Infection Control and Hospital Epidemiology最新文献

{"title":"Antimicrobial-resistant central line-associated bloodstream infections in adult intensive care units: findings from an Australian surveillance network, 2011-2022.","authors":"Lyn-Li Lim, Kang Wei Esther Lim, Michael J Malloy, Ann Bull, Judith Brett, Leon J Worth","doi":"10.1017/ice.2024.132","DOIUrl":"10.1017/ice.2024.132","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to describe the incidence, pathogens, and antimicrobial susceptibility of central line-associated bloodstream infections (CLABSI) in adult intensive care units (ICU).</p><p><strong>Design: </strong>State surveillance data from 2011 to 2022 were analyzed to identify patient and device days and CLABSI events. Pathogen data were analyzed to determine the most common organisms and patterns of antimicrobial resistance grouped into 3-year time epochs.</p><p><strong>Setting: </strong>Adult ICU in Victoria, Australia.</p><p><strong>Participants: </strong>Healthcare organizations participating in CLABSI state surveillance.</p><p><strong>Results: </strong>608 events were reported over 751,350 device days. Overall, CLABSI incidence was 0.81 per 1,000 central-line days, with a 49.3% rate reduction from 2011 to 2022 (1.39 to 0.70 per 1,000 central-line days). Overall device utilization ratio was 0.57, with a 15.4% reduction from 2011 to 2022 (0.67 vs 0.56). Of 690 pathogens, the most common by rank order were coagulase-negative Staphylococci (CNS), <i>Candida</i> species, <i>Staphylococcus aureus</i>, and <i>Enterococcus faecalis</i>. The proportion of CNS-causing events increased by 69.0% from 2011 to 2022; this trend was not observed for other organisms. For every increase in epoch, a 33% decrease in methicillin-resistant <i>S. aureus</i> (MRSA), 4% increase in vancomycin-resistant <i>Enterococcus faecium</i>, and 12% increase in ceftriaxone-resistant <i>Escherichia coli</i> pathogens were observed.</p><p><strong>Conclusions: </strong>We demonstrate a decreasing incidence of CLABSI in Victorian adult ICU and an increasing burden of infections due to CNS. No significant time trend increases in antimicrobial-resistant organisms, including MRSA, vancomycin-resistant <i>E. faecium</i>, and ceftriaxone-resistant <i>E. coli</i> were observed. These findings are relevant for identifying priorities for CLABSI prevention in Victorian adult ICU.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590805","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":"Sustainability of a customized electronic duplicate order alert for microbiology tests: assessment of alert fatigue 12 to 36 months after implementation.","authors":"Maryza Graham, Victoria Hornidge, Gillian Yap, Allen Cheng, Anjali Dhulia, Beena Kumar","doi":"10.1017/ice.2024.183","DOIUrl":"10.1017/ice.2024.183","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-2"},"PeriodicalIF":3.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590823","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 pilot intervention trial to reduce the use of post-procedural antimicrobials after common endourologic surgeries.","authors":"Daniel J Livorsi, Vignesh T Packiam, Qianyi Shi, Steven Y Alberding, Knute D Carter, James A Brown, James B Mason, Jeffrey P Weiss, Ryan L Steinberg","doi":"10.1017/ice.2024.172","DOIUrl":"10.1017/ice.2024.172","url":null,"abstract":"<p><strong>Objective: </strong>Post-procedural antimicrobial prophylaxis is not recommended by professional guidelines but is commonly prescribed. We sought to reduce use of post-procedural antimicrobials after common endoscopic urologic procedures.</p><p><strong>Design: </strong>A before-after, quasi-experimental trial with a baseline (July 2020-June 2022), an implementation (July 2022), and an intervention period (August 2022-July 2023).</p><p><strong>Setting: </strong>Three participating medical centers.</p><p><strong>Intervention: </strong>We assessed the effect of a bundled intervention on excess post-procedural antimicrobial use (<i>ie</i>, antimicrobial use on post-procedural day 1) after three types of endoscopic urologic procedures: ureteroscopy and transurethral resection of bladder tumor or prostate. The intervention consisted of education, local champion(s), and audit-and-feedback of data on the frequency of post-procedural antimicrobial-prescribing.</p><p><strong>Results: </strong>1,272 procedures were performed across all 3 sites at baseline compared to 525 during the intervention period; 644 (50.6%) patients received excess post-procedural antimicrobials during the baseline period compared to 216 (41.1%) during the intervention period. There was no change in the use of post-procedural antimicrobials at sites 1 and 2 between the baseline and intervention periods. At site 3, the odds of prescribing a post-procedural antimicrobial significantly decreased during the intervention period relative to the baseline time trend (0.09; 95% CI 0.02-0.45). There was no significant increase in post-procedural unplanned visits at any of the sites.</p><p><strong>Conclusions: </strong>Implementation of a bundled intervention was associated with reduced post-procedural antimicrobial use at one of three sites, with no increase in complications. These findings demonstrate both the safety and challenge of guideline implementation for optimal perioperative antimicrobial prophylaxis.This trial was registered on clinicaltrials.gov, NCT04196777.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590801","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":"Empiric antibiotic prescribing practices for gram-positive coverage of late-onset sepsis in neonatal intensive care units in North America.","authors":"Dara Simcha Petel, Sandra Isabel, Kyong-Soon Lee, Joseph Yuk Ting, David A Kaufman, Pablo Jose Sanchez, Sarah Khan, Kathryn Timberlake, James Wright, Michelle Science","doi":"10.1017/ice.2024.176","DOIUrl":"10.1017/ice.2024.176","url":null,"abstract":"<p><p>Late-onset sepsis (LOS) in the neonatal intensive care unit (NICU) causes significant morbidity and mortality, yet guidance on empiric management is limited. We surveyed NICUs across Canada and the United States regarding their empiric antimicrobial regimens for LOS, thereby identifying large practice variations and high rates of empiric vancomycin use.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":3.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590819","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":"What can building information modeling do for you? A perspective on integration into infection prevention and control programs for patient safety.","authors":"Scott C Roberts, Trini A Mathew, Windy D Tanner, Richard A Martinello","doi":"10.1017/ice.2024.179","DOIUrl":"https://doi.org/10.1017/ice.2024.179","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-2"},"PeriodicalIF":3.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576125","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":"Microbial burden on environmental surfaces in long-term care facilities: a quantitative analysis.","authors":"William A Rutala, Lauren M DiBiase, Amy W Powell, Maria F Gergen, Emily E Sickbert-Bennett, Hajime Kanamori, David J Weber","doi":"10.1017/ice.2024.129","DOIUrl":"https://doi.org/10.1017/ice.2024.129","url":null,"abstract":"<p><strong>Background: </strong>We conducted a quantitative analysis of the microbial burden and prevalence of epidemiologically important pathogens (EIP) found on long-term care facilities (LTCF) environmental surfaces.</p><p><strong>Methods: </strong>Microbiological samples were collected using Rodac plates (25cm2/plate) from resident rooms and common areas in five LTCFs. EIP were defined as MRSA, VRE, C. difficile and multidrug-resistant (MDR) Gram-negative rods (GNRs).</p><p><strong>Results: </strong>Rooms of residents with reported colonization had much greater EIP counts per Rodac (8.32 CFU, 95% CI 8.05, 8.60) than rooms of non-colonized residents (0.78 CFU, 95% CI 0.70, 0.86). Sixty-five percent of the resident rooms and 50% of the common areas were positive for at least one EIP. If a resident was labeled by the facility as colonized with an EIP, we only found that EIP in 30% of the rooms. MRSA was the most common EIP recovered, followed by C. difficile and MDR-GNR.</p><p><strong>Discussion: </strong>We found frequent environmental contamination with EIP in LTCFs. Colonization status of a resident was a strong predictor of higher levels of EIP being recovered from his/her room.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545244","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":"Multifaceted implementation strategy to improve the evaluation of penicillin allergies in perioperative patients: a pre-post feasibility implementation study.","authors":"Eileen J Carter, Katherine Zavez, Carol Schramm, Meagan M Zolla, Katelyn Baron, David B Banach","doi":"10.1017/ice.2024.119","DOIUrl":"https://doi.org/10.1017/ice.2024.119","url":null,"abstract":"<p><strong>Objective: </strong>The U.S. Centers for Disease Control and Prevention encourages nurses to evaluate penicillin allergies as part of hospital-based antibiotic stewardship programs. We evaluated the feasibility of an implementation strategy to improve nurses' comprehensive documentation of penicillin allergies. We defined feasibility as the uptake and acceptability of documentation procedures.</p><p><strong>Design: </strong>Six-month pre-post feasibility implementation study.</p><p><strong>Setting: </strong>Outpatient surgical areas of an academic medical center located in the U.S.</p><p><strong>Intervention: </strong>The implementation strategy was guided by the Capability, Opportunity, Motivation Model for Behavior Change and included, building an interdisciplinary coalition to iteratively evaluate the implementation effort, educational meetings with surgical prescribers and perioperative nurses, the development and distribution of educational pocket cards, and structured communication messages in the electronic medical record.</p><p><strong>Results: </strong>A total of 426 patients with 487 penicillin allergy records (216 records pre-implementation period, 271 records post-implementation period) were analyzed. Penicillin allergy documentation contained the following information in the pre- versus post-implementation period: symptoms of the reaction (87% vs 87%), timing/years since reaction (8% vs 26%), onset of reaction in relation to taking penicillin (0% vs 21%), how symptoms resolved (0% vs 21%), and penicillin re-exposure (3% vs 21%). Focus groups revealed nurses perceived documentation procedures as highly acceptable. Major drivers of acceptability included the perceived effectiveness of a detailed allergy history and self-efficacy in conducting a detailed allergy history.</p><p><strong>Conclusions: </strong>Nurses perceived the comprehensive documentation of penicillin allergy history intervention as acceptable, and uptake improved following a theory-informed implementation strategy. We offer implementation strategy components to facilitate nurses' engagement in penicillin allergy evaluation.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545245","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":"Performance of a large language model for identifying central line-associated bloodstream infections (CLABSI) using real clinical notes.","authors":"Guillermo Rodriguez-Nava, Goar Egoryan, Katherine E Goodman, Daniel J Morgan, Jorge L Salinas","doi":"10.1017/ice.2024.164","DOIUrl":"https://doi.org/10.1017/ice.2024.164","url":null,"abstract":"<p><p>We evaluated one of the first secure large language models approved for protected health information, for identifying central line-associated bloodstream infections (CLABSIs) using real clinical notes. Despite no pretraining, the model demonstrated rapid assessment and high sensitivity for CLABSI identification. Performance would improve with access to more patient data.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545266","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":"Operationalizing an adverse event detection surveillance system to support antimicrobial stewardship activities: perceptions and insights from the SHEA research network.","authors":"Hawra J Al Lawati, Kimberly L Harvey, Marlena Shin, Hillary Mull, Rebecca P Lamkin, Samuel Golenbock, Dipandita Basnet-Thapa, Judith M Strymish, Matthew Lee, Howard Gold, Matthew Bidwell Goetz, Westyn Branch-Elliman","doi":"10.1017/ice.2024.141","DOIUrl":"https://doi.org/10.1017/ice.2024.141","url":null,"abstract":"<p><p>A surveillance system for measuring patient-level antimicrobial adverse drug events (ADE) may support stewardship activities, however, design and implementation questions remain. In this national survey, stewardship experts favored simple, laboratory-based ADE definitions although there were tensions between feasibility, ability to identify attribution without chart review, and importance of specific ADE.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545246","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":"System infection prevention in hospital networks in the United States-an SHEA research network inquiry into operational characteristics and current challenges.","authors":"Michael P Stevens, Nkechi Emetuche, Catherine Passaretti, Graham Snyder, Rachael Snyders, Michael B Edmond, Jonas Marschall","doi":"10.1017/ice.2024.170","DOIUrl":"https://doi.org/10.1017/ice.2024.170","url":null,"abstract":"<p><p>A 54-question survey about System Healthcare Infection Prevention Programs (SHIPPs) was sent out to SHEA Research Network participants in August 2023. Thirty-eight United States-based institutions responded (38/93, 41%), of which 23 have SHIPPs. We found heterogeneity in the structure, staffing, and resources for system infection prevention (IP) programs.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":3.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499762","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}