Infection Control and Hospital Epidemiology最新文献

{"title":"Testing for methicillin-resistant <i>Staphylococcus aureus</i> in the anterior nares for antibiotic de-escalation in patients presenting with acute skin and soft tissue infections: systematic review and meta-analysis.","authors":"Sara Bohjanen, Connor Goldstick, Maria Hordinsky","doi":"10.1017/ice.2025.58","DOIUrl":"https://doi.org/10.1017/ice.2025.58","url":null,"abstract":"<p><strong>Objective: </strong>To improve the understanding of appropriate antibiotic de-escalation and stewardship by consolidating the evidence on screening for methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) colonization of the nares to predict MRSA in acute skin and soft tissue infections (SSTIs).</p><p><strong>Methods: </strong>This meta-analysis was performed according to PRISMA guidelines. Six databases were searched by two reviewers for articles on MRSA detection in the nares and acute SSTIs. The quality and risk of bias of the articles were then assessed. The primary outcomes of interest were pooled sensitivity and specificity. Sub-analyses were also performed to test for heterogeneity.</p><p><strong>Results: </strong>After screening 1040 records, 15 articles (n = 1,970) were included in the meta-analysis. Using MRSA nares screening to predict MRSA in acute SSTIs had an overall specificity of 0.949 and sensitivity of 0.474. With a prevalence of 29.1%, the calculated NPV was 0.815. There were sub-analyses on various study variables, such as study location, participant age, and detection by polymerase chain reaction versus culture. The only significant finding was an increased sensitivity for adults (0.543) compared to pediatric participants (0.285).</p><p><strong>Discussion: </strong>To our knowledge, this is the first meta-analysis that focuses on the performance of MRSA nares screening for predicting MRSA infection in patients presenting with acute SSTIs. The baseline prevalence of MRSA SSTIs is important for interpreting the screening results, and the prevalence is influenced by geography and patient factors. This clinical context must be considered before utilizing MRSA nares screening for acute SSTIs.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-5"},"PeriodicalIF":3.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012926","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 cluster of Burkholderia contaminans bloodstream infections in a rural hospital in Sierra Leone.","authors":"Ioana Diana Olaru, Laura C Kalkman, Emmanuel Marx Kanu, Islam Mohamed Kargbo, Christian Böing, Stefan Bletz, Martin P Grobusch, Frieder Schaumburg","doi":"10.1017/ice.2025.63","DOIUrl":"https://doi.org/10.1017/ice.2025.63","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-3"},"PeriodicalIF":3.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985078","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":"Social vulnerability influences racial and ethnic disparities in <i>Clostridioides difficile</i> infection outcomes.","authors":"Jacinda C Abdul-Mutakabbir, Karen K Tan","doi":"10.1017/ice.2025.57","DOIUrl":"https://doi.org/10.1017/ice.2025.57","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-2"},"PeriodicalIF":3.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016239","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":"Improving central line-associated bloodstream infection prevention practices in oncology clinic patients: mobile-app based surveillance & response.","authors":"Hiroki Saito, Shereen Nourollahi, Mohamad N Alsharif, Bardia Bahadori, Tom Tjoa, Amarah Mauricio, Jessica Bethlahmy, Justin Chang, Syma Rashid, Edward L Nelson, Richard A Van Etten, Linda Armendariz, Victor Torres, Sandra Masson, Marlene Esteves, Raheeb Saavedra, Raveena D Singh, Shruti K Gohil","doi":"10.1017/ice.2025.16","DOIUrl":"https://doi.org/10.1017/ice.2025.16","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the impact of a mobile-app-based central line-associated bloodstream infection (CLABSI) prevention program in oncology clinic patients with peripherally inserted central catheters (PICCs).</p><p><strong>Design: </strong>Pre-post prospective cohort study with baseline (July 2015-December 2016), phase-in (January 2017-April 2017), and intervention (May 2017-November 2018). Generalized linear mixed models compared intervention with baseline frequency of localized inflammation/infection and dressing peeling. Cox proportional hazards models compared days-to-removal of lines with localized inflammation/infection. Chi-square test compared bacteremia rates before and after intervention.</p><p><strong>Setting: </strong>Oncology clinic at a large medical center.</p><p><strong>Patients: </strong>Oncology clinic adult patients with PICCs.</p><p><strong>Intervention: </strong>CLABSI prevention program consisting of an actionable scoring system for identifying insertion site infection/inflammation coupled with a mobile-app enabling photo-assessments and automated physician alerting for remote response.</p><p><strong>Results: </strong>We completed 5,343 assessments of 569 PICCs in 401 patients (baseline: 2,924 assessments, 300 PICCs, 216 patients; intervention: 2,419 assessments, 269 PICCs, 185 patients). The intervention was associated with a 92% lower likelihood of having a dressing with peeling (OR 0.08, 95%CI 0.04-0.17, <i>P</i> < 0.001), 53% lower local inflammation/infection (OR 0.47, 95%CI 0.27-0.84, <i>P</i> < 0.011), and 24% (non-significant) lower CLABSI rates (<i>P</i> = .63). Physician mobile-app alerting and response enabled 80% lower risk of lines remaining in place after inflammation/infection was identified (HR 0.20, 95%CI:0.14-0.30, <i>P</i> < 0.001) and 85% faster removal of infected lines from mean (SD) 11.1 (9.7) to 1.7 (2.4) days.</p><p><strong>Conclusions: </strong>A mobile-app-based CLABSI prevention program decreased frequency of inflamed/infected central line insertion sites and increased speed of removal when inflammation/infection was found.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Risk factors for surgical site infections following cesarean delivery in urban safety-net hospitals\".","authors":"Khaleda Akter, Megan Folks, Temilola-Azeezat Bakare, Mary Fornek, Briana Episcopia, Marie Abdallah, Ngozi Nwankpa, John Quale","doi":"10.1017/ice.2025.46","DOIUrl":"https://doi.org/10.1017/ice.2025.46","url":null,"abstract":"<p><strong>Objective: </strong>To identify risk factors for surgical site infections (SSIs) following C-sections in an underserved, urban population.</p><p><strong>Design: </strong>Retrospective case-control study and multivariable regression analyses.</p><p><strong>Setting: </strong>Multicenter urban hospital system.</p><p><strong>Participants: </strong>All women undergoing C-sections during 2023.</p><p><strong>Methods: </strong>To identify risk factors for SSIs, patients suffering SSIs were compared to a propensity-matched control group (controlled for the following variables: age, body mass index, diabetes mellitus, American Society of Anesthesia (ASA) score, wound class, and duration of surgery). In addition, multivariable logistic regression analysis was performed to identify independent risks for SSIs.</p><p><strong>Results: </strong>Of 4,642 C-sections performed, 73 SSIs were identified; 90% were detected after hospital discharge. Compared to a propensity-matched group, more patients in the SSI cohort received gentamicin with clindamycin (vs a cefazolin-based regimen); gentamicin dosing was consistently below recommended levels. Also, significantly more patients in the SSI group were recent immigrants to the United States compared to the control group (20.5% vs 4.1%, <i>P</i> = .004). Multivariate regression analysis revealed 3 independent risk factors for SSIs: ASA score, surgery at a hospital without an Obstetrics-Gynecology residency program, and residence in the borough of the Bronx, NY.</p><p><strong>Conclusions: </strong>For women living in areas of low socioeconomic status, most SSIs after C-sections are detected following hospital discharge. Women who are recent immigrants and living in areas of high poverty are particularly at higher risk. Addressing the broader social determinants of health, particularly in underserved areas, will be crucial in reducing SSIs and improving overall maternal health outcomes.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-5"},"PeriodicalIF":3.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991632","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":"Have positive blood culture bottles been left unnoticed?: addressing this issue as important as the shortage of blood culture bottles.","authors":"Hideharu Hagiya, Shinnosuke Fukushima, Koji Iio","doi":"10.1017/ice.2025.55","DOIUrl":"https://doi.org/10.1017/ice.2025.55","url":null,"abstract":"","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-2"},"PeriodicalIF":3.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803174","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":"Infection prevention and control for measles in healthcare settings.","authors":"Irene Frantzis, Karen P Acker, E O Benjamin, Rookmin Pato, Stephanie Legall, Harjot K Singh, Lisa Saiman","doi":"10.1017/ice.2025.49","DOIUrl":"https://doi.org/10.1017/ice.2025.49","url":null,"abstract":"<p><p>Healthcare facilities in the U.S. are well positioned to assist with measles control by timely identification and isolation of suspected or confirmed cases and, as measles is nationally notifiable, by informing local health departments about both suspected and confirmed cases. However, responding to measles cases in acute healthcare settings presents unique challenges, is disruptive, and requires an intense outlay of resources before, during, and afterward primarily due to exposure investigations. We describe our measles preparedness efforts to improve identification of measles cases, facilitate appropriate isolation, reduce exposures, and provide timely post-exposure prophylaxis.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-8"},"PeriodicalIF":3.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803177","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":"Discharge antibiotic prescribing at children's hospitals with established antimicrobial stewardship programs.","authors":"Rebecca G Same, Giyoung Lee, Jared Olson, Brendan Bettinger, Adam L Hersh, Matthew P Kronman, Jason G Newland, Meg Grimshaw, Jeffrey S Gerber","doi":"10.1017/ice.2025.59","DOIUrl":"https://doi.org/10.1017/ice.2025.59","url":null,"abstract":"<p><strong>Objective: </strong>Antibiotic stewardship programs (ASPs) target hospitalized children, but most do not routinely review antibiotic prescriptions at discharge, despite 30% of discharged children receiving additional antibiotics. Our objective is to describe discharge antibiotic prescribing in children hospitalized for uncomplicated community-acquired pneumonia (CAP), skin/soft tissue infection (SSTI), and urinary tract infection (UTI).</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Four academic children's hospitals with established ASPs.</p><p><strong>Patients: </strong>ICD-10 codes identified 3,847 encounters for children <18 years admitted from January 1, 2021 to December 31, 2021 and prescribed antibiotics at discharge for uncomplicated CAP, SSTI, or UTI. After excluding children with medical complexity and encounters with concomitant infections, >7 days hospital stay, or intensive care unit stay, 1,206 encounters were included.</p><p><strong>Methods: </strong>Primary outcomes were the percentage of subjects prescribed optimal (1) total (inpatient plus outpatient) duration of therapy (DOT) and (2) antibiotic choice based on current national guidelines and available evidence.</p><p><strong>Results: </strong>Of 226 encounters for CAP, 417 for UTI, and 563 for SSTI, the median age was 4 years, 52% were female, and the median DOT was 9 days (8 for CAP, 10 for UTI, and 9 for SSTI). Antibiotic choice was optimal for 77%, and DOT was optimal for 26%. Only 20% of antibiotic courses included both optimal DOT and antibiotic choice.</p><p><strong>Conclusions: </strong>At 4 children's hospitals with established ASPs, 80% of discharge antibiotic courses for CAP, UTI, and SSTI were suboptimal either by choice of antibiotic or DOT. Discharge antibiotic prescribing represents an opportunity to improve antibiotic use in children.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803170","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 factor evaluation and performance improvement for surgical site infections in patients undergoing abdominal hysterectomy at a large academic safety net hospital.","authors":"Anna Buford, Tyler Anderson, Roman Jandarov, Joseph Schaffer, Jacqueline Wells, Marianne Bartlett, Latitia Houston, Calvin White, Laura Buford, Madhuri Sopirala","doi":"10.1017/ice.2025.34","DOIUrl":"10.1017/ice.2025.34","url":null,"abstract":"<p><strong>Objective: </strong>To identify Surgical Site Infection (SSI) risk factors for abdominal hysterectomy patients and report the results of a performance improvement initiative.</p><p><strong>Design: </strong>Retrospective case-control.</p><p><strong>Setting: </strong>Parkland Hospital, an 882-bed academic, safety-net, tertiary referral center and a level 1 trauma center serving a diverse population of primarily uninsured patients in North Texas.</p><p><strong>Participants: </strong>Patients over 18 who underwent abdominal hysterectomy and were diagnosed with SSIs within 30 days of surgery between 2019 and 2021.</p><p><strong>Methods: </strong>Cases were matched to controls from the same or closest calendar month in a 1:2 ratio. Chart review of electronic medical records (EMR) was performed comparing variables using Pearson's χ² test for categorical variables and Student's t-test for continuous variables followed by logistic regression for multivariate analysis. Upon identifying vaginal preparation technique as an area of improvement while investigating SSI bundle compliance, we implemented an OR staff training intervention.</p><p><strong>Results: </strong>Diabetes was identified as a significant risk factor while Hispanic or Latino ethnicity was associated with significantly lower rates of infection. Most organisms identified were enteric pathogens. Following the intervention, Parkland's deep and organ-space Standardized Infection Ratio (SIR) decreased from 1.46 in 2021 to 0.519 for the rolling 12 months as of June 2024.</p><p><strong>Conclusions: </strong>Our multidisciplinary intervention improving the quality and consistency of pre-operative vaginal preparation was associated with a reduction in abdominal hysterectomy SSI.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporating microbial cell-free DNA testing into healthcare-associated invasive fungal infection surveillance: benefits and challenges.","authors":"Daniel Z Uslan, Ishminder Kaur, Omai B Garner, Shangxin Yang","doi":"10.1017/ice.2025.48","DOIUrl":"https://doi.org/10.1017/ice.2025.48","url":null,"abstract":"<p><p>Surveillance by clinical epidemiology teams for invasive fungal infections (IFIs) in healthcare settings can be challenging due to several factors including low sensitivity of noninvasive conventional microbiologic diagnostics, nonspecific clinical presentation, and complex patient populations. Recently, availability of microbial cell-free DNA testing (cfDNA) via the Karius Test has shown promise for increased diagnostic sensitivity of IFIs. However, how to best incorporate cfDNA results into IFI surveillance remains a vexing challenge. Herein, we provide perspectives on the benefits and challenges of use of cfDNA for IFI surveillance.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-4"},"PeriodicalIF":3.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780051","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}