Infection Control and Hospital Epidemiology最新文献

{"title":"A cross-sectional survey of nursing home resident hand hygiene knowledge, hand hygiene habits, and bathing practices.","authors":"Hailey Blinkiewicz, Yasin Abul, Jessica Ameling, David H Canaday, Christopher J Crnich, Jon P Furuno, Stefan Gravenstein, Tiffany G Harris, Karen Jones, Morgan J Katz, Jennifer Meddings, Avinash Pyreddy, Emily K Short, Chin-Lin Su, Ganga Vijayasiri, Lona Mody","doi":"10.1017/ice.2026.10537","DOIUrl":"https://doi.org/10.1017/ice.2026.10537","url":null,"abstract":"<p><strong>Objective: </strong>To characterize nursing home (NH) resident hand hygiene knowledge, hand hygiene habits, and bathing practices to inform intervention strategies.</p><p><strong>Design: </strong>Cross-sectional survey.</p><p><strong>Setting: </strong>Twenty geographically diverse NHs between December 2023 and July 2024.</p><p><strong>Participants: </strong>NH residents.</p><p><strong>Methods: </strong>The survey was administered verbally to NH residents and consisted of 22 questions pertaining to residents' hand hygiene knowledge, hand hygiene habits at their previous residence and at the NH, and bathing practices at the NH.</p><p><strong>Results: </strong>Among the 495 NH residents who completed the survey, 54% were short-stay/temporary residents, 65% were female, and 79% were aged 70 years or older. Less than a third (29%) of the residents answered all three hand hygiene knowledge-based questions correctly. Residents washed their hands less often at the NH compared to their previous residence. Residents also washed their hands with running water less frequently at the NH (81% vs. 98%). Thirty percent of residents reported facing challenges with hand hygiene at the NH with 53% of the responses mentioning mobility impairments as the main reason why. Additionally, residents facing challenges with hand hygiene had a lower frequency of hand hygiene at the NH. Half (51%) of the residents reported bathing less at the NH compared to their previous residence with NH policy being the most commonly reported reason encompassing 54% of the responses.</p><p><strong>Conclusions: </strong>NH residents perform hand hygiene and bathe less frequently at the NH. Our multi-site study identified multiple barriers to resident hand hygiene and bathing that can be modifiable through practice or policy changes.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":2.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181384","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":"Analysis of nontuberculous mycobacteria infection risks from CDC's water-related healthcare outbreak consultations, 2018-2024.","authors":"Amy L Valderrama, Paige Gable, Heather A Moulton-Meissner, Joseph F Perz, Christine Yount, Kiran M Perkins","doi":"10.1017/ice.2026.10478","DOIUrl":"https://doi.org/10.1017/ice.2026.10478","url":null,"abstract":"<p><strong>Objective: </strong>Nontuberculous mycobacteria (NTM) are commonly found in healthcare facility water systems and can lead to serious and difficult-to-treat infections. We analyzed Centers for Disease Control and Prevention (CDC) consultations of water-related healthcare-associated infections (HAI) investigations involving NTM.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>We searched CDC consultation records from January 1, 2018, through December 31, 2024, using water-related terms and organisms, excluding <i>Legionella</i>, to identify and review investigations involving potential or confirmed transmission of water-related organisms; we reviewed investigations that involved NTM.</p><p><strong>Results: </strong>Among 1,458 consultations, we identified 639 (43.8%) water-related investigations involving 4,685 patients and 60 different organisms. Investigations involving NTM accounted for 10.3% (n = 66) with 15 NTM species identified. Among NTM-related investigations, almost half involved <i>M. abscessus</i> (n = 31, 47.0%) and two-thirds (n = 44, 66.7%) involved extrapulmonary infections only. More than half of identified NTM investigations (n = 37, 56.1%) occurred in hospitals and over one-third (n = 23, 34.8%) in outpatient settings. Exposures to surgery (n = 27, 40.9%) and medical products (e.g., medical devices, medications, and biological products) (n = 35, 53.0%) were common.</p><p><strong>Conclusions: </strong>Over this seven-year period, approximately one-tenth of CDC healthcare water-related consultations involved NTM. The majority involved extrapulmonary infections, with surgery and exposure to contaminated medical products representing the most common exposures of concern. These findings highlight the potential for NTM infections when water-related healthcare exposures occur. Healthcare facilities are encouraged to identify the potential for exposure to nonsterile water during surgery, during the use of medical devices, and during the preparation and administration of medications to reduce the risk from NTM.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181453","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":"Recurrent healthcare-associated pediatric HIV outbreaks in Pakistan: a call to reinforce infection prevention and control.","authors":"Alisha Sattar","doi":"10.1017/ice.2026.10599","DOIUrl":"https://doi.org/10.1017/ice.2026.10599","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1"},"PeriodicalIF":2.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169455","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":"NHSN central line day methodology: impact on CLABSI rates, benchmarking, and quality improvement across a multi-hospital health system.","authors":"Christopher Allen Linke, Zoe Gerber, Lauren Witty, Megan Balz, Kathryn Pendleton","doi":"10.1017/ice.2026.10564","DOIUrl":"https://doi.org/10.1017/ice.2026.10564","url":null,"abstract":"<p><strong>Background: </strong>Under current National Healthcare and Safety Network (NHSN) methodology for CLABSI reporting, patients with multiple, concurrent central lines are counted as one line day, potentially underestimating true central line exposure.</p><p><strong>Objective: </strong>To evaluate the impact of NHSN central line reporting guidelines on CLABSI rates, benchmarking, and quality improvement outcomes across a multi-hospital health system.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>Electronic health record (EHR) data was collected for 7,645 inpatients across three adult acute care and one pediatric acute care hospital from January 2024 through December 2024. Additional data from the academic medical center's intensive care units (ICU) was collected from January 2025 to July 2025. Reported and actual central line days were compared across hospitals and care settings.</p><p><strong>Results: </strong>Actual line days totaled 113,529 compared to 90,789 reported line days with significantly different proportions across hospitals (P < .001). The reduction in CLABSI rate calculation when using actual line days was largest at higher-acuity settings, with the academic medical center ICUs demonstrating a decrease from 1.54 to 1.03 per 1,000 line days, a 33% reduction. Evaluation of a quality improvement initiative revealed significant improvement across all three ICUs when using actual line days, compared to only two ICUs under reported data alone.</p><p><strong>Conclusions: </strong>Current NHSN reporting methodology systematically underestimates central line exposure at higher-acuity hospitals, impacting CLABSI benchmarking and obscuring quality improvement initiatives. Health systems should consider monitoring both reported and actual line days when evaluating performance or the impact of quality improvement initiatives.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165210","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":"Towards data-driven refinement of an automated cluster alert system: assessing the concordance of epidemiological expert assessment and genotyping.","authors":"Darius Ferenc Ruether, Marco Paul, Sandra Jendrossek, Nicholas Jakob Böhm, Brar Piening, Friederike Maechler, Anna Weber, Selin Saydan, Luis Alberto Peña Diaz, Michael Behnke, Christine Geffers, Seven Johannes Sam Aghdassi","doi":"10.1017/ice.2026.10569","DOIUrl":"https://doi.org/10.1017/ice.2026.10569","url":null,"abstract":"<p><strong>Objective: </strong>An automated CLuster AleRt system (CLAR) is employed at our hospital to detect clusters of relevant microorganisms. Alerts are subsequently assessed by infection prevention and control (IPC) experts to determine their epidemiological relevance. This study compares expert assessment of CLAR alerts with genotyping results.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>We analyzed all CLAR alerts and genotyping reports generated during routine IPC activities between 08/2019 and 12/2024. CLAR alerts were classified relevant/not relevant based on epidemiological assessment by IPC physicians. Selected isolates were genotyped when transmission was suspected. Where multiple alerts and genotyping reports were available for an epidemiological cluster, only the first alert with genotyped isolates and the first corresponding genotyping report were considered, in order to emulate conditions at the onset of potential outbreaks. Genotyping was performed either by whole-genome sequencing (cgMLST) or repetitive-sequence-based polymerase chain reaction (rep-PCR). We calculated the proportion of CLAR alerts with ≥1 genotypically clustering isolate and performed a multivariable regression analysis to identify parameters associated with a higher likelihood of concordance.</p><p><strong>Results: </strong>We identified 116 relevant CLAR alerts corresponding to first genotyping reports (n = 77 cgMLST, n = 39 rep-PCR) of epidemiological clusters. Overall, these alerts contained 253 genotyped isolates. Genotypic clustering of ≥1 CLAR alert isolate was confirmed for 87 CLAR alerts (75.0%). A higher proportion of concordance with genotyping was seen for relevant alerts in neonatology (93.8%) and with carbapenem-resistant Enterobacterales (94.4%), also confirmed by multivariable analysis.</p><p><strong>Conclusions: </strong>Expert-assessed epidemiological relevance of CLAR alerts showed promising concordance with genomic findings and may inform future machine learning-based predictions.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-9"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167272","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":"Hospital wastewater-based antimicrobial resistance epidemiology: a scoping review.","authors":"Erika Viana-Cardenas, Mingjun Jiang, Guillermo Rodriguez-Nava, Wajeeha Tariq, Sheena Conforti, Jose Luis Paredes, Nathan Pincus, Eugenia Miranti, Jenna Maco Wick, Evans Whitaker, Mindy M Sampson, Alessandro Zulli, Alexandre R Marra, Abdulrahman M AlSweed, Alexandria B Boehm, Jorge Luis Salinas","doi":"10.1017/ice.2026.10558","DOIUrl":"https://doi.org/10.1017/ice.2026.10558","url":null,"abstract":"<p><strong>Introduction: </strong>Wastewater-based epidemiology (WBE) offers pooled biological samples of defined populations, complementing clinical surveillance for infectious diseases. Hospitals are hotspots for antimicrobial resistance (AMR). We performed a scoping review assessing hospital wastewater for AMR monitoring.</p><p><strong>Methods: </strong>We searched Medline, Embase, Biosis, Web of Science, and biorxiv.org from inception to May 5, 2026, for studies using hospital wastewater to monitor AMR. The primary outcome was AMR detection and concordance with traditional surveillance. Concordance was reported by resistance class, and reported as strain- or gene-level, as discordant, or as not assessed. Secondary outcomes included sampling methods, and laboratory techniques.</p><p><strong>Results: </strong>Of 4,695 screened studies, 36 from 22 countries met inclusion criteria (high-income 53%, upper-middle-income 42%, and lower-middle-income 5%). Traditional surveillance used mostly routine diagnostics (58%); only 39% of studies aligned temporally with wastewater sampling. Extended-Spectrum Beta-Lactamase-producing organisms showed strain-level concordance in 2/6 studies, and gene-level concordance in 4/6; carbapenem resistance showed strain-level concordance in 2/9 and gene-level concordance in 4/9. Concordance was present for vancomycin-resistant enterococci (2/3), while inconsistent for <i>Methicillin-resistant Staphylococcus aureus</i> (0/2) and <i>Candida auris (1/2)</i>. One study quantified correlation statistically, finding strong association (Spearman's rho = .88). Wastewater sampling methods included grab sampling (39%), composite sampling (36%), and was unreported (25%). Most studies combined culture-based (89%) and molecular methods (PCR 75%, WGS 42%, metagenomics 17%), mostly targeting Gram-negatives (83%).</p><p><strong>Conclusion: </strong>Hospital WBE showed variable concordance with traditional surveillance, but methodological heterogeneity and limited temporal alignment constrain comparisons. Standardized frameworks and patient-level studies, particularly from low- and middle-income countries, are needed.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-12"},"PeriodicalIF":2.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136397","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":"Hospital variation in antibiotic utilization intensity across discharge diagnostic tiers.","authors":"Shungo Imai, Daniel J Livorsi, James Merchant, Hyunkeun Cho, Michihiko Goto","doi":"10.1017/ice.2026.10561","DOIUrl":"https://doi.org/10.1017/ice.2026.10561","url":null,"abstract":"<p><p>Among 737,384 stays in Veterans Health Administration wards, antibiotic days of therapy per days present and days of antibiotic spectrum coverage per days present decreased stepwise across discharge diagnoses that always (tier 1), sometimes (2), or never require antibiotics (3). Tier-related decreases varied by hospital. The overall risk-standardized benchmarking models remained similar.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":2.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136421","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":"Broad multiplex respiratory panel implementation and antibiotic prescribing in US emergency and urgent care departments: a staggered-adoption study.","authors":"Mayar Al Mohajer, Kady Phe, Nicholas S Teran, Todd M Lasco","doi":"10.1017/ice.2026.10567","DOIUrl":"https://doi.org/10.1017/ice.2026.10567","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between department-level implementation of broad multiplex respiratory pathogen panels and antibacterial prescribing.</p><p><strong>Design: </strong>Retrospective repeated cross-sectional staggered-adoption study with cohort-stacked difference-in-differences models.</p><p><strong>Setting: </strong>US emergency and urgent-care departments contributing deidentified electronic health record data to Epic Cosmos, 2016-2025.</p><p><strong>Participants: </strong>Adults with acute respiratory illness without a concurrent clear nonrespiratory bacterial indication.</p><p><strong>Methods: </strong>Incident implementation was the first sustained increase in strict panel use from below 2% to at least 10%, with complete 8-quarter preimplementation and postimplementation windows. Adopters were compared with contemporaneous nonadopters and not-yet-adopters. The primary outcome was a same-day systemic oral or enteral antibacterial order after emergency department discharge.</p><p><strong>Results: </strong>Among 55,059,432 eligible encounters, 32 adopting departments in 9 cohorts were compared with 1,075 departments, yielding 114,832 department-quarter observations. Implementation was associated with a 23.53-percentage-point increase in panel use (95% CI, 20.32 to 26.74) and a 1.21-percentage-point reduction in same-day antibacterial prescribing (95% CI, -2.37 to -0.05; <i>P</i> = .041), a 5.7% relative decrease. However, alternative 5, 15, and 20% thresholds were not statistically significant, unrestricted analyses were null, and several preimplementation diagnostics rejected flat trends.</p><p><strong>Conclusions: </strong>Sustained panel implementation was associated with a small reduction in antibiotic prescribing. Threshold sensitivity and mixed preimplementation diagnostics limit causal interpretation and support integrating testing into broader diagnostic-stewardship workflows.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":2.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136271","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":"Respiratory syndromic surveillance for monitoring infection trends in long-term care facilities.","authors":"Naoki Takayama, Atsushi Toyoda, Junji Ito, Masahiro Shirai, Yutaro Nakamura","doi":"10.1017/ice.2026.10565","DOIUrl":"https://doi.org/10.1017/ice.2026.10565","url":null,"abstract":"<p><strong>Objective: </strong>To assess the surveillance characteristics of respiratory syndromic surveillance criteria and their usefulness for monitoring infection trends in long-term care (LTC) facilities.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Two wards caring for children and adults with severe motor and intellectual disabilities in an LTC facility with 110 beds.</p><p><strong>Patients: </strong>Inpatients who underwent respiratory pathogen testing during febrile episodes between November 2022 and December 2025 were included. Episodes were defined as testing events associated with febrile periods and surveillance characteristics were assessed among tested episodes.</p><p><strong>Interventions: </strong>Surveillance criteria, derived from the patient-based component of the CARES strategy, were defined as fever ≥38.0°C lasting for ≥2 consecutive days accompanied by at least one respiratory symptom. Associations between surveillance-positive episodes and microbiologically confirmed respiratory infections were examined, and temporal trends were assessed. Sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios were calculated as descriptive surveillance characteristics.</p><p><strong>Results: </strong>Overall, 1,467 episodes from 124 patients were analyzed, including 375 microbiologically confirmed episodes. Surveillance criteria identified 140 (9.5%) episodes, of which 87 (62.1%) were microbiologically confirmed, with 23.2% sensitivity (95% confidence interval, 19.0-27.8) and 95.1% specificity (95% confidence interval, 93.7-96.3). Surveillance-positive episodes demonstrated temporal patterns consistent with confirmed infections.</p><p><strong>Conclusions: </strong>Respiratory syndromic surveillance criteria demonstrated high specificity and captured temporal changes in microbiologically confirmed respiratory infections in LTC wards. Although not designed to identify every infection, simple signals, such as ≥2 surveillance-positive episodes per week, may facilitate monitoring respiratory infection activity and support timely infection prevention and control responses.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":2.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136460","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 measurement of compliance with a Surgical Care Improvement Program (SCIP) antimicrobial prophylaxis guidelines in the Veterans health administration.","authors":"Hillary J Mull, Samuel Golenbock, Jacquelyn Pendergast, Rory Ostrow, Dipandita Basnet, Kathryn Colborn, Marlena H Shin, Ryann L Engle, Mary Hawn, Westyn Branch-Elliman","doi":"10.1017/ice.2026.10552","DOIUrl":"https://doi.org/10.1017/ice.2026.10552","url":null,"abstract":"<p><strong>Objective: </strong>The Surgical Care Improvement Project (SCIP) was developed and implemented nationally from 2005 to 2015 partly to improve surgical antimicrobial prophylaxis processes. SCIP's manual review process was costly yet led to high compliance rates in the Veterans Administration (VA). Our objective was to develop an electronic compliance algorithm to replicate the SCIP metric for timely discontinuation of antimicrobial prophylaxis (INF-3) in cardiac surgeries.</p><p><strong>Study design: </strong>This retrospective cohort study matched manually adjudicated INF-3 data from the VA External Peer Review Program (EPRP) with 2006-2015 cardiac surgeries in the Corporate Data Warehouse (CDW). Algorithm development used EPRP data as the gold standard, supplemented with manual review, to apply SCIP-defined electronic exclusions and flag cases with appropriate antimicrobial discontinuation. Algorithm validation used manual review of compliant (n = 90) and non-compliant cases (n = 210) among cardiac surgeries not in EPRP.</p><p><strong>Results: </strong>The algorithm utilized CDW prophylactic versus therapeutic antimicrobial drug names and timestamps for drug administration to reliably exclude cases with appropriate antimicrobial use before flagging INF-3 compliance/non-compliance. In the EPRP-CDW development sample (n = 29,431), the algorithm-measured INF-3 compliance rate was 96.2% versus EPRP's rate of 95.9%. In validation (n = 10,131), sensitivity was 92.1% (95%CI: 88.0%, 96.2%) and specificity was 97.0% (95%CI: 93.6%, 100%) compared to manual review. The algorithm exclusion rate in CDW cardiac surgeries was 18.5%-primarily for antimicrobial pharmacy administration indicative of pre-or postoperative infection (7,360/52,310 14.1%).</p><p><strong>Conclusions: </strong>The SCIP INF-3 cardiac electronic algorithm effectively replicated the EPRP manual review process and has the potential to extend surveillance of appropriate surgical antimicrobial prophylaxis.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-10"},"PeriodicalIF":2.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109287","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}