acquisition were oral vancomycin as a main therapy (aOR = 4.3, <i>P</i> < 0.001), exposure to systemic vancomycin in the previous 3 months (aOR = 3.2, <i>P</i> < 0.001), dependent functional status (aOR = 2.3, <i>P</i> = 0.006), and diabetes (aOR = 1.8, <i>P</i> = 0.04). After controlling for the PS, the independent association between oral vancomycin and later VRE acquisition remained significant in the regression model (aOR = 3.6, <i>P</i> < 0.01) and per PS matched-pairs analysis (aOR = 4.4, <i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>Oral vancomycin administered for CDI had a strong independent association with later VRE acquisitions. This finding could promote stewardship interventions in an effort to reduce the usage of oral vancomycin for certain CDI indications, leading to improved CDI management, while curbing the continued emergence of VRE at hospitals.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077733","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":"Reducing inappropriate antibiotic use in febrile neutropenia in hematology patients through the implementation of an antibiotic de-escalation protocol.","authors":"Jinghao Nicholas Ngiam, Victor Ling, Matthew Chung Yi Koh, Mohamed Nasar Fathima Rofina Farveen, Shi Hui Clarice Choong, Li Mei Michelle Poon, Liang Piu Koh, Nares Smitasin, Lionel Hon-Wai Lum","doi":"10.1017/ice.2025.90","DOIUrl":"https://doi.org/10.1017/ice.2025.90","url":null,"abstract":"<p><strong>Background: </strong>Broad-spectrum antibiotic use in febrile neutropenia is often driven by concerns for severe and drug-resistant infections. In select patients who do not have an active infection and improve, their prolonged and unnecessary use contributes to antimicrobial resistance, drug toxicity, and increased healthcare costs. We describe the implementation of an antibiotic de-escalation protocol to reduce inappropriate antibiotic use in febrile neutropenia among hematology patients.</p><p><strong>Methods: </strong>We conducted baseline analysis (January-June 2024) of antibiotic use in febrile neutropenia cases admitted under hematology. Interventions included the (i) development of an antibiotic de-escalation protocol to guide clinical management, (ii) a roadshow to educate and improve uptake of this protocol, and (iii) regular feedback via \"report cards\" for hematology teams. The primary outcome was the proportion of febrile neutropenia cases with inappropriate antibiotic use, with secondary measures including adverse outcomes (in-hospital mortality, <i>Clostridioides difficile</i> infection, need for intensive care).</p><p><strong>Results: </strong>Baseline data indicated inappropriate antibiotic use rates of 45.5-66.7% per month from January to June 2024, with 13-28 days of inappropriate therapy. The protocol was developed in July 2024, with a subsequent roadshow to promote its uptake. Regular feedback was provided in the form of \"report cards\" every 2-monthly thereafter. Post-intervention, inappropriate antibiotic use decreased to a median of 23.35% from July to December 2024, with no observed increase in adverse outcomes.</p><p><strong>Conclusions: </strong>The implementation of a structured de-escalation protocol, combined with frequent education and feedback, effectively reduced inappropriate antibiotic use in febrile neutropenia without compromising patient safety.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077662","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":"Electronic clinical decision support system guided blood culture stewardship in emergency departments: response to the national blood culture media shortage.","authors":"Kullaya Takkavatakarn, Gopi Patel, Wonsuk Oh, Melissa Gitman, Michael Nowak, Brendan Connell, Jonathan Nover, Lili Chan, Girish Nadkarni, Roopa Kohli-Seth, Nicholas Gavin, Bernard Camins, Ankit Sakhuja","doi":"10.1017/ice.2025.83","DOIUrl":"https://doi.org/10.1017/ice.2025.83","url":null,"abstract":"<p><p>CDSS-guided stewardship in six EDs during national culture bottles shortage was associated with significant reduction in median daily blood culture utilization per 1,000 ED visits from 141.5 (IQR:127.6-155.3) to 77.9 (IQR:68.3-86.3) and increased diagnostic yield from 6.2%(IQR:4.7%-7.6%) to 8.8%(IQR:6.1%-11.5%), without impacting length of stay or mortality.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077724","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}