Infection Control and Hospital Epidemiology最新文献

{"title":"Caution against using plasma mNGS for NHSN CLABSI surveillance.","authors":"Zoe F Weiss, Eliezer Zachary Nussbaum, Bhavarth Shukla, Shira Doron, Kap Sum Foong","doi":"10.1017/ice.2025.10301","DOIUrl":"https://doi.org/10.1017/ice.2025.10301","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-2"},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113041","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 the impact of an electronic health record intervention on testing and treatment for asymptomatic bacteriuria in older adults.","authors":"Eleanor E A Smith, Sabra Shay, Kady Phe, Andrei Zidaru, Barbara W Trautner, Mayar Al Mohajer","doi":"10.1017/ice.2025.10296","DOIUrl":"https://doi.org/10.1017/ice.2025.10296","url":null,"abstract":"<p><p>We developed an intervention to update the indications on a urinalysis and urine culture order set according to recent guidelines recommending against testing and treatment for bacteriuria in older adults with altered mental status or falls. The intervention had no impact on diagnostic or antibiotic stewardship.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080612","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 implementation of World Health Organization National Action Plans on antibiotic rates: a time series analysis of 37 countries.","authors":"Tate William Miner, Katherine Callaway Kim, Scott Rothenberger, Shanzeh Chaudhry, Mina Tadrous, Katie J Suda","doi":"10.1017/ice.2025.10293","DOIUrl":"10.1017/ice.2025.10293","url":null,"abstract":"<p><p>We conducted an interrupted time series analysis to assess changes in antibiotic sales in 37 countries that implemented National Action Plans (NAPs) between 2013 and 2018. Overall, NAP implementation was not associated with changes in antibiotic sales two years later, with country-specific effects ranging from a 38.3% decrease to 65.3% increase.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":2.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080642","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":"Evaluating the prevention potential of hospital-onset bacteremia in real-life setting.","authors":"Yael Pri-Paz Basson, Hadar Mudrik-Zohar, Pnina Shitrit","doi":"10.1017/ice.2025.10298","DOIUrl":"https://doi.org/10.1017/ice.2025.10298","url":null,"abstract":"<p><p>We calculated the prevention potential of nosocomial bacteremia and compared it to qualitative assessments by treating departments and Infection Control Unit. Most cases had high preventability scores. Agreement with treating departments was low, highlighting a gap in recognition of preventable factors and the need to improve awareness and prevention practices.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075330","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 comprehensive assessment of post-discharge antibiotic use across an integrated healthcare system.","authors":"Daniel J Livorsi, Matthew Bidwell Goetz, Bruce Alexander, Brice Beck, Shylo E Wardyn, Sarah C Murray, Michihiko Goto","doi":"10.1017/ice.2025.10230","DOIUrl":"https://doi.org/10.1017/ice.2025.10230","url":null,"abstract":"<p><strong>Objective: </strong>Antibiotics prescribed at hospital discharge are difficult to capture electronically for surveillance purposes unless patients are discharged to home with oral antibiotics. Our goal was to estimate the proportion of post-discharge antibiotics that are administered either in post-acute care facilities or via outpatient parenteral antibiotic therapy (OPAT) programs among patients discharged from Veterans Health Administration (VHA) hospitals.</p><p><strong>Design: </strong>We performed a retrospective study of all acute-care VHA admissions discharged during 2018-2021. The primary outcome was post-discharge antibiotic length of therapy, defined as the number of days of antibiotic exposure prescribed or recommended by inpatient providers at hospital discharge. Data on post-discharge antibiotic use was measured electronically for some discharge locations and estimated by performing manual chart reviews in randomly selected cases discharged to other locations.</p><p><strong>Setting: </strong>129 VHA hospitals.</p><p><strong>Results: </strong>There were 1,972,940 admissions, and 42.6% received inpatient antibiotics; 89.8% of patients were discharged to the community and 10.2% to post-acute care. The frequency of receiving post-discharge antibiotics varied by discharge location. Based on our calculations, 32.8% of all post-discharge days of antibiotic exposure occurred in post-acute care or via OPAT. Overall, 43.9% of all hospital-associated days of antibiotic exposure were administered during the hospital stay and the remaining 56.1% qualified as post-discharge.</p><p><strong>Conclusions: </strong>A third of all post-discharge antibiotics were dispensed in post-acute care facilities or by OPAT programs. These findings have implications for comparing hospitals on their post-discharge antibiotic use, because antibiotic data for patients discharged to these locations is often missing or difficult to collect.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":2.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075362","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":"Diagnostic stewardship cutoffs for urinalysis results prior to performing a urine culture: analysis of data from a healthcare system.","authors":"Deborah Kahler Kupferwasser, Amy Y Kang, Michael Bolaris, Holly Huse, Liz Chen, Loren Miller","doi":"10.1017/ice.2025.10265","DOIUrl":"https://doi.org/10.1017/ice.2025.10265","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections are commonly overdiagnosed. To minimize overdiagnosis, some laboratories utilize reflex algorithms that use urinalyses as preliminary screening before potentially proceeding to urine culture. However, the optimal urinalysis cutoffs for this diagnostic stewardship intervention remain poorly defined.</p><p><strong>Methods: </strong>We performed a retrospective, cross-sectional analysis from 2/1/21-1/31/23 in the Los Angeles County Department of Health Services healthcare system. We examined patient encounters in which urinalysis was ordered synchronously with urine culture. We categorized urine culture isolates as uropathogens or non-uropathogens. We calculated receiver operating characteristic curves of urinalysis parameters' ability, singularly or in combination, to identify uropathogens.</p><p><strong>Results: </strong>Among 80,949 paired urinalysis and urine cultures (17,488 inpatient, 20,716 emergency department, 42,745 outpatient), cultures yielded 35% (<i>n</i> = 28,993) uropathogens, 4% (<i>n</i> = 2960) non-uropathogens, 37% (<i>n</i> = 29,951) contaminants, and 24% (<i>n</i> = 19,045) no growth. Among urinalysis parameters, white blood cells (WBCs) had the highest diagnostic accuracy (area under the curve (AUC)=0.722, [95% CI 0.718-0.725]), followed by leukocyte esterase (AUC = 0.700, [95% CI 0.690-0.701]), bacteria (AUC = 0.673, [95% CI 0.670-0.677]), nitrite (AUC = 0.627, [95% CI 0.625-0.630]), and squamous epithelial cells (AUC = 0.530, [95% CI 0.526-0.534]). WBC AUC values were consistent across healthcare settings (outpatient, emergency department, and inpatient). The urinalysis parameter combination with the highest AUC, WBC plus bacteria, performed worse than WBCs alone (AUC = 0.711 vs. AUC = 0.722, <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>WBC on microscopic urinalysis demonstrated the highest diagnostic accuracy for predicting uropathogens in urine cultures. Stewardship programs should consider prioritizing urinalysis WBC count as the screening tool to optimize urine culture utilization.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069392","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":"Effect of type of vaginal preparation on abdominal hysterectomy surgical site infections (SSI).","authors":"Anupama Neelakanta, Brittany Lees, Tsai-Wei Wang, Kristin Fischer, Catherine Passaretti","doi":"10.1017/ice.2025.10258","DOIUrl":"https://doi.org/10.1017/ice.2025.10258","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":2.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069452","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":"Outcomes in patients with untreated versus treated asymptomatic bacteriuria within five Veterans Affairs facilities.","authors":"Kelly Davis, Angela Kaucher, Hans Scheerenberger, Jarred Bowden, Brittany DeJarnett, Garrett Fannin, Anna Mitchell, Morgan Johnson, Jessica Bennett","doi":"10.1017/ice.2025.10255","DOIUrl":"https://doi.org/10.1017/ice.2025.10255","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064620","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":"Epidemiology of device-associated healthcare-associated infections and carbapenem-resistant <i>Enterobacteriaceae</i> in intensive care units: a 7-year multicenter surveillance in Shanghai, China.","authors":"Meixia Wang, Qingfeng Shi, Wei Sun, Jiabing Lin, Xiang Chen, Yan Shen, Yixin Cui, Mengge Han, Hongfei Mi, Bijie Hu, Jue Pan, Xiaodong Gao","doi":"10.1017/ice.2025.10292","DOIUrl":"https://doi.org/10.1017/ice.2025.10292","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to update the incidence of device-associated healthcare-associated infections (DA-HAIs), and to characterize pathogen distribution and carbapenem-resistant Enterobacteriaceae (CRE) detection among ICU patients in Shanghai, China.</p><p><strong>Methods: </strong>Prospective surveillance in 223 ICUs using standardized International Nosocomial Infection Control Consortium methodology (INICC) protocols collected patient-level data on demographics, microbiology, device use, and DA-HAIs. Trends, annual percent change (APC) and average annual percent change (AAPC) were estimated using Joinpoint regression models.</p><p><strong>Results: </strong>The overall DA-HAIs incidence density in ICUs was 1.67 per 1000 catheter-days for catheter-associated urinary tract infection (CAUTI) (95% CI: 1.62-1.73), 0.59 per 1000 central line-days for central line-associated bloodstream infection (CLABSI) (95% CI: 0.56-0.63), and 4.63 per 1000 ventilator-days for ventilator-associated pneumonia (VAP) (95% CI: 4.51-4.76). Significant reductions were observed in VAP (AAPC: -15.36%; <i>P</i> < 0.001) and CLABSI (AAPC: -11.23%; <i>P</i> < 0.001). Pathogen distributions varied by infection type, with <i>Enterococcus faecium</i> (17.22%) and <i>Klebsiella pneumoniae</i> (16.63%) predominating in CAUTI patients, <i>Klebsiella pneumoniae</i> (26.87%) in CLABSI patients, and <i>Acinetobacter baumannii</i> (37.60%) in VAP patients. The overall CRE detection rate was 33.67% in CAUTI patients, 37.56% in CLABSI patients, and 35.24% in VAP patients.</p><p><strong>Conclusions: </strong>Although DA-HAI rates showed significant declines, the persistently high CRE prevalence underscores substantial antimicrobial resistance challenges in Chinese ICUs.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064665","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":"Colonization with antiseptic tolerant <i>Staphylococcus aureus</i> in children with cancer: a longitudinal study.","authors":"J Chase McNeil, Lauren M Sommer, Marritta Joseph, Charles Minard, Julienne Brackett, Amya Mitchell, Matthew Wilber, Anthony R Flores","doi":"10.1017/ice.2025.10243","DOIUrl":"https://doi.org/10.1017/ice.2025.10243","url":null,"abstract":"<p><strong>Objective: </strong>In <i>Staphylococcus aureus</i> the <i>qacA/B</i> and <i>smr</i> genes have been associated with elevated MICs to antiseptics with such organisms often termed antiseptic tolerant <i>S. aureus</i> (ATSA). The impact of repeated healthcare or antiseptic exposure on colonization with ATSA is uncertain.</p><p><strong>Design: </strong>Prospective longitudinal cohort study.</p><p><strong>Setting/participants: </strong>The high-risk cohort included children with a new diagnosis of malignancy recruited from a pediatric oncology clinic. The low-risk cohort were otherwise healthy children enrolled from general pediatrics clinics.</p><p><strong>Methods: </strong>Subjects had anterior nares and axillary cultures collected at 3-month intervals for one year. Identified <i>S. aureus</i> isolates underwent PCR for <i>qacA/B</i> and <i>smr</i>. The primary outcome was colonization with ATSA at least once during study follow-up. Logistic regression models were utilized to adjust for confounding across cohorts.</p><p><strong>Results: </strong>226 subjects were evaluable for the primary outcome. It was noted that 93.5% of high-risk subjects reported regularly using chlorhexidine gluconate (CHG) antiseptic products. Colonization with ATSA was found in 15.5% of subjects. In univariable analyses, subjects in the low-risk cohort more frequently had ATSA colonization; following adjustment for confounders, the rates of overall ATSA colonization were similar in the high- and low-risk cohorts. Only 2 subjects had colonization with an ATSA strain at more than one encounter.</p><p><strong>Conclusions: </strong>Pediatric oncology patients do not experience higher rates of ATSA colonization than healthy children. In addition, ATSA colonization is transient relative to strains negative for <i>smr</i>/<i>qacA/B</i>. These findings suggest that repeated use of infection prevention strategies including CHG do not predispose to colonization with ATSA in the ambulatory setting.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033274","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}