Infection Control and Hospital Epidemiology最新文献

{"title":"Consequences of reported β-lactam allergy on perioperative outcomes: a systematic review and meta-analysis of surgical site infection risk.","authors":"Yuki Hanai, Jun Hirai, Kazuhiro Matsuo, Keita Kouzu, Hiroji Shinkawa, Seiichi Shinji, Motomu Kobayashi, Yuichi Kitagawa, Chizuru Yamashita, Yasuhiko Mohri, Hiroshi Nobuhara, Katsunori Suzuki, Junzo Shimizu, Motoi Uchino, Seiji Haji, Masahiro Yoshida, Toru Mizuguchi, Toshihiko Mayumi, Yuko Kitagawa, Hiroki Ohge","doi":"10.1017/ice.2025.10294","DOIUrl":"https://doi.org/10.1017/ice.2025.10294","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of reported β-lactam allergy on the risk of surgical site infections (SSIs), given that most reported cases are unverified and may lead to suboptimal antibiotic prophylaxis.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>Four databases were systematically searched for studies reporting SSI rates in patients with and without β-lactam allergy. The primary outcome was SSI incidence; secondary outcomes included mortality, length of hospital stay (LOS) and adverse events. Subgroup analyses were conducted to explore potential sources of heterogeneity. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Risk of bias was assessed using the ROBINS-I tool.</p><p><strong>Results: </strong>Twenty-five retrospective observational studies comprising 460,284 patients were included. Reported β-lactam allergy was associated with a significantly increased risk of SSI (RR = 1.55, 95% CI = 1.24-1.94). This association remained consistent across sensitivity and subgroup analyses, particularly in studies relying on self-reported allergies. Patients receiving β-lactam antibiotics had a significantly lower SSI risk than that of patients receiving non-β-lactam alternatives (RR = 0.63, 95% CI = 0.42-0.94). No significant differences were found in LOS or hypersensitivity reaction rates. Mortality was not reported in any of the included studies.</p><p><strong>Conclusions: </strong>Reported β-lactam allergy is associated with an increased risk of SSI, highlighting the importance of accurate allergy assessment. Selective administration of β-lactam agents, such as cefazolin, may offer a safe and effective option for preoperative prophylaxis in patients without a history of severe hypersensitivity.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-11"},"PeriodicalIF":2.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029545","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 mitigation of shared room ventilation and filtration on SARS-CoV-2 transmission: a multicenter test-negative study.","authors":"Victoria Williams, Kevin L Schwartz, Kevin Brown, Matthew Muller, Jeff Powis, Daniel Ricciuto, Alexander Kiss, Mark Downing, Sharon Sukhdeo, Thomas Dashwood, Jacob Romano, Rob Kozak, Lorraine Maze Dit Mieusement, Jerome A Leis","doi":"10.1017/ice.2025.10256","DOIUrl":"https://doi.org/10.1017/ice.2025.10256","url":null,"abstract":"<p><strong>Background: </strong>Admission to shared hospital rooms are a risk factor of healthcare-associated (HA) SARS-CoV-2. Quantifying the impact of engineering controls such as ventilation and filtration is essential to informing resource utilization and infection prevention guidelines.</p><p><strong>Methods: </strong>Multicenter test-negative study of patients exposed to SARS-CoV-2 in shared rooms across five hospitals between January and October, 2022. Independent variables tested were measured air changes per hour (ACH), presence of any room mechanical ventilation (RMV), or portable high-efficiency particulate air (HEPA) filter. Covariates included facility (number of beds in room, outbreak status of unit), source patient (presence of symptoms, RT-PCR cycle threshold (Ct) value), and exposed patient factors (age, sex, time from last SARS-CoV-2 vaccine, previous SARS-CoV-2 infection, exposure duration). Multilevel logistic mixed models used to estimate the impact of engineering controls on transmission.</p><p><strong>Results: </strong>Among 468 exposed patients, secondary attack rate was 26.3% (range 7.5-33.3% across hospitals). In multivariable analysis, increased ACH was associated with decreased odds of infection (adjusted odds ratio (aOR) 0.88, 95% CI 0.78-1.00; p=.046) as were exposure duration and Ct value of source patient. Presence of RMV was also associated with decreased odds of infection (aOR 0.51, 95% CI 0.27-0.95; p=.034) while use of portable HEPA filter was not significant (aOR 0.58, 95% CI 0.26-1.31; p=.18).</p><p><strong>Conclusions: </strong>Improved ventilation was independently associated with lower odds of SARS-CoV-2 infection among exposed roommates. Ensuring RMV is present and optimizing ACH may significantly mitigate the risk of HA-SARS-CoV-2. Future prospective studies should assess optimal ACH thresholds and the impact of portable HEPA filters.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029559","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":"Healthcare-associated cluster of <i>Burkholderia sola</i> in two lung transplant recipients characterized through whole-genome sequencing.","authors":"Alexander Sundermann, Marissa Griffith, Deena Ereifej, Nathan J Raabe, Vatsala Rangachar Srinivasa, Kady Waggle, Kathleen Shutt, Hunter Coyle, Ashley Ayres, Spencer Schrank, Graham M Snyder, Daria Van Tyne, Lora Lee Pless, Lee H Harrison","doi":"10.1017/ice.2025.10261","DOIUrl":"https://doi.org/10.1017/ice.2025.10261","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015163","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":"Role of EDTA lock solution in preventing catheter-related bloodstream infections or central line-associated bloodstream infections: a systematic review and meta-analysis.","authors":"Sayan Chakraborty, Sanjay Bhattacharya, Abhinaba Ghosh, Soumyadip Chatterji","doi":"10.1017/ice.2025.10246","DOIUrl":"https://doi.org/10.1017/ice.2025.10246","url":null,"abstract":"<p><strong>Objective: </strong>Catheter-related bloodstream infections (CRBSI) or central line-associated bloodstream infections (CLABSI) occur frequently with long-term indwelling catheters. EDTA (Ethylenediaminetetraacetic acid) and other catheter lock solutions can prevent CRBSI/CLABSI. This study aimed to identify the role of EDTA lock solution in preventing CRBSI/CLABSI compared to the non-EDTA lock solutions.</p><p><strong>Materials and methods: </strong>Eligible studies comparing the effectiveness of EDTA versus a control group on averting CRBSI or CLABSI were identified through searches across PubMed, Embase, Scopus, Cochrane CENTRAL, medRxiv, bioRxiv, and ClinicalTrials.gov. The secondary outcomes were catheter colonization, catheter survival, and catheter thrombosis. The relative risk for all the outcomes was calculated.</p><p><strong>Results: </strong>This meta-analysis included eight studies (403 EDTA vs 425 control patients) and demonstrated a significant reduction in CRBSI/CLABSI with EDTA (15 vs 71 events; RR: 0.18; 95% CI: 0.10-0.33; <i>P</i> < 0.00001). Catheter colonization also decreased significantly (8 vs 38 events; OR: 0.11; 95% CI: 0.05-0.29). EDTA improved catheter survival in hemodialysis patients (OR: 3.77; 95% CI: 1.23-11.61; <i>P</i> < 0.02) but showed no significant effect on thrombolytic treatment or all-cause mortality. Subgroup analyses supported these findings, with no publication bias detected.</p><p><strong>Conclusion: </strong>EDTA significantly reduces CRBSI/CLABSI and catheter colonization, improves catheter survival, but does not affect thrombolytic treatment or mortality. Evidence certainty varies across outcomes.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000405","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":"SHEA/APIC/IDSA/PIDS multisociety position paper: Raising the bar: necessary resources and structure for effective healthcare facility infection prevention and control programs - CORRIGENDUM.","authors":"Thomas R Talbot, Christopher Baliga, Rebecca Crapanzano-Sigafoos, Tania N Bubb, Mohamad Fakih, Thomas G Fraser, Ibukunoluwa C Kalu, Vidya Mony, Anupama Neelakanta, Ann-Christine Nyquist, Catherine O'Neal, Jan E Patterson, David K Warren, Sharon B Wright","doi":"10.1017/ice.2025.10240","DOIUrl":"https://doi.org/10.1017/ice.2025.10240","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1"},"PeriodicalIF":2.9,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000470","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 efficacy of a filtered handheld far-ultraviolet disinfection device for decontamination of high-touch surfaces in healthcare settings: a genomic bacterial analysis.","authors":"Layale Yaghi, Roy F Chemaly, Rita Wilson-Dib, William C Shropshire, Sherry Cantu, Micah Bhatti, Piyali Chatterjee, Chetan Jinadatha, Amy Spallone","doi":"10.1017/ice.2025.10251","DOIUrl":"https://doi.org/10.1017/ice.2025.10251","url":null,"abstract":"<p><strong>Background and objectives: </strong>Enhanced environmental disinfection is linked to reduced hospital-acquired infection rates. In this study, we aimed to evaluate the efficacy of an emerging disinfection technology, a filtered far-UV-C handheld (FFUHH) device, for reducing bacterial loads on high-touch surfaces in shared clinical workrooms, and to isolate, identify and characterize clinically significant environmental pathogens.</p><p><strong>Methods: </strong>We compared samples from high-touch items (dictation device, mouse, armchair, desk, and keyboard) before and after FFUHH treatment. Samples were collected weekly: contact plates for colony counts and swabs before and after intervention on standardized adjacent areas for each surface, respectively. The swabs were enriched and cultured on selective media to isolate pathogens. Environmental samples, as well as clinical samples collected from patients during the study period, were validated using MALDI-TOF and whole genome sequencing.</p><p><strong>Results: </strong>Among the 440 collected plates (220 before and 220 after treatment), the highest mean colony count pre-treatment was detected from armchairs, and the lowest from keyboards. The mean reduction of colony-forming units ranged 53% and 83% and was statistically significant (<i>P</i> < 0.05) across all surfaces except for the keyboard. We characterized multidrug-resistant <i>Staphylococcus epidermidis</i> ST5 and ST16 strains, a carbapenem-resistant <i>Acinetobacter baumannii,</i> and a <i>Klebsiella pneumoniae</i> genetically related to a clinical isolate with a rare sequence type not previously detected in our institution.</p><p><strong>Conclusion: </strong>The FFUHH effectively reduced the microbial burden on high-touch surfaces. It can offer an advantage for surface disinfection and an alternative to routinely used biocides.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000486","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":"Real-word utility of procalcitonin in patients hospitalized with community-acquired pneumonia: A matched cohort study - CORRIGENDUM.","authors":"Dan Ilges, Dylan Kosaski, Maria Teresa Seville, Alyssa K McGary, John C O'Horo, Christine L Snozek, Ryan W Stevens, Aditya Shah","doi":"10.1017/ice.2025.10241","DOIUrl":"https://doi.org/10.1017/ice.2025.10241","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1"},"PeriodicalIF":2.9,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000462","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":"Two concurrent nationwide healthcare-associated outbreaks of <i>Burkholderia cepacia</i> complex linked to product contamination, UK and Ireland, 2010-2023.","authors":"Jason Doran, Clare Foster, Mike Saunders, Nastassya L Chandra, Jane F Turton, Dervla Td Kenna, Caroline Willis, Alex Orlek, Lesley L Smith, Peter Hoffman, Hannah Choi, Geraldine Leong, Mariyam Mirfenderesky, Mark H Wilcox, Neville Q Verlander, Susanna Frost, David Elliott, Amy Weaver, Yu Wan, Susan Hopkins, Isabel Oliver, Colin S Brown, J W T Elston","doi":"10.1017/ice.2025.10232","DOIUrl":"https://doi.org/10.1017/ice.2025.10232","url":null,"abstract":"<p><strong>Background: </strong>Species of the <i>Burkholderia (B.) cepacia complex</i> (Bcc) have been implicated in multiple nosocomial outbreaks linked to contaminated water-based products, including liquid soaps, mouthwash, and other non-alcoholic aqueous solutions.</p><p><strong>Objective: </strong>We describe two substantial healthcare-associated outbreaks of Bcc (<i>B. cepacia</i> and <i>B. contaminans</i>) in the United Kingdom and Ireland associated with contaminated products. We highlight the challenges during investigation and mitigation, and provide recommendations.</p><p><strong>Methods: </strong>A multidisciplinary, multi-stakeholder investigation across both outbreaks was adopted, involving interviews, trawling questionnaires, and targeted product sampling.</p><p><strong>Results: </strong>There were 153 and 66 confirmed cases in the <i>B. cepacia</i> and <i>B. contaminans</i> outbreaks, respectively. Cases predominantly comprised hospitalized individuals, and 70% of isolates were recovered from an invasive site. The outbreak strain of <i>B. cepacia</i> was isolated from non-sterile ultrasound gel. An analytical study suggested the <i>B. contaminans</i> cluster was also linked to ultrasound gel; however, a disinfectant wipe product was subsequently identified as the source (0-3 single nucleotide polymorphism differences between case and wipe isolates).</p><p><strong>Outbreak control measures: </strong>The affected disinfectant wipes were withdrawn. The ultrasound gel was not recalled but health system procurement was suspended, rapid clinical guidance was produced and a National Patient Safety Alert was issued. Inter-organizational partnership was required to mitigate risks.</p><p><strong>Conclusion: </strong>Identifying the source of outbreaks associated with contaminated products can be challenging, requiring complex multi-stakeholder interventions. We recommend a low threshold for investigation of Bcc clusters, adopting a multidisciplinary approach to investigation and mitigation, implementing interventions focusing on practice, and prompt product removal to protect patients.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992418","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 implementation of a patient engagement mHealth application in clinical infection prevention.","authors":"Robbert Gerard Bentvelsen, Rosalie van der Vaart, Niels H Chavannes, Karin Ellen Veldkamp","doi":"10.1017/ice.2025.10211","DOIUrl":"https://doi.org/10.1017/ice.2025.10211","url":null,"abstract":"<p><strong>Objective: </strong>Successful implementation of patient engagement (PE) and mHealth could reduce inappropriate catheter use and Catheter-associated urinary tract infections (CAUTIs). Insight into patient acceptance, impact on PE and quality of care, potential barriers and facilitators to the implementation of an mHealth intervention could improve the impact of both current and future infection prevention programs.</p><p><strong>Methods: </strong>Implementation of the smartphone app \"Participatient\" was evaluated in four Dutch hospitals. Patient questionnaires assessed the acceptability of the app and its impact. Healthcare professionals (HCPs) were interviewed to evaluate the implementation process.</p><p><strong>Results: </strong>Acceptability constructs were evaluated positively. PE and quality of care were rated high before and after implementation. All 22 HCPs perceived barriers, eg incomplete training for HCPs and unclear communication on roles; and lack of promotion by ward professionals. The principal facilitator was the HCPs' positive attitude toward PE.</p><p><strong>Conclusions: </strong>App users perceived the Participatient app as acceptable, which fulfills a precondition for implementation. The implementation strategy evaluated in the present study was designed to fulfill all the conditions considered crucial for implementation. Nevertheless, the level of adoption remained low, and HCPs still imputed their failure to promote the use of the app to insufficiencies in training and communication and to a misfit between the app and their existing workflow. These findings underscore the need to verify whether there may be additional, less evident barriers to the adoption of mHealth tools that support PE in general, and more specifically, to the adoption of Participatient to engage patients in preventing CAUTIs.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952886","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":"Healthcare outbreaks associated with contaminated antiseptics and disinfectants: a scoping review.","authors":"Hiroaki Baba, Hajime Kanamori, Emily E Sickbert-Bennett, William A Rutala, David J Weber","doi":"10.1017/ice.2025.10242","DOIUrl":"https://doi.org/10.1017/ice.2025.10242","url":null,"abstract":"<p><strong>Objective: </strong>Most outbreaks associated with contaminated antiseptics and disinfectants had been attributed to user errors, as identified in our previous review in 2007. Although numerous regulations and guidelines have been established for proper use of antiseptics and disinfectants since then, such outbreaks continue to occur. To address this issue, we conducted a literature review of outbreaks and pseudo-outbreaks linked to contaminated antiseptics and disinfectants, aiming to update the outbreak characteristics and propose new prevention strategies.</p><p><strong>Methods: </strong>We searched the published literature from 2006 to 2024 via the PubMed database.</p><p><strong>Results: </strong>Among 2,307 publications identified, twenty-one outbreaks and 4 pseudo-outbreaks were reviewed. Among the outbreaks, seventeen (81%) were linked to antiseptics including chlorhexidine or low-level disinfectants including quaternary ammonium compounds. A median of 12 individuals (range: 3-256) developed infections, including ventilator-associated pneumonia, skin and soft tissue infections, or catheter-related infections, resulting from direct use of contaminated mouthwashes and skin antiseptics on patients, leading to 55 fatalities. Thirteen (62%) outbreaks were attributed to intrinsically contaminated products, which led to product recall and regulatory changes. Seven (33%) were linked to extrinsically contaminated antiseptics or disinfectants, all associated with improper practices in preparation and storage. Control measures included use of sterile water for preparation, disinfection or replacement of dispensers and containers, and prohibition of using solutions prepared in the hospital laboratory.</p><p><strong>Conclusions: </strong>To avoid outbreaks associated with contaminated antiseptics and disinfectants, healthcare personnel should understand the risks of contaminated antiseptics and disinfectants, and prevention strategies to avoid extrinsic contamination.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952972","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}